| 1. |
- Alehagen, Siw, 1953-, et al.
(författare)
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Can women's cognitive appraisals be registered throughout childbirth?
- 2000
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Ingår i: Gynecologic and Obstetric Investigation. - : S. Karger AG. - 0378-7346 .- 1423-002X. ; 49:1, s. 31-35
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Tidskriftsartikel (refereegranskat)abstract
- The aims of the present study were: (a) to examine whether it was possible to measure women’s cognitive appraisals hourly during the whole process of labor and delivery, and (b) to explore how the appraisals varied during labor. Measurements from 12 nulliparous women are presented. The findings indicate that it is possible to study psychological appraisals directly, in detail and continuously during the process of labor and delivery. The women’s cognitive appraisals varied throughout labor both per individual woman and between the participating women.
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| 2. |
- Alehagen, Siw, 1953-, et al.
(författare)
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Catecholamine and cortisol reaction to childbirth
- 2001
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Ingår i: International Journal of Behavioral Medicine. - 1070-5503 .- 1532-7558. ; 8:1, s. 50-65
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Tidskriftsartikel (refereegranskat)abstract
- One way to study the stressfulness of childbirth is to examine the output of stress hormones. In this study, urinary catecholamines and salivary cortisol from 50 primiparous women were collected for 1 day during gestational weeks 37 to 39, hourly during labor and delivery, and 2 hr and 2 days postpartum. All three stress hormones increased statistically significantly from pregnancy to labor. The increase in adrenaline and cortisol was more than 500%, and the increase in noradrenaline was about 50%. After labor, the output decreased but not statistically significantly below the levels during late pregnancy. Hormone levels during late pregnancy, during labor and delivery, and during the period postpartum mostly did not correlate systematically. However, noradrenaline and adrenaline, as well as adrenaline and cortisol, were positively correlated during labor. After administration of epidural analgesia, there was a moderate but significant decrease in noradrenaline and adrenaline, whereas cortisol did not change. In conclusion, the results of this study support the assumption that childbirth is a very stressful event and that the stress responses vary considerably among women. The substantial increase of adrenaline and cortisol compared with noradrenaline indicates that mental stress is more dominant than physical stress during labor.
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| 3. |
- Alehagen, Siw, 1953-, et al.
(författare)
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Fear during labor
- 2001
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 80:4, s. 315-320
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Tidskriftsartikel (refereegranskat)abstract
- Background. The aims of the present study were to compare primiparous and multiparous women’s experiences of fear of delivery during an early stage of active labor (cervix dilatation 3–5 centimeters) and to study whether fear of delivery, measured during the early stage of active labor, was a predictor of the amount of pain relief received during the remaining part of labor (cervix dilatation 5 cm – partus), of the duration of the remaining part of labor, and of the occurrence of instrumental vaginal delivery and emergency cesarean section.Method. Thirty-five primiparous and 39 multiparous women answered the Delivery Fear Scale (DFS) once during the early stage of labor and before they had received any pain relief.Results. Primiparous women reported higher levels of fear than multiparous women did. Fear during the first phase of labor predicted only the total amount of pain relief received during labor.Conclusion. The clinical implications of the study are that the delivery staff should consider women’s fear during labor and pay attention especially to primiparous women’s increased risk of higher levels of fear during an early stage of active labor, as compared with multiparous women’s. The challenge for staff of a delivery ward is to support the woman in labor in a way that decreases fear, which in turn might reduce the woman’s need of pain relief.
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| 4. |
- Alehagen, Siw, 1953-, et al.
(författare)
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Fear of childbirth before, during, and after childbirth
- 2006
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 85:1, s. 56-62
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Tidskriftsartikel (refereegranskat)abstract
- Background. Only scanty research exists about the relationship between women's expectations during pregnancy and their experiences as reported during the actual process of labor and afterwards. The aims of the present study were: 1. to investigate the associations between fear of childbirth during pregnancy and postpartum and fear and pain during early active labor (phase 1: cervix dilatation 3–5 cm), and 2. to explore possible differences regarding fear of childbirth during pregnancy and postpartum between women who did or did not receive epidural analgesia during labor.Methods. Fear of childbirth was measured in 47 nulliparous women during gestation weeks 37–39 by means of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ version A). During early active labor we measured women's fear (Delivery Fear Scale) and their experiences of pain (a pain intensity scale). Finally, fear after childbirth (W-DEQ version B) was measured two hours, two days, and five weeks after delivery.Results. A positive correlation appeared between fear of childbirth during pregnancy, postpartum, and early active labor. There were no differences in fear of childbirth during late pregnancy between women who received epidural analgesia and those who did not. Postpartum fear was higher in the women who had received epidural analgesia.Conclusions. Pregnant women who fear childbirth are prone to report fear during the actual labor and postpartum. The administration of epidural analgesia is not a sufficient response to women's fear during the process of labor.
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| 5. |
- Alehagen, Siw, 1953-, et al.
(författare)
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Fear, pain and stress hormones during childbirth
- 2005
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Ingår i: Journal of Psychosomatic Obstetrics and Gynaecology. - : Informa UK Limited. - 0167-482X .- 1743-8942. ; 26:3, s. 153-165
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Tidskriftsartikel (refereegranskat)abstract
- Aims. To investigate the course of fear, pain and stress hormones during labor, and the associations between fear, pain, stress hormones and duration of labor in nulliparous women with and without epidural analgesia (EDA).Method. One day during gestation weeks 37–39, urinary and salivary samples were collected to measure catecholamines and cortisol. Hourly during labor, the participants answered the Delivery Fear Scale and a pain intensity scale, and urinary and salivary samples were collected to measure stress hormones.Results. The course of fear, pain and stress hormones differed throughout labor in women with and without EDA. Pain and cortisol increased throughout labor in women without EDA. Women who received EDA had more fear, but not more pain, before the administration of the EDA than women who did not receive EDA. Pain, fear and catecholamines decreased when women received EDA, but fear and pain increased again later in labor. Fear and pain correlated, as well as levels of fear in the different phases of labor. During phase one of labor epinephrine and duration of the phase were negatively correlated.Conclusion. The course of fear, pain and concentrations of stress hormones differed, highly influenced by the administration of EDA. Fear and pain correlated more pronounced than stress hormones and fear, pain and duration of labor.
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| 6. |
- Alehagen, Siw, et al.
(författare)
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Fear, pain and stress hormones during labor and delivery
- 2005
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Ingår i: Journal of Psychosomatic Obstetrics and Gynaecology. - : Informa UK Limited. - 0167-482X .- 1743-8942. ; 26:3, s. 153-165
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To investigate the course of fear, pain and stress hormones during labor, and the associations between fear, pain, stress hormones and duration of labor in nulliparous women with and without epidural analgesia (EDA).Method: One day during gestation weeks 37-39, urinary and salivary samples were collected to measure catecholamines and cortisol. Hourly during labor, the participants answered the Delivery Fear Scale and a pain intensity scale, and urinary and salivary samples were collected to measure stress hormones.Results: The course of fear, pain and stress hormones differed throughout labor in women with and without EDA. Pain and cortisol increased throughout labor in women without EDA. Women who received EDA had more fear, but not more pain, before the administration of the EDA than women who did not receive EDA. Pain, fear and catecholamines decreased when women received EDA, but fear and pain increased again later in labor. Fear and pain correlated, as well as levels of fear in the different phases of labor. During phase one of labor epinephrine and duration of the phase were negatively correlated.Conclusion: The course of fear, pain and concentrations of stress hormones differed, highly influenced by the administration of EDA. Fear and pain correlated more pronounced than stress hormones and fear, pain and duration of labor.
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| 7. |
- Alehagen, Siw, et al.
(författare)
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Pre- and postpartum fear of childbirth and fear and pain during labor
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Aims: The aims of the present study were 1) to investigate the associations between fear of childbirth during pregnancy and postpartum and fear and pain during labor (phase 1: cervix dilatation 3-5 cm), and 2) to explore possible differences regarding fear of childbirth during pregnancy and postpartum between women who did or did not receive epidural analgesia (EDA) during labor.Method. During gestation weeks 37-39, in 47 nulliparous women fear of childbirth was measured by means of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) version A. Early during labor (labor phase I = cervix dilatation 3-5cm) the women's fear (Delivery Fear Scale) and their experiences of pain (a pain intensity scale) were measured hourly. Finally, fear after childbirth (W-DEQ version B) was measured two hours, two days, and five weeks after delivery.Results. Fear of childbirth during pregnancy and in the three postpartum measures was positively related to fear during labor, phase I. Pain during phase 1 of labor was neither associated with fear of childbirth measured during late pregnancy, nor with postpartum fear. There were no differences in fear of childbirth during late pregnancy between those women who received EDA and those who did not. Postpartum fear was higher in those women who had received EDA.Conclusion. Late pregnant women who fear childbirth are prone to have a fearful delivery, as reported during the actual labor and postpartum.
