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| 2. |
- Alm, Bernt, 1951, et al.
(författare)
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Plötslig oväntad död hos spädbarn. Kunskapsstöd med nationella rekommendationer till hälso- och sjukvården
- 2016
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I detta kunskapsstöd presenteras rekommendationer till hälso- och sjukvår-den för rutiner vid plötslig oväntad död hos spädbarn. Vid plötslig oväntad död hos spädbarn bör hälso- och sjukvården använda Socialstyrelsens checklista för anamnesuppgifter använda Socialstyrelsens checklista för statusuppgifter använda Socialstyrelsens checklista för provtagningar och röntgenundersökning. Utredning av plötslig oväntad död hos spädbarn innefattar samverkan mellan tre aktörer med olika uppgifter, nämligen hälso- och sjukvården, Polismyndigheten och Rättsmedicinalverket. Rekommendationerna är avsedda som ett stöd till hälso- och sjukvårdspersonal vid omhändertagandet av det döda barnet och familjen. Rekommendationerna utgör även en grund för utveckling av lokala vårdprogram och de förväntas dessutom bidra till jämlikhet över landet när det gäller utredning samt till att förebygga plötslig oväntad död hos spädbarn. Eftersom det delvis saknas vetenskapliga studier med tillräcklig relevans och kvalitet om utredning av plötslig oväntad död hos spädbarn har Social-styrelsen genomfört en konsensusprocess för att formulera rekommendationerna. Att som förälder påträffa sitt spädbarn livlöst, eller att informeras om att barnet dött, innebär en extrem känslomässig påfrestning. I ett kapitel ger Socialstyrelsen stöd till hälso- och sjukvården med syfte att underlätta informationen till familjen om dödsorsaksutredningen och dödsorsaksdia-gnosen. I ett sista kapitel om stöd till föräldrar under utredningsprocessen ges vägledning om vad som är viktigt att tänka på i mötet med föräldrarna och andra närstående samt vad som bör göras för att utredningen ska bli så komplett som möjligt. I bilagan till kunskapsstödet finns också en beskrivning av de rättsliga förutsättningarna för utredning av plötslig oväntad död hos spädbarn.
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| 3. |
- Appelqvist, Emma, et al.
(författare)
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Parental views and the key role of nurses for high vaccine acceptance in Sweden – a focus group study
- 2023
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Ingår i: BMC Public Health. - 1471-2458. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: In Sweden, vaccine uptake is exceptionally high due to an efficient child immunization program. More than 97% of Swedish children were vaccinated at child health care centers (CHCs) according to the schedule at 2 years of age in 2021. From the age of 6 years, vaccinations are given within the school health care. Maintaining high vaccination coverage over time is one of the central motives to explore and understand drivers for vaccine acceptance. The current study aimed to assess parental vaccine acceptance concerning the national immunization program and explore factors contributing to the high vaccine acceptance in Sweden. Methods: Parents of children aged 1–2 years and 8–12 years were recruited through purposive sampling and asked to participate in focus groups held in three cities in Sweden, in February and March 2019. In total, 47 parents participated in two focus groups per city, one session for parents of younger (1–2 years) and older (8–12 years) children respectively. The focus group discussions were analyzed using qualitative content analysis. Results: Parents of children aged 1–2 years expressed the themes; strong compliance to and protection of the value of vaccinations; parents feel safe with an attentive relationship with their nurse; the spectrum of communication needs is essential to meet. For parents to children aged 8–12 years, the themes expressed were; vaccinate to do good for the individual and society; a foundation of trust is built at CHCs for decisions later on; decisions for vaccination become more complex as children get older; communication changes as children get older and need to be explicit and tailored to the situation. Conclusion: Both individual and societal perspectives were shown to influence the vaccination decision for childhood immunizations, as manifested in parental reflections and experiences. As nurses have a key role, it is important to provide them with continued support and tools to facilitate their support for parents in making informed decisions. Continuous work for supporting driving factors for vaccination over time is needed to maintain high vaccine acceptance in Sweden.
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| 4. |
- Lind, Johannes, et al.
