SwePub
Sök i SwePub databas

  Utökad sökning

Träfflista för sökning "WFRF:(Nissen Eva) "

Sökning: WFRF:(Nissen Eva)

  • Resultat 1-50 av 62
Sortera/gruppera träfflistan
   
NumreringReferensOmslagsbildHitta
1.
  • Carlsson, Ing-Marie, 1961-, et al. (författare)
  • Maintaining power : women's experiences from labour onset before admittance to maternity ward
  • 2012
  • Ingår i: Midwifery. - Oxon, United Kingdom : Elsevier. - 0266-6138 .- 1532-3099. ; 28:1, s. 86-92
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: in Sweden pregnant women are encouraged to remain at home until the active phase of labour. Recommendation is based on evidence, that women who seek care and are admitted in the latent phase of labour are subjected to more obstetric interventions and suffer more complications than women who remain at home until the active phase of labour. The aim of this study was to obtain a deeper understanding of how women, who remain at home until the active phase of labour, experience the period from labour onset until admission to labour ward.Method: interviews were conducted with 19 women after they had given birth to their first child. A Constructivist Grounded theory method was used.Findings: ‘Maintaining power’ was identified as the core category, explaining the women's experience of having enough power, when the labour started. Four related categories: ‘to share the experience with another’, ‘to listen to the rhythm of the body’, ‘to distract oneself’ and ‘to be encased in a glass vessel’, explained how the women coped and thereby maintained power.Conclusions: the first time mothers in this study, who managed to stay at home during the latent phase of labour, had a sense of power that was expressed as a driving force towards the birth, a bodily and mental strength and the right to decide over their own bodies. This implies that women who maintain power have the ability to make choices during the birth process. The professionals need to be sensitive, supportive and respectful to women's own preferences in the health-care encounter, to promote the existing power throughout the birthing process.
  •  
2.
  • Olsson, Ann, et al. (författare)
  • Assessing women's sexual life after childbirth : the role of the postnatal check
  • 2011
  • Ingår i: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 27:2, s. 195-202
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: to describe midwives' reflections on counselling women at the postnatal check with special focus on sexual life after childbirth. Design: qualitative descriptive study with focus group discussions as the method of data collection. Setting: antenatal clinics in Stockholm greater catchments' area. Participants: during 2006 and 2007, a voluntary sample of midwives from 10 different antenatal clinics were invited. Analysis: content analysis was undertaken through identification of codes, categories and themes. Findings: Two themes emerged: balancing between personal perceptions of the woman's needs and the health system restrictions and strategies for counselling about sexual life after childbirth'. The midwives tried to create a picture for themselves of the woman coming for the postnatal check and her needs before the consulation. This picture guided the midwives, but lack of time and knowledge restricted them when counselling on sexual life after childbirth. Two different strategies in counselling were identified, one task-oriented and one subject-oriented. Demands and time restrictions led midwives to distance themselves from their clients. A task-oriented approach was more visible in midwives' encounters with foreign-born women, where linguistic difficulties, cultural diversity and narrow time frames restricted the midwives' effectiveness and/or sensitivity as caregivers. In contrast, the subject-oriented strategy meant 'getting in tune', i.e. listening to the woman when she expressed her feelings and emotions, encouraging the woman to be an active participant in decisions involving her care. This strategy is used for women who arouse midwives' empathy and when there is some form of recognition and understanding. Conclusion: The picture created of the woman and her needs guided the midwives, but lack of knowledge and time limitations restricted counselling on sexual life after childbirth. Two counselling strategies were identified, one task-oriented and one subject-oriented. Balancing these two counselling strategies improves both the ethical aspects and the quality of the counselling. (C) 2009 Elsevier Ltd. All rights reserved.
  •  
3.
  • Olsson, Ann, et al. (författare)
  • Fatherhood in focus, sexual activity can wait : New fathers' experience about sexual life after childbirth
  • 2010
  • Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 24:4, s. 716-725
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Becoming a parent is overwhelming for most men  and  women  and  alters  the  sexual  relationship  for many couples. Aim: To describe fathers’ experience about sexual life after childbirth within the first 6 months after childbirth. Method: A descriptive design, using content analysis with a qualitative approach, based on focus group discussions and one-to-one interviews. Participants: Eight  first-time  and  two  subsequent  fathers participated. Results: Three subthemes were identified: Struggling between stereotypes  and  personal  perceptions  of  male  sexuality  during transition to fatherhood; new frames for negotiating sex; a need to feel  safe  and  at  ease  in  the  new  family  situation. The over-arching  theme  emerged  as  ‘transition  to  fatherhood  brings sexual life to a crossroads’ and guided us to a deeper understanding  of  the  difficulties  men  experience  during  the transition  to  fatherhood.  To  get  sexual  life  working,  a number  of  issues  had  to  be  resolved,  such  as  getting involved in the care of the baby and the household and getting  in  tune  with  their  partners  in  regard  to  sexual desire. The men needed to be reassured and prepared for this new situation by health care professionals. Conclusions: New fathers in our study put the baby in focus in early parenthood and were prepared to postpone sex until  both  parties  were  ready,  although  they  needed reassurance to feel at ease with the new family situation. The fathers’ perceptions of sexual life extended to include all kinds of closeness and touching, and it deviated from the stereotype of male sexuality. This is important information for health care providers and midwives to be aware of for their encounters with men (and women) during the transition  to  fatherhood,  and  parenthood  and  can  contribute  to  caring  science  with  a  gender  perspective  on adjustment of sexual life after childbirth.
  •  
4.
  • Rådmark, Lina, et al. (författare)
  • Autonomic function and inflammation in pregnant women participating in a randomized controlled study of mindfulness based childbirth and parenting
  • 2023
  • Ingår i: BMC Pregnancy and Childbirth. - : BioMed Central (BMC). - 1471-2393 .- 1471-2393. ; 23:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Pregnancy and childbirth are significant events in many women's lives, and the prevalence of depressive symptoms increases during this vulnerable period. Apart from well documented cognitive, affective, and somatic symptoms, stress and depression are associated with physiological changes, such as reduced heart-rate variability (HRV) and activation of the inflammatory response system. Mindfulness Based Interventions may potentially have an effect on both HRV, inflammatory biomarkers, and self-assessed mental health. Therefore, the aim of this study was to assess the effects of a Mindfulness Childbirth and Parenting (MBCP) intervention on HRV, serum inflammatory marker levels, through an RCT study design with an active control group.METHODS: This study is a sub-study of a larger RCT, where significant intervention effects were found on perinatal depression (PND) and perceived stress. Participants were recruited through eight maternity health clinics in Stockholm, Sweden. In this sub-study, we included altogether 80 women with increased risk for PND, and blood samples and HRV measures were available from 60 of the participants (26 in the intervention and 34 in the control group).RESULTS: Participants who received MBCP reported a significantly larger reduction in perceived stress and a significantly larger increase in mindfulness, compared to participants who received the active control treatment. However, in this sub-study, the intervention had no significant effect on PND, inflammatory serum markers or measures of HRV.CONCLUSIONS: No significant differences were found regarding changes in HRV measures and biomarkers of inflammation, larger studies may be needed in the future.
  •  
5.
  • Binder, Pauline, 1965-, et al. (författare)
  • Hi-TENS combined with PCA-morphine as post caesarean pain relief
  • 2011
  • Ingår i: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 27:4, s. 547-552
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives:  to examine effectiveness and overall opiate consumption between high-sensory transcutaneous  electrical  nerve  stimulation  (Hi-TENS)  combined  with  patient-controlled  analgesia  with morphine and patient-controlled analgesia with morphine alone following elective (e.g. scheduled) caesarean birth. Design:  randomised, controlled study. Setting:  a county hospital in south-west Sweden. Participants:  42 multiparous women. Measurements and findings:  participants were randomly assigned and connected to patient-controlled analgesia  with  morphine  alone  or  in  combination  with  Hi-TENS  apparatus.  Levels  of  morphine consumed were calculated every third hour during the first 24 hours post partum. Pain and sedation were assessed by visual analogue scale at one, three, six, nine, 12 and 24 hours post partum. Total consumption  of  morphine  differed  significantly  between  the  groups:  morphine  with  TENS  was 16.2+/-12.6 mg and morphine alone was 33.1+/-20.9 mg (p = 0.007). Assessment of pain relief showed no  significant  difference.  Sedation  differed  significantly  between  the  groups  (p = 0.045),  especially between three and 12 hours post partum (p = 0.011). Key conclusions and implications for practice:  pain relief from a combination of Hi-TENS and patient-controlled analgesia with morphine was as effective as patient-controlled analgesia with morphine alone, produced less sedation and reduced morphine use by approximately 50%. Women undergoing a caesarean section should be given the opportunity to make an informed choice about post operative pain relief before surgery. A presumed benefit of this treatment combination is that the mother is more alert and better able to interact with her newborn during the first hours after birth without drowsiness due to large doses of opiates.
  •  
6.
  • Carlsson, Ing-Marie, et al. (författare)
  • Psychometric properties of the Swedish childbirth self-efficacy inventory (Swe-CBSEI)
  • 2014
  • Ingår i: BMC Pregnancy and Childbirth. - London : BioMed Central. - 1471-2393 .- 1471-2393. ; 14, s. 1-
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Previous research has reported that women who are admitted to delivery wards in early labour process before an active stage of labour has started run an increased risk of instrumental deliveries. Therefore, it is essential to focus on factors such as self-efficacy that can enhance a woman's own ability to cope with the first stage of labour. However, there was no Swedish instrument measuring childbirth self-efficacy available. Thus, the aim of the study was to translate the Childbirth Self-efficacy Inventory and to psychometrically test the Swedish version on first-time mothers within the Swedish culture. Methods: The method included a forward-backward translation with face and content validity. The psychometric properties were evaluated using a Principal Component Analysis and by using Cronbach's alpha coefficient and inter-item correlations. Descriptive statistics and non-parametric tests were used to describe and compare the scales. All data were collected from January 2011 to June 2012, from 406 pregnant women during the gestational week 35-42. Results: The Swedish version of the Childbirth Self-Efficacy Inventory indicated good reliability and the Principal Component Analysis showed a three-component structure. The Wilcoxon Signed-Ranks Test indicated that the women could differentiate between the concepts outcome expectancy and self-efficacy expectatancy and between the two labour stages, active stage and the second stage of labour. Conclusions: The Swedish version of Childbirth Self-efficacy Inventory is a reliable and valid instrument. The inventory can act as a tool to identify those women who need extra support and to evaluate the efforts of improving women's self-efficacy during pregnancy.
  •  
7.
