| 1. |
- Anderbro, Therese, et al.
(författare)
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Fear of hypoglycaemia in adults with type 1 diabetes
- 2010
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Ingår i: Diabetic Medicine. - : Wiley. - 0742-3071 .- 1464-5491. ; 27:10, s. 1151-8
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Forskningsöversikt (refereegranskat)abstract
- Aims The aim of this study was to examine the fear of hypoglycaemia and its association with demographic and disease-specific variables in a large and unselective population of adult patients with Type 1 diabetes. Methods Questionnaires were sent by post to all patients with Type 1 diabetes who were identified in the local diabetes registries of two hospitals in Stockholm, Sweden (n = 1387). Fear of hypoglycaemia was measured using the Swedish Hypoglycaemia Fear Survey, the Worry subscale and the Aloneness subscale. Demographic variables and disease-specific factors were collected from patients' self reports and medical records. Univariate analysis and multiple stepwise linear regression analysis were used in the statistical analyses of the data. Results Seven hundred and sixty-four (55%) patients participated in the study (mean age 43.3 years and mean HbA(1c) 7.0%, normal < 5.0%). The Hypoglycaemia Fear Survey - Worry subscale was significantly associated with frequency of severe hypoglycaemia, number of symptoms during mild hypoglycaemia, gender, hypoglycaemic symptoms during hyperglycaemia and hypoglycaemic unawareness. The Hypoglycaemia Fear Survey - Aloneness subscale was significantly associated with frequency of severe hypoglycaemia, number of symptoms during mild hypoglycaemia, gender, frequency of mild hypoglycaemia, HbA(1c) , hypoglycaemic unawareness and visits to the emergency room because of severe hypoglycaemia. Fear of hypoglycaemia proved to be more prevalent in females and indicated a different pattern between genders in relation to factors associated with fear of hypoglycaemia. Conclusions This study identifies the frequency of severe hypoglycaemia as the most important factor associated with fear of hypoglycaemia. Moreover, for the first time, we document gender differences in fear of hypoglycaemia, suggesting that females are more affected by fear of hypoglycaemia than men.
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| 2. |
- Anderbro, Therese, et al.
(författare)
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Fear of hypoglycemia : relationship to hypoglycemic risk and psychological factors
- 2014
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Ingår i: Acta Diabetologica. - : Springer Science and Business Media LLC. - 0940-5429 .- 1432-5233.
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The major aims of this study were to examine (1) the association between fear of hypoglycemia (FOH) in adults with type 1 diabetes with demographic, psychological (anxiety and depression), and disease-specific clinical factors (hypoglycemia history and unawareness, A1c), including severe hypoglycemia (SH), and (2) differences in patient subgroups categorized by level of FOH and risk of SH.RESEARCH DESIGN AND METHODS: Questionnaires were mailed to 764 patients with type 1 diabetes including the Swedish translation of the Hypoglycemia Fear Survey (HFS) and other psychological measures including the Perceived Stress Scale, Hospital Anxiety and Depression Scale, Anxiety Sensitivity Index, Social Phobia Scale, and Fear of Complications Scale. A questionnaire to assess hypoglycemia history was also included and A1c measures were obtained from medical records. Statistical analyses included univariate approaches, multiple stepwise linear regressions, Chi-square t tests, and ANOVAs.RESULTS: Regressions showed that several clinical factors (SH history, frequency of nocturnal hypoglycemia, self-monitoring) were significantly associated with FOH but R (2) increased from 16.25 to 39.2 % when anxiety measures were added to the model. When patients were categorized by level of FOH (low, high) and SH risk (low, high), subgroups showed significant differences in non-diabetes-related anxiety, hypoglycemia history, self-monitoring, and glycemic control.CONCLUSION: There is a strong link between FOH and non-diabetes-related anxiety, as well as hypoglycemia history. Comparison of patient subgroups categorized according to level of FOH and SH risk demonstrated the complexity of FOH and identified important differences in psychological and clinical variables, which have implications for clinical interventions.
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| 3. |
- Avelin, Pernilla, et al.
(författare)
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Make the stillborn baby and the loss real for the siblings : parents' advice on how the siblings of a stillborn baby can be supported
- 2012
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Ingår i: Journal of Perinatal Education. - : Springer Publishing Company. - 1058-1243 .- 1548-8519. ; 21:2, s. 90-98
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to investigate parents' advice to other parents on the basis of their own experiences of siblings' taking leave of a stillborn sister or brother. The study was a Web questionnaire study of 411 parents. The thematic content analysis resulted in two categories: "Make the stillborn baby and the loss real for the siblings" and "Take the siblings' resources and prerequisites into account." Parents' advised that siblings should see and hold the stillborn baby and, thus, be invited and included into the leave-taking process with respect to the siblings' feelings, resources, and prerequisites. Based on these findings, professional caregivers can usefully be proactive in their approach to facilitate and encourage the involvement of siblings.
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| 4. |
- Avelin, Pernilla, et al.
