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1.
  • Adama, Esther Abena, et al. (författare)
  • Support needs of parents in neonatal intensive care unit : An integrative review.
  • 2022
  • Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell Publishing Inc.. - 0962-1067 .- 1365-2702. ; 31:5-6, s. 532-547
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Having an infant in the neonatal intensive care unit (NICU) is associated with intense emotional stress for both mothers and fathers. However, with the right support from staff, this stress can be reduced significantly. Although evidence on needs of parents in the neonatal unit exists, there is lack of a systematic integrative review on the support needs of parents in the neonatal unit. Current review evidence is needed to support busy neonatal unit clinicians in their practice.AIM AND OBJECTIVES: The purpose of this integrative review is to explore the current available evidence to describe and understand the support needs of parents of infants in the NICU.METHODS: The integrative review process of Whittemore and Knafl (2005) was used to guide this study. Six databases-MEDLINE, CINHAL, PubMed, Scopus, Google Scholar and PsycINFO-were searched for eligible studies using relevant keywords. Primary studies published in English language from 2010 to 2021 were reviewed following a pre-determined inclusion criteria. Studies that met the inclusion criteria were critically appraised using the Mixed Methods Appraisal Tool (MMAT). The review report is guided by the PRISMA 2020 checklist for systematic reviews.RESULTS: Overall, 24 primary qualitative, quantitative and mixed methods studies were included in the review. Analysis of included studies resulted in six themes that demonstrate the support needs of parents in the NICU; 1. Information needs; 2. Emotionally intelligent staff; 3. Hands-on support; 4. Targeted support; 5. Emotional needs; and 6. Practical needs.CONCLUSION: This review has presented the current evidence on the needs of parents from their own perspective. Healthcare workers' understanding and supporting these needs in the NICU is likely to increase parental satisfaction and improve health outcomes for parents, infants and their family.RELEVANCE TO CLINICAL PRACTICE: Parents of infants in the NICU require staff support to enhance their experiences, well-being, caring and parenting confidence during admission and post-discharge. As parents are in constant need for informational, emotional and practical support, continuing professional development for NICU staff should place emphasis on effective communication strategies, enhancing emotional intelligence and empathy among staff. NICU staff should build positive ongoing relationships with parents and provide targetted support for mothers and fathers.
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2.
  • Angelhoff, Charlotte, medicine doktor, 1974-, et al. (författare)
  • Effect of skin-to-skin contact on parents' sleep quality, mood, parent-infant interaction and cortisol concentrations in neonatal care units : study protocol of a randomised controlled trial
  • 2018
  • Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 8:7
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Separation after preterm birth is a major stressor for infants and parents. Skin-to-skin contact (SSC) is a method of care suitable to use in the neonatal intensive care unit (NICU) to minimise separation between parents and infants. Less separation leads to increased possibilities for parent-infant interaction, provided that the parents' sleep quality is satisfactory. We aimed to evaluate the effect of continuous SSC on sleep quality and mood in parents of preterm infants born <33 weeks of gestation as well as the quality of parent-infant interaction and salivary cortisol concentrations at the time of discharge.Methods and analysis: A randomised intervention study with two arms-intervention versus standard care. Data will be collected from 50 families. Eligible families will be randomly allocated to intervention or standard care when transferred from the intensive care room to the family-room in the NICU. The intervention consists of continuous SSC for four consecutive days and nights in the family-room. Data will be collected every day during the intervention and again at the time of discharge from the hospital. Outcome measures comprise activity tracker (Actigraph); validated self-rated questionnaires concerning sleep, mood and bonding; observed scorings of parental sensitivity and emotional availability and salivary cortisol. Data will be analysed with pairwise, repeated measures, Mann Whitney U-test will be used to compare groups and analysis of variance will be used to adjust for different hospitals and parents' gender.Ethics and dissemination: The study is approved by the Regional Research Ethics Board at an appropriate university (2016/89-31). The results will be published in scientific journals. We will also use conferences and social media to disseminate our findings.
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3.
  • Angelhoff, Charlotte, medicine doktor, 1974-, et al. (författare)
  • Like Walking in a Fog : Parents' perceptions of sleep and consequences of sleep loss when staying overnight with their child in hospital
  • 2020
  • Ingår i: Journal of Sleep Research. - : WILEY. - 0962-1105 .- 1365-2869. ; 29:2
  • Tidskriftsartikel (refereegranskat)abstract
    • Disruption of parental sleep in hospital, with frequent awakenings and poor sleep quality, limits the parents resources to meet the childs needs and maintain parental wellbeing. The aim of the study was to explore and describe how parents perceive their sleep when staying overnight with their sick child in hospital. A further aim was to explore and describe parents perception of what circumstances influence their sleep in the hospital. Twenty-two parents who were accommodated with their sick child (0-17 years) in paediatric wards in Norway and Sweden participated. Interviews were conducted during the hospital stay to elicit their perspectives. Phenomenography was used to analyse data. Two descriptive categories were found: (a) "Perceptions of sleep", with two sub-categories: "Sleep in the paediatric ward" and "Consequences of sleep loss"; and (b) "Circumstances influencing sleep in the paediatric ward" with three sub-categories: "The importance of the family", "Information and routines at the paediatric ward", and "Accommodation facilities". Parents sleep and needs must be acknowledged in paediatric wards. An individual plan of care for the upcoming night could be a valuable tool for both the parents and nurses. The childs medical needs must be met with respect to the parents willingness to take part in the childs care during the night, and the need for rest and sleep for both parent and child.
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4.
  • Angelhoff, Charlotte, 1974-, et al. (författare)
  • Parental mood when staying overnight at hospital with their sick child
  • 2015
  • Konferensbidrag (refereegranskat)abstract
    • Parental mood when staying overnight at hospital with their sick childObjectiveto describe mood in parents, staying with their sick children overnight at the hospital.MethodologyA descriptive design, including 75 parents staying overnight at hospital with their sick child, was used. The parents filled out Mood-scale the morning after staying overnight at the hospital. The Mood-scale is a validated and reliable self-administered instrument measuring six dimensions of mood; control, calmness, social orientation, pleasantness, activation, and extraversion (Sjöberg L, 1979). The study is a part of a larger project, with focus on mood, stress and sleep in parents staying with their sick children overnight at the hospital.ResultsThe result will describe how parents report their total mood and how they report the different dimensions when they stay with their sick children overnight at the hospital. A comparison will be made between the parent´s mood and gender and the child´s age. Data is under analysis and will be presented as preliminary data. ConclusionAccording to UNICEF Convention on the Rights of the Child, children in hospital have the right to have their parents with them at all times and parents should be offered accommodation and be encouraged to stay. However, the hospital environment, in combination with having a sick child, might affect the parent´s mood, which in turn might affect the ability to handle the situation and the child´s care. Therefore it is of importance to study parental mood and find ways to help the families during their hospital stay.
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6.
  • Angelhoff, Charlotte, 1974-, et al. (författare)
  • Parents´ perception of circumstances influencing their own sleep when living with a child enrolled in hospital-based home care services
  • 2015
  • Ingår i: The Gerry Schwartz and Heather Reisman 4th International Conference on Pediatric Chronic Diseases, Disability and Human Development. - Jerusalem : Paragon Israel.
  • Konferensbidrag (refereegranskat)abstract
    • Background: Caring for a sick child creates great demands for the parents. Sleep is an important aspect of wellbeing and is strongly related to stress and quality of life. Caring for a child at home gives the family the opportunity to be together in a familiar environment, but includes several sleep disturbances during the night which affects the ability to handle the situation.Aim: To describe parents’ perceptions of circumstances influencing their own sleep, living with a child enrolled in Hospital-Based Home Care Services.Method: This is a phenomenographic study with an inductive, exploratory design, using semi-structured interviews with main and follow-up questions. Fifteen parents with children enrolled in Hospital-Based Home Care Services were included.Findings: The outcome space consists of four descriptive categories: s; Sleep influence mood and mood influences sleep, Support and safeness influence sleep, The child´s needs and routines influence sleep, and Me-time influences sleep.Discussion: Parents to children in Hospital-Based Home Care Services perceive their sleep differently depending on how safe they feel with the situation. Troubling thoughts, bedtime worries, anxiety and stress affect sleep negatively. Safeness is prerequisite for sleep. Shared responsibility and social support help the parents to cope with the daily life and thus facilitate sleep. The parents adjust their routines after the cild´s needs to find time for sleep and relaxation. Me-time and physical activity was perceived as important tools to improve coping and sleeping.