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| 8. |
- Brohede, Sabina
(författare)
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Body Dysmorphic Disorder : Capturing a prevalent but under-recognized disorder
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundIndividuals with body dysmorphic disorder (BDD) are highly distressed due to defects they perceive in their physical appearance that are not noticeable to others. The condition often leads to impaired functioning in relationships, socialization, and intimacy and a decreased ability to function in work, school, or other daily activities. Although BDD seems to be relatively prevalent, it is under-recognized by people in general and by health care professionals. Individuals with BDD are secretive about their symptoms, and they usually do not recognize that they are suffering from a psychiatric disorder. Instead, in an attempt to relieve their symptoms by correcting their perceived defects, they commonly seek dermatological treatment or cosmetic surgery. However, such interventions usually do not result in any decrease in BDD symptom severity, but can rather aggravate the symptoms. Therefore, it is crucial that health care professionals recognize BDD in order to offer adequate care. Prior to the studies conducted for this thesis, there were no known data regarding the prevalence of BDD in Sweden.Main aims(i) To translate a screening questionnaire for BDD (the Body Dysmorphic Disorder Questionnaire, BDDQ) into Swedish and validate the questionnaire in a community sample. (ii) To estimate the prevalence of BDD in the general population of Swedish women and in female dermatology patients. (iii) To explore BDD patients’ experiences of living with the disorder, including their experiences of the health care system.MethodsThe BDDQ was validated using the Structured Clinical Interview for DSM-IV (SCID) as the gold standard for diagnosing BDD (Study I). The validated BDDQ was used to estimate the prevalence of BDD in a randomly selected population-based sample of Swedish women (n=2 885) (Study II) and in a consecutive sample of female dermatology patients (n=425) (Study III). In Studies II and III, the Hospital Anxiety and Depression Scale was used to assess symptoms of depression and anxiety. In Study III, quality of life was evaluated by the Dermatology Life Quality Index. BDD patients’ lived experiences were explored using a qualitative research design (Study IV). Fifteen individuals with BDD were interviewed, and the interviews were analysed using Interpretive Description.ResultsThe Swedish translation of the BDDQ displayed a sensitivity of 94%, a specidicity of 90% and a (positive) likelihood ratio of 9.4. The prevalence of women screening positive for BDD was 2.1% (95% CI 1.7–2.7) in the population-based sample of women and 4.9% (95% CI 3.2–7.4) in the dermatology patients’ sample. The positive predictive value of the BDDQ (71%) gave an estimated BDD prevalence of 1.5% (95% CI 1.1–2.0) in the female Swedish population. Women screening positive for BDD had signidicantly more symptoms of anxiety and depression compared to those screening negative for BDD in both samples. In the dermatology patients, quality of life was severely impaired in patients with positive BDD screening. The overarching concept found in Study IV was that patients with BDD felt imprisoned and were struggling to become free and to no longer feel abnormal. The participants had encountered difdiculties in accessing health care and had disappointing experiences of the health care system.ConclusionThe findings of this thesis indicate that BDD is a relatively common disorder in the Swedish female population, and that it is more prevalent in dermatology patients. BDD patients struggle to be free from a feeling of imprisonment, and in this struggle they encounter difficulties in accessing health care. Therefore, it is important to increase awareness and recognition of BDD among health care professionals to ensure that patients with BDD receive the appropriate care.
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| 9. |
- Brohede, Sabina, et al.
(författare)
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Body dysmorphic disorder in female Swedish dermatology patients
- 2017
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Ingår i: International Journal of Dermatology. - : WILEY. - 0011-9059 .- 1365-4632. ; 56:12, s. 1387-1394
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIndividuals with body dysmorphic disorder (BDD) are highly distressed and impaired owing to perceived defects in their physical appearance that are not noticeable to others. They are frequently concerned about their skin and often present to dermatologists rather than psychiatrists. However, BDD patients attending dermatology clinics may be at risk of not receiving an appropriate assessment and beneficial treatment. The aims of this study were to estimate the BDD prevalence rate among Swedish female dermatology patients and to assess the psychological condition of BDD patients compared to that of other dermatology patients. MethodsThe occurrence of BDD was estimated using the Body Dysmorphic Disorder Questionnaire (BDDQ), a validated self-report measure for BDD. Symptoms of depression and anxiety were measured by the Hospital Anxiety and Depression Scale (HADS), and quality of life was assessed using the Dermatology Life Quality Index (DLQI). ResultsThe prevalence rate of BDD among female Swedish dermatology patients was 4.9% (95% CI 3.2-7.4). Anxiety (HADS A11) was 4-fold more commonly reported by patients with positive BDD screening (48% vs. 11%), and depression (HADS D11) was over 10-fold more common in patients with positive BDD screening (19% vs. 1.8%) (Pamp;lt;0.001). The median DLQI score was 18 in the BDD group, compared to a score of 4 in the non-BDD group (Pamp;lt;0.001). ConclusionsOur results indicate that BDD is fairly common among female Swedish dermatology patients (4.9%) and that BDD patients have high levels of depression and anxiety and severely impaired quality of life.
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| 10. |
- Brohede, Sabina, et al.
(författare)
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'I will be at death's door and realize that I've wasted maybe half of my life on one body part' : the experience of living with body dysmorphic disorder
- 2016
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Ingår i: International journal of psychiatry in clinical practice (Print). - : Taylor & Francis. - 1365-1501 .- 1471-1788. ; 20:3, s. 191-198
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The purpose of this study was to explore the experiences of patients living with body dysmorphic disorder (BDD), including their experiences with the health care system.Methods: Fifteen individuals with BDD were interviewed, and interpretive description was used to analyse the interviews.Results: The following six themes were identified: being absorbed in time-consuming procedures, facing tension between one's own ideal and the perceived reality, becoming the disorder, being restricted in life, attempting to reduce one's problems and striving to receive care. The overarching concept derived from the themes was feeling imprisoned - struggling to become free and to no longer feel abnormal.Conclusions: Ideas of imprisonment and abnormality compose the entire experience of living with this disorder. Although the participants suffered greatly from their BDD, these patients encountered difficulties in accessing health care and had disappointing experiences during their encounters with the health care system. Therefore, it is important to increase awareness and knowledge of BDD among health care professionals to ensure that patients with BDD receive the appropriate care.
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| 11. |
- Brohede, Sabina, et al.
(författare)
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Prevalence of body dysmorphic disorder among Swedish women: A population-based study
- 2015
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Ingår i: Comprehensive Psychiatry. - : WB Saunders. - 0010-440X .- 1532-8384. ; 58, s. 108-115
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Tidskriftsartikel (refereegranskat)abstract
- Background: Body dysmorphic disorder (BDD) is characterized by a highly distressing and impairing preoccupation with nonexistent or slight defects in appearance. Patients with BDD present to both psychiatric and non-psychiatric physicians. A few studies have assessed BDD prevalence in representative samples of the general population and have demonstrated that this disorder is relatively common. Our primary objective was to assess the prevalence of BDD in the Swedish population because no data are currently available. Methods: In the current cross-sectional study, 2891 randomly selected Swedish women aged 18-60 years participated. The occurrence of BDD was assessed using the Body Dysmorphic Disorder Questionnaire (BDDQ), which is a validated self-report measure derived from the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria for BDD. In addition, symptoms of depression and anxiety were measured using the Hospital Anxiety and Depression Scale (HADS). Results: The prevalence of BDD among Swedish women was 2.1%. The women with BDD had significantly more symptoms of depression and anxiety than the women without BDD. Depression (HADS depression score greater than= 8) and anxiety (HADS anxiety score greater than= 8) were reported by 42% and 72% of the women with BDD, respectively. Conclusions: The results of the present study indicate that BDD is relatively common among Swedish women (2.1%) and that it is associated with significant morbidity.
