| 1. |
- Berg, Marie, 1955, et al.
(författare)
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Att bli förälder
- 2010
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Ingår i: Att stödja och stärka : vårdande vid barnafödande / Marie Berg, Ingela Lundgren (red.). - 9789144068206 ; , s. 69-84
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Bokkapitel (refereegranskat)
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| 2. |
- Berg, Marie, 1955, et al.
(författare)
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Caesarean section rate reduced by a redesigned birthing room. Results of a quality improvement intervention at a hospital in Democratic Republic of Congo
- 2024
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Ingår i: SEXUAL & REPRODUCTIVE HEALTHCARE. - 1877-5756 .- 1877-5764. ; 39
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate the influence of a new birthing room at a tertiary hospital in eastern Democratic Republic of Congo (DRC), on the caesarean section (CS) rate in women classified as Robson group 1, i.e., nulliparous women at term with spontaneous onset of labour of one foetus in cephalic presentation.Method: As part of quality improvement interventions, a new birthing room designed to promote personcentredness was constructed at the labour ward at Panzi General Referral Hospital in DRC. In a quasiexperimental study on women classified as Robson 1, a comparison was performed between the group being cared for in the new birthing room and the group being cared for in the general birthing room. The main outcome measure was CS rate.Results: In the new person-centred birthing room, the CS rate was 17.1 % versus 28.4 % in women cared for in the general birthing room (p-value 0.001). There was also a higher presence of accompanying persons (p-value < 0.0001) and less use of synthetic oxytocin for the augmentation of labour (p-value 0.024). No difference in fear and childbirth experience was identified between women in the two rooms.Conclusion: The results demonstrate that it is possible, in a low-income country as the Democratic Republic of Congo, to reduce the CS rate in women classified as Robson 1 by adapting the birthing environment to be more person-centred, without compromising other obstetric and neonatal outcomes.
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| 3. |
- Berg, Marie, 1955, et al.
(författare)
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Minimizing pregnancy weight gain in women with obesity - a challenge for midwives
- 2017
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Ingår i: 31st International Confederation for Midwives Triennal Conference, 18-22 June, Toronto, Canada.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Maternal Obesity is an increasing ill health issue associated with increased risk of complications for mother and child, both in a short perinatal perspective and in a life-long perspective. The risk aggravates with increasing maternal BMI and aggravates with increasing gestational weight gain. Purpose/Objective: To investigate whether a lifestyle intervention project at primary care level, offered by midwives to pregnant women with BMI ≥30 would lower gestational weight gain and lower BMI at 3 months after childbirth. Secondary aims were to study if such intervention had positive impact on maternal and child health, to assess the cost efficacy of the intervention, and to explore participating women´s respectively midwives’ experiences. Method: The project was performed years 2011-2013 in Gothenburg, Sweden as a case control study of pregnant women with BMI ≥30 in early pregnancy (n=1165). A control group (n=700) got usual care. Intervention group (n=465) were offered 1) systematised counselling, motivational sessions with midwife concerning nutrition and physical activity 2) group discussions and completing food diary with dietician, 3) aqua aerobics class with midwife/physiotherapist 4) guidance to suitable and locally available health activities 5) availability of pedometers and walking poles. Key Findings: A pilot study show significant positive effect (±SD) on gestational weight gain in the intervention group (8.6±4.9 kg vs. 12.5±5.1kg), and significant better maternal weight at the postnatal checkup. A greater proportion of the intervention group restricted their gestational weight gain to < 7 kg (36% vs. 16%). Full findings will be presented at conference comprising: main outcome whole group (n=1165), cost effectiveness of intervention, and experiences of participating midwives and women. Discussion: To establish good evidence based routines for pregnant women with obesity is important and especially by midwives. This study will inform us if this relatively low intensive intervention can improve maternal and child health in pregnancy, childbirth and first months postpartum. References: Haby K, Glantz A, Hanås R, Premberg Å. Mighty Mums - An antenatal health care intervention can reduce gestational weight gain in women with obesity. Midwifery 2015; 31 (7):685- 692. Marchi, J., Berg, M., Dencker, A., Olander, E. K., & Begley, C. Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews. Obes. Rev. 2015;16(8):621-38. doi: 10.1111/obr.12288. Epub 2015 May 28.
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| 4. |
- Berg, Urban, et al.
(författare)
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Fast-track program of elective joint replacement in hip and knee - Patients' experiences of the clinical pathway and care process
- 2019
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Ingår i: Journal of Orthopaedic Surgery and Research. - : Springer Science and Business Media LLC. - 1749-799X. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The clinical pathway and care program in elective total hip and knee replacement (THR/TKR) has, during the last decade, undergone considerable changes in many countries influenced by the concept of fast-track surgery, resulting in a very short hospital stay. Studies into patients' experiences of the entire fast-track program, from decision-making regarding surgery until recovery 3 months after surgery, are lacking. The aim of the study was to increase the knowledge about patients' experiences of the clinical pathway and care in a fast-track program of elective THR/TKR in order to identify factors that may influence recovery and clinical outcome. Methods: A qualitative research design was chosen with data collected from interviews 3 months after surgery and analyzed using an inductive content analysis method. In total, 24 patients from three hospitals with a fast-track care program were included in the study: 14 women and 10 men, 13 with THR and 11 with TKR. The mean age was 65 years (range 44-85). Results: The analysis identified three chronological phases in the clinical pathway: preparation, hospital stay for surgery, and recovery. In the preparation phase, patients' experiences and involvement in the planning of the operation were highlighted. The need to know the risks and expectations of recovery and outcome were also central, although there was great diversity in needs for information and involvement. In the hospital stay for the surgery phase, there were mainly positive experiences regarding admission, early mobilization, and early discharge. Experiences about the recovery phase focused on management of daily life, rehabilitation program, and recovery. Rehabilitation involved uncertainty as to whether or not the progress was normal. The recovery phase was also filled with questions about unfulfilled expectations. Regardless of the different phases, we found the importance of a person-centered care to be a pervasive theme. Conclusion: Our study supports the view that a person-centered approach, from surgery decision until recovery, is an important element in optimizing care in a THR and TKR fast-track care program. More focus on the period after hospital discharge may improve recovery, patient satisfaction, and functional outcome. © 2019 The Author(s).
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| 5. |
- Carlsson, Ing-Marie, 1961-, et al.
(författare)
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Reprioritizing life : A conceptual model of how women with type 1 diabetes deal with main concerns in early motherhood
- 2017
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - Abingdon : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 12:Sup. 2
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Becoming a mother is related to increased demands for women with type 1 diabetes mellitus, and more research is needed to identify their needs for support in everyday living. Thus, the aim of this study was to explore the main concerns in daily life in early motherhood for women with type 1 diabetes and how they deal with these concerns.Method: A grounded theory study was conducted in which 14 women with type 1 diabetes were interviewed individually 7 to 17 months after childbirth.Results: A conceptual model was identified with the core category “reprioritizing life”, and three related categories: adjusting to motherhood, taking command of the diabetes, and seeking like-minded women. Becoming a mother was a turning point towards a greater awareness and acceptance of prioritizing diabetes management and health, and thus, life. There was a gap in provision of diabetes care after birth and during the time of early motherhood compared with during pregnancy.Conclusions: Healthcare contacts already planned before delivery can promote person-centred care during the whole period from pregnancy to motherhood. Moreover, providing alternative sources for health information and peer support could improve the life situation during early motherhood.