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7.
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8.
  • Angelhoff, Charlotte, 1974-, et al. (författare)
  • Perceptions of sleep by parents of children in hospital organized home-care
  • 2014
  • Ingår i: Programbok Barnveckan 2014, Malmö, 7-11 april,  2014. ; , s. 33-33
  • Konferensbidrag (refereegranskat)abstract
    • IntroductionCaring for a sick child creates great demands for the parents. Sleep is an important aspect of wellbeing and is strongly related to stress and quality of life. Caring for a child at home gives the family the opportunity to be together in a familiar environment. On the other hand it includes several sleep disturbances during the night which affects the ability to handle the situation. AimTo explore parents’ perceptions of sleep living with a child enrolled in hospital-organized home-care. MaterialFifteen parents with children enrolled in hospital-organized home-care were included. MethodInterviews with open-ended questions, analysed with a phenomenographic method. ResultsFour descriptive categories were identified; ‘Anxiety, stress and demands affects sleep negatively’, ‘When I get support I feel safe’, ‘Routines optimizes time for sleep’, and ‘Time for oneself is important for relaxation’ ConclusionSleep is important for the parents in several aspects. They are in a stressful situation with high demands both from the society and from themselves and there is often a lack of support from relatives and friends. Nurses need to acknowledge and promote parents’ sleep when they care for their sick children at home and support them in the caregiving.
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10.
  • Angelhoff, Charlotte, 1974-, et al. (författare)
  • Perceptions of sleep quality and stress by parents of children enrolled in hospital organized home-care
  • 2013
  • Ingår i: Nordic Advances in Health Care Sciences Research, Lund, 2013. ; , s. 56-56
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • IntroductionCaring for a sick child creates much greater demands for parents than those associated with raising a healthy child. Parents of chronically ill children reports higher levels of parental stress as a consequence of the substantial social, emotional and personal demands associated with caring. Sleep quality is an important aspect of wellbeing and is strongly related to stress and quality of life. In some Swedish counties families are offered hospital organized home-care for sick children. Caring for a child at home gives the family the opportunity to be together in an environment they know well and where they can feel comfortable and secure. On the other hand it includes several sleep disturbances during the night which affects the ability to handle the situation and support their child. No other study is found about how parents sleep when their child is enrolled in hospital organized home-care. AimTo explore parents’ perceptions of sleep quality and stress when they sleep at home with a child enrolled in hospital organized home-care. MaterialFifteen parents (11 mothers and 4 fathers) with children enrolled in hospital organized home-care from one university hospital and one general hospital in South-eastern Sweden were included. The children ranged in age 0-12 years. MethodParents were interviewed with open-ended questions. Data was analysed with a phenomenographic method according to Marton and Both. ResultsFour descriptive categories in the phenomenon of parents’ perceptions of sleep quality and stress when they sleep at home with a child enrolled in hospital organized home-care were identified; Routines helps to manage the situation, Time for oneself and the partner, Feelings of isolation and Need of support ConclusionSleep is important for the parents in several aspects. They are in a stressful situation with high demands both from the society and from themselves and there is often a lack of support from relatives and friends. Nurses need to acknowledge and promote parents’ sleep when they care for their sick children at home and support them in the caregiving.
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11.
  • Angelhoff, Charlotte, 1974-, et al. (författare)
  • Sleep of Parents Living With a Child Receiving Hospital-Based Home Care: A Phenomenographical Study.
  • 2015
  • Ingår i: Nursing Research. - : Lippincott-Ravn Publisher. - 0029-6562 .- 1538-9847. ; 64:5, s. 372-380
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Caring for an ill child at home gives the family the chance to be together in a familiar environment. However, this involves several nocturnal sleep disturbances, such as frequent awakenings and bad sleep quality, which may affect parents' ability to take care of the child and themselves.Objectives: The aim of this study was to describe parents' perceptions of circumstances influencing their own sleep when living with a child enrolled in hospital-based home care (HBHC) services.Method: This is a phenomenographical study with an inductive, exploratory design. Fifteen parents (11 mothers and 4 fathers) with children enrolled in HBHC services were interviewed. Data were analyzed to discover content-related categories describing differences in ways parents experienced sleep when caring for their children receiving HBHC.Results: Four descriptive categories were detected: sleep influences mood and mood influences sleep; support influences safeness and safeness influences sleep; the child's needs influence routines and routines influence sleep; and "me time" influences sleep.Discussion: Sleep does not affect only the parents' well-being but also the child's care. Symptoms of stress may limit the parents' capacity to meet the child's needs. Support, me time, and physical activity were perceived as essential sources for recovery and sleep. It is important for nurses to acknowledge parental sleep in the child's nursing care plan and help the parents perform self-care to promote sleep and maintain life, health, and well-being.
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12.
  • Angelhoff, Charlotte, medicine doktor, 1974-, et al. (författare)
  • Sleep quality and mood in mothers and fathers accommodated in the family-centred paediatric ward
  • 2018
  • Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 27:3-4, s. e544-e550
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims and objectivesTo describe sleep quality and mood in parents accommodated with their sick child in a family‐centred paediatric ward. Secondary aims were to compare mothers’ and fathers’ sleep quality and mood in the paediatric ward and to compare the parents’ sleep quality and mood between the paediatric ward and in a daily‐life home setting after discharge.BackgroundFrequent interruptions, ward noise and anxiety affect parents’ sleep quality and mood negatively when accommodated with their sick child in paediatric wards. Poor sleep quality and negative mood decrease the parents’ ability to sustain attention and focus, and to care for their sick child.MethodsThis was a prospective and descriptive study. Eighty‐two parents (61 mothers and 21 fathers) with children (median age 6.25 years) admitted to six paediatric wards participated in the study. Uppsala Sleep Inventory, a sleep diary and the Mood Adjective Checklist were used to measure sleep quality and mood.ResultsThe parents had a good sleep quality in the paediatric ward even though they had more nocturnal awakenings compared to home. Moreover, they were less alert, less interested and had reduced concentration, and were more tired, dull and passive in the hospital than at home after discharge. Vital sign checks, noises made by the staff and medical treatment were given reasons influencing sleep. Poor sleep quality correlated with negative mood.ConclusionParents’ sleep quality in family‐centred paediatric care is good. However, the habitual sleep efficacy before admittance to the hospital is lower than expected and needs to be further investigated.Relevance to Clinical PracticeThe healthcare professionals should acknowledge parents’ sleep and mood when they are accommodated with their sick child. Further should care at night be scheduled and sleep promoted for the parents to maintain health and well‐being in the family.
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13.
  • Angelhoff, Charlotte, 1974- (författare)
  • What about the parents? : Sleep quality, mood, saliva cortisol response and sense of coherence in parents with a child admitted to pediatric care
  • 2017
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Parents experience many stressful situations when their child is ill and needs medical care, irrespective of the child’s age, diagnosis or the severity of the illness. Poor sleep quality and negative mood decrease the parents’ ability to sustain attention and focus, to care for their ill child, and to cope with the challenges they face.The overall aim of this thesis was to evaluate sleep, mood, cortisol response, and sense of coherence (SOC) in parents caring for children in need of medical care, and to identify factors that may influence parents’ sleep.This thesis includes four original studies; two of these are quantitative, prospective, descriptive and comparative studies including parents (n=82) accommodated in six pediatric wards with their ill child, using questionnaires and sleep logs to measure sleep, mood and SOC, and saliva cortisol to measure cortisol response. A follow-up was performed four weeks later at home, after hospital discharge. The other two studies are qualitative, inductive and explorative interview studies, including parents (n=12) staying overnight with their preterm and/or ill infant in three neonatal intensive care units, and parents (n=15) with a child receiving hospital-based home care in two pediatric outpatient clinics. The interviews were analyzed with a phenomenographic method.Being together with one’s family seems beneficial for sleep and may decrease stress. The ability to stay with the child, in the hospital or at home, was highly appreciated by the parents. When caring for a child with illness, parents’ sleep quality was sufficient in the hospital; however, sleep quality improved further (p<0.05) at home after discharge. The parents reported frequent nocturnal awakenings in the hospital caused by the child, medical treatment and hospital staff. Concern and anxiety about the child’s health, and uncertainty about the future were stressors affecting the parents’ sleep and mood negatively. The parents had lower (p=0.01) morning awakening cortisol levels in the pediatric ward compared to at home, and parents accommodated for more than one night had lower (p<0.05) post-awakening cortisol levels compared to parents staying their first night.The findings of this thesis conclude that being together as a family is important for the parents’ sleep. The ability to be accommodated in the hospital and gather the family around the child may have given the parents time for relaxation and recovery, that in turn may lead to a less stressful hospital stay. When it is beneficial for the child, the whole family should be included in the pediatric care. Moreover, pediatric nurses must acknowledge parents’ sleep, in hospital and at home. Medical treatment and care at night should be scheduled and sleep promoted for the parents in order to maintain health and well-being in the family.
