| 51. |
- Grundt, H., et al.
(författare)
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Associations Between Single-Family Room Care and Breastfeeding Rates in Preterm Infants
- 2021
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Ingår i: Journal of Human Lactation. - : SAGE Publications. - 0890-3344 .- 1552-5732. ; 37:3, s. 593-602
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Tidskriftsartikel (refereegranskat)abstract
- Hospitalization in neonatal intensive care units with a single-family room design enables continuous maternal presence, but less is known regarding the association with milk production and breastfeeding. Research aim To compare maternal milk production, breastfeeding self-efficacy, the extent to which infants received mother’s milk, and rate of direct breastfeeding in a single-family room to an open bay neonatal intensive care unit. Methods A longitudinal, prospective observational study comparing 77 infants born at 28– 32° weeks gestational age and their 66 mothers ( n = 35 infants of n = 30 mothers in single family room and n = 42 infants of n = 36 mothers in open bay). Comparisons were made on milk volume produced, the extent to which infants were fed mother’s milk, and rate of direct breastfeeding from birth to 4 months’ corrected infant age. Breastfeeding self-efficacy was compared across mothers who directly breastfed at discharge ( n = 45). Results First expression (6 hr vs. 30 hr, p < .001) and first attempt at breastfeeding (48 hr vs. 109 hr, p < .001) occurred significantly earlier, infants were fed a greater amount of mother’s milk ( p < .04), and significantly more infants having single-family room care were exclusively directly breastfed from discharge until 4 months’ corrected age; OR 6.8 (95% CI [2.4, 19.1]). Volumes of milk produced and breastfeeding self-efficacy did not differ significantly between participants in either units. Conclusion To increase the extent to which infants are fed mother’s own milk and are exclusively directly breastfed, the design of neonatal intensive care units should facilitate continuous maternal presence and privacy for the mother–infant dyad.
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| 52. |
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| 53. |
- Joffer, Junia, et al.
(författare)
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Exploring self-rated health among adolescents : a think-aloud study
- 2016
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Despite extensive use of self-rated health questions in youth studies, little is known about what such questions capture among adolescents. Hence, the aim of this study was to explore how adolescents interpret and reason when answering a question about self-rated health.METHODS: A qualitative study using think-aloud interviews explored the question, "How do you feel most of the time?", using five response options ("Very good", "Rather good", "Neither good, nor bad", "Rather bad", and "Very bad"). The study involved 58 adolescents (29 boys and 29 girls) in lower secondary school (7th grade) and upper secondary school (12th grade) in Sweden.RESULTS: Respondents' interpretations of the question about how they felt included social, mental, and physical aspects. Gender differences were found primarily in that girls emphasized stressors, while age differences were reflected mainly in the older respondents' inclusion of a wider variety of influences on their assessments. The five response options all demonstrated differences in self-rated health, and the respondents' understanding of the middle option, "Neither good, nor bad", varied widely. In the answering of potential sensitive survey questions, rationales for providing honest or biased answers were described.CONCLUSIONS: The use of a self-rated health question including the word 'feel' captured a holistic view of health among adolescents. Differences amongst response options should be acknowledged when analyzing self-rated health questions. If anonymity is not feasible when answering questions on self-rated health, a high level of privacy is recommended to increase the likelihood of reliability.
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| 54. |
- Joffer, Junia, 1984-
(författare)
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Health for future : self-rated health and social status among adolescents
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to explore self-rated health, subjective social status and smoking in adolescents.This thesis consists of a qualitative and a quantitative study. The qualitative study was an interview study that included 58 participants in the 7th and 12th grades. The cognitive interviewing technique ‘think-aloud’ was employed to explore how adolescents interpret and reason when answering a question about self-rated health (‘A person may feel good sometimes and bad sometimes. How do you feel most of the time?’). Additionally, factors contributing to subjective social status in school and the different strategies adolescents used for positioning were explored. Qualitative content analysis and thematic network analyzes were used to analyze the data. The quantitative study was a cohort study involving 1046 adolescents who answered questionnaires about their health in the 7th, 8th, 9th and 12th grades. Data were used to investigate predicting factors in the 7th grade for smoking in the 12th grade, as well as to examine associations between subjective social status in school, socioeconomic status and self-rated health in boys and girls in the 12th grade. Data were analyzed using chi-square tests, binary logistic regression and ordinal logistic regression analyses.The results from the interviews showed that participants interpreted the self-rated health question in holistic terms including social, mental and physical aspects. Results from the quantitative study showed that boys rated their health higher than girls at all ages. In a multivariable analysis lower selfesteem, a less negative attitude towards smoking and ever using snus in the 7th grade were significant predictors of smoking in the 12th grade. In addition, girls had an increased risk of becoming smokers. Cross-sectional analyses in the 12th grade revealed that adolescents’ self-rated health was positively associated with subjective social status in school, mood in the family and self-esteem in both girls and boys. Boys rated their subjective social status higher than girls. When exploring subjective social status in school further through interviews, status hierarchies in school were confirmed by the participants, which were strongly influenced by norms linked to gender, age, ethnicity and parental economy, but also expectations about how to look, act and interact.In conclusion, this thesis demonstrates that the self-rated health question ‘How do you feel most of the time?’ is useful for capturing a multidimensional view of health. Early efforts to strengthen adolescents’ self-esteem, promote anti-smoking attitudes and avoid an early initiation of snus seem to be important components of smoking prevention in adolescence. The positive association between self-rated health and subjective social status in school indicates that the subjective social status question is a useful healthrelated measure of social position in adolescents. Because social desirability in the school hierarchy was defined by norms that left little room for diversity, the possible negative impact of status hierarchies on adolescents’ health should to be considered. Overall, gender differences in health and social status emphasize the need for a gender-sensitive understanding of factors that impact adolescents’ lives
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| 55. |
- Joffer, Junia, et al.
