| 11. |
- Ahlin, Catharina, et al.
(författare)
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Implementation of a written protocol for management of central venous access devices : a theoretical and practical education, including bedside examinations.
- 2006
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Ingår i: Journal of Infusion Nursing. - : Lippincott Williams & Wilkins. - 1533-1458 .- 1539-0667. ; 29:5, s. 253/294 quiz-259/296
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Tidskriftsartikel (refereegranskat)abstract
- The objectives of this study were to evaluate registered nurses' (RN) compliance with a local clinical central venous access device (CVAD) protocol after completing an educational program and to determine RNs' perception of the program. Seventy-five RNs working in hematology participated in the educational part of the program. Sixty-eight RNs were examined while changing CVAD dressings or placing a Huber needle into a port on actual patients. Sixty percent of the RNs passed the examination and reported that the program increased their knowledge. The results indicated that the educational program could be recommended for use when implementing a new clinical protocol.
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| 12. |
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| 13. |
- Akselsson, Anna, et al.
(författare)
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Daily structured approach to awareness of fetal movements and pregnancy outcome - a prospective study
- 2019
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 20, s. 32-37
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: We investigated how women, seeking care due to decreased movements, had paid attention to fetal movements and if the method of monitoring was associated with pregnancy outcome.METHODS: A questionnaire was distributed to women from gestational week 28, who had sought care due to decreased fetal movements in Stockholm between January 1st and December 31st, 2014. Women were included in the study if the examination did not reveal any signs of a compromised fetus requiring immediate intervention. Birth outcome and sociodemographic data were collected from the obstetric record register.RESULTS: There were 29166 births in Stockholm in 2014, we have information from 2683 women who sought care for decreased fetal movements. The majority (96.6%) of the women stated that they paid attention to fetal movements. Some women observed fetal movements weekly (17.2%) and 69.5% concentrated on fetal movements daily (non-structured group). One in ten (9.9%) used counting methods daily for observing fetal movements (structured group). Women in the structured group more often had caesarean section before onset of labor (RR 1.6, 95% CI 1.2-2.2) and a lower risk of their baby being transferred to neonatal nursery (RR 0.25, 95% CI 0.03-0.94) compared to women in the non-structured group.CONCLUSIONS: Women, who had a daily and structured approach to awareness of fetal movements, were more likely to have a caesarean section but their babies were less likely to be transferred to a neonatal nursery as compared with women who used a non-structured method daily.
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| 14. |
- Akselsson, Anna, et al.
(författare)
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Increased labor induction and women presenting with decreased or altered fetal movements : A population-based survey
- 2019
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 14:5
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Women's awareness of fetal movements is important as perception of decreased fetal movements can be a sign of a compromised fetus. We aimed to study rate of labor induction in relation to number of times women seek care due to decreased or altered fetal movements during their pregnancy compared to women not seeking such care. Further, we investigated the indication of induction.MATERIAL AND METHODS: A prospective population-based cohort study including all obstetric clinics in Stockholm, Sweden. Questionnaires were distributed to women who sought care due to decreased or altered fetal movements ≥ 28 week's gestation in 2014, women for whom an examination did not indicate a compromised fetus that required induction of labor or cesarean section when they sought care. Women who gave birth at ≥ 28 weeks' gestation in 2014 in Stockholm comprises the reference group.RESULTS: Labor was induced more often among the 2683 women who had sought care due to decreased or altered fetal movements (RR 1.4, 95% CI 1.3-1.5). In women who presented with decreased or altered fetal movements induction of labor occurred more frequently for fetal indication than those with induction of labor and no prior fetal movement presentation (RR 1.6, 95% CI 1.4-1.8). The rate of induction increased with number of times a woman sought care, RR 1.3 for single presentation to 3.2 for five or more.CONCLUSIONS: We studied women seeking care for decreased or altered fetal movements and for whom pregnancy was not terminated with induction or caesarean section. Subsequent (median 20 days), induction of labor and induction for fetal indications were more frequent in this group compared to the group of women with no fetal movement presentations. Among women seeking care for altered or decreased fetal movements, the likelihood of induction of labor increased with frequency of presentation.
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| 15. |
- Akselsson, Anna, et al.