(författare)
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Hospital care for viral gastroenteritis in socio-economic and geographical context in Sweden 2006-2013
- 2018
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 107:11, s. 2011-2018
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Tidskriftsartikel (refereegranskat)abstract
- AIM: We investigated socio-economic and geographical determinants of hospital care for viral gastroenteritis in young children.METHOD: This is a register-based study in a national birth cohort of 752 078 children 0-5 years of age in Sweden during 2006-2012. Hazard ratios (HR) of time to first admission and first episode of outpatient emergency department (ED) care with a diagnosis of viral gastroenteritis were estimated with Cox regression.RESULTS: The adjusted HRs for hospital admission with a diagnosis of viral gastroenteritis were increased when the mother was below 25 years at the birth of the child, 1.30 (95% CI: 1.24-1.35), had a short (<=9 years) education, 1.18 (95% CI: 1.12-1.23), a psychiatric disorder, 1.34 (95% CI: 1.30-1.39), and/or when parents were born outside Europe, 1.23 (95% CI: 1.18-1.29). In contrast, the disposable income of the family was only marginally associated with such hospital admissions. The pattern of HRs for outpatient ED hospital care was similar. Hospital care incidences for viral gastroenteritis differed considerably between Swedish counties.CONCLUSION: Parental indicators associated with a lower level of health literacy increase the risk for hospital care due to gastroenteritis in young children. Information about oral rehydration should be provided in ways that are accessible to these parents.
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| 5. |
- Runngren, Eva, 1963-, et al.
(författare)
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Attitudes and knowledge about HPV vaccination of school children and their parents following a targeted information
- 2022
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Konferensbidrag (refereegranskat)abstract
- Background/Objective: This study aimed to investigate children’s’ and parents’attitudes and knowledge about HPV (human papilloma virus) following introductionof gender neutral HPV vaccination in the national immunization program (NIP) inSweden. An evaluation of a tailored information package for parents and childrenlaunched by the Public Health Agency (PHAS) alongside the introduction of genderneutral HPV vaccination was also performed.Method: In total, 276 parents and 206 children from 22 School Health Servicesresponded to a web-based survey, spring 2021 to January 2022.Result: Overall, parents (78%) perceived HPV vaccination to be of importance fortheir child’s health. About half of the participating children and two thirds of theparents had used the tailored information package for the HPV vaccination. The factsheet was mostly used by parents (55%) and children (20%) and also perceived as easyto understand (99% and 68% respectively). For both children and parents the schoolnurse (70% respectively) was the primary source for information. The teacher (59%)was also a common source of information of HPV vaccination for the children.Conclusion: The school health nurse is essential for informing about HPV vaccinationfor both children and parents. There is a need to strengthen the knowledge regardingHPV vaccination among teachers as they also are a key source of information for themajority of the children. Additional interventions are needed to support parents inmaking informed decisions for HPV vaccinations.POSTER 1Page 1
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| 6. |
- Runngren, Eva, 1963-, et al.
(författare)
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Attitudes and knowledge about HPV vaccination of school children and their parents following use of a targeted information
- 2023
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Konferensbidrag (refereegranskat)abstract
- Background/Objective: This study aimed to investigate children’s’ and parents’ attitudes and knowledge about HPV (human papillomavirus) following introduction of gender-neutral HPV vaccination in the national immunization program (NIP) in Sweden. An evaluation of a tailored information package for parents and children launched by the Public Health Agency (PHAS) alongside the introduction of gender-neutral HPV vaccination was also performed Method: In total, 276 parents and 206 children from 22 School Health Services responded to a web-based survey, spring 2021 to January 2022. Result: Overall, parents (78%) perceived HPV vaccination to be of importance for their child’s health. About half of the participating children and two thirds of the parents had used the tailored information package for the HPV vaccination. The fact sheet was mostly used by parents (55%) and children (20%) and also perceived as easy to understand (99% and 68% respectively). For both children and parents, the school nurse (70% respectively) was the primary source for information. The teacher (59%) was also a common source of information of HPV vaccination for the children. Conclusion: The school nurse is essential for informing about HPV vaccination for both children and parents. There is a need to strengthen the knowledge regarding HPV vaccination among teachers as they also are a key source of information for the majority of the children. Additional interventions are needed to support parents in making informed decisions for HPV vaccinations.
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| 7. |
- Schollin Ask, Lina, et al.
