| 1. |
- Dencker, Anna, 1956, et al.
(författare)
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Measuring women's experiences of decision-making and aspects of midwifery support: a confirmatory factor analysis of the revised Childbirth Experience Questionnaire
- 2020
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundWomen's experiences of labour and birth can have both short- and long-term effects on their physical and psychological health. The original Swedish version of the Childbirth Experience Questionnaire (CEQ) has shown to have good psychometric quality and ability to differentiate between groups known to differ in childbirth experience. Two subscales were revised in order to include new items with more relevant content about decision-making and aspects of midwifery support. The aim of the study was to develop new items in two subscales and to test construct validity and reliability of the revised version of CEQ, called CEQ2.MethodA total of 11 new items (Professional Support and Participation) and 14 original items from the first CEQ (Own capacity and Perceived safety), were answered by 682 women with spontaneous onset of labour. Confirmatory factor analysis was used to analyse model fit.ResultsThe hypothesised four-factor model showed good fit (CMIN=2.79; RMR=0.33; GFI=0.94; CFI=0.94; TLI=0.93; RMSEA=0.054 and PCLOSE=0.12) Cronbach's alpha was good for all subscales (0.82, 0.83, 0.76 and 0.73) and for the total scale (0.91).ConclusionsCEQ2, like the first CEQ, yields four important aspects of experience during labour and birth showing good psychometric performance, including decision-making and aspects of midwifery support, in both primiparous and multiparous women.
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| 2. |
- Dencker, Anna, 1956, et al.
(författare)
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Neonatal outcomes associated with mode of subsequent birth after a previous caesarean section in a first pregnancy: A Swedish population-based register study between 1999 and 2015
- 2022
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Ingår i: BMJ Paediatrics Open. - : BMJ. - 2399-9772. ; 6:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate neonatal outcomes within 28 days in the subsequent birth in women who gave birth to their first baby by caesarean section (CS). Design and setting National retrospective population-based register study. A cohort of 94 451 neonates who were born in Sweden between 1999 and 2015 as a second child to a mother who had her first birth by emergency or planned caesarean. Methods Data were retrieved from the national registers held by Statistics Sweden and the National Board of Health and Welfare. Logistic regression was used to calculate unadjusted and adjusted ORs (aOR) with 95% CIs for each outcome. Main outcome measures Neonatal infection, neonatal asphyxia/respiratory distress, neonatal hospital care and neonatal death within 28 days. Results Emergency CS and instrumental vaginal birth were associated with a doubled risk of neonatal infection (aOR 2.0) and planned CS with a decreased risk (aOR 0.7) compared with spontaneous vaginal birth. Compared with spontaneous vaginal birth, an increased risk of birth asphyxia and/or respiratory distress was identified with all other modes of birth (aOR 2.2-3.2). Emergency CS and instrumental vaginal birth, but not planned CS, were associated with neonatal hospital care (aOR 1.8 and 1.7) and an increased mortality rate during the neonatal period (aOR 2.9 and 3.2), compared with spontaneous vaginal birth. Conclusions In childbirth following a previous birth by CS, spontaneous vaginal birth appears to confer better neonatal outcomes within 28 days after birth overall than other modes of birth.
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| 3. |
- Dencker, Anna, 1956, et al.
(författare)
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Suturing after childbirth--a randomised controlled study testing a new monofilament material.
- 2006
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Ingår i: Bjog. - 1470-0328. ; 113:1, s. 114-6
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to assess if a monofilament suture material (Biosyn) compared with a commonly used multifilament suture (Dexon II) would cause fewer problems and lower levels of discomfort and pain after suturing lacerations and episiotomies following vaginal delivery. Women (1139) who required suturing by a midwife were allocated for repair with either the multifilament polyglycolic acid suture (Dexon II) or with a new monofilament of glycomer 631 (Biosyn). The outcome assessment involved inspection of the sutured area and measuring levels of discomfort and pain with a Visual Analogue Scale (VAS). At follow up after 8-12 weeks, more women in the monofilament group reported problems with the sutured area.
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| 4. |
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| 5. |
- Hansson, Malin, 1975, et al.
