| 1. |
- Danehorn, Emil, et al.
(författare)
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Mental health, self-rated health, risky sexual behaviour, alcohol use, and drug use among students who intend to spend a semester abroad - a cross-sectional study
- 2023
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Ingår i: Frontiers In Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Our aim was to investigate potential differences in mental health, self-rated health, risky sexual behaviour, alcohol use, and drug use between (1) Prospective exchange students and campus students separated by sex, and (2) male and female students as a group. Method: Comparative cross-sectional design using an online survey containing the following instruments: Knowledge, Attitudes, and Sexual Behaviour in Young People in Sweden; Self-Rated Health Questionnaire; and General Health Questionnaire 12. One-hundred and fourteen prospective exchange students and 451 campus students participated in the study. Results: Male prospective exchange students rated their mental health as being better and had used cannabis more often compared with female prospective exchange students. Male prospective exchange students also rated their mental health as being better than male campus students. Female students, in general, rated their mental health as worse than male students. A larger proportion of male prospective exchange students had sex together with alcohol compared with male campus students, and a larger proportion of female prospective exchange students had sex with a new partner and drank more alcohol compared to female campus students. Conclusion: The result shows that risky alcohol use and sexually risky behaviour is prominent amongst prospective exchange students. It is possible that they will continue, and even increase their risky behaviour whilst abroad as they find themselves in a new social context, and free from influence of the rules and restrictions that they might have at home. With limited knowledge of the local culture, native language, and in an unfamiliar environment, it is possible that the risks will be enhanced and possibly decrease their health. This highlights the need for proactive interventions, conceivably with some variations in content between sexes.
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| 2. |
- Danehorn, Emil, et al.
(författare)
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Swedish exchange students' alcohol use, drug use, risky sexual behaviour, mental health, and self-rated health : A follow-up study
- 2023
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Ingår i: Nordic Studies on Alcohol and Drugs. - : Sage Publications. - 1455-0725 .- 1458-6126. ; 40:3, s. 287-300
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To follow up on exchange students' alcohol use, drug use, mental health, self-rated health, and risky sexual behaviour after a semester abroad and to compare them with students who remained on campus. Methods: The study design was a follow-up study based on a previous baseline survey of 114 prospective exchange students and 451 campus students. Of the original 565 students, 48 (42.1%) prospective exchange students and 209 (43.3%) campus students responded to the follow-up. Both the baseline survey and the follow-up survey included the General Health Questionnaire 12, one single item from Self-Rated Health, and nine items from Knowledge, Attitudes and Sexual Behaviour in Young People in Sweden. Results: We found a statistically significant increase in the weekly consumption of alcohol among exchange students after their semester abroad. A larger proportion of exchange students had sex with a new partner and sex with more than three partners during their semester abroad compared to follow-up campus students. Conclusions: Our findings indicate that exchange students consume alcohol more frequently during their semester abroad and indulge in sexually risky behaviour. Exchange students' use of alcohol and sexually risky behaviour could be associated with even greater risks due to them being in an unknown environment, unfamiliar culture, and with limited support from family and friends. This highlights the need for further research on exchange students' experiences, especially concerning alcohol use and sex while abroad.
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| 3. |
- Simmons, Johanna, et al.
(författare)
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Validation of REAGERA-S : a new self-administered instrument to identify elder abuse and lifetime experiences of abuse in hospitalized older adults
- 2020
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Ingår i: Journal of Elder Abuse & Neglect. - : Taylor & Francis. - 0894-6566 .- 1540-4129. ; 32:2, s. 173-195
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to develop and validate REAGERA-S, a self-administered instrument to identify elder abuse as well as lifetime experiences of abuse in older adults. REAGERA-S consists of nine questions concerning physical, emotional, sexual, financial abuse and neglect. Participants were recruited among patients (≥ 65 years) admitted to acute in-hospital care (n = 179). Exclusion criteria were insufficient physical, cognitive, or language capacity to complete the instrument. A semi-structured interview conducted by a physician was used as a gold standard against which to assess the REAGERA-S. The final version was answered by 95 older adults, of whom 71 were interviewed. Sensitivity for lifetime experiences of abuse was 71.9% and specificity 92.3%. For elder abuse, sensitivity was 87.5% and specificity was 92.3%. REAGERA-S performed well in validation and can be recommended for use in hospitals to identify elder abuse as well as life-time experience of abuse among older adults.
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| 4. |
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| 5. |
- Smirthwaite, Goldina, 1965-, et al.
(författare)
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Comparing Critical Realism and the Situated Knowledges Approach in Research on (In)equity in Health Care : An Exploration of their Implications
- 2016
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Ingår i: Journal of Critical Realism. - : Routledge. - 1476-7430 .- 1572-5138. ; 15:5, s. 476-493
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Tidskriftsartikel (refereegranskat)abstract
- This article compares knowledge claims within critical realism and the situated knowledges approach, and will discuss the implications of adopting these two perspectives in research on inequity in health care. The concept of medical gender bias, as well as two empirical studies on inequity among patients waiting for cataract extractions in Sweden, will be used in order to illustrate the different implications of adopting a critical realist or a situated knowledges perspective. The article suggests that the latter of these two perspectives is compatible with critical realist claims about epistemic relativism, but that it is much harder to combine with the concept of judgmental rationality, at least in so far as this rationality is not treated as being situated itself. The article will also claim that critical realism and the situated knowledges approach emphasize different implications concerning responsibility during processes of knowledge production. Finally, it will suggest that the adoption of a critical realist-based intersectional ontology, in combination with a greater emphasis on the fact that researchers are always situated in various ways, is a fruitful starting point for grounding studies on inequity in health care.
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| 6. |
- Smirthwaite, Goldina, 1965-, et al.
(författare)
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Doctors Doing Gender at Eye Clinics : Gender Constructions in Relation to Waiting Times for Cataract Extractions in Sweden
- 2017
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Ingår i: NORA. - : Taylor & Francis. - 0803-8740 .- 1502-394X. ; 25:2, s. 107-125
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Tidskriftsartikel (refereegranskat)abstract
- Why do eye clinics differ in their waiting times for women's and men's access to cataract extraction (CE)/gra starroperation? Taking a doing-gender perspective as the starting point, this study explores how gender constructions embedded in Swedish eye clinics contribute to longer waiting times for women than for men. Focus group interviews were conducted with doctors at two Swedish eye clinics: one with a larger and another with a smaller than average gender difference in waiting times for CE. Several differences were found between the clinics regarding how gender was constructed: Women and men were constructed as different with respect to ascribed traits such as assertiveness and care-seeking behaviour. Their need for visual acuity in working life was perceived as different by the doctors, and the study indicates differences between the clinics regarding their interest and awareness concerning issues related to inequity, reflected in the dissimilar prevalence of jokes with racist and misogynist connotations at the two clinics.
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| 7. |
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| 8. |
- Smirthwaite, Goldina, 1965-, et al.
(författare)
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När patienten är brottsoffer och våldet en hälsofråga : Etiska perspektiv på examinationsmålet om mäns våld mot kvinnor
- 2021
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Ingår i: Socialmedicinsk Tidskrift. - : Socialmedicinsk tidskrift. - 0037-833X. ; 98:4, s. 581-587
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Tidskriftsartikel (refereegranskat)abstract
- Till skillnad från många andra tillstånd som behandlas inom vården är våldets hälsokonsekvenser orsakade av en förövare. Patienten är därmed inte bara patient, utan även ett brottsoffer. Vilka etiska krav ställer det på forskning och undervisning om våld? Frågan knyter an till förändringen av examinationsordningen för bland annat sjuksköterskeutbildningen som gjordes 2017. Artikeln tar avstamp i examensmålets bakgrund i jämställdhetspolitiken. Därefter följer reflektioner om etik i våldsundervisningen, och om det spänningsfält som uppstår när olika ämnens perspektiv gör anspråk på tolkningsföreträde till hur våld ska förstås.
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| 9. |
- Chalise, P., et al.
(författare)
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Addressing Domestic Violence in Antenatal Care Environments in Nepal (ADVANCE) - study protocol for a randomized controlled trial evaluating a video intervention on domestic violence among pregnant women
- 2023
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Ingår i: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundDomestic violence (DV) prior to, and during pregnancy is associated with increased risks for morbidity and mortality. As pregnant women routinely attend antenatal care this environment can be used to offer support to women experiencing DV. We have developed a video intervention that focuses on the use of behavioral coping strategies, particularly regarding disclosure of DV experiences. The effectiveness of this intervention will be evaluated through a randomized controlled trial (RCT) and a concurrent process evaluation.MethodsAll pregnant women between 12-22 weeks of gestation attending routine antenatal care at two tertiary level hospitals in Nepal are invited to participate. DV is measured using the Nepalese version of the Abuse Assessment Screen (N-AAS). Additionally, we measure participants' mental health, use of coping strategies, physical activity, and food security through a Color-coded Audio Computer Assisted Self Interview (C-ACASI). Irrespective of DV status, women are randomized into the intervention or control arm using a computer-generated randomization program. The intervention arm views a short video providing information on DV, safety improving actions women can take with an emphasis on disclosing the violence to a trusted person along with utilizing helplines available in Nepal. The control group watches a video on maintaining a healthy pregnancy and when to seek healthcare. The primary outcome is the proportion of women disclosing their DV status to someone. Secondary outcomes are symptoms of anxiety and depression, coping strategies, the use of safety measures and attitudes towards acceptance of abuse. Follow-up is conducted after 32 weeks of gestation, where both the intervention and control group participants view the intervention video after completing the follow-up questionnaire. Additionally, a mixed methods process evaluation of the intervention will be carried out to explore factors influencing the acceptability of the intervention and the disclosure of DV, including a review of project documents, individual interviews, and focus group discussions with members of the research team, healthcare providers, and participants.DiscussionThis study will provide evidence on whether pregnant women attending regular antenatal visits can enhance their safety by disclosing their experiences of violence to a trusted person after receiving a video intervention.Trial registrationThe study is registered in ClinicalTrial.gov with identifier NCT05199935.