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| 6. |
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| 7. |
- Carlsson-Lalloo, Ewa, et al.
(författare)
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People living with HIV in Sweden report high levels of sexual satisfaction in a registry-based cohort study
- 2021
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Ingår i: AIDS Care. - : Routledge. - 0954-0121 .- 1360-0451.
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Tidskriftsartikel (refereegranskat)abstract
- Sexual satisfaction can be challenging for people living with HIV (PLWH). To investigate self-reported sexual satisfaction in PLWH and its association with HIV-related biomarkers, a retrospective observational cohort study with data on sociodemographic characteristics and changes in PLWH’s assessment of their sexual satisfaction over time were retrieved from the Swedish National Quality Assurance Registry (InfCareHIV) where patient-related outcomes are reported annually. PLWH who had assessed self-reported sexual satisfaction 2011–2016 were included. Sexual satisfaction was dichotomized into sexual “satisfaction and dissatisfaction” and associations were analysed. In total, 3798 patients (66% men) answered 8202 questionnaires. Overall, 67% reported sexual satisfaction, with women more satisfied than men (72% vs 64%, p < 0.0001). Sexual satisfaction did not differ between patients on antiretroviral treatment (ART) >6 months whether the viral load was suppressed or not. Overall, the probability of reporting sexual satisfaction increased by 4% annually (p < 0.001). This increase may be explained by evolving knowledge about the minimal risks of sexual HIV transmission when on ART together with Sweden’s concomitant revision of legal restrictions. The use of patient-related outcomes in clinical practice is an important tool for facilitating conversations about sexuality in order to promote the health and well-being of PLWH. © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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| 8. |
- Carlsson-Lalloo, Ewa, 1976, et al.
(författare)
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Sexual satisfaction and its associations with patient-reported outcomes in a cohort of women living with human immunodeficiency virus in Sweden
- 2022
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Ingår i: International Journal of Std & Aids. - : SAGE Publications. - 0956-4624 .- 1758-1052. ; 33:8
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sexual satisfaction is an important dimension of health-related quality of life that needs to be addressed. Various factors may influence sexual satisfaction in women living with HIV (WLHIV); however, research in this area is limited. The aim of this study was to investigate patients' self-reported sexual satisfaction and its associations with patient-reported outcomes in WLHIV in Sweden. Methods: Data was retrieved from the InfCareHIV registry for the years 2011-2016. The registry includes a self-reported validated 9-item health questionnaire to assess patient-reported outcomes, side effects and adherence. In total, 1292 WLHIV aged >= 18 years were included, corresponding to 42.8% of the female Swedish InfCareHIV cohort 2011-2016. A total of 2444 questionnaires were included in the study. The patient-reported outcomes used were satisfaction with physical health and psychological health, sexual satisfaction, and experiencing side effects from HIV-medication. Associations were tested in univariable and multivariable models. Results: The study shows that there was a significant association between sexual satisfaction and satisfaction with psychological health (p <= 0.0001). There was a lower probability of reporting sexual satisfaction in women who were of an older age when they received an HIV-diagnosis (p = 0.033), who had lived for more years with HIV (p = 0.0004), or who had experienced side effects (p = 0.028). Conclusions: This national register-based study identified that sexual satisfaction in WLHIV is associated with psychological health and with having experienced side-effects. Patient-reported outcomes can provide valuable information so that the care of WLHIV covers all aspects of health and supports sexual satisfaction, which is an important part of quality of life.
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| 9. |
- Carlsson-Lalloo, Ewa, 1976, et al.
(författare)
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Sexuality and childbearing as it is experienced by women living with HIV in Sweden: a lifeworld phenomenological study
- 2018
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Ingår i: International Journal of Qualitative Studies on Health and Well-Being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- The effectiveness of antiretroviral treatment has reduced sexual HIV transmission and motherto-child-transmission. To optimally support women living with HIV, health care providers need deepened knowledge about HIV, sexuality and childbearing. The aim of this study was to describe the phenomenon sexuality and childbearing as experienced by women living with HIV in Sweden. Data were collected by phenomenon-oriented interviews with 18 HIV-positive women. A reflective lifeworld analysis based on phenomenological philosophy was conducted, describing the meaning structure of the phenomenon. The essence of the phenomenon is that perceptions about HIV and its contagiousness profoundly influence sexual habits and considerations in relation to pregnancy and childbearing. These perceptions are formed in combination with knowledge and interpretations about HIV by the women themselves and by their environments. The essence is further described by its constituents: Risk of transmission imposes demands on responsibility; The contagiousness of HIV limits sexuality and childbearing; Knowledge about HIV transmission provides confident choices and decisions; and To re-create sexuality and childbearing. Although HIV has a low risk of transmission if being well treated, our study shows that HIV-positive women feel more or less contagious, which influences sexuality and decision-making in relation to become pregnant and give birth.
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| 10. |
- Carlsson-Lalloo, Ewa, 1976, et al.
(författare)
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Sexuality and Reproduction in HIV-Positive Women: A Meta-Synthesis
- 2016
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Ingår i: AIDS Patients Care and STDs. - : Mary Ann Liebert Inc. - 1087-2914 .- 1557-7449. ; 30:2, s. 56-69
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Tidskriftsartikel (refereegranskat)abstract
- The increased access to effective antiretroviral treatment (ART) has made HIV comparable to a chronic disease in terms of life expectancy. Needs related to sexuality and reproduction are central to overall health and well-being. An interpretative meta-synthesis was performed to synthesize and assess how HIV-positive women’s experiences of sexuality and reproduction have been described in qualitative studies. A total of 18 peer-reviewed qualitative studies were included, which comprised a total of 588 HIV-positive interviewed women. The studies originated from resource-rich countries outside the Asian and African continents. The analysis, resulting in a lines-ofargument synthesis, shows that HIV infection was a burden in relation to sexuality and reproduction. The weight of the burden could be heavier or lighter. Conditions making the HIV burden heavier were: HIV as a barrier, feelings of fear and loss, whereas motherhood, spiritual beliefs, and supportive relationships made the HIV burden lighter. The findings are important in developing optimal health care by addressing conditions making the burden of HIV infection lighter to bear. In future research there is a need to focus not only on examining how HIV-positive women’s sexual and relationships manifest themselves, but also on how health care professionals should provide adequate support to the women in relation to sexuality and reproduction.
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| 11. |
- Carlsson-Lalloo, Ewa, 1976, et al.
(författare)
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Supportive conditions for sexual and perinatal wellbeing in women living with HIV in Sweden: A phenomenological study.
