| 1. |
- Blixt, Ingrid, 1968-, et al.
(författare)
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Process-oriented training in breastfeeding for health professionals decreases women’s experiences of breastfeeding challenges
- 2014
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Ingår i: International Breastfeeding Journal. - : BioMed Central. - 1746-4358. ; 9:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The World Health Organization recommends promoting exclusive breastfeeding for six months. Women much too often end breastfeeding earlier than they planned, but women who continue to breastfeed despite problems more often experience good support and counselling from health professionals. The aim in this study was to evaluate the effects of a process-oriented training in breastfeeding support counselling for midwives and child health nurses, in relation to women’s satisfaction with breastfeeding counselling, problems with insufficient breast milk, pain or nipple sores in relation to exclusive breastfeeding shorter or longer than 3 months.Methods: An intervention through process-oriented training for health professionals regarding support in childbearing and breastfeeding took part in the south west of Sweden. The present study was performed in Sweden, in 2000- 2003. Ten municipalities were paired, and within each pair, one was randomly assigned to the group of five intervention (IG) municipalities and one to the group of five control municipalities. Primiparas (n=540) were asked to participate in a longitudinal study to evaluate the care they received. A survey was distributed at 3 days, 3 months and 9 months postpartum. Data collection for control group A (n=162) started before the intervention was initiated. Data for control group B (n=172) were collected simultaneously with the intervention group (IG) (n=206).Women were also divided into two groups depending on whether they exclusive breastfed < 3 months or ≥ 3 months.Results: Women in IG were more satisfied with the breastfeeding counselling (p=0.008) and felt the breastfeeding counselling was more coherent (p=0.002) compared with control groups, when the exclusively breastfeeding was < 3 months. In addition fewer women in the IG, among the group exclusively breastfeeding < 3 months, had problems with insufficient breast milk compared to the control groups (p=0.01).Conclusion: A process-oriented training for health professionals in support influenced women's ability to solve breastfeeding problems such as the experience of insufficient breast milk production. Women with exclusive breastfeeding lasting ≥ 3 months more often had breastfeeding duration in conformity with their planned breastfeeding duration, compared with women who had breastfeeding duration < 3 months.Trial registration: ACTRN12611000354987
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| 2. |
- Blixt, Ingrid, 1968-, et al.
(författare)
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Utbildning minskar amningsproblem
- 2014
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Ingår i: Amningsnytt. - : Amningshjälpen. - 1102-7207. ; :4, s. 4-5
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 3. |
- Ekström, Anette C., 1958-, et al.
(författare)
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Nurses challenges to support hospitalized patients regarding sexual-health issues
- 2016
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Ingår i: Journal of Nursing & Care. - : OMICS Publishing Group. - 2167-1168. ; 5:3
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Tidskriftsartikel (refereegranskat)abstract
- Background: The approach to nursing should be characterized by a holistic view of the human being which includes sexual health. From a nursing perspective, it is therefore of most importance to have a dialogue about factors associated with sexual health also among hospitalized patients. However, to our knowledge there is a lack of qualitative studies regarding nurses attitudes about dialogue with patients about sexual health.Objective: To investigate nurses attitudes towards dialogue with hospitalized patients about sexual health.Methods: A qualitative method was used and interviews were conducted which then were analyzed using a qualitative content analysis. Eleven registered nurses were included, the inclusion criteria was: at least one year of experience as a nurse and working on a medical or surgical ward in a hospital in the southwest of Sweden. The participants were in the ages 25-65 and had worked as nurses between 2 and 30 years. Nine of the participants were women. The data were collected during 2011.Results: The nurses experiences of and reflections on dialogue with patients about sexual health were presented as a single main theme: Nurses challenges to support hospitalized patients with sexual health issues. This theme had three categories: Feeling uncomfortable, Feeling inadequate and Task-oriented care with related subcategories respectively.Conclusions: Nurses attitudes towards their dialogues about sexual health with hospitalized patients were less challenging if they were initiated by the patients or if the patients were men with medical causes related to sexual health. Lack of knowledge and support from colleagues became reasons why nurses felt inadequate about discussing sexual health with their patients.
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| 4. |
- Ekström, Anette, 1958-, et al.
(författare)
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Women’s use of nipple shields - their influence on breastfeeding duration after a process-oriented education for health professionals
- 2014
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Ingår i: Breastfeeding Medicine. - : Mary Ann Liebert. - 1556-8253 .- 1556-8342. ; 9:9, s. 458-466
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This study investigated if a process-oriented training for health professionals will influence women's use and reasons for using a nipple shield, the baby's weight, and the duration of breastfeeding.Materials and Methods: An intervention was performed for health professionals that included a process-oriented training program on breastfeeding support. Primiparas living in either the intervention municipality or in a control municipality were asked to participate in a longitudinal study to evaluate the care given. Data collection for control group A (CGA) (n=162) started before the intervention was initiated. Data for control group B (CGB) (n=172) were collected simultaneously with those for the intervention group (IG) (n=206). The mothers responded to questionnaires at 3 days, at 3 months, and at 9 months postpartum.Results: The mothers' use of nipple shields related to the finding that if the women had a higher body mass index in the beginning of the pregnancy, the babies had difficulty in grasping over the nipple, and the mothers had pain or wound on the nipple. For the mothers in the IG group, there was no significant difference if they had used nipple shields or not in relation to breastfeeding duration. In contrast, the mothers in the control groups had a significant shorter breastfeeding duration if they had used nipple shields. In the IG, there were no significant difference between the use of nipple shields and the babies' weights at 3 or 9 months. The babies of women in the CGB who used nipple shields had a significantly lower weight at 3 months than the babies of those who did not use nipple shields (p=0.02).Conclusions: A process-oriented training in breastfeeding counseling prolongs the duration of breastfeeding for women with breastfeeding problems, where the problems are remedied by the use of nipple shields.
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| 5. |
- Buckley, Sarah, et al.
(författare)
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Maternal and newborn plasma oxytocin levels in response to maternal synthetic oxytocin administration during labour, birth and postpartum : a systematic review with implications for the function of the oxytocinergic system
- 2023
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The reproductive hormone oxytocin facilitates labour, birth and postpartum adaptations for women and newborns. Synthetic oxytocin is commonly given to induce or augment labour and to decrease postpartum bleeding.AIM: To systematically review studies measuring plasma oxytocin levels in women and newborns following maternal administration of synthetic oxytocin during labour, birth and/or postpartum and to consider possible impacts on endogenous oxytocin and related systems.METHODS: Systematic searches of PubMed, CINAHL, PsycInfo and Scopus databases followed PRISMA guidelines, including all peer-reviewed studies in languages understood by the authors. Thirty-five publications met inclusion criteria, including 1373 women and 148 newborns. Studies varied substantially in design and methodology, so classical meta-analysis was not possible. Therefore, results were categorized, analysed and summarised in text and tables.RESULTS: Infusions of synthetic oxytocin increased maternal plasma oxytocin levels dose-dependently; doubling the infusion rate approximately doubled oxytocin levels. Infusions below 10 milliunits per minute (mU/min) did not raise maternal oxytocin above the range observed in physiological labour. At high intrapartum infusion rates (up to 32 mU/min) maternal plasma oxytocin reached 2-3 times physiological levels. Postpartum synthetic oxytocin regimens used comparatively higher doses with shorter duration compared to labour, giving greater but transient maternal oxytocin elevations. Total postpartum dose was comparable to total intrapartum dose following vaginal birth, but post-caesarean dosages were higher. Newborn oxytocin levels were higher in the umbilical artery vs. umbilical vein, and both were higher than maternal plasma levels, implying substantial fetal oxytocin production in labour. Newborn oxytocin levels were not further elevated following maternal intrapartum synthetic oxytocin, suggesting that synthetic oxytocin at clinical doses does not cross from mother to fetus.CONCLUSIONS: Synthetic oxytocin infusion during labour increased maternal plasma oxytocin levels 2-3-fold at the highest doses and was not associated with neonatal plasma oxytocin elevations. Therefore, direct effects from synthetic oxytocin transfer to maternal brain or fetus are unlikely. However, infusions of synthetic oxytocin in labour change uterine contraction patterns. This may influence uterine blood flow and maternal autonomic nervous system activity, potentially harming the fetus and increasing maternal pain and stress.
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| 6. |
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| 7. |
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| 8. |
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| 9. |
- Ekström, Anette, 1958-, et al.