(författare)
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Mindfetalness to increase women's awareness of fetal movements and pregnancy outcomes: a cluster-randomised controlled trial including 39 865 women
- 2020
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Ingår i: Bjog-an International Journal of Obstetrics and Gynaecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 127:7, s. 829-837
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Tidskriftsartikel (refereegranskat)abstract
- Objective To examine whether a method for raising women's awareness of fetal movements, Mindfetalness, can affect pregnancy outcomes. Design Cluster-randomised controlled trial. Setting Sixty-seven maternity clinics in Stockholm, Sweden. Population Women with singleton pregnancy with birth from 32 weeks' gestation. Methods Women registered at a clinic randomised to Mindfetalness were assigned to receive a leaflet about Mindfetalness (n = 19 639) in comparison with routine care (n = 20 226). Data were collected from a population-based register. Main outcome measures Apgar score <7 at 5 minutes after birth, visit to healthcare due to decrease in fetal movements. Other outcomes: Apgar score <4 at 5 minutes after birth, small-for-gestational-age and mode of delivery. Results No difference (1.1 versus 1.1%, relative risk [RR] 1.0; 95% CI 0.8-1.2) was found between the Mindfetalness group and the Routine care group for a 5-minute Apgar score <7. Women in the Mindfetalness group contacted healthcare more often due to decreased fetal movements (6.6 versus 3.8%, RR 1.72; 95% CI 1.57-1.87). Mindfetalness was associated with a reduction of babies born small-for-gestational-age (RR 0.95, 95% CI 0.90-1.00), babies born after gestational week 41(+6) (RR 0.91, 95% CI 0.83-0.98) and caesarean sections (19.0 versus 20.0%, RR 0.95; 95% CI 0.91-0.99). Conclusions Mindfetalness did not reduce the number of babies born with an Apgar score <7. However, Mindfetalness was associated with the health benefits of decreased incidence of caesarean section and fewer children born small-for-gestational-age. Tweetable abstract Introducing Mindfetalness in maternity care decreased caesarean sections but had no effect on the occurrence of Apgar scores <7.
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| 16. |
- Akselsson, Anna, et al.
(författare)
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Pregnancy outcomes among women born in Somalia and Sweden giving birth in the Stockholm area - a population-based study
- 2020
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Ingår i: Global health action. - : Informa UK Limited. - 1654-9880 .- 1654-9880 .- 1654-9716. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Studies report that women born in some African countries, after migrating to the Nordic countries, have worse pregnancy outcomes than women born in the receiving countries. With the aim of identifying unmet needs among Somali-born women, we here study this subgroup. Objective We compared pregnancy outcomes among women born in Somalia to women born in Sweden. Further, we investigated whether the proactive maternal observation of fetal movements has effects on birth outcomes among women born in Somalia. Methods In Stockholm, half of the maternity clinics were randomized to intervention, in which midwives were instructed to be proactive towards women by promoting daily self-monitoring of fetal movements. Data for 623 women born in Somalia and 26 485 born in Sweden were collected from a population-based register. Results An Apgar score below 7 (with stillbirth counting as 0) at 5 minutes was more frequent in babies of women born in Somalia as compared to babies of women born in Sweden (RR 2.17, 95% CI 1.25-3.77). Babies born small for gestational age were more common among women born in Somalia (RR 2.22, CI 1.88-2.61), as were babies born after 41 + 6 gestational weeks (RR 1.65, CI 1.29-2.12). Somali-born women less often contacted obstetric care for decreased fetal movements than did Swedish-born women (RR 0.19, CI 0.08-0.36). The differences between women born in Somalia and women born in Sweden were somewhat lower (not statistically significant) among women allocated to proactivity as compared to the Routine-care group. Conclusions A higher risk of a negative outcome for mother and baby is seen among women born in Somalia compared to women born in Sweden. We suggest it may be worthwhile to investigate whether a Somali-adapted intervention with proactivity concerning self-monitoring of fetal movements may improve pregnancy outcomes in this migrant population.
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| 17. |
- Akselsson, Anna, et al.
(författare)
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Women's attitudes, experiences and compliance concerning the use of Mindfetalness- a method for systematic observation of fetal movements in late pregnancy
- 2017
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393 .- 1471-2393. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Maternal perception of decreased fetal movements and low awareness of fetal movements are associated with a negative birth outcome. Mindfetalness is a method developed for women to facilitate systematic observations of the intensity, character and frequency of fetal movements in late pregnancy. We sought to explore women's attitudes, experiences and compliance in using Mindfetalness.METHODS: We enrolled 104 pregnant women treated at three maternity clinics in Stockholm, Sweden, from February to July of 2016. We educated 104 women in gestational week 28-32 by providing information about fetal movements and how to practice Mindfetalness. Each was instructed to perform the assessment daily for 15 min. At each subsequent follow-up, the midwife collected information regarding their perceptions of Mindfetalness, and their compliance. Content analyses, descriptive and analytic statistics were used in the analysis of data.RESULTS: Of the women, 93 (89%) were positive towards Mindfetalness and compliance was high 78 (75%). Subjective responses could be binned into one of five categories: Decreased worry, relaxing, creating a relationship, more knowledge about the unborn baby and awareness of the unborn baby. Eleven (11%) women had negative perceptions of Mindfetalness, citing time, and the lack of need for a method to observe fetal movements as the most common reasons.CONCLUSION: Women in late pregnancy are generally positive about Mindfetalness and their compliance with daily use is high. The technique helped them to be more aware of, and create a relationship with, their unborn baby. Mindfetalness can be a useful tool in antenatal care. However, further study is necessary in order to determine whether the technique is able to reduce the incidence of negative birth outcome.