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| 12. |
- Brohede, Sabina, et al.
(författare)
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Validation of the Body Dysmorphic Disorder Questionnaire in a community sample of Swedish women
- 2013
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Ingår i: Psychiatry Research. - : Elsevier. - 0165-1781 .- 1872-7123. ; 210:2, s. 647-652
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Tidskriftsartikel (refereegranskat)abstract
- Body Dysmorphic Disorder (BDD) is characterized by a distressing and impairing preoccupation with a nonexistent or slight defect in appearance. Patients with the disorder present to both psychiatric and non-psychiatric physicians. A few studies have assessed BDD prevalence in the general population and have shown that the disorder is relatively common. To date, no BDD assessment instruments have been validated in the general population. Our aim was to validate a brief self-screening instrument, the Body Dysmorphic Disorder Questionnaire (BDDQ), in a female community sample. The BDDQ was translated into Swedish and filled out by 2891 women from a randomly selected community sample. The questionnaire was validated in a subsample of 88 women, using the Structured Clinical Interview for DSM-IV (SCID) together with clinical assessment as the gold standard. In the validation subsample, the BDDQ showed good concurrent validity, with a sensitivity of 94%, a specificity of 90% and a likelihood ratio of 9.4. The questionnaire can therefore be of value when screening for BDD in female populations.
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| 13. |
- Engman, Maria, et al.
(författare)
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Itch and burning pain in women with partial vaginismus with or without vulvar vestibulitis
- 2007
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Ingår i: Journal of Sex and Marital Therapy. - : Informa UK Limited. - 0092-623X .- 1521-0715. ; 33:2, s. 171-186
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Tidskriftsartikel (refereegranskat)abstract
- Fifty-three women with partial vaginismus with or without vulvar vestibulitis and 27 asymptomatic women estimated sensations of burning pain and itch at 20 standardized moments during a standardized penetration situation, including vaginal muscle contractions. Forty-three women with partial vaginismus (81.1%) reported burning pain, 23 (43.4%) itch, and 22 (41.5%) both complaints, compared to 0% of the asymptomatic women. In 17 of 22 cases, burning pain preceded the appearance of itch and in four cases the two complaints coincided. The median time from the moment when burning pain started until itch appeared was 150 seconds.
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| 14. |
- Engman, Maria, et al.
(författare)
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Long-term coital behaviour in women treated with cognitive behaviour therapy for superficial coital pain and vaginismus
- 2010
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Ingår i: Cognitive Behaviour Therapy. - : Routledge. - 1650-6073 .- 1651-2316. ; 39:3, s. 193-202
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the present study was to investigate long-term coital behaviour in women treated with cognitive behaviour therapy (CBT) for superficial coital pain and vaginismus. Data were taken from a questionnaire concerning long-term coital behaviour sent to 59 women who presented to Linköping University Hospital because of superficial coital pain, had been diagnosed with vaginismus, and had been treated with CBT. Data were also traced from therapy records: mean follow-up time was 39 months, the women had suffered for an average of almost 4 years, and required a mean of 14 treatment sessions. Forty-four of the 59 women returned the questionnaire, for a response rate of 74.6%. At follow-up, 81% of the treated women had had intercourse. A majority (61%) rated their ability to have intercourse without pain as 6 or higher (on a scale from 0-10), and 61% rated their ability to enjoy intercourse as 6 or higher (on a scale from 0-10). The proportion of women with positive treatment outcome at follow-up ranged from 81% (able to have intercourse) to 6% (able to have pain-free intercourse). An ability to have intercourse at end of therapy was maintained at follow-up. Two-thirds of the women reported high fulfillment of individual treatment goals. At follow-up, the women estimated a significantly higher self-worth as sex partners, and as women and human beings, than before treatment. Twelve per cent of the original sample had healed after a few assessment sessions and without treatment.
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| 15. |
- Engman, Maria, et al.
(författare)
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Postcoital burning pain and pain at micturition : early symptoms in women with partial vaginismus with or without vulvar vestibulitis?
- 2008
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Ingår i: Journal of Sex and Marital Therapy. - : Informa UK Limited. - 0092-623X .- 1521-0715. ; 34:5, s. 413-428
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Tidskriftsartikel (refereegranskat)abstract
- Twenty-four women with partial vaginismus with or without vulvar vestibulitis participated in a semi-structured telephone interview concerning early signs and development of their pain symptoms during/after intercourse. At the onset of the problem, pain after intercourse was more common than pain during penetration. Pain intensity during penetration increased from the onset of the problem to when the women ceased having intercourse. Pain during penetration lasted for 1 minute, and was most often described as sharp/incisive/bursting, while pain after intercourse had a duration of 2 hours and was described as burning and/or smarting. Post-coital pain during micturition was described by 70% of the women.
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| 16. |
- Nieminen, Katri, 1965-
(författare)
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Clinical aspects of childbirth-related anxiety
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Although giving birth is a positive experience for many, some 10% of pregnant Swedish women suffer from severe fear of childbirth (FOC), which impairs their daily functioning and poses a risk for a negative delivery experience. This thesis focuses on the mental and health-economic effects of severe FOC, and explores new treatment options for childbirth-related anxiety.Aims: (i) to investigate the prevalence of and variables associated with severe FOC, (ii) to estimate the cost of illness of severe FOC and (iii) to explore whether Internetbased cognitive behaviour therapy (ICBT) is feasible for treating pregnant women with severe FOC and those with childbirth-related symptoms of posttraumatic stress disorder (PTSD).Design and Results: Study 1: In a cross-sectional study 1635 pregnant women were asked about their FOC via the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), and provided socio-demographic data and information of their preferred mode of delivery. It was found that 15.6% of the participants had a severe FOC, which also strongly correlated with the preference of a caesarean section. Study 2: In a prospective case-control cohort study we mapped all visits, in-patient care, sick leave and delivery variables from medical records and estimated the societal costs in two groups of women; one group with severe FOC and one with low FOC. The costs for the group with severe FOC were 38% higher than for the low FOC group. Study 3: Twenty-eight nulliparous women with severe FOC were self-recruited to an eight weeks ICBT program for severe FOC. Fifteen women followed the entire program. Their FOC decreased significantly after treatment (Cohen’s d=0.95, p<0.0001), which means that ICBT is feasible and an option for treating women with severe FOC. Study 4: Fifteen participants in Study 3 wrote narratives of the imminent delivery before as well as after therapy. After treatment, the women had a more realistic attitude towards childbirth, more self-confidence and more active coping strategies. Partners and staff were perceived as more helpful, and the women were more aware of the child they were bearing. Study 5: Fifty-six women with a traumatic delivery experience were included in a randomized wait-list controlled study (RCT) of the effects of an eight week long ICBT program for childbirth-related PTSD symptoms. These symptoms decreased in both groups during active therapy, while the between-group effect size varied depending on measurements. Psychiatric comorbidity decreased in both groups after active treatment.Conclusion: Severe FOC is prevalent among Swedish pregnant women, and the cost of illness of this marker of peripartum psychological vulnerability is considerable when treated using standard care. A new treatment option for this group with ICBT seems feasible and is associated with more realistic attitudes towards the imminent delivery. An RCT with eight weeks of ICBT for parous women with PTSD symptoms also had promising results.As severe FOC is prevalent and associated with mental and economic burdens for the individual and the society, there is an urgent need to expand the research field. It is important to find feasible and effective treatments that can be applied on a large scale.
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| 17. |
- Nieminen, Katri, et al.
(författare)
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Nulliparous pregnant womens narratives of imminent childbirth before and after internet-based cognitive behavioural therapy for severe fear of childbirth: a qualitative study
- 2015
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Ingår i: British Journal of Obstetrics and Gynecology. - : Wiley: 12 months. - 1470-0328 .- 1471-0528. ; 122:9, s. 1259-1265
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo describe the expectations concerning imminent childbirth before and after 8weeks of internet-based cognitive behavioural therapy (ICBT) among nulliparous pregnant women with severe fear of childbirth. DesignQualitative study of nulliparous pregnant womens narratives before and after CBT. SettingThe first ICBT programme for treating severe fear of childbirth. SampleFifteen nulliparous pregnant Swedish women with severe fear of childbirth participating in an ICBT self-help programme. MethodsSemi-structured open-ended questions over the internet before and after 8weeks of ICBT. The data were analysed using thematic analysis. Main outcome measuresThe participants narratives pertaining to five different situations during labour and delivery before and after ICBT. ResultsAfter therapy, participants described a more realistic attitude towards imminent childbirth, more self-confidence and more active coping strategies. They perceived their partners and the staff as more supportive. They were more aware of the approaching meeting with their baby when giving birth. ConclusionsFollowing the ICBT programme, participants changed their attitude towards imminent childbirth from negative to more positive. This was manifested in positive and more realistic expectations regarding themselves, their partner and the staff that would look after them.
