| 1. |
- Persson, Margareta, et al.
(författare)
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Regional and clinical guidelines for prevention and care of obstetric anal sphincter injuries - A critical frame analysis
- 2023
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Ingår i: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 119
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Policy documents govern how the prevention and care of obstetric anal sphincter injuries (OASIS) are implemented. Thus, in the absence of Swedish national guidelines on OASIS, differing views may be visible in the regional and local policy documents. Therefore, we aimed to analyse regional and local policies, guidelines, and care programs on the prevention of OASIS and care for OASIS-affected women in a Swedish context by applying a critical frame analysis inspired by Verloo.Design and setting: A cross-sectional study of existing policy documents from Swedish healthcare regions was performed. The documents were analysed using Verloo's critical frame analysis.Findings: We found that OASIS was framed as a preventable problem addressed by skilled protective manoeuvres of the healthcare staff. Education, communication, and teamwork were three frames of crucial solutions to minimise the prevalence of OASIS. However, complicating power dimensions between professional groups and between professionals and birthing women were identified. Furthermore, several discursive struggles were found, predominantly regarding the scientific evidence for the suggested prevention and care.Conclusion: The policy documents emphasised that OASIS is preventable, and improved education, communication, and teamwork could diminish the OASIS prevalence. Nevertheless, power dimensions and discursive struggles may challenge the preventive efforts. Furthermore, each Swedish region has the sovereignty to develop its policies, which was reflected in our findings and may imply inequities in care provision. Thus, there is an urgent need to develop comprehensive national high-quality guidelines of high quality for OASIS prevention and care so that all women giving birth have access to equal care and treatment in Sweden.
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| 2. |
- Tjernström, Katharina, et al.
(författare)
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Negotiating the ambiguity of an (in)authentic working life : a grounded theory study into severe perineal trauma
- 2023
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Ingår i: BMC Women's Health. - : BioMed Central (BMC). - 1472-6874. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: In Sweden, persistent physical and psychological health problems occur in about three in ten women who sustain severe perineal trauma (SPT) during childbirth. As most Swedish women work outside the home, the question of if and how SPT-related morbidity influences working life needs exploration. This study aims to qualitatively explore how women with persistent SPT-related morbidities experience and conceptualise their problems concerning working life. Further, we theorise the findings by applying Simone de Beauvoir’s feminist framework of immanence and transcendence as well as authentic and inauthentic life.Methods: Ten interviews with women recruited via a Swedish social media community for perineal trauma were analysed according to Charmaz’s constructivist approach to grounded theory.Results: The theoretical model and related core category ‘Negotiating the ambiguity of an (in)authentic working life’ reflected the women’s negotiations of immanence as ‘the silent covert object’ versus transcendence as the ‘the resourceful overt subject’. The model also mirrored the conflict of (in)authenticity in working life. An inauthentic working life was experienced when women were denied their subjectivity at work or constructed themselves as subjects in denial of their SPT. On the other hand, women who acknowledged their SPT and were constructed as subjects by ‘others’ achieved an authentic working life despite SPT.Conclusions: The conflicting gendered process of ‘the silent covert object’ versus ‘the resourceful overt subject’ problematised women’s vulnerability at work. Aspects that enable subjectification and transcendence are essential for policymakers, employers, healthcare services, and society to eradicate the taboo of SPT and create a working environment characterised by understanding, support, and flexibility. Further, access to adequate care, sick leave, and occupational rehabilitation are essential. Such measures support transcendence towards an authentic working life and, consequently, a more gender-equal working environment that does not deprive women of career opportunities due to a physical ailment.
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| 3. |
- Nordmark, Sofi, et al.