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| 10. |
- Colombini, Manuela, et al.
(författare)
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Factors shaping political priorities for violence against women-mitigation policies in Sri Lanka
- 2018
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Ingår i: BMC International Health and Human Rights. - : BioMed Central (BMC). - 1472-698X. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although violence against women (VAW) is a global public health issue, its importance as a health issue is often unrecognized in legal and health policy documents. This paper uses Sri Lanka as a case study to explore the factors influencing the national policy response to VAW, particularly by the health sector. Methods: A document based health policy analysis was conducted to examine current policy responses to VAW in Sri Lanka using the Shiffman and Smith (2007) policy analysis framework. Results: The findings suggest that the networks and influences of various actors in Sri Lanka, and their ideas used to frame the issue of VAW, have been particularly important in shaping the nature of the policy response to date. The Ministry of Women and Child Affairs led the national response on VAW, but suffered from limited financial and political support. Results also suggest that there was low engagement by the health sector in the initial policy response to VAW in Sri Lanka, which focused primarily on criminal legislation, following global influences. Furthermore, a lack of empirical data on VAW has impeded its promotion as a health policy issue, despite financial support from international organisations enabling an initial health systems response by the Ministry of Health. Until a legal framework was established (2005), the political context provided limited opportunities for VAW to also be construed as a health issue. It was only then that the Ministry of Health got legitimacy to institutionalise VAW services. Conclusion: Nearly a decade later, a change in government has led to a new national plan on VAW, giving a clear role to the health sector in the fight against VAW. High-level political will, criminalisation of violence, coalesced women's groups advocating for legislative change, prevalence data, and financial support from influential institutions are all critical elements helping frame violence as a national public health issue.
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| 11. |
- Dahal, Pranab, et al.
(författare)
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A qualitative study on gender inequality and gender-based violence in Nepal
- 2022
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Ingår i: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Gender inequality and violence are not mutually exclusive phenomena but complex loops affecting each other. Women in Nepal face several inequalities and violence. The causes are diverse, but most of these results are due to socially assigned lower positioning of women. The hierarchies based on power make women face subordination and violence in Nepal. The study aims to explore participants' understanding and experience to identify the status of inequality for women and how violence emerges as one of its consequences. Furthermore, it explores the causes of sex trafficking as an example of an outcome of inequality and violence. Method The study formulated separate male and female groups using a purposive sampling method. The study used a multistage focus group discussion, where the same groups met at different intervals. Six focus group discussions, three times each with male and female groups, were conducted in a year. Thirty-six individuals, including sixteen males and twenty females, were involved in the discussions. The study used constructivist grounded theory for the data analysis. Results The study participants identify that a power play between men and women reinforce inequality and increases the likelihood of violence for women. The findings suggest that the subjugation of women occurs due to practices based on gender differences, constricted life opportunities, and internalization of constructed differences among women. The study identifies that interpersonal and socio-cultural violence can result due to established differences between men and women. Sex trafficking, as an example of the outcome of inequality and violence, occurs due to the disadvantageous position of women compounded by poverty and illiteracy. The study has developed a concept of power-play which is identified as a cause and consequence of women's subordination and violence. This power play is found operative at various levels with social approval for men to use violence and maintain/produce inequality. Conclusion The theoretical concept of power play shows that there are inequitable power relations between men and women. The male-centric socio-cultural norms and practices have endowed men with privilege, power, and an opportunity to exploit women. This lowers the status of women and the power-play help to produce and sustain inequality. The power-play exposes women to violence and manifests itself as one of the worst expressions used by men.
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| 12. |
- Dahal, Pranab, et al.
(författare)
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Does Forum Theater Help Reduce Gender Inequalities and Violence? Findings From Nepal
- 2022
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Ingår i: Journal of Interpersonal Violence. - : Sage Publications. - 0886-2605 .- 1552-6518. ; 37:13-14, s. NP12086-NP12110
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Tidskriftsartikel (refereegranskat)abstract
- Gender inequality and violence against women are present in every society and culture around the world. The intensities vary, however, based on the local guiding norms and established belief systems. The society of Nepal is centered on traditional belief systems of gender roles and responsibilities, providing greater male supremacy and subordination for the females. This has led to the development and extensive practices of social gender hierarchal systems, producing several inequalities and violence toward women. This study has utilized Forum Theater interventions as a method of raising awareness in 10 villages in eastern Nepal. The study aimed to understand the perception and changes in the community and individuals from the interactive Forum Theater performances on pertinent local gender issues. We conducted 6 focus group discussions and 30 individual interviews with male and female participants exposed to the interventions. The data analysis utilized the constructivist grounded theory methodology. The study finds that exposure and interactive participation in the Forum Theater provide the audience with knowledge, develop empathy toward the victim, and motivate them to change the situation of inequality, abuse, and violence using dialogues and negotiations. The study describes how participation in Forum Theater has increased individual’s ability for negotiating changes. The engagement by the audience in community discussions and replication of efforts in one of the intervention sites show the level of preparedness and ownership among the targeted communities. The study shows the methodological aspects of the planning and performance of the Forum Theater and recommends further exploration of the use of Forum Theater in raising awareness.
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| 13. |
- Dahal, Pranab, et al.
(författare)
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The prevalence of gender inequalities and violence in the Eastern Nepal
- 2019
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Ingår i: Kathmandu University Medical Journal. - : Kathmandu University. - 1812-2027 .- 1812-2078. ; 17:68, s. 298-305
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Tidskriftsartikel (refereegranskat)abstract
- Background Gender inequality and gender based violence is more established in societies with stratification and stronger gender norms. Objective To determine prevalence of gender violence, perception on gender issues and awareness on sexual trafficking and rights among men and women in Morang district of Nepal. Method This cross sectional study was conducted among 810 men and 1190 women in twenty different VDCs of Morang district using self-administered computer based self-interview methods during October-November 2016. Result Male in comparison to female reported more physical abuse during their lifetime. Females (n=259, 21.7%) reported more severe lifetime emotional abuse (n=148, 18.2%) compared to the males. Lifetime severe sexual abuse was reported by a close to five percent (n=95) of both sexes. The severe forms of partner violence include choking, threat or use of weapon and setting on fire was identified to be perpetrated by both the sexes. More than 50% (n=1095) of the respondents had known someone using physical violence against their partner in the community. The involvement of female in key economic decision-making was reported by less than 12%. Nearly 72% (n=1441) were aware of occurrence of sexual trafficking from Nepal while only 46% (n=918) were aware of sexual trafficking occurring from their vicinity. Conclusion The study confirms that despite awareness on gender equality and sexual trafficking, the prevalence of violence and adherence to stronger gender stereotypes, stigmas and roles indicates much need of awareness for establishing equalities and reducing gender violence. © 2019, Kathmandu University. All rights reserved.
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| 14. |
- Ghimire, Narayani Paudel, et al.
(författare)
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Women's Experience of Disrespect and Abuse during Institutional Delivery in Biratnagar, Nepal
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 18:18
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Tidskriftsartikel (refereegranskat)abstract
- Worldwide, a large number of women experience disrespectful and abusive behavior from care providers during childbirth. This violates the rights of women to attain respectful care. This study aimed to find out the women's experience of disrespect and abuse during institutional delivery. A cross-sectional study was conducted in two hospitals of Morang district situated in eastern Nepal. Two hundred eighteen women from a public hospital and 109 women from a private hospital (N = 327) with normal vaginal delivery were selected purposively for this study. Data were collected through face-to-face interviews using a structured questionnaire based on the Disrespectful and Abusive Scale by Bowser and Hill. All women had experienced at least one type of disrespect and/or abuse during labor and delivery, most common being non-consented care (100%), non-dignified care (72%), and non-confidential care (66.6%), respectively. Discriminatory care and physical abuse were experienced by 32.33% and 13.23%, respectively. Ethnicity, religion, place of delivery, and numbers of living children were the main predictors of reporting disrespect and abuse. Overall, the occurrence of disrespect and abuse during institutional delivery was found to be very high.
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| 15. |
- Hilden, Malene, et al.
(författare)
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A history of sexual abuse and health : A Nordic multicentre study
- 2004
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Ingår i: British Journal of Obstetrics and Gynecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 111:10, s. 1121-1127
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To determine if a history of sexual abuse is associated with objective and subjective indicators of health and if certain abusive incidents had a stronger impact on health than others. Design: A cross-sectional, multicentre study. Setting: Five gynaecological departments in the five Nordic countries. Sample: Three thousand five hundred and thirty-nine gynaecology patients. Methods: The NorVold Abuse Questionnaire (NorAQ) on abuse history and current health was mailed to all patients who consented to participate. Main outcome measures: Reason for index visit at the gynaecologic clinic as well as several questions on health were recorded. General health status was measured as self-estimated health, psychosomatic symptoms (headache, abdominal pain, muscle weakness, dizziness), number of health care visits and number of periods on sick leave. Result: A history of sexual abuse was reported by 20.7% of respondents. A history of sexual abuse was significantly associated with chronic pelvic pain as reason for index visit (P < 0.01), laparoscopic surgery (P < 0.01), psychosomatic symptoms (P < 0.01), self-estimated poor health (P < 0.01), many health care visits (P < 0.01) and high incidence of sick leave (P < 0.01). Several subgroups within the group of sexually abused women were more likely to report poor health: women abused as both children and adults, women who experienced additional emotional and/or physical abuse and women abused by a person they knew. Conclusion: Sexual abuse has a profound impact on women's health. Taking a history of sexual abuse seems particularly warranted when the patient presents with chronic pelvic pain or symptoms of a vague and diffuse nature.
