| 1. |
- Bitar, Dima, et al.
(författare)
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Application to promote communication between midwives and Arabic-speaking women at antenatal care : Challenges met by researchers when developing content
- 2022
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Ingår i: European Journal of Midwifery. - : European Publishing. - 2585-2906. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION Providing good communication is at the core of recent international guidelines for improving women's outcomes at birth. Communication barriers are identified as major obstacles to providing effective and equal care among foreign-born women. There is a need for accurate communication tools in antenatal care. The aim of this study was to describe challenges met by researchers when developing culturally sensitive content in a Swedish-Arabic application for communication support at antenatal care in Sweden. METHODS A co-design methodology was used for the development of the application, entailing collaboration between users and researchers in five different phases: users' needs and preferences, development, field testing I, refinement, and field testing II. RESULTS Five challenges emerged: evidence-based information, time frame, realistic photographs, norm-critical perspective, and cultural issues. One challenge was to meet the needs of the users and combine it with information following evidence-based obstetric welfare guidelines. It was also challenging to produce short informational videos that could be adjusted for the duration of the visit with the midwife without omitting important information and to produce photographs which can become outdated. It was also a challenge to portray a less clinical environment and to maintain parents' integrity. It was also challenging to produce norm-critical content from the women's perspective. CONCLUSIONS When developing content of an application for antenatal care, converting content proposals into a finished product is challenging. Collaboration between a cross-disciplinary research team, midwives and target-language women is essential to ensure that the content is usable and reliable.
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| 2. |
- Bitar, Dima, et al.
(författare)
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Arabic-speaking women's experiences of communication at antenatal care in Sweden using a tablet application : part of development and feasibility study
- 2020
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Ingår i: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 84:May, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The purpose of this study was to explore Arabic-speaking women´s experiences of communication at antenatal care in Sweden when using a tablet application (app). Design: The study is a part of a major research project, where a Swedish-Arabic app was developed to improve and facilitate communication between Arabic-speaking women and midwives. The first prototype was developed in 2017 and tested at six antenatal clinics in southeast of Sweden. Ten Arabic-speaking women were purposively recruited, and individual interviews were performed. Content analysis was used. Findings: Four main categories emerged: "Adapting the content to the patient group", "language and communication", "user-friendly" and "improvement proposal". The women reported that the content was educational, reliable and understandable. The information gave the women a sense of security. It was time effective and allowed opportunity for dialogue. Depending on language skills, there were different opinions as to whether the App should be a complement to having an interpreter or used separately. Key conclusion: Arabic-speaking women perceived the App as being a communication tool despite their language skills in Swedish. There is a need for digital support for communication in maternity care
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| 3. |
- Bjelke, Maria, et al.
(författare)
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Mode of delivery and birth outcomes in relation to the duration of the passive second stage of labour : A retrospective cohort study of nulliparous women
- 2023
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Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the mode of delivery and birth outcomes in relation to the duration of the passive second stage of labour in nulliparous women.Methods and findings: A retrospective cohort study of all nulliparous women (n = 1131) at two delivery units in Sweden. Maternal and obstetric data were obtained from electronic medical records during 2019. The passive second stage was defined as the complete dilation of the cervix until the start of the active second stage. The duration of the passive second stage was categorized into three groups: 0 to 119 min (0 to <2 h), 120–239 min (2- <4h) and ≥240 min (≥4h). Differences between the groups were examined using t-test and Chi2-tests and regression analyses were used to analyse adjusted odds ratio with 95% confidence intervals. The primary outcome was mode of delivery in relation to the duration of the passive second stage and the secondary outcomes covered a series of adverse maternal and neonatal birth outcomes. The rates of instrumental and caesarean deliveries increased as the duration of the passive second stage increased. A ≥4-hour duration of the passive second stage was associated with a nine-times increased risk of caesarean section, and a four-times risk of instrumental delivery compared to a duration of <2 hours in the adjusted analyses. No differences were found in the maternal birth outcomes. The risk of a 5-minute Apgar score <7 was increased in the 2-<4h group. A longer passive second stage was not associated with an increased risk of negative birth experience.Conclusions: Our study demonstrates an increased risk of operative delivery for a longer duration (>2h) of the passive second stage in nulliparous women, although most of the women gave birth by spontaneous vaginal delivery even after ≥4 hours. There was no evidence of an increased risk of adverse maternal outcomes in a longer duration of the passive second stage but there were indications of increased adverse neonatal outcomes. Assessment of fetal well-being is important when the duration of the passive phase is prolonged.