(författare)
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Swedish parents' experiences of parenthood and the need for support to siblings when a baby is stillborn
- 2011
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Ingår i: Birth. - : John Wiley & Sons. - 0730-7659 .- 1523-536X. ; 38:2, s. 150-8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: It has been argued that having a stillborn baby in the family affects older siblings more than parents realize. The aim of this study was to describe parenthood and the needs of siblings after stillbirth from the parents' perspective.METHODS: Six focus groups were held with 27 parents who had experienced a stillbirth and who had had children before the loss. The discussion concerned parents' support to the siblings, and the sibling's meeting, farewell, and memories of their little sister or brother. Data were analyzed using qualitative content analysis.RESULTS: The overall theme of the findings was parenthood in a balance between grief and everyday life. In the analysis, three categories emerged that described the construction of the theme: support in an acute situation, sharing the experiences within the family, and adjusting to the situation.CONCLUSIONS: The siblings' situation is characterized by having a parent who tries to maintain a balance between grief and everyday life. Parents are present and engaged in joint activities around the stillbirth together with the siblings of the stillborn baby. Although parents are aware of the sibling's situation, they feel that they are left somewhat alone in their parenthood after stillbirth and therefore need support and guidance from others.
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| 5. |
- Johansson, Margareta, et al.
(författare)
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Childbirth : an emotionally demanding experience for fathers
- 2012
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Ingår i: Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives. - : Elsevier BV. - 1877-5764 .- 1877-5756. ; 3:1, s. 11-20
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: While attending birth mostly has a positive impact on becoming a father, it has also been described as including feelings of discomfort and is more demanding than expected.OBJECTIVE: The objective was to explore Swedish fathers' birth experiences, and factors associated with a less-positive birth experience.METHODS: Mixed methods including quantitative and qualitative data were used. Two months after birth 827 fathers answered a questionnaire and 111 (13%) of these commented on the birth experience. Data were analysed with descriptive statistics, chi-square test for independence, risk ratios with a 95% confidence interval, logistic regression and content analysis.RESULTS: In total, 604 (74%) of the fathers had a positive or very positive birth experience. Used method identified a less-positive birth experience associated with emergency caesarean section (RR 7.5; 4.1-13.6), instrumental vaginal birth (RR 4.2; 2.3-8.0), and dissatisfaction with the partner's medical care (RR 4.6; 2.7-7.8). Healthcare professionals' competence and approach to the fathers were also related to the birth experience.CONCLUSIONS: As the fathers' birth experiences were associated with mode of birth and experiences of the intrapartum medical care fathers should be respectfully and empathically treated during labour and birth. It is essential to better engage fathers during the intrapartum period through involvement and support to improve the likelihood of a positive birth experience.
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| 6. |
- Johansson, Margareta, et al.
(författare)
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Improvements of postnatal care are required by Swedish fathers
- 2013
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Ingår i: International Journal of Health Care Quality Assurance. - 0952-6862 .- 1758-6542. ; 26:5, s. 465-480
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Tidskriftsartikel (refereegranskat)abstract
- Purpose – This paper has two main aims: to explore fathers' postnatal care experiences with a specific focus on deficiencies and to investigate which service deficiencies remained important for fathers one year after childbirth.Design/methodology/approach – This is a prospective longitudinal study. Two months and one year after birth, the overall satisfaction with care were sought. A care quality index was created, based on perceived reality and subjective importance of the care given. The study excluded fathers not mastering Swedish. Total eligible fathers was consequently not known therefore pregnancies served as an estimate.Findings – In total, 827 fathers answered the questionnaire two months after birth and 655 returned the follow-up questionnaire after one year; 21 per cent were dissatisfied with overall postnatal-care. The most important dissatisfying factors were the way fathers were treated by staff and the women's check-up/medical care. Two months after the birth, information given about the baby's care and needs were most deficient when parents had been cared for in a hotel ward. Furthermore, information about the baby's needs and woman's check-up/medical care was most deficient when fathers had participated in emergency Caesarean section.Practical implications – Most fathers were satisfied with the overall postnatal care, but how fathers are treated by caregivers; the woman's check-up/medical care and information given about the baby's care and needs can be improved. Professionals should view early parenthood as a joint project and support both parents' needs.Originality/value – The paper provides knowledge about postnatal service quality including fathers' needs.
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| 7. |
- Lindgren, Helena, 1965, et al.
(författare)
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Transfer in planned home births in Sweden - effects on the experience of birth : A nationwide population-based study
- 2011
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Ingår i: Sexual & Reproductive HealthCare. - Amsterdam : Elsevier BV. - 1877-5756 .- 1877-5764. ; 2:3, s. 101-105
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Tidskriftsartikel (refereegranskat)abstract
- Objective: More than 10% of all planned home births in high-income countries are completed in the hospital. The aim of this study was to compare the birth experiences among women who planned to give birth at home and completed the birth at home and women who were transferred to hospital during or immediately after the birth. Methods: All women in Sweden who had a planned home birth between 1998 and 2005 (n = 671) were invited to participate in the study. The women who agreed to participate received one questionnaire for each planned home birth. Mixed methods were used for the analysis. Results: Women who had been transferred during or immediately after the planned home birth had a more negative birth experience in general. In comparison with women who completed the birth at home, the odds ratio for being less satisfied was 13.5, CI 8.1-22.3. Reasons for being dissatisfied related to organizational factors, the way the women were treated or personal ability. Conclusion: Being transferred during a planned home birth negatively affects the birth experience. Treatments as well as organizational factors are considered to be obstacles for a positive birth experience when transfer is needed. Established links between the home birth setting and the hospital might enhance the opportunity for a positive birth experience irrespective of where the birth is completed. © 2011.