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| 16. |
- Infanti, Jennifer J., et al.
(författare)
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Addressing domestic violence through antenatal care in Sri Lanka's plantation estates : Contributions of public health midwives
- 2015
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Ingår i: Social Science and Medicine. - : Elsevier. - 0277-9536 .- 1873-5347. ; 145, s. 35-43
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Tidskriftsartikel (refereegranskat)abstract
- Domestic violence in pregnancy is a significant health concern for women around the world. Globally, much has been written about how the health sector can respond effectively and comprehensively to domestic violence during pregnancy via antenatal services. The evidence from low-income settings is, however, limited. Sri Lanka is internationally acknowledged as a model amongst low-income countries for its maternal and child health statistics. Yet, very little research has considered the perspectives and experiences of the key front line health providers for pregnant women in Sri Lanka, public health midwives (PHMs). We address this gap by consulting PHMs about their experiences identifying and responding to pregnant women affected by domestic violence in an underserved area: the tea estate sector of Badulla district. Over two months in late 2014, our interdisciplinary team of social scientists and medical doctors met with 31 estate PHMs for group interviews and a participatory workshop at health clinics across Badulla district In the paper, we propose a modified livelihoods model to conceptualise the physical, social and symbolic assets, strategies and constraints that simultaneously enable and limit the effectiveness of community-based health care responses to domestic violence. Our findings also highlight conceptual and practical strategies identified by PHMs to ensure improvements in this complex landscape of care. Such strategies include estate-based counselling services; basic training in family counselling and mediation for PHMs; greater surveillance of abusive men's behaviours by male community leaders; and performance evaluation and incentives for work undertaken to respond to domestic violence. The study contributes to international discussions on the meanings, frameworks, and identities constructed at the local levels of health care delivery in the global challenge to end domestic violence. In turn, such knowledge adds to international debates on the roles and responsibilities of health care professionals in responding to and preventing domestic violence.
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| 17. |
- Infanti, Jennifer J., et al.
(författare)
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Feasibility of Participatory Theater Workshops to Increase Staff Awareness of and Readiness to Respond to Abuse in Health Care : A Qualitative Study of a Pilot Intervention Using Forum Play among Sri Lankan Health Care Providers
- 2020
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:20, s. 1-14
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Tidskriftsartikel (refereegranskat)abstract
- Women globally experience mistreatment by health providers during childbirth. Researchers have identified strategies to counteract this type of abuse in health care, but few have been evaluated. We used a theater technique, Forum Play, in a brief training intervention to increase awareness of abuse in health care and promote taking action to reduce or prevent it. The intervention was implemented in four workshops with 50 participating physicians and nurses from three hospitals in Colombo, Sri Lanka. This article reports the views of 23 workshop participants who also took part in four focus group discussions on the acceptability and feasibility of the method. The participants reported that the intervention method stimulated dialogue and critical reflection and increased their awareness of the everyday nature of abuses experienced by patients. Participants appreciated the participatory format of Forum Play, which allowed them to re-enact scenarios they had experienced and rehearse realistic actions to improve patient care in these situations. Structural factors were reported as limitations to the effectiveness of the intervention, including under-developed systems for protecting patient rights and reporting health provider abuses. Nonetheless, the study indicates the acceptability and feasibility of a theater-based training intervention for reducing the mistreatment of patients by health care providers in Sri Lanka.
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| 18. |
- Jonsdottir, Sigridur Sia, et al.
(författare)
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Pain management and medical interventions during childbirth among perinatal distressed women and women dissatisfied in their partner relationship : A prospective cohort study
- 2019
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Ingår i: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 69, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The purpose of this study was to investigate possible associations between distress in pregnant women and their use of pain management and medical interventions. Furthermore, we assessed the effects of reported dissatisfaction in relationship with their partner, or weak social support. Design: This was a prospective cohort study. Setting: Women were invited to participate while attending prenatal care at participating Icelandic health care centres. Birth outcome data were obtained from the hospitals where these women gave birth. Participants: Women in this study participated in a research project where 2523 women were screened three times during pregnancy for anxiety and depression. Women who had positive results at screening were invited to a semi-structured interview during pregnancy as well as every fourth woman who had negative results. Five hundred and sixty-two women participated in the interviews and the final sample was 442 women. Measurements: Distress was defined as symptoms of anxiety, stress and depression. The Edinburgh Post-partum Depression Scale (EPDS) and the Depression, Anxiety and Stress Scales (DASS) were used for screening purposes. During the interview, the women answered the Dyadic Adjustment Scale (DAS), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Adverse Experienced Interview (AEI). The main outcome variables that were obtained from the women's childbirth records were: (1) use of pain management, categorized as: epidural analgesia, non-pharmacological pain management, nitrous oxide, pharmacological medication, or no pain management; (2) medical interventions categorized as: induction, stimulation, and episiotomy; and (3) mode of childbirth. A logistic regression analysis, adjusted for significant covariates, was conducted. Findings: A significant association was found between perinatal distress at 16 weeks gestation and use of epidural as single pain management. Overall, distressed women were 2.6 times more likely than non-distressed women to use epidural as a single pain management. They were also less likely to go through childbirth without use of any pain management method. Women who were dissatisfied in their relationship were significantly more likely to undergo induction of childbirth, an episiotomy and/or a vacuum extraction than those who were satisfied in their relationship, regardless if they were distressed or not. No association was found between social support and the outcome variables. Key conclusions: Women with perinatal distress were more likely to use an epidural than non-distressed women. The use of an epidural might help them manage pain and uncertainties related to childbirth. Women who were dissatisfied in their partner relationship may be more likely to undergo induction of childbirth, episiotomy and/or vacuum extraction. Implication for practice: Midwives need to acknowledge the possible association of distress and use of an epidural during childbirth and screen for distress early in pregnancy. It is important to offer counselling and help during pregnancy for expectant parents who are distressed or dissatisfied in their relationship. (C) 2018 Elsevier Ltd. All rights reserved.
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| 19. |
- Jonsdottir, Sigridur Sia, et al.
(författare)
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Partner relationship, social support and perinatal distress among pregnant Icelandic women
- 2017
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Ingår i: Women and Birth. - : Elsevier. - 1871-5192 .- 1878-1799. ; 30:1, s. e46-e55
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: It is inferred that perinatal distress has adverse effects on the prospective mother and the health of the foetus/infant. More knowledge is needed to identify which symptoms of perinatal distress should be assessed during pregnancy and to shed light on the impact of women's satisfaction with their partner relationship on perinatal distress.AIM: The current study aimed to generate knowledge about the association of the partner relationship and social support when women are dealing with perinatal distress expressed by symptoms of depression, anxiety and stress.METHODS: A structured interview was conducted with 562 Icelandic women who were screened three times during pregnancy with the Edinburgh Depression Scale and the Depression, Anxiety, Stress Scale. Of these, 360 had symptoms of distress and 202 belonged to a non-distress group. The women answered the Multidimensional Scale of Perceived Social Support and the Dyadic Adjustment Scale. The study had a multicentre prospective design allowing for exploration of association with perinatal distress.FINDINGS: Women who were dissatisfied in their partner relationship were four times more likely to experience perinatal distress. Women with perinatal distress scored highest on the DASS Stress Subscale and the second highest scores were found on the Anxiety Subscale.CONCLUSION: Satisfaction in partner relationship is related to perinatal distress and needs to be assessed when health care professionals take care of distressed pregnant women, her partner and her family. Assessment of stress and anxiety should be included in the evaluation of perinatal distress, along with symptoms of depression.
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| 20. |
- Jonsdottir, Sigridur Sia, et al.
(författare)
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Pregnancy complications, sick leave and service needs of women who experience perinatal distress, weak social support and dissatisfaction in their partner relationships
- 2020
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 34:1, s. 167-180
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Although perinatal distress is acknowledged as a burdening condition for pregnant women, its effects on pregnancy are not well known. This study was conducted to increase knowledge regarding the effects of distress on pregnancy-related problems. The study also assessed women's need for sick leave and increased prenatal care due to distress, and the effects of weak social support and dissatisfaction with their partner relationships. Methods In total, 2523 women were screened for perinatal distress three times during pregnancy in this quantitative cohort study. Structured psychiatric interviews were conducted following the screening, with 562 of the participants. Data from participants' pregnancy records were also analysed. The study was conducted in primary healthcare centres in Iceland after receiving approval from the Icelandic National Bioethical Committee. The main outcome measures were pregnancy problems, sick leave issued and prenatal service needs. Results Data from 503 women were analysed. The perinatal distress group (PDG) was significantly more likely than was the nondistressed group (NDG) to experience fatigue, vomiting and pelvic pain after controlling for background variables. Distressed women who reported weak family support experienced symptoms of nausea and heartburn. The PDG needed more frequent prenatal care than did the NDG and was issued sick leave for up to 42 days longer. Dissatisfaction in the partner relationship and with the division of household tasks and childcare was strongly associated with distress, the development of complications and the need for sick leave. Discussion Identification of perinatal distress by midwives and other healthcare professionals is important, since distress may be linked to women's complaints of fatigue, vomiting, pelvic pain and need for prolonged sick leave, and additional prenatal care services will be needed. Perceived dissatisfaction in the partner relationship and with the division of household tasks should also form part of clinical practice and assistance provided.
