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- Eriksson, Monica, 1952-, et al.
(author)
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Meaning of wellness in caring science based on Rodgers's evolutionary concept analysis
- 2024
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In: Scandinavian Journal of Caring Sciences. - West Sussex : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 38:1, s. 185-99
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Journal article (peer-reviewed)abstract
- Background: Wellness is a holistic, multidimensional, and process-oriented property on a continuum. It has been used interchangeably with and is undifferentiated from concepts such as health and well-being without an in-depth clarification of its theoretical foundations and a reflection on its meaning. The concept of wellness is frequently used, but its definition remains unclear. Aim: To conceptually and theoretically explore the concept of wellness to contribute to a deeper understanding in caring science. Method: Rodgers' evolutionary concept analysis was applied to the theoretical investigation of data from publications of international origins. The focus was on antecedents, attributes, consequences, surrogate and related terms, and contextual references. A literature search was performed through a manual review of reference lists and an online search in CINAHL and PubMed via EBSCO, and in ProQuest. Abstracts were examined to identify relevant studies for further review. The inclusion criteria were peer-reviewed papers in English; papers published in scientific journals using the surrogate terms ‘wellness’, ‘health’, ‘health care’, and ‘health care and wellness’; and papers discussing and/or defining the concept of wellness. Twenty-six studies met the inclusion criteria. Results: Based on the findings from this concept analysis, a definition of wellness was developed: ‘a holistic and multidimensional concept represented on a continuum of being well that goes beyond health’. Implications for nursing practice were correspondingly presented. Conclusion: Wellness is defined as a holistic and comprehensive multidimensional concept represented on a continuum of being well, that goes beyond health. It calls attention by applying the salutogenic perspective to health promotion in caring science. It is strongly related to individual lifestyle and health behaviour and is frequently used interchangeably with health and well-being without an in-depth clarification of its theoretical foundation.
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| 2. |
- Truong, Anh
(author)
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Developing an educational intervention to support work-integrated learning among professionals in health and social care for individuals with intellectual disabilities
- 2024
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Doctoral thesis (other academic/artistic)abstract
- Continuing education in the workplace has become a crucial part of contemporary working life, in alignment with modern labor market policies advocating lifelong learning. Work-integrated learning (WIL) is aimed at supporting professional development as part of lifelong learning, emphasizing both theoretical and practical knowledge alongside interactive engagement. Despite its significance, WIL within the context of educational interventions geared toward supporting learning and development among professionals remains an under-researched domain compared to its application in higher education focused on student learning. Previous research has shown that the learning process among professionals may follow a different logic compared to that of students in higher education. This dissertation highlights the development of an educational intervention from both an effectiveness and theory-based perspective, with WIL based on socio-constructivism serving as the point of departure. The intervention was aimed at professionals in municipal health and care for individuals with intellectual disabilities. The intention behind studying these professionals’ learning and development was to extend our knowledge of the ways in which the educational intervention influenced the professionals’ learning process and to reveal key aspects that must be considered in further developments of the intervention. Such knowledge contributions can potentially improve and expand future educational efforts aimed at professionals.The development of the educational intervention followed a pragmatic process consisting of three stages described in four individual papers. Data were collected through surveys and individual semi-structured interviews, which were then analyzed using statistical calculations and qualitative content analysis.The findings illustrated that learning and development among professionals did not follow a straightforward trajectory from the completed educational intervention to the learning outcome. The intervention, consisting of web-based lectures and structured group reflections, was found to support the professionals’ learning, with group reflections acting as a catalyst for collective learning and for the integration of theoretical knowledge into daily practice. However, creating the conditions needed for all participants to engage in group reflections was a key issue and should not be taken for granted in future educational initiatives in which group reflections are intended to be used. Likewise, organizational support and encouragement were found to constitute an important driving force in the professionals’ learning. Overall, learning and development among professionals are complex and influenced by multiple factors and mechanisms. Addressing these complexities requires a simultaneous focus on three fundamental elements: the actors involved in the learning process, the educational intervention itself, and the surrounding context. This can be best accomplished through a structured and systematic approach to the developmental process of the intervention. Such an approach could strengthen professionals’ commitment to lifelong learning and contribute to sustainable educational efforts, both economically and socially.