(författare)
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Receiving early information and trusting Swedish child health centre nurses increased parents' willingness to vaccinate against rotavirus infections
- 2017
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 106:8, s. 1309-1316
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Rotavirus vaccines are effective against severe infections, but have a modest impact on mortality in high-income countries. Parental knowledge and attitudes towards vaccines are crucial for high vaccination coverage. This study aimed to identify why parents refused to let their infant have the vaccination or were unsure. Methods: This cross-sectional study was based on 1,063 questionnaires completed by the parents of newborn children in 2014. Stepwise logistic regression was used to identify the main predictors. Results: Most (81%) parents intended to vaccinate their child against the rotavirus, while 19% were unwilling or uncertain. Parents with less education and children up to five weeks of age were more likely to be unwilling or uncertain about vaccinating their child. Factors associated with a refusal or uncertainty about vaccinating were not having enough information about the vaccine, no intention of accepting other vaccines, paying little heed to the child health nurses' recommendations, thinking that the rotavirus was not a serious illness and not believing that the vaccine provided protection against serious forms of gastroenteritis. Conclusion: Early information, extra information for parents with less education and close positive relationships between parents and child health nurses were important factors in high rotavirus vaccination rates.
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| 8. |
- Schollin Ask, Lina, et al.
(författare)
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The Effect of Rotavirus Vaccine on Socioeconomic Differentials of Paediatric Care Due to Gastroenteritis in Swedish Infants
- 2019
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 16:7
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Tidskriftsartikel (refereegranskat)abstract
- Background: Previous Swedish studies have shown a social gradient on paediatric care for viral gastroenteritis. Aim: To study the effect of a free rotavirus vaccine programme on hospital care for viral gastroenteritis. Method: A register-based national cohort study of paediatric in- and outpatient care for viral gastroenteritis in children <2 years old in two Swedish counties in 2014-2017, with the rest of the country as comparison. Adjusted hazard ratios were estimated by the differences-in-differences (DiD) estimator in Cox regression in the entire cohort and by social indicators. Results: Reductions of 37% and 24% for inpatient care, and 11 % and 21% for outpatient care for viral gastroenteritis were found in the Stockholm and Jonkoping counties, respectively, after adjusting for time trends and social indicators. For inpatient care, the change was similar over social groups in both counties. In the larger county of Stockholm, smaller reductions in outpatient care were detected for children in socially disadvantaged families. Conclusions: A free rotavirus vaccination programme moderately reduced paediatric care for viral gastroenteritis. There were indications of an increase in socioeconomic differences in paediatric outpatient care for viral gastroenteritis, but further studies are needed to confirm this result in a broader health care perspective.
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| 9. |
- Schollin Ask, Lina
(författare)
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The introduction of rotavirus vaccine in Sweden : setting the scene and short term outcomes
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: The rotavirus causes the most severe cases of viral gastroenteritis in small children worldwide, resulting in both high morbidity and mortality. The World Health Organization has recommended vaccination against the rotavirus since 2009 and the vaccine had been introduced by more than 90 countries in 2017. Since 2014, the vaccine has been offered to all newborn infants in Stockholm and Jönköping counties and it will be introduced into the national Swedish immunization program in September 2019. The aim of this thesis is to create a platform for the national implementation of the rotavirus vaccine in Sweden. It studies parental attitudes to the vaccine, examines the rare, but serious, adverse event of intussusception and looks at how the vaccine affects the burden of disease. The thesis also looks at social disparities in hospital use due to gastroenteritis. Methods and Results: Different methods have been used to illustrate different aspects of the introduction of the rotavirus vaccine in Sweden in the five studies included in this thesis. The thesis highlights the importance of good relationships between child health care nurses and parents, sets the scene for safety surveillance, shows how paediatric care for gastroenteritis has been reduced by the rotavirus vaccine and also shows social differences in the utilization of paediatric care for gastroenteritis in small children. Studies I and II focused on parental attitudes, conceptions and knowledge of the rotavirus vaccine during the implementation of the vaccine in Stockholm. Both studies included parents of newborn infants before the first dose of the rotavirus vaccine was offered. Study I was a cross-sectional questionnaire study of 1,063 parents. The analyses were carried out using Pearson´s chi-square test and stepwise logistic regression in order to find the main predictors for vaccination or not. Most parents (81%) intended to vaccinate their child, 8% did not want to vaccinate and 11% were uncertain. Poor knowledge about the vaccine and the rotavirus infection, less trust in the child health care nurse, lower levels of education and having a child of up to five weeks of age were associated with being hesitant or unwilling to vaccinate. Study II was a qualitative