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| 21. |
- Karim, K.M. Rabiul, et al.
(författare)
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Development of the Social Acceptance of Wife Abuse Scale in Rural Bangladesh
- 2021
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Ingår i: Partner Abuse. - : Springer. - 1946-6560 .- 1946-6579. ; 12:1, s. 21-41
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to develop and validate the Social Acceptance of Wife Abuse Scale (SAWAS) in a Bangladeshi context. A total of 18 initial items were generated through literature review and focus group interviews with 16 university students. After meetings with 3 experts and 4 research students having extensive fieldwork experiences on domestic violence issues in rural Bangladesh, 12 items remained. These 12 items were subjected to exploratory factor analysis (EFA) with a sample of 186 university students. This produced a 2-factor, 6-item scale. We labeled the two factors, the circumstances where wife abuse is socially accepted: “disobeying family obligations” and “challenging male-authority.” Using a confirmatory factor analysis (CFA), the factor solution was further tested with another sample of 1,929 rural citizens. The SAWAS showed very good internal consistency and validity. The SAWAS can serve as a protocol to direct measures in the effective prevention of widespread wife abuse in Bangladesh.
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| 22. |
- Karim, K.M. Rabiul, et al.
(författare)
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Differences in the acceptance of wife abuse among ethnic minority Garo and Santal and mainstream Bengali communities in rural Bangladesh
- 2020
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Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 15:7, s. 1-19
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Tidskriftsartikel (refereegranskat)abstract
- Studies on wife abuse in Bangladesh predominantly include the mainstreamBengalipopulation, although there are at least 27 ethnic minority communities including a few 'female-centered' matrilineal groups living in the country. This study explored ethnic differences in the attitudinal acceptance of wife abuse among matrilineal ethnic minorityGaro, patrilineal ethnic minoritySantal, and mainstream patriarchalBengalicommunities in rural Bangladesh. Adopting a cross-sectional design, the study included 1,929 women and men randomly selected from 24Garo,Santal, andBengalivillages. Multivariate Poisson regression was performed to predict the number of contextual events, where the respondents attitudinally endorsed wife abuse. Of the sample, 33.2% were fromGaro, 33.2% fromSantal, and 33.6% from theBengalicommunities. The acceptance of wife abuse was high in the sample; specifically, 34.1% of the respondents accepted physical wife abuse, 67.5% accepted emotional abuse, and 71.6% accepted any abuse (either physical or emotional) at least on one contextual reason provided in a 10-item scale. The mean for accepting any abuse was 3.0 (SD= 2.8), emotional abuse 2.3 (SD= 2.2), and physical abuse 0.8 (SD= 1.4). The study showed that the rates of accepting any abuse and physical abuse were respectively 16% and 56% lower amongGaroas well as 14% and 33% lower amongSantalthan that of theBengalicommunity. Data also revealed that individual level factors like younger age, higher education, prestigious occupation as well as family level factors such as higher income, female mobility, and female family authority were inversely associated with the acceptance of wife abuse in the sample. It appears that the gender regime of a society has a great influence on the attitudes toward wife abuse. We argue that a comprehensive socio-cultural transformation of the patriarchal societies into a gender equal order is imperative for the prevention of widespread wife abuse in the country.
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| 23. |
- Karim, K.M. Rabiul, et al.
(författare)
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Does Childhood Experience of Family Victimization influence Adulthood Refusal of Wife Abuse? Evidence from Rural Bangladesh.
- 2021
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Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 16:6
-
Tidskriftsartikel (refereegranskat)abstract
- This study examined how different forms of childhood family victimization are associated with the attitudinal (not actual action) refusal of wife abuse among women and men in rural Bangladesh. It included 1,929 randomly selected married women and men. Of the sample, 31.3% (Men = 49.3%, Women = 13.5%) attitudinally refused overall wife abuse, 38.5% (Men = 53.2%, Women = 23.8%) refused emotional abuse, 67.0% (Men = 82.5%, Women = 51.6%) refused physical abuse, 78.0% (Men = 88.6%, Women = 67.4%) refused abuse on wife’s disobeying family obligations, and 32.3% (Men = 50.3%, Women = 14.6%) refused abuse on challenging male authority. Multivariate logistic regression revealed that the odds ratio (ORs) of the attitudinal refusal of overall wife abuse were 1.75 (p = .041) for the childhood non-victims of emotional abuse and 2.31 (p < .001) for the victims of mild emotional abuse, compared to the victims of severe emotional abuse. On the other hand, the ORs of the overall refusal of abuse were 1.84 (p = .031) for the non-victims of physical abuse and 1.29 (p = .465) for the victims of mild physical abuse, compared to the childhood victims of severe physical abuse. Data further revealed that the childhood non-victimization of physical abuse increased all types of attitudinal refusal of wife abuse, e.g., emotional abuse, physical abuse, abuse on disobeying family obligations, and abuse on challenging male authority. Compared to the childhood experiences of severe emotional abuse, data also indicated that childhood exposure to mild emotional abuse might increase the attitudinal refusal of wife abuse on a few issues, e.g., abuse on disobeying family obligations, abuse on challenging male authority, and physical abuse. It appeared that childhood experiences of family victimization greatly influence different types of attitudinal refusal of wife abuse. We argue that the issue of childhood victimization should be brought to the forefront in the discourse. We recommend that state machinery and social welfare agencies should expend significant efforts to stop child abuse within the family and in other areas of society in rural Bangladesh.
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| 24. |
- Karim, K.M. Rabiul, et al.
(författare)
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Does female authority prevent male marital violence? : Evidence from rural Bangladesh
- 2021
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Ingår i: Journal of Interpersonal Violence. - : Sage Publications. - 0886-2605 .- 1552-6518. ; 36:11-12, s. 5055-5074
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Tidskriftsartikel (refereegranskat)abstract
- While relative resource status between husband and wife is widely discussed in the explanation of male marital violence (MMV) behaviors, the influence of relative family authority between husband and wife on the violence has been generally overlooked in previous studies. An examination can provide a better understanding of the issue. This study examined how various levels of female authority within the family are associated with MMV against women in rural Bangladesh. The study adopted a cross-sectional design and included 342 married men randomly selected from five northwest villages. Negative binomial regression was performed to predict the frequency of self-reported MMV behaviors in a 1-year recall period which estimated the ratios comparing absolute male authority to egalitarian authority within the family. Of the sample, 37.4% were the egalitarian/fair female authority, 41.2% were the higher male authority, and 21.4% were absolute male authority families; 71.1% of the men revealed that they had resorted to at least one incident of MMV (psychological or physical or sexual) against their wives in the year preceding the survey. The mean of yearly MMV occurrences was 6.29 ( SD = 7.58), ranging from 0 to 42. The study revealed that the frequency of MMV against women was 1.96 times higher among absolute male authority families than in egalitarian families. It further revealed that the frequency of psychological abuse was 1.63 times, physical attack 2.89 times, and sexual coercion 1.88 times higher among absolute male authority families than among egalitarian/fair female authority families. Higher male authority did not appear to be different from egalitarian authority in MMV occurrences. The study suggests that increased female authority within the family unit may prevent women from being exposed to MMV in a patriarchal social order.
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| 25. |
- Karim, K.M. Rabiul, et al.
(författare)
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Gender and Awareness of Laws on Intimate Partner Violence : A Study Among Bengali, Garo, and Santal Ethnic Communities in Rural Bangladesh
- 2023
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Ingår i: Journal of Interpersonal Violence. - : Sage Publications. - 0886-2605 .- 1552-6518. ; 38:1-2, s. 6013-645
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Tidskriftsartikel (refereegranskat)abstract
- Previous studies on intimate partner violence (IPV) against women in Bangladesh rarely focused on the effectiveness of primary prevention strategies like legal remedies. There is also a lack of studies on the issues among the ethnic minority communities in the country. This study examines the awareness of laws on IPV (such as recognizing the abusive acts and knowing the sanctions) among the ethnic Garo and Santal and mainstream Bengali communities in rural Bangladesh. The study randomly included 1929 married women and men from 24 villages. It appeared that the respondents were not adequately aware of the relevant legal provisions. There were also gender and ethnic differences in the issues. On average, the respondents maintained a low score on recognizing abusive acts. The awareness was further lower among the women compared to the men. In addition, multivariate analysis indicated that the Bengali women had relatively a better understanding of the issues than the Garo and Santal women. However, the Garo men showed poorer awareness of recognizing the abusive acts than the Bengali and Santal men. On the other hand, the respondents also maintained a very insufficient knowledge of the sanctions against such abusive acts, whereas women also showed a lower awareness compared to their male counterparts. Data further revealed that the Santal women had a more inadequate understanding of the issues than the Bengali and Garo women. However, the Garo men had more awareness of the sanctions than the Bengali and Santal men. The study reveals that people are unfamiliar with the laws governing IPV. It shows that understanding legal issues is another field of gender and ethnic inequality in the country. We suggest that there should be intervention to make aware the citizen, mainly women of all ethnicities, to ensure the efficacy of the laws.