(författare)
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Job satisfaction in midwives and its association with organisational and psychosocial factors at work : a nation-wide, cross-sectional study
- 2022
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Ingår i: BMC Health Services Research. - London : Springer Science and Business Media LLC. - 1472-6963. ; 22:1, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundMidwives report a challenging work environment globally, with high levels of burnout, insufficient work resources and low job satisfaction. The primary objective of this study was to identify factors in the organisational and psychosocial work environment associated with midwives’ job satisfaction. A secondary objective was to identify differences in how midwives assess the organisational and psychosocial work environment compared to Swedish benchmarks.MethodsThis nation-wide, cross-sectional web survey study analysed midwives’ assessment of their organisational and psychosocial work environment using the COPSOQ III instrument. A multivariable, bi-directional, stepwise linear regression was used to identify association with job satisfaction (N = 1747, 99.6% women). A conventional minimal important score difference (MID ± 5 as a noticeable difference with clinical importance) were used to compare midwives’ results with Swedish benchmarks.ResultsA multivariable regression model with 13 scales explained the variance in job satisfaction (R2 = .65). Five scales, possibilities for development, quality of work, role conflict, burnout and recognition, explained most of the variance in midwives’ job satisfaction (R2 = .63) and had β values ranging from .23 to .10. Midwives had adverse MID compared to Swedish benchmarks with higher difference in mean values regarding quantitative demands (8.3), work pace (6.0) emotional demand (20.6), role conflicts (7.9) and burnout (8.3). In addition, lower organisational justice (-6.4), self-rated health (-8.8), influence (-13.2) and recognition at work (-5.8). However, variation and meaning of work showed a beneficial difference in mean values with 7.9 and 13.7 respectively.ConclusionsMidwives reported high levels of meaningfulness in their work, and meaningfulness was associated with job satisfaction. However, midwives also reported adversely high demands and a lack of influence and recognition at work and in addition, high role conflict and burnout compared to Swedish benchmarks. The lack of organisational resources are modifiable factors that can be taken into account when structural changes are made regarding organisation of care, management and resource allocation. Midwives are necessary to a high quality sexual, reproductive and perinatal health care. Future studies are needed to investigate if job satisfaction can be improved through professional recognition and development, and if this can reduce turnover in midwives.
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| 6. |
- Hansson, Malin, 1975, et al.
(författare)
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Professional courage to create a pathway within midwives’ fields of work : a grounded theory study
- 2021
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Ingår i: BMC Health Services Research. - London : Springer Science and Business Media LLC. - 1472-6963. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- The theory of salutogenesis focuses on resources for health and health-promoting processes. In the context of midwives’ work, this is not well described despite the importance for occupational health and the intention to remain in the profession. In order to promote a healthy workplace, it is necessary to consider the facilitating conditions that contribute to a sustainable working life. Therefore, the aim of this study was to explore health-promoting facilitative conditions in the work situation on labour wards according to midwives.
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| 7. |
- Hansson, Malin, 1975, et al.
(författare)
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Professional courage to create a pathway within midwives’ fields of work
- 2022
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Ingår i: https://njfcongress.fi/abstracts-and-posters.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: The theory of salutogenesis focuses on resources for health and health-promoting processes. In the context of midwives’ work, this is not well described despite the importance for occupational health and the intention to remain in the profession. In order to promote a healthy workplace, it is necessary to consider the facilitating conditions that contribute to a sustainable working life. Aim: To explore health-promoting facilitative conditions in the work situation on labour wards according to midwives. Methods: Face-to-face interviews with midwives constituted the empirical material in this classical grounded theory study. Results: The substantive theory of Professional courage to create a pathway within midwives’ fields of work emerged as an explanation of the health-promoting facilitative conditions in midwives’ work situation. The theory consists of a four-stage process with prerequisite contextual conditions: visualising midwifery, organisational resources and a reflective and learning environment, that were needed to fulfil the midwives’ main concern a Feasibility of working as a midwife. This meant being able to work according to best-known midwifery theory and practice in each situation. Positive consequences of a fulfilled main concern were a professional identity and grounded knowledge that enabled the development of the resistant resource professional courage. The courage made it feasible for midwives to move freely on their pathway within the different fields of work extending between normal and medicalised birth and being autonomous and regulated. Conclusions: Professional courage could be seen as a resistance resource, enabling midwives to become resilient when dealing with the unpredictable work situation. The theory can be used to foster health-promoting and sustainable work environments for midwives, which is possible if the organisational preconditions are met, visualising midwifery, having organisational resources and a reflective and learning environment. This could be a key factor in retaining midwives in the profession.
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| 8. |
- Hansson, Malin, 1975, et al.
