| 1. |
- Dencker, Anna, 1956, et al.
(författare)
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Adopting a healthy lifestyle when pregnant and obese – an interview study three years after childbirth.
- 2016
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Background Obesity during pregnancy is increasing and is related to life-threatening and ill-health conditions in both mother and child. Initiating and maintaining a healthy lifestyle when pregnant with body mass index (BMI)≥30 kg/m2 can improve health and decrease risks during pregnancy and of long-term illness for the mother and the child. To minimise gestational weight gain women with BMI≥30 kg/m2 in early pregnancy were invited to a lifestyle intervention including advice and support on diet and physical activity in Gothenburg, Sweden. The aim of this study was to explore the experiences of women with BMI≥30 kg/m2 regarding minimising their gestational weight gain, and to assess how health professionals’ care approaches are reflected in the women’s narratives. Methods Semi-structured interviews were conducted with 17 women who had participated in a lifestyle intervention for women with BMI≥30 kg/m2 during pregnancy 3 years earlier. The interviews were digitally recorded and transcribed in full. Thematic analysis was used. Results The meaning of changing lifestyle for minimising weight gain and of the professional’s care approaches is described in four themes: the child as the main motivation for making healthy changes; a need to be seen and supported on own terms to establish healthy routines; being able to manage healthy activities and own weight; and need for additional support to maintain a healthy lifestyle. Conclusions To support women with BMI≥30 kg/m2 to make healthy lifestyle changes and limit weight gain during pregnancy antenatal health care providers should 1) address women’s weight in a non-judgmental way using BMI, and provide accurate and appropriate information about the benefits of limited gestational weight gain; 2) support the woman on her own terms in a collaborative relationship with the midwife; 3) work in partnership to give the woman the tools to self-manage healthy activities and 4) give continued personal support and monitoring to maintain healthy eating and regular physical activity habits after childbirth involving also the partner and family.
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| 2. |
- Dencker, Anna, 1956, et al.
(författare)
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Support to adopt a healthy lifestyle for pregnant women with BMI > 30
- 2016
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Ingår i: The NJF Congress (Nordiskt Jordemorförbund), Gothenburg, 12-14 May 2016. - 9789163742699
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Konferensbidrag (refereegranskat)abstract
- Background A change towards healthy habits during pregnancy and in early motherhood, including weight control, increased physical activity and optimal diet habits will promote health for the woman with body mass index (BMI) ≥ 30 kg/m2, her fetus/ child, as well as for the whole family. To optimise a healthy lifestyle from early pregnancy in women with BMI ≥ 30 kg/m2 an intervention called Mighty Mums, including advice and support on diet and physical activity was carried out in the maternity health care in Gothenburg, Sweden. . Aim To explore women´s experiences 3 years after participating in a lifestyle intervention targeting pregnant women with BMI ≥ 30 kg/m2. Methods Qualitative interviews were performed with 17 mothers who had participated in a lifestyle intervention 3 years earlier. The interviews were semi-structured and thematic analysis was used. Results All interviews were transcribed verbatim and read in full in the first analysis step. Second, initial codes were identified in the data. All features with a meaning were coded and initial codes were condensed and formed four themes. Conclusions The expected child was the main motivation for the women to participate in the intervention. The women needed to be seen and get personal support from the antenatal health care midwife and receive help to be able to control the selection and implementation of healthy activities. Extra support during pregnancy helped temporarily but there was still a need of support to maintain a healthy lifestyle in the long run.
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| 3. |
- Hansson, Malin, 1975, et al.
(författare)
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Work situation and professional role for midwives at a labour ward, pre and post the introduction of a midwifery model of care.
- 2019
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Ingår i: NJF Congress Reykjavik 2019.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: The work situation for midwives in different countries is related to high levels of stress, burnout and heavy work load. One aspect of the professional role of midwives is woman-centeredness, theoretically described in midwifery models of care. However, no studies are found about the outcome for midwives work related to midwifery models of care. Therefore, the aim of this study was to explore and analyse the experience of work situation and professional role for midwives at a labour ward, pre and post the introduction of a midwifery model of care (MiMo). Methods: A simultaneous qualitative and quantitative mixed method approach was used in this longitudinal study. The core component comprised of a qualitative inductive secondary content analysis of three focus group interviews with 16 midwives exploring how midwives experienced and described their work situation and professional role pre and post implementation of MiMo. The supplemental component were a quantitative survey analysis of the work situation for midwives (n=58) pre and post the intervention, and the deductive analysis was driven by the qualitative result. Findings: The qualitative core component consisted of the concepts Balance between Women and Organisation, Midwives - Diverse as both Profession and Person and Strained Work Situation pre intervention. Post intervention Balance between Midwifery and Organisation, Midwives - An Adaptable Profession, Strained Work Situation and lastly a new category Ability to concretise midwifery emerged. The quantitative items that had corresponding measures connected to the qualitative categories were analysed. There were no significant differences in any of the quantitative analyses pre and post the introduction of MiMo. Conclusion: Working according to MiMo appears not to have any effect on the strained work situation in midwives, in the context and with the measurements studied here. Although MiMo contributed to raise awareness of the professional role.