- 2021
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Ingår i: Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives. - : Elsevier BV. - 1877-5764 .- 1877-5756. ; 29
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Tidskriftsartikel (refereegranskat)abstract
- Women living with HIV have specific needs regarding sexuality, pregnancy, and childbirth. However, there is lack of knowledge about how these needs can be met. The aim of this study was to identify supportive conditions for sexual and perinatal wellbeing in women living with HIV in Sweden.A phenomenological reflective lifeworld research approach was used. Transcribed interviews with 18 women living with HIV in Sweden were analyzed focusing on the meanings of the study phenomenon.When living with HIV, "feeling safe with oneself and in relationships with others" is essential for sexual and perinatal wellbeing. This is constituted by having good overall health, being in a caring context, having access to high quality information about HIV, and being ensured the same rights as other women.The study shows that women living with HIV have specific needs for the support of their sexual and perinatal wellbeing. This knowledge can be used by all those engaged in HIV care and HIV prevention in order to improve and implement supportive conditions for women living with HIV. It is important that all those involved in the care of women living with HIV constantly update their knowledge about HIV and women's experiences of living with HIV in order to provide safe arenas and caring contexts that support the wellbeing of these women.
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| 12. |
- Carlsson-Lalloo, Ewa, 1976, et al.
(författare)
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Testing the feasibility of a translated and culturally adapted person-centred training programme in maternal and newborn healthcare in Democratic Republic of Congo: A process evaluation.
- 2024
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Ingår i: Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives. - 1877-5764. ; 40
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Tidskriftsartikel (refereegranskat)abstract
- Ensuring quality of maternal and newborn healthcare is challenging in the Democratic Republic of Congo (DRC) as the maternal and newborn mortality and morbidity rate is high. Essential for quality care is a person-centred approach. One model of person-centred care (PCC) has been developed at Gothenburg University. To support its implementation a training programme, "Mutual Meetings", has been developed. This study aims to test the feasibility of a translated and culturally adapted version of this PCC training programme for healthcare providers in the maternal and newborn healthcare context of DRC.The PCC programme was translated into French and tested in a workshop with 31 maternal and newborn healthcare providers in eastern DRC. The feasibility of the programme was evaluated through focus group interviews and individual interviews. The interview transcripts were analysed deductively using key components in a process evaluation framework including fidelity, dose, reach, adaptation, acceptability, and application.The French PCC programme exceeded the participants' expectations and was found being applicable in both teaching and clinical setting with some suggested contextual modifications. Its pedagogic structure including a participatory reflective approach, was perceived innovative and inspirational, mediated a sense of comfort, and enabled the participants to use a person-centred approach towards each other.The results show that the French on-site version of the PCC training programme was valid in terms of feasibility and how it was received by the participants. The study demonstrates the importance of contextual adaptation of complex interventions in new settings.
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| 13. |
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| 14. |
- 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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| 15. |
- 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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| 16. |
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| 17. |
- Gyllensten, Hanna, 1979, et al.
(författare)
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Cost effectiveness of a controlled lifestyle intervention for pregnant women with obesity.
- 2021
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Ingår i: BMC pregnancy and childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- The Mighty Mums antenatal lifestyle intervention is a person-centered behavioral intervention focusing on nutrition and physical activity for pregnant women with obesity (body mass index [BMI] ≥30). The aim of this study was to evaluate the costs and clinical outcomes of adding the Mighty Mums intervention to standard antenatal care.Participants in the intervention group (n=434) received motivational talks with their midwife and a selection of physical and/or nutritional activities in addition to antenatal care. Control participants (n=867) from adjacent geographic areas received standard antenatal care. Costs for staff, unit costs for specific activities, and registered costs for specialized antenatal care were analyzed for associations with gestational weight gain and self-reported health. Results are reported for the intention-to-treat (ITT) population and a per protocol (PP) population identified by participation in the intervention. Analyses included bootstrapped linear regressions adjusted for background characteristics that differed significantly between groups.The average costs were SEK 9727 higher (95% confidence interval [CI]: 6677 to 12,777) among participants in the intervention group than in the control ITT population and SEK 8655 (95% CI 4586 to 12,724) higher than in the PP population. The cost increase per 1kg reduction in gestational weight gain was SEK 12,369 in the ITT population and SEK 7209 for the PP population.Participation in the Mighty Mums intervention was associated with higher costs, but also reduced gestational weight gain. The cost per kilogram reduction in gestational weight gain was low, particularly in the PP population. A future decision to implement this behavioral intervention in standard care should take into account society's willingness to pay per unit reduction in gestational weight gain.The study is registered at ClinicalTrials.gov , Identifier: NCT03147079 .
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| 18. |
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| 19. |
- Haby, Karin, 1960, et al.
(författare)
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A Lifestyle Intervention During Pregnancy and Its Effects on Child Weight 2.5 Years Later
- 2022
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Ingår i: Maternal and Child Health Journal. - : Springer Science and Business Media LLC. - 1092-7875 .- 1573-6628. ; 26, s. 1881-1890
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this study was to evaluate if overweight and obesity in the offspring is reduced by a low-intensity antenatal primary care intervention with focus on diet and physical activity for pregnant women with obesity, comparing children to mothers receiving the intervention with children to mothers who did not. Methods: This study is a follow-up of children 2.5years of age after their mothers’ participation in a non-randomised controlled intervention intending to limit gestational weight gain. All study participants received standard antenatal care. The intervention group received lifestyle support via motivational talks with midwife and support from dietician. Data on child weight were collected by medical records, letter and phone. Results: There was no significant difference between the groups 2.5years after intervention (International Obesity Task Force ISO-BMI 25 (child BMI corresponding to adult BMI of 25): 20% vs. 21%; ISO-BMI 30: 4.6% vs. 1.3%). The mother’s BMI at the beginning of pregnancy significantly influenced child BMI at 2.5years (r = 0.13, p = 0.014, r2 = 0.017). For each unit of increase in maternal BMI at enrollment, the probability of child ISO-BMI ≥ 25 increased by 7.5% (p = 0.021) and of ≥ 30, by 12.9% (p = 0.017). Conclusion: The frequency of overweight and obesity of the children at 2.5years of age was significantly correlated to the mother’s BMI, but not correlated to the mothers’ participation in the antenatal lifestyle intervention. Thus, it seems important to address obesity and lifestyle issues before and between pregnancies. Trial registration The study has been registered at ClinicalTrials.gov, Identifier: NCT03147079.
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| 20. |
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| 21. |
- Haby, Karin, 1960, et al.