(författare)
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Work situation and professional role for midwives at a labour ward pre and post implementation of a midwifery model of care - A mixed method study
- 2020
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Ingår i: International journal of qualitative studies on health and well-being. - : Informa UK Limited. - 1748-2631. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To explore and analyse the experience of work situation and professional role for midwives at a labour ward pre and post the implementation of a midwifery model of care (MiMo). Methods: A simultaneous mixed method was used. The qualitative core component departed from three focus group interviews (n=16 midwives). Secondary inductive and deductive content analysis was performed using an unconstrained matrix to make a corresponding comparison of the different time points. The supplemental component was a quantitative survey about the work situation (n=58). Results: The qualitative results pre the implementation showed three categories: Balance between Women and Organization, Midwives-Diverse as both Profession and Person, and Strained Work Situation. Post the intervention they transformed to Balance between Midwifery and Organization, Midwives-An Adaptable Profession, Strained Work Situation, and a new category Ability to concretize midwifery was found. There were no significant differences in the measures of work situation in the quantitative analyses. Conclusions: The synthesized findings based on the qualitative part show that MiMo has a potential to strengthen the professional role and midwifery practice. As such, MiMo has the capability to offer benefits to the labour wards with additional considerations.
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| 9. |
- Hansson, Malin, 1975, et al.
(författare)
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Work situation and professional role for midwives at a labour ward, pre and post the introduction of a midwifery model of care.
- 2019
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Ingår i: NJF Congress Reykjavik 2019.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: The work situation for midwives in different countries is related to high levels of stress, burnout and heavy work load. One aspect of the professional role of midwives is woman-centeredness, theoretically described in midwifery models of care. However, no studies are found about the outcome for midwives work related to midwifery models of care. Therefore, the aim of this study was to explore and analyse the experience of work situation and professional role for midwives at a labour ward, pre and post the introduction of a midwifery model of care (MiMo). Methods: A simultaneous qualitative and quantitative mixed method approach was used in this longitudinal study. The core component comprised of a qualitative inductive secondary content analysis of three focus group interviews with 16 midwives exploring how midwives experienced and described their work situation and professional role pre and post implementation of MiMo. The supplemental component were a quantitative survey analysis of the work situation for midwives (n=58) pre and post the intervention, and the deductive analysis was driven by the qualitative result. Findings: The qualitative core component consisted of the concepts Balance between Women and Organisation, Midwives - Diverse as both Profession and Person and Strained Work Situation pre intervention. Post intervention Balance between Midwifery and Organisation, Midwives - An Adaptable Profession, Strained Work Situation and lastly a new category Ability to concretise midwifery emerged. The quantitative items that had corresponding measures connected to the qualitative categories were analysed. There were no significant differences in any of the quantitative analyses pre and post the introduction of MiMo. Conclusion: Working according to MiMo appears not to have any effect on the strained work situation in midwives, in the context and with the measurements studied here. Although MiMo contributed to raise awareness of the professional role.
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| 10. |
- Lundgren, Ingela, 1957, et al.
(författare)
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Evaluation of a midwifery model of woman-centred care during childbirth – a mixed method study
- 2019
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Ingår i: NJF Congress 2019 Reykjavik Conference app.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Midwifery models of woman-centred care have been developed in different cultural context but few have been evaluated. A theoretical Midwifery Model of woman-centred care (MiMo) based on research in Sweden and Iceland was evaluated and assessed with the overall aim to explore the applicability of the model and the impact it has on outcome of childbirth care. Aim: To evaluate the effects and the applicability of a model of woman-centred care provided by midwives during childbirth. Methods: A mixed methods, before-after controlled study at two units for normal deliveries at Sahlgrenska University Hospital, Sweden,. The intervention comprised a one-day (8 hours) education about the model together with regularly scheduled reflection groups for midwives 2015-2016. The effects were studied by evaluating delivery outcomes, and mothers’ childbirth experiences. The primary outcomes were augmentation with oxytocin (n=.1600) and mothers’ childbirth experiences assessed with the Childbirth Experience Questionnaire (CEQ 2.0) (n=800). The applicability was studied by focus group interviews with a total of 43 participants: midwives (n=16), obstetricians (n = 8), assistant nurses (n= 11) and managers (n=8), before and after the intervention. Results: Findings from the study will be presented at the conference. Conclusion: A midwifery model of woman-centred care based on previous research has been evaluated in clinical practice.
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