| 1. |
- Ekelöf, Katarina, et al.
(författare)
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A hybrid type I, multi-center randomized controlled trial to study the implementation of a method for Sustained cord circulation And VEntilation (the SAVE-method) of late preterm and term neonates : a study protocol
- 2022
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 22, s. 1-13
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: An intact umbilical cord allows the physiological transfusion of blood from the placenta to the neonate, which reduces infant iron deficiency and is associated with improved development during early childhood. The implementation of delayed cord clamping practice varies depending on mode of delivery, as well as gestational age and neonatal compromise. Emerging evidence shows that infants requiring resuscitation would benefit if respiratory support were provided with the umbilical cord intact. Common barriers to providing intact cord resuscitation is the availability of neonatal resuscitation equipment close to the mother, organizational readiness for change as well as attitudes and beliefs about placental transfusion within the multidisciplinary team. Hence, clinical evaluations of cord clamping practice should include implementation outcomes in order to develop strategies for optimal cord management practice.METHODS: The Sustained cord circulation And Ventilation (SAVE) study is a hybrid type I randomized controlled study combining the evaluation of clinical outcomes with implementation and health service outcomes. In phase I of the study, a method for providing in-bed intact cord resuscitation was developed, in phase II of the study the intervention was adapted to be used in multiple settings. In phase III of the study, a full-scale multicenter study will be initiated with concurrent evaluation of clinical, implementation and health service outcomes. Clinical data on neonatal outcomes will be recorded at the labor and neonatal units. Implementation outcomes will be collected from electronic surveys sent to parents as well as staff and managers within the birth and neonatal units. Descriptive and comparative statistics and regression modelling will be used for analysis. Quantitative data will be supplemented by qualitative methods using a thematic analysis with an inductive approach.DISCUSSION: The SAVE study enables the safe development and evaluation of a method for intact cord resuscitation in a multicenter trial. The study identifies barriers and facilitators for intact cord resuscitation. The knowledge provided from the study will be of benefit for the development of cord clamping practice in different challenging clinical settings and provide evidence for development of clinical guidelines regarding optimal cord clamping.TRIAL REGISTRATION: Clinicaltrials.gov, NCT04070560 . Registered 28 August 2019.
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| 2. |
- Lind, Britt‐Marie, et al.
(författare)
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Child healthcare nurses’ experience of communication with 4‐year‐old children during their visit to the child health care center
- 2024
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Ingår i: Public Health Nursing. - 0737-1209 .- 1525-1446.
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Tidskriftsartikel (refereegranskat)abstract
- Objective:To illuminate child healthcare nurses’ experiences of communication with 4-year-old children during their visit to the child healthcare center.DesignA qualitative method, using data collected from individual interviews.Sample: Fifteen semistructured interviews with nurses working in a child healthcare center.Measurements:The results were analyzed using reflexive thematic analysis.Results:The analysis resulted in three themes and eight subthemes: Adapting to the child in the conversation, based on the subthemes Preparing for the visit, Listening in and observing, and Creating a welcoming environment; Combining strategies for the conversation, based on the subthemes Engaging the child, Using visual tools, and Parental involvement; and Challenges due to language barriers, based on the subthemes Using an interpreter and Parent acts as interpreter.Conclusion: Child healthcare nurses focus on the child when communicating and strive to create joy and a welcoming environment. The communication strategies employed during the visit include engaging the child directly, involving parents in the conversation, and balancing the parental involvement. Communication challenges related to language barriers are addressed, particularly during interpreter-assisted conversations. The study indicates a need for tailored strategies, collaboration, and sensitivity to ensure a child-centered approach.
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| 3. |
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| 4. |
- Patriksson, Katarina, 1964, et al.
(författare)
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Conditions for communication between health care professionals and parents on a neonatal ward in the presence of language barriers
- 2019
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Ingår i: International Journal of Qualitative Studies on Health and Well-Being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Family-centred neonatal care views parents and child as a unit, and aims to support each family on the basis of its specific needs. Good communication can increase parents' satisfaction and reduce tension, and is necessary to create a mutual trustful relation, but is influenced by language barriers. We aimed to describe communication between neonatal health care professionals and parents in the presence of language barriers. Methods: A field study using a hermeneutic lifeworld approach, participative observation, and interviews with parents and health care professionals. Results: The main theme, endeavouring to understand the meaning behind the words, comprised three themes. Wanting to speak for oneself meant that parents wanted to speak for themselves or call on a friend or multilingual health care professionals, in contrast to the health care professionals wish to use an interpreter. Being aware of cultural keys meant that some wards had access to a "cultural broker" to assist health care professionals and parents with both language translation and understanding of the Swedish health care environment. Understanding one another in the employees' arena reflected varying language skills among health care professionals. The health care professionals had the power to decide the level of access to communication, and decided both the intensity and the frequency of the conversations. Conclusions: Health care professionals preferred to use an interpreter when communicating with parents, while parents wished to be independent and speak for themselves. If an interpreter was used, parents preferred this to be a friend or health care professionals; this option was less popular among health care professionals.
