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- Larsson, E., et al.
(författare)
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The Swedish study on improved contraceptive counselling for immigrant women postpartum
- 2020
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Ingår i: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 30:Supplement_5
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Contraceptive choices postpartum have not previously been studied in Sweden. Being foreign born is a risk factor for induced abortion. Improving postpartum contraceptive counseling could potentially fulfill unmet needs for contraception.This is an organizational case study using a Quality Improvement Collaborative (QIC) within the regular healthcare setting at 3 maternal health clinics in Stockholm. The active phase of the study was Sep2018-Sep2019. Quantitative and qualitative methods were combined. Routine registration of choice of postpartum contraception was introduced at the clinics and analyzed focusing on Swedish born and foreign-born women. Midwives and researchers met continuously, and during the active phase every 2-3 months in learning seminars with around 20 participants. During the learning seminars PDSA-cycles were used and areas of improvements for continuous performance measures were chosen. The midwives decided on and tested multiple evidence-based changes in contraceptive counselling and services during action periods. Goals were set and competency building in areas chosen by the midwifes were held. In addition, both foreign- and Swedish born women gave their input to the improvement areas. Qualitative data was analyzed through content analysis from field notes and verbatim transcripts.Preliminary results show that the proportion of women choosing an effective contraceptive method (SARC or LARC) among immigrant women increased from 40% to 55% when comparing the start and the end of the project. The midwives reported how they had changed their approach when counselling women who were skeptical about contraception and tried to find a new way to meet women's needs.As much as the QIC showed positive results, it was a small-scale study in 3 clinics in one geographical area. A larger study to determine and explain the effectiveness of QIC on the proportion of immigrant women choosing an effective contraceptive method postpartum is planned for 2021-2024.
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- Weinryb, RM, et al.
(författare)
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Reliability of the Karolinska Psychodynamic Profile (KAPP) among patients with and without psychoactive substance abuse disorders
- 1998
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Ingår i: Psychotherapy and psychosomatics. - : S. Karger AG. - 0033-3190 .- 1423-0348. ; 67:1, s. 10-16
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Tidskriftsartikel (refereegranskat)abstract
- <b>Background: </b>The Karolinska Psychodynamic Profile (KAPP) is a rating instrument, based on psychoanalytic theory, that assesses different aspects of character from clinical interviews. The aim of the present study was to examine interrater reliability of the KAPP in a sample of patients with and without psychoactive substance abuse disorders, using interviewers and a reliability judge who had not been trained by the developers of the instrument. <b>Methods: </b>The sample comprised 47 consecutive patients with and without psychoactive substance abuse disorders, who were referred to an outpatient psychotherapy unit specializing in the treatment of substance abuse and dependence. The two interviewers and the reliability judge had not been trained by the developers of the KAPP, and they worked outside the setting where it was constructed. <b>Results: </b>The intraclass correlations were satisfactory for the total sample (mean 0.84, median 0.89, range 0.62–0.95), as well as for various subsamples, such as males and females, and patients with and without substance abuse disorders. <b>Conclusions: </b>The results show that interviewers and a reliability judge who had not been trained by the developers of the KAPP can attain high interrater reliability in a sample of patients with substance abuse disorders. Some recommendations for conducting KAPP interviews are given.
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