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| 26. |
- Karim, K.M. Rabiul, et al.
(författare)
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Gender differences in marital violence : a cross-ethnic study among Bengali, Garo, and Santal communities in rural Bangladesh
- 2021
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Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 16:5
-
Tidskriftsartikel (refereegranskat)abstract
- Studies on marital violence (MV) in Bangladesh have primarily focused on the women of the mainstream Bengali people, although half of the population is men, and there are also ethnic minority communities with diverse gender constructions. The current study examined the gender differences in MV among the matrilineal ethnic minority Garo, patrilineal ethnic minority Santal, and the patrilineal mainstream Bengali communities in rural Bangladesh. Adopting a cross-sectional design, we randomly included 1,929 currently married men and women from 24 villages. We used cross-tabulations as well as multivariate logistic regressions to estimate the ethnic and gender differences in MV. Data revealed that women were widely exposed to different types of MV, while only a few men experienced such abuses. It showed that 95.6% of the women experienced emotional abuse, 63.5% physical abuse, 71.4% sexual abuse, and 50.6% poly-victimization, whereas these rates were quite low among the men (emotional = 9.7%, physical = 0.7%, sexual = 0.1%). No men reported poly-victimization. The odds ratio (OR) for emotional, physical, and sexual MV were respectively, 184.44 (95% CI = 93.65−363.24, p<0.001), 449.23 (95% CI = 181.59−1111.35, p<0.001), and 2789.71(95% CI = 381.36−20407.08, p<0.001) for women compared to men. Data further revealed that matrilineal Garo women experienced less MV (emotional = 90.7%, physical = 53.4%, sexual = 64.0%, poly = 38.8%) than the patrilineal Santal (emotional = 99.4%, physical = 67.3%, sexual = 71.3%, poly = 53.9%) and Bengali women (emotional = 96.6%, physical = 69.6%, sexual = 78.8%, poly = 58.9%). Multivariate regressions also showed that the Bengali society perpetrated more physical (OR = 1.90, 95% CI = 1.27−2.85, p = 0.002) and sexual (OR = 2.04, 95% CI = 1.34−3.10, p = 0.001) MV than the Garo society. It appears that MV is largely a gendered issue in the country. Though both women and men can be the victims of MV, the nature/extent of victimization noticeably differs according to the social organization. Matrilineal society appears to be less abusive than the patrilineal one. Interventions aimed to prevent domestic violence in rural Bangladesh should take these findings into account.
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| 27. |
- Ludvigsson, Mikael, 1976-, et al.
(författare)
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Experiences of elder abuse : a qualitative study among victims in Sweden
- 2022
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Ingår i: BMC Geriatrics. - : BioMed Central. - 1471-2318. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundElder abuse is underreported and undertreated. Methods for prevention and intervention are being developed, but the knowledge guiding such measures is often insufficiently based on the victims’ own voices due to a paucity of studies. The aim of this study was therefore to explore experiences of elder abuse among the victims themselves.MethodsConsecutive inpatients ≥ 65 years of age at a hospital clinic in Sweden were invited to participate, and 24 victims of elder abuse were identified. Semi-structured qualitative interviews were conducted, and transcripts were analyzed using qualitative content analysis.ResultsThe analysis generated four themes that together give a comprehensive picture of elder abuse from the participants’ subjective perspectives. The participants’ experiences of abuse were similar to previous third-party descriptions of elder abuse and to descriptions of abuse among younger adults, but certain aspects were substantially different. Vulnerability due to aging and diseases led to dependance on others and reduced autonomy. Rich descriptions were conveyed of neglect, psychological abuse, and other types of abuse in the contexts of both care services and family relations.ConclusionsElder abuse is often associated with an individual vulnerability mix of the aging body, illnesses, and help dependence in connection with dysfunctional surroundings. As individual differences of vulnerability, exposure to violence, and associated consequences were so clear, this implies that components of prevention and intervention should be individually tailored to match the needs and preferences of older victims.
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| 28. |
- Ludvigsson, Mikael, 1976-, et al.
(författare)
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Responding to Elder Abuse in GERiAtric care (REAGERA) educational intervention for healthcare providers : a non-randomised stepped wedge trial
- 2022
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Ingår i: BMJ Open. - London, United Kingdom : BMJ Publishing Group Ltd. - 2044-6055. ; 12:5
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Elder abuse is prevalent and associated with different forms of ill health. Despite this, healthcare providers are often unaware of abusive experiences among older patients and many lack training about elder abuse. The overall aim of this study is to determine the effectiveness of an educational intervention on healthcare providers' propensity to ask older patients questions about abusive experiences. Methods and analysis Healthcare providers at hospital clinics and primary healthcare centres in Sweden will undergo full-day education about elder abuse between the fall of 2021 and spring of 2023. The education consists of (1) theory and group discussions; (2) forum theatre, a form of interactive theatre in which participants are given the opportunity to practise how to manage difficult patient encounters; and (3) post-training reflection on changing practices. The design is a non-randomised cluster, stepped wedge trial in which all participants (n=750) gradually transit from control group to intervention group with 6-month interval, starting fall 2021. Data are collected using the Responding to Elder Abuse in GERiAtric care-Provider questionnaire which was distributed to all clusters at baseline. All participants will also be asked to answer the questionnaire in conjunction with participating in the education as well as at 6-month and 12-month follow-up. Main outcome is changes in self-reported propensity to ask older patients questions about abuse post-intervention compared with pre-intervention. Linear mixed models including cluster as a random effect will be used to statistically evaluate the outcome. Ethics and dissemination The study has been approved by the Swedish Ethical Review Authority. The results will be published in peer-reviewed journals and conference proceedings. If the intervention is successful, a manual of the course content will be published so that the education can be disseminated to other clinics.
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| 29. |
- Muzrif, Munas M., et al.
(författare)
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Domestic violence : a cross-sectional study among pregnant women in different regions of Sri Lanka
- 2018
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 8:2
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The aims of this study were to assess the regional differences in domestic violence among pregnant women in the capital district and in the tea plantation sector of Sri Lanka, to explore potential contributory factors and to assess whether healthcare workers addressed domestic violence and disclosure among survivors. Design A cross-sectional study was carried out using interviewer-administered Abuse Assessment Screen. Setting Fifty-seven antenatal clinic centres in the capital district and 30 in the tea plantation sector. Participants Pregnant women between 6 and 40 weeks of gestational age. In the capital district, 1375 women were recruited from antenatal clinic centres in the urban (n= 25) and in the rural areas (n= 32), and 800 women from 30 centres in the tea plantation sector. The response rate in the capital district was 95.6% and 96.7% in the tea plantation sector. Results Among the total sample of pregnant women (n= 2088), the prevalence of 'ever abused' was 38.6%, and the prevalence of 'currently abused' was 15.9%. 'Ever abused' (31.5% vs 50.8%) and 'currently abused' (10% vs 25.8%) were significantly higher (P< 0.001) among the women living in the tea plantation sector. 'Ever abused' was associated with living in the tea plantation sector, being employed, living far from gender-based violence care centre and of Muslim ethnicity, after adjusting for age, education and family income. Only 38.8% of all participants had been asked by healthcare workers about abuse. Living in the tea plantation sector and lower level of education were associated with not being asked. Among those who reported 'ever abused', only 8.7% had disclosed the experience to a healthcare worker. Conclusion Domestic violence was prevalent and highest among women in the tea plantation sector compared with the capital district. The capacity of healthcare workers in addressing domestic violence should be increased.
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| 30. |
- Möllerberg, Marie-Louise, et al.
(författare)
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Adaptation and psychometric evaluation of the short version of Family Sense of Coherence Scale in a sample of persons with cancer in the palliative stage and their family members
- 2020
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Ingår i: Palliative & Supportive Care. - : Cambridge University Press. - 1478-9515 .- 1478-9523. ; 18:1, s. 24-32
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Tidskriftsartikel (refereegranskat)abstract
- Objectives For patients' entire families, it can be challenging to live with cancer during the palliative stage. However, a sense of coherence buffers stress and could help health professionals identify families that require support. Therefore, the short version of the Family Sense of Coherence Scale (FSOC-S) was translated, culturally adapted, and validated in a Swedish sample. Methods Translation and cross-cultural adaptation of the FSOC-S into Swedish was conducted in accordance with the World Health Organization's Process for Translation and Adaptation of Research Instruments guidelines. Participants were recruited from two oncology clinics and two palliative centers in Sweden. Results Content validity was supported by experts (n = 7), persons with cancer (n = 179), and family members (n = 165). Homogeneity among items was satisfactory for persons with cancer and family members (item-total correlations were 0.45-0.70 and 0.55-0.72, respectively) as well as internal consistency (ordinal alpha = 0.91 and 0.91, respectively). Factor analyses supported unidimensionality. FSOC-S correlated (r(s) > 0.3) with hope, anxiety, and symptoms of depression, which supported convergent validity. The test-retest reliability for items ranged between fair and good (k(w) = 0.37-0.61).
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| 31. |
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| 32. |
- Möllerberg, Marie-Louise, et al.