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| 4. |
- Bjelke, Maria, et al.
(författare)
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Nulliparous women’s lived experiences of the prolonged passive stage of labour: A thematic analysis based on descriptive phenomenology
- 2024
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier. - 1877-5756 .- 1877-5764. ; 41, s. 100985-100985
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Prolonged progress can occur in the first and second stages of labour and may contribute to a negative birth experience. However, previous studies have mainly focused on quantitative aspects or overall birth experience, and little is known about women's experiences of a prolonged passive second stage. Objective: To describe the lived experiences of a prolonged passive second stage of labour in nulliparous women. Methods: A qualitative study was conducted with 15 nulliparous women with a passive second stage lasting three hours or more. Data were analysed using thematic analysis based on descriptive phenomenology. Results: The analysis resulted in four themes: “An unknown phase” that entailed remaining in a phase that the women lacked an awareness of. “Trust and mistrust in the body's ability” represents the mindset for vaginal birth as well as feelings of powerlessness and self-guilt. The theme “Loss of control” included experiences of frustration, fatigue, and having to deny bodily instincts. “Support through presence and involvement” signifies support through the midwife's presence in the birthing room, although there were also descriptions of emotional or physical absence. Conclusions: The findings contribute to the understanding of prolonged labour based on women's lived experiences and add to the body of knowledge about the prolonged passive second stage. This study highlights that women need support through information, presence, and encouragement to remain in control. It can be beneficial during birth preparation to include knowledge about the passive second stage together with unexpected or complicated situations during birth, such as prolonged labour.
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| 5. |
- Bjelke, Maria, et al.
(författare)
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Prolonged passive second stage of labor in nulliparous women-Prevalence and risk factors : A historical cohort study
- 2022
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : John Wiley & Sons. - 0001-6349 .- 1600-0412. ; 101:5, s. 499-505
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Tidskriftsartikel (refereegranskat)abstract
- Introduction This study examined the prevalence of and risk factors for a prolonged passive second stage of labor in nulliparous women. Material and Methods This was a historical cohort study of all nulliparous women (n = 1131) at two delivery units in Sweden. Maternal and obstetric data were obtained from electronic medical records during 2019. Duration of the passive second stage was measured as time from retracted cervix to start of pushing. Prolonged passive second stage was defined as >= 2 h. Prevalence was calculated and associations between prolonged passive second stage and maternal, obstetric and neonatal characteristics and potential risk factors were assessed using logistic regression models. Results The prevalence of prolonged passive second stage was 37.6%. Factors associated with an increased risk of prolonged passive second stage were epidural analgesia (adjusted odds ratio [aOR] 3.93; 95% confidence interval [CI] 2.90-5.34), malpresentation (aOR 2.26; 95% CI 1.27-4.05), maternal age >= 30 years (aOR 2.00; 95% CI 1.50-2.65) and birth weight >= 4 kg (aOR 1.50; 95% CI 1.05-2.15). Maternal body mass index >= 30 (aOR 0.52; 95% CI 0.34-0.79) and noncohabiting (aOR 0.51; 95% CI 0.30-0.89) reduced the odds of prolonged passive second stage. Conclusions A prolonged passive second stage of labor in nulliparous women is common (n = 425 [38%]). We found epidural analgesia, malpresentation, maternal age >= 30 years and birthweight >= 4 kg to be major risk factors associated with an increased risk of a prolonged passive second stage. Birth outcomes for prolonged passive second stage need to be investigated to strengthen evidence for the management of the second stage of labor.
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| 6. |
- Bjelke, Maria
(författare)
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Prolonged passive second stage of labour in nulliparous women : A multi perspective study
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: This study aimed to describe the prolonged passive second stage of labour in nulliparous women in relation to its prevalence, risk factors, birth outcomes, midwives’ intrapartum management, and women's birth experiences. Methods: Study I was a qualitative study in which 36 midwives participated in seven focus group discussions. Data were analysed using qualitative content analysis. Studies II and III were retrospective observational cohort studies where medical records from 1131 nulliparous women in Sweden were reviewed. Analyses were performed using descriptive statistics and multivariable logistic regression. Study IV included 15 individual interviews with nulliparous women who had a passive second stage lasting three hours or more. Data were analysed using thematic analysis based on descriptive phenomenology.Results: Midwives’ management of the passive phase is complex, especially if progress is slow. Guidelines were considered, but women were preferably managed individually. The prevalence of prolonged passive second stage (≥2h) was 38%. Epidural analgesia, malpresentation, maternal age ≥30 years, and birth weight of ≥4 kg were identified as risk factors for prolonged passive second stage. Longer duration of the passive second stage was associated with an increased risk of operative delivery. There were no associations with adverse maternal outcomes. Associations with adverse neonatal outcomes were found, although the rate of adverse neonatal outcomes were low in the study population. Women’s experiences of prolonged passive second stage were described in four themes: “An unknown phase”, “Trust and mistrust in the body’s ability”, ”Loss of control“, and “Support through presence and involvement”.Conclusion: This thesis describes the prolonged passive second stage from multiple perspectives, including midwives, epidemiological data, and women’s experiences. The midwives’ management of the passive second stage included a complex continuous process of assessment and balancing options for the next step. A prolonged passive second stage was common and did not result in increased risks of adverse maternal outcomes, although further fetal surveillance can be called for. Nulliparous women experienced the passive second stage as an unknown phase and expected a different path for birth, and the experience could include loss of control and increased need for emotional and physical support.
