| 1. |
- Bauer, Georg F., et al.
(författare)
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Future directions for the concept of salutogenesis : A position article
- 2020
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Ingår i: Health Promotion International. - : Oxford University Press. - 0957-4824 .- 1460-2245. ; 35:2, s. 187-195
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Tidskriftsartikel (refereegranskat)abstract
- Aaron Antonovsky advanced the concept of salutogenesis almost four decades ago (Antonovsky, Health, Stress and Coping. Jossey-Bass, San Francisco, CA, 1979; Unravelling the Mystery of Health. Jossey-Bass,San Francisco, CA, 1987). Salutogenesis posits that life experiences shape the sense of coherence (SOC)VC that helps to mobilize resources to cope with stressors and manage tension successfully (determiningone's movement on the health Ease/Dis-ease continuum). Antonovsky considered the three-dimensionalSOC (i.e. comprehensibility, manageability, meaningfulness) as the key answer to his question about theorigin of health. The field of health promotion has adopted the concept of salutogenesis as reflected in theinternational Handbook of Salutogenesis (Mittelmark et al., The Handbook of Salutogenesis. Springer,New York, 2016). However, health promotion mostly builds on the more vague, general salutogenic orientation that implies the need to foster resources and capacities to promote health and wellbeing. Tostrengthen the knowledge base of salutogenesis, the Global Working Group on Salutogenesis (GWG-Sal)of the International Union of Health Promotion and Education produced the Handbook of Salutogenesis.During the creation of the handbook and the regular meetings of the GWG-Sal, the working group identified four key conceptual issues to be advanced: (i) the overall salutogenic model of health; (ii) the SOC concept; (iii) the design of salutogenic interventions and change processes in complex systems; (iv) the application of salutogenesis beyond health sector. For each of these areas, we first highlight Antonovsky'soriginal contribution and then present suggestions for future development. These ideas will help guideGWG-Sal's work to strengthen salutogenesis as a theory base for health promotion.
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| 2. |
- Berg, Marie, 1955, et al.
(författare)
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The use of a salutogenic framework in empirical studies of maternity care
- 2014
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Ingår i: Optimizing childbirth across Europe conference - part of COST Action IS0907: Childbirth Cultures, Concerns & Consequences: Creating a dynamic EU framework for Optimal maternity care. 9-10 April 2014, Brussels.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: There is general agreement that maternity care services should be organized in a way that improves health. In many European settings, this entails changing the lens of maternity care from one focused on risk and the prevention of ill-health to one stressing positive outcomes including strengths and resources. Several frameworks have been proposed for a positive health care approach within the salutogenic framework. The most wellknown, and with a strong evidence base, is Antonovsky´s Sense of Coherence Theory. Aim: To establish if and how a salutogenic theoretical approach has been used in empirical studies of maternity care. Objectives: To identify how salutogenesis has been defined in empirical research around the maternity episode, and how and in what kind of contexts salutogenic theory has been used in empirical research around the maternity episode. To generate discussion about what promotes salutogenic approaches in maternity care provision. method: A systematic literature review, based on a predetermined search strategy. no language restrictions were applied. Included studies were subject to narrative analysis. Ethical approval was not required. Findings: Eight papers met the criteria for inclusion, comprising seven areas in the antenatal, intrapartum and postnatal periods. Of these, two papers employed both a positive health philosophy and explicit use of Antonovsky's Sense of Coherence (SoC) scale. The remaining studies used discrete aspects of a salutogenic approach. Conclusion: These findings demonstrate that, to date, salutogenic framing is rarely used in maternity care research. To guide future policy making and service provision, salutogenic theory could be used to find out what works well in promoting wellbeing for those using maternity care, rather than simply minimizing ill-health and risk. Funding: The study is part of the EU-funded COST Action IS0907
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| 5. |
- Heazell, Alexander E P, et al.
(författare)
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Stillbirths : economic and psychosocial consequences.
