| 1. |
- Andersen Dovland, Randi, et al.
(författare)
-
PEARL : Pain in early life. A new network for research and education
- 2016
-
Ingår i: Scandinavian Journal of Pain. - : Elsevier. - 1877-8879.
-
Konferensbidrag (refereegranskat)abstract
- Aims: To establish a network for research and education and to provide expert knowledge to parents and health care professionals about pain in early life.Methods: In November 2014 a group of Nordic researchers and research students, committed to the field of pain in early life, gathered for an open lecture day and workshop in Örebro, Sweden. Inspired by the work of the Canadian initiative PICH – Pain In Child Health, the network formulated it’s vision: To be a stabile and competent research and training network within the area of pain in early life. A first collaborate project was designed: “Translation, cultural adaptation and validation of the revised version of the Premature Infant Pain Profile (PIPP-R): An effort to improve pain assessment in infants in the Nordic countries”.Results: Fourteen months later, in January 2016, the second PEARL-meeting was held, in Oslo, Norway. The lecture day provided clinically active nurses and physicians from several countries with the latest findings on how to best manage pain in neonatal settings. The network which now consist of 18 researchers from different professions and academic levels presents itself on a five-language website: www.pearl.direct. The PIPP-R project has progressed according to the plan. The PIPP-R is translated into Finnish, Icelandic, Norwegian and Swedish. The cultural adaptation and validation should be finished in fall 2016. The members work on and plan for further collaborate projects. The next two steps are to translate and distribute educational material for parents via Internet and social media, and to establish a research and masters course about pain in early life. The work has been secured by funding from Örebro University and and Örebro University Hospital Research Foundation.Conclusions: PEARL fulfils the need for a collaborative network for pain in early life researchers in the Nordic countries.
|
|
| 2. |
|
|
| 3. |
- Ashish, K.C. 1982-, et al.
(författare)
-
Coverage, associated factors, and impact of companionship during labor : A large-scale observational study in six hospitals in Nepal
- 2019
-
Ingår i: Birth. - : John Wiley & Sons. - 0730-7659 .- 1523-536X. ; 47:1, s. 80-88
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Companionship at the time of birth is a nonclinical intervention that has been proven to improve the quality of intrapartum care. This study aims to evaluate the coverage, associated factors, and impact of companionship during labor at public hospitals in Nepal.METHODS: We conducted a cross-sectional observational study in six public hospitals in Nepal. The study was conducted from July 2018 to August 2018. Data were collected on sociodemographic, maternal, obstetric, and neonatal characteristics from patient case notes and through predischarge interviews. Coverage of companionship during labor and its association with intrapartum care was analyzed. Bivariate and multivariate analyses were done to assess the association between companionship during labor and demographic, obstetric, and neonatal characteristics.RESULTS: A total of 63 077 women participated in the study with 19% of them having a companion during labor. Women aged 19-24 years had 65% higher odds of having a companion during labor compared with women aged 35 years and older (aOR 1.65 [95% CI, 1.40-1.94]). Women who were from an advantaged ethnic group (Chhetri/Brahmin) had fourfold higher odds of having a companion than women from a disadvantaged group (aOR 3.84; [95% CI, 3.24-4.52]). Women who had companions during labor had fewer unnecessary cesarean births than those who had no companions (5.2% vs 6.8%, P < .001).CONCLUSIONS: In Nepal, sociodemographic factors affect women's likelihood of having a companion during labor. As companionship during labor is associated with improved quality of care, health facilities should encourage women's access to birth companions.
|
|
| 4. |
- Axelin, Anna, et al.
(författare)
-
Neonatal intensive care nurses' perceptions of parental participation in infant pain management : a comparative focus group study
- 2015
-
Ingår i: Journal of Perinatal & Neonatal Nursing. - Philadelphia, USA : Lippincott Williams & Wilkins. - 0893-2190 .- 1550-5073. ; 29:4, s. 363-374
-
Tidskriftsartikel (refereegranskat)abstract
- This comparative focus group study explored nurses' experiences and perceptions regarding parental participation in infant pain management in the neonatal intensive care unit (NICU). A total of 87 nurses from 7 NICUs in Finland, Sweden, and the United States participated in focus-group interviews (n = 25). Data were analyzed using deductive and inductive thematic analysis. Nurses' experiences and perceptions varied considerably, from nurses being in control, to nurses sharing some control with parents, to nurse-parent collaboration in infant pain management. When nurses controlled pain management, parents were absent or passive. In these cases, the nurses believed this led to better pain control for infants and protected parents from emotional distress caused by infant pain. When nurses shared control with parents, they provided information and opportunities for participation. They believed parent participation was beneficial, even if it caused nurses or parents anxiety. When nurses collaborated with parents, they negotiated the optimal pain management approach for an individual infant. The collaborative approach was most evident for the nurses in the Swedish NICUs and somewhat evident in the NICUs in Finland and the United States. Further research is needed to address some nurses' perceptions and concerns and to facilitate greater consistency in the application of evidence-based best practices.
|
|
| 5. |
|
|
| 6. |
- Axelin, Anna, et al.