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| 3. |
- Buckley, Sarah, et al.
(author)
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Maternal and newborn plasma oxytocin levels in response to maternal synthetic oxytocin administration during labour, birth and postpartum : a systematic review with implications for the function of the oxytocinergic system
- 2023
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In: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 23:1
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Journal article (peer-reviewed)abstract
- BACKGROUND: The reproductive hormone oxytocin facilitates labour, birth and postpartum adaptations for women and newborns. Synthetic oxytocin is commonly given to induce or augment labour and to decrease postpartum bleeding.AIM: To systematically review studies measuring plasma oxytocin levels in women and newborns following maternal administration of synthetic oxytocin during labour, birth and/or postpartum and to consider possible impacts on endogenous oxytocin and related systems.METHODS: Systematic searches of PubMed, CINAHL, PsycInfo and Scopus databases followed PRISMA guidelines, including all peer-reviewed studies in languages understood by the authors. Thirty-five publications met inclusion criteria, including 1373 women and 148 newborns. Studies varied substantially in design and methodology, so classical meta-analysis was not possible. Therefore, results were categorized, analysed and summarised in text and tables.RESULTS: Infusions of synthetic oxytocin increased maternal plasma oxytocin levels dose-dependently; doubling the infusion rate approximately doubled oxytocin levels. Infusions below 10 milliunits per minute (mU/min) did not raise maternal oxytocin above the range observed in physiological labour. At high intrapartum infusion rates (up to 32 mU/min) maternal plasma oxytocin reached 2-3 times physiological levels. Postpartum synthetic oxytocin regimens used comparatively higher doses with shorter duration compared to labour, giving greater but transient maternal oxytocin elevations. Total postpartum dose was comparable to total intrapartum dose following vaginal birth, but post-caesarean dosages were higher. Newborn oxytocin levels were higher in the umbilical artery vs. umbilical vein, and both were higher than maternal plasma levels, implying substantial fetal oxytocin production in labour. Newborn oxytocin levels were not further elevated following maternal intrapartum synthetic oxytocin, suggesting that synthetic oxytocin at clinical doses does not cross from mother to fetus.CONCLUSIONS: Synthetic oxytocin infusion during labour increased maternal plasma oxytocin levels 2-3-fold at the highest doses and was not associated with neonatal plasma oxytocin elevations. Therefore, direct effects from synthetic oxytocin transfer to maternal brain or fetus are unlikely. However, infusions of synthetic oxytocin in labour change uterine contraction patterns. This may influence uterine blood flow and maternal autonomic nervous system activity, potentially harming the fetus and increasing maternal pain and stress.
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| 4. |
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| 5. |
- Leinweber, Julia, et al.
(author)
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Developing a woman-centered, inclusive definition of positive childbirth experiences : A discussion paper
- 2023
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In: Birth. - : John Wiley & Sons. - 0730-7659 .- 1523-536X. ; 50:2, s. 362-383
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Journal article (peer-reviewed)abstract
- Introduction A positive childbirth experience promotes women’s health, both during and beyond the perinatal period. Understanding what constitutes a positive childbirth experience is thus critical to providing high-quality maternity care. Currently, there is no clear, inclusive, woman-centered definition of a positive childbirth experience to guide practice, education, and research.Aim To formulate an inclusive woman-centered definition of a positive childbirth experience.Methods A six-step process was undertaken: (a) Key concepts associated with a positive childbirth were derived from a rapid literature review; (b) The key concepts were used by interdisciplinary experts in the author group to create a draft definition; (c) The draft definition was presented to clinicians and researchers during a European research meeting on perinatal mental health; (d) The authors integrated the expert feedback to refine the working definition; (e) A revised definition was shared with women from consumer groups in six countries to confirm its face validity; and (f) A final definition was formulated based on the women’s feedback (n = 42).Results The following definition was formulated: “A positive childbirth experience refers to a woman’s experience of interactions and events directly related to childbirth that made her feel supported, in control, safe, and respected; a positive childbirth can make women feel joy, confident, and/or accomplished and may have short and/or long-term positive impacts on a woman’s psychosocial well-being.”Conclusions This inclusive, woman-centered definition highlights the importance of provider interactions for facilitating a positive childbirth experience. Feeling supported and having a sense of control, safety, and respect are central tenets. This definition could help to identify and validate positive childbirth experience(s), and to inform practice, education, research, advocacy, and policy-making.