  • Carlsson, Ing-Marie, 1961- (författare)
  • The movement towards birth : A study of women's childbirth self-efficacy and early labour
  • 2014
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Aim: The overall aim of this thesis was to increase the understanding of early labour, the latency phase of labour, based on women’s experiences and ability to handle the situation. Furthermore, the aim was to perform a psychometric testing of an instrument measuring childbirth self-efficacy and to explore the relationships to women´s well-being and number of obstetric interventions and birth outcomes.Methods: In study I, a grounded theory method was used to obtain a deeper understanding of how women who seek care at an early stage experience the latent phase of labour. The same method, grounded theory was used in study II, but in this study, the aim was to obtain a deeper understanding of how women, who remain at home until the active phase of labour, experience the period from labour onset before admission to maternity ward. In both these studies (I & II) interviews were used to collect data. Study III and IV were cross sectional studies with a  consecutive data collection. In study III, a forward-backward translation was used to translate the childbirth self-efficacy inventory (CBSEI) into a Swedish version. An explorative factor analysis with principal component analysis was used to test the psychometric properties of the inventory and reliability tests with Cronbach's alpha and inter item total correlation was performed. In study IV, chi-2 test, Fisher's exact test and student's t-test for independent samples was performed between women´s estimated childbirth self-efficacy and demographics, obstetric interventions and birth outcomes. Correlations were also performed between different scales measuring well-being during pregnancy and childbirth self-efficacy. Finally a logistic regression analysis was performed to predict the probability for low or high childbirth self-efficacy.Findings: Being in a safe place is essential for the women in the early labour process. But a safe place has different meanings for different women, depending on how they assess their own ability to handle their impending labour. For some women, the hospital is a secure place, a place where somebody else can take over the responsibility for themselves, the labour process or their child’s well-being. Some women choose to remain in their homes, which they consider as a kind of base camp which they can leave and go back to whenever they please. There is also a difference in how women ascribe ability to their own bodies and women´s belief in their own ability to cope and deal with the impending birth, their self-efficacy. These differences together with the women´s choice of seeking care or not, during the early labour process, affect the women´s experience of the labour process. The women's experience during the early labour process varies from feeling powerful and strong, to perceiving themselves as victims and feeling totally powerless. Women with high self-efficacy as measured by CBSEI had less previous mental illness and had more often been told their sister´s birth story. During the labour process, women with a higher childbirth self-efficacy have a lower frequency of epidural analgesia than women with low childbirth self-efficacy.Conclusion: Women´s belief in their childbirth self-efficacy affects their choice of place to be, during the early labour process. The place in turn, affects the women´s experiences and the way they handle the early labour process. The early labour process is a sensitive period that requires attention and should not be neglected. Through increased knowledge and understanding of the problematic issues related to the early labour process, the birth preparation and antenatal obstetric care, as well as the care during labour can be improved.
  •  
8.
  • Carlsson, Ing-Marie, 1961-, et al. (författare)
  • The relationship between childbirth self-efficacy and aspects of well-being, birth interventions and birth outcomes
  • 2015
  • Ingår i: Midwifery. - London : Elsevier. - 0266-6138 .- 1532-3099. ; 31:10, s. 1000-1007
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: this study aimed to examine how women׳s childbirth self-efficacy beliefs relate to aspects of well-being during the third trimester of pregnancy and whether there was any association between childbirth self-efficacy and obstetric factors.DESIGN: a cross-sectional design was used. The data was obtained through the distribution of a composite questionnaire and antenatal and birth records.SETTING: data were recruited from antenatal health-care clinics in Halland, Sweden.PARTICIPANTS: a consecutive sample of 406 pregnant women was recruited at the end of pregnancy at gestational weeks of 35-42.MEASUREMENTS: five different measures were used; the Swedish version of Childbirth Self-Efficacy Inventory, the Wijma Delivery Expectancy/Experience Questionnaire, the Sense of Coherence Questionnaire, the Maternity Social Support Scale and finally the Profile of Mood States.FINDINGS: results showed that childbirth self-efficacy was correlated with positive dimensions as vigour, sense of coherence and maternal support and negatively correlated with previous mental illness, negative mood states and fear of childbirth. Women who reported high childbirth self-efficacy had less epidural analgesia during childbirth, compared to women with low self-efficacy.KEY CONCLUSIONS: this study highlights that childbirth self-efficacy is a positive dimension that interplays with other aspects and contributes to well-being during pregnancy and thereby, acts as an asset in the context of childbirth. © 2015 Elsevier Ltd.
  •  
9.
  • Cato, Karin, 1977- (författare)
  • Breastfeeding – Initiation, duration, attitudes and experiences
  • 2018
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The overall aim of this thesis was to increase knowledge about factors that influence breastfeeding initiation and duration, as well as about women’s attitudes towards breastfeeding during pregnancy.The first two studies were a part of the UPPSAT project, a population-based cohort study conducted in Uppsala, Sweden. The women answered questionnaires five days, six weeks and six months postpartum, including questions on breastfeeding initiation and duration. Eight hundred and seventy-nine women and 679 women were included in the first study (Paper I) and second study (Paper II), respectively. The third study (Paper III) was part of the BASIC study, a large cohort following women from pregnancy and up to one year postpartum. In BASIC, the women completed web-questionnaires, and 1217 women participated during mid-pregnancy and postpartum. The fourth study (Paper IV) was part of a qualitative project, “Narratives of breastfeeding”, and included 11 women, interviewed individually in late pregnancy.The prevalence of the hands-on approach was 38%. Women who received the hands-on approach were more likely to report a negative experience of the first breastfeeding session (Paper I). Seventy-seven percent of the women reported exclusive breastfeeding up to, at least, two months postpartum. Being a first-time mother, reporting emotional distress during pregnancy, and giving birth by cesarean section were factors independently associated with exclusive breastfeeding lasting less than two months postpartum (Paper II). Women with depressive symptoms during pregnancy who breastfed for the first time later than two hours postpartum had the highest odds of not breastfeeding exclusively at six weeks postpartum (Paper III). When pregnant women thought about their future breastfeeding, they were balancing between social norms and personal desires (Paper IV).These results can help to develop clinical practice to improve women’s experience of the first breastfeeding session. Additionally, the results may facilitate identifying women in need for targeted support, in order to promote longer exclusive breastfeeding duration. By acknowledging pregnant women’s thoughts and attitudes about breastfeeding, breastfeeding information and support, health care professionals can meet the needs and desires of women. 
  •  
10.
  • Ekström, Anette, et al. (författare)
  • A Mother's feelings for Her Infant Are Strengthened by Excellent Breastfeeding Counseling and Continuity of Care
  • 2006
  • Ingår i: Pediatrics. - : American Academy of Pediatrics. - 0031-4005 .- 1098-4275. ; 118:2, s. e309-e314
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE. Continuous support during the childbirth process ultimately may strengthen the mother's self-esteem and her capacity to interact with and nurture her infant and also may improve paternal involvement in general. In the present study, we investigated whether mothers, who were attended by midwives and nurses who had had a process-oriented training program in breastfeeding counseling, perceived stronger maternal feelings for their infant than mothers who had received only routine care.METHODS. In a previous study, an intervention that included a process-oriented program on breastfeeding counseling for health professionals and continuity in family classes through childbirth was conducted. The 10 largest municipalities were classified in pairs that were similar in size and had similar figures of breastfeeding duration. The municipalities were randomized pairwise to either an intervention or a control group. The present study is a follow-up study on women's feelings for their infants in relation to the kind of care that they had had and was undertaken between April 2000 and January 2003. The sampling frame was based on women who were cared for at either the intervention clinic or control clinics. The mothers at the control clinics had received standard routine care and had attended family classes through the point of birth. Data collection for control group A started before effects of the intervention could be studied. Data for control group B were collected simultaneously with data collection for the intervention group (n = 540). The mothers responded to 3 questionnaires at 3 days and at 3 and 9 months postpartum. Background data of the mothers were collected. The perception of support that was provided by the health professionals and the perception of mother–infant relationship and feelings for the infant were rated on Likert scales.RESULTS. At 3 days postpartum, both the intervention group and control group B versus the control group A thought that their understanding of the infant was better, they perceived more strongly that the infant as their own, and they enjoyed more breastfeeding and resting with the infant. Although there was no significant difference between the intervention group and control group B at 3 days and 3 months observation, mothers in the intervention group talked more to their infant, perceived their infant to be more beautiful than other infants, and perceived more strongly that the infant was their own than did the mothers in control group B at 9 months observation. In addition, the mothers in the intervention group felt significantly more confident with the infant and felt the infant to be closer than did the mothers in control group B.CONCLUSION. A process-oriented breastfeeding training program for antenatal midwives and postnatal nurses that included an intervention that guaranteed continuity of care strengthened the maternal relationship with the infant and the feelings for the infant.
  •  
11.
  • Ekström, Anette, et al. (författare)
  • A process-oriented breastfeeding training program for healthcare professionals to promote breastfeeding : an intervention study
  • 2012
  • Ingår i: Breastfeeding Medicine. - : Mary Ann Liebert. - 1556-8253 .- 1556-8342. ; 7:2, s. 85-92
  • Tidskriftsartikel (refereegranskat)abstract
    • Abstract Aim: The aim of the study was to evaluate the effects of process-oriented training in supportive breastfeeding counseling for midwives and postnatal nurses on the time lapse between the initial breastfeeding session, introduction of breastmilk substitutes and solids, and the duration of breastfeeding. Materials and Methods: Ten municipalities in Sweden were randomized to either the intervention or control groups. The intervention included a process-oriented training program for midwives and postnatal nurses in the intervention municipalities. Primiparas (n=540) living in either an intervention or 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 the intervention group (IG) (n=206). The mothers responded to questionnaires at 3 days, 3 months, and 9 months postpartum. Results: As a result of the process-oriented training program for midwives and postnatal nurses, the IG mothers had a significantly longer duration of exclusive breastfeeding, even if the initial breastfeeding session did not occur within 2 hours after birth, than the corresponding group of CGA mothers (p=0.01). Fewer infants in the IG received breastmilk substitutes (in the first week of life) without medical reasons compared with the control groups (p=0.01). The IG infants were significantly older (3.8 months) when breastmilk substitutes were introduced (after discharge from the hospital) compared with the infants in the control groups (CGA, 2.3 months, p=0.01; CGB, 2.5 months, p=0.03). Conclusion: A process-oriented training program for midwives and postnatal nurses was associated with a reduced number of infants being given breastmilk substitutes during the 1st week without medical reasons and delayed the introduction of breastmilk substitutes after discharge from the hospital.
  •  
12.
  • Ekström, Anette, et al. (författare)
  • A Process-Oriented Breastfeeding Training Program for Healthcare Professionals to Promote Breastfeeding
  • 2010
  • Ingår i: Proceedings of the Second Biannual Uppsala Symposium on lactation research in mammals and humans. - Uppsala : CRU. - 9789157690135 ; , s. 9-
  • Konferensbidrag (refereegranskat)abstract
    • Introduction: The impact of giving an infant food other than breast milk depends on several factors. Evidence to date supports the recommendation for exclusive breastfeeding for six months.The aim of the this study was to evaluate the effect of a process-oriented training in support during childbirth and breastfeeding for midwives and postnatal nurses in relation to  the time of initial breastfeeding session, introduction of breast milk substitute and solids effects on  the duration of breastfeeding.Materials and methods: Ten municipalities in Sweden were randomized to either intervention (IG) or control groups (CGA and CGB). The intervention included a process-oriented training program* for midwives and postnatal nurses in the intervention municipalities. Primiparas (n=540) who were living at either site were asked to respond to questionnaires at three days, three and nine months postpartum. Data collection for mothers in CGA (n=162) started before effects of the intervention could be studied, CGB (n=172) was collected simultaneously with the IG (n=206).Results: Preliminary results showed that fewer infants in the IG received breast milk substitute (the first week of life) without medical reasons (p=0.01) and were older (3.8 months) when breast milk substitute was introduced after discharge compared with the infants in the control groups (CGA 2.3 months p= 0.01 and CGB 2.5 months p= 0.03).Discussion and Conclusion: A process-oriented training program for midwives and postnatal nurses (by changed attitudes among health staff and changing mothers self imaging) reduced the number of infants who got breastmilk substitute during the first week without medical reasons and delayed the introduction of breast milk substitute after the first week.
  •  
13.