(författare)
-
Pain in early life (pearl) – a network for pain research and education
- 2019
-
Konferensbidrag (refereegranskat)abstract
- BackgroundSmall children are especially vulnerable to the deleterious effects of pain. High quality research is needed to protect young children from the negative effects of pain. Previously pediatric pain research in the Nordic region was severely limited; hampered by small samples and small-scale, time-consuming studies carried out by a few dedicated researchers. The similarities across the Nordic countries, concerning population composition, healthcare systems, and culture, made it reasonable to join forces for advances in child pain research and evidence-based practice. Methods In 2014, a group of Nordic researchers from the field of pain in early life gathered for a workshop in Örebro, Sweden. The participants knew each other from conferences or participation in common projects. Several were also collaborators, trainees, or alumni in the Canadian Pain in Child Health (PICH) network. The group decided to form a new network with the vision: To be a stable and competent research and training network within the area of pain in early life. The network was named PEARL – Pain in EARly Life. Three areas of work were defined: to provide parents with evidence-based information on pain relieving strategies, to provide healthcare professionals with evidence-based tools for the management of pain, and to perform collaborative research. Results Since then, PEARL has held yearly lecture days about pain in early life in Sweden, Norway, Finland and Denmark and thereby reached hundreds of clinicians. The meeting in Denmark was organized together with PICH as a PICH2Go-event with participants from 13 countries around the world. Four trainees have been awarded their PhD-degree, three members have become associate professors and two have become full professors. In all, 24 persons from the Nordic countries, Poland and Canada are members of PEARL. In the past 5 years, researchers from PEARL have published 94 papers about pain and stress (Fig 1). In a collaborative project, the pain assessment scale PIPP-R has been translated and culturally adapted for four Nordic languages. PEARL has established a website in six languages, with sections for parents, professionals and researchers: www.pearl.direct.Conclusion In five years, PEARL has had significant impact in pediatric pain research and attracted new collaborators and students. Moving forward, PEARL will focus on increasing its collaboration with other research groups. We will also make an effort to strengthen and develop parent partnerships and collaboration to ensure the best research and care possible for vulnerable small children.
|
|
| 7. |
- Flacking, Renée, et al.
(författare)
-
Pathways to emotional closeness in neonatal units - a cross-national qualitative study.
- 2016
-
Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393 .- 1471-2393. ; 16:1
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Research shows evidence for the importance of physical and emotional closeness for the infant, the parent and the infant-parent dyad. Less is known about how, when and why parents experience emotional closeness to their infants in a neonatal unit (NU), which was the aim of this study.METHODS: A qualitative study using a salutogenic approach to focus on positive health and wellbeing was undertaken in three NUs: one in Sweden, England and Finland. An 'emotional closeness' form was devised, which asked parents to describe moments/situations when, how and why they had felt emotionally close to their infant. Data for 23 parents of preterm infants were analyzed using thematic networks analysis.RESULTS: A global theme of 'pathways for emotional closeness' emerged from the data set. This concept related to how emotional, physical, cognitive and social influences led to feelings of emotional closeness between parents and their infants. The five underpinning organising themes relate to the: Embodied recognition through the power of physical closeness; Reassurance of, and contributing to, infant wellness; Understanding the present and the past; Feeling engaged in the day to day and Spending time and bonding as a family.CONCLUSION: These findings generate important insights into why, how and when parents feel emotionally close. This knowledge contributes to an increased awareness of how to support parents of premature infants to form positive and loving relationships with their infants. Health care staff should create a climate where parents' emotions and their emotional journey are individually supported.
|
|
| 8. |
- Gurung, Rejina, et al.
(författare)
-
Scaling Up Safer Birth Bundle Through Quality Improvement in Nepal (SUSTAIN) - a stepped wedge cluster randomized controlled trial in public hospitals
- 2019
-
Ingår i: Implementation Science. - : BMC. - 1748-5908. ; 14
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Each year, 2.2 million intrapartum-related deaths (intrapartum stillbirths and first day neonatal deaths) occur worldwide with 99% of them taking place in low- and middle-income countries. Despite the accelerated increase in the proportion of deliveries taking place in health facilities in these settings, the stillborn and neonatal mortality rates have not reduced proportionately. Poor quality of care in health facilities is attributed to two-thirds of these deaths. Improving quality of care during the intrapartum period needs investments in evidence-based interventions. We aim to evaluate the quality improvement packageScaling Up Safer Bundle Through Quality Improvement in Nepal (SUSTAIN)on intrapartum care and intrapartum-related mortality in public hospitals of Nepal.Methods: We will conduct a stepped wedge cluster randomized controlled trial in eight public hospitals with each having least 3000 deliveries a year. Each hospital will represent a cluster with an intervention transition period of 2months in each. With a level of significance of 95%, the statistical power of 90% and an intra-cluster correlation of 0.00015, a study period of 19months should detect at least a 15% change in intrapartum-related mortality. Quality improvement training, mentoring, systematic feedback, and a continuous improvement cycle will be instituted based on bottleneck analyses in each hospital. All concerned health workers will be trained on standard basic neonatal resuscitation and essential newborn care. Portable fetal heart monitors (Moyo (R)) and neonatal heart rate monitors (Neobeat (R)) will be introduced in the hospitals to identify fetal distress during labor and to improve neonatal resuscitation. Independent research teams will collect data in each hospital on intervention inputs, processes, and outcomes by reviewing records and carrying out observations and interviews. The dose-response effect will be evaluated through process evaluations.Discussion: With the global momentum to improve quality of intrapartum care, better understanding of QI package within a health facility context is important. The proposed package is based on experiences from a similar previous scale-up trial carried out in Nepal. The proposed evaluation will provide evidence on QI package and technology for implementation and scale up in similar settings.
|
|
| 9. |
- Gurung, Rejina, et al.