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| 6. |
- Thapa, Dip Raj, et al.
(author)
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A Qualitative Evaluation and Cross-Cultural Adaptation of the Short Form of the Sense of Coherence Scale (SOC-13) in Nepali
- 2023
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In: Kathmandu University Medical Journal. - : Kathmandu University. - 1812-2027 .- 1812-2078. ; 21:82, s. 112-117
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Journal article (peer-reviewed)abstract
- Background Sense of Coherence (SOC) relates to an individual’s overall life orientation, and stronger SOC is associated with better health, quality of life, and coping strategies. When our research group used the SOC-13 questionnaire for the first time in Nepal, we identified difficulties in response patterns. The findings necessitated further evaluation of the Nepali version of the SOC-13 questionnaire.Objective To qualitatively evaluate the SOC-13 questionnaire in Nepali for cross-cultural adaptation.Method Nineteen nurses were interviewed. We used the methodological approach of “think aloud” to obtain a deeper understanding of the interferences of the scales. Transcribed materials were analyzed using a deductive approach through qualitative content analysis. The original translated version of the SOC-13 questionnaire in Nepali was modified by replacing words that were easier to understand.Result Participants found the questionnaire content general and non-specific but easy to complete. The nurses experienced that the meanings and sentences in some of the items and response alternatives were difficult to understand. However, the overall comprehensiveness of most items and response alternatives was perceived as good. Nurses’ interpretation of the SOC-items in the translated version of the SOC-13 questionnaire in Nepali matched the original English version. Items that were experienced as difficult in the Nepali language were modified to increase their comprehensiveness. Modified items and response alternatives had the same content as before, but some words and meanings were substituted with easier language.Conclusion The current revised version of SOC-13 in Nepali is valid and useful to explore individuals’ overall life orientation and their abilities to deal and cope with various life events in the Nepalese context.
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| 7. |
- Ekström-Bergström, Anette, 1958-, et al.
(author)
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The concept, importance and values of support during childbearing and breastfeeding : A discourse paper
- 2022
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In: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 9:1, s. 156-167
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Journal article (peer-reviewed)abstract
- Background: Professional support in childbearing has beneficial effects on childbirth experience, interactions within the family, breastfeeding and medical outcomes. However, more knowledge is needed about prerequisites for professional support to be valuable and satisfactory during childbearing. Aim: The aim of this discourse paper is to describe and explore prerequisites for professional support that are of value for women and their families during childbearing as well as how healthcare organizations can be formed to facilitate these prerequisites. Design: Discourse paper. Methods: This discourse paper is based on our own experiences and is supported by literature and theory. Results: Well-functioning structures and processes facilitate professional support that leads to safe, secure, calm and prepared parents with the ability to handle the challenges of childbearing and parenting. When organizing care in childbearing, prerequisites for support needs must also be considered.
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| 8. |
- Leinweber, Julia, et al.
(author)
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Developing a woman-centered, inclusive definition of traumatic childbirth experiences : A discussion paper.
- 2022
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In: Birth. - : John Wiley & Sons. - 0730-7659 .- 1523-536X. ; 49:4, s. 585-842
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Journal article (peer-reviewed)abstract
- INTRODUCTION: Many women experience giving birth as traumatic. Although women's subjective experiences of trauma are considered the most important, currently there is no clear inclusive definition of a traumatic birth to help guide practice, education, and research.AIM: To formulate a woman-centered, inclusive definition of a traumatic childbirth experience.METHODS: After a rapid literature review, a five-step process was undertaken. First, a draft definition was created based on interdisciplinary experts' views. The definition was then discussed and reformulated with input from over 60 multidisciplinary clinicians and researchers during a perinatal mental health and birth trauma research meeting in Europe. A revised definition was then shared with consumer groups in eight countries to confirm its face validity and adjusted based on their feedback.RESULTS: The stepwise process confirmed that a woman-centered and inclusive definition was important. The final definition was: "A traumatic childbirth experience refers to a woman's experience of interactions and/or events directly related to childbirth that caused overwhelming distressing emotions and reactions; leading to short and/ or long-term negative impacts on a woman's health and wellbeing."CONCLUSIONS: This definition of a traumatic childbirth experience was developed through consultations with experts and consumer groups. The definition acknowledges that low-quality provider interactions and obstetric violence can traumatize individuals during childbirth. The women-centered and inclusive focus could help women to identify and validate their experiences of traumatic birth, offering benefits for practice, education, and research, as well as for policymaking and activism in the fields of perinatal mental health and respectful maternity care.