(författare)
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Nurses and midwives professional support increases with improved attitudes - design and effects of a longitudinal randomized controlled process-oriented intervention
- 2015
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Ingår i: BMC Pregnancy and Childbirth. - : BioMed Central. - 1471-2393 .- 1471-2393. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Becoming parents for the first time is challenging. Mothers need both social and professional support to handle these challenges. Professionals’ attitudes affect quality of care and support. So to improve professional support, an intervention consisting of a process-oriented training was performed. Due to the positive results of the intervention there is a need to illuminate the methodological approach further. The overall aim was therefore to describe a methodological approach to improve and evaluate health care professionals’ attitudes toward breastfeeding and parental support in order to improve quality of care in childbearing.Methods: This study was a longitudinal randomized control intervention study, in which groups of mothers received care in childbearing from midwives and child health nurses. These health professionals had gone through a process-oriented training, or not. In order to improve attitudes of health professionals the training was based on evidence, practical skills and reflective processes (both private and professional experiences) in relation to breastfeeding and parental support. Included in the longitudinal study were health professionals from five intervention municipalities n = 36 and health professionals from five control municipalities n = 45. All mothers who fulfilled the inclusion criteria were consecutively identified from the hospital register and asked to participate in the study. Mothers who accepted to participate were included in the interventions group (n = 206) or control groups (n = 162, n = 172 respectively) based on which municipality they belonged to.Results: The results of the process-oriented training improved the professionals’ attitudes toward breastfeeding and parental support. These improved attitudes in health professionals increased intervention-group mother’s satisfaction with professional and social support. Intervention-group mother’s relation to and feelings for their baby as well as breastfeeding was also improved.Conclusion: These results stress the importance of professionals’ attitude in quality of care during childbearing, as well as pointing to the possibility to improve professionals’ attitudes with a process-oriented training.Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR), trial registration:ACTRN12611000354987.
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| 10. |
- Ekström-Bergström, Anette, 1958-, et al.
(författare)
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The concept, importance and values of support during childbearing and breastfeeding : A discourse paper
- 2022
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Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 9:1, s. 156-167
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Tidskriftsartikel (refereegranskat)abstract
- Background: Professional support in childbearing has beneficial effects on childbirth experience, interactions within the family, breastfeeding and medical outcomes. However, more knowledge is needed about prerequisites for professional support to be valuable and satisfactory during childbearing. Aim: The aim of this discourse paper is to describe and explore prerequisites for professional support that are of value for women and their families during childbearing as well as how healthcare organizations can be formed to facilitate these prerequisites. Design: Discourse paper. Methods: This discourse paper is based on our own experiences and is supported by literature and theory. Results: Well-functioning structures and processes facilitate professional support that leads to safe, secure, calm and prepared parents with the ability to handle the challenges of childbearing and parenting. When organizing care in childbearing, prerequisites for support needs must also be considered.
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| 11. |
- Eriksson, Monica, 1952-, et al.
(författare)
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Meaning of wellness in caring science based on Rodgers's evolutionary concept analysis
- 2024
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Ingår i: Scandinavian Journal of Caring Sciences. - West Sussex : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 38:1, s. 185-99
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Tidskriftsartikel (refereegranskat)abstract
- Background: Wellness is a holistic, multidimensional, and process-oriented property on a continuum. It has been used interchangeably with and is undifferentiated from concepts such as health and well-being without an in-depth clarification of its theoretical foundations and a reflection on its meaning. The concept of wellness is frequently used, but its definition remains unclear. Aim: To conceptually and theoretically explore the concept of wellness to contribute to a deeper understanding in caring science. Method: Rodgers' evolutionary concept analysis was applied to the theoretical investigation of data from publications of international origins. The focus was on antecedents, attributes, consequences, surrogate and related terms, and contextual references. A literature search was performed through a manual review of reference lists and an online search in CINAHL and PubMed via EBSCO, and in ProQuest. Abstracts were examined to identify relevant studies for further review. The inclusion criteria were peer-reviewed papers in English; papers published in scientific journals using the surrogate terms ‘wellness’, ‘health’, ‘health care’, and ‘health care and wellness’; and papers discussing and/or defining the concept of wellness. Twenty-six studies met the inclusion criteria. Results: Based on the findings from this concept analysis, a definition of wellness was developed: ‘a holistic and multidimensional concept represented on a continuum of being well that goes beyond health’. Implications for nursing practice were correspondingly presented. Conclusion: Wellness is defined as a holistic and comprehensive multidimensional concept represented on a continuum of being well, that goes beyond health. It calls attention by applying the salutogenic perspective to health promotion in caring science. It is strongly related to individual lifestyle and health behaviour and is frequently used interchangeably with health and well-being without an in-depth clarification of its theoretical foundation.
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| 12. |
- Granberg, Agnes, et al.
(författare)
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First-Time Mothers' Enjoyment of Breastfeeding Correlates with Duration of Breastfeeding, Sense of Coherence, and Parental Couple and Child Relation : A Longitudinal Swedish Cohort Study
- 2020
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Ingår i: Nursing Research and Practice. - : Hindawi Publishing Corporation. - 2090-1429 .- 2090-1437. ; 2020
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Many women do not reach their own breastfeeding goals regarding duration of breastfeeding. Different factors influence breastfeeding, and to learn more about breastfeeding within a multidimensional and longitudinal perspective, further research is needed. Therefore, the aim of the present study was to investigate diverse factors correlated with first-time mothers' enjoyment of breastfeeding and breastfeeding duration, between childbirth and two years after birth.Methods: In a prospective longitudinal cohort study, 324 newly become mothers were followed. The Spearman correlation test was used to investigate factors correlated with the degree to which mothers enjoy breastfeeding and the duration of breastfeeding. The Mann-Whitney test was conducted for comparisons of demographic characteristics between mothers who did or did not breastfeed.Results: Among the mothers, 99.2% initiated breastfeeding after birth. Frequencies of breastfeeding were 54.8% at six months, 9.1% at one year, and 1.0% at two years. The degree to which the mother enjoyed breastfeeding was correlated positively with (1) the duration of breastfeeding, (2) more positive feelings for and relation to the child, (3) the partner's perceived relation to the child, (4) a higher sense of coherence, and (5) stronger perceived parental couple's relationship. Longer breastfeeding duration was correlated positively with (1) a higher degree of enjoyment of breastfeeding, (2) more positive relation to the child, and (3) stronger perceived parental couple's relationship. Additionally, breastfeeding during the first two hours after birth, more positive feelings for and relation to the child, and a higher degree of enjoyment of breastfeeding were more frequently reported among breastfeeding mothers, in comparison with not breastfeeding mothers.Conclusion: Mothers' subjective experience from breastfeeding, sense of coherence, and couple relationship with partner and relationship with the child are valuable factors in regard to breastfeeding.
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| 13. |
- Handlin, Linda, 1981-, et al.
(författare)
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Promoting health of Swedish workers by complementary methods : example of a study design of a longitudinal randomized controlled intervention study
- 2017
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Ingår i: Medical Research Archives. - USA : KEI Journals. - 2375-1916 .- 2375-1924. ; 5:8, s. 1-13
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Tidskriftsartikel (refereegranskat)abstract
- Background: When designing, implementing, and evaluating a work site health promotion program, it is necessary to ensure that the program is evidence based. The present article aims to present in-depth information on the design of a longitudinal randomized controlled complementary intervention pilot study that follows the Consort recommendations to evaluate possible effects of a health promotive intervention in healthy workers.Methods: Employees from four different workplaces were randomly assigned to one of the following groups: i) Massage and mental training (sitting in the armchair and receiving mechanical massage while listening to mental training programs, n=19), ii) Massage (sitting in the armchair and receiving mechanical massage only, n=19), iii) Mental training (sitting in the armchair and listening to mental training programs only, n=19), iv) Pause (sitting in the armchair but not receiving mechanical massage or listening to mental training programs, n=19), v) Control (not sitting in the armchair at all, n=17). The study lasted for eight weeks. Immediately before the randomization, after four weeks and after eight weeks the participants responded to statements from the Swedish Scale of Personality and had their heart rate, blood pressure and fingertip temperature measured.Results: Receiving mechanical massage and listening to mental training programs, either separately or in combination, during working hours had some positive effects on the employees’ own evaluation of their health, as well as their heart rate, blood pressure and fingertip temperature. However, the intervention need to be evaluated further.Conclusion: The approach described makes it possible to design, implement and evaluate a work site health promotion program, also on pilot-study level and these results should be seen as a first step towards larger randomized studies. This types of studies need to focus on healthy participants and special care should be taken to guarantee adequately powered study groups and their homogeneity.
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| 14. |
- Hrybanova, Yana, 1987-, et al.
(författare)
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First-time fathers' experiences of professional support from child health nurses
- 2019
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 33:4, s. 921-930
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Tidskriftsartikel (refereegranskat)abstract
- Nowadays, in Sweden, fathers are expected to be active in their father role and to share caring responsibilities for their children equally with mothers. This active role of a father in a family can be challenging, especially for the first-time fathers. Child health nurses’ support is an important factor for fathers to become confident caregivers. The Father Perceived Professional Supportscale (FaPPS scale) can be used in nursing practice for better understanding father’s needs of professional support. The aim of this study was to describe first-timefathers’ experiences of the professional support received from child health nurses and to validate the instrument:‘FaPPS scale’. A qualitative design, with inductive and deductive approaches, was used in this study.Twelve first-time fathers participated in the semi-structuredinterviews, thereafter grading the FaPPS scaleitems and commenting on them. The fathersexperienced nurses’ support positively when nursesprovided practical information and stimulated them to be involved in care of their children. In contrast, thes upport was experienced negatively because of nurses’ lack of commitment, availability and adaptation to the fathers’ individual needs. The fathers also felt inequality between the support received by fathers and by mothers. Although some fathers perceived it as negative, others considered it fair, believing that mothers needed more support. In addition, fathers expect nurses to actively offer support to them and supervise them in childcare. The fathers also needed meeting other parents, for example in parental groups.This study also indicates that FaPPS scale can be used both in research and clinical practice, though still needing further development.