(författare)
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Lifestyle intervention in pregnant women with BMI ≥30
- 2018
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Ingår i: NEON, The Network in Epidemiology and Nutrition. From evidence to practice. April 18-19 2018.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background Obesity (BMI ≥30) during pregnancy is becoming an increasing public health issue and is associated with adverse maternal and perinatal outcomes. Excessive gestational weight gain (GWG) further increases the risks of adverse outcomes. However, lifestyle intervention can help pregnant women with obesity to limit their GWG. This study evaluated whether an antenatal lifestyle intervention programme for pregnant women with obesity, with emphasis on nutrition and physical activity, could influence GWG and maternal and perinatal outcomes. Methods The intervention was performed in a city in Sweden 2011–2013. The study population was women with BMI ≥30 in early pregnancy who received standard antenatal care and were followed until postpartum check-up. The intervention group (n = 459) was provided with additional support for a healthier lifestyle, including motivational talks with the midwife, food advice, prescriptions of physical activity, walking poles, pedometers, and dietician consultation. The control group was recruited from the same (n = 105) and from a nearby antenatal organisation (n = 790). Results In the per-protocol population, the intervention group had significantly lower GWG compared with the control group (8.9 ± 6.0 kg vs 11.2 ± 6.9 kg; p = 0.031). The women managed to achieve GWG <7 kg to a greater extent (37.1% vs. 23.0%; p = 0.036) and also had a significantly lower weight retention at the postpartum check-up (-0.3 ± 6.0 kg vs. 1.6 ± 6.5 kg; p = 0.019) compared to the first visit. The most commonly used components of the intervention, apart from the extra midwife time, were support from the dietician and retrieval of pedometers. Overall compliance with study procedures, actual numbers of visits with logbook activity, and dietician contact correlated significantly with GWG. There was no statistically significant difference in GWG (10.3 ± 6.1 kg vs. 11.2 ± 6.9 kg) between the intervention and control groups in the intention-to-treat population. Conclusion Pregnant women with obesity who follow a lifestyle intervention programme in primary health care can limit their weight gain during pregnancy and show less weight retention after pregnancy. This modest intervention can easily be implemented in a primary care setting.
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| 22. |
- Haby, Karin, 1960, et al.
(författare)
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Mighty Mums - a Lifestyle intervention at primary care level reduces gestational weiht gain in women with obesity
- 2018
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Ingår i: BMC Obesity. - : Springer Science and Business Media LLC. - 2052-9538. ; 5:16
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Tidskriftsartikel (refereegranskat)abstract
- Background Obesity (BMI ≥30) during pregnancy is becoming an increasing public health issue and is associated with adverse maternal and perinatal outcomes. Excessive gestational weight gain (GWG) further increases the risks of adverse outcomes. However, lifestyle intervention can help pregnant women with obesity to limit their GWG. This study evaluated whether an antenatal lifestyle intervention programme for pregnant women with obesity, with emphasis on nutrition and physical activity, could influence GWG and maternal and perinatal outcomes. Methods The intervention was performed in a city in Sweden 2011–2013. The study population was women with BMI ≥30 in early pregnancy who received standard antenatal care and were followed until postpartum check-up. The intervention group (n = 459) was provided with additional support for a healthier lifestyle, including motivational talks with the midwife, food advice, prescriptions of physical activity, walking poles, pedometers, and dietician consultation. The control group was recruited from the same (n = 105) and from a nearby antenatal organisation (n = 790). Results In the per-protocol population, the intervention group had significantly lower GWG compared with the control group (8.9 ± 6.0 kg vs 11.2 ± 6.9 kg; p = 0.031). The women managed to achieve GWG <7 kg to a greater extent (37.1% vs. 23.0%; p = 0.036) and also had a significantly lower weight retention at the postpartum check-up (-0.3 ± 6.0 kg vs. 1.6 ± 6.5 kg; p = 0.019) compared to the first visit. The most commonly used components of the intervention, apart from the extra midwife time, were support from the dietician and retrieval of pedometers. Overall compliance with study procedures, actual numbers of visits with logbook activity, and dietician contact correlated significantly with GWG. There was no statistically significant difference in GWG (10.3 ± 6.1 kg vs. 11.2 ± 6.9 kg) between the intervention and control groups in the intention-to-treat population. Conclusion Pregnant women with obesity who follow a lifestyle intervention programme in primary health care can limit their weight gain during pregnancy and show less weight retention after pregnancy. This modest intervention can easily be implemented in a primary care setting.
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| 23. |
- Haby, Karin, 1960, et al.
(författare)
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Mighty Mums; can a ifestyle intervention for pregnant women with obesity have positive effects on weight gain during pregnancy?l
- 2016
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Ingår i: SAPC, Society for Academic Primary Care, Dublin, 8th of July, 2016.
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Konferensbidrag (refereegranskat)abstract
- The problem Maternal obesity is an increasing public health issue and 13% of women in antenatal care (AC) in Sweden have obesity (BMI≥30). The risk of complications during pregnancy and delivery, and for the child, increases with increasing BMI and is aggravated if the gestational weight gain (GWG) is high. From a public health perspective, the burden of obesity for the woman and her family is a challenge considering the complexity of factors associated with lifestyle choices and the impact on health care resources. The Approach A controlled low intensive lifestyle project, Mighty Mums (MM), was performed in a primary care setting in Gothenborg, Sweden, directed to pregnant women with BMI ≥30. All study participants (n=1165) received standard AC, and the intervention group (n= 465) additionally received support for changing to a more healthy life style. A log was used to register weight, activity and food. The primary aim was to evaluate whether a systematised counselling with the midwife, support from dietician, active guidance to local health centers and availability of pedometers and walking poles, can result in lower mean GWG and lower weight and BMI at the postnatal check-up. Findings A previously presented analysis of a pilot group of 50+50 women showed significant effect on GWG (8.6±4.9 kg vs. 12.5±5.1kg; p=0.001) in the intervention group, among whom a greater proportion managed to restrict their GWG to less than 7 kg (36% vs. 16%; p=0.039). The result from the full scale study will be presented and discussed at the conference. Consequences Our pilot study showed that with a modest and economically realistic effort - done with simple measures possible to adhere to also after the pregnancy - it is possible to guide the woman in AC towards lifestyle changes that decreases GWG. A project like MM would be of great advantage if incorporated in the regular AC, not only for the health of mothers and babies. This requires a general consensus in the health care organisation that obesity and overweight are important issues, and that the management of AC is supportive and implements an effective method of taking care of the women with overweight and obesity in routine AC.
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| 24. |
- Josefsson, Ulrika, 1965, et al.
(författare)
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Person-centred web-based support - development through a Swedish multi-case study.
- 2013
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Ingår i: BMC medical informatics and decision making. - : Springer Science and Business Media LLC. - 1472-6947. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Departing from the widespread use of the internet in modern society and the emerging use of web applications in healthcare this project captures persons' needs and expectations in order to develop highly usable web recourses. The purpose of this paper is to outline a multi-case research project focused on the development and evaluation of person-centred web-based support for people with long-term illness. To support the underlying idea to move beyond the illness, we approach the development of web support from the perspective of the emergent area of person-centred care. The project aims to contribute to the ongoing development of web-based supports in health care and to the emerging field of person-centred care.Methods/designThe research design uses a meta-analytical approach through its focus on synthesizing experiences from four Swedish regional and national cases of design and use of web-based support in long-term illness. The cases include children (bladder dysfunction and urogenital malformation), young adults (living close to persons with mental illness), and two different cases of adults (women with breast cancer and childbearing women with type 1 diabetes). All of the cases are ongoing, though in different stages of design, implementation, and analysis. This, we argue, will lead to a synthesis of results on a meta-level not yet described.
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| 25. |
- Mukwege, Denis, 1955, et al.