study of 10 in-depth interviews with parents. We identified four main categories that showed different conceptions of the rotavirus vaccine: to vaccinate without doubt, hesitant to vaccinate, risky to vaccinate and unnecessary to vaccinate. Study III was a validation study of the diagnosis of intussusception in children under three years of age and it used data from the Swedish National Patient Register for the period 1987-2013. The aim of this study was to create a platform for further register-based follow-up studies of this rare, but serious, adverse event of the rotavirus vaccine. We manually reviewed 392 medical records that were randomly selected by The National Board of Health and Welfare from both pediatric and surgery care in Sweden, by using accepted international criteria of case definitions. A positive predictive value (PPV) of 89% was reached for the total study population and the PPV for the 240 children under one year of age was 88%. Studies IV and V were register-based studies of national birth cohorts. In both studies the children were linked to their parents and the outcome was viral gastroenteritis for paediatric inpatient and outpatient care. In study IV the outpatient care was defined as visits at emergency departments (ED). In study V the outpatient care included both paediatric hospital care in the EDs as well as publically funded paediatric care outside of the hospital. The adjusted hazard ratios (HR) for a diagnosis of viral gastroenteritis were estimated by Cox regression. Study IV consisted of 752,048 children below five years of age in Sweden from 2006-2012. Socioeconomic risk factors for the outcomes and national differences in geographical incidences of the outcomes were investigated. In total 3.1% children were admitted for inpatient care and 9.4% children received paediatric outpatient care at EDs. The adjusted HRs for both outcomes were increased when the mother was under 25 years of age, had a lower level of education, any parent had a psychiatric disorder, and/or when parents were born outside Europe. All these factors were associated with a lower level of health literacy. There were also considerable differences between the incidences of the outcomes between Swedish counties. Study V consisted of 518,500 children aged two months to two years who were born alive between 1 March 2011 and 31 December 2015. The observation period ended in 31 March 2017. Children in Stockholm and Jönköping counties were compared with the rest of Sweden in order to study the effect that the rotavirus vaccine had on outcomes and on the social gradient. After adjustments for time trends and social indicators, reductions of 37% and 24% for inpatient care and 11% and 21% for outpatient care were shown in the Stockholm and Jönköping counties, respectively, compared to the rest of Sweden. The social gradient was maintained for inpatient care, but increased for paediatric outpatient care in Stockholm after the vaccine was introduced. Conclusions: This thesis showed reductions of paediatric care of gastroenteritis in small children by the rotavirus vaccine in two Swedish counties. The thesis also showed that it is important to maintain our child health care organization built around child health care centers if we are to achieve high and socially equitable vaccine coverages for the rotavirus vaccine when it is nationally implemented. In addition, other interventions may be needed to support the introduction of the rotavirus vaccine so that we can reduce the impact that social factors have on its potential uptake. Such supportive interventions would include both targeted information and overall policy changes that focus on parents with low health literacy. The thesis also presented that the quality of the diagnosis of intussusception in children under three years of age in the Swedish Patient Register is high, as a prerequisite for further studies. A robust safety surveillance of the newly introduced rotavirus vaccine will also be important so that we can maintain the high levels of trust that the public already have in Swedish child health care nurses and the country’s preventive health care program.
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| 10. |
- Sjögren, Eva, et al.
(författare)
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Parental conceptions of the rotawirus vaccine during implementation in Stockholm: A phenomenographic study
- 2017
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Ingår i: Journal of Child Health Care. - : SAGE Publications. - 1367-4935 .- 1741-2889. ; 21:4, s. 476-487
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Tidskriftsartikel (refereegranskat)abstract
- In 2014, Stockholm became the first Swedish county to introduce the rotavirus vaccine, which is given from as early as six weeks of age. The aim of this study was to describe parental conceptions of rotavirus infection and vaccination during its implementation as part of the child immunization program, as their support is vital for any new vaccine. The study followed a descriptive, qualitative design with a phenomenographic approach. Ten in-depth interviews with parents were conducted in Stockholm County, transcribed and analyzed to describe qualitatively different conceptions of rotavirus infection and vaccination. Four main categories were identified: to vaccinate without doubt, hesitant to vaccinate, risky to vaccinate, and unnecessary to vaccinate. All the parents had in common the desire to protect their children from suffering, either by vaccinating their child in order to avoid rotavirus infection or by not vaccinating their child because of concerns about the side effects. It is important that child health-care professionals understand the variations of conceptions that influence the parents' decisions and that these conceptions may differ considerably. Individualized parental information about rotavirus infection and vaccination would help to achieve a successful implementation of the vaccination program.
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