(författare)
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“It’s all about time and timing”: nursing staffs’ experiences with an agile development process, from its initial requirements to the deployment of its outcome of ICT solutions to support discharge planning
- 2022
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Ingår i: BMC Medical Informatics and Decision Making. - : Springer Nature. - 1472-6947. ; 22
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundAgile projects are statistically more likely to succeed then waterfall projects. The overall aim of this study was to explore the nursing staffs’ experiences with an agile development process, from its initial requirements to the deployment of its outcome of ICT solutions aimed at supporting discharge planning.MethodsAn explorative design with quantitative and qualitative methods was used. Qualitative data was collected through seven focus group interviews. Quantitative data was collected via an ICT-system, and with an evaluation form submitted by fourteen registered nurses and nine district nurses.ResultsQualitative result of the experiences with the agile development process and its outcome resulted in one theme, four categories, and ten subcategories. The theme was found to be about time and timing, namely the amount of time for the different activities and the timing of activities within and between organisations. The agile development process increased the participants’ readiness for change by offering time to learn, practice, engage and reflect, and then adopt the ICT as a support to daily practice. Quantitative results showed a variated adoption of the ICT.ConclusionThere is a need for time to prepare, understand and adopt new tools, services and procedures and a need for additional time to prepare, understand and adopt the new among individuals, collectives, organizations, and sometimes even between different collectives or organizations. The agile development process offered the end-users involvement through the development process, which gave them time to change it both individually and collectively. However, there is a need for close collaboration between the development project team and management to reach an organizational change that is timely for both the individual and the collective change. When time or timing fails in the development or implementation process, there is a huge risk of non-adoption of new tools, services, or procedures or among the end-users.
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| 4. |
- Lindberg, Inger, et al.
(författare)
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"Taken by surprise" : Women's experiences of the first eight weeks after a second degree perineal tear at childbirth
- 2020
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Ingår i: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 87
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: This study explores women's experience of having a second degree perineal tear and related consequences to daily life during the first eight weeks after childbirth.METHOD: Written responses to open-ended questions in a questionnaire distributed about eight weeks postpartum and completed by 1,007 women with second degree perineal tears were excerpted from the national quality register, Perineal Laceration Register. Inductive qualitative content analysis was applied to the data.RESULT: The theme Taken by surprise illustrates women's experience of the first two months after having a second degree perineal tear at childbirth. Women were not prepared for the inconveniences and expressed concerns about their bodies. Further, they expressed distress about their physical and psychological recovery as well as how to return to a pre-childbirth condition.CONCLUSIONS: Although many women recovered fairly well the first months after a second degree perineal tear at childbirth, it was evident that a substantial number of women were unprepared for the pain and discomfort they experienced. It is apparent that also women with the "minor" perineal tears at childbirth need improved postpartum care with tailored analgesia and improved information, but also check-ups and reassurance of recovery from healthcare professionals. Health care professionals need to identify women with persisting problems so that they can be referred to inpatient care for additional assessments of the injury.
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| 5. |
- Lindberg, Inger, et al.
(författare)
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Taken by surprise
- 2020
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Ingår i: Midwifery. - : ELSEVIER SCI LTD. - 0266-6138 .- 1532-3099. ; 87
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study explores womens experience of having a second degree perineal tear and related consequences to daily life during the first eight weeks after childbirth. Method: Written responses to open-ended questions in a questionnaire distributed about eight weeks postpartum and completed by 1,007 women with second degree perineal tears were excerpted from the national quality register, Perineal Laceration Register. Inductive qualitative content analysis was applied to the data. Result: The theme Taken by surprise illustrates womens experience of the first two months after having a second degree perineal tear at childbirth. Women were not prepared for the inconveniences and expressed concerns about their bodies. Further, they expressed distress about their physical and psychological recovery as well as how to return to a pre-childbirth condition. Conclusions: Although many women recovered fairly well the first months after a second degree perineal tear at childbirth, it was evident that a substantial number of women were unprepared for the pain and discomfort they experienced. It is apparent that also women with the "minor" perineal tears at childbirth need improved postpartum care with tailored analgesia and improved information, but also check-ups and reassurance of recovery from healthcare professionals. Health care professionals need to identify women with persisting problems so that they can be referred to inpatient care for additional assessments of the injury. (C) 2020 Elsevier Ltd. All rights reserved.
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| 6. |
- Johansson, Sofie, 1969, et al.