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| 9. |
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| 10. |
- Thapa, Dip Raj
(author)
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A health-promotive approach to maintain and sustain health in women-dominated work in Nepal and Sweden
- 2022
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Doctoral thesis (other academic/artistic)abstract
- Background: The characteristics of women-dominated work differ in Nepal compared to Sweden. Women in Nepal perform household and other low-income work, including nursing, which is a women-dominated occupation in both Nepal and Sweden. Work-related adverse health outcomes, such as burnout, fatigue, depression, sleep disturbances, and long-term sickness absence, are evident in women-dominated work, especially within nursing. These challenges are accompanied by an increasing elderly population and a shortage of nursing personnel. Good health and well-being for all, improvingworking conditions and working environment, and providing adequate health and safety at work are the targets of sustainable development goals. Healthpromotive actions and interventions are needed to maintain and sustain health in women-dominated work.Aims: The overall aim of this thesis was to identify means for promoting and sustaining health in women-dominated work in Nepal and Sweden through the evaluation and exploration of sense of coherence (SOC), work-related health, job demands, job resources, and health outcomes.Methods: This thesis includes five individual papers. Paper I is a community-based intervention study with a quantitative design conducted in Nepal. The participants were 857 women before and 1268 women after health educationintervention in Nepal, who responded to a translated version of the SOC-13 questionnaire in Nepali. Papers II and III have a qualitative design and are based on 19 individual interviews with nurses in Nepal. Paper IV is also a qualitative study, based on 13 individual interviews with midwives and nurses in Sweden. Paper V is derived from the Swedish Longitudinal Occupational Survey of Health (SLOSH). Data were collected in 2016–2019 for all papers. The quantitative studies were analyzed through descriptive statistics, chisquared tests, one-way analyses of variance (ANOVAs), multivariable oneway ANOVAs, and logistic regression analyses. The qualitative studies werebased on individual interviews, and the data were analyzed through qualitative content analysis and thematic analysis.Results: Women in semi-urban Nepal exhibited total SOC mean values between 51.1 and 57.4, which are comparable to India within a similar context. Qualitative validation of the SOC-13 questionnaire in Nepali was found to be general and not specific, and some translations were confusing. The SOC-13 items needed to undergo further editing in translation to increase theircomprehensions. Nurses in Nepal and nurses and midwives in Sweden described their work experience as meaningful, and several experiences were partially similar; their work and health were reported to be strengthened through collegial support, teamwork, and opportunities for skills and competence development. Shift work, lack of rewards and appreciation from managers, low staff-patient ratios, and high workload affected their work-related health negatively. In particular, nurses in Nepal experienced a lack of a safe physical work environment and insufficient managerial support. Results from SLOSH-data showed that the nursing professionals’ job demands were associated with lower self-rated health, higher burnout, and higher sickness absence. Job resources were associated with higher self-rated health and lower burnout.Conclusion: This thesis shows that the SOC-13 questionnaire is useful and qualitatively validated for future use in the Nepalese context, to explore individuals’ overall life orientation and abilities to cope with various life events. Health education can be useful in strengthening SOC among women. To maintain, promote, and sustain health in women-dominated work, a health-promotive approach should be fostered. Nursing professionals’ health can be strengthened and sustained through the development of a positive work environment through good collegial, organizational, and managerial support, offering skills and competence development opportunities, and creating a safe physical and psychosocial work environment. Increasing job resources and minimizing job demands are important to increase positive health outcomes and decrease adverse health outcomes. Nursing professionals in Nepal and Sweden can also adopt strategies that support recovery and stress-management at work
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