(författare)
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Playing the complex game of social status in school – a qualitative study
- 2020
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Ingår i: Global Health Action. - : Taylor & Francis. - 1654-9716 .- 1654-9880. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Research suggests that social status in school plays an important role in the social lives of adolescents and that their social status is associated with their health. Additional knowledge about adolescents’ understanding of social hierarchies could help to explain inequalities in adolescents’ health and guide public health interventions.Objective: The study aimed to explore what contributes to subjective social status in school and the strategies used for social positioning.Methods: A qualitative research design with think-aloud interviews was used. The study included 57 adolescents in lower (7th grade) and upper secondary school (12th grade) in Sweden. Subjective social status was explored using a slightly modified version of the MacArthur Scale of Subjective Social Status in school. Data were analyzed using thematic network analysis.Results: The participants were highly aware of their social status in school. Elements tied to gender, age, ethnicity and parental economy influenced their preconditions in the positioning. In addition, expectations on how to look, act and interact, influenced the pursue for social desirability. The way these different factors intersected and had to be balanced suggests that social positioning in school is complex and multifaceted.Conclusions: Because the norms that guided social positioning left little room for diversity, the possible negative impact of status hierarchies on adolescents’ health needs to be considered. In school interventions, we suggest that norms on e.g. gender and ethnicity need to be addressed and problematized from an intersectional approach.
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| 56. |
- Joffer, Junia, et al.
(författare)
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Self-rated health, subjective social status in school and socioeconomic status in adolescents: a cross-sectional study
- 2019
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- Background: Social position, traditionally measured by objective data on socioeconomic status (SES), is linked to health status in adults. In adolescents, the association is more uncertain and there are some studies suggesting that subjective social status (SSS) might be more adequate in relation to health. This study aimed to examine associations between SSS in school, SES and self-rated health (SRH) in adolescent boys and girls.Methods: A descriptive cross-sectional research design with quantitative survey data was used. The study involved 705 Swedish adolescents in upper secondary school (17–18-year-olds). SRH was measured with a single-item question and SSS by a question where adolescents were asked to assess their social position within their school. Formal education level of the parents was used as a proxy for objective SES. Univariable and multivariable ordinal regression analyses were conducted to assess the associations between SRH and SSS in school and SES.Results: In the multivariable analysis, SSS in school was positively associated with SRH, whereas no significant association between SES and SRH was found. The proportion of adolescents with high SRH increased with higher steps on the SSS ladder. Significant gender differences were found in that boys rated their SRH and SSS in school higher than girls did.Conclusions: The study shows that self-rated health in adolescents is related to perceived social position in school. Subjective social status in school seems to be a useful health-related measure of social position in adolescents.
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| 57. |
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| 58. |
- Jonsdottir, Rakel B, et al.