  • Ekström, Anette (författare)
  • Amning och vårdkvalitet
  • 2005
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The over all objectives of this thesis was to map factors of importance for breastfeeding such as maternal background factors, maternal perception of breastfeeding support, confidence, caring routines, breastfeeding attitudes of health care professionals, and to investigate whether a training intervention within the care team ofthe antenatal (ANC) and child health centres (CHC) would improve maternal perception of support and strengthen maternal feelings for the baby.Material and method: A questionnaire was sent to mothers when their babies were 9-12 months old (n=540). The questionnaire embraced questions regarding maternal background, caring routines, perception of support and duration of breastfeeding (I-II). Thereafter an attitudinal instrument was developed to measure breastfeeding attitudes in health care professionals (n=168). Four attitude dimensions were identified by factor analysis (III). Ten municipalities in a county of south west Sweden was paired and randomized to intervention or control (IV). Thus, all midwives and postnatal nurses working at the ANC or CHC in a randomised municipality were asked to participate in the study (n=81). Health professionals in the intervention group had a process-oriented training in breastfeeding counselling including planned continuity in family education and development of a common breastfeeding policy within the caring team. Changes in attitude were measured by the instrument developed in study III. For study V, mothers were recruited from the maternity and were allocated to intervention- or control group according to the randomization of municipalities in study IV (n=565). Questionnaires were sent out at three days, 3 and 9 months post partum to investigate how the care and counselling skills acquired by the health care professionals would be reflected in maternal perception of breastfeeding support and maternal feelings for and relation to the baby.Results: Early initiation of suckling, late discharge from hospital (more than 72 hours) and perceived good support contributed positively to the duration of exclusive breastfeeding. Supplementation the first days after birth for other than medical reasons shortened the duration of breastfeeding. For primiparas, the partner’s presence after childbirth contributed positively to the duration of exclusive breastfeeding. Multiparas who were aware of their mothers breastfeeding history had a longer breastfeeding period than those who did not know of their mother’s breastfeeding history. Mothers were more satisfied with the breastfeeding information they had received at maternity than the breastfeeding information they got from the ANC and CHC (I-II). This induced the idea to develop an attitude instrument and start a training intervention for the care team at ANC and CHC. The attitudinal dimensions identified by the factor analysis were: The regulating factor comprising statements scheduling breastfeeding; the facilitating factor comprising statements showing confidence in the ability of the mother-infant dyad to breastfeed on their own; the disempowering factor comprising statements that objectified the woman and ascribed her no ability to breastfeed without guidance of the health care professional and the breastfeeding antipathy factor comprising statements that showed unwillingness and failing knowledge about breastfeeding (III). After training the health care professionals became less regulating and more facilitating (IV). Family classes provided the intervention mothers with better breastfeeding information, more knowledge about their social rights, the needs of the baby and a stronger social network than the control mothers (V). The postnatal nurse gave a better over all support, was a better listener, showed more understanding and provided the mother with better information about breastfeeding and the needs of the baby. Mothers in the intervention group reported that they interacted more with their baby. They had also more positive views on their baby and felt more confident and close with the baby than mothers in the control groups (V).Conclusion: This study showed that it is important to adopt caring routines, which will facilitate breastfeeding. The health care professional needs to find out the background of the mother to be able to provide her with adequate breastfeeding counselling. Caring routines should include early suckling. Supplementation of the baby the first week after birth should only be given on medical grounds. This study showed that a processoriented training in breastfeeding counselling alters attitudes of health care professionals in a positive way. The trained health care professionals organized continuity of family classes and developed a common breastfeeding policy and were more supportive in their encounters with the mothers. These behaviors strengthen the mother’s feelings for her baby and brought about a richer interaction with her baby. A model to provide continuity of family classes, conducted by trained antenatal midwives and postnatal nurses should thus be practiced within the caring team around first time parents.
  •  
14.
  • Ekström, Anette, et al. (författare)
  • Breastfeeding attitudes among counselling health professionals : Development of an instrument to describe breastfeeding attitudes
  • 2005
  • Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 33:5, s. 353-359
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: The aim of the study was to develop an instrument that can be used for accurate assessment of nurses' and midwives' attitudes toward breastfeeding in a group of midwives, maternity-nursing staff and postnatal nurses experienced in breastfeeding counselling. Method: An instrument based on WHO standards was developed to measure breastfeeding attitudes. In all, 168 healthcare professionals filled in the instrument. A factor analysis using maximum likelihood and varimax rotation was performed. Spearman's correlation was used to correlate factorial dimensions and self-described interest in breastfeeding. Results: By means of factor analysis four factors were identified: the "regulating" factor focused on regulating the mothers' breastfeeding management, the "facilitating" factor focused on making it easy for mothers to manage their breastfeeding, the "disempowering" factor focused on giving advice, disregarding the needs of the mother being counselled, and the "breastfeeding antipathy" factor focused on insufficient, basic, breastfeeding knowledge and aversive reactions to breastfeeding. Midwives rated higher on the facilitating factor and breastfeeding antipathy factor and lower on the regulating factor than postnatal nurses. Breastfeeding interest was positively correlated with the facilitating factor, and negatively with the disempowering factor and the breastfeeding antipathy factor. Conclusion: This instrument provides a picture of health professionals' attitudes towards breastfeeding. Four factors were identified in order of importance: regulating, facilitating, disempowering, and breastfeeding antipathy factors. Harmful attitudes were identified and suggested a need for educational programmes to help health professionals to reconcile damaging values, in order to improve breastfeeding counselling
  •  
15.
  • Ekström, Anette, et al. (författare)
  • Breastfeeding support from partners and grandmothers : Perceptions of Swedish women
  • 2003
  • Ingår i: Birth. - : Wiley-Blackwell. - 0730-7659 .- 1523-536X. ; 30:4, s. 261-266
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Support from the mother’s network of relatives, friends, and professional caregivers during childbirth is likely to be important for breastfeeding success. Few studies have been conducted to examine mothers’ perceptions of breastfeeding support. The objective of this study was to describe breastfeeding support and feelings of confidence of primiparas and multiparas in relation to duration of breastfeeding. Methods: Mothers whodelivered vaginally were eligible for inclusion. After receiving a questionnaire when their children were 9 to 12 months of age, 194 primiparas and 294 multiparas responded to questions onbreastfeeding history and on perceived and overall breastfeeding support and feelings of confidence. Results: Feelings of overall breastfeeding support were correlated with duration ofexclusive breastfeeding in both primiparas (p < 0.001) and multiparas (p < 0.001). Multiparas who knew how long they were breastfed as a child showed a longer duration of exclusive(p ¼ 0.006) and total (p ¼ 0.007) breastfeeding than multiparas who did not know. The time during which the partner was present after labor was correlated with the duration of exclusive(p < 0.001) and total breastfeeding (p ¼ 0.002) in primiparas. Feelings of confidence when the baby was 6 to12 months old, as retrospectively rated on a visual analog scale, was correlatedwith feelings of confidence in the partner during childbirth in both primiparas (p < 0.001) and multiparas (p < 0.001) and the experience of overall breastfeeding support (primiparas,p ¼ 0.002; multiparas, p < 0.001). Both groups were more content with breastfeeding information they received from midwives in the maternity wards, compared with that from antenatal midwives and postnatal nurses (p < 0.001). Conclusions: A helpful support strategy for mothers with respect to breastfeeding outcome is for health professionals to discuss the grandmother’s perception of breastfeeding with the mother. It is important for perinatalcaregivers to provide an environment that enables the family to stay together after delivery. A helpful support strategy for health professionals might be to mobilize grandmothers with positive breastfeeding perception to provide support for their daughters’ breastfeeding. (BIRTH 30:4 December 2003)
  •  
16.
  • Ekström, Anette, et al. (författare)
  • Does Continuity of Care by Well-Trained Breastfeeding Counselors Improve a Mother´s Perception of Support?
  • 2006
  • Ingår i: Birth. - : Wiley-Blackwell. - 0730-7659 .- 1523-536X. ; 33:2, s. 123-130
  • Tidskriftsartikel (refereegranskat)abstract
    • Background:Social support has been shown to be greatly important for breastfeeding success. The objective of this study was to investigate if mothers who were attended by midwives and nurses specially trained in breastfeeding counseling perceived better continuity of care and emotional and informative breastfeeding support than mothers who received only routine care. Method:Ten municipalities, each with an antenatal center and child health center, in southwest Sweden were randomized either to intervention or control municipalities. The intervention included a process-oriented training in breastfeeding counseling and continuity of care at the antenatal and child health centers. Primiparas were asked to evaluate the care given, and those living in the control municipalities were divided into control groups A and B. Data collection took place at different points in time for the two control groups. The 540 mothers responded to 3 questionnaires at 3 days and at 3 and 9 months postpartum. The perception of support provided by the health professionals and from the family classes was rated on Likert scales. Results:Intervention group mothers rated the breastfeeding information given during the family class as significantly better during pregnancy than both control groups, and better than control group B mothers at 3 months postpartum; compared with both control groups, intervention group mothers perceived that they received significantly better overall support and that postnatal nurses provided better information about breastfeeding and the baby's needs. At 9 months, intervention group mothers were more satisfied with knowledge about social rights, information about the baby's needs, and their social network than control group B mothers. Both intervention group and control group B mothers perceived better overall support than control group A during pregnancy. At 3 and 9 months, intervention group mothers perceived that postnatal nurses were more sensitive and understanding compared with both control groups. Conclusions:After implementation of a process-oriented breastfeeding training program for antenatal midwives and postnatal nurses that included an intervention guaranteeing continuity of care, the mothers were more satisfied with emotional and informative support during the first 9 months postpartum. The results lend support to family classes incorporating continuity of care. (BIRTH 33:2 June 2006)
  •  
17.
  • Ekström, Anette, et al. (författare)
  • Duration of Breastfeeding in Swedish Primiparous and Multiparous Women
  • 2003
  • Ingår i: Journal of Human Lactation. - : Sage Publications. - 0890-3344 .- 1552-5732. ; 19:2, s. 172-178
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to describe the effects of sociodemographicfactors and maternity ward practices on the duration of breastfeedingin Swedish primiparas (n = 194) and multiparas (n = 294), consecutivelyselected from hospital birth files for 3 months, who respondedto a questionnaire 9 to 12 months after childbirth. The impactof sociodemographic data and maternity ward practices on exclusiveand any breastfeeding were examined. Smoking and supplementationwithout medical reasons influenced the duration of both exclusiveand any breastfeeding negatively, whereas early first breastfeedinginfluenced the duration of both exclusive and any breastfeedingpositively, and parity had no significant influence. Late hospitaldischarge influenced the duration of exclusive breastfeedingpositively, and higher maternal age influenced the durationof any breastfeeding positively. These variables altogetherexplained 11.4% (P <.001) of the variance in the durationof exclusive breastfeeding and 8.2% (P <.001) of the durationof any breastfeeding
  •  
18.
  • Ekström, Anette, et al. (författare)
  • Process-oriented training in breastfeeding alters attitudes to breastfeeding in health professionals
  • 2005
  • Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 33:6, s. 424-431
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: The purpose of the study was to measure the attitudes of antenatal midwives and postnatal nurses to breastfeeding before and after common, process-oriented breastfeeding training. Method: Antenatal centres and child-health centres in 10 municipalities were randomized to either an intervention or a control group. The antenatal midwives and postnatal nurses in the intervention group were together given process-oriented breastfeeding training and were, in addition, asked to develop a common breastfeeding policy. A previously developed instrument was used to measure the effects of a training programme on breastfeeding attitudes among midwives and postnatal nurses. It consisted of four scales measuring a person's attitudes toward breastfeeding in four dimensions: regulating, facilitating, disempowering, and breastfeeding-antipathy attitudes. A mean score was calculated for each individual on these four dimensional scales. The higher the score, the stronger the attitude. Results: After one year, the intervention group reduced their scores on the regulating scale when compared with the control group (p<0.001). The intervention group decreased their scores on the regulating scale and increased their scores on the facilitating scale over the first year after training. The control group also significantly increased their scores on the facilitating scale. When the results were analysed profession-wise, the postnatal nurses in the intervention group decreased their scores on the regulating and disempowering scales and increased their scores on the facilitating scale. In contrast, the midwives in the intervention group decreased their scores only on the breastfeeding antipathy scale. The control group midwives decreased their scores on the disempowering scale. No differences were found among the postnatal nurses in the control group. Conclusion: Process-oriented breastfeeding training made both antenatal midwives and postnatal nurses better disposed to breastfeeding; postnatal nurses in particular improved their attitudes. Attitudes to breastfeeding tended to be stable over time, but process-oriented training lowered the scores a little on the regulating scale, suggesting that after this kind of training counsellors would find it less necessary to schedule and control the mothers' breastfeeding behaviour.
  •  
19.
