| 1. |
- Vixner, Linda, et al.
(författare)
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Acupuncture with manual and electrical stimulation for labour pain : a longitudinal randomised controlled trial
- 2014
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Ingår i: BMC Complementary and Alternative Medicine. - : BioMed Central (BMC). - 1472-6882. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Background: Acupuncture is commonly used to reduce pain during labour despite contradictory results. The aim of this study is to evaluate the effectiveness of acupuncture with manual stimulation and acupuncture with combined manual and electrical stimulation (electro-acupuncture) compared with standard care in reducing labour pain. Our hypothesis was that both acupuncture stimulation techniques were more effective than standard care, and that electro-acupuncture was most effective.Methods: A longitudinal randomised controlled trial. The recruitment of participants took place at the admission to the labour ward between November 2008 and October 2011 at two Swedish hospitals . 303 nulliparous women with normal pregnancies were randomised to: 40 minutes of manual acupuncture (MA), electro-acupuncture (EA), or standard care without acupuncture (SC). Primary outcome: labour pain, assessed by Visual Analogue Scale (VAS). Secondary outcomes: relaxation, use of obstetric pain relief during labour and post-partum assessments of labour pain. The sample size calculation was based on the primary outcome and a difference of 15 mm on VAS was regarded as clinically relevant, this gave 101 in each group, including a total of 303 women.Results: Mean estimated pain scores on VAS (SC: 69.0, MA: 66.4 and EA: 68.5), adjusted for: treatment, age, education, and time from baseline, with no interactions did not differ between the groups (SC vs MA: mean difference 2.6, 95% confidence interval [CI] -1.7-6.9 and SC vs EA: mean difference 0.6 [95% CI] -3.6-4.8). Fewer number of women in the EA group used epidural analgesia (46%) than women in the MA group (61%) and SC group (70%) (EA vs SC: odds ratio [OR] 0.35; [95% CI] 0.19-0.67).Conclusions: Acupuncture does not reduce women’s experience of labour pain, neither with manual stimulation nor with combined manual and electrical stimulation. However, fewer women in the EA group used epidural analgesia thus indicating that the effect of acupuncture with electrical stimulation may be underestimated.These findings were obtained in a context with free access to other forms of pain relief.
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| 2. |
- Vixner, Linda, et al.
(författare)
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Manual and Electroacupuncture for Labour Pain : Study Design of a Longitudinal Randomized Controlled Trial
- 2012
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Ingår i: Evidence-based Complementary and Alternative Medicine. - : Hindawi Publishing Corporation. - 1741-427X .- 1741-4288. ; , s. Article ID 943198-
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Tidskriftsartikel (refereegranskat)abstract
- Introduction. Results from previous studies on acupuncture for labour pain are contradictory and lack important information on methodology. However, studies indicate that acupuncture has a positive effect on women's experiences of labour pain. The aim of the present study was to evaluate the efficacy of two different acupuncture stimulations, manual or electrical stimulation, compared with standard care in the relief of labour pain as the primary outcome. This paper will present in-depth information on the design of the study, following the CONSORT and STRICTA recommendations. Methods. The study was designed as a randomized controlled trial based on western medical theories. Nulliparous women with normal pregnancies admitted to the delivery ward after a spontaneous onset of labour were randomly allocated into one of three groups: manual acupuncture, electroacupuncture, or standard care. Sample size calculation gave 101 women in each group, including a total of 303 women. A Visual Analogue Scale was used for assessing pain every 30 minutes for five hours and thereafter every hour until birth. Questionnaires were distributed before treatment, directly after the birth, and at one day and two months postpartum. Blood samples were collected before and after the first treatment. This trial is registered at ClinicalTrials.gov:NCT01197950.
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| 3. |
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| 4. |
- Ericson, Jenny, et al.
(författare)
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Breastfeeding and risk for ceasing in mothers of preterm infants - long-term follow-up
- 2018
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Ingår i: Maternal and Child Nutrition. - : Wiley. - 1740-8695 .- 1740-8709. ; 14:4
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Tidskriftsartikel (refereegranskat)abstract
- Breastfeeding is challenging for mothers of preterm infants. The aim of this paper is to describe risk factors for ceasing breastfeeding and methods of feeding until 12 months postnatal age in mothers who breastfed their preterm infants at discharge from neonatal intensive care units (NICUs). The data come from a randomised controlled trial, which evaluated the effectiveness on exclusive breastfeeding at 8 weeks of proactive telephone support compared with reactive support offered to mothers of preterm infants following discharge from NICU. Six NICUs across Sweden randomised a total of 493 mothers. We used regression and survival analyses to assess the risk factors for ceasing breastfeeding and the long-term outcomes of the intervention. The results showed that 305 (64%) of the infants were breastfed at 6 months and 49 (21%) at 12 months. Partial breastfeeding at discharge, low maternal educational level, and longer length of stay in the NICU increased the risk for ceasing breastfeeding during the first 12 months. Furthermore, the Kaplan-Meier analysis showed that the proportion of mothers who ceased breastfeeding did not differ between the intervention (n = 231) and controls (n = 262) during the first 12 months (log-rank test p = .68). No difference was found between groups on method of feeding. More than 85% of the infants were fed directly at the breast. These findings provide important insights for health professionals who are supporting mothers of preterm infants to breastfeed long term.Registered in www.clinicaltrials.gov (NCT01806480).