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14.
  • Arabiat, Diana, et al. (författare)
  • Interactive technology use and child development: A systematic review
  • 2023
  • Ingår i: Child Care Health and Development. - : WILEY. - 0305-1862 .- 1365-2214. ; 49:4, s. 679-715
  • Forskningsöversikt (refereegranskat)abstract
    • BackgroundThere is mixed evidence regarding the impact of interactive digital devices on child development. Tentatively some studies suggested that the use of digital devices may correlate negatively with language, executive function, and motor skills. However, attempts to amalgamate this evidence has been limited related to the available number of experimental and cohort studies that have evaluated the impact of digital technology use on child development. We conducted this review to determine the impact of interactive digital devices on child development among children aged 7 years or younger. Interactive technology has been defined as methods, tools, or devices that users interact with in order to achieve specific tasks. Data sourceTo carry out this systematic review, databases CINAHL, MEDLINE, Embase, PsychINFO, Scopus and Google Scholar were searched for relevant studies. Study selectionWe used the Joanna Briggs Institute methodology for systematic reviews. Data extractionData extraction and synthesis was carried out by two reviewers and checked by a third reviewer. Studies were stratified into tiers depending on the level of evidence provided and the domain of development assessed. ResultsFifty-three studies were eligible for inclusion in the review, 39 Tier 1 (randomized controlled trials and quasi-experimental studies) and 16 Tier 2 (descriptive studies). Childrens use of interactive digital technology was positively associated with receptive language and executive function and negatively associated or unrelated to motor proficiency. Other critical aspects informing the evidence, such as dose of exposure, intensity, or duration, were inconsistently reported, making estimates of exposure tentative and imprecise. ConclusionThe studies included in this review were predominantly correlational or comparative in nature and focuses on cognitive domains of learning rather than a specific developmental outcome. It is difficult to generalize our findings beyond the digital devices or applications that have been evaluated by earlier studies. The contextual factors that may moderate the relationship require elaboration in future studies.
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15.
  • Arabiat, Diana, et al. (författare)
  • Pain assessment tools for use in infants: a meta-review
  • 2023
  • Ingår i: BMC Pediatrics. - : BMC. - 1471-2431. ; 23:1
  • Forskningsöversikt (refereegranskat)abstract
    • BackgroundIdentifying pain in infants is challenging due to their inability to self-report pain, therefore the availability of valid and reliable means of assessing pain is critical.ObjectiveThis meta-review sought to identify evidence that could guide the selection of appropriate tools in this vulnerable population.MethodsWe searched Scopus, Medline, Embase, CINAHL, MIDRIS, EMCare and Google Scholar for eligible systematic reviews. Eligible reviews documented psychometric properties of available observational tools used to assess pain in infants.ResultsA total of 516 reviews were identified of which 11 met our inclusion criteria. We identified 36 pain assessment tools (evaluated in 11 reviews) of which seven were reported in at least three reviews. The level of evidence reported on the psychometric properties of pain assessment tools varied widely ranging from low to good reliability and validity, whilst there are limited data on usability and clinical utility.ConclusionsCurrently, no observer administered pain assessment tool can be recommended as the gold standard due to limited availability and quality of the evidence that supports their validity, reliability and clinical utility. This meta-review attempts to collate the available evidence to assist clinicians to decide on what is the most appropriate tool to use in their clinical practice setting. It is important that researchers adopt a standard approach to evaluating the psychometric properties of pain assessment tools and evaluations of the clinical utility in order that the highest level of evidence can be used to guide tool selection.
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16.
  • Areskoug Sandberg, Elin, et al. (författare)
  • Saliva Cortisol in Girls With Functional Abdominal Pain Disorders : A Randomized Controlled Dance and Yoga Intervention.
  • 2022
  • Ingår i: Frontiers in Pediatrics. - : Frontiers Media S.A.. - 2296-2360. ; 10
  • Tidskriftsartikel (refereegranskat)abstract
    • INTRODUCTION: Functional abdominal pain disorders (FAPDs) are common among girls and has been associated with stress. Cortisol is one of the major stress hormones. Dance and yoga have been shown to reduce abdominal pain among girls with FAPDs.AIM: To investigate the effect of an 8-month intervention with dance and yoga on cortisol levels in saliva among girls with FAPDs.METHODS: A total of 121 girls aged 9-13 years with irritable bowel syndrome (IBS) or functional abdominal pain were included in the study. Participants were randomized into an intervention group and a control group. The intervention group attended a combined dance and yoga session twice a week for 8 months. Saliva samples were collected during 1 day, in the morning and evening, at baseline, and at 4 and 8 months. Subjective pain and stress were assessed as well.RESULTS: No significant effects on saliva cortisol levels between groups were observed after completion of the intervention at 8 months. However, evening cortisol and evening/morning quotient were significantly reduced at 4 months in the intervention group compared to the control group (p = 0.01, p = 0.004). There was no association between cortisol quota and pain or stress.CONCLUSION: Improvements in cortisol levels were seen in the intervention group at 4 months but did not persist until the end of the study. This indicates that dance and yoga could have a stress-reducing effect during the ongoing intervention.
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17.
  • Arribas, Christina, et al. (författare)
  • Global cross-sectional survey on neonatal pharmacologic sedation and analgesia practices and pain assessment tools : impact of the sociodemographic index (SDI)
  • 2024
  • Ingår i: Pediatric Research. - : Nature Publishing Group. - 0031-3998 .- 1530-0447.
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: There is variability in the use of sedatives and analgesics in neonatal intensive care units (NICUs). We aimed to investigate the use of analgesics and sedatives and the management of neonatal pain and distress.Methods: This was a global, prospective, cross-sectional study. A survey was distributed May–November 2022. The primary outcome of this research was to compare results between countries depending on their socio-sanitary level using the sociodemographic index (SDI). We organized results based on geographical location.Results: The survey collected 1304 responses, but we analyzed 924 responses after database cleaning. Responses from 98 different countries were analyzed. More than 60% of NICUs reported having an analgosedation guideline, and one-third of respondents used neonatal pain scales in more than 80% of neonates. We found differences in the management of sedation and analgesia between NICUs on different continents, but especially between countries with different SDIs. Countries with a higher SDI had greater availability of and adherence to analgosedation guidelines, as well as higher rates of analgosedation for painful or distressing procedures. Countries with different SDIs reported differences in analgosedation for neonatal intubation, invasive ventilation, and therapeutic hypothermia, among others.Conclusions: Socio-economic status of countries impacts on neonatal analgosedation management.
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18.
