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1.	Akhter, Tansim, 1967-, et al. (författare) Dimethylarginines correlate to common carotid artery wall layer dimensions and cardiovascular risk factors in pregnant women with and without preeclampsia 2018 Ingår i: Atherosclerosis. - : ELSEVIER IRELAND LTD. - 0021-9150 .- 1879-1484. ; 275, s. E69-E70 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
2.	Bodin, Maja, et al. (författare) Can Reproductive Life Plan-based counselling increase men's fertility awareness? 2018 Ingår i: Upsala Journal of Medical Sciences. - : Uppsala Medical Society. - 0300-9734 .- 2000-1967. ; 123:4, s. 255-263 Tidskriftsartikel (refereegranskat)abstract Background: Many men have limited knowledge about reproductive health and fertility. The aim of the study was to evaluate if Reproductive Life Plan (RLP)-based counselling during a sexual health visit could increase men’s fertility awareness.Material and methods: The study was a randomized controlled trial including 201 men aged 18–50 who visited either of two participating sexual health clinics in Sweden for sexually transmitted infection testing during 2014–2016. All men received standard care, and men in the intervention group (IG) also received oral and written RLP-based information about lifestyle and fertility. Awareness about fertility and lifestyle-related factors were the main outcomes, measured through a questionnaire before the intervention and through a telephone survey after three months. Impressions from the counselling were also assessed at follow-up.Results: A majority (71%) of men wanted children in the future. General fertility awareness increased from a mean score of 4.6 to 5.5 out of 12 (P = 0.004) in the IG. The mean number of accurate lifestyle factors (that could affect fertility) mentioned increased from 3.6 to 4.4 (P < 0.001) in the IG. There were no improvements in the control group. Among the men in the IG, 76% had a positive experience of the counselling, and 77% had received new information.Conclusion: The intervention managed to increase different aspects of men’s fertility awareness. In the future, the format for preconception care for men needs further development. Including men in preconception health policy guidelines and identifying suitable actors for care provision would be important first steps.
3.	Bodin, Maja, 1984-, et al. (författare) Evaluating Reproductive Life Plan-Based Counseling with Men During a Sexual Health Visit: a Randomized Controlled Trial Tidskriftsartikel (refereegranskat)
4.	Bodin, Maja, et al. (författare) Exploring men's pregnancy-planning behaviour and fertility knowledge : a survey among fathers in Sweden 2017 Ingår i: Upsala Journal of Medical Sciences. - : Uppsala Medical Society. - 0300-9734 .- 2000-1967. ; 122:2, s. 127-135 Tidskriftsartikel (refereegranskat)abstract INTRODUCTION: Research about pregnancy-planning behaviour mostly focuses on women, even though pregnancy planning usually also concerns men. The purpose of this study was to investigate how men plan for family, and to measure their fertility knowledge after having become fathers.MATERIAL AND METHODS: Data were collected in 2014 as part of a Swedish longitudinal pregnancy-planning study. Men were recruited through their female partner one year after childbirth. Participants were asked to fill out a questionnaire about pregnancy planning, lifestyles, and fertility.RESULTS: Of the 796 participants, 646 (81%) stated that the pregnancy had been very or fairly planned, and 17% (n = 128) had made a lifestyle adjustment before pregnancy to improve health and fertility. The most common adjustments were to reduce/quit the consumption of alcohol, cigarettes, or snuff, and to exercise more. First-time fathers and those who had used assisted reproductive technology to become pregnant were more likely to have made an adjustment. Fertility knowledge varied greatly. Men with university education had better fertility knowledge than men without university education.CONCLUSION: Our findings indicate that there is variation in how men plan and prepare for pregnancy. Most men did not adjust their lifestyle to improve health and fertility, while some made several changes. Both pregnancy-planning behaviour and fertility knowledge seem to be related to level of education and mode of conception. To gain deeper understanding of behaviour and underlying factors, more research is needed.