  •  
20.
  • Fenner, Merle Friederike, et al. (författare)
  • Effect of selective IK,ACh inhibition by XAF-1407 in an equine model of tachypacing-induced persistent atrial fibrillation
  • 2020
  • Ingår i: British Journal of Pharmacology. - : Wiley. - 0007-1188 .- 1476-5381. ; 177:16, s. 3778-3794
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and Purpose: Inhibition of the G-protein gated ACh-activated inward rectifier potassium current, IK,ACh may be an effective atrial selective treatment strategy for atrial fibrillation (AF). Therefore, the anti-arrhythmic and electrophysiological properties of a novel putatively potent and highly specific IK,ACh inhibitor, XAF-1407 (3-methyl-1-[5-phenyl-4-[4-(2-pyrrolidin-1-ylethoxymethyl)-1-piperidyl]thieno[2,3-d]pyrimidin-6-yl]azetidin-3-ol), were characterised for the first time in vitro and investigated in horses with persistent AF. Experimental Approach: The pharmacological ion channel profile of XAF-1407 was investigated using cell lines expressing relevant ion channels. In addition, eleven horses were implanted with implantable cardioverter defibrillators enabling atrial tachypacing into self-sustained AF. The electrophysiological effects of XAF-1407 were investigated after serial cardioversions over a period of 1 month. Cardioversion success, drug-induced changes of atrial tissue refractoriness, and ventricular electrophysiology were assessed at baseline (day 0) and days 3, 5, 11, 17, and 29 after AF induction. Key Results: XAF-1407 potently and selectively inhibited Kir3.1/3.4 and Kir3.4/3.4, underlying the IK,ACh current. XAF-1407 treatment in horses prolonged atrial effective refractory period as well as decreased atrial fibrillatory rate significantly (~20%) and successfully cardioverted AF, although with a decreasing efficacy over time. XAF-1407 shortened atrioventricular-nodal refractoriness, without effect on QRS duration. QTc prolongation (4%) within 15 min of drug infusion was observed, however, without any evidence of ventricular arrhythmia. Conclusion and Implications: XAF-1407 efficiently cardioverted sustained tachypacing-induced AF of short duration in horses without notable side effects. This supports IK,ACh inhibition as a potentially safe treatment of paroxysmal AF in horses, suggesting potential clinical value for other species including humans.
  •  
21.
  • Hammarlund, Kina, 1955- (författare)
  • Riskfyllda möten : en studie om unga människors upplevelser av sexuellt överförbara infektioner och sexuellt risktagande
  • 2009
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The overall aim of the present thesis is to contribute to the knowledge in young people´s experiences, thoughts and norms regarding sexually transmitted infections (STI) and sexual risk-taking. The specific aims are two-fold. The first aim is to explain and understand young Swedish men and women´s lived experience of an STI, in this case genital warts (I, II). The second is to explain and understand the values and attitudes of young men and women to sexual risk-taking (III) in relation to perceptions of gender (IV).   The theoretical perspectives are a reflective lifeworld approach, hermeneutic and gender perspectives. The thesis is based on individual interviews (I, II) and focus groups (III, IV).  The results show that a young person infected by an STI, will experience encounters at different levels. A person with an STI is forced to meet him/herself and their own prejudices. Loss of innocence is highly significant and symbolic for women, while other person´s attitudes are more important for men (I, II). Also, being a disease carrier is of great significance, which has an impact on their views of future meaningful relationships (II).      Sexual risk-taking, such as it was expressed in the focus groups with young people, revealed a pattern that is described as a ‘game’. In that game, a dialogue might feel more intimate than intercourse. These teenagers often view their one night stand partners as objects, as opposed to love relationships where they are viewed as subjects, i.e. persons to be cared for. Engaging in sexual risk-taking often starts at a club where these teenagers pretend that they are spontaneous (III). This game is further illuminated in a secondary analysis with a gender perspective. There are frequent misunderstandings between young men and women that are based on gender constructions, which derive from lack of communication. Hence, they have to take part in a balancing act while shaping their sexual identity and trying to maintain their self-esteem. For these young women, this also concerns not getting a bad reputation. In this act of balance, it is difficult to discuss sexuality and how to protect one’s sexual health (IV). The discussion emphasizes that a professional caring dialogue with young people about STI: s and sexual-risk taking must have reference in the young person´s own reality. Thus, professional health care workers who meet a young person infected with an STI appear to face a challenging task. This involves helping reduce anxiety by defusing the situation, and at the same time to make the person understand the importance of using a condom in order to prevent STI: s.  
  •  
22.
  • Handlin, Linda, et al. (författare)
  • Effects of Sucking and Skin-to-Skin Contact on Maternal ACTH and Cortisol Levels During the Second Day Postpartum - Influence of Epidural Analgesia and Oxytocin in the Perinatal Period
  • 2009
  • Ingår i: Breastfeeding Medicine. - : Mary Ann Liebert. - 1556-8253 .- 1556-8342. ; 4:4, s. 207-220
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and Aims: In this study we made a detailed analysis of the mothers' release pattern of adreno-corticotropic hormone (ACTH) and cortisol during a breastfeeding session during the second day postpartum and related these patterns to maternal oxytocin levels as well to the duration of sucking and the duration of skin-to-skin contact before sucking the breast. Furthermore, we investigated if epidural analgesia and oxytocin administration during and after labor influenced the release pattern of ACTH and cortisol.Methods: Sixty-three primiparae were included in the study. Fourteen received oxytocin intramuscularly postpartum, nine received oxytocin infusion, 14 received epidural analgesia combined with oxytocin infusion, and six received epidural analgesia alone. Twenty mothers did not receive any of these medical interventions. Blood samples were analyzed for ACTH and cortisol by enzyme-linked immunoassay.Results: Both ACTH and cortisol levels fell significantly during the breastfeeding session. A significant negative relationship was found between oxytocin and ACTH levels, but not between oxytocin and cortisol levels. A contact before onset of sucking was significantly and negatively associated with lower cortisol levels, but not with ACTH levels. Cortisol levels differed significantly between mothers having received epidural analgesia with and without oxytocin.Conclusions: Breastfeeding is associated with a decrease of ACTH and cortisol levels. Skin-to-skin contact contributes to this effect. ACTH correlated negatively with the duration of sucking and median oxytocin levels, whereas cortisol levels correlated inversely with the duration of skin-to-skin contact preceding sucking, suggesting a partial dissociation between the mechanisms regulating ACTH and cortisol release. In addition, medical interventions in connection with birth influence the activity of the hypothalamic-pituitary-adrenal axis 2 days after birth.
  •  
23.
  • Handlin, Linda (författare)
  • Human-Human and Human-Animal Interaction : Some Common Physiological and Psychological Effects
  • 2010
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The aim of the present thesis was to investigate hormonal and physiological effects in mothers during a breastfeeding session and in dogs and their owners in response to short-term interaction. In study one, sixty-six mothers receiving either exogenous oxytocin infusion and/or epidural analgesia (EDA) during labor or intramuscular oxytocin injection post partum were studied. Oxytocin, prolactin, adrenocorticotrophic hormone (ACTH) and cortisol levels, as well as blood pressure were measured during a breastfeeding session two days after birth. In response to breastfeeding two days after birth, the mothers displayed a pulsatile release of oxytocin and increasing prolactin levels. In addition, the activity in the HPA-axis was reduced and maternal blood pressure decreased. The results also show that EDA administration in combination with oxytocin during labor resulted insignificantly lower oxytocin levels and higher cortisol levels, as well as higher bloodpressure in response to breastfeeding two days after birth, compared to EDA administration alone. In addition, oxytocin infusions dose-dependently lowered the mothers’ endogenous oxytocin levels two days after birth. In study two, ten female dog owners and their male Labrador dogs participated, together with ten controls. Their levels of oxytocin, cortisol and insulin, as well as their heart rate, were measured. The connection between the quality of the dogowner relationship and hormone levels was also explored. Short-term interaction between dogs and their owners resulted in oxytocin release in both species and their cortisol levels and heart rate were also affected. Oxytocin levels and positive attitudes regarding the dog-owner relationship were positively correlated. In conclusion, both human-human and human-animal interactions induce oxytocin release and promote oxytocin mediated effects, such as decreasing cortisol levels and blood pressure. In addition, social interaction and oxytocin levels arepositively related.
  •  
24.
  • Handlin, Linda, et al. (författare)
  • Influence of Common Birth Interventions on Maternal Blood Pressure Patterns During Breastfeeding 2 Days After Birth
  • 2012
  • Ingår i: Breastfeeding Medicine. - : Mary Ann Liebert. - 1556-8253 .- 1556-8342. ; 7:2, s. 93-99
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: This study investigated possible influences of medical interventions during labor on maternal blood pressure during a breastfeed 2 days postpartum.Subjects and Methods: Sixty-six primiparae with normal deliveries were consecutively recruited. Blood pressure was measured at –5, 10, 30, and 60 minutes during a morning breastfeed 2 days postpartum. Five treatment groups were formed based on the medical interventions received during labor: Non-medicated mothers (Control group, n=21); mothers receiving epidural analgesia (EDA) with oxytocin (OT) stimulation (EDAOT group, n=14); mothers receiving EDA without OT stimulation (EDAnon-OT group, n=7); mothers receiving OT stimulation only (OT intravenously [iv] group, n=9); and mothers receiving 10 IU of OT intramuscularly (im) only (OT im group, n=15).Results: Baseline diastolic, but not systolic, blood pressure differed between the groups as displayed by significantly lower diastolic blood pressure in the EDAnon-OT group compared with the Control group, the OT iv group, and the EDAOT group (p=0.045, p=0.041, and p=0.024, respectively). Both systolic and diastolic blood pressure fell significantly during the breastfeeding session in the Control group (p=0.001 and p=0.004, respectively), the OT im group (p=0.006 and p=0.001, respectively), and the EDAOT group (p=0.028 and p=0.002, respectively), and the fall in diastolic blood pressure tended to be significant in the OT iv group (p=0.050). The duration of skin-to-skin contact before breastfeeding correlated positively with the decrease in systolic blood pressure in the OT im group (Rs=0.540, p=0.046).Conclusion: Administration of EDA during labor lowers baseline diastolic blood pressure and abolishes the fall in blood pressure in response to a breastfeed 2 days after birth.
  •  
25.
  • Hertfelt Wahn, Elisabeth, et al. (författare)
  • A description of Swedish midwives' reflections on their experience of caring for teenage girls during pregnancy and childbirth
  • 2007
  • Ingår i: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 23:3, s. 269-278
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectiveto describe Swedish midwives' reflections on their experiences of caring for teenage girls during pregnancy and childbirth.Designa hermeneutical approach was used, with focus-group discussions as the method of data collection.Settingthree focus-group discussions were conducted in a county comprising urban, suburban and rural districts in south-western Sweden.Participantsa voluntary sample of 24 midwives, aged 32–61 years, who were caring for women in different birth settings, participated in 2004.Findingstwo main themes, with three sub-themes each, were generated by the midwives: (1) the teenage mother, as ‘teenagers who are proud of becoming mothers’, ‘teenagers who are unprepared for becoming mothers’ and ‘teenagers with an immigrant background’, and (2) ‘the midwives’ wish to care for the teenage mother’, as ‘taking the teenage mother seriously’, ‘being an important person for the teenage mother’, and ‘being a help for the teenage mother’.Key conclusions and implications for practicethe findings provide some understanding of the unique characteristics of caring for teenage mothers. For the midwives, the most important aspects of caring for the teenage mother included taking the teenage mother seriously, allowing the midwife herself to become an important person for the teenage mother, and being a help to the mother. This help requires the midwife to balance the different needs of each teenage mother.
  •  
26.