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| 15. |
- Huusko, Linda, et al.
(författare)
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First-Time Fathers´ Experience of Support from Midwives in Maternity Clinics : An Interview Study
- 2018
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Ingår i: Nursing Research and Practice. - : Hindawi Limited. - 2090-1429 .- 2090-1437.
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Tidskriftsartikel (refereegranskat)abstract
- Background.Research shows that first-time fathers want to take part in preparation for birth and parenthood but they describe being excluded by health professionals. Aim. The aim of this study was to illustrate first-time fathers' experiences of support from midwives in maternity clinics as a step in the validation of "The Father Perceived-Professional-Support" (The FaPPS) scale.Methods.A qualitative content analysis with an inductive and deductive approach was used; seven first-time fathers were strategically selected and interviewed. In the inductive part the following open question was asked: "How did you perceive the support from the antenatal midwife/midwives?" In the deductive part, the fathers were asked to respond to the FaPPS scale, in order to receive their thoughts and understanding of the scale, inspired by the "Think-aloud" method. Findings. The inductive results showed two main categories: Experience of not knowing what support they needed and Experience of being excluded. The fathers found support from other fathers in parental education classes, but they lack time to discuss. Overall it seems as if the fathers answered both from their own perspective and from the mothers' perspective. This was not evident in the deductive results. The FaPPs scale should therefore include professionals' ability to strengthen social support from other first-time fathers and professionals' ability to offer support to the mother.Conclusion and Clinical Implications.The fathers experienced exclusion both by themselves and also by midwives. Midwives should offer both parents the opportunity to pose questions. It is important for expectant fathers that time for discussion is planned in parental education classes. The FaPPS scale is useful but needs further development. Parts of our result are in line with earlier research, for decades; therefore it is necessary to focus more on support for fathers.
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| 16. |
- Leinweber, Julia, et al.
(författare)
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Developing a woman-centered, inclusive definition of positive childbirth experiences : A discussion paper
- 2023
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Ingår i: Birth. - : John Wiley & Sons. - 0730-7659 .- 1523-536X. ; 50:2, s. 362-383
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Tidskriftsartikel (refereegranskat)abstract
- Introduction A positive childbirth experience promotes women’s health, both during and beyond the perinatal period. Understanding what constitutes a positive childbirth experience is thus critical to providing high-quality maternity care. Currently, there is no clear, inclusive, woman-centered definition of a positive childbirth experience to guide practice, education, and research.Aim To formulate an inclusive woman-centered definition of a positive childbirth experience.Methods A six-step process was undertaken: (a) Key concepts associated with a positive childbirth were derived from a rapid literature review; (b) The key concepts were used by interdisciplinary experts in the author group to create a draft definition; (c) The draft definition was presented to clinicians and researchers during a European research meeting on perinatal mental health; (d) The authors integrated the expert feedback to refine the working definition; (e) A revised definition was shared with women from consumer groups in six countries to confirm its face validity; and (f) A final definition was formulated based on the women’s feedback (n = 42).Results The following definition was formulated: “A positive childbirth experience refers to a woman’s experience of interactions and events directly related to childbirth that made her feel supported, in control, safe, and respected; a positive childbirth can make women feel joy, confident, and/or accomplished and may have short and/or long-term positive impacts on a woman’s psychosocial well-being.”Conclusions This inclusive, woman-centered definition highlights the importance of provider interactions for facilitating a positive childbirth experience. Feeling supported and having a sense of control, safety, and respect are central tenets. This definition could help to identify and validate positive childbirth experience(s), and to inform practice, education, research, advocacy, and policy-making.
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| 17. |
- Leinweber, Julia, et al.
(författare)
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Developing a woman-centered, inclusive definition of traumatic childbirth experiences : A discussion paper.
- 2022
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Ingår i: Birth. - : John Wiley & Sons. - 0730-7659 .- 1523-536X. ; 49:4, s. 585-842
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Many women experience giving birth as traumatic. Although women's subjective experiences of trauma are considered the most important, currently there is no clear inclusive definition of a traumatic birth to help guide practice, education, and research.AIM: To formulate a woman-centered, inclusive definition of a traumatic childbirth experience.METHODS: After a rapid literature review, a five-step process was undertaken. First, a draft definition was created based on interdisciplinary experts' views. The definition was then discussed and reformulated with input from over 60 multidisciplinary clinicians and researchers during a perinatal mental health and birth trauma research meeting in Europe. A revised definition was then shared with consumer groups in eight countries to confirm its face validity and adjusted based on their feedback.RESULTS: The stepwise process confirmed that a woman-centered and inclusive definition was important. The final definition was: "A traumatic childbirth experience refers to a woman's experience of interactions and/or events directly related to childbirth that caused overwhelming distressing emotions and reactions; leading to short and/ or long-term negative impacts on a woman's health and wellbeing."CONCLUSIONS: This definition of a traumatic childbirth experience was developed through consultations with experts and consumer groups. The definition acknowledges that low-quality provider interactions and obstetric violence can traumatize individuals during childbirth. The women-centered and inclusive focus could help women to identify and validate their experiences of traumatic birth, offering benefits for practice, education, and research, as well as for policymaking and activism in the fields of perinatal mental health and respectful maternity care.
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| 18. |
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| 19. |
- Muller, Jasmin, 1968-, et al.
(författare)
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Mechanical massage and mental training program effect employees' heart rate, blood pressure and fingertip temperature : An exploratory pilot study
- 2016
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Ingår i: European Journal of Integrative Medicine. - : Elsevier. - 1876-3820 .- 1876-3839. ; 8:5, s. 762-768
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Inability to relax and recover is suggested to be a key factor for stress-related health problems. This study aimed to investigate possible effects of mechanical massage and mental training, used either separately or in combination during working hours. Methods: Employees were randomly assigned to one of the following groups: i) Mechanical massage combined with mental training (n = 19), ii) Mechanical massage (n = 19), iii) Mental training (n = 19), iv) Pause (n = 19), v) Control (n = 17). The study lasted for eight weeks. Heart rate, blood pressure and fingertip temperature were measured at start, after four and after eight weeks. Results: Between-group analysis showed that heart rate differed significantly between the groups after 4 weeks (p = 0.020) and tended to differ after eight weeks (p = 0.072), with lowest levels displayed in the massage group and the control group. Blood pressure and fingertip temperature did not differ between the groups. Within-group analysis showed that mechanical massage decreased heart rate (p = 0.038) and blood pressure (systolic p = 0.019, diastolic p = 0.026) and increased fingertip temperature (p = 0.035). Mental training programs reduced heart rate (p = 0.036). Combining the two methods increased diastolic blood pressure (p = 0.028) and decreased fingertip temperature (p = 0.031). The control group had a significant decrease in systolic blood pressure during the first four weeks of the study (p = 0.038) Conclusion: Receiving mechanical massage and listening to mental training programs, either separately or in combination, during working hours had some positive effects on the employees’ heart rate, blood pressure and fingertip temperature. The effects were especially strong for employees who received mechanical massage only.
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| 20. |
- Muller, Jasmin, 1968-, et al.
(författare)
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Mechanical massage and mental training programmes affect employees´ anxiety, stress susceptibility and detachment – a randomised explorative pilot study
- 2015
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Ingår i: BMC Complementary and Alternative Medicine. - : BioMed Central (BMC). - 1472-6882. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Working people's reduced ability to recover has been proposed as a key factor behind the increase in stress-related health problems. One not yet evidence-based preventive method designed to help employees keep healthy and be less stressed is an armchair with built-in mechanical massage and mental training programmes, This study aimed to evaluate possible effects on employees' experience of levels of "Anxiety", "Stress Susceptibility", "Detachment" and "Social Desirability" when using mechanical massage and mental training programmes, both separately and in combination, during working hours.METHODS:Employees from four different workplaces were randomly assigned to one of the following groups: i) Massage and mental training (sitting in the armchair and receiving mechanical massage while listening to the mental training programmes, n=19), ii) Massage (sitting in the armchair and receiving mechanical massage only, n=19), iii) Mental training (sitting in the armchair and listening to the mental training programmes only, n=19), iv) Pause (sitting in the armchair but not receiving mechanical massage or listening to the mental training programmes, n=19), v) Control (not sitting in the armchair at all, n=17). In order to discover how the employees felt about their own health they were asked to respond to statements from the "Swedish Scale of Personality" (SSP), immediately before the randomisation, after four weeks and after eight weeks (end-of-study).RESULTS:There were no significant differences between the five study groups for any of the traits studied ("Somatic Trait Anxiety", "Psychic Trait Anxiety", "Stress Susceptibility", "Detachment" and "Social Desirability") at any of the occasions. However, the massage group showed a significant decrease in the subscale "Somatic Trait Anxiety" (p=0.032), during the entire study period. Significant decreases in the same subscale were also observed in the pause group between start and week eight (p=0.040) as well as between week four and week eight (p=0.049) and also in the control group between the second and third data collection (p=0.014). The massage and mental training group showed a significant decrease in "Stress Susceptibility" between week four and week eight (p=0.022). The pause group showed a significant increase in the subscale "Detachment" (p=0.044).CONCLUSIONS:There were no significant differences between the five study groups for any of the traits studied. However, when looking at each individual group separately, positive effects in their levels of "Anxiety", "Stress Susceptibility" and "Detachment" could be seen. Although the results from this pilot study indicate some positive effects, mechanical chair massage and mental training programmes used in order to increase employee's ability to recover, needs to be evaluated further as tools to increase the employees ability to recover.