(författare)
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A Holistic, Person-Centred Care Model for Victims of Sexual Violence in Democratic Republic of Congo: The Panzi Hospital One-Stop Centre Model of Care
- 2016
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Ingår i: PLoS Medicine. - : Public Library of Science (PLoS). - 1549-1277 .- 1549-1676. ; 13:10
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Tidskriftsartikel (refereegranskat)abstract
- - One-Stop Centre (OSC) is an innovative, holistic, person-centred care model developed in recent years for survivors of violence against women and girls. - OSC at Panzi Hospital in eastern Democratic Republic of Congo has been developed after years of treating girls and women who have been raped in combination with extreme bodily harm. - OSC comprises four pillars, covering medical, psychosocial, legal, and socioeconomic care needs, which are fulfilled in partnership. Based on genuine listening to a harmed girl’s or woman’s personal narrative, personalised care is planned, implemented, and documented with the aim of achieving health and reintegration in society. - OSC gives more than holistic individual care; it provides a platform for achieving a healthy life at the micro- (the person) and meso- (local society) levels and, if conscientiously and systematically implemented in all health care structures, facilitates achievement of the right to health for all on the macro (national) level.
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| 26. |
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| 27. |
- Olander, Ellinor K., et al.
(författare)
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Offering weight management support to pregnant women with high body mass index: A qualitative study with midwives
- 2019
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Ingår i: Sexual and Reproductive Healthcare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 20, s. 81-86
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Tidskriftsartikel (refereegranskat)abstract
- © 2019 Objective: The prevalence of pregnant women with high body mass index is increasing worldwide. High body mass index is associated with health risks for mother and baby and supporting healthy gestational weight gain is important. Midwives play an important role in supporting women to engage in behaviours such as healthy eating and physical activity. The aim of this study was to explore how midwives’ support pregnant women with high body mass index to establish a healthy lifestyle with emphasis on nutrition and physical activity in order to minimise gestational weight gain. Methods: Semi-structured interviews were conducted with 16 midwives working in antenatal health care in Sweden. Interviews were conducted shortly after new guidelines on care for pregnant women with high body mass index had been introduced. The interviews were recorded, transcribed and analysed by thematic analysis. Results: Three main themes were identified; use a conscious approach, invite to participate and have a long-term health perspective. Midwives built a relationship with a woman through identifying her concerns and circumstances, before sensitively discussing weight. Some midwives used Motivational Interviewing to help women identify their own resources. To reach long-term health benefits, midwives set achievable goals with the women. Conclusion: These study findings provide practical examples of how midwives can support women with weight management during pregnancy. Through being sensitive when developing a relationship, midwives enabled the women to identify their own resources and achievable goals. Support after the baby is born is needed subsequently to help women maintain their healthy behaviour changes.
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| 28. |
- Premberg, Åsa, 1955, et al.
(författare)
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Can a lifestyle intervention for pregnant women with obesity have positive effects on weight gain during pregnancy?
- 2016
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Ingår i: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-661X .- 1654-6628.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background & aims Maternal obesity is becoming an increasing global public health issue, and the adverse effects on mother and child are substantial.1 In Sweden, 25% of women have overweight (BMI>25-29.9) and 13% obesity (BMI ≥30) at the onset of pregnancy.2 Objectives To evaluate the Mighty Mums project3 , a low intensive lifestyle intervention directed to pregnant women with BMI ≥30, with the primary aim to reduce gestational weight gain to less than 7 kg. Material & methods A controlled intervention study was conducted in 2011-2013 in Gothenburg, Sweden. All study participants (n=1165) received standard antenatal care, and the intervention group (n= 465) additionally received support to change to a more healthy life style, including physical activity and healthy eating. A log was used throughout pregnancy to register weight, activity and food. Data was derived from medical records during pregnancy until postnatal check up and from the birth register. Results and Conclusion Analysis of a pilot group showed significant effect on gestational weight gain (8.6±4.9 kg vs. 12.5±5.1kg; p=0.001) in the intervention group, among whom a greater proportion managed to restrict their gestational weigh gain to less than 7 kg (36% vs. 16%; p=0.039).3 The result from the full scale study will be presented and discussed at the conference.
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| 29. |
- Premberg, Åsa, 1955, et al.
(författare)
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Can a Lifestyle intervention for pregnant women with obesity have positive effects on weight gain during pregnancy?
- 2016
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Ingår i: Abstract Book, NNC Nordic Nutrition Conference, Gothenburg, 20-22th of June, 2016.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background and aims: Maternal obesity is increasing and 13% of women assigned to antenatal care (AC) in Sweden have BMI≥30. The risk of complications during pregnancy and delivery, and for the child, increases with increasing BMI and is aggravated by high gestational weight gain (GWG). It is crucial to reduce the burden of adverse maternal and foetal outcomes by minimizing GWG. In this study - Mighty Mums (MM) - a coordinated project with standardized care, given by midwives and supported by dietician and aiming at reducing GWG in obese pregnant women, is evaluated. Methods: All study participants (n=1165) received standard AC, and the intervention group (n=465) additionally received two extra sessions with the midwife and optional offer of activities towards a more healthy life style: food advice, prescription of physical activity, meetings with a dietician, active guidance to local health centers, pedometers, walking poles. A log was used throughout pregnancy to register weight, activity, food, thoughts and feelings. The control groups consisted of women (n=104) getting standard AC followed prospectively, and women (n=700) from adjacent geographical areas followed retrospectively using register data. Results: A previously presented analysis of a pilot group of 50+50 women showed significant effect on GWG (8.6±4.9 kg vs. 12.5±5.1kg) in the intervention group, and a significantly lower weight at the postnatal checkup vs. the first contact with AC (-0.2 ± 5.7 kg vs. +2.0 ± 4.5 kg). A greater proportion of MM also managed to restrict their GWG to less than 7 kg (36% vs. 16%). The result from the full scale study will be presented and discussed at the conference. Conclusion: Our pilot study showed that it is possible to guide the woman in AC towards lifestyle changes that decrease GWG, with a modest and economically realistic effort with simple measures, and we expect similar results from the full study.
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| 30. |
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| 31. |
- Premberg, Åsa, 1955, et al.
(författare)
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Experiences of the first year as father.
- 2008
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Ingår i: Scandinavian journal of caring sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 22:1, s. 56-63
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: The importance of fathers' participation for development of the child and the well-being of the family is recognized from earlier research. In Sweden, legislation allows fathers to share the parental leave equally with the mother even so fathers only use a small of their paid leave. The aim of the study was to explore experiences of the first year as a father. METHOD: A phenomenological life world approach was used. Ethical approval was obtained. Ten men, recruited by a purposive sample, were interviewed 12-14 months after the delivery of their first child. The data collection was performed during June and August 2004 in the south-west area of Sweden. FINDINGS: The essence of the experiences of the first year as father was to place the baby in the centre without giving up one's own person. The child provided warmth and happiness in the family and men experienced a deeper relationship to their partner. The contact between father and child was facilitated by engagement and time spent alone with the child. The major constituents identified from the findings were 'To be overwhelmed', 'To master the new situation' and 'To get a new completeness in life'. DISCUSSION AND CONCLUSION: To master fatherhood maintenance of integrity and possibility to develop an independent relationship with the child is important. Fathers are invited to participate in postnatal childbirth education but the activities address women's needs and it is doubtful if the fathers benefit from participation. Though fathers entered the delivery room some decades ago, as a support to the woman, health personnel of today must be aware of fathers' own needs and the impact gender aspects have on their professional support.