(författare)
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Breastfeeding initiation, duration, and experiences of mothers of late preterm twins : a mixed-methods study
- 2022
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Ingår i: International Breastfeeding Journal. - : Springer Science and Business Media LLC. - 1746-4358. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Twins and late preterm (LPT) infants are at an increased risk of being breastfed to a lesser extent than term singletons. This study aimed to describe the initiation and duration of any and exclusive breastfeeding at the breast for mothers of LPT twins and term twins during the first 4 months and to explore the breastfeeding experiences of mothers of LPT twins.METHODS: A sequential two-sample quantitative-qualitative explanatory mixed-methods design was used. The quantitative data were derived from a longitudinal cohort study in which 22 mothers of LPT twins and 41 mothers of term twins answered questionnaires at one and four months after birth (2015-2017). The qualitative data were obtained from semi-structured interviews with 14 mothers of LPT twins (2020-2021), based on results from the quantitative study and literature. Analysis included descriptive statistics of quantitative data and deductive content analysis of the qualitative data, followed by condensation and synthesis.RESULTS: All mothers of LPT twins (100%) and most mothers of term twins (96%) initiated breastfeeding. There was no difference in any breastfeeding during the first week at home (98% versus 95%) and at 1 month (88% versus 85%). However, at 4 months, the difference was significant (44% versus 75%). The qualitative data highlighted that mothers of LPT twins experienced breastfeeding as complex and strenuous. Key factors influencing mothers' experiences and decisions were their infants' immature breastfeeding behaviors requiring them to express breast milk alongside breastfeeding, the burden of following task-oriented feeding regimes, and the lack of guidance from healthcare professionals. As a result, mothers started to question the worth of their breastfeeding efforts, leading to changes in breastfeeding management with diverse results. Support from fathers and grandparents positively influenced sustained breastfeeding.CONCLUSIONS: Mothers of LPT twins want to breastfeed, but they face many challenges in breastfeeding during the first month, leading to more LPT twins' mothers than term twins' mothers ceasing breastfeeding during the following months. To promote and safeguard breastfeeding in this vulnerable group, care must be differentiated from routine term infant services, and healthcare professionals need to receive proper education and training.
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| 59. |
- Jónsdóttir, Rakel B, et al.
(författare)
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Breastfeeding progression in late preterm infants from birth to one month.
- 2020
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Ingår i: Maternal and Child Nutrition. - : Wiley. - 1740-8695 .- 1740-8709. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to describe and compare breastfeeding progression, infants' feeding behaviours, maternal feeding difficulties, and mothers' usage of breastfeeding interventions for singleton late preterm (LPT) and term infants. A further aim was to identify associated factors for exclusive breastfeeding at breast at 1 month in LPT infants. This was a cohort study where mothers of LPT infants from a neonatal unit (n = 60), LPT infants from a maternity unit (n = 62), and term infants from a maternity unit (n = 269) answered a questionnaire approximately 1 month after delivery. Findings showed no significant differences in exclusive breastfeeding at breasts between LPT infants admitted to the neonatal unit compared with the maternity unit, during the first week at home (38% vs. 48%), or at 1 month of age (52% vs. 50%). Term infants were more likely to be exclusively breastfed at the breast (86% and 74%, p < 0.05) compared with LPT infants. Multiple regression analysis showed that usage of a nipple shield, not feeding breast milk exclusively during the first week at home, or feeding less than 10 times per day at 1 month were statistically significant for not exclusively breastfeed at the breast. A protective factor was the mothers' experience of having an abundance of milk during the first week at home. In conclusion, LPT infants are less likely to be exclusively breastfed at the breast than term infants, highlighting the need for further research to guide interventions aimed at optimising exclusive breastfeeding rates.
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| 60. |
- Kainiemi, Emma, et al.
(författare)
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Psychometric Properties of an Instrument to Measure the Quality of Family-Centered Care in NICUs
- 2022
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Ingår i: Journal of Obstetric, Gynecologic and Neonatal Nursing. - : Elsevier. - 0884-2175 .- 1552-6909. ; 51:4, s. 461-472
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine the psychometric properties of the Digi Family-Centered Care-Parent Version (DigiFCC-P), which was developed to measure parents' perceptions of family-centered care (FCC) in NICUs. Design: Cross-sectional psychometric study. Setting: Twenty-three NICUs in 15 countries in Europe, Canada, and Australia. Participants: Mothers (n = 565) and fathers (n = 406) of preterm infants hospitalized in NICUs.Methods: Participants reported their perceptions of the quality of FCC during their infants' hospitalizations by answering one DigiFCC-P question delivered to their mobile phones every evening. Nine questions rotated in random order. Participants responded on a 7-point Likert scale. We evaluated the instrument's internal consistency, construct and concurrent validity, and sensitivity.Results: The internal consistency of the DigiFCC-P was satisfactory; the Cronbach's alpha coefficient was .74 (95% confidence interval [.71, .77]), and all the corrected item-total correlations were greater than .30. We identified that the items formed two factors, support from staff and the parent's active participation, and observed no strong item cross-loadings on the two factors. We discovered some items with weak interitem correlations, and the two factors explained 35.2% of the variance. Scores on the DigiFCC-P and Family-Centered Care Questionnaire were significantly correlated (r = .59, p < .001) and supported the convergent validity of the instrument. In addition, changes were discovered in the participants' ratings over time, which indicated that the instrument was sensitive to detect changes in their evaluations.Conclusion: The psychometric testing of the DigiFCC-P provided initial support for the convergent validity and reliability of the instrument. The instrument was also sensitive in detecting changes in the evaluations of FCC over time. However, there is a need for further development of the content validity of the instrument.
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