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| 21. |
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| 22. |
- Möller Ranch, Matilda, et al.
(författare)
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First-Time Mothers Have a Desire to Be Offered Professional Breastfeeding Support by Pediatric Nurses : An Evaluation of the Mother-Perceived-Professional Support Scale
- 2019
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Ingår i: Nursing Research and Practice. - : Hindawi Limited. - 2090-1429 .- 2090-1437.
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although the World Health Organization recommends exclusive breastfeeding for six months, the rate of breastfeeding has decreased worldwide. Breastfeeding is the natural way of feeding a baby, but it is a process that has to be learnt. It is not unusual for problems to occur and hence support for breastfeeding is vital. The aim of this study was to explore first-time mothers' experiences of the breastfeeding support offered by pediatric nurses, as well as to develop and evaluate the Mother Perceived Support from Professionals (MoPPS) scale.Methods: A qualitative design involving both inductive and deductive approaches was chosen. Nine first-time mothers were interviewed regarding their experiences of the breastfeeding support offered by pediatric nurses. Semistructured interviews were conducted. The mothers were also asked to grade their experiences of breastfeeding support on the MoPPS scale. A qualitative content analysis was applied when analyzing the data obtained using both the inductive (interviews) and deductive (MoPPS scale) approaches.Results: The results revealed that the mothers felt the desire to breastfeed, although they all experienced some difficulties. They wanted the pediatric nurses to be perceptive and provide professional support based on their own experiences. When the pediatric nurses took time and booked extra appointments, the mothers felt supported. The inductive analysis resulted in one theme: "When wanting to breastfeed, mothers have a desire to be offered professional breastfeeding support". Two main categories were identified, namely "Mothers wanted but lacked breastfeeding support" and "Mothers received professional support." The deductive analysis of the MoPPS scale showed similar results, and the questions were perceived as relevant to the aim. The mothers considered it important that the pediatric nurses had sufficient knowledge about breastfeeding. It was also considered important that the pediatric nurses involved the mothers' partners in the breastfeeding support. Therefore, we suggest that these areas should be included in the MoPPS scale for pediatric nurses.Conclusions: The MoPPS scale can be a useful tool for helping pediatric nurses to offer mothers professional breastfeeding support. Indeed, when offering breastfeeding support, pediatric nurses can use the items included on the MoPPS scale as guidance.
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| 23. |
- Olza, Ibone, et al.
(författare)
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Birth as a neuro-psycho-social event : An integrative model of maternal experiences and their relation to neurohormonal events during childbirth
- 2020
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Ingår i: PLOS ONE. - San Francisco, California, USA : PLOS. - 1932-6203. ; 15:7, s. 1-15
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Psychological aspects of labor and birth have received little attention within maternity care service planning or clinical practice. The aim of this paper is to propose a model demonstrating how neurohormonal processes, in particular oxytocinergic mechanisms, not only control the physiological aspects of labor and birth, but also contribute to the subjective psychological experiences of birth. In addition, sensory information from the uterus as well as the external environment might influence these neurohormonal processes thereby influencing the progress of labor and the experience of birth.METHODOLOGY: In this new model of childbirth, we integrated the findings from two previous systematic reviews, one on maternal plasma levels of oxytocin during physiological childbirth and one meta-synthesis of women´s subjective experiences of physiological childbirth.FINDINGS: The neurobiological processes induced by the release of endogenous oxytocin during birth influence maternal behaviour and feelings in connection with birth in order to facilitate birth. The psychological experiences during birth may promote an optimal transition to motherhood. The spontaneous altered state of consciousness, that some women experience, may well be a hallmark of physiological childbirth in humans. The data also highlights the crucial role of one-to-one support during labor and birth. The physiological importance of social support to reduce labor stress and pain necessitates a reconsideration of many aspects of modern maternity care.CONCLUSION: By listening to women's experiences and by observing women during childbirth, factors that contribute to an optimized process of labor, such as the mothers' wellbeing and feelings of safety, may be identified. These observations support the integrative role of endogenous oxytocin in coordinating the neuroendocrine, psychological and physiological aspects of labor and birth, including oxytocin mediated. decrease of pain, fear and stress, support the need for midwifery one-to-one support in labour as well as the need for maternity care that optimizes the function of these neuroendocrine processes even when birth interventions are used. Women and their partners would benefit from understanding the crucial role that endogenous oxytocin plays in the psychological and neuroendocrinological process of labor.
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| 24. |
- Thapa, Dip Raj
(författare)
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A health-promotive approach to maintain and sustain health in women-dominated work in Nepal and Sweden
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: The characteristics of women-dominated work differ in Nepal compared to Sweden. Women in Nepal perform household and other low-income work, including nursing, which is a women-dominated occupation in both Nepal and Sweden. Work-related adverse health outcomes, such as burnout, fatigue, depression, sleep disturbances, and long-term sickness absence, are evident in women-dominated work, especially within nursing. These challenges are accompanied by an increasing elderly population and a shortage of nursing personnel. Good health and well-being for all, improvingworking conditions and working environment, and providing adequate health and safety at work are the targets of sustainable development goals. Healthpromotive actions and interventions are needed to maintain and sustain health in women-dominated work.Aims: The overall aim of this thesis was to identify means for promoting and sustaining health in women-dominated work in Nepal and Sweden through the evaluation and exploration of sense of coherence (SOC), work-related health, job demands, job resources, and health outcomes.Methods: This thesis includes five individual papers. Paper I is a community-based intervention study with a quantitative design conducted in Nepal. The participants were 857 women before and 1268 women after health educationintervention in Nepal, who responded to a translated version of the SOC-13 questionnaire in Nepali. Papers II and III have a qualitative design and are based on 19 individual interviews with nurses in Nepal. Paper IV is also a qualitative study, based on 13 individual interviews with midwives and nurses in Sweden. Paper V is derived from the Swedish Longitudinal Occupational Survey of Health (SLOSH). Data were collected in 2016–2019 for all papers. The quantitative studies were analyzed through descriptive statistics, chisquared tests, one-way analyses of variance (ANOVAs), multivariable oneway ANOVAs, and logistic regression analyses. The qualitative studies werebased on individual interviews, and the data were analyzed through qualitative content analysis and thematic analysis.Results: Women in semi-urban Nepal exhibited total SOC mean values between 51.1 and 57.4, which are comparable to India within a similar context. Qualitative validation of the SOC-13 questionnaire in Nepali was found to be general and not specific, and some translations were confusing. The SOC-13 items needed to undergo further editing in translation to increase theircomprehensions. Nurses in Nepal and nurses and midwives in Sweden described their work experience as meaningful, and several experiences were partially similar; their work and health were reported to be strengthened through collegial support, teamwork, and opportunities for skills and competence development. Shift work, lack of rewards and appreciation from managers, low staff-patient ratios, and high workload affected their work-related health negatively. In particular, nurses in Nepal experienced a lack of a safe physical work environment and insufficient managerial support. Results from SLOSH-data showed that the nursing professionals’ job demands were associated with lower self-rated health, higher burnout, and higher sickness absence. Job resources were associated with higher self-rated health and lower burnout.Conclusion: This thesis shows that the SOC-13 questionnaire is useful and qualitatively validated for future use in the Nepalese context, to explore individuals’ overall life orientation and abilities to cope with various life events. Health education can be useful in strengthening SOC among women. To maintain, promote, and sustain health in women-dominated work, a health-promotive approach should be fostered. Nursing professionals’ health can be strengthened and sustained through the development of a positive work environment through good collegial, organizational, and managerial support, offering skills and competence development opportunities, and creating a safe physical and psychosocial work environment. Increasing job resources and minimizing job demands are important to increase positive health outcomes and decrease adverse health outcomes. Nursing professionals in Nepal and Sweden can also adopt strategies that support recovery and stress-management at work
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| 25. |
- Thapa, Dip Raj, et al.