  • Hertfelt Wahn, Elisabeth, et al. (författare)
  • Becoming and Being a Teenage Mother : How Teenage Girls in South Western Sweden View Their Situation
  • 2005
  • Ingår i: Health Care for Women International. - : Routledge. - 0739-9332 .- 1096-4665. ; 26:7, s. 591-603
  • Tidskriftsartikel (refereegranskat)abstract
    • Our aim in this study was to describe the perspectives, experiences, and reasonings about becoming and being a teenage mother by Swedish teenage girls. Twenty pregnant and parenting teenage girls, aged 15 to 19 years, were interviewed. The teenagers described a pattern of early childbirth in their families, lack of opportunity in life, and ambivalence in contraceptive use as reasons for becoming a teenage mother . They experienced being pregnant and a teenage mother as both a positive transition into adulthood but also as a physiological and psychological hardship. Furthermore, the teenagers emphasized the importance of supportive relationships with families, friends, and society as a prerequisite for successful parenting. The results of our study may be viewed as generating a working hypothesis that can be transferred to other settings on the basis of the information gathered.
  •  
27.
  • Hertfelt Wahn, Elisabeth, et al. (författare)
  • Sociodemographic background, lifestyle and psychosocial conditions of swedish teenage mothers and their perception of health and social support during pregnancy and childbirth
  • 2008
  • Ingår i: Scandinavian Journal of Public Health. - : Taylor & Francis. - 1403-4948 .- 1651-1905. ; 36:4, s. 415-423
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: Among Swedish pregnant teenage girls it is unusual to continuepregnancy and to choose to have a baby. Swedish teenage motherscan therefore be expected to differ from adult mothers, at agroup level. The aim of this study was to describe and compareteenage mothers who were giving birth in hospital with adultmothers as to sociodemographic background, perception of healthand social support. Methods: A descriptive comparative studywas conducted over one year, in a county in south-western Sweden,which comprised a group of all teenage mothers aged 15—19,who gave birth at hospital (study group n=97) and the same numberof adult mothers aged 25—29, matched for parity and birthof a baby closest to the index mother (reference group). Bothgroups answered a questionnaire regarding sociodemographic variables,lifestyle, health, self-esteem, depressive symptoms, and support.Information on the mothers' pregnancy and delivery was obtainedfrom their maternal health and delivery charts. Results: Teenagemothers had more often been exposed to a difficult family situation,had more often experienced school failure than adult mothers,and showed health-risk behavior. Teenage mothers perceived lesssupport, had lower self-esteem, and more depressive symptomsthan adult mothers. Conclusions: Teenage mothers differed fromadult mothers regarding family situation and health behavioras well as perception of support, self-esteem, and depressivesymptoms, which may negatively influence their ability to copewith parenthood. Efforts should be made early in pregnancy tomeet both health and support needs of teenage mothers.
  •  
28.
  • Hertfelt Wahn, Elisabeth (författare)
  • Teenage childbearing in Sweden : support from social network and midwife
  • 2007
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The aim of this thesis was to contribute to the knowledge and understanding of Swedish- speaking pregnant and parenting teenage girls’ situation and experiences of becoming mothers in the Swedish context as well as midwives’ reflections on their experiences of caring for teenage girls during pregnancy and childbirth.Specific aims were to describe Swedish teenage girls’ perspectives, experiences and thoughts about becoming and being a teenage mother (I); to describe Swedish midwives’ reflections on their experiences of caring for teenage girls during pregnancy and childbirth (II); to describe and compare a group of Swedish-speaking teenage mothers, aged 15-19, with adult mothers, aged 25-29, all of whom gave birth in hospital, in terms of sociodemographic background, perception of health during pregnancy, and social support (III); to describe and compare the perception of received social support, self-esteem and different background factors among teenage mothers, aged15-19, with and without depressive symptoms (IV).Methods The studies were conducted in a county in south western Sweden during 2003 and 2004. Both qualitative and quantitative methods were used: individual semi-structured interviews with 20 teenage mothers (I); three focus group discussions (FGDs) with 24 midwives; and a questionnaire developed specifically for this study given to 97 teenage mothers and 97 adult mothers 1-3 days postpartum (III, IV). Content and hermeneutical text analyses were applied to qualitative data (I, II), and descriptive statistics were used to analyse quantitative data (II, IV).Results from studies showed that there were two main reasons for Swedish-speaking teenagers to become mothers (I, II, III). It was seen as a way out of a difficult psychosocial situation, or it was seen as something natural because of a family pattern of early motherhood (I, II). Teenage mothers had more often had an early experience of parental separation, had experienced physical and/or psychological violence, were more often inclined to engage in risky behaviours, and smoked more often during pregnancy. In addition they perceived less support from their social network, had lower self-esteem, and had more depressive symptoms than adult mothers (III). Teenage mothers with depressive symptoms had lower self-esteem, perceived less support from family and friends, had more often been exposed to violence, and were more often smokers than teenage mothers without depressive symptoms (IV). Support from the midwives was generally well perceived by teenage mothers, but support from the midwife attending delivery was less well perceived in teenage mothers with depressive symptoms (IV). Reflections by the midwives about their experience of caring for teenage mothers revealed a true presence in the encounters with teenage mothers (II).Conclusions Our findings provide midwives and other health care providers with a picture of the experience of teenage motherhood, which highlights the importance of antenatal assessment of each teenage mother’s strengths, weaknesses, hopes, self-esteem, depressive symptoms, health risk behaviours, social support networks, and satisfaction with social support prior to care planning. The midwife needs to lend a listening ear to the teenage mother, giving her time, showing that she is taking her seriously and trying to understand her complex situation. Teenage mothers need acceptance and clear communication.
  •  
29.
  • Hertfelt Wahn, Elisabeth, et al. (författare)
  • Teenage Childbearing in Sweden – Depressive Symptoms among Teenage Mothers, Influencing Factors, Perception of Support and Self-Esteem : A Comparative Cross-Sectional Study
  • 2012
  • Ingår i: Journal of Nursing & Care. - : OMICS Publishing Group. - 2167-1168. ; 1:6
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Becoming a teenage mother is confronted with parental responsibilities at a time when a teenage girl has to deal with her own intense development. Depressive symptoms and postpartum depression are commonly reported in teenage mothers and are of particular concern since depressive symptoms are linked with poor general health.Objective: To examine if the perception of support, self-esteem and social background factors differ between teenage mothers with depressive symptoms compared with teenage mothers without depressive symptoms. Design: A descriptive comparative cross-sectional study.Participants: Swedish speaking teenage mothers aged 15-19 who gave birth in hospital in a county of south western Sweden, n=76. The group was divided into two groups based on their score on Edinburgh postnatal depression scale, depressive symptoms, n=24 and without depressive symptoms, n=52.Measurements: Data were collected by a questionnaire including socio-demographic variables, scales to measure support, self-esteem and depressive symptoms. Differences between teenage mothers scoring high or low on the EPDS were tested. Teenage mothers with depressive symptoms perceived less support from family and friends and had lower self-esteem than teenage mothers without depressive symptoms. They had more often been exposed to mental/physical abuse and were more often smokers than the teenage mothers without depressive symptoms. Support from the midwives were generally well perceived by teenage mothers, but support from the midwife attending delivery was less well perceived by teenage mothers with depressive symptoms.Conclusion: Teenage mothers with depressive symptoms may have a difficult life situation characterized by low self-esteem and perceived failing support from their social network.Implications for practice: The result suggests that assessment of the health status of the teenage mother should include screening for depressive symptoms, risk-taking behaviours and perception of current family/friend and partner support to inform individual planning of care
  •  
30.
  • Jonas, W., et al. (författare)
  • Effects of Intrapartum Oxytocin Administration and Epidural Analgesia on the Concentration of Plasma Oxytocin and Prolactin, in Response to Suckling During the Second Day Postpartum
  • 2009
  • Ingår i: Breastfeeding Medicine. - : Mary Ann Liebert. - 1556-8253 .- 1556-8342. ; 4:2, s. 71-82
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Oxytocin and prolactin stimulate milk ejection and milk production during breastfeeding. The aim of the present study was to make a detailed analysis of maternal release of oxytocin and prolactin in response to breastfeeding during the second day postpartum in mothers who had received oxytocin either intravenously for stimulation of labor or intramuscularly for prevention of postpartum hemorrhage and/or epidural analgesia or those who had received no such treatment in connection with birth.Methods: In a descriptive comparative study plasma oxytocin and prolactin concentrations were measured in response to suckling during the second day postpartum in women who had received intravenous intrapartum oxytocin (n = 8), intramuscular postpartum oxytocin (n = 13), or epidural analgesia, either with (n = 14) or without (n = 6) intrapartum oxytocin infusion, and women who received none of these interventions (n = 20). Hormone levels were analyzed by enzyme immunoassay.Results: All mothers showed a pulsatile oxytocin pattern during the first 10 minutes of breastfeeding. Women who had received epidural analgesia with oxytocin infusion had the lowest endogenous median oxytocin levels. The more oxytocin infusion the mothers had received during labor, the lower their endogenous oxytocin levels were during a breastfeeding during the second day postpartum. A significant rise of prolactin was observed after 20 minutes in all women, but after 10 minutes in mothers having received oxytocin infusion during labor. In all women, oxytocin variability and the rise of prolactin levels between 0 and 20 minutes correlated significantly with median oxytocin and prolactin levels.Conclusion: Oxytocin, released in a pulsatile way, and prolactin were released by breastfeeding during the second day postpartum. Oxytocin infusion decreased endogenous oxytocin levels dose-dependently. Furthermore, oxytocin infusion facilitated the release of prolactin. Epidural analgesia in combination with oxytocin infusion influenced endogenous oxytocin levels negatively.
  •  
31.
  • Jonas, Wibke, et al. (författare)
  • Influence of oxytocin or epidural analgesia on personality profile in breastfeeding women : a comparative study
  • 2008
  • Ingår i: Archives of Women's Mental Health. - : Springer. - 1434-1816 .- 1435-1102. ; 11:5-6, s. 335-345
  • Tidskriftsartikel (refereegranskat)abstract
    • Women undergo physiological and psychological changes during pregnancy, labor and lactation. The psychological adaptations can be affective, cognitive and behavioral and can be measured by dimensional personality instruments. This study aims to compare (1) the personality profile in mothers after birth with a normative group of non-lactating women and to examine (2) whether the personality profile differs 2 days, 2 months and 6 months after birth between mothers who have been exposed to epidural anesthesia, oxytocin administration or neither. Sixty-nine primiparae were assigned to four groups: mothers having received oxytocin infusion during labor (OT iv group, n=9), mothers having received epidural analgesia with/without oxytocin infusion (EDA group, n=23), mothers having received 10 iU oxytocin intramuscularly after birth (OT im group, n=15) and mothers having received none of these treatments (unmedicated group, n=22). At 2 days and 2 and 6 months postpartum mothers completed the Karolinska Scales of Personality (KSP). The unmedicated, the OT iv- and OT im groups scored significantly lower on anxiety and aggression related scales and higher on the socialization subscale during the entire observation period when compared with a normative group. These differences were not observed in the EDA group 2 days postpartum. At´2 and 6 months postpartum, the scores of the EDA group had changed significantly and were almost similar to the KSP scores of the other groups. ANCOVA analysis revealed that OT infusion, over and above the effects of EDA, was associated with decreased levels of several anxiety and aggression subscales. We conclude that women who received exogenous oxytocin during labor show similar positive personality traits during breastfeeding such as reduction in anxiety and aggression and increasing socialization, including maternal behavior, that have previously been ascribed to endogenous oxytocin. More importantly, these effects were not seen at 2 days postpartum in women who received epidural anesthesia during labor.
  •  
32.