(författare)
-
Scaling Up Safer Birth Bundle Through Quality Improvement in Nepal (SUSTAIN)-a stepped wedge cluster randomized controlled trial in public hospitals.
- 2019
-
Ingår i: Implementation science : IS. - : Springer Science and Business Media LLC. - 1748-5908. ; 14:1
-
Tidskriftsartikel (refereegranskat)abstract
- Each year, 2.2 million intrapartum-related deaths (intrapartum stillbirths and first day neonatal deaths) occur worldwide with 99% of them taking place in low- and middle-income countries. Despite the accelerated increase in the proportion of deliveries taking place in health facilities in these settings, the stillborn and neonatal mortality rates have not reduced proportionately. Poor quality of care in health facilities is attributed to two-thirds of these deaths. Improving quality of care during the intrapartum period needs investments in evidence-based interventions. We aim to evaluate the quality improvement package-Scaling Up Safer Bundle Through Quality Improvement in Nepal (SUSTAIN)-on intrapartum care and intrapartum-related mortality in public hospitals of Nepal.We will conduct a stepped wedge cluster randomized controlled trial in eight public hospitals with each having least 3000 deliveries a year. Each hospital will represent a cluster with an intervention transition period of 2 months in each. With a level of significance of 95%, the statistical power of 90% and an intra-cluster correlation of 0.00015, a study period of 19 months should detect at least a 15% change in intrapartum-related mortality. Quality improvement training, mentoring, systematic feedback, and a continuous improvement cycle will be instituted based on bottleneck analyses in each hospital. All concerned health workers will be trained on standard basic neonatal resuscitation and essential newborn care. Portable fetal heart monitors (Moyo®) and neonatal heart rate monitors (Neobeat®) will be introduced in the hospitals to identify fetal distress during labor and to improve neonatal resuscitation. Independent research teams will collect data in each hospital on intervention inputs, processes, and outcomes by reviewing records and carrying out observations and interviews. The dose-response effect will be evaluated through process evaluations.With the global momentum to improve quality of intrapartum care, better understanding of QI package within a health facility context is important. The proposed package is based on experiences from a similar previous scale-up trial carried out in Nepal. The proposed evaluation will provide evidence on QI package and technology for implementation and scale up in similar settings.ISRCTN16741720 . Registered on 2 March 2019.
|
|
| 10. |
- Olsson, Emma, 1980-, et al.
(författare)
-
Cultural adaptation and harmonization of four Nordic translations of the revised Premature Infant Pain Profile (PIPP-R)
- 2018
-
Ingår i: BMC Pediatrics. - : BioMed Central. - 1471-2431 .- 1471-2431. ; 18
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Preterm infants are especially vulnerable to pain. The intensive treatment often necessary for their survival unfortunately includes many painful interventions and procedures. Untreated pain can lead to both short- and long-term negative effects. The challenge of accurately detecting pain has been cited as a major reason for lack of pain management in these non-verbal patients. The Premature Infant Pain Profile (PIPP) is one of the most extensively validated measures for assessing procedural pain in premature infants. A revised version, PIPP-R, was recently published and is reported to be more user-friendly and precise than the original version. The aims of the study were to develop translated versions of the PIPP-R in Finnish, Icelandic, Norwegian, and Swedish languages, and to establish their content validity through a cultural adaptation process using cognitive interviews.Methods: PIPP-R was translated using the recommendations from the International Society for Pharmacoeconomics and Outcomes Research and enhanced with cognitive interviews. The respondent nurse was given a copy of the translated, national version of the measure and used this together with a text describing the infant in the film to assess the pain of an infant in a short film. During the assessment the nurse was asked to verbalize her thought process (thinking aloud) and upon completion the interviewer administered probing questions (verbal probing) from a structured interview guide. The interviews were recorded, transcribed, and analyzed using a structured matrix approach.Results: The systematic approach resulted in translated and culturally adapted versions of PIPP-R in the Finnish, Icelandic, Norwegian and Swedish languages. During the cultural adaptation process several problems were discovered regarding how the respondent understood and utilized the measure. The problems were either measure problems or other problems. Measure problems were solved by a change in the translated versions of the measure, while for other problems different solutions such as education or training were suggested.Conclusions: This study have resulted in translations of the PIPP-R that have content validity, high degree of clinical utility and displayed beginning equivalence with each other and the original version of the measure.
|
|