(författare)
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The Development of Swedish Receptive Vocabulary in CLIL: A Multilingual Perspective
- 2019
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Ingår i: Investigating content and language integrated learning : insights from Swedish high schools / edited by Liss Kerstin Sylvén.. - Bristol. UK : Multilingual Matters. - 9781788922401 ; , s. 236-258
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Bokkapitel (refereegranskat)abstract
- The fact that parallel English and Swedish data were collected on two consecutive occasions in the CLISS project offers a unique opportunity to compare the effects of CLIL in terms of English as well as Swedish language development on a longitudinal basis. A substantial proportion of the students taking part in the CLISS project were second language (L2) speakers of Swedish, which from a multilingual perspective makes such comparisons even more interesting. This chapter concerns vocabulary development with a special focus on L2 Swedish students in CLIL. Before turning to the field of L2 vocabulary development and the actual study, we will give a brief background of English in multilingual Sweden, the recently adopted Swedish Language Act, and multilingual students in CLIL.
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| 7. |
- Lindqvist, Maria, et al.
(författare)
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“Struggling to settle with a damaged body” : a Swedish qualitative study of women’s experiences one year after obstetric anal sphincter muscle injury (OASIS) at childbirth
- 2019
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier. - 1877-5756 .- 1877-5764. ; 19, s. 36-41
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveThis study aimed to explore women’s experiences related to recovery from obstetric anal sphincter muscle injuries (OASIS) one year after childbirth.MethodThis is a qualitative study based on written responses from 625 women approximately one year after childbirth in which OASIS occurred. Data was obtained from a questionnaire distributed by the national Perineal Laceration Register (PLR) in Sweden. Inductive qualitative content analysis was applied for analysis.ResultsThe theme “Struggling to settle with a damaged body “indicated that the first year after OASIS involved a struggle to settle to and accept living with a changed and sometimes still-wounded body. Many participants described problems related to a non-functional sexual life, physical and psychological problems that left them feeling used and broken, and increased worries for their future health and pregnancies. However, some women had adjusted to their situation, had moved on with their lives, and felt recovered and strong. Encountering a supportive and helpful health care professional was emphasized as vital for recovery after OASIS.ConclusionThis study provides important insights on how women experience their recovery approximately one year after having had OASIS at childbirth, wherein many women still struggled to settle into their damaged bodies. Clear pathways are needed within health care organizations to appropriate health care services that address both physical and psychological health problems of women with prolonged recovery after OASIS.
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| 8. |
- Elf, Marie, 1962-, et al.
(författare)
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The Swedish version of the Normalization Process Theory Measure S-NoMAD : translation, adaptation, and pilot testing
- 2018
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Ingår i: Implementation Science. - : Springer. - 1748-5908. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe original British instrument the Normalization Process Theory Measure (NoMAD) is based on the four core constructs of the Normalization Process Theory: Coherence, Cognitive Participation, Collective Action, and Reflexive Monitoring. They represent ways of thinking about implementation and are focused on how interventions can become part of everyday practice.AimTo translate and adapt the original NoMAD into the Swedish version S-NoMAD and to evaluate its psychometric properties based on a pilot test in a health care context including in-hospital, primary, and community care contexts.MethodsA systematic approach with a four-step process was utilized, including forward and backward translation and expert reviews for the test and improvement of content validity of the S-NoMAD in different stages of development. The final S-NoMAD version was then used for process evaluation in a pilot study aimed at the implementation of a new working method for individualized care planning. The pilot was executed in two hospitals, four health care centres, and two municipalities in a region in northern Sweden. The S-NoMAD pilot results were analysed for validity using confirmatory factor analysis, i.e. a one-factor model fitted for each of the four constructs of the S-NoMAD. Cronbach’s alpha was used to ascertain the internal consistency reliability.ResultsIn the pilot, S-NoMAD data were collected from 144 individuals who were different health care professionals or managers. The initial factor analysis model showed good fit for two of the constructs (Coherence and Cognitive Participation) and unsatisfactory fit for the remaining two (Collective Action and Reflexive Monitoring) based on three items. Deleting those items from the model yielded a good fit and good internal consistency (alphas between 0.78 and 0.83). However, the estimation of correlations between the factors showed that the factor Reflexive Monitoring was highly correlated (around 0.9) with the factors Coherence and Collective Action.ConclusionsThe results show initial satisfactory psychometric properties for the translation and first validation of the S-NoMAD. However, development of a highly valid and reliable instrument is an iterative process, requiring more extensive validation in various settings and populations. Thus, in order to establish the validity and reliability of the S-NoMAD, additional psychometric testing is needed.