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| 18. |
- Nieminen, Katri, et al.
(författare)
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Severe fear of childbirth indicates high perinatal costs for Swedish women giving birth to their first child.
- 2017
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : John Wiley & Sons. - 0001-6349 .- 1600-0412. ; 96:4, s. 438-446
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: The objective of this study was to calculate costs associated with severe fear of childbirth (FOC) during pregnancy and peripartum by comparing two groups of women expecting their first child and attending an ordinary antenatal program; one with low FOC and one with severe FOC.MATERIAL AND METHODS: In a prospective case-control cohort study one group with low FOC [Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) sum score ≤60, n = 107] and one with severe FOC (W-DEQ ≥85, n = 43) were followed up till 3 months postpartum and included in the analysis. Medical records were assessed and medical parameters were mapped. Mean costs for healthcare consumption and sick leave during pregnancy were calculated and compared.RESULTS: When means were compared between the groups, the group with severe FOC had more visits for psychosocial reasons (p = 0.001) and more hours on sick leave (p = 0.03) during pregnancy, and stayed longer at the maternity ward (p = 0.04). They also more seldom had normal spontaneous deliveries (p = 0.03), and more often had an elective cesarean section on maternal request (p = 0.02). Postpartum, they more often than the group with low FOC paid visits to the maternity clinic because of complications (p = 0.001) and to the antenatal unit because of adverse childbirth experiences (p = 0.001). The costs for handling women with severe FOC was 38% higher than those for women with low FOC.CONCLUSION: Women with severe FOC generate considerably higher perinatal costs than women with low FOC when handled in care as usual.
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| 19. |
- Nieminen, Katri, et al.
(författare)
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Treatment of nulliparous women with severe fear of childbirth via the Internet : a feasibility study
- 2016
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Ingår i: Journal of Psychosomatic Obstetrics and Gynaecology. - : Taylor & Francis. - 0167-482X .- 1743-8942. ; 37:2, s. 37-43
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of the present study was to test the feasibility of Internet interventions among nulliparous women suffering from severe fear of childbirth (FOC) by means of an Internet-delivered therapist-supported self-help program based on cognitive behavioral therapy (ICBT).Design: Prospective, longitudinal cohort study.Setting: A feasibility study of an ICBT program for the treatment of severe FOC in pregnant women.Sample: Twenty-eight Swedish-speaking nulliparous women with severe FOC recruited via a project home page from January 2012 to December 2013.Methods: The main components of the ICBT program for the treatment of severe FOC comprised psycho-education, breathing retraining, cognitive restructuring, imaginary exposure, in vivo exposure and relapse prevention. The study participants were anonymously self-recruited over the Internet, interviewed by telephone and then enrolled. All participants were offered 8 weeks of treatment via the Internet. Participants reported their homework weekly, submitted measurements of their fear and received feedback from a therapist via a secure online contact management system.Main outcome measures: Level of FOC measured with the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ A) during screening at enrollment and weekly during the treatment (W-DEQ version A), and after the delivery (W-DEQ version B).Results: A statistically significant (p < 0.0005) decrease of FOC [W-DEQ sum score decreased pre to post-therapy, with a large effect size (Cohen’s d = 0.95)].Conclusions: The results of this feasibility study suggest that ICBT has potential in the treatment of severe FOC during pregnancy in motivated nulliparous women. The results need to be confirmed by randomized controlled studies.
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| 20. |
- Ryding, E.L., et al.
(författare)
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Emergency cesarean section : 25 Women's experiences
- 2000
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Ingår i: Journal of Reproductive and Infant Psychology. - : Informa UK Limited. - 0264-6838 .- 1469-672X. ; 18:1, s. 33-39
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to investigate the possibility to categorize women's experiences of emergency cesarean section based on the patterns displayed in their narration of the event, and to describe, if possible, typical features of those categories. Twenty-five consecutive women were interviewed a few days and 1-2 months after emergency cesarean section. The narratives of the women were recorded according to a time-spatial model from disaster psychiatry. The occurrence of a traumatic delivery experience and of posttraumatic intrusive stress reactions 6 weeks postpartum in the various categories was assessed. The narratives of the 25 women can be categorized as follows: Pattern 1 - confidence whatever happens (n = 5), Pattern 2 - positive expectations turning into disappointment (n = 7), Pattern 3 - fears that come true (n = 9), and Pattern 4 - confusion and amnesia (n = 4). In the second and third groups all women had experienced the delivery as traumatic. The women in the second group had the highest prevalence of posttraumatic intrusive stress reactions 6 weeks after the emergency cesarean section.
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| 21. |
- Samelius, Charlotta, 1964-
(författare)
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Abused Women : Health, Somatization, and Posttraumatic Stress
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aims of this thesis were to estimate the lifetime prevalence of physical, sexual, and psychological abuse in a random population-based sample of women aged 18-60 years; to estimate current suffering thereof; and to investigate associations between abuse and health problems, more specifically to study abuse related variables associated with somatization and PTSD, respectively.The studies had a cross-sectional design. Studies I and II comprised 4150 women 18-60 years. Study III included 547 women, and study IV consisted of 213 women, randomly selected from the population-based sample of the first two studies.The first study found lifetime prevalence rates of 19.4% for physical abuse, 9.2% for sexual abuse, and 18.2% for psychological abuse. Abused women reported more ill-health and a less advantageous social situation than non-abused women. There was an association between magnitude of abuse and health problems. Even a low magnitude of abuse was substantially associated with ill-health. In the second study we found that of the 27.5% of women who had reported any kind of abuse in the first study, 69.5 % reported current suffering thereof. Abused suffering women reported more health problems than abused non-suffering women and non-abused women, and abused non-suffering women reported more health problems than non-abused women. In study three, psychological abuse and sexual abuse without penetration were found to be associated with somatization. Physical abuse and sexual abuse with penetration were not associated with somatization, when adjustments for other kinds of abuse were made. In study four, PTSD and somatization were found to be separately reported phenomena in abused women, although PTSD was positively associated with having somatic symptoms. Women with PTSD reported higher total magnitude of abuse and a higher number of perpetrators than women with somatization. Sexually abused women with PTSD more often described their experience as an act of abuse compared with sexually abused women with somatization.The present thesis demonstrates that even a low magnitude of abuse is associated with health problems. It also shows that a majority of the abused women, when investigating lifetime history of abuse, reported current suffering thereof, which warrants considering abuse an important societal problem. The relationship between somatization and posttraumatic stress in abused women is discussed in relation to abuse variables. Other factors than severity of abuse, such as whether the abused woman herself perceives her experience as abuse, seem to be more decisive for development of somatization in abused women. The findings suggest that PTSD is not a necessary mediator between abuse and somatization.
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| 22. |
- Samelius, Charlotta, et al.
(författare)
-
Lifetime history of abuse, suffering, and psychological health
- 2010
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 64:4, s. 227-232
-
Tidskriftsartikel (refereegranskat)abstract
- Background: In a representative Swedish sample, we investigated lifetime prevalence of physical, sexual and psychological abuse of women and their current suffering. The relationship between current suffering from abuse and psychological health problems was also studied. Method: The study was cross-sectional and population-based. The Abuse Screening Inventory (ASI), measuring experiences of physical, sexual and psychological abuse and including questions on health and social situation, was sent by mail to 6000 women, randomly selected from the population register. The questionnaire was completed and returned by 4150 (70%) of 5896 eligible women. Results: 27.5% of the women reported abuse of any kind. Of those, 69.5% reported current suffering from abuse. Abused suffering women reported more anxiety, depression and sleep disturbances, and a less advantageous social situation than both non-abused and abused non-suffering women. Also, abused non-suffering women reported more depression than non-abused women. Somatization was reported more often by both abused suffering and non-suffering women than by non-abused women, with no difference between suffering and non-suffering women when adjusted for possible confounders. Conclusion: A majority of abused women, when investigating lifetime history of abuse, report current suffering thereof, which warrants considering abuse an important societal problem. Suffering could be a valuable construct, possibly useful to assess psychological health problems normally not captured by existing diagnostic instruments, although further investigations of the concept are needed.