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| 18. |
- Alden-Joyce, Tara, et al.
(författare)
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Tanzanian Nursing Students' Experiences of Student Exchange in Sweden : A Qualitative Case Study
- 2023
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Ingår i: Sage Open Nursing. - : Sage Publications. - 2377-9608. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionNeeds within healthcare are changing and nurses require new skills and knowledge in global nursing. Student exchange programs in global contexts provide an opportunity to develop the necessary skills. ObjectiveThe aim of this study was to describe Tanzanian nursing students' experiences of student exchange in Sweden. MethodsA qualitative design was used for this empirical study. Semistructured interviews were conducted with six Tanzanian nursing students who had participated in student exchange in Sweden. The participants were recruited by purposeful sampling. Inductive reasoning and qualitative content analysis were applied. ResultsFour main themes were formed; new roles, experience a new culture, establish new competencies, and global work ambitions. The findings revealed that the students experienced new approaches in Sweden, giving them new competencies and understanding. Furthermore, they increased their global perspectives on nursing and interest in working with global health issues, but they also experienced challenges in the new environment. ConclusionThe present study showed that Tanzanian nursing students benefitted from their student exchange, both personally, as well as for their future careers as nurses. More research is needed in examining nursing students from low-income countries participating in student exchange in high-income countries.
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| 19. |
- Alexandersson, Kristina, et al.
(författare)
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Att uppmärksamma barn till svårt sjuka patienter på en neurologisk klinik - utvärdering av implementering av rutiner och arbetssätt
- 2017
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Ingår i: Socialmedicinsk Tidskrift. - 0037-833X. ; 94:4, s. 485-495
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Tidskriftsartikel (refereegranskat)abstract
- Barn till allvarligt somatiskt sjuka föräldrar löper en förhöjd risk för egen psykisk ohälsa. Här presenteras resultat från utvärderingen av implementering av rutiner och arbetssätt som syftade till att förbättra arbetet med att identifiera, informera samt stödja minderåriga barn till patienter på en neurologisk klinik. Fyra delstudier genomfördes. Resultaten indikerar att trots betydande insatser för att säkerställa att kliniken lever upp till sina lagstadgade uppgifter, fanns en stor förbättringspotential. Hela 80% av patienter med minderåriga barn hade inte fått information om sina barns rätt till stöd och 40% hade inte tillräckligt stöd för att utöva sin föräldraroll. Samtidigt noterades en tydlig ökning i andelen personal på kliniken som hade kunskap om sin skyldighet att erbjuda information, råd och stöd.
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| 20. |
- Almqvist, C, et al.
(författare)
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Direct and indirect exposure to pets : - risk of sensitization and asthma at 4 years in a birth cohort
- 2003
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Ingår i: Clinical and Experimental Allergy. - : Wiley-Blackwell. - 0954-7894 .- 1365-2222. ; 33, s. 1190-
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: There are conflicting data on the association between early exposure to pets and allergic diseases. Bias related to retrospective information on pet ownership has been addressed as a reason for distorted study results.OBJECTIVE: To elucidate how early exposure to cat and dog relates to IgE-sensitization and asthma in children at 2 and 4 years of age, in a prospective birth-cohort study.METHODS: Four thousand and eighty-nine families with children born 1994-1996 in predefined areas of Stockholm answered questionnaires on environmental factors and symptoms of allergic disease at birth, one, two and four years of age. Dust samples collected from the mothers' beds at birth were analysed for Fel d 1 and Can f 1 in a subgroup of the cohort. Blood samples taken at four years from 2614 children were analysed for allergen-specific IgE to common airborne allergens. Risk associations were calculated with a multiple logistic regression model, with adjustment for potential confounders.RESULTS: A correlation was seen between allergen levels and reported exposure to cat and dog. Exposure to cat seemed to increase the risk of cat sensitization, OR (odds ratio) 1.44 (95% confidence interval 1.03-2.01), whereas dog exposure did not have any effect on dog sensitization, OR 1.16 (0.79-1.72). Dog ownership was related to a reduced risk of sensitization to other airborne allergens, OR 0.36 (0.15-0.83), and a similar tendency was seen for cat ownership OR 0.63 (0.37-1.07). Early dog ownership seemed to be associated with a lower risk of asthma, OR 0.50 (0.24-1.03), with no corresponding effect after cat ownership, OR 0.88 (0.56-1.38).CONCLUSION: Early exposure to cat seems to increase the risk of sensitization to cat but not of asthma at 4 years of age. Dog ownership, on the other hand, appears to be associated with lowered risk of sensitization to airborne allergens and asthma. Both aetiological relationships and selection effects have to be considered in the interpretation of these findings.
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