  • Berg, Valeska, et al. (författare)
  • Young Children and the Creation of a Digital Identity on Social Networking Sites: Scoping Review
  • 2024
  • Ingår i: JMIR Pediatrics and Parenting. - : JMIR PUBLICATIONS, INC. - 2561-6722. ; 7
  • Forskningsöversikt (refereegranskat)abstract
    • Background: There is limited understanding of the concept of the digital identity of young children created through engagement on social networking sites. Objective: The objective of this scoping review was to identify key characteristics of the concept of digital identity for children Methods: This scoping review was conducted using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. The key databases searched were EBSCO, Web of Science, ProQuest ERIC, and Scopus. Gray literature sources (National Grey Literature Collection, ProQuest Dissertations and Theses, and Google Scholar) were also searched to identify unpublished studies. Articles were selected if they were published in English and reported data on the digital identity of children in relation to social networking sites. Results: The key terms used in the literature were sharenting, followed by digital footprints and children's identities. Our study revealed 2 approaches to the creation of digital identity: social digital identity and performative digital identity. The articles in this review most commonly used the term sharenting to describe the behavior parents engage in to create digital identities for children on social networking sites. Motivations to post information about children differed among parents; however, the most common reasons were to share with friends and family and create digital archives of childhood photos, termed social digital identity. The second motivation was categorized as performative digital identity. The risk of digital kidnapping and identity theft associated with the creation of digital identities also influenced parents' behaviors. Conclusions: The creation of a digital identity for children is an emerging concept. Our review develops a deeper understanding of sharenting behaviors that can be used to better support parents and their children in creating a digital identity with children and awareness of the potential future impact. We recommend that future studies explore the perspectives of children as key stakeholders in the creation of their digital identity.
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19.
  • Blamires, Julie, et al. (författare)
  • The experiences and perceptions of healthy siblings of children with a long-term condition: Umbrella review
  • 2024
  • Ingår i: Journal of Pediatric Nursing. - : ELSEVIER SCIENCE INC. - 0882-5963 .- 1532-8449. ; 77, s. 191-203
  • Forskningsöversikt (refereegranskat)abstract
    • Problem: The lives of healthy siblings living with a sibling with a long- term condition are often shaped by the family, type of illness, length of illness, age of the child, caregiver demands, and support provided to the family, ill sibling, and healthy sibling. While the experiences of healthy siblings are documented in the literature by parent proxy, literature on healthy siblings self-reported experiences of living with a sibling who has a long-term condition remains scarce. Purpose: This umbrella review aims to synthesize reviews on the self-reported experiences of healthy siblings of children living with a sibling who has a long-term condition. Eligibility criteria: Published peer-reviewed reviews in English language exploring the self-reported experiences of healthy siblings under 24 years old, whose siblings are diagnosed with a long-term condition. Sample: Using a developed search strategy, seven electronic databases (CINAHLPlus, Scopus, PubMed, PsycINFO, Cochrane Database of Systematic Reviews, Clinical Key, and Google Scholar) were searched from 2018 till December 2023. Eleven reviews met the inclusion criteria and were subjected to narrative synthesis. Results: Four themes (adjusting to changes, wanting to help, living the ups and downs, living the changes), and eight subthemes were generated from the syntheses. Conclusion: This is the first umbrella review undertaken on healthy siblings self-reported experiences of living with a sibling who has a long-term condition. The impact of a long-term condition on healthy siblings of children with a long-term condition suggests a need for healthcare providers and organisations to provide better emotional, psychological, and informational support to healthy siblings and their families. Implications: Findings from this review will inform healthcare providers, organisations, researchers, and policymakers on the development of future clinical practices and research for healthy siblings.
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20.
  • Edelbring, Samuel, PhD, Docent, 1969-, et al. (författare)
  • Should the PBL tutor be present? : A cross-sectional study of group effectiveness in synchronous and asynchronous settings
  • 2020
  • Ingår i: BMC Medical Education. - : BioMed Central. - 1472-6920. ; 20:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The tutorial group and its dynamics are a cornerstone of problem-based learning (PBL). The tutor's support varies according to the setting, and it is pertinent to explore group effectiveness in relation to different settings, for example online or campus-based. The PBL groups' effectiveness can partly be assessed in terms of cognitive and motivational aspects, using a self-report tool to measure PBL group effectiveness, the Tutorial Group Effectiveness Instrument (TGEI).This study's aim was to explore tutor participation in variations of online and campus-based tutorial groups in relation to group effectiveness. A secondary aim was to validate a tool for assessing tutorial group effectiveness in a Swedish context.Methods: A cross-sectional study was conducted with advanced-level nursing students studying to become specialised nurses or midwives at a Swedish university. The TGEI was used to measure motivational and cognitive aspects in addition to overall group effectiveness. The instrument's items were translated into Swedish and refined with an expert group and students. The responses were calculated descriptively and compared between groups using the Mann-Whitney U and Kruskal-Wallis tests. A psychometric evaluation was performed using the Mokken scale analysis. The subscale scores were compared between three different tutor settings: the tutor present face-to-face in the room, the tutor present online and the consultant tutor not present in the room and giving support asynchronously.Results: All the invited students (n=221) participated in the study. There were no differences in motivational or cognitive aspects between students with or without prior PBL experience, nor between men and women. Higher scores were identified on cognitive aspects (22.6, 24.6 and 21.3; p<0.001), motivational aspects (26.3, 27 and 24.5; p=002) and group effectiveness (4.1, 4.3, 3.8, p=0.02) for the two synchronously tutored groups compared to the asynchronously tutored group. The TGEI subscales showed adequate homogeneity.Conclusions: The tutor's presence is productive for PBL group effectiveness. However, the tutor need not be in the actual room but can provide support in online settings as long as the tutoring is synchronous.
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21.
  • Edéll-Gustafsson, Ulla, et al. (författare)
  • Hindering and buffering factors for parental sleep in neonatal care. A phenomenographic study
  • 2015
  • Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 24:5-6, s. 717-727
  • Tidskriftsartikel (refereegranskat)abstract
    • AIMS AND OBJECTIVES:To explore and describe how parents of preterm and/or sick infants in neonatal care perceive their sleep.BACKGROUND:Parents experience many stressful situations when their newborn infant is preterm and/or sick. This affects bonding. By developing more family-centred care units with single-family rooms, parents are given the opportunity to stay and care for their newborn infant(s) 24 hours a day. Lack of sleep may affect new parents' ability to cope with the many challenges they face on a daily basis.DESIGN:A phenomenographic study with an inductive and exploratory design.METHODS:Semi-structured interviews were conducted with twelve parents of infants in neonatal care between January-March 2012. To describe variations in perception of the phenomenon, data were analysed using phenomenography.FINDINGS:Four descriptive categories were identified within the phenomenon sleep in parents of preterm and/or sick infants in neonatal care: impact of stress on sleep; how the environment affects sleep; keeping the family together improves sleep; and, how parents manage and prevent tiredness.CONCLUSION:Anxiety, uncertainty and powerlessness have a negative influence on sleep. This can be decreased by continuous information, guidance and practical support. Skin-to-skin care was perceived as a stress-reducing factor that improved relaxation and sleep and should be encouraged by the nurse. The parents also mentioned the importance of being together. Having a private place where they could relax and take care of themselves and their newborn infant improved sleep. It was also desirable to involve older siblings in order to decrease feelings of loneliness, sadness and isolation.RELEVANCE FOR CLINICAL PRACTICE:Improved parental sleep in neonatal care may help the families cope with the situation and facilitate problem-solving, emotional regulation and the transition to parenthood.
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22.
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23.
  • Edell-Gustafsson, Ulla, et al. (författare)
  • Parents’ perceptions of sleeping in a neonatal intensive care unit
  • 2013
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • IntroductionSleep is important for mental and emotional health. For parents staying in the hospital with their preterm and/or sick infant, lack of sleep may affect their ability to handle the situation, supporting their infant, and participate in decision-making. Moreover, when a child is born preterm, parents may experience stress that potentially affects their ability to interact and bond with the infant. PurposeTo describe parents’ perceptions of what it is like to sleep in a neonatal intensive care unit (NICU) in a room nearby or in the same room as their infant. MaterialTwelve parents (eight mothers and four fathers) of infants born between week 29 and 36, in three different hospitals, were included. Eight of the parents slept in the same room as their infants and four parents slept in parents’ rooms in the NICU.   MethodsParents were interviewed with open-ended questions. Data was analysed with a phenomenographic method according to Marton and Both. ResultsFive descriptive categories in the phenomenon of parents’ perception of how it is to sleep  in a NICU  were  identified; Transition to parenthood, How parents perceive and manage their tiredness, A feeling of being out of control, Different forms of support and Environment. ConclusionsParents in the NICU are vulnerable, in a stressful situation, with an infant in need of neonatal intensive care. At the same time they are going through a complicated transition to parenthood. Hence sleep is important for the parents in several aspects, and NICU staff needs to acknowledge and promote parents’ sleep. 