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| 5. |
- Palmér, Lina, 1979-, et al.
(författare)
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A qualitative study on the breastfeeding experience of mothers of preterm infants in the first 12 months after birth
- 2019
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Ingår i: International Breastfeeding Journal. - : Springer Science and Business Media LLC. - 1746-4358. ; 14:35, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- Background: Being a mother of a preterm infant (< 37 gestational weeks) puts the mother in a vulnerable andfragile situation wherein breastfeeding is an important part of becoming a mother and bonding with the infant.Nevertheless, the breastfeeding experience of mothers during the first year after a preterm birth has not been wellstudied. To develop professional caring and supporting relationships, it is important to address this knowledge gap.The aim of this study was to describe the breastfeeding experience of mothers of preterm infants from birth upuntil 12 months after birth.Methods: The data in this qualitative study are derived from a multicentre randomized controlled trial where 270mothers of preterm infants provided 496 written comments through questionnaires containing open-endedquestions. The questionnaires were sent to the mother three times during the first 12 months after birth. Athematic network analysis based on hermeneutical philosophy was used to analyse and interpret the resulting datato describe the mothers’ experiences of breastfeeding.Results: Three organizing themes, namely, “navigating smoothly,” “navigating with a struggle” and “navigating inambiguity” were revealed in the mothers’ narratives regarding their breastfeeding experiences during the first 12months after birth. These organizing themes were further interpreted as one global theme that was deemed “Ajourney to finding one’s unique way in breastfeeding.”Conclusion: Mothers of preterm infants are in an exposed and vulnerable situation when initiating breastfeedingduring the first year. This situation leads to a unique journey wherein each mother navigates through breastfeedingdepending on her individual situation. An awareness of the diversity of breastfeeding experiences may contributeto the provision of professional caring and supportive relationships.
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| 6. |
- Eriksson Crommert, Martin, 1974-, et al.
(författare)
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Women's experiences of living with increased inter-recti distance after childbirth : an interview study
- 2020
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Ingår i: BMC Women's Health. - : BioMed Central. - 1472-6874. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Although an increased inter-recti distance, also known as diastasis recti, is common after pregnancy, evidence-based knowledge about the condition is relatively limited. In particular, little is known about the consequences as perceived by the women. The objective of the present study was to describe how postpartum women with increased inter-recti distance experience the condition as well as the contacts they have had with healthcare providers regarding their symptoms.METHODS: A purposeful sampling approach was used to recruit 19 participants from an existing study cohort of 144 women. All participants had an inter-recti distance of at least two finger widths and at least one child, with the youngest child between the ages of 1 and 6 years. Individual interviews based on a semi-structured interview guide were performed and subsequently analysed using qualitative content analysis.RESULTS: Four categories emerged from the interviews: the body's function and ability has changed; the body does not look like it used to; uncomprehending attitudes and treatment in their surroundings; and trying to acquire an understanding of and strategies to cope with the diastasis. The findings reveal that women with increased inter-recti distance might experience fear of movement and engage in avoidance behaviour. In combination with feelings of physical instability in the midsection of their bodies and body dissatisfaction, many of the women restrict their everyday lives and physical activities.CONCLUSIONS: The findings indicate that increased inter-recti distance is a complex phenomenon that affects the women in a multitude of ways, highlighting the importance of considering the condition for each individual in her own context from a biopsychosocial perspective.
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| 7. |
- Hermansson, Ruth S., et al.
(författare)
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Elderly women's experiences of self-sampling for HPV testing.
- 2020
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Ingår i: BMC Cancer. - : Springer Science and Business Media LLC. - 1471-2407. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Self-sampling for HPV testing, as an alternative to the conventional speculum based sampling, is highly acceptable to women of screening ages. The aim of this study was to describe older women's (60 to 75 years) experiences of self-sampling.METHODS: In Sweden a descriptive study with quantitative and qualitative methods was designed to collect data from a survey of women who participated in self-sampling for HPV testing. Individual interviews were done with women who tested positive in the first self-sampling, and were either negative in their second HPV test or were positive in their second HPV test, but without precancerous lesions or cancer.RESULTS: Of 893 eligible women, 868 (97.2%) answered the survey. Among the surveyed women, 49.2% reported it was very easy to perform self-sampling, 46.8% answered it was easy and 2.0% answered it was not easy. A majority (58.9%) answered that they prefer self-sampling, 16.5% that they prefer sample collection by a healthcare provider, 23.7% did not have any preference and 0.9% did not answer the question. In the interviews, 13 of 16 invited women participated. Most of them reported that they prefer self-sampling because it was easy to perform, less embarrassing and less time consuming than a visit to a clinic. The majority of women reported that they were not worried when informed about having an HPV positive test. Overall, participating women with better knowledge about the significance of an HPV infection were more worried about having a positive HPV test.CONCLUSION: Cervical cancer remains a highly preventable disease through screening and early treatment. Our results indicated that vaginal self-sampling for HPV testing was a well-accepted method for cervical cancer prevention in this group of older women.TRIAL REGISTRATION: https://www.researchweb.org/is/en/fouckfuu/project/272587. Registered 24 June 2019-retrospectively registered. www.researchweb.org.