- 2016
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Ingår i: The Lancet. - 0140-6736 .- 1474-547X. ; 387:10018, s. 604-16
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Tidskriftsartikel (refereegranskat)abstract
- Despite the frequency of stillbirths, the subsequent implications are overlooked and underappreciated. We present findings from comprehensive, systematic literature reviews, and new analyses of published and unpublished data, to establish the effect of stillbirth on parents, families, health-care providers, and societies worldwide. Data for direct costs of this event are sparse but suggest that a stillbirth needs more resources than a livebirth, both in the perinatal period and in additional surveillance during subsequent pregnancies. Indirect and intangible costs of stillbirth are extensive and are usually met by families alone. This issue is particularly onerous for those with few resources. Negative effects, particularly on parental mental health, might be moderated by empathic attitudes of care providers and tailored interventions. The value of the baby, as well as the associated costs for parents, families, care providers, communities, and society, should be considered to prevent stillbirths and reduce associated morbidity.
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| 6. |
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| 7. |
- Magistretti, Claudia Meier, et al.
(författare)
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Best practice in maternity care: a salutogenic approach
- 2014
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Ingår i: Optimising Childbirth Across Europe An interdisciplinary maternity care conference, 9 & 10 of April, 2014 in Vrije University, Etterbeek campus, Brussels, Belgium.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: The current practice to enhance and ensure quality in maternity and early infant care is mainly focused on the avoidance and management of risk. Even though studies have investigated midwives' and other professional's views, revealing several health oriented factors of quality in maternal care. most of these studies lack a theoretical framework underpinning the empirical findings and results often remain limited to the specific settings the studies were conducted in. Aim: The study "best practice in maternity care" takes a systematic theoretical approach rooted in Aaron Antonovsky's theory of salutogenesis. Although Antonovsky's concepts are widely used and empirically underpinned, they have not yet been broadly applied to maternity care and childbirth. no studies have been conducted to describe what a salutogenic midwifery practice could be. We lack evidence of questions as to how health promoting processes come about and how professionals' care can be fostered to strengthen health of mothers in maternity care. The study aims to allow maternity care professionals to express their implicit salutogenic knowledge and their action-oriented implicit frameworks for choices, decisions and conflict management and to validate and make such knowledge accessible to researchers and teachers. methods 27 narrative interviews were conducted with midwives working in pre-, peri- and postnatal care in different settings of selected regions in Austria, Switzerland and the United Kingdom. A hermeneutic analyses following the theory of Antonovsky was conducted. Ethical approval was received by all universities and health authorities concerned. findings and Conclusions: full findings will be presented showing different types of dealing with hospital and other working environments and reveal a definite spectrum of distinct Components of the three parameters of the sense of coherence (understandability, manageability, meaningfulness) in midwifery salutogenic practice. implications for training, research and practice are described in conclusion and projects in midwifery education are presented.
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| 8. |
- Magistretti, Claudia Meier, et al.
(författare)
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Setting the stage for health: Salutogenesis in midwifery professional knowledge in three European countries.
- 2016
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Ingår i: International journal of qualitative studies on health and well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- There is a lack of systematic evidence concerning health orientation in maternity practice in the current climate of risk avoidance. The midwifery professional project is orientated toward the preservation of normal physiological processes during the maternity episode. This study investigates accounts of midwives who were working in health-orientated birth settings, to examine if and how they frame a health orientation in professional practice. Twenty-seven narrative interviews were conducted with midwives working in pre-, peri-, and postnatal care in different maternity care settings in Switzerland, Austria, and Germany. In-depth and comparative pattern data analyses were conducted. The distinct practice orientation of the participants was revealed in three main concepts, underpinned by a common framework mirroring the three parameters of the Sense of Coherence (comprehensibility, manageability, and meaningfulness) described in Aaron Antonovsky’s salutogenic theory. The midwives’ implicit salutogenic knowledge shaped their reported actions in supporting mothers, fathers, and families to have health-promoting experiences in maternity care. These results suggest that an implicit health orientation in maternity care practice can be prefered through examination of the practice reports of midwives working in settings that have a health-promoting philosophy. Implications for midwifery practice and research are discussed. Consideration is given to the relevance of the results for debates about avoiding overtreatment and for the operationalization of salutogenic theory in health care practice.