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24.
  • Eriksson, Mats, 1959-, et al. (författare)
  • Neonatal omvårdnad viktigt forskningsområde
  • 2014
  • Ingår i: Läkartidningen. - Stockholm : Sveriges Läkarförbund. - 0023-7205 .- 1652-7518. ; 111:39, s. 1666-1666
  • Tidskriftsartikel (populärvet., debatt m.m.)
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25.
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26.
  • Flankegård, Gunilla, 1974- (författare)
  • Childhood functional constipation : Parents' everyday life experiences
  • 2022
  • Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Background: Functional constipation is the most common chronic disorder in childhood with a great impact on family life. Treatment focuses on the behavioural nature of the disorder with toilet training and laxatives, with the goal of daily stool passage without difficulties. Management of care is predominantly carried out at home by parents, making them key partners in the paediatric care.Aim: The overall aim of this thesis was to explore and understand childhood functional constipation through the experiences of parents.Design and method: This thesis comprise two studies based on a phenomenological research method and design with an inductive reflective lifeworld approach using qualitative individual interviews to gather data. A theoretical framework was used in the analysis to further elucidate the findings.Findings: Shame was the essential finding, providing the reason parents acted in certain ways and the result of the same actions. Study I showed that everyday life was put on hold due to the time and effort invested in the adaptations demanded by the constipation. This left the parents feeling lonely, guilty, and fighting frustrating battles as they tried to gain control by being always one step ahead. Study II showed that giving constipation treatment resulted in parents questioning their parental identity. Treatment needed to be affirmed, as doubt and second thoughts sometimes made parents give treatment against their own will as well as defying their child’s will, bordering on feelings of being abusive. The findings were interpreted in the light of theories of illness beliefs and good parenting beliefs, suggesting belief systems are the path into the parents’ feelings of shame. Re-evaluating the beliefs might diminish failure to adhere to treatment regimens.Conclusions: This project shows that functional constipation is like other childhood chronic illnesses in respect of its importance and impact on everyday family life. Shame is a prominent feature of functional constipation experiences. However, the shame felt might be mitigated by targeting and re-evaluating the belief systems that form the lifeworld of the parents and family.
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27.
  • Flankegård, Gunilla, 1974-, et al. (författare)
  • Everyday life with childhood functional constipation: A qualitative phenomenological study of parents' experiences
  • 2022
  • Ingår i: Journal of Pediatric Nursing. - : Elsevier. - 0882-5963 .- 1532-8449. ; 67, s. E165-E171
  • Tidskriftsartikel (refereegranskat)abstract
    • Childhood functional constipation (FC) is a worldwide problem with treatment regiments affecting everyday life.AimTo explore parents´ experiences of living with a child with FC and its impact on everyday family life.MethodA qualitative phenomenological interview study using a reflective lifeworld research approach. Interviews with 15 parents of otherwise healthy children aged 1–14 years affected by FC.FindingsShame is the driving force making parents put everyday life on hold. The quest for control, self-imposed loneliness, guilt, inadequacy, and frustrating battles become essential parts of everyday life to protect it from FC-related shame.ConclusionFC has as great an impact on everyday life as any childhood illness. Every part of family life is affected by FC. Continuously family support and guidance are needed.Practice implicationsHealthcare professionals need to take FC more seriously, listen to the parents and try to understand their experiences of everyday life to enable custom made care plans with the family-unit in focus. Care with clinical sensitivity might help parents deal with the attendant shame and stigmatization that stem from illness beliefs about FC.
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28.
  • Flankegård, Gunilla, et al. (författare)
  • Experiences of parents who give pharmacological treatment to children with functional constipation at home
  • 2020
  • Ingår i: Journal of Advanced Nursing. - : Wiley-Blackwell Publishing Inc.. - 0309-2402 .- 1365-2648. ; 76:12, s. 3519-3527
  • Tidskriftsartikel (refereegranskat)abstract
    • AimThe aim was to explore the lived experiences of parents who give oral and rectal pharmacological treatment to their children with functional constipation at home.DesignA phenomenological design with a reflective lifeworld research approach that describes phenomena as they are experienced by individuals.MethodsFrom January–May 2019, 15 interviews were conducted with parents of children with functional constipation with home‐based oral and rectal treatment. Parents were recruited from three different healthcare levels. Open‐ended questions were used starting from the description of a normal day with constipation treatment. Analyses were made with an open and reflective ‘bridling’ attitude.FindingsConstipation treatment causes parents to question their parental identity and what it means to be a good parent. Forced treatment makes them feel abusive and acting against their will as parents. There is a conflict between doubt and second thoughts about the treatment, the urge to treat based on the child's needs and encouragement from healthcare professionals to give treatment.ConclusionAs pharmacological constipation treatment can be experienced as challenging, it is important to help parents make an informed decision about how such treatment should be carried out at home. The findings reveal a medical treatment situation where parents hesitate and children resist, resulting in insecure parents who question their parental identity.ImpactThe findings point to the importance of supporting parents in treatment situations. Healthcare providers need to treat children with constipation with greater focus and more prompt management to prevent these families from lingering longer than necessary in the healthcare system.
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29.
  • Forsner, Maria, 1954-, et al. (författare)
  • Expectation prior to human papilloma virus vaccination : 11 to 12-Year-old girls' written narratives.
  • 2016
  • Ingår i: Journal of Child Health Care. - : SAGE Publications. - 1367-4935 .- 1741-2889. ; 203, s. 365-373
  • Tidskriftsartikel (refereegranskat)abstract
    • Expectations prior to needle-related procedures can influence individuals' decision making and compliance with immunization programmes. To protect from human papilloma virus (HPV) and cervical cancer, the immunization needs to be given before sexual debut raising interest for this study's aim to investigate how 11 to 12-year-old girls narrate about their expectations prior to HPV vaccination. A total of 27 girls aged 11 to 12 years participated in this qualitative narrative study by writing short narratives describing their expectations. The requirement for inclusion was to have accepted HPV vaccination. Data were subjected to qualitative content analysis. Findings showed the following expectations: going to hurt, going to be scared and going to turn out fine. The expectations were based on the girls' previous experiences, knowledge and self-image. The latent content revealed that the girls tried to transform uneasiness to confidence. The conclusion drawn from this study is that most girls of this age seem confident about their ability to cope with possible unpleasantness related to vaccinations. However, nurses need to find strategies to help those children who feel uneasy about needle-related procedures.
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30.
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31.
  • Forsner, Maria, 1954-, et al. (författare)
  • Läkemedelshantering för barn
  • 2013. - 6
  • Ingår i: Kvalitetsindikatorer inom omvårdnad. - Stockholm : Gothia Förlag AB. - 9789172058576 ; , s. 62-64
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)
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32.
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33.
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34.
  • Forsner, Maria, 1954-, et al. (författare)
  • Questionnaires to Measure Process and Structure of Quality Indicators for Pediatric Nursing
  • 2021
  • Ingår i: Pediatric quality & safety. - : Lippincott Williams & Wilkins. - 2472-0054. ; 6:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: The quality of nursing care has a significant impact on the outcomes of care. The specific needs of children requiring hospital care make it essential to monitor and compare data not only on the medically oriented outcome measure but also on nursing care, structure, and process, requiring perspectives from registered nurses (RNs) and nurse managers (NMs). Thus, this project aimed to evaluate the structure and process of nursing quality indicators in pediatric hospital care with questionnaires distributed to RN and NM.Methods: We developed separate questionnaires for NMs and RNs to assess the process and structure of the quality indicators of breastfeeding, management of pain, venous access, medication management, and provision of a child-oriented environment. Nine NMs and 113 RNs from 9 pediatric wards answered the questionnaires.Result: Local guidelines were available for 3 out of the 5 quality indicators: pain management, venous access, and medication management. RNs reported varying levels of adherence to pain management (62%), and venous access management (72%). Satisfaction with the conditions for safe medication management was 90%. Approximately, two-thirds (67%) of RN reported sufficient knowledge regarding the impact of the child-oriented environment and less than half (44%) regarding how to support breastfeeding.Conclusion: Structure and process is a prerequisite for quality of care outcomes. This study discloses areas for quality improvement and offers instruments to compare structure and process in pediatric nursing care to discuss with consumers, managers, staff, and other stakeholders.