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| 4. |
- Abbaspoor, Zahra, et al.
(författare)
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Translation and cultural adaptation of the Childbirth Experience Questionnaire (CEQ) in Iran
- 2019
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Ingår i: Iranian Journal of Nursing and Midwifery Research. - 1735-9066 .- 2228-5504. ; 24:4, s. 296-300
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Tidskriftsartikel (refereegranskat)abstract
- © 2019 Iranian Journal of Nursing and Midwifery Research Published by Wolters Kluwer - Medknow. A standardized method to measure and quantify women's birth experiences is required to study satisfaction of childbirth care. Therefore, this study aimed to translate and culturally adapt the Childbirth Experience Questionnaire (CEQ) for use in Iran. Materials and Methods: This was a cross-sectional study including 203 women who attended 2 hospitals and 2 health centers and met the inclusion criteria in Ahvaz city, between February 2013 and June 2014. After forward and backward translation of the Swedish CEQ into Persian language, content validity was assessed by an expert panel. Scale reliability (internal consistency and test-retest reliability) was assessed with respect to the psychometric properties of the scale. Results: Minor cultural differences were identified and resolved during the translation process. One item was excluded. The intraclass correlation coefficient ranging from 0.63 to 0.90 was satisfactory. Conclusions: The Persian version of the CEQ appears to be valid and reliable; hence, it can be an effective tool in designing childbirth experience interventions and also childbirth care and education interventions for the promotion of positive childbirth experience in Iranian women.
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| 5. |
- Dencker, Anna, 1956, et al.
(författare)
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Midwife-led maternity care in Ireland - a retrospective cohort study
- 2017
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Ingår i: Bmc Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 17:101
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Tidskriftsartikel (refereegranskat)abstract
- Background: Midwife-led maternity care is shown to be safe for women with low-risk during pregnancy. In Ireland, two midwife-led units (MLUs) were introduced in 2004 when a randomised controlled trial (the MidU study) was performed to compare MLU care with consultant-led care (CLU). Following study completion the two MLUs have remained as a maternity care option in Ireland. The aim of this study was to evaluate maternal and neonatal outcomes and transfer rates during six years in the larger of the MLU sites. Methods: MLU data for the six years 2008-2013 were retrospectively analysed, following ethical approval. Rates of transfer, reasons for transfer, mode of birth, and maternal and fetal outcomes were assessed. Linear-by-Linear Association trend analysis was used for categorical data to evaluate trends over the years and one-way ANOVA was used when comparing continuous variables. Results: During the study period, 3,884 women were registered at the MLU. The antenatal transfer rate was 37.4% and 2,410 women came to labour in the MLU. Throughout labour and birth, 567 women (14.6%) transferred to the CLU, of which 23 were transferred after birth due to need for suturing or postpartum hemorrhage. The most common reasons for intrapartum transfer were meconium stained liquor/abnormal fetal heart rate (30.3%), delayed labour progress in first or second stage (24.9%) and woman's wish for epidural analgesia (15.1%). Of the 1,903 babies born in the MLU, 1,878 (98.7%) were spontaneous vaginal births and 25 (1.3%) were instrumental (ventouse/forceps). Only 25 babies (1.3%) were admitted to neonatal intensive care unit. All spontaneous vaginal births from the MLU registered population, occurring in the study period in both the MLU and CLU settings (n = 2,785), were compared. In the MLU more often 1-2 midwives (90.9% vs 69.7%) cared for the women during birth, more women had three vaginal examinations or fewer (93.6% vs 79.9%) and gave birth in an upright position (standing, squatting or kneeling) (52.0% vs 9.4%), fewer women had an amniotomy (5.9% vs 25.9%) or episiotomy (3.4% vs 9.7%) and more women had a physiological management of third stage of labour (50.9% vs 4.6%). Conclusions: Midwife-led care is a safe option that could be offered to a large proportion of healthy pregnant women. With strict transfer criteria there are very few complications during labour and birth. Maternity units without the option of MLU care should consider its introduction.