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| 8. |
- Malm, Mari-Cristin, et al.
(författare)
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Development of a tool to evaluate fetal movements in full-term pregnancy
- 2014
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 5:1, s. 31-35
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To study women's description of fetal movements in full-term pregnancy. Further to investigate if their descriptions could be sorted with regard to intensity and type of movements, using a matrix under development to be a tool for evaluating fetal movements in clinical praxis. Methods: Data were collected by distributing questionnaires including an open question: "Please describe your perception of the baby's movements during this gestational week." A matrix listed seven categories of movements divided into powerful and non-powerful movements, was used for the content analysis. Results: 393 (78%) women responded to the open question. The movements were split into two domains: Powerful movements and Non-powerful movements. Altogether, 383 (96%) women perceived fetal movements that were sorted as powerful movement: firm, slow stretching, large and side to side. Ten (4%) women described movements exclusively, i.e. movements that did not include any of the movements in the powerful domain. Most women perceived movements that corresponded to more than one type of category, and all movements described by the women could be referred to at least one of the categories in the matrix. Conclusion: The matrix was useful for identification of the women's perceptions of fetal movements in full-term pregnancy. Further studies are needed in order to develop the tool and its potential to evaluate the well-being of the fetus before it is to be used in clinical praxis.
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| 9. |
- Malm, Mari-Cristin, et al.
(författare)
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Women's experiences of two different self-assessment methods for monitoring fetal movements in full-term pregnancy - a crossover trial
- 2014
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Ingår i: Bmc Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 14:349
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Tidskriftsartikel (refereegranskat)abstract
- Background: Low maternal awareness of fetal movements is associated with negative birth outcomes. Knowledge regarding pregnant women's compliance with programs of systematic self-assessment of fetal movements is needed. The aim of this study was to investigate women's experiences using two different self-assessment methods for monitoring fetal movements and to determine if the women had a preference for one or the other method. Methods: Data were collected by a crossover trial; 40 healthy women with an uncomplicated full-term pregnancy counted the fetal movements according to a Count-to-ten method and assessed the character of the movements according to the Mindfetalness method. Each self-assessment was observed by a midwife and followed by a questionnaire. A total of 80 self-assessments was performed; 40 with each method. Results: Of the 40 women, only one did not find at least one method suitable. Twenty of the total of 39 reported a preference, 15 for the Mindfetalness method and five for the Count-to-ten method. All 39 said they felt calm, relaxed, mentally present and focused during the observations. Furthermore, the women described the observation of the movements as safe and reassuring and a moment for communication with their unborn baby. Conclusions: In the 80 assessments all but one of the women found one or both methods suitable for self-assessment of fetal movements and they felt comfortable during the assessments. More women preferred the Mindfetalness method compared to the count-to-ten method, than vice versa.
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| 10. |
- Olsen, Marie, 1967-, et al.
(författare)
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Psychometric properties of the Swedish version of the Fear of Complications Questionnaire
- 2014
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Ingår i: Open Journal of Endocrine and Metabolic Diseases. - : Scientific Research Publishing. - 2165-7432 .- 2165-7424. ; 4, s. 69-76
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To translate and evaluate the psychometric properties of the Swedish version of the Fear of Complications Questionnaire. Design: Cross-sectional study design and scale development. Settings: Totally, 469 adults (response rate 63.5%) with Type 1 diabetes completed the questionnaires. Participants were recruited from two university hospitals in Sweden. Participants: Eligible patients were those who met the following inclusion criteria: diagnosed with Type 1 diabetes, diabetes duration of at least 1 year and aged at least 18 years. Methods: The Fear of Complications Questionnaire was translated using the forward-backward translation method. Factor analyses of the questionnaire were performed in two steps using both exploratory and confirmatory factor analysis. Convergent validity was examined using the Hospital Anxiety and Depression Scale and the Fear of Hypoglycaemia Fear Survey. Internal consistency was estimated using Cronbach’s alpha.Results: Exploratory factor analysis supported a two-factor solution. One factor contained three items having to do with fear of kidney-related complications and one factor included the rest of items concerning fear of other diabetes-related complications, as well as fear of complications in general. Internal consistency was high Cronbach’s alpha 0.96. The findings also gave support for convergent validity, with significant positive correlations between measures (r = 0.51 to 0.54). Conclusion: The clinical relevance of the identified two-factor model with a structure of one dominant subdomain may be considered. We suggest, however a one-factor model covering all the items as a relevant basis to assess fear of complications among people with Type 1 diabetes.
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