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| 5. |
- Patriksson, Katarina, 1964, et al.
(författare)
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Health care professional's communication through an interpreter where language barriers exist in neonatal care: a national study
- 2019
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Background A number of parents in neonatal care are foreign-born and do not speak the local language, which makes communication between healthcare professionals and parents more difficult. Interpreters can be used when language barriers exist - parent interactions, medical communication and communication about the care of the child. The aim in this study was to examine healthcare professionals' use of interpreters and awareness of local guidelines for interpreted communication in neonatal care. Method A survey was distributed to all 2109 employees at all 38 neonatal units in Sweden, thus to all physicians, registered nurses and nurse assistants in active service. Data were analysed with descriptive statistics and dichotomized so the professionals were compared in groups of two using the Mantel-Haenszel Chi Square test and Fisher's Non Parametric Permutation test. Results The survey was answered by 41% (n = 858) representing all neonatal units. The study showed a difference between the professional groups in awareness of guidelines, availability of interpreters, and individual resources to communicate through an interpreter. Nurse assistants significantly lesser than registered nurses (p < .0001) were aware of guidelines concerning the use of interpreters. In emergency communications nurse assistants used authorized interpreters to a significantly lesser extent than physicians (p < .0001) and registered nurses (p < .0001). Physicians used authorized interpreters to a significantly higher extent than registered nurses (p 0.006) and non-authorized interpreters to a significantly lesser extent than registered nurses (p 0.013). In planned communications, nurse assistants used authorized interpreters to a significantly lesser extent than physicians (p < .0001) and registered nurses (p < .0001). Nurse assistants rated their ability to communicate with parents through an interpreter to a significantly lesser extent than physicians (p 0.0058) and registered nurses (p 0.0026). No other significant differences were found. Conclusion The results of the study show insufficient awareness of guidelines in all neonatal units in Sweden. Clinical implications might be to provide healthcare professionals with guidelines and training clinical skills in using interpreters and increasing the availability of interpreters by having interpreters employed by the hospital.
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| 6. |
- Patriksson, Katarina, et al.
(författare)
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Immigrant parents’ experiences of communicating with healthcare professionals at the neonatal unit: An interview study
- 2019
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Ingår i: Journal of Neonatal Nursing. - : Elsevier BV. - 1355-1841. ; 25:4, s. 194-9
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Tidskriftsartikel (refereegranskat)abstract
- © 2019 Neonatal Nurses Association Background: When newborn children of immigrants require care in a neonatal unit, parents frequently encounter not only a new language, but also a new healthcare organisation. Aim: To examine parents’ experiences of communication with healthcare professionals in a neonatal unit when language barriers are present. Method: Twenty interviews were conducted with families who spoke Arabic and had a child who had been cared for at one of five neonatal care units, level II-III in western Sweden. The interviews were analysed using a phenomenological hermeneutic approach. Results: The main theme, having the opportunity to exercise one's parental role, included four themes encountering emotional warmth, feeling accepted, encountering a lack of understanding, and compensating for inadequate language skills. Conclusion: It is not only language barriers that affect communication between parents and healthcare professionals; different expectations and pre-understandings are also of importance.
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| 7. |
- Patriksson, Katarina, et al.
(författare)
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Midwives' Experiences of Intact Cord Resuscitation in Nonvigorous Neonates After Vaginal Birth in Sweden
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Ingår i: JOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing. - 0884-2175.
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe midwives' experiences of intact cord resuscitation close to the mother for nonvigorous neonates after vaginal birth.DESIGN: Descriptive qualitative.SETTING: Four labor wards in Sweden.PARTICIPANTS: Midwives (N = 13) currently or previously employed in labor wards where the Sustained Cord Circulation and Ventilation (SAVE) study was conducted.METHODS: We analyzed semistructured interviews using reflexive thematic analysis.RESULTS: Participants' experiences are presented in an overarching theme: Midwives balance knowledge with doing the right thing in a challenging work environment during intact cord resuscitation. Three primary themes emerged: A New Workflow, Zero Separation: The Big Advantage, and The Midwife: Guardian of Childbirth.CONCLUSION: The participants were keen to keep the umbilical cord intact even for nonvigorous neonates. They wanted to work with the neonate close to the mother to facilitate zero separation and family participation. Ventilation with an intact umbilical cord was considered a routine to be implemented in the future, but the participants identified certain difficulties with the design of the SAVE study.
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| 8. |
- Patriksson, Katarina, et al.