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| 9. |
- Nyman, Viola, 1961, et al.
(författare)
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Insider Action research as an approach and a method – Exploring institutional encounters from within a birthing context
- 2016
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Ingår i: Action Research. - : SAGE Publications. - 1476-7503 .- 1741-2617. ; 14:2, s. 217-233
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this paper was to describe the first person perspective of being a peer midwife and a novice researcher initiating collaborative AR in her own organization to develop knowledge about the first encounters between the labouring woman and her care-givers in a hospital birthing context. It was motivated by the author’s longstanding professional clinical experience of observing and hearing parents’ stories of vulnerability and fear of childbirth, and how staff’s attitudes affected the childbirth experience negatively. Data were collected between 2010 and 2013 and included the researcher’s log with reflections from clinical work, as well as interviews, participant observation, and research group communications. A reflective interpretative lifeworld research approach was used to analyze the data. The experience of being a novice insider action researcher (IARr) consisted of three thematic meanings: “the struggle to initiate a clinical insider action research project,” “standing alone at the messy front line,” and “being a catalytic counterbalance to the prevailing medico technical focus.” The comprehensive understanding was “learning how to clinically reflect on and to voice the tacit components of care.” The strategy used in undertaking this study was influenced by the philosophies of both midwifery care and AR.
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| 10. |
- Nyman, Viola, 1961, et al.
(författare)
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Midwives´ experiences of action research and the nature of the first encounter on a hospital based labour ward in Sweden
- 2014
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Ingår i: Optimizing childbirth across Europe - an intedisciplinary maternity care conference. 9-10 April 2014, Brussels. Part of COST Action IS0907: Childbirth Cultures, Concerns & Consequences: Creating a dynamic EU framework for Optimal maternity care..
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: An Action research study was undertaken with midwives based on one Swedish labour ward, to improve the quality of the first encounter with women and their partners. Aim of presentation: To describe 1) the Ar process 2) midwives' responses to a changed approach in the initial labour ward encounter. Research methodology: An insider action research design included several planning meetings with the midwives, agreeing on change, implementing the changes together, and evaluating the effects. To meet the woman's and partner's need for support even in the first encounter the ambition was to stay with the woman and partner while the fetal heart monitoring was running. The researcher kept a research journal documenting thoughts, reactions, reflections and the development of the Ar process. Thirty seven out of 57 midwives working on the labour ward were interviewed about their experiences. Interviews were tape recorded, transcribed and analysed using interpretive description. Ethical approval Ethical approval was received Study findings: The Ar started 2010. Initially, midwives found it most difficult to change their routine of starting the fetal heart monitoring when women first arrived in labour, and then leaving to read the woman's medical record and notes. Through the debates in the Ar meetings, more midwives moved towards spending time in the room with the woman and partner, talking with them, thereby creating meaningful relationships from the outset. The midwives' reflexive responses in the interviews illuminate their initial reluctance to respond to the Ar process, but also, the value of reflecting beyond routines to build a lingering presence in the first labour encounter. Conclusions: Examination of the three years of insider Ar process through qualitatively analyse clinical documents, the researcher's journal including notes of observations and interviews revealed the complexity and the difficulty of providing time to manage reflection in a large organization. To a greater or lesser extent, midwives had integrated relatively impersonal system-wide technocratic norms of childbirth into their belief systems and behaviors. The Ar study design enabled midwives reflect on routines and start the transformation of tacit use-inaction to reflection-in-action.
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| 11. |
- Nyman, Viola, 1961, et al.