(författare)
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Family sense of coherence and its associations with hope, anxiety and symptoms of depression in persons with cancer in palliative phase and their family members : A cross-sectional study
- 2019
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Ingår i: Palliative Medicine. - : Sage Publications. - 0269-2163 .- 1477-030X. ; 33:10, s. 1310-1318
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is evidence indicating that family sense of coherence predicts quality of family life and promotes family well-being. In families living with the palliative phase of cancer, low hope, anxiety and symptoms of depression are common in both persons with cancer and their family members. Aim: To determine whether family sense of coherence was associated with hope, anxiety and symptoms of depression, respectively, in persons with cancer in the palliative phase and their family members. Design: An observational, cross-sectional, multicentre study was conducted. Nested linear regression analyses were performed in two blocks to determine whether family sense of coherence was associated with hope, anxiety and symptoms of depression. Setting/participants: Persons with cancer (n = 179) and their family members (n = 165) were recruited from two oncology clinics and two palliative centres in three regions in Sweden. Results: The main findings showed that family sense of coherence was significantly and independently associated with hope, anxiety and symptoms of depression. Stronger family sense of coherence was associated with higher hope and lower anxiety and symptoms of depression levels in both persons with cancer and their family members. Conclusion: Health care providers should strive to identify families with weak family sense of coherence, because of its associations with hope, anxiety and symptoms of depression, in order to offer them professional support and thereby achieve increased well-being during the palliative phase of cancer. Future studies should expand our knowledge of family sense of coherence and how to identify families at risk of lower levels of well-being.
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| 33. |
- Oscarsson, Marie, 1956-, et al.
(författare)
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When fetal hydronephrosis is suspected antenatally : a qualitative study
- 2015
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Ingår i: BMC Pregnancy and Childbirth. - : BioMed Central. - 1471-2393 .- 1471-2393. ; 15:349
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Tidskriftsartikel (refereegranskat)abstract
- Background: The information about fetal malformation findings during the ultrasound examination often comes unexpectedly, and the women and their partners may not necessarily receive any conclusive statement on the prognosis. A finding such as fetal hydronephrosis range from being a soft markers or mild anomaly, to a serious condition associated with neonatal morbidity and mortality. The aim of this study was to explore women’s reactions to the discovery of fetal hydronephrosis in the context of uncertainty regarding the prognosis.Methods: Ten women were interviewed and the interviews were conducted six to twelve months after the women gave birth. They had experience of suspected fetal hydronephrosis in gestational week 18–20. The interviews were recorded, transcribed verbatim and analysed using constant comparative analysis.Results: The core category, ‘Going through crisis by knowing that you are doing the right thing’ illustrates the meaning of women’s reactions and feelings. It illuminates the four categories: ‘When the unexpected happens’– on the one hand, women had positive views that the suspicious malformation could be discovered; however, on the other hand, women questioned the screening. ‘To live in suspense during pregnancy’ – the suspicious malformation caused anxiety and was a stressful situation. ‘Difficulties in understanding information’ – the women thought they had limited knowledge and had difficulties in understanding the information. ‘Suppress feelings and hope for the best’ – the women tried to postpone the problem and thought they should deal with it after delivery.Conclusions: Women are worried irrespective of suspicious or severe malformations, and in need of information and counselling tailored to their individual needs. Other sources of support could be: written information, links to reliable sources on the Internet and possibilities for ongoing follow-ups.
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| 34. |
- Perera, Dinusha, et al.
(författare)
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Obstetric Violence Is Prevalent in Routine Maternity Care : A Cross-Sectional Study of Obstetric Violence and Its Associated Factors among Pregnant Women in Sri Lanka's Colombo District
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:16
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Tidskriftsartikel (refereegranskat)abstract
- The phenomenon of obstetric violence has been documented widely in maternity care settings worldwide, with scholars arguing that it is a persistent, common, but preventable impediment to attaining dignified health care. However, gaps remain in understanding local expressions of the phenomenon, associations with other types of violence against women, and implications for women's trust and confidence in health providers and services. We focused on these issues in this cross-sectional study of 1314 women in Sri Lanka's Colombo district. Specifically, in this study, we used Sinhalese and Tamil translations of the NorVold Abuse Questionnaire and the Abuse Assessment Screen to measure prevalence of women's experiences with obstetric violence in maternity care and lifetime and pregnancy-specific domestic violence. Then, the results were interpreted by considering the women's sociodemographic characteristics, such as age, ethnicity, and family income, to reveal previously undocumented associations between obstetric and domestic violence during pregnancy, as well as other factors associated with experiencing obstetric violence. We argue that obstetric violence is prevalent in government-sector (public) maternity care facilities in the Colombo district and is associated with young age, lower family income, non-majority ethnicity, and rural residency. Significantly, this study sheds light on a serious concern that has been underexamined, wherein women who report experiencing obstetric violence are also less likely to be asked by a health care provider about domestic violence experiences. Further research at the clinical level needs to focus on appropriate training and interventions to ensure women's safety and cultivate relationships between patients and health care providers characterized by trust, confidence, and respect.
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| 35. |
- Perera, Dinusha, et al.
(författare)
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'When helpers hurt' : women's and midwives' stories of obstetric violence in state health institutions, Colombo district, Sri Lanka
- 2018
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Ingår i: BMC Pregnancy and Childbirth. - : BioMed Central. - 1471-2393 .- 1471-2393. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Background: The paper explores how age, social position or class, and linguistic and cultural background intersect and place women in varying positions of control and vulnerability to obstetric violence in state health institutions in Colombo district, Sri Lanka. Obstetric violence occurs during pregnancy, childbirth and the immediate postpartum period; hence, it is violence that directly affects women. The authors aim to break the traditional culture of silence around obstetric violence and bring attention to the resulting implications for quality of care and patient trust in obstetric care facilities or providers. Methods: Five focus group discussions were held with 28 public health midwives who had prior experience working in labor rooms. Six focus group discussions were held with 38 pregnant women with previous childbirth experience. Additionally, 10 of the 38 women, whom felt they had experienced excessive pain, fear, humiliation, and/or loss of dignity as patients in labor, participated in individual in-depth interviews. An intersectional framework was used to group the qualitative data into categories and themes for analysis. Results: Obstetric violence appears to intersect with systems of power and oppression linked to structural gender, social, linguistic and cultural inequities in Sri Lanka. In our dataset, younger women, poorer women, and women who did not speak Sinhala seemed to experience more obstetric violence than those with relevant social connections and better economic positions. The women in our study rarely reported obstetric violence to legal or institutional authorities, nor within their informal social support networks. Instead, they sought obstetric care, particularly for childbirth, in other state hospitals in subsequent pregnancies. Conclusions: The quality of obstetric care in Sri Lanka needs improvement. Amongst other initiatives, policies and practices are required to sensitize health providers about the existence of obstetric violence, and repercussions are required for abusive or discriminatory practices. The ethics of care should be further reinforced in the professional training of obstetric health providers.
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| 36. |
- Petersson, Carina, et al.
(författare)
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Experience of violence and self-rated health : Do youths disclose their experiences when visiting a Youth Centre in Sweden
- 2021
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Ingår i: Scandinavian Journal of Public Health. - London : Sage Publications. - 1403-4948 .- 1651-1905. ; 49:3, s. 277-284
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Tidskriftsartikel (refereegranskat)abstract
- Background: Being exposed to violence is a global health problem, increasing the risk of suffering from ill health. The main aim of this study was to estimate the prevalence of emotional, physical and sexual violence victimisation and its association to self-rated health among youths. The second aim was to investigate whether the youths had disclosed to healthcare professionals at a Youth Centre or others about being exposed. Methods: The cross-sectional study includes data from a web survey of youths, aged 15–25 (n=500), collected in Sweden. Descriptive statistics and univariate analyses were used for the analyses. Results: In all, emotional, physical or sexual violence during their lifetime was reported by 43.2% and 22.8% of youths during the last year. In total, 88% of the respondents assessed their self-rated health as good, very good or excellent. Those who had been exposed to emotional, physical or sexual violence during their lifetime reported statistically significant lower self-rated health (fair and poor) than those who were not victimised. When healthcare professionals at the Youth Centre asked youths about exposure during their lifetime, one-fifth disclosed having been exposed. Conclusions: Youths who reported any type of violence during their lifetime showed lower self-rated health compared to those who were not exposed. Youth Centres have an important role in identifying youths who are exposed to violence and/or self-report their health as low. Still, only a minority of youths who have been exposed to violence told health professionals at a Youth Centre about it when asked. It is necessary to further investigate how the issues can be best addressed.
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| 37. |
- Petersson, Carina, et al.
(författare)
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Health and sexual behavior among exchange students
- 2016
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 44:7, s. 671-677
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The objective was to describe the exchange students’ health and sexual behaviour associated with their exchange studies, and examine the extent to which they had received preventive efforts against human immunodeficiency virus (HIV)/sexually transmitted infection (STI) and safer sex before departure. Methods: A cross-sectional study was conducted based on a web survey with questions about sexual behaviour, self-esteem and psychological well-being. Data were analysed using descriptive and analytical statistics. Results: A total of 136 outgoing exchange students from a Swedish University participated. Most of the exchange students rated their health as good, had psychological well-being and rated their self-esteem as being high. Approximately half of the exchange students had sex with a new partner during the exchange semester, and 87% of them had sexually risky behaviour. More than half (61%) of the exchange students had received preventive efforts before departure. No statistically significant difference regarding preventive information was found between those who reported sexually risky behaviour and those who did not. The group that had sexually risky behaviour desired free condoms and access to clinics for sexual health. Conclusions: Exchange students rated their health as good, and the majority of them participated in information sessions that addressed preventive efforts on HIV/STI and safer sex before departure. Sexually risky behaviour during exchange studies was reported and highlights the need for more effective preventive measures; for example, a recollection of reading STI information.