  • Jonas, W., et al. (författare)
  • Newborn skin temperature two days postpartum during breastfeeding related to different labour ward practices
  • 2007
  • Ingår i: Early Human Development. - : Elsevier BV. - 0378-3782 .- 1872-6232. ; 83:1, s. 55-62
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: To investigate (1) the skin temperature pattern in newborns two days after birth in connection to breastfeeding and to examine (2) if the administration of epidural analgesia (EDA) and oxytocin (OT) infusion during labour influences this parameter at this point of time. Method: Forty-seven mother-infant pairs were included in the study: nine mothers had received OT stimulation during labour (OT group), 20 mothers had received an EDA and OT during labour (EDA group), while 18 mothers had received neither EDA nor OT stimulation during labour (control group). A skin temperature electrode was attached between the newborn's shoulder blades. The newborn was placed skin-to-skin on the mother's chest and covered with a blanket. The temperature was recorded immediately after the newborn was put on the mother's chest and at 5, 10, 20 and 30 min. Results: The temperature measured when the newborns were put skin-to-skin on their mothers' chest was significantly higher in the infants of the EDA group (35.07 °C) when compared to the control group (34.19 °C, p = 0.025). Skin temperature increased significantly (p = 0.001) during the entire experimental period in the infants belonging to the control group. The same response was observed in infants whose mothers received OT intravenously during labour (p = 0.008). No such rise was observed in infants whose mothers were given an EDA during labour. Conclusion: The results show that the skin temperature in newborns rises when newborns are put skin-to-skin to breastfeed two days postpartum. This effect on temperature may be hampered by medical interventions during labour such as EDA. © 2006 Elsevier Ireland Ltd. All rights reserved.
  •  
33.
  • Jonas, W., et al. (författare)
  • Short- and long-term decrease of blood pressure in women during breastfeeding
  • 2008
  • Ingår i: Breastfeeding Medicine. - New Rochelle : Mary Ann Liebert Inc. - 1556-8253 .- 1556-8342. ; 3:2, s. 103-109
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and aims: The benefits of breastfeeding for infants are well known. Recently data have started to emerge showing that breastfeeding may also induce positive effects in the mother. This study aimed to investigate the pattern of maternal blood pressure before, during, and after a breastfeed 2 days postpartum. Additionally, blood pressure during the following 25-week breastfeeding period was investigated. Methods: Sixty-six primiparae with normal deliveries were consecutively recruited. Blood pressure was measured at -5, 10, 30, and 60 minutes in connection with a morning breastfeed. Thirty-three women continued to measure blood pressure before and after breastfeeding for 25 weeks. Results: Blood pressure fell significantly in response to breastfeeding 2 days after birth. The fall in systolic and diastolic blood pressure amounted to 8.8 (SD = 11.00) and 7.7 (SD = 9.3) mm Hg, respectively. During the 25-week follow-up period a significant fall of basal blood pressure (systolic, df = 3, F = 7.843, p < 0.001; diastolic, df = 3, F = 5.453, p = 0.002) was observed. The total fall in systolic and diastolic blood pressure amounted to a mean of 15 (SD = 10.4) mm Hg and 10 (SD = 9.7) mm Hg, respectively. In addition, blood pressure fell significantly in response to individual breastfeeding sessions during the entire observation period. Conclusions: In conclusion, both systolic and diastolic blood pressures fall during a breastfeeding session, and pre-breastfeeding blood pressure decreases during at least the first 6 months of a breastfeeding period in a homelike environment. This study lends further support to the health-promoting effects of breastfeeding. © 2008 Mary Ann Liebert, Inc.
  •  
34.
  • Jörgen, Nissen, et al. (författare)
  • Global statistik, alternativa fakta och (o)möjligheter
  • 2021
  • Ingår i: Ämnet som blev. Rapporter från fjärde nationella konferensen i pedagogiskt arbete. - Umeå : Institutionen för estetiska ämnen, Umeå Universitet. - 9789178556038
  • Konferensbidrag (refereegranskat)abstract
    • Vår tid kännetecknas av att samtidigt som den empirisk-realistiska uppfattningen om betydelsen av vetenskap och kunskap är ifrågasatt, står mänskligheten inför en rad utmaningar såsom hot mot klimatet, hot mot demokratiska institutioner, växande ojämlikhet och pandemier. För att möta detta behöver medborgare inte enbart kunna sovra och bedöma information utan också kan agera som politiska subjekt. Kapitlet bygger på en studie i två klassrum i ämnet samhällskunskap där elever använder officiell statistik för att med hjälp av ett visualiseringsverktyg undersöka globala handelsmönster. Eleverna presenterar sedan muntligt och visuellt sina insikter, och läraren bedömer elevernas redovisningar. Studien visar att eleverna med hjälp av visualiserad information, kan förstå ekonomiska och politiska samband, vilket skulle kunna ligga till grund för politiskt engagemang. I klassrummet uteblir dock insikten om att det “skulle kunna vara annorlunda” och att den enskilde/gruppen kan medverka till förändring. Istället hamnar fokus på bedömning av elevens prestation. Studien visar därmed att även om pedagogiska praktiker kan skapa förutsättningar för politisk subjektivitet så tenderar dessa att undergrävas av krav på bedömning, kvalificering och prestationer.
  •  
35.
  • Kornaros, Katarina, et al. (författare)
  • A hermeneutic study of integrating psychotherapist competence in postnatal Child Health Care : Parents' perspectives
  • 2020
  • Ingår i: Infant Mental Health Journal. - : Wiley. - 0163-9641 .- 1097-0355. ; 41:1, s. 108-125
  • Tidskriftsartikel (refereegranskat)abstract
    • A child's emotional and social development depends on the parents' provision of optimal support. Many parents with perinatal distress experience difficulties in mastering parenthood and seek help from professionals within primary healthcare. A clinical project was launched in Stockholm, where psychodynamic psychotherapists provided short-term consultations at Child Health Centers. This study qualitatively explored parents' experiences of perinatal distress and of receiving help by nurses and therapists in the project. Thirteen parents were interviewed, and their responses were analyzed with a hermeneutical method. Three main themes crystallized; accessibility of psychological help and detection of emotional problems; experiences of therapy at the Child Health Center; and the therapists' technique. Parents were also clustered into three so-called ideal types: the insecure; parents in crisis; and parents with lifelong psychological problems. Parents experienced obstacles in accessing psychological care within primary healthcare. Psychotherapists with a holistic family perspective and who managed to oscillate between insight-promoting and supportive interventions were especially appreciated. Patient categories who benefitted from insight promotion and support, respectively, were identified.
  •  
36.
  • Kornaros, Katarina, et al. (författare)
  • A hermeneutic study of integrating psychotherapist competence in postnatal child health care : Nurses' perspectives
  • 2018
  • Ingår i: BMC Nursing. - : Springer Science and Business Media LLC. - 1472-6955. ; 17
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: There is a considerable prevalence of and an increasing attention to emotional problems in families with infants. Yet, knowledge is scant of how to create efficient and accessible mental health services for this population. The study qualitatively explored public health nurses' conceptions of a clinical project, in which psychotherapists provided short-term consultations and supervisions for nurses at Child Health Centres in Stockholm.Methods: In-depth interviews with fifteen nurses. The guideline of the interviews contained open-ended questions that were analysed applying a hermeneutical approach.Results: Four main themes crystallized; The nurses' conceptions of their psychosocial work, Trespassing on another professional role, Interprofessional collaboration at the Child Health Centre, and The nurses' conceptions of the psychotherapist's function. In a second step, an analysis that clustered the nurses' attitudes towards handling mental health problems yielded one last theme with three "Ideal types"; nurses who expressed "I don't want to", "I want to but I cannot", and "I want to and I can" (take care of families' emotional problems at the CHC).Conclusion: The nurses appreciated the easy referral and accessibility to the psychotherapists, and the possibilities of learning more about perinatal mental illness and parent-infant interactions. For a successful cooperation with the nurses, the therapist should be a team member, be transparent about his/her work, and give feedback about cases in treatment. The study also shows how the organization needs to clarify its guidelines and competence to improve psychological child health care. The paper suggests improvements for an integrated perinatal mental health care.
  •  
37.
  • Lilja, Gunilla, et al. (författare)
  • Depressive mood in women at childbirth predicts their mood and relationship with infant and partner during the first year postpartum
  • 2012
  • Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 26:2, s. 245-253
  • Tidskriftsartikel (refereegranskat)abstract
    • Depressive mood in women at childbirth predicts their mood and relationship with infant and partner during the first year postpartum Background: Although many studies have reported negative impact of maternal depressive symptoms on family relations, few studies have explored whether or not early depressive symptoms influence interfamily relationships. The aim was to describe first-time mothers feelings for their infant and partner during the first postpartum year in relation to maternal depressive symptoms. Research questions were addressed about: What is the prevalence of maternal depressive symptoms 10 days postpartum? How does maternal depressive symptoms on day 10 relate to her mood and feelings for the infant and partner at days 3 and 10, and at 6 and 12 months postpartum? Methods: A longitudinal study with first-time mothers, normal pregnancies, giving birth to healthy babies participated in the study; altogether, n = 419. Depressive symptoms were measured by Edinburgh Postnatal Depression Scale (EPDS) at 3 and 10 days. Additional questionnaires assessing the womans mood and relationship with her infant and partner were filled out at days 3 and 10, and at 6 and 12 months postpartum. Results: Twenty-two per cent of the women scored high on EPDS on day 10 postpartum. In addition, low mood seemed to remain prevalent over the babys first year, as confirmed by the mood scale at 6 and 12 months postpartum. Women with depressive symptoms showed less closeness, warmth and confidence as measured by the infant and partner relationship scales over the first year. Mothers with a high EPDS score on day 3 scored less optimal on the relationship scale to the infant at days 3 and 10, but not 6 or 12 months postpartum. Conclusions: To screen women for depressive symptoms, 10 days postpartum seems to be predictive of maternal assessment of maternalinfant relationship throughout the first year and enables early intervention.
  •  
38.
  • Lundgren, Ingela, 1957, et al. (författare)
  • Care seeking during the latent phase of labour – Frequencies and birth outcomes in two delivery wards in Sweden
  • 2013
  • Ingår i: Sexual & Reproductive HealthCare. - 1877-5756. ; 4:4, s. 141-146
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To explore the frequency of women seeking care during the latent phase of labour at two delivery wards. Also, to investigate interventions during labour and birth outcomes in relation to parity and remaining in hospital or not during the latent phase. Methods: A retrospective, population-based cohort study in two delivery wards in Sweden. The sample was based on electronic childbirth records of all births with spontaneous onset. Results: Of 5797 women, 17.6% (n = 1023) sought care during the latent phase. Of these, 57.8% (n = 591) remained at the hospital, and 50.5% (n = 517) had a prolonged latent phase. Nulliparae remaining in hospital had a lower rate of spontaneous vaginal births (p = 0.007), more emergency Caesarean sections (CSs) (p < 0.001) and more babies with Apgar <7 at 5 min (p = 0.045) compared with those returning home. Nulliparae having a prolonged latent phase and remaining in hospital had fewer spontaneous vaginal births (p = 0.045), more emergency CSs (p = 0.002) and more babies with Apgar <7 at 5 min (p = 0.023) compared with those returning home. For multiparous women with a previous vaginal birth, with or without prolonged latent phase, mode of delivery was not influenced by remaining in hospital or not. Conclusion: These findings indicate a need for different guidelines for nulliparous and multiparous women seeking hospital care during the latent phase, and for special attention to be given to nulliparous with a prolonged latent phase remaining in hospital during the latent phase.
  •  
39.
  • Melander, Eva, et al. (författare)
  • Utilisation of antibiotics in young children: opposite relationships to adult educational levels in Danish and Swedish counties.