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| 32. |
- Premberg, Åsa, 1955, et al.
(författare)
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Father for the first time - development and validation of a questionnaire to assess fathers' experiences of first childbirth (FTFQ).
- 2012
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Ingår i: BMC pregnancy and childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: A father's experience of the birth of his first child is important not only for their birth-giving partner but also for the father himself, his relationship with the mother and the newborn. No validated questionnaire assessing first-time fathers' experiences during childbirth is currently available. Hence, the aim of this study was to develop and validate an instrument to assess first-time fathers' experiences of childbirth. METHOD: Domains and items were initially derived from interviews with first-time fathers, and supplemented by a literature search and a focus group interview with midwives. The comprehensibility, comprehensiveness and relevance of the items were evaluated by four paternity research experts and a preliminary questionnaire was pilot tested in eight first-time fathers. A revised questionnaire was completed by 200 first- time fathers (response rate = 81%) Exploratory factor analysis using principal component analysis with varimax rotation was performed and multitrait scaling analysis was used to test scaling assumptions. External validity was assessed by means of known-groups analysis. RESULTS: Factor analysis yielded four factors comprising 22 items and accounting 48% of the variance. The domains found were Worry, Information, Emotional support and Acceptance. Multitrait analysis confirmed the convergent and discriminant validity of the domains; however, Cronbach's alpha did not meet conventional reliability standards in two domains. The questionnaire was sensitive to differences between groups of fathers hypothesized to differ on important socio demographic or clinical variables CONCLUSIONS: The questionnaire adequately measures important dimensions of first-time fathers' childbirth experience and may be used to assess aspects of fathers' experiences during childbirth. To obtain the FTFQ and permission for its use, please contact the corresponding author.
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| 33. |
- Premberg, Åsa, 1955, et al.
(författare)
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First time fathers´experiences of childbirth
- 2010
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Ingår i: Book of Abstracts. The 18th Congress of the Nordic Federation of Midwives June 2010..
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Konferensbidrag (refereegranskat)abstract
- A description of first time fathers´experience of childbirth
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| 34. |
- Premberg, Åsa, 1955, et al.
(författare)
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First-time Fathers’ Experiences of Childbirth
- 2011
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Ingår i: Book of abstracts, ICM 29th Triennial Congress. International Confederation of Midwives. Durban 18-23 June 2011. ; :ICM 29th Triennial Congress. International Confede
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Konferensbidrag (refereegranskat)abstract
- Abstract for oral presentation at ICM 29th Triennial Congress Durban, South Africa 19 - 23 June 2011 Title: First- time Fathers’ Experiences of Childbirth- a Phenomenological Study. Name and title of all authors: Åsa Premberg; RNM, MSc, Doctoral student, Gunilla Carlsson , RN, PhD, Associate Professor; Anna-Lena Hellström; RN, Phd, Professor ,Marie Berg; RNM, MNSc, MPH, PhD, Associate Professor Contact e-mail: asa.premberg@gu.se Background and Aim: Fathers have become routine participants during labor and delivery, but since the fathers entered the delivery room in the 1970s, their positions have been ambiguous. The aim of the study was to describe fathers’ experiences during childbirth including caregivers’ support. Setting: The study was performed in the Southwest area of Sweden during the autumn 2008. Ten fathers were located at two hospitals and interviewed 4-6 weeks after the childbirth. Ethical approval was obtained from the Regional Ethical Review Board in Gothenburg Methods: A qualitative method with phenomenological life world approach was chosen. The interviews were guided by a re-enactment method and carried out and analyzed in accordance with Dahlberg (2008). Preliminary results: First-time fathers’ experienced childbirth as a mutually shared process for the couple. This means that the man, in cooperation with the midwife, is highly involved in childbirth with engagement in the process of support and care to the woman in her suffering. However, experience of the woman’s pain, fear of the unknown combined with the gendered preconceptions of masculine hegemony can be hard to bear for the father to be. To maintain and strengthen childbirth as a mutually shared experience for the couple, the father needs to be recognised and supported as a parent to be. Midwives and other caregivers have to acknowledge the fathers role as valued participant, but also support a significant position for the father. Further results, discussion and conclusions are going to be presented at the congress. Keywords. First time Fathers, Childbirth, Experience, Support,
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| 35. |
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| 36. |
- Premberg, Åsa, 1955, et al.
(författare)
-
First-time fathers' experiences of childbirth-A phenomenological study.
- 2011
-
Ingår i: Midwifery. - : Elsevier BV. - 1532-3099 .- 0266-6138. ; 27:6, s. 848-853
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: to describe fathers' experiences during childbirth. DESIGN: qualitative method with phenomenological lifeworld approach. A re-enactment interview method, with open-ended questions analysed with a phenomenological method, was used. PARTICIPANTS AND SETTING: 10 first-time fathers from two hospitals were interviewed four to six weeks after childbirth in Southwest Sweden during the autumn of 2008. FINDINGS: the essential meaning of first-time fathers' lived experience of childbirth was described as an interwoven process pendulating between euphoria and agony. The four themes constituting the essence was: 'a process into the unknown', 'a mutually shared experience', 'to guard and support the woman' and 'in an exposed position with hidden strong emotions'. KEY CONCLUSIONS: childbirth was experienced as a mutually shared process for the couple. The fathers' high involvement in childbirth, in cooperation with the midwife, and being engaged in support and care for his partner in her suffering is fulfilling for both partners, although the experience of the woman's pain, fear of the unknown and the gendered preconceptions of masculine hegemony can be difficult to bear for the father-to-be. IMPLICATIONS FOR PRACTICE: in order to maintain and strengthen childbirth as a mutually shared experience for the couple, the father needs to be recognised and supported as a parent-to-be. Midwives have to acknowledge fathers as valued participants and support their significant position.
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| 37. |
- Premberg, Åsa, 1955, et al.
(författare)
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How to use first-time father questionnaire (FTFQ) - fathers experiences of childbirth
- 2014
-
Ingår i: The International Confederation of Midwives. ICM 30th Triennial Congress. 1-5 June 2014 Prague, Czech Republic.
-
Konferensbidrag (refereegranskat)abstract
- Background: The quality of first-time fathers’ participation during childbirth is important not only for his birth-giving partner but also for the father himself, his relationship with the mother and the newborn. No validated questionnaire assessing first-time fathers’ experiences during childbirth was available. The aim of this study was to develop and validate an instrument to assess first-time fathers’ experiences of childbirth (FTFQ). The study was approved by the Regional Ethical Review Board in Gothenburg and was conducted in accordance with ethical principles of the Declaration of Helsinki [27] Method: The questionnaire was constructed with items derived from interviews with first-time fathers, and a questionnaire, completed by 200 first-time fathers (response rate=81 %), was tested and validated. An exploratory factor analysis using principal component analysis with varimax rotation was performed and multitrait scaling analysis was used to test scaling assumptions. The external validity was assessed by means of known-groups analysis. Results: Factor analysis yielded four factors comprising 22 items and accounting 48 % of the variance. The domains found were Worry, Information, Emotional support and Acceptance. Multitrait-scaling analysis confirmed the convergent and discriminant validity of the domains; however, Cronbach’s alpha did not meet conventional reliability standards in two domains. The questionnaire was sensitive to differences between groups of fathers hypothesized to differ on important socio demographic or clinical variables Conclusions: The questionnaire adequately measures important dimensions of first-time fathers’ childbirth experiences’ and may be used to assess aspects of fathers’ experience during childbirth. Implications: At the seminar the main focus will be an instruction on how to use the First-Time Father Questionnaire. Key words: Fathers, childbirth, questionnaire, factor analysis
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| 38. |
- Ranerup, Agneta, 1960, et al.