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| 23. |
- Samelius, Charlotta, et al.
(författare)
-
Post-traumatic stress and somatization in abused women
- 2009
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Ingår i: Traumatology. - : Sage Publications. - 1534-7656 .- 1085-9373. ; 15:1, s. 103-112
-
Tidskriftsartikel (refereegranskat)abstract
- This study examines the relationship between posttraumatic stressdisorder (PTSD) and somatization in abused women; 213 abusedwomen were assessed for PTSD, somatization, health care contacts,and abuse-related variables. The main analyses in this exploratorystudy are based on the 91 respondents reporting either PTSDor somatization. We found no association between the occurrenceof PTSD and somatization in abused women. Women with PTSD reportedhigher total magnitude of abuse and a larger number of perpetratorsthan women with somatization. Sexually abused women with PTSDmore often described their experience as an act of abuse comparedwith sexually abused women with somatization. Results suggestthat PTSD might not be a necessary mediator between abuse andsomatization and that variables other than abuse magnitude aredecisive for the development of somatization in abused women.
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| 24. |
- Siwe, Karin, et al.
(författare)
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Medical students learning the pelvic examination : Comparison of outcome in terms of skills between a professional patient and a clinical patient model
- 2007
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 68:3, s. 211-217
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare two models of learning the pelvic examination (PE) for medical students, with professional patients (PP) or with clinical patients (CP), by measuring perceived distress and learning outcome in terms of skills. Methods: Prospective longitudinal study. Assessments of self-perceived distress on four occasions at the prospect of performing a PE. Evaluation of the learning session (LS) and clinical clerkship concerning outcome of palpation skills. Results: During the LS, students in the PP model (PP students) received enough guidance from their coaches, were certain they had palpated the uterus and at least one ovary, and were less distressed afterwards compared with students who were instructed using the CP model (CP students). During the clinical clerkship, the PP students performed twice as many PEs as CP students did and had more often confirmed palpating the uterus and an ovary. Conclusion: PP students were more skilful in palpating the uterus and ovaries and performed more PEs during the clinical clerkship than did CP students. Practice implications: Engaging healthy and voluntary women as PPs takes time and effort. It is, however, worthwhile as it increases the confidence of students who perform PEs, makes them more competent, and ultimately improves their skills in performing the examination during their clinical clerkship.
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| 25. |
- Sluijs, Anne-Marie, et al.
(författare)
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Is fear of childbirth related to the womans preferred location for giving birth? A Dutch low-risk cohort study
- 2020
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Ingår i: Birth. - : WILEY. - 0730-7659 .- 1523-536X. ; 47:1, s. 144-152
-
Tidskriftsartikel (refereegranskat)abstract
- Background In The Netherlands, women with low-risk pregnancy are routinely given the option of home birth, providing a unique opportunity to study the relationship between fear of childbirth (FOC) and preference for childbirth location, and whether women experience higher FOC when the actual location differs from their preference. Methods In this prospective cohort study, 331 nulliparous and parous women completed a questionnaire at gestational week 30 (T1) and two months postpartum (T2). FOC was assessed using versions A (T1) and B (T2) of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ). Results At T1, women who preferred home birth had significantly lower FOC compared with women who preferred a hospital birth (mean +/- SD W-DEQ scores: 55 +/- 19.8 and 64 +/- 18.3, respectively, P amp;lt; .01). About 28% of women who responded at T2 gave birth at home. Congruence between the preferred and actual childbirth location was not predictive of FOC assessed at T2 when adjusted for obstetric and psychological variables. In an extended analysis, we found that except for prepartum FOC, the following variables also correlated with postpartum FOC: being referred because of complications and poor neonatal condition. Conclusions Compared to women who prefer hospital birth, women who prefer home birth have lower prepartum and postpartum FOC. Giving birth at a location other than the preferred location does not appear to affect postpartum FOC. Whether giving birth at home or in the hospital, caregivers should pay extra attention to women with high FOC because they are vulnerable to postpartum FOC, especially after a complicated birth and referral.
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| 26. |
- Sluijs, Anne-Marie, et al.
(författare)
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Preferred and actual mode of delivery in relation to fear of childbirth
- 2020
-
Ingår i: Journal of Psychosomatic Obstetrics and Gynaecology. - : TAYLOR & FRANCIS LTD. - 0167-482X .- 1743-8942. ; 41:4, s. 266-274
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: This prospective cohort study aimed to investigate the interrelation between preferred/actual mode of delivery and pre- and postpartum fear of childbirth (FOC). Material and methods: Participants from 13 midwifery practices and four hospitals in Southwest Netherlands filled out questionnaires at 30 weeks gestation (n = 561) and two months postpartum (n = 463), including questions on preferred mode of delivery, the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) and Hospital Anxiety Depression Scale (HADS). Results were related to obstetric data. Results: Both severe FOC (OR 7.0, p amp;lt; .001) and previous Cesarean section (CS) (OR 16.6, p amp;lt; .001) predicted preference for CS. Severe prepartum FOC also predicted actual CS. Preferring a vaginal delivery (VD) and actually having a CS predicted higher postpartum W-DEQ scores (partial r = 0.107, p amp;lt; .05). Other significant predictors for high postpartum W-DEQ scores were high prepartum W-DEQ (partial r = 0.357) and HADS anxiety scores (partial r = 0.143) and the newborn in need of medical assistance (partial r = -0.169). Conclusions: Women preferring a VD but ending up with a CS are at risk for severe FOC postpartum, while the same risk was not demonstrated for women who preferred a CS but had a VD. Prepartum FOC is strongly associated with postpartum FOC, regardless of congruence between preferred and actual mode of delivery.
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| 27. |
- Söderquist, Johan, et al.
(författare)
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Risk factors in pregnancy for post-traumatic stress and depression after childbirth
- 2009
-
Ingår i: BJOG - An international journal of obstetrics and gynaecology. - : Wiley. - 1470-0328. ; 116:5, s. 672-680
-
Tidskriftsartikel (refereegranskat)abstract
- Objective The objective of this study was to find risk factors in pregnancy for post-traumatic stress and depression 1 month after childbirth. Furthermore, the relation between post-traumatic stress and depression was explored.Design A prospective longitudinal study.Setting Pregnant women in Linköping and Kalmar, Sweden.Population A total of 1224 women were assessed in pregnancy, week 12–20 and 32, as well as 1 month postpartum.Methods Post-traumatic stress and depression after delivery were assessed 1 month postpartum. Potential risk factors were assessed in early and late pregnancy. Variables measured during pregnancy were trait anxiety, depression, fear of childbirth, childbirth-related traumatic stress, stress coping capacity, social support, parity, educational level, age, gestation week, parity, educational level, civil status, previous psychological/psychiatric counselling, and previous experience of any traumatic events. Delivery mode was assessed from the medical records.Main outcome measures Prevalence of post-traumatic stress (criteria A, B, C, D, E, and F according to DSM-IV) and depression (Beck’s depression inventory).Results One month postpartum, 12 (1.3%) women had post-traumatic stress (met symptom criteria B, C, and D for post-traumatic stress disorder according to Diagnostic and statistical manual of mental disorders, 4th edition [DSM-IV]). The most important risk factors in pregnancy were depression in early pregnancy (OR = 16.3), severe fear of childbirth (OR = 6.2), and ‘pre’-traumatic stress (in view of the forthcoming delivery) in late pregnancy (OR = 12.5). The prevalence of depression was 5.6%. Post-traumatic stress and depression were positively related 1 month postpartum and were predicted by mainly the same factors.Conclusions Risk factors for post-traumatic stress and depression after childbirth can be assessed in early pregnancy. Post-traumatic stress and depression also seem to share the same underlying vulnerability factors.
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| 28. |
- Söderquist, Johan, 1968-, et al.