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| 7. |
- Byrman, Gunilla, 1953-, et al.
(författare)
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Sadima : Vänta barn på arabiska, engelska och svenska! Effektiv och integrerande design för interaktiv mödrahälsovård
- 2020
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Annan publikation (mjukvara/multimedium) (refereegranskat)abstract
- Målet har varit att göra ett effektivt, integrerande och interaktivt dialogstöd (https://sadima.lnu.se/). Stödet är avsett att användas i mödravårdssamtal mellan kvinnor med begränsade kunskaper i svenska och svensktalande barnmorskor och är ett komplement till tolk. Samtalsstödet finns på arabiska, engelska, svenska och är fritt tillgängligt på internet. Vi vill uppnå förbättrad och effektiviserad kommunikation mellan barnmorskor och kvinnor. Samtalsstödet ska leda till ökad patientsäkerhet med färre komplikationer och minskad sjuklighet och dödlighet bland kvinnorna och deras barn, och därigenom öka vårdkvaliteten och effektivisera bruket av samhälleliga resurser. Avsikten är att sprida och nyttiggöra samtalsstödet till ansvariga i Sveriges Kommuner och Regioner (SKR) och samordningsbarnmorskor i Sverige. Stödet består av en del där information kan inhämtas och en del där information kan ges om graviditet, förlossning och preventivmedel. Genom webbsidan ska mödrahälsovården göras mer jämlik och kommunikativ, med ökad patientsäkerhet och egenmakt för kvinnor i mödravården.Vi har analyserat material med språkliga, normkritiska och vårdvetenskapliga metoder. I projektet har appen Sadima utvecklats i två versioner, en första testversion och sedan en andra version som utformats som en webbsida. För utvecklandet av den första versionen av appen fick vi medel av Vinnova (2016–2019). Vi arbetade med barnmorskor och skapade en testapp som sedan reviderades och förbättrades successivt genom forskning om kvinnornas och barnmorskornas erfarenhet av att använda samtalsstödet. Det befintliga stödets innehåll är patientsäkrat av läkare och barnmorskor i Region Kalmar. Vi har mätt funktionaliteten i samtalsstödet genom iterativa tester, enkäter och fokusgrupper med barnmorskor och arabisktalande kvinnor, där stödets information har problematiserats; det har gällt etnicitet (språk och kultur), klass (utbildning) och jämlikhet mellan kvinnor. Mätningarna har granskats och utvärderats av referensgruppen för bedömning av funktionaliteten hos samtalsstödet. Gruppen har bedömt att samtalsstödet bidragit till bättre förståelse, ökad patientsäkerhet och effektivare vård.
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| 8. |
- Danehorn, Emil, et al.
(författare)
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Mental health, self-rated health, risky sexual behaviour, alcohol use, and drug use among students who intend to spend a semester abroad - a cross-sectional study
- 2023
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Ingår i: Frontiers In Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Our aim was to investigate potential differences in mental health, self-rated health, risky sexual behaviour, alcohol use, and drug use between (1) Prospective exchange students and campus students separated by sex, and (2) male and female students as a group. Method: Comparative cross-sectional design using an online survey containing the following instruments: Knowledge, Attitudes, and Sexual Behaviour in Young People in Sweden; Self-Rated Health Questionnaire; and General Health Questionnaire 12. One-hundred and fourteen prospective exchange students and 451 campus students participated in the study. Results: Male prospective exchange students rated their mental health as being better and had used cannabis more often compared with female prospective exchange students. Male prospective exchange students also rated their mental health as being better than male campus students. Female students, in general, rated their mental health as worse than male students. A larger proportion of male prospective exchange students had sex together with alcohol compared with male campus students, and a larger proportion of female prospective exchange students had sex with a new partner and drank more alcohol compared to female campus students. Conclusion: The result shows that risky alcohol use and sexually risky behaviour is prominent amongst prospective exchange students. It is possible that they will continue, and even increase their risky behaviour whilst abroad as they find themselves in a new social context, and free from influence of the rules and restrictions that they might have at home. With limited knowledge of the local culture, native language, and in an unfamiliar environment, it is possible that the risks will be enhanced and possibly decrease their health. This highlights the need for proactive interventions, conceivably with some variations in content between sexes.