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| 6. |
- Dencker, Anna, 1956, et al.
(författare)
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Multidimensional fatigue inventory and post-polio syndrome - a Rasch analysis
- 2015
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Ingår i: Health and Quality of Life Outcomes. - : Springer Science and Business Media LLC. - 1477-7525. ; 13:20
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Tidskriftsartikel (refereegranskat)abstract
- Background: Fatigue is a common symptom in post-polio syndrome (PPS) and can have a substantial impact on patients. There is a need for validated questionnaires to assess fatigue in PPS for use in clinical practice and research. The aim with this study was to assess the validity and reliability of the Swedish version of Multidimensional Fatigue Inventory (MFI-20) in patients with PPS using the Rasch model. Methods: A total of 231 patients diagnosed with PPS completed the Swedish MFI-20 questionnaire at post-polio out-patient clinics in Sweden. The mean age of participants was 62 years and 61% were females. Data were tested against assumptions of the Rasch measurement model (i.e. unidimensionality of the scale, good item fit, independency of items and absence of differential item functioning). Reliability was tested with the person separation index (PSI). A transformation of the ordinal total scale scores into an interval scale for use in parametric analysis was performed. Dummy cases with minimum and maximum scoring were used for the transformation table to achieve interval scores between 20 and 100, which are comprehensive limits for the MFI-20 scale. Results: An initial Rasch analysis of the full scale with 20 items showed misfit to the Rasch model (p < 0.001). Seven items showed slightly disordered thresholds and person estimates were not significantly improved by rescoring items. Analysis of MFI-20 scale with the 5 MFI-20 subscales as testlets showed good fit with a non-significant x(2) value (p = 0.089). PSI for the testlet solution was 0.86. Local dependency was present in all subscales and fit to the Rasch model was solved with testlets within each subscale. PSI ranged from 0.52 to 0.82 in the subscales. Conclusions: This study shows that the Swedish MFI-20 total scale and subscale scores yield valid and reliable measures of fatigue in persons with post-polio syndrome. The Rasch transformed total scores can be used for parametric statistical analyses in future clinical studies.
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| 7. |
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| 8. |
- Ghanbari-Homayi, Solmaz, et al.
(författare)
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Validation of the Iranian version of the childbirth experience questionnaire 2.0
- 2019
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- © 2019 The Author(s). Background: Assessing women's childbirth experiences is a crucial indicator in maternity services because negative childbirth experiences are associated with maternal mortalities and morbidities. Due to the high caesarean birth rate in Iran, measuring childbirth experience is a top priority, however, there is no standard tool to measure this key indicator in Iran. The aim of present study is to adapt the "Childbirth Experience Questionnaire 2.0" to the Iranian context and determine its psychometric characteristics. Methods: Childbirth Experience Questionnaire 2.0 was translated into Farsi. A total of 500 primiparous women, at 4 to 16 weeks postpartum, were randomly selected from 54 healthcare centres in Tabriz. Internal consistency and reliability was calculated using the Cronbach's Coefficient alpha and Intraclass Correlation Coefficient, respectively. Construct validity was assessed using exploratory and confirmatory factor analysis and discriminant validity using the known-group method and the Mann-Whitney U-test. Results: The internal consistency and reliability for the total tool were high (Cronbach's alpha = 0.93; Intraclass Correlation Coefficient = 0.97). Explanatory factor analysis demonstrated the adequacy of the sampling (Kaiser-Meyer-Olkin = 0.923) and significant factorable sphericity (p < 0.001). Confirmation factor analysis demonstrated acceptable values of fitness (RMSEA = 0.07, SRMSEA = 0.06, TLI = 0.97, CFI > 0.91, x 2/ df = 4.23). Discriminatory validity of the tool was confirmed where the CEQ score and its subdomains were significantly higher in women who reported having control over their childbirth than women who did not. Conclusion: The Farsi version of the Childbirth Experience Questionnaire 2.0 tool is a valid and reliable tool and can be used to measure the childbirth experience in Iranian women.
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| 9. |
- Lundgren, Ingela, 1957, et al.