(författare)
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The longitudinal course of post-traumatic stress after childbirth
- 2006
-
Ingår i: Journal of Psychosomatic Obstetrics and Gynaecology. - : Informa UK Limited. - 0167-482X .- 1743-8942. ; 27:2, s. 113-119
-
Tidskriftsartikel (refereegranskat)abstract
- Post-traumatic stress was assessed in early and late pregnancy, and 1, 4, 7, and 11 months postpartum by means of questionnaires among 1224 women. Thirty-seven women (3%) had post-traumatic stress (meeting criteria B, C, and D for PTSD) at least once within 1–11 months postpartum. In pregnancy, depression, severe fear of childbirth, ‘pre’-traumatic stress, previous counseling related to pregnancy/childbirth, and self-reported previous psychological problems were associated with an increased risk of having post-traumatic stress within 1–11 months postpartum. Sum-scores of post-traumatic stress did not decrease over time among women who at least once had post-traumatic stress (criteria B, C, and D) within 1–11 months postpartum. Women with post-traumatic stress also showed a decrease in perceived social support over time postpartum.
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| 29. |
- Söderquist, Johan, 1968-, et al.
(författare)
-
Traumatic stress after childbirth : the role of obstetric variables
- 2002
-
Ingår i: Journal of Psychosomatic Obstetrics and Gynaecology. - : Informa UK Limited. - 0167-482X .- 1743-8942. ; 23:1, s. 31-39
-
Tidskriftsartikel (refereegranskat)abstract
- In a sample of 1550 recently delivered women, traumatic stress after childbirth was studied in relation to obstetric variables.A post-traumatic stress disorder (PTSD) symptom profile and traumatic stress symptoms were assessed by means of the Traumatic Event Scale (TES) Obstetric data comprised delivery mode, duration of the second stage of labor (the time from cervical dilation of 10 cm to partus) and the use of analgesia/anesthesia.Traumatic stress symptoms and having a PTSD symptom profile were both significantly related to the experience of an emergency cesarean section or an instrumental vaginal delivery It is of clinical importance, however that most women with a PTSD symptom profile were found in the normal vaginal delivery group (NVD) This implies that a normal vaginal delivery can be experienced as traumatic, lust as an emergency cesarian section is not necessarily traumatic Traumatic stress symptoms were neither substantially correlated to the duration of the second stage of labor, nor to the use of analgesia/anesthesia.
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| 30. |
- Söderquist, Johan, et al.
(författare)
-
Traumatic stress in late pregnancy
- 2004
-
Ingår i: Journal of Anxiety Disorders. - 0887-6185 .- 1873-7897. ; 18:2, s. 127-142
-
Tidskriftsartikel (refereegranskat)abstract
- Traumatic stress has traditionally been studied in the aftermath of traumatic events. In contrast, this study aimed to explore if traumatic stress can occur before an event that is perceived as threatening or feared. Traumatic stress, as related to the forthcoming delivery, was studied in 1224 women. Background data and psychological characteristics were assessed in early pregnancy and traumatic stress and fear of childbirth in late pregnancy. Of all subjects, 2.3% met all DSM-IV criteria for posttraumatic stress disorder (PTSD) and 5.8% fulfilled criteria B, C, and D in late pregnancy. Traumatic stress and fear of childbirth correlated significantly. High trait anxiety, depressive symptomatology, psychological/psychiatric counseling related to childbirth, and self-reported psychological problems, measured in early pregnancy, were risk factors for traumatic stress and fear of childbirth in late pregnancy. Results suggest the occurrence of “pre”traumatic stress (i.e., a threatening forthcoming event provoking symptoms similar to those after a traumatic event).
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| 31. |
- Wijma, Barbro, 1944-, et al.
(författare)
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A model for critical review of literature - With vaginismus as an example
- 2007
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Ingår i: Journal of Psychosomatic Obstetrics and Gynaecology. - : Informa UK Limited. - 0167-482X .- 1743-8942. ; 28:1, s. 21-36
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Tidskriftsartikel (refereegranskat)abstract
- In this article we present a behavioral model for the critical review of the literature within a certain research field, using vaginismus as an example. We searched the literature for the title word "vaginismus" and analyzed to what extent the articles dealt with the following seven categories: prevention, etiology, maintaining factors, consequences, object of intervention, method of intervention, and method of evaluation. In each category we scrutinized the content of the articles for biological, psychological, social, relational, and gender aspects. Quality requirements of etiological and treatment studies were then added and the results presented in a "quality-adjusted" model. There were 102 articles during 1985-2001, of which 22 were included in the review. Most of the articles deal with supposed predisposing factors of etiology and different aspects of intervention. Only a few articles discuss precipitating factors, maintaining factors, or consequences of the problem. No article had a gender analysis. Only 11 of the articles fulfilled some of the proposed quality criteria. We found the behavioral model with quality requirements useful for classifying and evaluating the literature of vaginismus. The model may also be used as a guide to design methodologically good studies. © 2007 Informa UK Ltd.
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| 32. |
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| 33. |
- Wijma, Barbro, et al.
(författare)
-
Kronisk bäckensmärta
- 2004
-
Ingår i: Öppenvårdsgynekologi. - Stockholm : Liber. - 9147050799 - 9789147050796 ; , s. 268-280
-
Bokkapitel (refereegranskat)abstract
- Öppenvårdsgynekologi är en lärobok som riktar sig främst till läkarstuderande och allmänmedicinare. Vanliga åkommor och problem belyses och boken försöker att ge aktuella behandlingsråd och riktlinjer som går att tillämpa i det dagliga sjukvårdsarbetet. Den är därför en värdefull kunskapskälla även för gynekologer, distriktssjuksköterskor och barnmorskor. I denna andra upplaga har ett helt nyskrivet kapitel tillkommit som behandlar ultraljud inom gynekologin. Boken har försetts med en ny layout, delvis nya illustrationer och med mjuka pärmar för att göra boken mer lättillgänglig och användarvänlig i det dagliga arbetet.
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| 34. |
- Wijma, Barbro, 1944-, et al.
(författare)
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Total och partiell vaginism
- 2003
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Ingår i: Vulvasjukdomar. - Stockholm : Svensk Förening för Obstetrik och Gynekologi (SFOG). ; , s. 59-62
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 35. |
- Wijma, Barbo, et al.
(författare)
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Vulvar vestibulitis syndrome and vaginismus : A case report
- 2000
-
Ingår i: Journal of reproductive medicine. - 0024-7758 .- 1943-3565. ; 45, s. 219-223
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Recent reports have argued for a revision of the criteria used for the establishment of a diagnosis of vulvar vestibulitis syndrome (VVS). On theoretical grounds it might be hypothesized that women with VVS also suffer from vaginismus. CASE: A young woman presented with a history, symptoms and objective findings typical of vaginismus, yet she suffered from continuous, burning pain and itching in the vestibule. Earlier in the course of the problem she had received a diagnosis VVS. The patient was treated with behavioral therapy developed for vaginismus. Notations made during the course of therapy supported the assumption that the pain and itching were conditioned responses to penetration in the same way that a vaginal muscular reflex is. CONCLUSION: Differential diagnostic difficulties exist in the field of VVS and vaginismus. Psychophysiologic theories are needed as the basis for research to clarify the connections between different diagnostic entities associated with coital burning pain and itching in the vestibule.
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| 36. |
- Wijma, Klaas, 1946-, et al.
(författare)
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Development of the delivery fear scale
- 2002
-
Ingår i: Journal of Psychosomatic Obstetrics and Gynaecology. - : Informa UK Limited. - 0167-482X .- 1743-8942. ; 23:2, s. 97-107
-
Tidskriftsartikel (refereegranskat)abstract
- This article reviews the development of the Delivery Fear Scale (DFS) to measure fear during labor and delivery.In an initial study, 92 women in labor answered a list of 60 items, expressing fear-related appraisals and their contrasts that were characteristic of women in labor. Ten items were then selected by means of an item-total analysis. In a second study, the final list of ten items was tested psychometrically and a semi-structured interview was performed on 45 women in labor, to explore the women s descriptions of the content of each of the ten items. According to the content analysis of the interviews, the dominating connotation of the ten items is fear based on the appraisal of being captured. The studies show that the DFS is a questionnaire that almost effortlessly can be completed within 60-90 seconds during any moment of labor and delivery. The scale has a good reliability: Cronbach‘s alpha was 0.88 in both studies.