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| 8. |
- Erlandsson, Kerstin, et al.
(författare)
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Support after stillbirth and its effect on parental grief over time
- 2011
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Ingår i: Journal of Social Work in End-of-Life & Palliative Care. - : Informa UK Limited. - 1552-4256 .- 1552-4264. ; 7:2-3, s. 139-52
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Tidskriftsartikel (refereegranskat)abstract
- In this study the authors describe parents' experiences of support over a 2-year period after a stillbirth and its effect on parental grief. Data was collected by questionnaire from 33 mothers and 22 fathers at 3 months, 1 year, and 2 years after a stillbirth. Midwives, physicians, counselors, and priests--at the hospital where the stillbirth occurred--are those on the front line providing professional support. The support from family and friends was seen to be important 2 years after the stillbirth. The need for professional support after stillbirth can differ, depending on the support provided by family, friends, and social networks. They may not fully realize the value of their support and how to be supportive. Printed educational materials given to individuals in the social network or family might therefore be helpful.
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| 9. |
- Graner, Sophie, 1971-, et al.
(författare)
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Maternal health care professionals' perspectives on the provision and use of antenatal and delivery care : a qualitative descriptive study in rural Vietnam
- 2010
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 10:1, s. 608-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: High quality maternal health care is an important tool to reduce maternal and neonatal mortality. Services offered should be evidence based and adapted to the local setting. This qualitative descriptive study explored the perspectives and experiences of midwives, assistant physicians and medical doctors on the content and quality of maternal health care in rural Vietnam. METHOD: The study was performed in a rural district in northern Vietnam. Four focus group discussions with health care professionals at primary health care level were conducted. The data was analysed using qualitative manifest and latent content analysis. Result Two main themes emerged: "Contextual conditions for maternal health care" and "Balancing between possibilities and constraints". Contextual conditions influenced both pregnant women's use of maternal health care and health care professionals' performance. The study participants stated that women's uses of maternal health care were influenced by economical constraints and cultural norms that impeded their autonomy in relation to childbearing. Structural constraints within the health care system included inadequate financing of the primary health care, resulting in lack of human resources, professional re-training and adequate equipment. CONCLUSION: Contextual conditions strongly influenced the performance and interaction between pregnant women and health care professionals within antenatal care and delivery care in a rural district of Vietnam. Although Vietnam is performing comparatively well in terms of low maternal and child mortality figures, this study revealed midwives' and other health care professionals' perceived difficulties in their daily work. It seemed maternal health care was under-resourced in terms of staff, equipment and continuing education activities. The cultural setting in Vietnam constituting a strong patriarchal society and prevailing Confucian norms limits women's autonomy and reduce their possibility to make independent decisions about their own reproductive health. This issue should be further addressed by policy-makers. Strategies to reduce inequities in maternal health care for pregnant women are needed. The quality of client-provider interaction and management of pregnancy may be strengthened by education, human resources, re-training and provision of essential equipment.
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| 10. |
- Schytt, Erica, et al.
(författare)
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Incompleteness of Swedish local clinical guidelines for acupuncture treatment during childbirth
- 2011
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : John Wiley & Sons. - 0001-6349 .- 1600-0412. ; 90:1, s. 77-82
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To investigate the presence and content of local clinical guidelines for acupuncture treatment in Swedish labor and postnatal wards. Design. A Swedish national survey. Main Outcome Measures. Presence and content of clinical guidelines for acupuncture. Setting. All Swedish labor and postnatal wards at the time of data collection (April 2007–March 2008). Material and Methods. Enquiry was made on local clinical guidelines for acupuncture treatment at 50 labor and 50 postnatal wards. The standards for reporting interventions in controlled trials of acupuncture document was used to identify core aspects of acupuncture treatment and the proportion of wards with guidelines on these aspects was evaluated. Results. Guidelines were obtained from 27 labor wards and 22 postnatal wards. Descriptions of the core aspects of acupuncture treatment, such as acupuncture rationale, needling details and treatment regimens, were limited in most. All local guidelines included indications for treatment, but these were not based on scientific evidence of effect, and only two mentioned the importance of achieving de-qi – a feeling of soreness reflecting an effective treatment. Few clinical guidelines required that the practitioners’ acupuncture education should be on an academic level and relevant references based on clinical trials were lacking in all guidelines. Conclusion. Swedish local clinical guidelines on acupuncture for childbirth-related symptoms lack sufficient information to support midwives and obstetricians in administering acupuncture treatment. The content of the guidelines was unclear, inconclusive and, in some cases, irrelevant, and a majority lacked important information on indications and technique.
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