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Table 5 Visualization of thematic analysis process

From: Impact of macro-socioeconomic determinants on sustainable perinatal health care in Portugal: a qualitative study on the opinion of healthcare professionals and experts

Step 1: Key conceptsa Step 2: Codesa Step 3: Nodesa Step 4: Themes Step 5: Quality Standards
experience, nurses, normal pregnancy, medical advice, appointments, preparations, tiredness, immediate referral, neonatologist, waiting, no appointment, EAP, staff, lack, follow, incomplete, risks, aggravated prohibition, direct, negative, hiring, replacing, teams, incomplete, public, retired, public, private Medical treatment, medical advice, antenatal appointment, postnatal follow-up, prevention, lack of staff, EAP, care provision brain drain, healthcare unit, hospital Quality, antenatal care postnatal care, Primary care provision, Secondary intra- and postnatal care provision, Waiting times and time management, Psychological and formal support provision 1) Availability of Human resources QS 1 Evidence based practices for routine care and management of complications
recorded, followed, accompanied, professionals, interest, report, observed, intervention, terms, signed, assist, register, sheet, failure, computer, waiting, EAP, cuts, crisis, GP, schedule, appointments, observe Observation, Monitoring, data collection, follow-up, systems, EAP cuts, medical records Monitoring and medical records, Actionable information systems articulation and communication, Physical resources 5) Essential physical resources available QS 2 Actionable information systems
surgery, manage, request, improvements, sick, essential, concern, terrible, waiting, scientific, coordination, department, diagnosis, send, maternity, unit, closing, staff, lack, EAP, crisis Staff exchange, hospital merge, closure of maternity units, EAP, crisis, GP, healthcare professionals Appropriate referral, Shortage in staff and capacity in inter-facilities transport, Non-attendance of antenatal care consultations, Referral system articulation, Gate-keeping-system 2) Functional referral systems QS 3 Functional referral system
attention, questions, awareness, poor explanation, face, contact, hours, infections, discharge, risks, knew nothing, response, decide, agrees, future, abortion, notion, lie, purpose, lost, horrible, measure, stuck, no information, died Interaction, Information, knowledge, communication, Information provision, cuts by EAP, salaries, adequate response Parents and healthcare staff communication, Emotional support provision, Effective communication 4) Emotional support QS 4 Effective communication
carefulness, important, kind, zero privacy, sense, receive, friendly, involve, approach, expectation, thanks, protect, learned, waited, secure, loving, participation, comfort, staff, lack, EAP, cuts, leave, retire, stress, tired, career, salary, extra, time, working, hours, payment, years, public, private, contracts, nurse, medical doctor, young, cheaper, labour, specialization, job Accompaniment, comforting care, lack of staff, EAP cuts, emotional support, higher workload, given regulations Appropriate and respective treatment, Emotional support provision, 3) Competent, motivated, human resources QS 5 Respect and preservation of dignity
traumatised, guilt, painful, crying, shock, difficult, psychologist, suffer, time lap, lack of feeling, no support, emotions, reasons, alone, reality, obsessive, behaviour, anxiety, panicked, desperate, erase, memory, frightened, staff, cuts, EAP, crisis, emotional, alone, guilt Emotional management, Stress coping, support, EAP, cuts, psychologist available Observation, premature birth, traumatic event Emotional and psychological support,
Formal and informal support, psychological surveillance
4) Emotional support QS 6 Emotional support
unfriendly, time, impact, visits, value, knowledge, advised, not motivated, impatient, extreme, avoid, eye-contact, trainee, intensive, staff, complaints, distance, interfere, staff, EAP, cuts, crisis Healthcare staff, time availability, treatment, competence, routine care, EAP, cuts, burnout, fragile teams, anxiety, stress, working hours, salary based, cheaper labour, inadequate care, increased working hours, workload, Availability and suitability of healthcare staff, brain-drain to the private sector, burnout and stress increase 3) Competent, motivated, human resources QS 7 Competent, motivated, human resources
machine, time restriction, all together, full room, inappropriate, fragile, un-practical, allowed, effort, breastfeeding, clock, pressure, conditions, influence, bathing, interruption practices, crisis, EAP, cuts, needles, preeclampsia, postpartum haemorrhage, birth, sepsis, premature Adequate medicines, time restrictions, facilities, resources available, Capacity issues, closure of rooms, premature infections Time and management of medical equipment, Capacity issues, Material and Equipment, Medication available 5) Essential physical resources available QS 8 Essential physical resources available
  1. a  Several examples were used, as not all concepts could be displayed