(författare)
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Neonatal healthcare professionals’ experiences of intact cord resuscitation in the mother´s bed : an interview study
- 2024
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science+Business Media B.V.. - 1471-2393. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Intact cord resuscitation in the frst three minutes of life improves oxygenation and Apgar scores. Thepractise of intact cord resuscitation implies the umbilical cord still being connected to the placenta for at least oneminute while providing temperature control and equipment for resuscitation. Healthcare professionals describedpractical challenges in providing intact cord resuscitation. This study aimed to explore neonatal healthcare profession‑als’ experiences of providing intact cord resuscitation in the mother’s bed.Method An interview study with an inductive, interpretative approach was chosen and analysed according to refex‑ive thematic analysis by Braun & Clarke. An open interview guide was used and 20 individual interviews with neonatalhealthcare professionals were performed. The study was conducted at fve level I-III neonatal care units. In Sweden,resuscitation is performed either in or outside the labour room.Results The results contributed insight into the participants’ experiences of prerequisites for providing neonatal carein intact cord resuscitation. The sense of the mother’s vulnerability was noticeable, as the participants reported reduc‑ing the risk of exposure to protect and preserve the mother’s integrity. The practical challenges in the environmentinvolved working in a limited space. The desire for multi-professional team training comprised education and trainingas well as debriefng to manage intact cord resuscitation.Conclusion The result of the present study highlights the fact that neonatal healthcare professionals’ experiencesof providing ICR in the mother’s bed were positive and had signifcant benefts for the neonate, namely zero sepa‑ration between the neonate and parents and better physical recovery for the neonate. However, the fact that ICRin the mother’s bed can be challenging in several ways, such as emotionally, managing environmental circumstancesand ensuring efective team collaboration. Therefore, it is of the utmost importance that healthcare professionals aregiven the opportunity to refect and train together as a team. Future recommendations are to summarize evidencebased knowledge to design guidelines for ICR situation.
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| 9. |
- Patriksson, Katarina, et al.
(författare)
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Parents and newborn "togetherness" after birth
- 2022
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Zero separation is a family-centred approach where newborns should be accompanied by their parents, regardless of the type of birth or health status. To our knowledge, few studies have described the way this approach is realized in clinical practice. This study describes situations of separation between mother/partner and newborn after birth on the labour ward, maternity ward and at the neonatal unit. Method An observation study was conducted during four months at a Swedish hospital. All caregivers at the three units were given the task of collecting the data. A semantic thematic analysis was performed with an inductive approach. Results Six themes emerged from the analysis. Two themes were common to all three units, one theme was common to two units and three themes emerged at only one unit. The themes describe various causes of separation, such as organizational and economic barriers, clinical routines, parents' own decisions, shortage of collaboration within and between units, as well as a shortage of interprofessional communication. Conclusion Our study shows that there is still a gap between the latest evidence-based knowledge of the importance of zero separation and current practice in newborn care. There is a need for continuous collaboration between all units responsible for the care of mother and newborn.
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| 10. |
- Patriksson, Katarina, 1964
(författare)
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Säg till om du önskar tolk - Kommunikation i neonatalvård mellan föräldrar och vårdpersonal när språkbarriärer föreligger
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Family-centred neonatal care encourages parents to participate in the care of their child. When language barriers exist between healthcare personnel and parents, a third party is needed to achieve satisfactory communication. Difficulties in direct communication increase the risk of misunderstanding between healthcare personnel and parents, and may lead to elevated anxiety among parents. The overarching objective of this dissertation was to increase knowledge concerning the communication difficulties that arise between parents and healthcare personnel when language barriers are present. Study I is a quantitative questionnaire study analysing the use of interpreters and awareness of the guidelines for their use. Study II is a qualitative interview study describing the experiences of care personnel regarding communication with parents. Study III is a qualitative interview study of parents who speak Arabic through an interpreter, describing their experiences of having their child under care in the neonatal ward and communicating with care providers. Study IV is a qualitative observational study elucidating the communication difficulties that arise between healthcare personnel and parents when their child is under care in the neonatal ward and language barriers are present. The results show that healthcare personnel lack guidelines for the use of interpreters, and that interpreters are mainly used in the context of medically oriented discussions. Healthcare personnel expressed anxiety and frustration because the information they wished to communicate to parents was misunderstood. The parents expressed gratitude for the warmth and concern of the healthcare personnel despite inadequate communication. Communication was complicated by the constant need to have a third party present to interpret. Our observations revealed that language was not the only significant barrier, and that cultural differences could also lead to misunderstandings. Cultural interpreters or cultural navigators were used to facilitate communication; they were not trained interpreters, but did speak several frequently occurring languages. These individuals were made available to the parents and were able to interpret situations that could arise during nursing care, or to clarify when misunderstandings arose between parents and healthcare personnel. When the father spoke Swedish but the mother did not, the father often wished to interpret for his partner; however, such offers were rarely accepted by healthcare personnel, who instead preferred to call in an interpreter. The results of the study suggest that parents who encounter language barriers should be offered the services of an interpreter for discussions related to medical issues or to the care and treatment of the child. Information must be available in the parents’ native language, and parents must also be given the opportunity to participate in the care of their child, which requires complete understanding of all communications. Parents should be provided with the opportunity to speak their minds, should they so desire. Healthcare personnel must also be aware of how vulnerable parents with language barriers may become when information cannot be directly conveyed.
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