(författare)
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Role of Theories in the Design of Web-Based person-Centered Support: A Critical Analysis
- 2014
-
Ingår i: International Journal of Chronic Diseases. - New York, NY : Hindawi Limited. - 2356-6981 .- 2314-5749. ; 2014
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Tidskriftsartikel (refereegranskat)abstract
- Objective.The aim of this study was to provide a critical understanding of the role of theories and their compatibility with a person centered approach in the design and evaluation of web-based support for themanagement of chronic illness. Methods. Exploration of web-based support research projects focusing on four cases: (1) preschool children aged 4–6 with bladder dysfunction and urogenital malformation; (2) young adults aged 16–25 living with mental illness; (3) women with type 1 diabetes who are pregnant or in early motherhood; and (4) women who have undergone surgery for breast cancer. Data comprised interviews with research leaders and documented plans. Analysis was performed bymeans of a cross-case methodology. Results.The used theories concerned design, learning, health and well-being, or transition. All web support products had been developed using a participatory design (PD). Fundamental to the technology design and evaluation of outcomes were theories focusing on learning and on health and wellbeing. All theories were compatible with a person-centered approach. However, a notable exception was the relatively collective character of PD and Communities of Practice. Conclusion. Our results illustrate multifaceted ways for theories to be used in the design and evaluation of web-based support.
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| 39. |
- Rusner, Marie, 1958, et al.
(författare)
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Bipolar disorder in pregnancy and childbirth: a systematic review of outcomes
- 2016
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Ingår i: Bmc Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Background: Bipolar Disorder (BD) is a mental disorder usually diagnosed between 18 and 30 years of age; this coincides with the period when many women experience pregnancy and childbirth. As specific problems have been reported in pregnancy and childbirth when the mother has BD, a systematic review was carried out to summarise the outcomes of pregnancy and childbirth, in mother and child, when the mother has BD diagnosed before pregnancy. Methods: An a priori protocol was designed and a systematic search conducted in PubMed, CINAHL, Scopus, PsycINFO and Cochrane databases in March 2015. Studies of all designs were included if they involved women with a diagnosis of bipolar disorder prior to pregnancy, who were pregnant and/or followed up to one year postpartum. All stages of inclusion, quality assessment and data extraction were done by two people. All maternal or infant outcomes were examined, and narrative synthesis was used for most outcomes. Meta-analysis was used to achieve a combined prevalence for some outcomes and, where possible, case and control groups were combined and compared. Results: The search identified 2809 papers. After screening and quality assessement (using the EPHPP and AMSTAR tools), nine papers were included. Adverse pregnancy outcomes such as gestational hypertension and antepartum haemorrhage occur more frequently in women with BD. They also have increased rates of induction of labour and caesarean section, and have an increased risk of mood disorders in the postnatal period. Women with BD are more likely to have babies that are severely small for gestational age (<2nd-3rd percentile), and it appears that those women not being treated with mood stabilisers in pregnancy might not have an increased risk of having a baby with congenital abnormalities. Discussion: Due to heterogeneity of data, particularly the use of differing definitions of bipolar disorder, narrative synthesis was used for most outcomes, rather than a meta-analysis. Conclusions: It is evident that adverse outcomes are more common in women with BD and their babies. Large cohort studies examining fetal abnormality outcomes for women with BD who are not on mood stabilisers in pregnancy are required, as are studies on maternal-infant interaction.
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| 40. |
- Skärsäter, Ingela, 1952, et al.
(författare)
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Web-based learning and support – a person-centred care approach in long-term illness.
- 2012
-
Ingår i: Scandinavian Conference on Health Informatics.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The poster outlines a research project that aims to develop and evaluate a person-centred model of web-based learning and support for people with long-term illness. Departing from the widespread use of the internet in modern society and the emerg-ing use of web interventions in healthcare 1-3 the multi-case project captures persons’ needs and expectations in order to develop highly usable web recourses. To support the underly-ing idea to move beyond the illness, we approach the develop-ment of web support from the perspective of the emergent area of person-centred care (PCC).
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| 41. |
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| 42. |
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| 43. |
- Sparud Lundin, Carina, 1964, et al.
(författare)
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Use of participatory design in the development of person-centred web-based support for persons with long-term illness
- 2015
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Ingår i: Abstracts: 19th International Philosophy of Nursing Society (IPONS) conference August 24-26, 2015 Karolinska Institutet, Stockholm, Sweden. - Stockholm : Karolinska Institutet. ; , s. 43-43
-
Konferensbidrag (refereegranskat)abstract
- Background: E-health solutions are increasingly developed to meet patients’ preferences and promote their participation in their health care. This has led to increased interest in person-centred technology developed by means of participatory approaches. However, few studies explore the participatory design process from the perspective of person-centeredness including how it becomes materialized in the informational technology. This paper explores how applied participatory approaches and the design of four web based supports correspond to key areas of person-centeredness.Aim and method: The purpose was to create shared knowledge and understanding of each separate case and to generate relevant categories. Data was collected from four Swedish research projects. The analysis followed an inductive approach involving a step-wise cross-case analysis.Results: A number of question areas describe the dialogue with the participants in the cases. The areas cover individual, social, and practical issues. The results of the dialogue are categorized into four support areas; psychological/emotional, personal, information, technical. By means of common as well as specifically developed technical solutions the support areas becomes visible in the design. Person-centredness will appear in the participatory design (PD) process as the approach promotes the development of a holistic view of the person and the illness and a partnership between patients and carers.Conclusions: Our results contribute to a central development area within eHealth involving greater opportunities for the patient to actively contribute in real time, getting access to and add information, and sometimes interact directly with carers. However, it is concluded that neither participatory approaches nor technology for online information and communication can guarantee personcenteredness by itself. Instead, it is the design of the PD process and the forming of the actual use of technology together with the particular purpose of the web based support that shape person-centred online support.
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| 44. |
- Sparud-Lundin, Carina, 1964-, et al.
