| 1. |
- Dencker, Anna, 1956, et al.
(författare)
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Adopting a healthy lifestyle when pregnant and obese – an interview study three years after childbirth.
- 2016
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Background Obesity during pregnancy is increasing and is related to life-threatening and ill-health conditions in both mother and child. Initiating and maintaining a healthy lifestyle when pregnant with body mass index (BMI)≥30 kg/m2 can improve health and decrease risks during pregnancy and of long-term illness for the mother and the child. To minimise gestational weight gain women with BMI≥30 kg/m2 in early pregnancy were invited to a lifestyle intervention including advice and support on diet and physical activity in Gothenburg, Sweden. The aim of this study was to explore the experiences of women with BMI≥30 kg/m2 regarding minimising their gestational weight gain, and to assess how health professionals’ care approaches are reflected in the women’s narratives. Methods Semi-structured interviews were conducted with 17 women who had participated in a lifestyle intervention for women with BMI≥30 kg/m2 during pregnancy 3 years earlier. The interviews were digitally recorded and transcribed in full. Thematic analysis was used. Results The meaning of changing lifestyle for minimising weight gain and of the professional’s care approaches is described in four themes: the child as the main motivation for making healthy changes; a need to be seen and supported on own terms to establish healthy routines; being able to manage healthy activities and own weight; and need for additional support to maintain a healthy lifestyle. Conclusions To support women with BMI≥30 kg/m2 to make healthy lifestyle changes and limit weight gain during pregnancy antenatal health care providers should 1) address women’s weight in a non-judgmental way using BMI, and provide accurate and appropriate information about the benefits of limited gestational weight gain; 2) support the woman on her own terms in a collaborative relationship with the midwife; 3) work in partnership to give the woman the tools to self-manage healthy activities and 4) give continued personal support and monitoring to maintain healthy eating and regular physical activity habits after childbirth involving also the partner and family.
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| 2. |
- Dencker, Anna, 1956, et al.
(författare)
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Support to adopt a healthy lifestyle for pregnant women with BMI > 30
- 2016
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Ingår i: The NJF Congress (Nordiskt Jordemorförbund), Gothenburg, 12-14 May 2016. - 9789163742699
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Konferensbidrag (refereegranskat)abstract
- Background A change towards healthy habits during pregnancy and in early motherhood, including weight control, increased physical activity and optimal diet habits will promote health for the woman with body mass index (BMI) ≥ 30 kg/m2, her fetus/ child, as well as for the whole family. To optimise a healthy lifestyle from early pregnancy in women with BMI ≥ 30 kg/m2 an intervention called Mighty Mums, including advice and support on diet and physical activity was carried out in the maternity health care in Gothenburg, Sweden. . Aim To explore women´s experiences 3 years after participating in a lifestyle intervention targeting pregnant women with BMI ≥ 30 kg/m2. Methods Qualitative interviews were performed with 17 mothers who had participated in a lifestyle intervention 3 years earlier. The interviews were semi-structured and thematic analysis was used. Results All interviews were transcribed verbatim and read in full in the first analysis step. Second, initial codes were identified in the data. All features with a meaning were coded and initial codes were condensed and formed four themes. Conclusions The expected child was the main motivation for the women to participate in the intervention. The women needed to be seen and get personal support from the antenatal health care midwife and receive help to be able to control the selection and implementation of healthy activities. Extra support during pregnancy helped temporarily but there was still a need of support to maintain a healthy lifestyle in the long run.
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| 3. |
- Nilvér, Helena, et al.
(författare)
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Women's childbirth experiences in the Swedish Post-term Induction Study (SWEPIS) : a multicentre, randomised, controlled trial
- 2021
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 11:4
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare childbirth experiences in women randomly assigned to either induction of labour at 41 weeks or to expectant management until 42 weeks, in the Swedish Post-term Induction Study.DESIGN: A register-based, multicentre, randomised, controlled, superiority trial.SETTING: Women were recruited at 14 hospitals in Sweden, 2016-2018.PARTICIPANTS: Women with an uncomplicated singleton pregnancy were recruited at 41 gestational weeks.INTERVENTIONS: The women were randomly assigned to induction of labour at 41 weeks (induction group, n=1381) or expectant management until 42 weeks (expectant management group, n=1379).OUTCOME MEASURES: As main outcome, women's childbirth experiences were measured using the Childbirth Experience Questionnaire version 2 (CEQ2), in 656 women, 3 months after the birth at three hospitals. As exploratory outcome, overall childbirth experience was measured in 1457 women using a Visual Analogue Scale (VAS 1-10) within 3 days after delivery at the remaining eleven hospitals.RESULTS: The total response rate was 77% (2113/2760). There were no significant differences in childbirth experience measured with CEQ2 between the groups (induction group, n=354; expectant management group, n=302) in the subscales: own capacity (2.8 vs 2.7, p=0.09), perceived safety (3.3 vs 3.2, p=0.06) and professional support (3.6 vs 3.5, p=0.38) or in the total CEQ2 score (3.3 vs 3.2, p=0.07), respectively. Women in the induction group scored higher in the subscale participation (3.6 vs 3.4, p=0.02), although with a small effect size (0.19). No significant difference was observed in overall childbirth experience according to VAS (8.0 (n=735) vs 8.1 (n=735), p=0.22). CONCLUSIONS: There were no differences in childbirth experience, according to CEQ2 or overall childbirth experience assessed with VAS, between women randomly assigned to induction of labour at 41 weeks or expectant management until 42 weeks. Overall, women rated their childbirth experiences high.TRIAL REGISTRATION NUMBER: ISRCTN26113652.
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| 4. |
- Hadžibajramović, Emina, 1977, et al.
(författare)
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Burnout among midwives—the factorial structure of the burnout assessment tool and an assessment of burnout levels in a Swedish national sample
- 2022
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Many workplaces, within the healthcare sector, experience high rates of mental health problems such as burnout, anxiety, and depression, due to poor psychosocial working conditions and midwives are not an exception. To develop preventive interventions, epidemiologic surveillance of burnout levels, and their relation to professional specific working conditions is needed. Aims of this study is to assess the construct validity of the Burnout Assessment Tool (BAT) in the context of Swedish midwives, to evaluate whether the item responses can be combined into a single score and differential item functioning regarding age. Another aim was to assess the burnout levels of Swedish midwives. Methods: Data come from a national cohort of Swedish midwives (n = 1664). The construct validity was evaluated using Rasch analysis. Burnout levels were presented by median and first (Q1) and third (Q3) quartiles for the BAT total score and the four subscales (exhaustion, mental distance, cognitive and emotional impairment). Results: In the analysis including all 23 items the fit to the Rasch model was not obtained. Items within each subscale clustered together in a residual correlation matrix in a pattern consistent with the underlying conceptualization of the BAT, indicating multidimensionality. The Rasch analysis was re-run using the four testlets as input variables which resulted in a good fit. The median burnout level was 2.0 (Q1 = 1.6, Q3 = 2.4). The four subscales differentiated the picture (elevated levels on exhaustion and low levels on the other three subscales). Conclusions: The construct validity of the BAT for use in the context of Swedish midwives was confirmed. The results indicated a strong general factor, meaning that the responses can be combined into a single burnout score. The scale works invariantly for different age groups. The results of this study secure access to a validated instrument to be used for accurate assessment of the burnout levels among midwives in Sweden.
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| 6. |
- 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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| 7. |
- 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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| 8. |
- 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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| 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 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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| 10. |
- 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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