(författare)
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A Qualitative Evaluation and Cross-Cultural Adaptation of the Short Form of the Sense of Coherence Scale (SOC-13) in Nepali
- 2023
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Ingår i: Kathmandu University Medical Journal. - : Kathmandu University. - 1812-2027 .- 1812-2078. ; 21:82, s. 112-117
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Tidskriftsartikel (refereegranskat)abstract
- Background Sense of Coherence (SOC) relates to an individual’s overall life orientation, and stronger SOC is associated with better health, quality of life, and coping strategies. When our research group used the SOC-13 questionnaire for the first time in Nepal, we identified difficulties in response patterns. The findings necessitated further evaluation of the Nepali version of the SOC-13 questionnaire.Objective To qualitatively evaluate the SOC-13 questionnaire in Nepali for cross-cultural adaptation.Method Nineteen nurses were interviewed. We used the methodological approach of “think aloud” to obtain a deeper understanding of the interferences of the scales. Transcribed materials were analyzed using a deductive approach through qualitative content analysis. The original translated version of the SOC-13 questionnaire in Nepali was modified by replacing words that were easier to understand.Result Participants found the questionnaire content general and non-specific but easy to complete. The nurses experienced that the meanings and sentences in some of the items and response alternatives were difficult to understand. However, the overall comprehensiveness of most items and response alternatives was perceived as good. Nurses’ interpretation of the SOC-items in the translated version of the SOC-13 questionnaire in Nepali matched the original English version. Items that were experienced as difficult in the Nepali language were modified to increase their comprehensiveness. Modified items and response alternatives had the same content as before, but some words and meanings were substituted with easier language.Conclusion The current revised version of SOC-13 in Nepali is valid and useful to explore individuals’ overall life orientation and their abilities to deal and cope with various life events in the Nepalese context.
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| 26. |
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| 27. |
- Thapa, Dip Raj, et al.
(författare)
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Determination and evaluation of sense of coherence in women in semi-urban nepal: A part of the heart-health associated research, dissemination, and intervention in the community (hardic) trial
- 2021
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Ingår i: Kathmandu University Medical Journal. - : Kathmandu University. - 1812-2027 .- 1812-2078. ; 19:73, s. 69-75
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Tidskriftsartikel (refereegranskat)abstract
- Background Sense of coherence (SOC) is a core concept of salutogenesis which relates to individuals’ overall life orientation. Stronger SOC associates with better coping strategies, better health, and better quality of life. Although the SOC-questionnaire is validated in many cultures and languages, it has not, to date, been applied in Nepal. Objective To determine and evaluate women’s SOC before and after a health education intervention. Method This study was conducted as a part of the Heart-health Associated Research, Dissemination, and Intervention in the Community in the semi-urban Jhaukhel-Duwakot Health Demographic Surveillance Site in Nepal. Jhaukhel and Duwakot were selected as the control and intervention areas, respectively. Participants were women with children aged 1-7 years. Eight hundred and fifty-seven women before and 1,268 women after the health education intervention participated in the study. The statistical analysis was carried out with chi-square tests and one-way uni-variate ANOVA. Result Women’s total SOC mean values at baseline were 51.1-57.4 and at follow up 54.4-54.9 in the intervention and control area, respectively. At baseline, SOC was significantly weaker in the intervention area compared to the control area (p < 0.001). At follow-up three months later, SOC was significantly stronger in the intervention area than in the control area (p < 0.001). Conclusion Nepalese women had weaker SOC than women in high-income countries, but comparable to neighboring country India with similar cultural features. Empowerment of women through community participation and health education strengthened SOC. The SOC-13-questionnaire in its Nepali version is recommended to be further evaluated. © 2021, Kathmandu University. All rights reserved.
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| 28. |
- Thapa, Dip Raj, et al.
(författare)
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Facilitators for and barriers to nurses’ work-related health : a qualitative study
- 2022
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Ingår i: BMC Nursing. - : BioMed Central (BMC). - 1472-6955. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Work-related health problems, such as work stress, fatigue, and burnout constitute a global challenge within the nursing profession. Work-related health among nurses is not yet a prioritized phenomenon in Nepal. Health-promoting approaches to maintaining and sustaining nurses’ health are therefore essential. The aim of this study was to explore and thereby gain a deeper understanding of how nurses in Nepal’s hospitals experience their everyday work, with a focus on promoting and sustaining their work-related health.Methods: A qualitative design with semi-structured individual interviews were used. Nineteen registered nurses working at hospitals in Kathmandu Valley, Nepal, were individually interviewed between October 6 and December 5, 2018. Transcribed interviews were analyzed through thematic analysis.Results: Four main themes with belonging eight subthemes were constructed from the analysis: (1) “Sense of meaningfulness and belongingness in work culture” with subthemes; “Open environment” and “Sharing attitude and cooperating for the entire team” (2) “Support and rewards from the management team” with subthemes; “Lacking managerial support” and “Fair evaluation and job promotion opportunities”(3) “Workload and protection against work-related hazards” with subthemes; “Stressful and multitasking in workload” and “Lacking equipment for own health and caring”, and (4) “Motivation through opportunities and activities” with subthemes; “Employment benefits that motivate work”, and “Activities outside of work needed to recover”. These main themes and subthemes described nurses’ facilitators for and barriers to their work environment and health.Conclusion: Our study highlighted nurses’ experiences with facilitators and barriers to their work-related health. Nurses’ work-related health was positively affected by support from colleagues, managers, and the organization. Conversely, less support from managers, lack of equipment, and unfair judgment were barriers to nurses’ work-related health. This study adds new knowledge about nurses’ work-related health from the context of Nepal. Hospital organizations and nursing managers in similar cultural and healthcare settings can apply the results of our study to develop strategies to promote and sustain nurses’ health and prevent work-related illness.
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| 29. |
- Thapa, Dip Raj, et al.
(författare)
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Job demands, job resources, and health outcomes among nursing professionals in private and public healthcare sectors in Sweden - a prospective study
- 2022
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Ingår i: Bmc Nursing. - : Springer Science and Business Media LLC. - 1472-6955. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Nursing professionals exhibit high prevalence of stress-related health problems. Job demands and job resources are parallel drivers of health and well-being among employees. Better job resources associate with better job satisfaction, job motivation and engagement even when job demands are high. To date, there is limited research which explores the association between job demands, job resources and health outcomes among nursing professionals in the Swedish context. The aim of this study was therefore to investigate Swedish nursing professionals' job demands and job resources in relation to health outcomes, with comparisons between the private and public healthcare sectors. The specific research questions were as follows: (1) Are there differences between private and public healthcare regarding job demands, job resources, and health outcomes? and (2) Are there prospective associations between job demands and job resources in relation to health outcomes? Methods Data were drawn from the Swedish Longitudinal Occupational Survey of Health (SLOSH) 2016 and 2018, including 520 nurses and 544 assistant nurses working in the private and public healthcare sectors from 2016 (baseline). Data were analyzed using binary logistic regression. Results Nursing professionals reported higher threats, lower bullying, lower control, lower social support, and lower cohesion in the public healthcare units compared to the private healthcare units. The prospective analyses showed that job resources in terms of social support and rewards were associated with higher self-rated health and lower burnout. Cohesion was associated with higher self-rated health. Job demands in terms of psychological demands and job efforts were associated with lower self-rated health, higher burnout, and higher sickness absence, while emotional demands were associated with higher burnout. Conclusions Nursing professionals' job resources are deficient in public healthcare units. Job resources are associated with positive health outcomes, whereas job demands are associated with negative health outcomes, among nursing professionals. Strengthening job resources among nursing professionals in the private and public healthcare sectors can promote and sustain their work-related health.
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| 30. |
- Thapa, Dip Raj, et al.
(författare)
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Support and resources to promote and sustain health among nurses and midwives in the workplace : A qualitative study
- 2021
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Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 41:3, s. 166-174
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Tidskriftsartikel (refereegranskat)abstract
- Registered nurses and midwives are in short supply and have among the highest rates of sick leave in the global workforce. The aim of this study was therefore to explore and gain a deeper understanding of how nurses and midwives experience their everyday work, with a view toward promoting and sustaining their work-related health. Nine registered nurses and four registered midwives working in hospitals and community healthcare facilities in Sweden were interviewed. The interviews were analyzed using content analysis. This study is reported in accordance with COREQ. One main category emerged: ‘Quality of organizational and collegial support and opportunities to facilitate recovery, health, and patient care’. From this category, four generic categories describing the overall experiences of registered nurses and midwives could be discerned. Based on these results, it is recommended that employers adopt a systematic health-promotive approach to foster and maintain the workplace health of registered nurses and midwives.
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| 31. |
- Thorstensson, Stina, 1956-, et al.
(författare)
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Effects of the “Inspirational Lecture” in Combination With “Ordinary Antenatal Parental Classes” as Professional Support for Expectant Parents : A Pilot Study as a Randomized Controlled Trial
- 2020
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Ingår i: Frontiers In Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Background: Both expectant mothers and their partners describe weaknesses in ordinary parental preparatory professional support provided internationally and nationally within Sweden. Therefore, it is necessary to develop the parental preparatory professional support provided by midwives for expectant parents within Sweden. This study will evaluate the effects on expectant parents of receiving a combination of an “inspirational lecture” and “ordinary antenatal parental classes” compared with only “ordinary antenatal parental classes.”Methods/Design: This block randomized controlled trial included an intervention as a pilot study, in which expectant parents were randomized for (1) the inspirational lecture and ordinary antenatal parental classes (intervention group [IG]) (n = 66) or (2) ordinary antenatal parental classes (control group [CG]) (n = 60). Data collection with repeated questionnaires was conducted in the first week and 6 months after birth. Statistical analyses were conducted for participant characteristics, differences between parents within IG and CG, effects of the intervention, intention to treat, and internal consistency of the included measurements.Results: The intervention showed a tendency to be gainful for one out of four outcomes related to birth experience, and parents' perceived quality of parental couple relationship consensus and sexuality and manageability. These results were more prominent for the partners. Parents within both the intervention and control groups reported decreased social support in the first 6 months after birth.Conclusion and Clinical Implications: Overall, the concept of the inspirational lecture in combination with ordinary antenatal parental classes as parental preparatory professional support seems to be a valuable care intervention. However, this study was a pilot study and the results should therefore be interpreted with caution. More research is needed since childbirth and transition to parenthood are complex processes in need of comprehension.