(författare)
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Routine interventions in childbirth before and after initiation of an Action Research project : Sexual & Reproductive Healthcare
- 2017
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Ingår i: Sexual and Reproductive Healthcare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 11, s. 86-90
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Tidskriftsartikel (refereegranskat)abstract
- © 2016 Elsevier B.V.Background Unnecessary routine interventions in uncomplicated labour and birth, like cardiotocography (CTG), amniotomy, use of scalp electrode and oxytocin treatment, are associated with further interventions that could harm the woman and the infant. A four year Action Research (AR) project was done on a labour ward to enhance the capacity of local midwives in the promotion of physiological labour and birth. Aim To describe the use of interventions during labour and birth in healthy women at term with spontaneous onset of labour, before and after initiation of an Action Research project. Methods A retrospective before and after comparative study of clinical records from 2009 (before) and 2012 (after), based on a random selection of records from primiparous and multiparous women. Outcome measures were duration of admission CTG, frequency of admission CTG over 30 min, frequency of amniotomy, use of scalp electrode, and frequency of oxytocin augmentation in spontaneous labour. Results 903 records were included. The duration of admission CTG (p = 0.001), frequency of admission CTG duration over 30 min (p = <0.001), the use of scalp electrodes (p = <0.001), and use of oxytocin augmentation of spontaneous labour (p = 0.014) were reduced significantly after initiation of the AR project. There were no significant differences in frequency of amniotomy, duration of total CTG, postpartum bleeding, sphincter tears, Apgar score <5 at 5 min, and mode of birth. Conclusion Following an AR project, several interventions were reduced during labour and birth. Controlled studies in other settings are needed to assess the impact of collaborative action on decreasing unnecessary interventions.
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| 12. |
- Nyman, Viola, 1961, et al.
(författare)
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Waiting for permission to enter the labour ward world: first time parents' experiences of the first encounter on a labour ward
- 2011
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Ingår i: Sexual & Reproductive HealthCare. - 1877-5756. ; 2:3, s. 129-134
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Tidskriftsartikel (refereegranskat)abstract
- For women and their partners, the first meeting with professional staff on the labour ward is important. This initial encounter is a short but sensitive meeting. It may be particularly crucial for first time parents, most of whom have no prior experience of the birth environment. The objective of this study was to explore the meaning of first time mothers' and their partners' first encounter with midwives and other maternity care staff when they arrive on a hospital labour ward.
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| 13. |
- Perez-Botella, Mercedes, et al.
(författare)
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The use of salutogenesis theory in empirical studies of maternity care for healthy mothers and babies
- 2015
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756. ; 6:1, s. 33-39
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Tidskriftsartikel (refereegranskat)abstract
- Background: Health care outcomes used in service evaluation and research tend to measure morbidity and mortality. This is the case even in maternity care, where most women and babies are healthy. Salutogenesis theory recognises that health is a continuum, with explicit inclusion of well-being as well as illness and pathology. This offers the potential to reframe the outcomes and therefore, the focus of, maternity care research and provision. Aim: The aim of this study was to identify how salutogenesis has been defined and used in maternity care research undertaken with healthy women. Method: A scoping review was undertaken, using a formal pre-defined search strategy. Inclusion criteria encompassed research papers relating to the maternity episode up to 1 year after birth, using salutogenesis or any of its associated concepts, focused on healthy women, and written in a language which any of the members of the group could understand. The search was undertaken in two phases (database inception – April 2011 and May 2011–February 2013). Included studies were subject to narrative analysis. Findings: Eight papers met the inclusion criteria. They covered seven topics, spanning the antenatal, intrapartum and postnatal periods. Only two papers employed both positive health orientation and explicit use of Antonovsky’s theory. The remaining studies used discrete aspects of the theory. Conclusion: Salutogenic framing is rarely used in maternity care research with healthy participants. An increase in research that measures salutogenically orientated outcomes could, eventually, provide a balance to the current over-emphasis on pathology in maternity care design and provision worldwide.
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| 14. |
- Smith, Valerie, et al.