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| 9. |
- Danehorn, Emil, et al.
(författare)
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Swedish exchange students' alcohol use, drug use, risky sexual behaviour, mental health, and self-rated health : A follow-up study
- 2023
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Ingår i: Nordic Studies on Alcohol and Drugs. - : Sage Publications. - 1455-0725 .- 1458-6126. ; 40:3, s. 287-300
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To follow up on exchange students' alcohol use, drug use, mental health, self-rated health, and risky sexual behaviour after a semester abroad and to compare them with students who remained on campus. Methods: The study design was a follow-up study based on a previous baseline survey of 114 prospective exchange students and 451 campus students. Of the original 565 students, 48 (42.1%) prospective exchange students and 209 (43.3%) campus students responded to the follow-up. Both the baseline survey and the follow-up survey included the General Health Questionnaire 12, one single item from Self-Rated Health, and nine items from Knowledge, Attitudes and Sexual Behaviour in Young People in Sweden. Results: We found a statistically significant increase in the weekly consumption of alcohol among exchange students after their semester abroad. A larger proportion of exchange students had sex with a new partner and sex with more than three partners during their semester abroad compared to follow-up campus students. Conclusions: Our findings indicate that exchange students consume alcohol more frequently during their semester abroad and indulge in sexually risky behaviour. Exchange students' use of alcohol and sexually risky behaviour could be associated with even greater risks due to them being in an unknown environment, unfamiliar culture, and with limited support from family and friends. This highlights the need for further research on exchange students' experiences, especially concerning alcohol use and sex while abroad.
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| 10. |
- Ek, Emmelie, et al.
(författare)
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Sömnproblem och sömnkvalitet bland gravida – en enkätstudie
- 2022
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Ingår i: Sömn och hälsa. - Kristianstad : Kristianstad University Press. - 2003-234X .- 2003-2501. ; :7, s. 13-32
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Tidskriftsartikel (refereegranskat)abstract
- Sömnen påverkas under en graviditet med bland annat fler uppvaknanden och mindre djupsömn. Sömnproblem under graviditeten ökar risken för psykiska problem och medicinska komplikationer hos den gravida och fostret. Det saknas svenska studier om sömnproblem och graviditet.Syftet var att kartlägga sömnproblem och sömnkvalitet bland gravida och jämföra de tre trimestrarna, samt undersöka samband mellan sömnproblem och självskattad hälsa.Studien genomfördes som en tvärsnittsstudie med en webbaserad enkät som besvarades av 836 gravida kvinnor.Resultatet analyserades med en deskriptiv och analytisk statistik. Resultatet visar att majoriteten av de gravida (69,5 %) rapporterade sömnproblem och 84,2 % rapporterade dålig sömnkvalitet. Inga signifikanta skillnader fanns mellan de olika trimestrarna. Av de gravida skattade 79,5 % sin hälsa som god. Bland gravida med god självskattad hälsa hade 65,3 % sömnproblem, bland gravida med dålig självskattad hälsa hade 86 % sömnproblem (p <0,001). Av de gravida med god självskattad hälsa hade 81,4 % dålig sömnkvalitet och bland gravida med dålig självskattad hälsa hade 95,3 % dålig sömnkvalitet (p <0,001). Kvinnorna rapporterade många graviditetssymtom störde de gravidas sömn. En majoritet (62,9 %) besvärades av illamående i första trimestern. Påverkan av sura uppstötningar/reflux, ryggont och obekväma ställningar ökade med varje trimester. Livliga drömmar och oro för förlossningen upplevdes störst i första trimestern. Över 80 % av alla gravida kvinnor i alla tre trimestrarna fick störd nattsömn av frekvent urinering.Majoriteten av de gravida hade sömnproblem och dålig sömnkvalitet. Trots detta skattade de flesta sin hälsa som god.
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