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| 32. |
- Thorstensson, Stina, 1956-, et al.
(författare)
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To be Supportive or to Care for
- 2014
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Ingår i: Journal of Nursing & Care. - : OMICS Group. - 2167-1168. ; 3:6
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 33. |
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| 34. |
- Thorstensson, Stina, 1956-, et al.
(författare)
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Women's Experiences of Midwifery Support during Pregnancy A step in the Validation of the Scale: "The Mother Perceived Support from Professionals"
- 2015
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Ingår i: Journal of Nursing & Care. - : OMICS Group. - 2167-1168. ; 4:2
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pregnancy can be physically and emotionally stressful for the parents, which means they need adequate professional support. Easy-to-use, validated scales are important in order to develop professional support in Antenatal care as well as in research.The aim: Our aim was to illuminate pregnant women’s experience of professional support at the Antenatal care, in relation to the Mother-Perceived-Professionals-Support (MoPPS) scale.Method: A qualitative study design using the method “Think aloud” with both inductive and deductive approaches, was used. Five first-time mothers were interviewed with open questions followed by questions related to the MoPPS scale items. Data was analyzed using inductive and deductive qualitative content analyses.Results: The inductive analysis resulted in one theme: “Professional support from midwives made women created a feeling of security and unique or rejected and lonely during pregnancy” and three categories: “Continuity and competence”, “Perceiving trust or not” and “Parental groups or individual visits”. The deductive analysis described the mothers’ understanding of each item. However, coherence between the inductive and deductive analyses varied and the MoPPS-scale needs development.Conclusion: The result shows that women's experience of professional support affects their sense of feeling safe or lonely during pregnancy. Important for midwives were to meet the women’s unique individual needs. The MoPPS scale was considered to be relevant and easy to understand, but it needs development to include questions about continuity, parental groups and the perception of midwives’ competence, which all were important for the women during their pregnancies.Clinical implications: To offer adequate professional support for women during pregnancy, midwives need to meet the women’s unique individual needs with both medical and supportive knowledge.
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| 35. |
- Truong, Anh, et al.
(författare)
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A work-integrated educational intervention in health and social care : professionals’ experiences of joint education
- 2024
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Ingår i: Studies in Continuing Education. - 0158-037X .- 1470-126X. ; , s. 1-17
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Tidskriftsartikel (refereegranskat)abstract
- Worldwide, educational interventions (EI) are continuously carried out to support the development of individuals and organisations. Keeping pace with rapid changes in modern workplaces requires continuous learning on the part of professionals. The same requirement applies to professionals in the sector of health and social care. Although research has begun to identify the knowledge and competence requirements of professionals within the sector, we need more knowledge about the implementation of EIs as well as their impact on professionals’ learning in this context. Accordingly, this study aimed to explore professionals’ experience with a work-integrated learning – designed EI that combined web-based lectures and structured group reflections, with a focus on learning and the learning process. Qualitative content analysis of the interview data revealed that the work-integrated learning (WIL) design had a positive impact on individual, as well as intraprofessional and interprofessional, learning. This resulted in an understanding of the fundamentals of professionals’ learning and how it was supported or disrupted during the course of the intervention. Moreover, a sense of affirmation was shown to have an impact on professionals’ learning. These findings may constitute a meaningful contribution to the development of EIs for professionals both within this context and more generally.
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| 36. |
- Truong, Anh, et al.
(författare)
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A Work-Integrated intervention in health and social care : Professionals´ experiences of joint education
- 2022
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Ingår i: International Conference on Work Integrated Learning. - Trollhättan : University West. - 9789189325302 ; , s. 97-98
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction:Worldwide, educational interventions are carried out continuously as an ongoing activity linked to competence provision and development of the organization. In follow-up and evaluation of the interventions, the result, i.e., the effect of the intervention, has usually been the main concern whereas the mechanism behind the operation of the intervention is often obscured. The aim of this evaluation study is to contribute knowledge to the field of intervention research regarding aspects that should be considered in designing a learning-supportive educational intervention. Such knowledge would increase the likelihood that experiences generated from the intervention are implemented in the daily undertaking.Accordingly, knowledge within intervention research increased significantly since the field expanded rapidly in the past decade. However, critical voices have been raised regarding aspects that are often overlooked in the field and highlighted the tendency that intervention studies frequently focus on the meth ods used to test the intervention whereas the rigor of intervention development and design has not received the attention it deserves. When it comes to educational intervention, concerning the aforementioned viewpoint, the process of learning cannot be lef t out. Studying learning processes and studies in designing education to support learners´ learning process is one of the main areas of interests in Work-Integrated Learning (WIL), particularly in the matter of learning in relation to working life, where the goal is to help the learners to integrate knowledge from education into practice. From the perspective of WIL, the social dimension has a certain influential effect on learning, which should be taken into account. A key word in this dimension is interaction. Nationally and internationally, within health care, recurring training, intraprofessional and/or interprofessional is given aiming to improve professionals' knowledge, attitudes, confidence levels and practices in care, in addition, to enhancing the collaboration to safeguard the patient safety and the quality-of-care. In Sweden, one area that has been debated and discussed regarding competence and knowledge scarcity among professionals and urged for measures to support competence provision, is health and social care for people with intellectual disabilities. In this context, the knowledge that can be applied in development and design of effective educational intervention appears to be almost zero. We are in the opinion that this knowledge gap should be a matter of concern and an area that needs to be explored.Methods:Data was gathered by way of semi structured interviews. Qualitative inductive analysis was applied using qualitative content analysis of Graneheim and Lundman.Totally, 24 individual interviews were conducted with the participating professionals. With guidance of the checklist COREQ, our ambition is to make the research process in this study as transparent as possible which further increases the replicability.Results:By exploring pa rticipants' experiences of the different components in an intervention with regard to their learning and knowledge development, both individual and of the group, in relation to their profession, finding answers to “what works” and “how it works”. Thereby gaining understanding and knowledge that can be applied in the design of future interventions and consequently, fill the existing knowledge gap.Ethics:Approval was obtained from the Swedish Ethical Review Authority, Dnr 35 517 for the project as whole. In addition, a supplemental application to phase two has made and is approved, on September 21, 2021, Dnr 2021-0460.
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| 37. |
- Truong, Anh, et al.
(författare)
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Caring for Persons With Intellectual Disabilities and Challenging Behavior : Staff Experiences With a Web-Based Training Program
- 2021
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Ingår i: Frontiers in Psychiatry. - : Frontiers Media SA. - 1664-0640. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Background: Clear and effective communication is a prerequisite to provide help and support in healthcare situations, especially in health, and social care services for persons with intellectual disabilities, as these clients commonly experience communication difficulties. Knowledge about how to communicate effectively is integral to ensuring the quality of care. Currently, however, there is a lack of such knowledge among staff working in the disabilities sector, which is exacerbated by challenges in the competence provision in municipal health and social care services. Therefore, the aim of the study was to explore staffs' experience of web-based training in relation to their professional caring for persons with intellectual disabilities and challenging behavior. The intention is to move toward well-evaluated and proven web-based training in order to contribute to competence provision in this specific context.Methods: Fourteen semi-structured interviews were carried out with individual staff members to gather data regarding their experiences with web-based training in relation to their profession. The collected data were analyzed using qualitative content analysis with a focus on both manifest and latent content.Results: The staff's experiences with the web-based training program were presented as a single main theme: "Web-based training for staff initiates a workplace learning process by promoting reflections on and awareness of how to better care for persons with intellectual disabilities and challenging behavior." This theme contained three categories which are based on eight sub-categories.Conclusion and clinical implications: The benefits of web-based training for workplace learning could clearly be observed in the strengthening of professional care for persons with intellectual disabilities and challenging behavior. Staff members claimed to have gained novel insights about how to better care for clients as well as about the importance of interactions in their encounters with clients. Professional teamwork is crucial to providing effective care for persons with intellectual disabilities and challenging behavior. Hence, future research aimed at investigating the views of other healthcare professionals, such as registered nurses, is recommended to improve the competence provision within municipal health and social care services and thereby enhance the quality of care.
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| 38. |
- Truong, Anh, et al.