  • 2003
  • Ingår i: European Journal of Clinical Pharmacology. - : Springer Science and Business Media LLC. - 1432-1041 .- 0031-6970. ; 59:4, s. 331-335
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. Antibiotic utilisation varies profoundly among and within countries, and the extent of antibiotic utilisation correlates with the frequency of bacterial resistance, particularly among children. Hence, it is important to assess which factors may influence prescribing. In addition to variations in morbidity, health-care organisation, drug regulatory and supply systems, prescriber's attitudes, parents' behaviour, attitudes and socio-economic positions seem important. We compared socio-economic position (educational level of adults) and antibiotic utilisation in children in the municipalities within a Danish and a Swedish county which are geographically close, have similar social and economic development, and similar drug regulatory and supply systems. Methods. Data on antibiotic utilisation (1998), expressed in defined daily doses per 1000 inhabitants per day (DDD/TID), were obtained from the Copenhagen County Health Insurance register and from the National Corporation of Swedish Pharmacies. Data on municipal educational levels were obtained from Statistics Denmark and Statistics Sweden. Results. The utilisation of antibiotics in 0- to 6-year-old children was higher in the Swedish than in the Danish county but varied between the municipalities within both the Swedish (9.6-17.7 DDD/TID) and the Danish (8.0-12.9 DDD/TID) counties. Most notably, utilisation rates correlated negatively with the education levels in the Danish (r=-0.539, P=0.021) but positively in the Swedish (r=+0.390, P=0.025) municipalities. Conclusion. The observed variations in antibiotic prescribing may reflect different parental and/or prescriber attitudes towards use of antibiotics and they emphasise that antibiotic prescribing is influenced by factors other than the prevalence of bacterial infections. Relationships between socio-economic position (educational level) and drug utilisation should not be generalised from one area to another.
  •  
40.
  • Nissen, Eva (författare)
  • Effects of some ward routines on behavioural and physiological adaptation to breast-feeding
  • 1996
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The overall aim of this thesis was to study how early breast-feeding would be influenced by pethidine given during labour and by an emergency Caesarean section. Eighteen mother-infant pairs which were exposed and 26 which were not exposed to pethidine during labour were observed the first two hours after birth. The infants were put skin-to-skin on their mothers' chest. The developing breast-feeding behaviour was observed. It was found that the pethidine exposed infants had a delayed and depressed sucking and rooting behaviour. Infants with a short dose-to-delivery interval had the most depressed sucking behaviour and infants with high concentration of pethidine in the umbilical cord did not suck the breast at all during the observation. Seventeen primiparous women who had had an emergency Caesarean section and 20 women who had had a vaginal delivery were blood sampled during a breast-feeding two days after childbirth and oxytocin, prolactin and cortisol levels were measured with RIA. Women who had had vaginal delivery had a pulsatile oxytocin the first ten minutes of breast-feeding (ranging from 1-5 pulses) pattern and elevated levels of prolactin 20-30 mimltes after the onset of breast-feeding. The number of pulses was related to the amount of milk the infant ingested during the studied breast-feed and the duration of exclusive breast-feeding. Women who had had a Caesarean section had significantly fewer pulses of oxytocin (ranging from 0-3) and no elevation of prolactin. The number of pulses was related to the amount of milk the infant ingested during the studied breast-feeding in both groups. Regression analysis showed two factors to be of importance for for the differences in oxytocin patterns between the groups and that was the absence of a second stage of labour and a delayed first suckling occasion. Cortisol decreased significantly in both groups. The personality inventory, the Karolinska Scales of personality, were filled in on the second day by the mothers described above and on the day of partus by 13 primiparae and 16 multiparae and were compared with a normative group of women. The results showed that women who had had a vaginal delivery scored lower in anxiety variables and higher in socialisation than the normative group. In addition the multiparous women but not the primiparous women showed similar differences on the day of partus. The women who had had a Caesarean section did not show these differences. Basal levels of oxytocin were inversely correlated with anxiety scores in mothers with a Caesarean section and the number of pulses of oxytocin were correlated with social desirability in the women who had had a vaginal delivery. The data give further support for the importance of early breast-feeding for some maternal adaptations, such as milk production and behaviour. Furthermore, early interaction may together with labour influence maternal oxytocin secretion which may underlie some maternal adaptations. Two routines were found to disturb early suckling -pethidine given during labour and Caesarean section. Some suggestions as how to compensate for this are given.
  •  
41.
  • Nissen, Eva Rames, et al. (författare)
  • Internet-delivered mindfulness-based cognitive therapy for anxiety and depression in cancer survivors : A randomized controlled trial
  • 2020
  • Ingår i: Psycho-Oncology. - : John Wiley & Sons. - 1057-9249 .- 1099-1611. ; 29:1, s. 68-75
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective Internet-delivered interventions may alleviate distress in cancer survivors with limited access to psychological face-to-face treatment. In collaboration with a group of cancer survivors, we developed and tested the efficacy of a therapist-assisted internet-delivered mindfulness-based cognitive therapy (iMBCT) program for anxiety and depression in cancer survivors. Methods A total of 1282 cancer survivors were screened for anxiety and depression during their routine oncology follow-up; eligible breast (n = 137) and prostate cancer (n = 13) survivors were randomized to iMBCT or care-as-usual (CAU) wait-list. Primary outcomes of anxiety and depression were assessed at baseline, 5 weeks, 10 weeks (post intervention), and 6 months. Results Significant effects were found for both anxiety (Cohen's d = 0.45; P = .017) and depressive symptoms (d = 0.42; P = .024) post intervention. The effects were maintained at follow-up for anxiety (d = 0.40; P = .029), but not for depressive symptoms (d = 0.28; P = .131). Conclusions Our preliminary findings suggest iMBCT to be a helpful intervention for cancer survivors suffering from symptoms of anxiety. Further studies on the efficacy for symptoms of depression are needed.
  •  
42.
  • Nissen, Eva Rames, et al. (författare)
  • Internet-delivered Mindfulness-Based Cognitive Therapy for anxiety and depression in cancer survivors : Predictors of treatment response
  • 2021
  • Ingår i: Internet Interventions. - : Elsevier. - 2214-7829. ; 23, s. 1-10
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The present study investigates possible predictors of treatment response in an Internet-delivered Mindfulness-Based Cognitive Therapy (iMBCT) intervention with therapist support. This iMBCT program, a fully online delivered intervention with asynchronous therapist support, has previously been shown to be efficacious in reducing symptoms of anxiety and depression in women treated for breast cancer and men treated for prostate cancer. Methods: Eighty-two breast- and prostate cancer survivors experiencing psychological distress received 8 weeks of therapist-guided iMBCT. Primary outcomes were improvement in anxiety and depression scores from baseline to post-treatment and from baseline to six-months follow-up. Clinical predictors included levels of depression and anxiety at the time of screening and at baseline, as well as time since diagnosis. Demographic predictors included age and educational level. Therapy-related predictors included working alliance, self-compassion, and five facets of mindfulness. Mixed Linear Models were employed to test the prediction effects over time. Results: Higher levels of baseline depression were associated with increased treatment response in anxiety at post-treatment, and lower levels of self-compassion were associated with increased treatment response in depression at post-treatment. None of the proposed predictors significantly predicted treatment response at six-months follow-up. Conclusion: The findings suggest that iMBCT can be provided for cancer survivors regardless of their age, educational level, and time since diagnosis (up to five years) and that therapeutic alliance is not crucial for treatment response. We did not identify characteristics predicting treatment response, although many factors were tested. Still, other characteristics may be predictors, and given the relatively small sample size and a large number of statistical tests, the results should be interpreted with caution.
  •  
43.
  • Nissen, Jörgen, 1958-, et al. (författare)
  • Global statistik, alternativa fakta och (o)möjligheten att utveckla elevers demokratiska subjektivitet
  • 2021
  • Ingår i: Ämnet som blev. - Umeå : Inst för estetiska ämnen. Umeå universitet. - 9789178556045 ; , s. 65-80
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
    • Vår tid kännetecknas av att samtidigt som den empirisk-realistiska uppfattningen om betydelsen av vetenskap och kunskap är ifrågasatt, står mänskligheten inför en rad utmaningar såsom hot mot klimatet, hot mot demokratiska institutioner, växande ojämlikhet och pandemier. För att möta detta behöver medborgare inte enbart kunna sovra och bedöma information utan också kan agera som politiska subjekt.Kapitlet bygger på en studie i två klassrum i ämnet samhällskunskap där elever använder officiell statistik för att med hjälp av ett visualiseringsverktyg undersöka globala handelsmönster. Eleverna presenterar sedan muntligt och visuellt sina insikter, och läraren bedömer elevernas redovisningar.Studien visar att eleverna med hjälp av visualiserad information, kan förstå ekonomiska och politiska samband, vilket skulle kunna ligga till grund för politiskt engagemang. I klassrummet uteblir dock insikten om att det “skulle kunna vara annorlunda” och att den enskilde/gruppen kan medverka till förändring. Istället hamnar fokus på bedömning av elevens prestation. Studien visar därmed att även om pedagogiska praktiker kan skapa förutsättningar för politisk subjektivitet så tenderar dessa att undergrävas av krav på bedömning, kvalificering och prestationer.
  •  
44.
  • Nissen, Lars Johan, et al. (författare)
  • Angiogenic factors FGF2 and PDGF-BB synergistically promote murine tumor neovascularization and metastasis.
  • 2007
  • Ingår i: The Journal of clinical investigation. - 0021-9738. ; 117:10, s. 2766-77
  • Tidskriftsartikel (refereegranskat)abstract
    • Tumors produce multiple growth factors, but little is known about the interplay between various angiogenic factors in promoting tumor angiogenesis, growth, and metastasis. Here we show that 2 angiogenic factors frequently upregulated in tumors, PDGF-BB and FGF2, synergistically promote tumor angiogenesis and pulmonary metastasis. Simultaneous overexpression of PDGF-BB and FGF2 in murine fibrosarcomas led to the formation of high-density primitive vascular plexuses, which were poorly coated with pericytes and VSMCs. Surprisingly, overexpression of PDGF-BB alone in tumor cells resulted in dissociation of VSMCs from tumor vessels and decreased recruitment of pericytes. In the absence of FGF2, capillary ECs lacked response to PDGF-BB. However, FGF2 triggers PDGFR-alpha and -beta expression at the transcriptional level in ECs, which acquire hyperresponsiveness to PDGF-BB. Similarly, PDGF-BB-treated VSMCs become responsive to FGF2 stimulation via upregulation of FGF receptor 1 (FGFR1) promoter activity. These findings demonstrate that PDGF-BB and FGF2 reciprocally increase their EC and mural cell responses, leading to disorganized neovascularization and metastasis. Our data suggest that intervention of this non-VEGF reciprocal interaction loop for the tumor vasculature could be an important therapeutic target for the treatment of cancer and metastasis.
  •  
45.
  • Olsson, Ann, et al. (författare)
  • Women´s thoughts about sexual life after childbirth : focus group discussions with women after childbirth
  • 2005
  • Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 19:4, s. 381-387
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: To give birth and become a parent is a source of many emotions and expectations. Several studies show that women experience different problems after giving birth. It can bring many physical, emotional and social changes that may alter the woman’s sexual needs and impact on her relationship. The aim of this study was to elucidate how some women experienced their sexual life with their partner after giving birth. Methods: Twenty-seven women participated in six focus group discussions (FGDs). These discussions took place 3–24 months postdelivery. The midwives at their antenatal clinics selected them. A discussion guide with broad questions related to the subject was used and an observer took notes during the FGD. Results: Four themes were identified: body image after childbirth, how sexual patterns are altered following new stresses of family life, discordance of sexual desire with the partner and the necessity for reassurance. The women did not feel comfortable with the physical changes that had taken place and their body image. Childbirth meant less sleep and less free time; consequently, instead of having sex, women wanted to sleep or have time for themselves and that led to a changed sex pattern. Discordance of sexual desire with the partner was a problem but most of the women expressed confidence that their sexual desire would return shortly. Reassurance and confirmation that they were physically alright and back to normal was essential. Conclusion: New mothers are concerned with their body image and the ability to adapt to parenting. They need sensitive, professional counselling and reassurance about their body, as well as about sexual life after childbirth. This level of professional counselling is presently not widely available to new mothers, while midwives and gynaecologistsshould be the key persons to provide this service.
  •  
46.