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35.
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36.
  • Foster, Mandie Jane, et al. (författare)
  • Seeing lockdown through the eyes of children from around the world : Reflecting on a children's artwork project
  • 2021
  • Ingår i: Nursing Praxis in Aotearoa New Zealand. - : College of Nurses Aotearoa - NZ - Inc. - 2703-4542. ; 37:3, s. 104-115
  • Tidskriftsartikel (refereegranskat)abstract
    • The COVID-19 pandemic created new challenges for children including access to education and limiting social and emotional connections to extended family, friends, and the community. Globally, opportunities for sharing children’s self-reported experiences during lockdown were limited. The primary aim of this project was to create an art-eBook that reflects children’s experiences of life during the COVID-19 pandemic that could be shared with other children around the world. Secondly, we wanted to reflect on the consultation undertaken within the International Network of Child and Family Centered Care (INCFCC) using Gibbs (1988) reflective cycle framework. Children from around the world were invited to submit a piece of artwork that reflected their experience during the COVID-19 pandemic via a Qualtrics-survey in May 2020. The children’s artwork and written pieces were transcribed verbatim into an eBook and the artwork was further placed into groups based on similarity of meaning. Fifty-five children from 17 countries submitted an artwork piece. Four groups were evident within the children’s artwork including infection control measures, positive experiences and emotions (connection to family, fun activities), negative experiences and emotions (social impact, emotional impact), and uniting children globally. The eBook illustrates how children of all ages can provide meaningful insightful commentary and valuable information on their experiences during an unprecedented pandemic.
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37.
  • Göthesson, Johanna, et al. (författare)
  • Children's and adolescent's narratives about pain and negative experiences in diabetes treatment
  • 2023
  • Ingår i: Journal for Specialists in Pediatric Nursing. - : John Wiley & Sons. - 1539-0136 .- 1744-6155. ; 28:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Pain and fear associated with needle procedures have been found to be more common among children and adolescents treated for type 1 diabetes (T1D) than among others in their age group. Furthermore, high glycated haemoglobin (HbA1c) values are associated with needle-related fear.Aim: To describe negative experiences of needle procedures in childhood diabetes treatment from children's and adolescents' own perspectives. Methods: Short written narratives (n = 83) and drawings (n = 2) from children and adolescents treated for T1D, aged 7–18 years, were subjected to inductive qualitative content analysis.Results: Negative experiences with needle procedures had many facets, such as pain and fear, changing over time and affecting everyday life. All kinds of needle procedures caused difficulties, but venipunctures were described as the worst.Conclusion: All needle procedures involved in diabetes treatment are potentially experienced as creating pain and fear, but the negative experiences are multifaceted and vary between individuals. These experiences create suffering for children and adolescents, and influence their daily lives. Besides finding techniques to decrease the number of needle procedures in the treatment, research should focus on implementing methods to decrease pain, fear, and other negative experiences as well as to promote self-coping. This is urgent, since needle-related fear has an impact on glycaemic control and therefore increases the risk of long-term complications. Clinical Implications: When caring for children and adolescents with diabetes, their previous experiences with needle procedures need to be considered.
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38.
  • Hanberger, Lena, et al. (författare)
  • Needle-Related Pain, Affective Reactions, Fear, and Emotional Coping in Children and Adolescents With Type 1 Diabetes : A Cross-Sectional Study
  • 2021
  • Ingår i: Pain Management Nursing. - : Elsevier. - 1524-9042 .- 1532-8635. ; 22:4, s. 516-521
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The self-care of type 1 diabetes (T1D) includes undergoing procedures with needles several times daily, which may cause pain and fear.Aims: The aim was to identify the degree of perceived pain, affective reactions, fear, and emotional coping among children and adolescents with T1D.Design: A cross-sectional survey was performed.Methods: Children and adolescents 7-18 years of age (n = 197) and their parents (n = 123) completed the Coloured Analogue Scale (CAS), the Facial Affective Scale (FAS), the Diabetes Fear of Injection Questionnaire (D-FISQ), and the Faces Emotional Coping Scale (FECS) in relation to needle procedures.Results: The higher the values of the CAS, FAS and D-FISQ scores, the lower values for coping were reported by children and adolescents regarding treatment with insulin pen or pump, blood glucose test, and venipuncture (p < .001). Patients reported strong negative affect regarding insulin injections (35%) and blood glucose tests (32%), as well as negative affect (48%, 69%) and substantial pain (27%, 50%) for inserting a pump needle and venipuncture, respectively. Parents reported significantly higher values than children on all scales and procedures except D-FISQ (blood glucose tests) and FECS (venipuncture).Conclusions: Children and adolescents who perceive greater pain during needle-related procedures have poorer coping ability. Pediatric diabetes teams need to identify those in need of extra support to develop pain coping strategies.
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39.
  • Hogstrom, Sofie, et al. (författare)
  • A source of empowerment and well-being
  • 2023
  • Ingår i: Frontiers in Pediatrics. - : FRONTIERS MEDIA SA. - 2296-2360. ; 11
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundFunctional abdominal pain disorders are common among children and adolescents worldwide and effective treatments are needed to alleviate suffering for these children and their families. This study aimed to explore the experience of participating in a combined dance and yoga intervention from the perspectives of girls aged 9-13 years with functional abdominal pain disorders.Materials and MethodsA randomized controlled trial called Just in TIME (Try, Identify, Move and Enjoy) recruited 121 girls aged 9-13 years with functional abdominal pain disorders. The eight-month intervention combined dance and yoga twice a week, focusing on enjoyment, socialization and playful creativity in an undemanding and non-judgemental environment. The intervention group comprised 64 girls, of whom 25 were purposefully selected for this qualitative interview study. Semi-structured interviews were conducted and analysed using qualitative content analysis with an inductive approach.ResultsThe girls experiences of the Just in TIME intervention can be described as "A source of empowerment and well-being which facilitated personal growth and new ways of engaging in life". The main category was derived from six generic categories: "A sense of belonging", "Joy and emotional expression through movement", "Relief from pain", "More self-confident", "More active in daily life" and "A sense of calm."ConclusionsRegular participation in an eight-month intervention with combined dance and yoga in a supportive and non-judgemental atmosphere can ease pain and strengthen inner resources, resulting in empowerment, well-being and a more active life for girls with functional abdominal pain disorders.
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40.
  • Hollman Frisman, Gunilla, et al. (författare)
  • The experience of becoming a grandmother to a premature infant - A balancing act, influenced by ambivalent feeling
  • 2012
  • Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 21:21-22, s. 3297-3305
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims and objectives.  To explore and describe the experience of becoming a grandmother to a premature infant.Background.  Becoming a grandmother involves a new perspective of life. Grandmothers of sick infants find themselves in a new situation with an adult child undergoing serious stress. Few studies have approached the grandmothers’ own experience of becoming a grandmother to a premature infant.Design.  A qualitative content analysis was used.Methods.  Eleven women, 52–66 years of age, who were grandmothers to premature infants born at a gestational age of 25–34 weeks, were interviewed during 2010. The infants were less than three years old at the time of the interview. The interviews were analysed with qualitative content analysis.Results.  The overall theme was a balancing act. Two categories of experience were identified: emotional experiences and a new role. ‘Emotional experiences’ was related to the first meeting, ambivalent feelings and confidence in care. ‘A new role’ was related to the subcategories supportive, a balance of involvement and limitations.Conclusions.  To become a grandmother to a premature infant was experienced as a balancing act influenced by ambivalent feelings of joy, fear and worry. The grandmothers sensed the seriousness of the situation at the same time as they wanted to be happy about the newborn infant. They worried about their adult child’s as well as the premature infant’s health but put their own needs aside. The grandmothers’ new role was a balance between being involved and supportive without disturbing.Relevance to clinical practice.  Neonatal intensive care unit staff should be open to grandmothers’ needs and acknowledge them as an obvious support for the immediate family of a premature infant. The grandmothers need guidance and information about what to expect concerning the infants health, the parents situation and their own role.