(författare)
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Use of participatory design in the development of person-centred web-based support for persons with long-term illness
- 2013
-
Ingår i: European Journal for Person Centered Healthcare. - Buckingham, UK : University of Buckingham Press. - 2052-5648 .- 2052-5656. ; 1:2, s. 369-380
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Tidskriftsartikel (refereegranskat)abstract
- Background: E-health solutions are increasingly being developed to meet patients’ preferences and promote their participation in healthcare. Few studies have explored the participatory design process from the perspective of person-centeredness, including how it becomes materialized in technology. This paper explores how applied participatory approaches and the design of 4 web-based interventions directed towards long-term illness correspond to key areas of person-centeredness. Methods: Data were collected during 2009 to 2012, from 4 Swedish research projects. The analysis followed an inductive approach involving a step-wise cross-case analysis. The purpose was to create shared knowledge and understanding of each separate case and to generate relevant categories.Results: A number of question areas describe the dialogue with the case participants. Results of the dialogue are categorized into 4 support areas: psychological/emotional, personal, information and technical. Person-centeredness becomes visible in the participatory design process as the approach promotes the development of a holistic view of the person and the illness and a partnership between patients and carers. The use of communication technology exemplifies concrete materialization of person-centeredness in the design of the web-based supports. The purpose of the web supports and the shaping of the actual use of the functionalities are more abstract forms of materialization.Conclusions: Our results contribute to a central development area within eHealth involving increased opportunities for patients to contribute actively in real time, obtaining access to information and sometimes interacting with carers. However, neither participatory approaches nor technology for online information and communication, can guarantee person-centeredness in isolation.
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| 45. |
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| 46. |
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| 47. |
- Adolfsson, Annsofie, 1960-, et al.
(författare)
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A web-based support for pregnant women and new mothers with type 1 diabetes mellitus in Sweden (MODIAB-Web) : study protocol for arandomized controlled trial
- 2014
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Ingår i: Trials. - : Springer Science and Business Media LLC. - 1745-6215. ; 15, s. 513-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Women with type 1 diabetes face particular demands in their lives in relation to childbearing. During pregnancy, in order to optimize the probability of giving birth to a healthy child, their blood glucose levels need to be as normal as possible. After childbirth, they experience a 'double stress': in addition to the ordinary challenges they face as new mothers, they also need to focus on getting their blood glucose levels normal. To improve self-management of diabetes and overall well-being in women with type 1 diabetes, a person-centered web-based support was designed to be tested in a randomized controlled trial (RCT) to be used during pregnancy and early motherhood. This protocol outlines the design of this RCT, which will evaluate the effectiveness of the specially designed web-based support for mothers with type 1 diabetes in Sweden.Methods: The study is designed as an RCT. The web support consists of three parts: 1) evidence-based information, 2) a self-care diary, and 3) communication with peers. The primary outcome is general well-being evaluated with the Well-Being Questionnaire short version (W-BQ12) and diabetes management evaluated with the Diabetes Empowerment Scale, short version (SWE-DES). Women attending six hospital-based antenatal care centers in Sweden are invited to participate. The inclusion period is November 2011 to late 2014. The allocation of participants to web support (intervention group) and to usual care (control group) is equal (1:1). In total, 68 participants in each group will be needed to reach a statistical power of 80% with significance level 0.05.Discussion: The web support is expected to strengthen the women's personal capacity and autonomy during pregnancy, breastfeeding, and early motherhood, leading to optimal well-being and diabetes management.
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| 48. |
- Adolfsson, Annsofie, 1960-, et al.
(författare)
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Miscarriage : Evidence Based Information for the Web and Its Development Procedure
- 2015
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Ingår i: Advances in Sexual Medicine. - Irvine, USA : Scientific Research Publishing. - 2164-5191 .- 2164-5205. ; 5:4, s. 89-110
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this paper is to describe the process of developing web information on miscarriage based on scientific evidence, for women and couples in Sweden experiencing miscarriage. Method: A participatory design was used which included researchers, professional xperts and users. A participatory design was used involving researchers, professional experts and users. The information was developed in six stages: 1) identifying the needs of information; 2) identifying and constructing the main areas of information and its paths; 3) identifying and inviting experts for revision; 4) developing the text; 5) reviewing the text; 6) design and structuring for adaption to website. Results: The text of information developed gradually based on the seven steps. The final text comprised three parts: 1) what is miscarriage; 2) experiences of miscarriage; 3) processing and lanning for new pregnancy. Conclusion: Using participatory design was time and resource consuming, however it was functional for producing appropriate information for the target group. The developed evidence based facts text is assumed to be a complement to the information that is provided by the health care system.
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| 49. |
- Ahlborg, Tone, 1950, et al.
(författare)
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Föräldraskap och parrelation
- 2013
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Ingår i: Omvårdnad på avancerad nivå. Kärnkompetenser inom sjuksköterskans specialistområden. A-K. Edberg, A. Ehrenberg, F. Friberg, L. Wallin, H. Wijk & J. Öhlén (red). Artikelsamling på bokens webbutgåva.. - Lund : Studentlitteratur. - 9789144071459
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Bokkapitel (refereegranskat)abstract
- Att bli förälder är bland de största händelserna i livet med många förändringar, både på personnivå och vad gäller rutiner och andra praktikaliteter i dagligt liv. Det är en känslosam tid som möjliggör förändrad livsinriktning men också ger en ökad utsatthet. Föräldraskapet är livslångt. I detta kapitel beskrivs olika dimensioner i föräldrablivandet samt hur parrelationer kan påverkas av det tidiga föräldraskapet, d.v.s. de första åren som förälder. Målet med den hälso- sjukvård och omsorg som ges till par i samband med övergången till föräldraskap är att främja hälsa och välbefinnande. Barnmorskan på Mödravårdscentral och inom förlossningsverksamhet har en nyckelroll i vård och stöd till blivande och nyblivna föräldrar. Specialistsjuksköterskan vid neonatalvårdsenhet och barnavårdscentral har också central roll. Andra specialistsjuksköterskor kan komma att vårda blivande och nyblivna föräldrar och oftast sker detta i samband med att komplikationer inträffar1. Också andra professioner är centrala och har stor möjlighet att i samverkan stödja de nyblivna föräldrarna i föräldraskapet och i deras parrelation. Centralt vid vård och omsorg som ges i samband med parrelation och föräldraskap, precis som i all hälso- och sjukvård, är att den är evidensbaserad, samt anpassad till och centrerad på den enskilda personen med fungerande kommunikation och tillräcklig information.
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| 50. |
- Andrén, Anna, et al.
(författare)
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The birthing room and its influence on the promotion of a normal physiological childbirth-a qualitative interview study with midwives in Sweden
- 2021
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- The birthing room is a major workplace for midwives but how it influences them in practice is not enough investigated. Purpose: This study aimed to explore midwives ' experiences of how the birthing room affects them in their work to promote a normal physiological birth. Methods: A phenomenological reflective lifeworld research approach was used and included individual interviews with 15 midwives working at four different hospitals in western Sweden, and of which two also assisted at homebirths. The analysis focused on the meanings of the study phenomenon. Results: A birthing room can by its design either support a normal physiological birth or support a risk approach to childbirth. Four opposing constituents complete the essential meaning of the birthing rooms, and to which the midwives need to relate in their roles as guardians for normal birth: i) a private or a public room; ii) a home-like or hospital-like room; iii) a room promoting activity or passivity; iv) a room promoting the midwife ' s presence or absence. Conclusions: The birthing room mirrors a pathogenic-oriented care approach. A presupposition for the work to keep the birth bubble intact is to protect the mother from disturbing elements both inside and outside the room.
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