(författare)
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Protocol for the development of a salutogenic intrapartum core outcome set (SIPCOS)
- 2017
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Ingår i: BMC Medical Research Methodology. - : Springer Science and Business Media LLC. - 1471-2288. ; 17:61
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Tidskriftsartikel (refereegranskat)abstract
- Background: Maternity intrapartum care research and clinical care more often focus on outcomes that minimise or prevent adverse health rather than on what constitutes positive health and wellbeing (salutogenesis). This was highlighted recently in a systematic review of reviews of intrapartum reported outcomes where only 8% of 1648 individual outcomes, from 102 systematic reviews, were agreed as being salutogenically-focused. Added to this is variation in the outcomes measured in individual studies rendering it very difficult for researchers to synthesise, fully, the evidence from studies on a particular topic. One of the suggested ways to address this is to develop and apply an agreed standardised set of outcomes, known as a ‘core outcome set’ (COS). In this paper we present a protocol for the development of a salutogenic intrapartum COS (SIPCOS) for use in maternity care research and a SIPCOS for measuring in daily intrapartum clinical care. Methods: The study proposes three phases in developing the final SIPCOSs. Phase one, which is complete, involved the conduct of a systematic review of reviews to identify a preliminary list of salutogenically-focused outcomes that had previously been reported in systematic reviews of intrapartum interventions. Sixteen unique salutogenically-focused outcome categories were identified. Phase two will involve prioritising these outcomes, from the perspective of key stakeholders (users of maternity services, clinicians and researchers) by asking them to rate the importance of each outcome for inclusion in the SIPCOSs. A final consensus meeting (phase three) will be held, bringing international stakeholders together to review the preliminary SIPCOSs resulting from the survey and to agree and finalise the final SIPCOSs for use in future maternity care research and daily clinical care. Discussion: The expectation in developing the SIPCOSs is that they will be collected and reported in all future studies evaluating intrapartum interventions and measured/recorded in future intrapartum clinical care, as routine, alongside other outcomes also deemed important in the context of the study or clinical scenario. Using the SIPCOSs in this way, will promote and encourage standardised measurements of positive health outcomes in maternity care, into the future.
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| 15. |
- Uvnäs-Moberg, Kerstin, et al.
(författare)
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Maternal plasma levels of oxytocin during physiological childbirth : a systematic review with implications for uterine contractions and central actions of oxytocin
- 2019
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Oxytocin is a key hormone in childbirth, and synthetic oxytocin is widely administered to induce or speed labour. Due to lack of synthetized knowledge, we conducted a systematic review of maternal plasma levels of oxytocin during physiological childbirth, and in response to infusions of synthetic oxytocin, if reported in the included studies.METHODS: An a priori protocol was designed and a systematic search was conducted in PubMed, CINAHL, and PsycINFO in October 2015. Search hits were screened on title and abstract after duplicates were removed (n = 4039), 69 articles were examined in full-text and 20 papers met inclusion criteria. As the articles differed in design and methodology used for analysis of oxytocin levels, a narrative synthesis was created and the material was categorised according to effects.RESULTS: Basal levels of oxytocin increased 3-4-fold during pregnancy. Pulses of oxytocin occurred with increasing frequency, duration, and amplitude, from late pregnancy through labour, reaching a maximum of 3 pulses/10 min towards the end of labour. There was a maximal 3- to 4-fold rise in oxytocin at birth. Oxytocin pulses also occurred in the third stage of labour associated with placental expulsion. Oxytocin peaks during labour did not correlate in time with individual uterine contractions, suggesting additional mechanisms in the control of contractions. Oxytocin levels were also raised in the cerebrospinal fluid during labour, indicating that oxytocin is released into the brain, as well as into the circulation. Oxytocin released into the brain induces beneficial adaptive effects during birth and postpartum. Oxytocin levels following infusion of synthetic oxytocin up to 10 mU/min were similar to oxytocin levels in physiological labour. Oxytocin levels doubled in response to doubling of the rate of infusion of synthetic oxytocin.CONCLUSIONS: Plasma oxytocin levels increase gradually during pregnancy, and during the first and second stages of labour, with increasing size and frequency of pulses of oxytocin. A large pulse of oxytocin occurs with birth. Oxytocin in the circulation stimulates uterine contractions and oxytocin released within the brain influences maternal physiology and behaviour during birth. Oxytocin given as an infusion does not cross into the mother's brain because of the blood brain barrier and does not influence brain function in the same way as oxytocin during normal labour does.
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