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41.
  • Högström, Sofie, et al. (författare)
  • “A source of empowerment and well-being” : Experiences of a dance and yoga intervention for young girls with functional abdominal pain disorders
  • 2023
  • Ingår i: Frontiers in Pediatrics. - : Frontiers Media S.A.. - 2296-2360. ; 11
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Functional abdominal pain disorders are common among children and adolescents worldwide and effective treatments are needed to alleviate suffering for these children and their families. This study aimed to explore the experience of participating in a combined dance and yoga intervention from the perspectives of girls aged 9–13 years with functional abdominal pain disorders.Materials and Methods: A randomized controlled trial called Just in TIME (Try, Identify, Move and Enjoy) recruited 121 girls aged 9–13 years with functional abdominal pain disorders. The eight-month intervention combined dance and yoga twice a week, focusing on enjoyment, socialization and playful creativity in an undemanding and non-judgemental environment. The intervention group comprised 64 girls, of whom 25 were purposefully selected for this qualitative interview study. Semi-structured interviews were conducted and analysed using qualitative content analysis with an inductive approach.Results: The girls' experiences of the Just in TIME intervention can be described as “A source of empowerment and well-being which facilitated personal growth and new ways of engaging in life”. The main category was derived from six generic categories: “A sense of belonging”, “Joy and emotional expression through movement”, “Relief from pain”, “More self-confident”, “More active in daily life” and “A sense of calm.”Conclusions: Regular participation in an eight-month intervention with combined dance and yoga in a supportive and non-judgemental atmosphere can ease pain and strengthen inner resources, resulting in empowerment, well-being and a more active life for girls with functional abdominal pain disorders.
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42.
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43.
  • Ivars, Katrin, et al. (författare)
  • Development of Salivary Cortisol Circadian Rhythm and Reference Intervals in Full-Term Infants
  • 2015
  • Ingår i: Plos One. - San Francisco, USA : Public Library of Science (PLoS). - 1932-6203. ; 10:6
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Cortisol concentrations in plasma display a circadian rhythm in adults and children older than one year. Earlier studies report divergent results regarding when cortisol circadian rhythm is established. The present study aims to investigate at what age infants develop a circadian rhythm, as well as the possible influences of behavioral regularity and daily life trauma on when the rhythm is established. Furthermore, we determine age-related reference intervals for cortisol concentrations in saliva during the first year of life. 130 healthy full-term infants were included in a prospective, longitudinal study with saliva sampling on two consecutive days, in the morning (07:30-09:30), noon (10:00-12:00) and evening (19:30-21:30), each month from birth until the infant was twelve months old. Information about development of behavioral regularity and potential exposure to trauma was obtained from the parents through the Baby Behavior Questionnaire and the Life Incidence of Traumatic Events checklist. A significant group-level circadian rhythm of salivary cortisol secretion was established at one month, and remained throughout the first year of life, although there was considerable individual variability. No correlation was found between development of cortisol circadian rhythm and the results from either the Baby Behavior Questionnaire or the Life Incidence of Traumatic Events checklist. The study presents salivary cortisol reference intervals for infants during the first twelve months of life. Cortisol circadian rhythm in infants is already established by one month of age, earlier than previous studies have shown. The current study also provides first year age-related reference intervals for salivary cortisol levels in healthy, full-term infants.
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44.
  • Ivars, Katrin, 1978-, et al. (författare)
  • Development of salivary cortisol circadian rhythm in preterm infants
  • 2017
  • Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 12:8
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: To investigate at what age preterm infants develop a salivary cortisol circadian rhythm and identify whether it is dependent on gestational age and/or postnatal age. To evaluate whether salivary cortisol circadian rhythm development is related to behavioral regularity. To elucidate salivary cortisol levels in preterm infants during the first year of life.Methods: This prospective, longitudinal study included 51 preterm infants. 130 healthy full-term infants served as controls. Monthly salivary cortisol levels were obtained in the morning (07:30-09:30), at noon (10:00-12:00), and in the evening (19:30-21:30), beginning at gestational age week 28-32 and continuing until twelve months corrected age. Behavioral regularity was studied using the Baby Behavior Questionnaire.Results: A salivary cortisol circadian rhythm was established by one month corrected age and persisted throughout the first year. The preterm infants showed a cortisol pattern increasingly more alike the full-term infants as the first year progressed. The preterm infants increase in behavioral regularity with age but no correlation was found between the development of salivary cortisol circadian rhythm and the development of behavior regularity. The time to establish salivary cortisol circadian rhythm differed between preterm and full-term infants according to postnatal age (p = 0.001) and was dependent on gestational age. Monthly salivary cortisol levels for preterm infants from birth until twelve months are presented. Additional findings were that topical corticosteroid medication was associated with higher concentrations of salivary cortisol (p = 0.02) and establishment of salivary cortisol circadian rhythm occurred later in infants treated with topical corticosteroid medication (p = 0.02).Conclusions: Salivary cortisol circadian rhythm is established by one month corrected age in preterm infants. Establishment of salivary cortisol circadian rhythm is related to gestational age rather than to postnatal age. Salivary cortisol circadian rhythm development is not related to behavioral regularity.
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45.
  • Ivars, Katrin, et al. (författare)
  • Nasopharyngeal suctioning does not produce a salivary cortisol reaction in preterm infants
  • 2012
  • Ingår i: Acta Paediatrica. - : Wiley-Blackwell. - 0803-5253 .- 1651-2227. ; 101:12, s. 1206-1210
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: To investigate whether nasopharyngeal suctioning produces a physiological and behavioural stress reaction in preterm infants and if a possible reaction can be dampened by sweet solution. Methods: Eleven preterm infants were randomly assigned to receive either 30% oral glucose or nothing prior to morning nasopharyngeal suctioning; the procedure was reversed in the afternoon. The study included a total of 44 samples from preterm infants evaluated with salivary cortisol, pain score (Visual Analogue Scale), heart rate, oxygen saturation and recovery time through the Newborn Individualized Developmental Care and Assessment Program. For reference, 44 samples from eleven full-term infants were evaluated for salivary cortisol. Results: Regardless of whether or not preterm infants received glucose before nasopharyngeal suctioning, no statistically significant difference was found in salivary cortisol reactivity, pain score, heart rate, oxygen saturation or recovery time. Nor were any statistically significant differences between salivary cortisol baseline and response values found in full-term infants after nasopharyngeal suctioning. Conclusion: In the present setting, nasopharyngeal suctioning was not stressful enough to increase salivary cortisol or pain score. Oral glucose did not alter salivary cortisol levels.
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46.
  • Ivars, Katrin, 1978- (författare)
  • Stress : Clinical and Developmental Aspects of Salivary Cortisol in Infants
  • 2016
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • A functional stress-response system is essential for survival at birth, as well as for health and further development. Altered cortisol response and hypothalamic-pituitary-adrenal system function may have both short and long-term effects on health and development throughout life. Cortisol secretion follows a circadian rhythm in adults. Data in the literature concerning basal cortisol levels is scant, with divergent results regarding the timeframe for establishment of cortisol circadian rhythm in children. Nevertheless, cortisol is often studied in stress-related research concerning preterm infants, full-term infants, and infants at high psychosocial risk.This thesis aimed to investigate at what age cortisol circadian rhythm develops in healthy full-term infants, preterm infants, and infants at high psychosocial risk and to identify whether such development is dependent on gestational or postnatal age. A secondary aim was to investigate whether either behavioral regularity or daily life trauma are associated with establishment of cortisol circadian rhythm. The last two interventional studies explored whether a) parental participation in the Hagadal daycare attachment program in one  study and b) oral administration of glucose during nasopharyngeal suctioning in the other study influenced development of salivary cortisol circadian rhythm and/or cortisol levels. The effects, if any, of the Hagadal daycare attachment program on caregiver sensitivity to infants were also investigated.The present thesis includes four original studies. Papers I, II, and III describes prospective, longitudinal studies extending over a year, including a survey of the cortisol levels and development of cortisol circadian rhythm in three infant groups. Paper III also included an intervention component addressing the possible effects of the Hagadal daycare attachment program. Paper IV describes a case-control study designed to generate paired baseline-response data concerning the effects of oral glucose administration during nasopharyngeal suctioning as an interventional procedure.Cortisol circadian rhythm in salivary cortisol secretion was similarly established at one month postnatal age in full-term infants and at one month corrected age in preterm infants, reflecting a process dependent on gestational age. This rhythm persisted throughout the first year of life in all infants and consolidated over time in healthy full-term and preterm infants, but not in infants at high psychosocial risk, who displayed higher variability in cortisol levels. The infants in paper IV had not yet reached one month of corrected age and therefore had not yet developed cortisol circadian rhythm at the time of the investigation. No correlation was found between development of cortisol circadian rhythm and either behavioral regularity or reported traumatic life events. This thesis presents data on salivary cortisol levels among three different groups of infants during the first year of life. Cortisol circadian rhythm among infants in study III evolved in response to parental participation in the Hagadal daycare attachment program, which increased caregiver sensitivity to infants. Study IV found that nasopharyngeal suctioning was not a sufficiently stressful stimulus to increase salivary cortisol or impact pain score. Oral glucose administration had no effect on salivary cortisol levels.This thesis concludes that cortisol circadian rhythm is already established in infants by one month of age, earlier than previous studies have shown, and further that this process is dependent on gestational age. The Hagadal daycare attachment program enhances parental sensitivity toward children, which helps to stabilize development of cortisol circadian rhythm.