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| 9. |
- Lindqvist, Maria, et al.
(författare)
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'A worse nightmare than expected' - a Swedish qualitative study of women's experiences two months after obstetric anal sphincter muscle injury
- 2018
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Ingår i: Midwifery. - London, United Kingdom : ELSEVIER SCI LTD. - 0266-6138 .- 1532-3099. ; 61, s. 22-28
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Tidskriftsartikel (refereegranskat)abstract
- Objective: this study explores women's experiences of the first two months after obstetric anal sphincter injury ( OASIS) during childbirth with a focus on problematic recovery. Methods: this qualitative study used inductive qualitative content analysis to investigate open-ended responses from 1248 women. The data consists of short and comprehensive written responses to open-ended questions focusing on recovery in the national quality register, the Perineal Laceration Register, two months after OASIS at childbirth. Results: the theme 'A worse nightmare than expected' illustrated women's experiences of their life situation. Pain was a constant reminder of the trauma, and the women had to face physical and psychological limitations as well as crushed expectations of family life. Furthermore, navigating healthcare services for help added further stress to an already stressful situation. Conclusions: we found that women with problematic recovery two months after OASIS experienced their situation as a worse nightmare than expected. Extensive pain resulted in physical and psychological limitations, and crushed expectations of family life. Improved patient information for women with OASIS regarding pain, psychological and personal aspects, sexual function, and subsequent pregnancy delivery is needed. Also, there is a need for clear organizational structures and information to guide help-seeking women to needed care.
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| 10. |
- Sandberg, Ylva, 1968-
(författare)
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Bilingual subject-specific literacies? Teachers’ and learners’ views and experiences of two school languages in biology, civics, history and mathematics : Case studies from the Swedish upper secondary school
- 2018
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This licentiate thesis investigates teachers’ and students’ cognitions of bilingual subject-specific literacies. The thesis builds on three different studies, referred to as case studies, conducted in Content and Language Integrated Learning (CLIL) study programmes in the Swedish upper secondary school. Participants’ views and experiences of two languages of schooling, English and Swedish, were elicited in interviews, and analysed thematically. To gain understanding of the three studies in combination, a further analytical framework was developed and tested. In this analysis, participants’ descriptions, explanations and reflections on teaching and learning curriculum content bilingually emerged as three-dimensional discourses.In the first study, new and experienced teachers’ challenges and strategies were in focus. The biology and civics teachers, who were new teachers, and new to CLIL, found teaching through the second language of schooling, English, time-consuming and demanding. They expressed concern about limited communication and learning in the classroom. The mathematics teachers, who had long teaching experience, and of teaching in the CLIL programme, had developed strategies to meet perceived challenges, for example, they had designed parts of lessons in a monolingual mode, and parts of lessons in a bilingual mode.The second study explored intermediate CLIL teachers’ rationales for language choice in teaching. The biology and history teachers found that access to English, as afforded through the CLIL framework, coincided well with the new syllabi for their school subjects. For instance, the history teachers could use web-based study materials in English in class, and found teaching and learning more authentic than in the mainstream, Swedish-speaking, study programmes. The biology teachers mentioned that access to English terminology facilitated the teaching and learning of complex subject-specific content areas. It functioned as a potential source to enhance students’ understanding.The third study documented students ́cognitionsof CLIL. The views of upper secondary students studying curriculum content through English were overall positive. However, results showed that their experiences of CLIL varied with school subject. Whereas studying mathematics through English was reported to be conducive to learning and understanding, learning civics through English only, or trying to listen to lectures in civics, where teachers would change languages seemingly without a rationale, were perceived as less conducive to learning.
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