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| 37. |
- Wijma, Klaas, et al.
(författare)
-
Posttraumatic stress disorder after childbirth : a cross sectional study
- 1997
-
Ingår i: Journal of Anxiety Disorders. - 0887-6185 .- 1873-7897. ; 11:6, s. 587-597
-
Tidskriftsartikel (refereegranskat)abstract
- The prevalence of having a posttraumatic stress disorder (PTSD) profile after childbirth and women's cognitive appraisal of the childbirth were studied cross sectionally in an unselected sample of all women who had given birth over a 1-year period in Linköping, Sweden. The PTSD profile was assessed by means of Traumatic Event Scale (TES), which is based on diagnostic criteria from Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV; American Psychiatric Association, 1994). The women's cognitive appraisal of the childbirth was measured by means of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ). Twenty-eight women (1.7%) of 1640 met criteria for a PTSD profile related to the recent delivery. A PTSD profile was related to a history of having received psychiatric/psychological counseling, a negative cognitive appraisal of the past delivery, mulliparity, and rating the contact with delivery staff in negative terms.
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| 38. |
- Wijma, Klaas, et al.
(författare)
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Predicting psychological well-being after emergency caesarean section : A preliminary study
- 2002
-
Ingår i: Journal of Reproductive and Infant Psychology. - : Informa UK Limited. - 0264-6838 .- 1469-672X. ; 20:1, s. 25-36
-
Tidskriftsartikel (refereegranskat)abstract
- The experience of emergency caesarean section (EmCS) is traumatic for many women. Up to now, a possible relationship between psychological variables before and after EmCS has not been studied. Therefore, the present study was designed, to examine whether the women's psychological condition during pregnancy correlates with their psychological well-being after EmCS. Questionnaires were administered in gestation week 32, a few days and one month after EmCS. A consecutive sample of pregnant women (N = 1981) completed questionnaires (the predictors) at Time 1. Predictors were operationalized by means of the Wijma-Delivery Expectancy/Experience Questionnaire (W-DEQ vers. A), the Spielberger Trait Anxiety Inventory (STAI) and the Stress Coping Inventory (SCI). Of those women who had an EmCS (N = 97), a selection (N = 40) completed questionnaires (the criterion variables) at Times 2 and 3. The criterion variables were operationalized by means of the W-DEQ vers. B, the Impact of Event Scale (IES), and the Symptom Checklist (SCL). Fear of childbirth (W-DEQ vers. A) was the best overall predictor of the three criterion variables, whereas general anxiety (STAI) was the best predictor of mental distress (SCL) after EmCS. In conclusion, according to the results of this study, particularly fear of childbirth during late pregnancy, but also general anxiety, is associated with mental distress after a subsequent EmCS. Maternal follow-up after a complicated delivery should perhaps be directed especially to women with a history of serious fear of childbirth and/or other anxiety difficulties during gestation.
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| 39. |
- Wijma, Klaas, 1946-, et al.
(författare)
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Prevalence of post-traumatic stress disorder among gynecological patients with a history of sexual and physical abuse
- 2000
-
Ingår i: Journal of Interpersonal Violence. - 0886-2605 .- 1552-6518. ; 15:9, s. 944-958
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Tidskriftsartikel (refereegranskat)abstract
- All patients who visited the Department of Obstetrics and Gynaecology of Link÷ping, Sweden over a 2-week period were sent a questionnaire about experiences of sexual/physical abuse and the Traumatic Event Scale, assessing post-traumatic stress disorder (PTSD). Of 649 patients, 26.3% showed a history of sexual or physical abuse in childhood or adulthood. Childhood and adulthood sexual abuse were experienced by 11.6% and 6.5%, respectively, childhood and adulthood physical abuse by 16.9% and 7.9%, respectively. Twenty-nine of all participants (4.5%) met PTSD criteria, according to the Diagnostic and Statistical Manual. PTSD was associated with multiple experiences of abuse. The frequency of PTSD symptoms was positively related to the amount and recency of abuse. PTSD participants reported more visits to a physician than abused non-PTSD and nonabused participants. The PTSD group reported less satisfaction than the other two groups with (a) contact with the physician and (b) the help received during visits to the clinic.
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| 40. |
- Wijma, Klaas, et al.
(författare)
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The association between ill-health and abuse: a cross-sectional population-based study
- 2007
-
Ingår i: Scandinavian Journal of Psychology. - : Wiley-Blackwell. - 0036-5564 .- 1467-9450. ; 48:6, s. 567-575
-
Tidskriftsartikel (refereegranskat)abstract
- The lifetime prevalence of physical, sexual and psychological abuse was studied cross-sectionally in a representative sample of Swedish women. The association between the three kinds of abuse and ill-health, and the relation between magnitude of abuse and various health problems were also investigated. The Abuse Screening Inventory (ASI), measuring experiences of physical, sexual and psychological abuse and including questions on health and social situation, was sent by mail to 6,000 women, randomly selected from the population register. The questionnaire was completed and returned by 4,150 (70%) of 5,896 eligible women. Various kinds of abuse were reported by 1,142 women (27.5%). The prevalence rates were 19.4% for physical abuse, 9.2% for sexual abuse and 18.2% for psychological abuse. Abused women reported more ill-health and a less advantageous social situation than non-abused women. There was an association between magnitude of abuse and health problems. Also a low magnitude of abuse was substantially associated with ill-health.
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| 41. |
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| 42. |
- Zar, M, et al.
(författare)
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Relations between anxiety disorders and fear of childbirth during late pregnancy
- 2002
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Ingår i: Clinical Psychology and Psychotherapy. - : Wiley. - 1063-3995 .- 1099-0879. ; 9:2, s. 122-130
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Tidskriftsartikel (refereegranskat)abstract
- In a group of late pregnant women we investigated the prevalence of extreme fear of childbirth and anxiety disorders, both assessed by means of diagnostic interviews. We also explored the relation between anxiety disorders and extreme fear of childbirth on the one hand and fear of childbirth, as measured by means of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), on the other hand. A subgroup of women (2.4%) fulfilled the criteria for a phobia-like fear of childbirth. Anxiety disorders were related to fear of childbirth, as measured by the W-DEQ. The group of women with extreme fear of childbirth (with or without anxiety disorders) had obviously the highest W-DEQ scores. But also in the group of women with anxiety disorders only the W-DEQ scores were high. Clinical assessment of anxiety disorders among pregnant women should be considered, above all in women who report fear of the anticipated delivery. Copyright ⌐ 2002 John Wiley & Sons, Ltd.
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| 43. |
- Andersson, Erik, et al.
(författare)
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A Randomized Controlled Trial of Guided Internet-delivered Cognitive Behavioral Therapy for Erectile Dysfunction
- 2011
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Ingår i: Journal of Sexual Medicine. - : Wiley-Blackwell. - 1743-6095 .- 1743-6109. ; 8:10, s. 2800-2809
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Tidskriftsartikel (refereegranskat)abstract
- Introduction. Men with erectile dysfunction are often worried about their condition, have interpersonal difficulties, and have a reduced quality of life. Internet-delivered cognitive behavior therapy (ICBT) has been shown effective for a number of health problems but evidence is limited concerning the treatment of erectile dysfunction. less thanbrgreater than less thanbrgreater thanAim. The study investigated the effects of ICBT for erectile dysfunction. less thanbrgreater than less thanbrgreater thanMethods. Seventy-eight men were included in the study and randomized to either ICBT or to a control group, which was an online discussion group. Treatment consisted of a 7-week Web-based program with e-mail-based therapist support. Each therapist spent an average of 55 minutes per participant. less thanbrgreater than less thanbrgreater thanMain Outcome Measure. The International Index of Erectile Functioning five-item version was administered via the telephone at pretreatment, post-treatment, and 6 months after receiving ICBT. less thanbrgreater than less thanbrgreater thanResults. At post-treatment, the treatment group had significantly greater improvements with regard to erectile performance compared with the control group. Between-group differences at post-treatment were small (d = 0.1), but increased at the 6-month follow-up (d = 0.88). less thanbrgreater than less thanbrgreater thanConclusions. This study provides support for the use of ICBT as a possible treatment format for erectile dysfunction.
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| 44. |
- Ayers, Susan, et al.