(författare)
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Caring for Persons With Intellectual Disabilities and Challenging Behavior : Staff Experiences With a Web-Based Training Program
- 2022
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Ingår i: International Conference on Work Integrated Learning. - Trollhättan : University West. - 9789189325302 ; , s. 39-41
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: The quality of care for persons with intellectual disabilities (ID) is affected by many factors, including the knowledge of the professionals. Educational training in, for example, general communication was identified as a priority issue among healthcare professionals working with persons with IDs, as it is the basis for a better understanding of the clients and their behavior, which can otherwise be perceived as problematic and challenging. Challenging behaviors (CB) have been reported by professionals as problems they frequently witness or experience and/or struggle to manage in the daily work. Yet they do not always have access to such training nor to the resources needed to practice skillful communication when supporting persons with IDs. In addition, challenges concerning the competence provision in the sector are likely to contribute to further deterioration of the situation.Earlier research has shown that web-based training for staff within healthcare settings can generate good results. In addition to being able to participate during work hours, staff can also overcome access issues in the delivery of training. With this study, we hope to advance an existing web-based training program with the intention to move toward well-evaluated and proven training in order to contribute to competence provision in the context of health and social care.Aim: To explore staff experiences with a web-based training program in relation to their professional care for persons with ID and CB. Methods: Staff working in residences for people with ID within municipal health and social care were offered the web-based training. In total 20 residences in a medium-size city in Sweden were included in this study. After completed training, fourteen semi-structured interviews were carried out with individual staff members to gather data regarding their experiences with web-based training in relation to their profession. The informants constituted of 11 women and 3 men, aged 27–55. Of the nine informants who had received upper secondary school education, five had specialized in the care of persons with IDs. More precisely, one informant had received higher vocational education, whereas the remaining four had received university education in the social sciences. The work experience with persons with IDs ranged from 8 to 30 years. The interviews were based on two open -ended questions: “What is your experience of attending the web-based training?” and “What do you think about the web-based training in relation to your daily work with persons with IDs and CB?” Follow-up questions were directed in such a way as to encourage the staff to freely share their experiences. This study has an inductive approach. The collected data were analyzed using qualitative content analysis as described by Graneheim and Lundman (2014). Results: The staff’s experiences with the web-based training program in relation to their professional care for persons with IDs and CB were presented as a single main theme: “Web-based training for staff initiates a workplace learning process by promoting reflections on and awareness of how to better care for persons with IDs and CB”. This theme contained three categories: “Web-based training provides freedom but also requires responsibility, both of which affect the learning outcome”, “The learning process contributes to generating insights about caring” and “The mutual impact of training and the opinions of staff about learning for the care of persons with IDs and CB”. These categories were based on eight sub-categories.Overall, the staff claimed that they had gained novel insights into the profession and into the caring process for the clients. Opinions about clients and CB changed somewhat, and the staff was inspired to adopt new ways of working which ultimately benefited interactions with the client. At the same time, requests were made for additional group discussions, and the desire for better planning to enhance learning among the staff was expressed.Discussion: In this study, web-based training seemed to have had a stimulating effect on workplace learning. Sharing self-reflections with group members in addition to individual study is essential for stimulating and consequently extracting knowledge from training. In the preparation of the training, close attention was paid to how to enable both individuals and social processes in learning but, judging from the results, further developments should focus on optimizing the effect of social interaction.Additionally, organizational support appears to be relevant for improving learning outcomes. However, prior research has shown significant differences in perceived workplace learning support from different occupational groups. Higher-status occupations offer a workplace environment that is more conducive to learning than that of lower-status occupations.These aspects must be addressed and overcome to fully develop the competence provision and counteract potential negative consequences in terms of job satisfaction and well-being among professionals working with persons with IDs.Conclusions and clinical implications: Our findings illustrate the complexity of providing staff training in the workplace through a web-based training program. Beyond the benefits of web-based training for workplace learning, some challenges also emerged. We conclude that web-based training, workplace organization, and individuals’ opinions each have an important impact on the learning outcome. To reach the best possible outcome, however, resources need to be invested in all three parts concurrently. This knowledge can contribute to the development of competence provision in municipal health and social care services more generally, where similar circumstances in terms of a notable downward trend in competence provision prevail, a pattern that could have negative impact on the welfare of the professionals.In addition to knowledge, cooperation in both healthcare and social services was also highlighted to improve care for persons with IDs and CB. In order to better meet their needs, professional teamwork is critically important. Hence, future research should investigate the views of other professionals e.g. nurses regarding education and competence development. This approach would enrich our knowledge and understanding of how the competence provision could be enhanced in this context to contribute to social sustainability in the sector.
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| 39. |
- Truong, Anh
(författare)
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Developing an educational intervention to support work-integrated learning among professionals in health and social care for individuals with intellectual disabilities
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Continuing education in the workplace has become a crucial part of contemporary working life, in alignment with modern labor market policies advocating lifelong learning. Work-integrated learning (WIL) is aimed at supporting professional development as part of lifelong learning, emphasizing both theoretical and practical knowledge alongside interactive engagement. Despite its significance, WIL within the context of educational interventions geared toward supporting learning and development among professionals remains an under-researched domain compared to its application in higher education focused on student learning. Previous research has shown that the learning process among professionals may follow a different logic compared to that of students in higher education. This dissertation highlights the development of an educational intervention from both an effectiveness and theory-based perspective, with WIL based on socio-constructivism serving as the point of departure. The intervention was aimed at professionals in municipal health and care for individuals with intellectual disabilities. The intention behind studying these professionals’ learning and development was to extend our knowledge of the ways in which the educational intervention influenced the professionals’ learning process and to reveal key aspects that must be considered in further developments of the intervention. Such knowledge contributions can potentially improve and expand future educational efforts aimed at professionals.The development of the educational intervention followed a pragmatic process consisting of three stages described in four individual papers. Data were collected through surveys and individual semi-structured interviews, which were then analyzed using statistical calculations and qualitative content analysis.The findings illustrated that learning and development among professionals did not follow a straightforward trajectory from the completed educational intervention to the learning outcome. The intervention, consisting of web-based lectures and structured group reflections, was found to support the professionals’ learning, with group reflections acting as a catalyst for collective learning and for the integration of theoretical knowledge into daily practice. However, creating the conditions needed for all participants to engage in group reflections was a key issue and should not be taken for granted in future educational initiatives in which group reflections are intended to be used. Likewise, organizational support and encouragement were found to constitute an important driving force in the professionals’ learning. Overall, learning and development among professionals are complex and influenced by multiple factors and mechanisms. Addressing these complexities requires a simultaneous focus on three fundamental elements: the actors involved in the learning process, the educational intervention itself, and the surrounding context. This can be best accomplished through a structured and systematic approach to the developmental process of the intervention. Such an approach could strengthen professionals’ commitment to lifelong learning and contribute to sustainable educational efforts, both economically and socially.
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| 40. |
- Truong, Anh, et al.