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47.
  • Kervezee, Laura, et al. (författare)
  • Development of 24-hour rhythms in cortisol secretion across infancy : a systematic review and meta-analysis of individual participant data
  • 2024
  • Ingår i: Journal of Clinical Endocrinology and Metabolism. - : Oxford University Press. - 0021-972X .- 1945-7197.
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: In adults, cortisol levels show a pronounced 24-hour rhythm with a peak in the early morning. It is unknown at what age this early-morning peak in cortisol emerges during infancy, hampering the establishment of optimal dosing regimens for hydrocortisone replacement therapy in infants with an inborn form of adrenal insufficiency. Therefore, we aimed to characterize daily variation in salivary cortisol concentration across the first year of life.METHODS: We conducted a systematic review followed by an individual participant data meta-analysis of studies reporting on spontaneous (i.e., not stress induced) salivary cortisol concentrations in healthy infants aged 0-1 year. A one-stage approach using linear mixed-effects modelling was used to determine the interaction between age and time of day on cortisol concentrations.FINDINGS: Through the systematic review, 54 eligible publications were identified, reporting on 29,177 cortisol observations. Individual participant data were obtained from 15 study cohorts, combining 17,079 cortisol measurements from 1,904 infants. The morning/evening cortisol ratio increased significantly from 1.7 (95% CI: 1.3-2.1) at birth to 3.7 (95% CI: 3.0-4.5) at 6-9 months (p < 0.0001). Cosinor analysis using all available data revealed the gradual emergence of a 24-hour rhythm during infancy.INTERPRETATION: The early-morning peak in cortisol secretion gradually emerges from birth onwards to form a stable morning/evening ratio from age 6-9 months. This might have implications for hydrocortisone replacement therapy in infants with an inborn form of adrenal insufficiency.
  •  
48.
  • Kleberg, Agneta, et al. (författare)
  • Lower stress responses after newborn individualized developmental care and assessment program care during eye screening examinations for retinopathy of prematurity : A randomized study
  • 2008
  • Ingår i: Pediatrics. - : American Academy of Pediatrics (AAP). - 0031-4005 .- 1098-4275. ; 121:5, s. E1267-E1278
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE. Screening examination for retinopathy of prematurity is distressing and painful. The aim of the present study was to investigate whether a Newborn Individualized Developmental Care and Assessment Program intervention during a retinopathy of prematurity examination results in less adverse behavioral, pain, and stress responses as compared with standard care. METHODS. The first 2 eye examinations in 36 preterm infants were evaluated. The infants were randomly assigned at the first eye examination to receive either Newborn Individualized Developmental Care and Assessment Program care or standard care. At the second examination, crossover of subject assignment was performed. The assessments included behavioral responses, recordings of heart rate, respiration, and oxygenation, pain scores (premature infant pain profile), and salivary cortisol at defined time points up to 4 hours after the eye examination. The nursing support given during the eye examinations (intervention score) were scored using predefined criteria. RESULTS. Altogether, 68 examinations were evaluated. Newborn Individualized Developmental Care and Assessment Program care was associated with better behavioral scores during the examination but there was no difference in heart rate, respiratory rate, oxygenation, or premature infant pain profile score between the 2 care strategies before or after the eye examination. Salivary cortisol increased from baseline to 30 minutes after the eye examination independent of care strategy and decreased significantly between 30 and 60 minutes when infants were subjected to Newborn Individualized Developmental Care and Assessment Program care but not after standard care. During the study period the intervention score for standard care increased and approached the score for Newborn Individualized Developmental Care and Assessment Program care at the later eye examinations. CONCLUSION. A Newborn Individualized Developmental Care and Assessment Program-based intervention during eye examination does not decrease pain responses but results in faster recovery, as measured by lower salivary cortisol 60 minutes after the examination. The differences were seen despite the influence from the Newborn Individualized Developmental Care and Assessment Program intervention on the standard care treatment that occurred during the study period.
  •  
49.
  • Lundqvist, Lars-Olov, 1958-, et al. (författare)
  • Salivary cortisol levels and stress in adults with profound intellectual and multiple disabilities participating in the Structured Water Dance Intervention : a randomised controlled crossover trial
  • 2022
  • Ingår i: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 12:1
  • Tidskriftsartikel (refereegranskat)abstract
    • The Structured Water Dance Intervention (SWAN) is a dance-oriented aquatic group activity directed to give opportunities for the joy of movement, relaxation, and reduced stress. This study aimed to evaluate the effects of SWAN on salivary cortisol and stress in adults with profound intellectual and multiple disabilities (PIMD). A total of 34 adults with PIMD at four habilitation centres in Sweden completed the SWAN intervention. The intervention was administered for 40 min once a week during a 12-week period. Saliva cortisol was collected in the morning and evening at baseline one week before the intervention, thrice during the intervention period, and one week after the intervention. Moreover, in connection with the SWAN sessions, the participants' level of stress was also assessed by the accompanying assistants. The results showed that salivary cortisol and participants stress decreased significantly, directly after the SWAN sessions compared with measures directly before sessions. The study demonstrates that adults with PIMD have diurnal salivary cortisol patterns consistent with those observed in adults without disability and that the SWAN reduces salivary cortisol levels and stress in people with PIMD; this justifies that SWAN could be considered in the choice of interventions to reduce stress in adults with PIMD.
  •  
50.
  • Moyes, Anita, et al. (författare)
  • A parent first : Exploring the support needs of parents caring for a child with medical complexity in Australia.
  • 2022
  • Ingår i: Journal of Pediatric Nursing. - : Elsevier. - 0882-5963 .- 1532-8449. ; 67, s. e48-e57
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: In a recent paediatric nursing research priority setting study, youth, parents and healthcare professionals included 'practical and emotional support' among the top ten areas to focus on. The aim of this study was to explore the support needs of parents who have a child with medical complexity living in the family home.DESIGN: Exploratory with a qualitative inductive approach.METHODS: Semi-structured interviews with 12 mothers of children living with heterogenous medical complexity. Interviews were recorded, transcribed and analysed using thematic analysis. The COREQ checklist was used as a reporting guide.RESULTS: Three themes were tied together by the finding that participants identified as 'a parent first'. The first theme represents the early days where participants desired emotional and practical support for becoming a parent of a child with medical complexity. In the second theme, participants desired more support for the discharge home from the hospital. In the last theme, participants described high levels of knowledge and expertise in relation to their child's unique needs and desired highly accessible support for keeping their child out of hospital.CONCLUSION: Parents' support needs change over time and are similar despite the heterogeneity of their children's medical complexity. Parents seek services that support an independent family life and are responsive to their confidence and competence in caring for their child at home.PRACTICE IMPLICATIONS: Interventions should be tailored to the changing support needs of parents over time.
  •  
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