(författare)
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Post-traumatic stress disorder following childbirth : current issues and recommendations for future research
- 2008
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Ingår i: Journal of psychosomatic obstetrics and gynaecology. - : Informa UK Limited. - 0167-482X .- 1743-8942. ; 29:4, s. 240-250
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Tidskriftsartikel (refereegranskat)abstract
- Background: An increasing body of research shows that a proportion of women experience significant symptoms of Post-Traumatic Stress Disorder (PTSD) following childbirth. Aims and method: An international group of researchers, clinicians, and user-group representatives met in 2006 to discuss the research to date into PTSD following childbirth, issues and debates within the field, and recommendations for future research. This paper reports the content of four discussions on (1) prevalence and comorbidity, (2) screening and treatment, (3) diagnostic and conceptual issues, and (4) theoretical issues. Conclusions: Current knowledge from the perspectives of the researchers is summarized, dilemmas are articulated and recommendations for future research into PTSD following childbirth are made. In addition, methodological and conceptual issues are considered.
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| 45. |
- Ayers, S., et al.
(författare)
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The aetiology of post-traumatic stress following childbirth: a meta-analysis and theoretical framework
- 2016
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Ingår i: Psychological Medicine. - : CAMBRIDGE UNIV PRESS. - 0033-2917 .- 1469-8978. ; 46:6, s. 1121-1134
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Forskningsöversikt (refereegranskat)abstract
- There is evidence that 3.17% of women report post-traumatic stress disorder (PTSD) after childbirth. This meta-analysis synthesizes research on vulnerability and risk factors for birth-related PTSD and refines a diathesis-stress model of its aetiology. Systematic searches were carried out on PsycINFO, PubMed, Scopus and Web of Science using PTSD terms crossed with childbirth terms. Studies were included if they reported primary research that examined factors associated with birth-related PTSD measured at least 1 month after birth. In all, 50 studies (n = 21 429) from 15 countries fulfilled inclusion criteria. Pre-birth vulnerability factors most strongly associated with PTSD were depression in pregnancy (r = 0.51), fear of childbirth (r = 0.41), poor health or complications in pregnancy (r = 0.38), and a history of PTSD (r = 0.39) and counselling for pregnancy or birth (r = 0.32). Risk factors in birth most strongly associated with PTSD were negative subjective birth experiences (r = 0.59), having an operative birth (assisted vaginal or caesarean, r = 0.48), lack of support (r = -0.38) and dissociation (r = 0.32). After birth, PTSD was associated with poor coping and stress (r = 0.30), and was highly co-morbid with depression (r = 0.60). Moderator analyses showed that the effect of poor health or complications in pregnancy was more apparent in high-risk samples. The results of this meta-analysis are used to update a diathesis-stress model of the aetiology of postpartum PTSD and can be used to inform screening, prevention and intervention in maternity care.
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| 46. |
- Ekbäck, Maria [Palmetun], et al.
(författare)
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"It is always on my mind" : women's experiences of their bodies when living with hirsutism
- 2009
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Ingår i: Health Care for Women International. - London : Taylor & Francis. - 0739-9332 .- 1096-4665. ; 30:5, s. 358-372
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Tidskriftsartikel (refereegranskat)abstract
- Many women suffer from excessive hair growth, often in combination with polycystic ovarian syndrome (PCOS). It is unclear how hirsutism influences such women's experiences of their bodies. Our aim is to describe and interpret women's experiences of their bodies when living with hirsutism. Interviews were conducted with 10 women with hirsutism. We used a qualitative latent content analysis. Four closely intertwined themes were disclosed: the body was experienced as a yoke, a freak, a disgrace, and as a prison. Hirsutism deeply affects women's experiences of their bodies in a negative way.
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| 47. |
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| 48. |
- Kjaergaard, Hanne, et al.
(författare)
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Fear of childbirth in obstetrically low‐risk nulliparous women in Sweden and Denmark
- 2008
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Ingår i: Journal of Reproductive and Infant Psychology. - : Informa UK Limited. - 0264-6838 .- 1469-672X. ; 26:4, s. 340-350
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Tidskriftsartikel (refereegranskat)abstract
- The prevalence of troublesome fear of childbirth (FOC) in Western countries is about 20%, of which approximately 6–10% suffer from severe FOC that impacts daily life. The countries of Sweden and Denmark are quite alike as far as childbirth culture is concerned. However, to some extent they differ in the organisation of midwifery care during the antenatal and labour period, respectively, and this may influence women's FOC. The aims of this study were to compare FOC among Danish and Swedish nulliparous women and to investigate a possible difference in FOC between women who, during pregnancy, had met the midwife who they were subsequently coincidentally allocated to receive labour care from and women who had not previously met the midwife. In total 165 women participated, comprising 55 Swedes and 110 Danes, of whom 55 among the latter group had met the midwife during pregnancy. Severe FOC was found in 10%. There were no differences between the Swedish women and the Danish women who had or had not met the midwife. Fear of childbirth measured in gestational week 37 correlated positively with fear at admission to the labour ward.
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| 49. |
- Kjölhede, Preben, et al.
(författare)
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Impact of stress coping capacity on recovery from abdominal hysterectomy in a fast-track programme: a prospective longitudinal study
- 2012
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Ingår i: British Journal of Obstetrics and Gynecology. - : Wiley-Blackwell. - 1470-0328 .- 1471-0528. ; 119:8, s. 998-1007
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Tidskriftsartikel (refereegranskat)abstract
- Objective To evaluate the effect of stress coping capacity in combination with mode of anaesthesia on postoperative recovery in fast-track abdominal hysterectomy. Design Prospective longitudinal study. Setting Five hospitals in the south-east of Sweden. Population A cohort of 162 women undergoing fast-track abdominal hysterectomy for benign conditions. Methods Self-administered questionnaires, the Stress Coping Inventory (SCI) and the Swedish Postoperative Symptom Questionnaire (SPSQ), and clinical information were collected prospectively. Stress coping capacity was categorised as high or low according to the summed score of the SCI. Comparisons of effect variables were adjusted using a propensity score-matching model. Main outcome measures Associations between stress coping capacity and hospital stay, sick leave, use of analgesic and self-reported postoperative symptoms. Results Women with high stress coping capacity had a significantly shorter sick leave, experienced postoperative symptoms significantly less often, and with lower intensity, than women with low stress coping capacity. With the exception of symptom intensity, these findings were related to having had the operation under spinal anaesthesia as opposed to general anaesthesia. Hospital stay, use of analgesics and abdominal pain were not related to stress coping capacity. Conclusions In patients for whom spinal anaesthesia was applied, high stress coping seems to be a quality that helps patients manage the burden of surgery. It is desirable for the individual, as well as for the healthcare system, to enhance recovery by using intervention programmes designed to improve or manage stress coping, particularly for individuals with low stress coping capacity. This recommendation merits further investigation.
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| 50. |
- Klabbers, Gert A., et al.
(författare)
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Haptotherapy as a new intervention for treating fear of childbirth: a randomized controlled trial
- 2019
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Ingår i: Journal of Psychosomatic Obstetrics and Gynaecology. - : TAYLOR & FRANCIS LTD. - 0167-482X .- 1743-8942. ; 40:1, s. 38-47
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate the effect of haptotherapy on severe fear of childbirth in pregnant women.Design: Randomized controlled trial.Setting: Community midwifery practices and a teaching hospital in the Netherlands.Population or Sample: Primi- and multigravida, suffering from severe fear of childbirth (N=134).Methods: Haptotherapy, psycho-education via Internet and care as usual were randomly assigned at 20-24weeks of gestation and the effects were compared at 36weeks of gestation and 6weeks and 6months postpartum. Repeated measurements ANOVA were carried out on the basis of intention to treat. Since there were crossovers from psycho-education via Internet and care as usual to haptotherapy, the analysis was repeated according to the as treated principle.Main outcome measures: Fear of childbirth score at the Wijma Delivery Expectancy/Experience Questionnaire.Results: In the intention to treat analysis, only the haptotherapy group showed a significant decrease of fear of childbirth, F(2,99)=3.321, p=.040. In the as treated analysis, the haptotherapy group showed a greater reduction in fear of childbirth than the other two groups, F(3,83)=6.717, pamp;lt;.001.Conclusion: Haptotherapy appears to be more effective in reducing fear of childbirth than psycho-education via Internet and care as usual.
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