(författare)
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Evaluation of a midwifery model of woman-centred care during childbirth – a mixed method study
- 2019
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Ingår i: NJF Congress 2019 Reykjavik Conference app.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Midwifery models of woman-centred care have been developed in different cultural context but few have been evaluated. A theoretical Midwifery Model of woman-centred care (MiMo) based on research in Sweden and Iceland was evaluated and assessed with the overall aim to explore the applicability of the model and the impact it has on outcome of childbirth care. Aim: To evaluate the effects and the applicability of a model of woman-centred care provided by midwives during childbirth. Methods: A mixed methods, before-after controlled study at two units for normal deliveries at Sahlgrenska University Hospital, Sweden,. The intervention comprised a one-day (8 hours) education about the model together with regularly scheduled reflection groups for midwives 2015-2016. The effects were studied by evaluating delivery outcomes, and mothers’ childbirth experiences. The primary outcomes were augmentation with oxytocin (n=.1600) and mothers’ childbirth experiences assessed with the Childbirth Experience Questionnaire (CEQ 2.0) (n=800). The applicability was studied by focus group interviews with a total of 43 participants: midwives (n=16), obstetricians (n = 8), assistant nurses (n= 11) and managers (n=8), before and after the intervention. Results: Findings from the study will be presented at the conference. Conclusion: A midwifery model of woman-centred care based on previous research has been evaluated in clinical practice.
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| 10. |
- Lundgren, Ingela, 1957, et al.
(författare)
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Evaluation of a model of woman-centred care during childbirth
- 2017
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Ingår i: 31th ICM Triennieal Congress 18-22 June 2017.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Based on a synthesis of 12 qualitative studies on women’s and midwives’ experiences of childbearing, a model of woman-centred care has been developed. The model has three central intertwined themes: a reciprocal relationship, a birthing atmosphere, and grounded knowledge; and two overall themes: the cultural context and the balancing act. Purpose/Objective: To evaluate the use and effects of the model of woman-centred care provided by midwives during childbirth. Method: A mixed methods, before-after controlled study at two units for normal deliveries at Sahlgrenska University Hospital, Sweden, and an ethnographic actions research study at the labour ward of Landspitali, University Hospital in Iceland. The intervention in Sweden comprised a one-day (8 hours) education about the model together with regularly scheduled reflection groups for midwives. The effects are studied by evaluating delivery outcomes, mothers’ childbirth experiences and midwives’ work-related experiences. The primary outcomes are augmentation with oxytocin (n=1600) and mothers’ childbirth experiences assessed with the Childbirth Experience Questionnaire (CEQ 2.0) (n=801). The secondary outcomes are midwives’ experiences, assessed by means of questionnaires, including stress, burn-out, work satisfaction, and sense of coherence before and one year after the intervention (n=120). The qualitative part will study if the model is considered applicable by midwives, obstetricians, assistant nurses and managers at delivery wards, and to the content of midwifery care. An ethnographic field study with midwives and a focus-group study with assistant nurses, obstetricians, midwives and managers have been conducted before start and will be performed after the intervention. The ethnographic action research study in Iceland is focusing on midwives’ experiences and the development of guidelines for implementing the model in practice. The study period was Mars 2015-Mars 2016. Key Findings: Findings from the study will be presented at the conference. Discussion: The findings will present knowledge about the clinical relevans of a theretical midwifery model of woman-centred care. References: Berg M, Olofsdottir O, & Lundgren I. (2012). A midwifery model of woman-centred childbirth care – In Swedish and Icelandic settings. Sexual and Reproductive Healthcare, 3(2), 79-87. Bryar R, & Sinclair M. (2011). Theory for midwifery practice (andra upplagan). NY: Palgrave Macmillan Cohen S, Kamarck T, Mermelstein R. (1983). A global measure of perceived stress. Health Soc Behav, 24, 385-396. Hildingsson I, Westlund K, Wiklund I. (2013). Burnout in Swedish midwives. Sex Reprod Healthcare. 4(3), 87-91. doi: 10.1016/j.srhc.2013.07.001. Epub 2013 Jul 30. Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. (2013). Continuous support for women during childbirth. Cochrane Database Syst Rev. Jul 15;7:CD003766. [Epub ahead of print] Karasek R, Theorell T. (1990). Healthy work: stress, productivity and the reconstruction of working life. New York: Basic Book Inc. Kristensen T, Borritz M, Villadsen E, Christensen, K. (2005). The Copenhagen burnout inventory: A new tool for the assessment of burnout. Work & Stress, 19 (3), 192-207. Morse Jm & Niehaus L (2009). Mixed Method Design: Principles and Procedures. Walnut Creek, CA, USA: Left Coast Press Inc.
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