  • Palmér, Lina, 1979- (författare)
  • Amning och existens : Moderskap, sårbarhet och ömsesidigt beroende vid inledande amning
  • 2015
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Aim: The overall aim of the thesis is to create knowledge about what it means for women to initiate breastfeeding and what consequences these meanings have from an existential perspective.Approach and method: A lifeworld approach based on the epistemology of phenomenology and hermeneutics was used. Lifeworld interviews and meaningoriented analysis in accordance with the chosen lifeworld approach were performed. A synthesis and a philosophical analysis were carried out that facilitates an understanding of the existential meaning of initial breastfeeding and its consequences as a whole.Main findings: Initiating breastfeeding, when it functions well, entails an existential challenge, a movement from a bodily performance to an embodied relationship with the infant and with oneself as a mother. When breastfeeding is experienced as being severely difficult, it entails an existential lostness as a mother, forcing her into a constant fight with herself, the infant, and others in order to find her way into motherhood. Severe breastfeeding difficulties can evoke existential vulnerability, forcing the mother to continue breastfeeding despite the difficulties, while hoping to be confirmed as a good mother; a fear of breastfeeding may be a consequence. Existential security is a necessary condition for continued breastfeeding whilst insecurity and fear of breastfeeding can lead to ceased attempts to breastfeed when experiencing severe initial difficulties. Initial breastfeeding and motherhood are intertwined in a way that affects the woman’s existence as a mother.Conclusions: Initial breastfeeding is a complex phenomenon that is more than just a biological adaptation or a cultural issue; it touches on and evokes existential aspects of being a woman and a mother. Though anchored in both biology and culture, breastfeeding cannot be reduced to one or the other: it is both. There is a struggle between biology and culture that has existential consequences for women’s experiences of breastfeeding, the breastfeeding decision, and the women’s existence as a mother. There is a need for health professionals to look beyond the statistics of breastfeeding and consider the existential dimensions of breastfeeding-as-lived when encountering mothers wanting to breastfeed.
  •  
47.
  • Phoosuwan, Nitikorn, 1982- (författare)
  • Perinatal Depressive Symptoms among Women in North-Eastern Thailand : Risk Factors, Support and Prevention
  • 2020
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Perinatal depressive symptoms among women remain a global burden. Improvements in self-efficacy among public health professionals (PHPs) in primary healthcare settings to detect and manage perinatal depressive symptoms among women are needed.The aims of this thesis were to: identify prevalence and risk factors associated with perinatal depressive symptoms among women; to explore and describe life situation and support among women with antenatal depressive symptoms (ADS) and their partners; and to improve self-efficacy of PHPs in detection and management of perinatal depressive symptoms in Sakonnakhon province in Thailand. Qualitative and quantitative studies with different types of data collection methods were used.Study I determined prevalence of ADS and associated risk factors among 449 Thai women in late pregnancy using the Edinburgh Postnatal Depression Scale (EPDS). The prevalence was 46.8% and associated risk factors were insufficient money, being a teenager, low psychological well-being, low self-esteem and low sense of coherence.Study II explored and described life situation and support during pregnancy among women with ADS and their partners using semi-structured interviews. Four categories emerged: Having obstacles in life, Facing life situation, Enhancing confidence and Dissatisfaction with help.Study III determined risk factors associated with postpartum depressive symptoms at one month among 319 women and at three months among 276 women. Risk factors at one month were antenatal psychological well-being, non-exclusive breastfeeding, low personal income and caregiver not a mother; risk factors at three months were unintended pregnancy, low personal income/month, low self-esteem, low psychological well-being and low maternal competence.Study IV evaluated a self-efficacy improvement programme (SIP) intended to increase PHPs’ self-efficacy in efforts to detect and manage perinatal depressive symptoms among women. After the SIP, PHPs in the intervention group (n=33) had higher self-efficacy scores than PHPs in the control group (n=33). Four categories emerged in qualitative evaluation: Having confidence, Changing knowledge and attitudes, Increasing perception of an important role, and Increasing awareness of performed function.Women who are at increased risk for perinatal depressive symptoms should be screened using the EPDS. Health care professionals should involve expectant fathers in ANC process. The SIP enhances PHPs’ ability to detect and manage perinatal depressive symptoms.
  •  
48.
  • Rådestad, Ingela, et al. (författare)
  • Tears in the vagina, perineum, sphincter ani, and rectum and first sexual intercourse after childbirth : A Nationwide Follow-up
  • 2008
  • Ingår i: Birth. - : Wiley Interscience. - 0730-7659 .- 1523-536X. ; 35:2, s. 98-106
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The first sexual intercourse after childbirth may be challenging for women, especially if the birth resulted in injuries in the genital area. The purpose of this study was to investigate whether or not tears in the vagina, perineum, sphincter ani, or rectum hindered sexual intercourse during the year after childbirth. Methods: We obtained information from 2,490 women in a population-based cohort identified at antenatal care. Information about first sexual intercourse was collected by means of a questionnaire sent 1 year after birth to the women and about women's tears reported in the population-based Swedish Medical Birth Register. Results: Adjusted relative risks with 95 percent confidence intervals for not having had sexual intercourse within 3 and 6 months, respectively, after childbirth were 1.5 (95% CI 1.2–1.8) and 1.6 (95% CI 1.2–2.3) for tears in the vagina, 1.4 (95% CI 1.1–1.6) and 1.5 (95% CI 1.1–2.1) for tears in the perineum, and 2.1 (95% CI 1.4–3.1) and 2.2 (95% CI 1.1–4.6) for tears in the sphincter ani and rectum. No statistically significant differences were found at 1-year follow-up. No associations between episiotomy and delay in resuming intercourse were found after adjusting the relative risks. Conclusions: Tears in the vagina, perineum, sphincter ani, or rectum are associated with a delay in women's resumption of sexual intercourse 6 months after childbirth in Sweden
  •  
49.
  • Salomonsson, Björn, et al. (författare)
  • Short-term psychodynamic infant–parent interventions at Child health centers : Outcomes on parental depression and infant social–emotional functioning
  • 2021
  • Ingår i: Infant Mental Health Journal. - : Wiley. - 0163-9641 .- 1097-0355. ; 42:1, s. 109-123
  • Tidskriftsartikel (refereegranskat)abstract
    • Randomized controlled trials (RCTs) demonstrate efficacy of parent–infant psychotherapy, but its applicability and effectiveness in public health care are less known. The method followed is Naturalistic study evaluating Short-term Psychodynamic Infant–Parent Interventions at Child Health Centers (SPIPIC) in Stockholm, Sweden. One hundred distressed mothers with infants were recruited by supervised nurses. Six therapists provided 4.3 therapy sessions on average (SD = 3.3). Sessions typically included the mothers, often with the baby present, while fathers rarely attended sessions. The Edinburgh Postnatal Depression Scale (EPDS) and the Ages and Stages Questionnaire: Social–Emotional (ASQ: SE) were distributed at baseline and at 3 and 9 months later. Data from a nonclinical group were collected simultaneously to provide norm data. Multilevel growth models on the mothers’ questionnaire scores showed significant decreases over time on both measures. Nine months after baseline, 50% achieved a reliable change on the EPDS and 14% on the ASQ: SE. Prepost effect-sizes (d) were 0.70 and 0.40 for EPDS and ASQ: SE, figures that are comparable to results of other controlled studies. Psychotherapists integrated with public health care seem to achieve good results when supporting distressed mothers with brief interventions in the postnatal period. SPIPIC needs to be compared with other modalities and organizational frameworks.
  •  
50.
  • Seimyr, Louise, et al. (författare)
  • Antenatal maternal depressive mood and parental-fetal attachment at the end of pregnancy
  • 2009
  • Ingår i: Archives of Women's Mental Health. - : Springer. - 1434-1816 .- 1435-1102. ; 12:5, s. 269-279
  • Tidskriftsartikel (refereegranskat)abstract
    • The present study investigates if mothers and fathers have similar ways of thinking and feeling about their babies during late pregnancy and how aspects of parental-fetal attachment are related to maternal depressive mood. Two hundred and ninety-eight Swedish-speaking women at 30-32 weeks of gestation and partners (n=274) participated in the study. Socio-demographic background data were collected. Prenatal attachment was assessed with the maternal/paternal-fetal attachment scale (MFA/PFA), and depressive symptoms were assessed by the Edinburgh postnatal depression scale (EPDS). MFA and PFA scores mirrored each other. After factor analysis, five different factors loaded somewhat differently for men were revealed as significant. These factors were (I) concerns about the fetus and health behavior, (II) mental preparation to take care of the unborn child, (III) experiences of pregnancy, (IV) experiences of fetal movements, and (V) naming of the baby. Factors III and IV were related to depressive symptoms. Mothers with slight depressive symptoms were somewhat less positive about the pregnancy but showed more attention to the fetal movements. Midwives should conduct interviews on the women's psychosocial history and use validated instruments, which may help them to identify problems with the psychosocial health of the mother and her partner as they journey through pregnancy and transition to parenthood.
  •  
Skapa referenser, mejla, bekava och länka
  • Resultat 1-50 av 62
Typ av publikation
tidskriftsartikel (46)
doktorsavhandling (10)
bokkapitel (3)
konferensbidrag (2)
annan publikation (1)
Typ av innehåll
refereegranskat (49)
övrigt vetenskapligt/konstnärligt (13)
Författare/redaktör
Uvnäs-Moberg, Kersti ... (9)
Jonas, W (3)
Petersson, Maria (3)
Kylberg, Elisabeth (2)
Borre, Michael (2)
Wiklund, Ingela (2)
visa fler...
Nilbert, Mef (2)
Rubertsson, Christin ... (2)
Faxelid, Elisabeth (2)
Zachariae, Robert (2)
Zwedberg, Sofia (2)
Björklund, Anders (1)
Lundgren, Ingela, 19 ... (1)
Lilliengren, Peter (1)
Lidfors, Lena (1)
Merlo, Juan (1)
Berg, Marie, 1955 (1)
Odberg Pettersson, K ... (1)
Skalkidou, Alkistis (1)
Henriksson, P (1)
Melander, Eva (1)
Ahlberg, Beth Maina (1)
Jackson, Claire (1)
Borg, Åke (1)
Rådestad, Ingela (1)
Funa, Keiko, 1949 (1)
Karlsson, Håkan (1)
Algers, Bo (1)
Lithman, Thor (1)
Cao, Renhai (1)
Cao, Yihai (1)
Kaldo, Viktor, Profe ... (1)
Lundqvist, Martina (1)
Hansen, Ebba Holme (1)
Osika, Walter (1)
Kaldo, Viktor (1)
Sahlberg-Blom, Eva, ... (1)
Melander, Arne (1)
Platonov, Pyotr (1)
Mölstad, Sigvard (1)
Andrén, Karin (1)
Jönsson, Göran B (1)
Fransson, Emma, PhD, ... (1)
Palmér, Lina, 1979- (1)
Velandia, Marianne (1)
Brunt, David, Profes ... (1)
Ransjö-Arvidson, Ann ... (1)
Höjer, Bengt (1)
Sylvén, Sara (1)
Schotten, Ulrich (1)
visa färre...
Lärosäte
Karolinska Institutet (41)
Högskolan i Skövde (39)
Sveriges Lantbruksuniversitet (7)
Lunds universitet (6)
Uppsala universitet (5)
Högskolan i Halmstad (4)
visa fler...
Örebro universitet (4)
Linnéuniversitetet (4)
Göteborgs universitet (3)
Högskolan i Borås (3)
Högskolan Dalarna (3)
Mälardalens universitet (2)
Linköpings universitet (2)
Sophiahemmet Högskola (2)
Umeå universitet (1)
Röda Korsets Högskola (1)
visa färre...
Språk
Engelska (55)
Svenska (7)
Forskningsämne (UKÄ/SCB)
Medicin och hälsovetenskap (37)
Samhällsvetenskap (8)
Naturvetenskap (2)
Lantbruksvetenskap (2)

År

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

 
pil uppåt Stäng

Kopiera och spara länken för att återkomma till aktuell vy