(författare)
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Staff’s self-reported frequency and management difficulty of challenging behavior among persons with intellectual disabilities in connection with web-based training
- 2022
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Ingår i: International Conference on Work Integrated Learning. - Trollhättan : University West. ; , s. 42-45
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Healthcare professionals, nationally and internationally, experience that exposure to persons withintellectual disabilities (ID) during education is often insufficient. Professionals within the sector urge enhancedtraining that will better prepare them for working with their clients. Providing care and support to persons with IDis complex and places high demands on the professionals such as knowledge about ID and cha llenging behaviors(CB) as well as communication and interaction. Earlier studies have shown that knowledge deficiencies in theseareas may prevent healthcare professionals from understanding their clients and their behaviors, particularly thosebehaviors considered to be challenging.However, staff working with persons with ID reported CB as a problem they could not always address in thedesired manner while performing their work duties. This predicament was shown to often generate stress, angerand powerlessness among staff, increasing the likelihood of burnout. Helping staff to better understand and bebetter prepared prior to meeting, communicating and interacting with persons with ID, especially concerningaddressing CB, could therefore help to establish and maintain a healthy work environment and sustainable workinglife.In this study, we investigated the impact of web-based training on the staff´s perception of the frequency andmanagement difficulties of CB among persons with ID in residential settings in Sweden. The training addressedthe topics ID and CB as well as communication and interaction and was offered to the staff working in theresidences. Since the basic assumption was that CB is a consequence of interrupted communication and interactionbetween staff and persons with ID, we hypothesized that by introducing web-based training focusing on ID andCB as well as communication and interaction, the frequency of CB and degree of management difficulty of CB indaily care would be reduced.Aim: To explore staff’s perceptions about CB among clients with ID in residential settings before and after a web -based training program, specifically addressing ID and CB as well as communication and interaction.Research questions1. Do staff report a lower frequency of CB among clients with ID in residential settings after the web -basedtraining?2. Do staff report a lower degree of management difficulty of CB among clients with ID in residential settings afterthe web-based training?Methods: A within-subjects study design was applied in which the participants were exposed to the treatment –in this case, web-based training – and measurements were made using the survey instrument “Checklist ofChallenging Behavior” (CCB) before and after exposure to examine any potential changes that occurred.Cluster sampling was conducted whereby 20 residential facilities were included. All staff in those residences wereoffered web-based training and invited to participate in this study.A total of 212 participants accepted the invitation to the survey by filling in CCB and accordingly systematicallyrate the frequency of CB among the clients and the own difficulty in managing these behaviors as perceived byparticipating staff. The CCB includes 41 items related to topographies of aggressive and other CB divided alongthe dimensions of physical violence/aggressive behavior, property destruction, miscellaneous behavior and mentalillness. The CCB was developed by Harris and Humphreys, who assessed the instrument’s content validity andinter-rater reliability. The researchers concluded that the instrument was a reliable indicator of the presence orabsence of CB. All measurements were based on five-point scale.43First, descriptive analysis was performed to summarize the characteristics of the sample. Central measurementswere presented as the mean and dispersion by standard deviation. As the data were represented on an ordinal scale,the Wilcoxon signed-rank test was used to determine whether a lterations existed between the responses before andafter training concerning the frequency of CB and management difficulty of these behaviors.Considering the number of calculations performed, a significance value of p < 0.05 was established. In addition,p-values < 0.1 were interpreted as tendencies. In order to contribute to indications of practical significance, acorrelation coefficient r was calculated by converting the z-values, as described by Pautz and Olivier, of those subitems with significant values. According to the rule of thumb for interpretation of Cohen’s r: 0.1 = small effectsize, 0.3 = medium effect size and 0.5 = large effect size.Results: The demographic description revealed that, of those who provided information about their job ty pe andlevel of education, approximately 87% worked as support assistants in the facilities, and most had completedsecondary education. The analysis showed that, after training, staff self-reported a significantly lower degree offrequency on the dimension of property destruction, on the sub-item “damaging others’ clothes, furniture, or otherobjects”. Similarly, a significant difference was revealed in the dimension of mental illness. In addition, regardingthe management difficulty of CB, the analysis revealed that, after training, staff self-reported a significantly lowerdegree of management difficulty on all sub-items on the dimension of property destruction. However, the effectsizes were considered small. Apart from that, the calculations also showed tendencies towards significance on anumbers of sub-items e.g biting, throwing things at people, breaking windows and absconding.Discussions: The observed reduction in the frequency of CB after the web-based training may have been due toenhanced knowledge and understanding by staff of CB among their clients, which could have consequently ledthem to no longer consider these behaviors as challenging. In earlier research, it was found that the amount ofknowledge possessed by staff could act as a significa nt predictor of their behavioral responses to CB. Accordingly,it is reasonable to suspect that the reduced management difficulty of CB as perceived by staff may have been dueto their enhanced knowledge of such behaviors, which impacted their views and behavioral responses to CB.Considering the formal education the majority of the staff have and the complexity of the job within this sector, itwould be unreasonable to expect all of the staff to have the capability to perform all job duties without sufficientopportunities to expand their knowledge and improve their skills with the support of the relevant healthcareorganization. This aspect has been equally emphasized to promote a healthy and sustainable workplace from theview of Work-Integrated Learning.Conclusion: Considering the complexity of meeting the needs of persons with ID, in addition to job -specificknowledge, collaboration with multi-professional teams is also recommended. As such, routinely training tosupport Work-Integrated Learning should be offered to all professionals involved in caring for individuals withintellectual disabilities to reinforce social sustainability in the sector.
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| 41. |
- Truong, Anh, et al.
(författare)
-
Staff’s self-reported frequency and management difficulty of challenging behaviour among persons with intellectual disabilities in connection with web-based training
- 2022
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Ingår i: Nordic journal of nursing research. - : SAGE Open. - 2057-1585 .- 2057-1593. ; 43:1, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Providing care and support to persons with intellectual disabilities (ID) requires in-depth knowledge about ID and challenging behaviour (CB) as well as communication and interaction. Knowledge deficiencies in these areas may prevent staff from understanding their clients and their behaviours, particularly those behaviours considered to be challenging. The aim of this study was to explore staff’s perceptions about CB among clients with ID in residential settings before and after a web-based training programme using the survey instrument ‘Checklist of Challenging Behaviour’ (CCB). The CRe-DEPTH guideline has served as a guide in this study. Upon completion of the training, staff perceived a reduced frequency of CB as well as reduced management difficulty of CB among clients. As such, training should routinely be offered to all staff in residential settings, but also healthcare professionals in general responsible for caring for clients exhibiting CB to ensure, improve and reinforce the quality of care and support provided to them.
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| 42. |
- Truong, Anh, et al.
(författare)
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Studying intraprofessional and interprofessional learning processes initiated by an educational intervention applying a qualitative design with multimethod approach : a study protocol
- 2022
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 12:4
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Interprofessional collaboration in education and practice has been highlighted as a premise for providing good care. Both the intraprofessional and interprofessional impacts have bearing on healthcare professionals' performance and learning. Likewise, from the perspective of work-integrated learning, intraprofessional and interprofessional learning play an enduring part in studies about the development of healthcare organisations and professional competence. Educational-intervention research has become significant, which may indicate challenges the healthcare, for example, the area of disabilities is confronting. Earlier studies on intraprofessional and interprofessional learning have often focused on the learning outcome, whereas the learning process remains unexplored. The learning process is complex and is normally influenced by several factors. Therefore, develop knowledge about the intraprofessional and interprofessional learning processes initiated by an educational-intervention and the factors influencing this process may contribute to educational-intervention research, which is also the aim of the forthcoming study. Methods and analysis An inductive qualitative study design with interpretivism as the epistemological stand will be applied. Professionals in healthcare services for people with intellectual disabilities in four residential settings in Sweden are included in the educational-intervention based on web-based training and structured group reflections. Intended data collections are videorecordings of group reflections and individual interviews. An ethnomethodological approach will be applied for studying the details of conversation and interaction in group reflections. The interviews will be analysed using qualitative content analysis to gain participants' viewpoints of the intervention. Ethics and dissemination Approval was obtained from the Swedish Ethical Review Authority, Dnr 35 517. In Addition, a supplemental application to the extended part of the intervention in the forthcoming study has been submitted and approval was received on 21 September 2021. Ethical principles following the Declaration of Helsinki will be strictly followed.
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| 43. |
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| 44. |
- Uvnäs-Moberg, Kerstin, et al.
(författare)
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Maternal plasma levels of oxytocin during breastfeeding-A systematic review
- 2020
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 15:8
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction Oxytocin is a key hormone in breastfeeding. No recent review on plasma levels of oxytocin in response to breastfeeding is available. Materials and methods Systematic literature searches on breastfeeding induced oxytocin levels were conducted 2017 and 2019 in PubMed, Scopus, CINAHL, and PsycINFO. Data on oxytocin linked effects and effects of medical interventions were included if available. Results We found 29 articles that met the inclusion criteria. All studies had an exploratory design and included 601 women. Data were extracted from the articles and summarised in tables. Breastfeeding induced an immediate and short lasting (20 minutes) release of oxytocin. The release was pulsatile early postpartum (5 pulses/10 minutes) and coalesced into a more protracted rise as lactation proceeded. Oxytocin levels were higher in multiparous versus primiparous women. The number of oxytocin pulses during early breastfeeding was associated with greater milk yield and longer duration of lactation and was reduced by stress. Breastfeeding-induced oxytocin release was associated with elevated prolactin levels; lowered ACTH and cortisol (stress hormones) and somatostatin (a gastrointestinal hormone) levels; enhanced sociability; and reduced anxiety, suggesting that oxytocin induces physiological and psychological adaptations in the mother. Mechanical breast pumping, but not bottle-feeding was associated with oxytocin and prolactin release and decreased stress levels. Emergency caesarean section reduced oxytocin and prolactin release in response to breastfeeding and also maternal mental adaptations. Epidural analgesia reduced prolactin and mental adaptation, whereas infusions of synthetic oxytocin increased prolactin and mental adaptation. Oxytocin infusion also restored negative effects induced by caesarean section and epidural analgesia. Conclusions Oxytocin is released in response to breastfeeding to cause milk ejection, and to induce physiological changes to promote milk production and psychological adaptations to facilitate motherhood. Stress and medical interventions during birth may influence these effects and thereby adversely affect the initiation of breastfeeding.
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| 45. |
- 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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| 46. |
- Van Dijk, Willeke, et al.
(författare)
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The Effect of Mechanical Massage and Mental Training on Heart Rate Variability and Cortisol in Swedish Employees : A Randomized Explorative Pilot Study
- 2020
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Ingår i: Frontiers In Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Work-related stress is relatively common in modern society and is a major cause of sick-leave. Thus, effective stress reducing interventions are needed. This study examined the effects of mental training and mechanical massage, on employee's heart rate variability (HRV) and plasma cortisol at their workplaces. Moreover, it was investigated whether baseline systolic blood pressure (SBP) can explain differences in effectiveness of the intervention. Ninety-three participants from four workplaces were randomly assigned to one of the five programs: (I) Mechanical massage and mental training combined, II) Mechanical massage, III) Mental training, IV) Pause, or V) Control. HRV and plasma cortisol were measured at baseline and after 4 and 8 weeks. SBP was measured at baseline. On the reduction of cortisol levels, a small effect of the mechanical massage program was found, whereas no effect was found for the other programs. None of the programs showed any effect on HRV. Nonetheless, when the level of systolic blood pressure was taken into account, some small beneficial effects on HRV and cortisol of mental training and the mechanical massage were found. This exploratory pilot-study provides useful information for future studies that aim to reduce stress among employees.
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