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| 38. |
- Petersson, Carina
(författare)
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Kommer du att döma mig om jag berättar? : ... om ungdomars sexuella beteende och utsatthet för våld
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: In Sweden, youth sexual health is worse than that of other residents. Youth also report exposure to violence to a greater extent, threatening their health.Aim: The aim was to investigate youth’s sexual behaviour, their exposure to violence and self-rated health and its potential relationship, and explore whether youth exposed to violence disclose this.Method: Cross-sectional studies include data from a web survey among exchange students and youth visiting a youth centre (I–III). Besides background questions, online questionnaires contained validated questions and instruments covering sexual behaviour, exposure to violence, and mental health. Descriptive and analytical statistics were used. A qualitative study was conducted where abused youth were interviewed, and the data were analysed with content analysis (IV).Results: Most outgoing exchange students rated their health highly, and over half had received information regarding HIV/sexually transmitted infection or safer sex before their trip (I). Eight out of ten exchange students reported at least one sexual risk behaviour. Among youth visiting the youth centre, a greater proportion of teenagers reported sexual debut before age 15 compared with young adults (II). A greater proportion of young adults indicated having had a sexually transmitted infection compared with teenagers (II). Associations were shown between several sexual risk behaviours and exposure to violence, while no difference was shown between the age groups regarding the occurrence of violence (II). Nine out of ten youth rated their health as high, but four out of ten reported being exposed to violence in their lifetime (III). A larger proportion of those exposed to violence reported low self-rated health compared with those not exposed to violence (III). All the youth interviewed expressed that being exposed to violence resulted in losing their security; they described the importance of being questioned about violence, and most of them wanted to disclose having been exposed to violence (IV).Conclusion: A high incidence of sexual risk behaviour and exposure to violence and the relationship between these experiences was demonstrated in youth. Midwives need to ask sensitive questions to identify youth who risk their health and offer advice or support. How questions are posed can determine whether youth disclose exposure to violence.
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| 39. |
- Petersson, Carina, et al.
(författare)
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Teenagers' and young adults' sexual behaviour and its associations with exposure to violence, among visitors at a Youth Centre in Sweden
- 2022
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier. - 1877-5756 .- 1877-5764. ; 34
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: This study aimed to investigate differences between teenagers and young adults in sexual behaviours and exposure to emotional, physical and/or sexual violence, and the associations between sexual behaviours and exposure to violence, among youths who visit a Youth Centre in Sweden.METHODS: A cross-sectional web survey was used among sexually experienced teenagers, aged 15-19, and young adults 20-24 years, wherein a total of 452 participated. Descriptive and bivariate analyses were used in the study.RESULTS: A majority had unprotected sex during the last year, namely 55.4 % of teenagers and 58.3 % of young adults. A higher proportion of teenagers reported having early sex debut, before 15 years age, compared with young adults (p = .003). A higher proportion of young adults reported having experienced a sexually transmitted infection (p = <.001). Nearly half of the teenagers (44.9 %) and the young adults (44.6 %) stated having been exposed to emotional, physical and/or sexual violence during their lifetime. Associations were found between all types of exposure to violence and having unprotected sex, using alcohol or drugs together with sex, and having had three or more different sex partners during last year.CONCLUSIONS: Regardless of age, there was a high proportion of youths, visiting a Youth Centre, having unprotected sex and who experienced exposure to violence. As these experiences may negatively affect youths' future sexual and reproductive health, healthcare professionals should identify youths in need or with early-in-life needs.
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| 40. |
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| 41. |
- Pun, Kunta Devi, et al.
(författare)
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Community perceptions on domestic violence against pregnant women in Nepal : a qualitative study
- 2016
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Ingår i: Global Health Action. - : Taylor & Francis Group. - 1654-9716 .- 1654-9880. ; 9, s. 1-13
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Tidskriftsartikel (refereegranskat)abstract
- Background: Globally, knowledge of health sector options to respond to domestic violence during pregnancy is increasing, but this topic is under-investigated in Nepal. This gap affects the provision of adequate antenatal care services and understanding of factors that influence women's willingness and ability to use available services. It is critical to know more about the social norms in a community that promote and prevent women experiencing domestic violence from seeking antenatal care. Objective: To explore community perceptions of domestic violence against pregnant women. Methods: A qualitative study was conducted in Dhulikhel municipality, involving 41 men and 76 women in 12 focus group discussions in different gender and family role separated groups. The interviews were recorded, transcribed in verbatim, and analyzed using content analysis. A socio- ecological model was used as a theoretical framework to illustrate linkages between individual, relationship, community, and societal influences on perceptions of domestic violence during pregnancy. Results: The community recognized different forms of violence during pregnancy threatening women's physical and psychological health and presenting obstacles to seeking antenatal care. Some types of culturally specific violence were considered particularly harmful, such as pressure to give birth to sons, denial of food, and forcing pregnant women to do hard physical work during pregnancy, which may leave daughters- in-law vulnerable to domestic violence in extended families. A culture where violence is normalized and endurance and family reconciliation are promoted above individual health was perceived to cause women to tolerate and accept the situation. Participants suggested actions and strategies to address continuing violence, which indicated a societal transition toward increased awareness and changing attitudes and practices. Conclusions: Domestic violence during pregnancy needs to be addressed at different levels in Nepal, where women are often dependent on others for access to health care. Social norms were perceived to be shifting toward reduced acceptance of violence against women, but restrictions on women's life options, movement, and decision-making authority were still considered impediments to pregnant women's health.
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| 42. |
- Pun, Kunta Devi, et al.
(författare)
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Domestic violence and perinatal outcomes - a prospective cohort study from Nepal
- 2019
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Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- Background: Domestic violence is one of the most common forms of violence against women. Domestic violence during pregnancy is associated with adverse perinatal and maternal outcomes. We aimed to assess whether domestic violence was associated with mode of delivery, low birthweight and preterm birth in two sites in Nepal. Methods: In this prospective cohort study we consecutively recruited 2004 pregnant women during antenatal care at two hospitals between June 2015 and September 2016. The Abuse Assessment Screen (modified) was used to assess fear and violence. Having ever experienced either fear or violence was defined as any domestic violence. Obstetric outcomes were obtained from hospital records for 1381 (69%) women, selecting singleton pregnancies only. Mode of delivery was assessed as birth by cesarean section or not. A birthweight of less than 2500g was defined as low birthweight and preterm birth as birth before completion of 37weeks gestation. Descriptive and multiple logistic regression analyses were performed to assess associations. Results: Twenty percent of the women reported any domestic violence. Among all 1381 women, 37.6% gave birth by cesarean section. Of those women who delivered by cesarean section, 84.7% had an emergency cesarean section. Less than 10% of the babies were born prematurely and 13.5% were born with low birthweight. We found no significant association between exposure to any domestic violence during pregnancy and risk of a low birthweight baby or birth by cesarean section. However, having experienced both violence and fear was significantly associated with giving birth to a preterm infant [aOR 2.33 (95% CI;1.10-4.73)]. Conclusions: Domestic violence is common in Nepal. This is a potential risk factor for severe morbidity and mortality in newborns. We found that the risk of having a preterm baby was higher for pregnant women who experienced both fear and violence. This should be recognized by the health sector. In this study, no significant differences were found in the rate of cesarean section nor low birthweight for women who had experienced any domestic violence compared to those who did not.
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| 43. |
- Rahman, Hafijur, et al.
(författare)
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Women's Social Mobility and Attitudinal Acceptance of Wife Abuse : A Cross-Sectional Study Among Bengali, Santal, and Garo Ethnic Communities in Rural Bangladesh
- 2024
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Ingår i: Journal of Interpersonal Violence. - : Sage Publications. - 0886-2605 .- 1552-6518. ; 39:7-8, s. 1676-1703
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Tidskriftsartikel (refereegranskat)abstract
- Previous studies exploring the influential factors associated with attitudinal acceptance of wife abuse (AAWA) did not widely focus on the relation between women's social mobility (WSM) and different dimensions of AAWA in rural Bangladesh. This current study examined the association between WSM and different dimensions of AAWA in the context of socio-cultural differences among the Bengali, the Santal, and the Garo ethnic communities in rural Bangladesh. Adopting a cross-sectional design, 1,929 married men and women were randomly included in the study from 8 Bengali, 8 Santal, and 8 Garo villages where 50.2% were women and 49.8% were men. Of the sample, 33.2% Garo, 33.2% Santal, and 33.6% Bengali participants were included in this study. Data revealed that 45.5% of women had low social mobility and the prevalence of different dimensions of AAWA was high and varied among the study communities. We used descriptive statistics, chi-square, and binary logistic regression analysis to estimate the association. The multivariate binary logistic regression analysis results revealed that the likelihood of attitudinal acceptance of overall abuse, psychological abuse, physical abuse, abuse on disobeying family obligation, and abuse on challenging male authority were significantly lower for the respondents who belonged to families where women enjoyed high mobility compared to those who belonged to families where WSM was low. This study also showed that the Bengali and the Santal participants were more likely to accept different dimensions of AAWA compared to the Garos. This study suggests that WSM should be considered in policy-making and implementing interventions to reduce the different dimensions of AAWA in rural Bangladesh.
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| 44. |
- Rask, Marie, et al.
(författare)
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Notification of an abnormal Pap smear : an intervention study
- 2019
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Ingår i: European Journal of Cancer Care. - : Wiley-Blackwell. - 0961-5423 .- 1365-2354. ; 28:2, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- This study aims to assess whether notification of an abnormal Pap smear result via a phone call, delivered by a trained healthcare provider, has an effect on women's HRQoL, coping and awareness of HPV. For this intervention study, women were consecutively recruited from a women's health clinic in Sweden. Women in the intervention group (n = 113) were notified of their Pap smear result via a phone call by a trained healthcare provider, while those in the comparison group (n = 122) were notified via a standard letter. A questionnaire was used to collect data. The results found no significant differences between the groups for HRQoL. However, 42.5% ofwomen in the intervention group versus 48.3% in the comparison group reported anxiety. Women in the intervention group were more satisfied with the manner in which they were notified of their abnormal result than those in the comparison group (92.0% vs. 67.2%; p < 0.001), more aware of HPV (71% vs. 50%; p = 0.001), and called healthcare services less often (10.6% vs. 18.0%; p = 0.113), no significance. In conclusion, notification of an abnormal Pap smear result via a phone call does not increase women's HRQoL or reduce their anxiety.
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| 45. |
- Rask, Marie, et al.
(författare)
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Swedish women's awareness of human papillomavirus, and health-related quality of life, anxiety and depression after a notification of an abnormal Pap smear result : a cross-sectional study
- 2019
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Ingår i: European Journal of Cancer Prevention. - : Wolters Kluwer. - 0959-8278 .- 1473-5709. ; 28:2, s. 96-101
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Tidskriftsartikel (refereegranskat)abstract
- This study aims to assess (a) women's awareness of the human papillomavirus (HPV), (b) women's health-related quality of life (HRQoL) and levels of anxiety and depression symptoms, and (c) to compare the outcomes between women who are aware of the sexually transmitted nature of the HPV infection and women who are not. Swedish women who have been notified of an abnormal Pap smear result completed a questionnaire. This questionnaire consisted of sociodemographic characteristics, items on awareness of HPV, and how to cope with the Pap smear result and the instruments: the Functional Assessment of Chronic Illness Therapy - Cervical Dysplasia and the Hospital Anxiety and Depression Scale (HADS). Data were analyzed using descriptive statistics, Student's t-test, χ-tests, Fisher's exact test, the Mann-Whitney U-test, and Fisher-Freeman-Halton exact test. In total, 122 women participated. The women reported a median (quartile 1-quartile 3) score of 87.6 on the Functional Assessment of Chronic Illness Therapy - Cervical Dysplasia (81.8-107.0), compatible with a good HRQoL. The median (quartile 1-quartile 3) scores on HADS-anxiety and HADS-depression were 7.0 (4.0-10.0) and 3.0 (1.0-5.3), respectively; however, 48.4% of the women reported anxiety (compared with 20% in a normal population). There were no statistically significant differences in the median scores in any of the scales, including the prevalence of distress between the subgroups. Women with abnormal Pap smear results have a good HRQoL; they can become anxious, but not depressed. Awareness of HPV as a sexually transmitted infection is low, but being aware does not impact on women's HRQoL or on anxiety and depression.
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| 46. |
- Rask, Marie, et al.
(författare)
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The Swedish translation and cross-cultural adaptation of the Functional Assessment of Chronic Illness Therapy – Cervical Dysplasia (FACIT-CD) : linguistic validity and reliability of the Swedish version
- 2017
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Ingår i: BMC Women's Health. - : BioMed Central. - 1472-6874. ; 17:1, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundCervical dysplasia is a precancerous condition, which has been shown to create anxiety in women. To be able to investigate these women’s health-related quality of life, a disease-specific instrument is required. There does not seem to be a Swedish version of an instrument to screen for this specific disease. Therefore, this study aims to translate and cross-culturally adapt the Functional Assessment of Chronic Illness Therapy – Cervical Dysplasia (FACIT-CD) into a Swedish context and evaluate its linguistic validity and reliability.MethodsThe Functional Assessment of Chronic Illness Therapy (FACIT) translation methodology was used, which consists of several steps including pilot testing of the FACIT-CD instrument through cognitive debriefing interviews. Ten women diagnosed with cervical dysplasia participated in the cognitive debriefing interviews. The internal consistency reliability of the Swedish FACIT-CD was estimated by Cronbach’s alpha coefficient. Homogeneity of the items was evaluated by corrected item-total correlations. The sample consists of 34 women who were diagnosed with cervical dysplasia.ResultsThe translation and cross-cultural adaptation went smoothly without any problems for the majority of the items. The cognitive debriefing interviews indicated that the Swedish FACIT-CD consists of relevant items, is easy to understand and complete, and has unambiguous and comprehensive response categories. The translation and cross-cultural adaptation resulted in a Swedish FACIT-CD, which is conceptually and semantically equivalent to the English version and linguistically valid. The total scale of the Swedish FACIT-CD exhibited good internal consistency reliability with a Cronbach’s alpha coefficient of 0.84, and all of the subscales exhibited acceptable value between 0.71 and 0.81 except the Relationships subscale, which had a value of 0.67. Finally, all but four items exceeded the acceptable level for the corrected item-total correlations of ≥ 0.20.ConclusionsThe Swedish FACIT-CD is conceptually and semantically equivalent to the English version and linguistically valid; further, it exhibits good internal consistency reliability.
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| 47. |
- Rask, Marie, et al.
(författare)
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Women with abnormal Pap smear result : a qualitative study of Swedish healthcare professionals' experiences
- 2016
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Ingår i: European Journal of Cancer Care. - : John Wiley & Sons. - 0961-5423 .- 1365-2354. ; 25:6, s. 980-991
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Tidskriftsartikel (refereegranskat)abstract
- A Papanicolaou (Pap) smear can be used to detect pre-cancerous cellular changes, so that they can be treated before they develop into cervical cancer. When the results of a Pap smear test are abnormal, women need further investigation, treatment and follow-up. Healthcare professionals (HCPs) are in a position to care for these women with abnormalities. The aim of this study was to explore the experiences of HCPs in caring for women with abnormal Pap smear results. In total, 20 HCPs from two counties in south-eastern Sweden participated in individual interviews, based on two open-ended questions. Interviews were recorded, transcribed verbatim and analysed using content analysis. The results showed that HCPs experienced that abnormal Pap smear results created anxiety in women, who often sought information from the Internet as a way to cope. Furthermore, the HCPs thought that it was a problem that women chose not to attend investigation, treatment and follow-ups. However, information about the seriousness of abnormal Pap smear results causes women to participate. It is a challenge for HCPs to inform in a reassuring manner. Finally, HCPs should collaborate with women to meet their information needs and to also provide support regarding finding and filtering reliable information on the Internet.
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| 48. |
- Rask, Marie, et al.
(författare)
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Women's experiences of abnormal Pap smear results : a qualitative study
- 2017
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier. - 1877-5756 .- 1877-5764. ; 12, s. 3-8
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesTo describe women’s experiences of abnormal Pap smear result.MethodsTen women were recruited from a women’s health clinic. Qualitative interviews based on six open-ended questions were conducted, transcribed verbatim, and analyzed by content analysis.ResultsThe women believed that their abnormal Pap smear result was indicative of having cancer. This created anxiety in the women, which resulted in the need for emotional support and information. Testing positive with human papillomavirus (HPV) also meant consequences for the relatives as well as concerns about the sexually transmitted nature of the virus. Finally, the women had a need to be treated with respect by the healthcare professionals in order to reduce feelings of being abused.ConclusionsIn general, women have a low level of awareness of HPV and its relation to abnormal Pap smear results. Women who receive abnormal Pap smear results need oral information, based on the individual women’s situation, and delivered at the time the women receive the test result. It is also essential that a good emotional contact be established between the women and the healthcare professionals.
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| 49. |
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| 50. |
- Rishal, Poonam, et al.
(författare)
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Improving Safety Among Pregnant Women Reporting Domestic Violence in Nepal - A Pilot Study
- 2020
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:7, s. 1-13
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Domestic violence (DV) during pregnancy is associated with poor health outcomes for both the mother and newborn, and sometimes death. In a low-income country like Nepal, women have few options to leave abusive situations. Therefore, there is a need for interventions to improve their safety. The aim of our study was to explore the use of safety measures before and after an educational intervention among women who have reported DV during pregnancy. Materials and methods: Of 1010 pregnant women screened consecutively for DV using the Abuse Assessment Screen (AAS) during routine antenatal care, 181 women reported domestic violence. All 1010 participating pregnant women were taught 15 safety measures using a locally developed flipchart. We obtained contact with 80 of the 181 eligible women postpartum, of whom 62 completed the follow-up assessment. We explored and described the use of safety measures at baseline and follow-up, using a standardized instrument called the Safety Behavior Checklist. Results: At follow-up, less than half of the women (n = 30, or 48.3%) reported any form of DV. Of the women who reported DV at follow-up, significantly more reported the experience of both violence and fear at baseline (21.9%, p = 0.01) compared with the women who did not report DV at follow-up (3.3%, p = 0.01). Women reporting DV at baseline and follow-up used more safety measures at baseline (56) and follow-up (80) compared with women reporting DV at baseline only (36 and 46). Women reporting DV at baseline and follow-up used more safety measures for the first time at follow-up, 57 new measures compared with the 28 new measures used by women reporting DV at baseline only. Conclusions: The use of a flipchart teaching session on safety measures within antenatal care may increase the number of safety measures women use to protect themselves during pregnancy and decrease the risks of adverse health effects of DV.
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