5.	Carlsson, Sven G., 1935, et al. (författare) Olika BB-rutiners inflytande på amning och mor-barn kontakt 1976 Ingår i: Stockholm, Sweden, May 1976. - Stockholm : Rädda Barnen. ; , s. 38-43 Rapport (övrigt vetenskapligt/konstnärligt)
6.	Daka, Bledar, 1976, et al. (författare) Circulating concentrations of endothelin-1 predict coronary heart disease in women but not in men: A longitudinal observational study in the Vara-Skövde Cohort 2015 Ingår i: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 15:1 Tidskriftsartikel (refereegranskat)abstract © 2015 Daka et al.Background: The vasoconstricting peptide endothelin-1 has been proposed to be a marker of cardiovascular disease. Our aim was to investigate whether circulating endothelin-1 levels predict coronary heart disease (CHD) in Sweden. Methods: In 2002-2005, 2816 adult participants (30-74 years) were randomly selected from two municipalities in south-western Sweden. Cardiovascular risk factors and endothelin-1 levels were assessed at baseline, and incident CHD was followed-up in all participants through 2011. After exclusion of 50 participants due to known CHD at baseline and 21 participants because of unsuccessful analysis of endothelin-1, 2745 participants were included in the study. In total, 72 CHD events (52 in men and 20 in women) were registered during the follow-up time. Results: We showed that baseline circulating endothelin-1 levels were higher in women with incident CHD than in women without CHD (3.2 pg/ml, SE: 0.36 vs 2.4 pg/ml, SE: 0.03, p = 0.003) whereas this difference was not observed in men (2.3 pg/ml, SE: 0.16 vs 2.3 pg/ml, SE: 0.04, p = 0.828). An age-adjusted Cox proportional regression analysis showed an enhanced risk of CHD with increasing baseline endothelin-1 levels in women (hazard ratio (HR) = 1.51, 95 % CI = 1.1-2.1, p = 0.015) but not in men (HR = 0.98, 95 % CI = 0.8-1.2, p = 0.854). Furthermore, the predictive value of endothelin-1 for incident CHD in women was still significant after adjustments for age, HOMA-IR, apolipoprotein (apo)B/apoA1 and smoking (HR = 1.53, CI = 1.1-1.2, p = 0.024). Conclusion: Circulating endothelin-1 levels may predict CHD in women.
7.	Ekstrand, Maria, et al. (författare) Exposing oneself and one's partner to sexual risk-taking as perceived by young Swedish men who requested a Chlamydia test 2011 Ingår i: European journal of contraception & reproductive health care. - : Informa UK Limited. - 1362-5187 .- 1473-0782. ; 16:2, s. 100-107 Tidskriftsartikel (refereegranskat)abstract Objectives: To explore young men's perceptions of (i) the risk for themselves and their partners in connection with unprotected intercourse, and (ii) the main barriers to practising safe sex. Methods: Qualitative latent content analysis of interviews involving 22 Swedish males aged 16-20, who requested a Chlamydia test. Results:The main categories identified were: (1) Low perceived threat regarding sexual risk-taking - personal consequences in focus. Threats could be both immediate and distant with varying preventative strategies. The young men worried more about their personal consequences than about the consequences for their partner. They were confident that an unintended pregnancy would be terminated, leading to decreased motivation for sharing pregnancy-preventing practices with their partner. (2) Perceived barriers to practising safe sex. Main barriers to condom use were interference with spontaneity, pleasure reduction, fear of loosing one's erection, and embarrassment or distrust. Other obstacles were the girl's use of hormonal contraception, and difficulties in communicating about safe sex. Conclusion The young men did not seem to worry about risks when having unprotected sex. To protect men's - and women's - sexual and reproductive health, efforts are needed to increase the former's contraceptive responsibilities and awareness of consequences related to unprotected sex.
8.	Ekstrand, Maria, et al. (författare) Sex education in Swedish schools as described by young women 2011 Ingår i: European journal of contraception & reproductive health care. - : Informa UK Limited. - 1362-5187 .- 1473-0782. ; 16:3, s. 210-224 Tidskriftsartikel (refereegranskat)abstract Objectives: To investigate sex education in Swedish schools regarding content, satisfaction, and suggested improvements, as described by teenagers and young adults. Methods: Waiting-room survey conducted among 225 female patients (aged 13-25) at youth and student health clinics in one large-, and one medium-sized Swedish city. Results: Most participants (97%, n = 218) had received sex education in school, of varying content and quality. Sixty percent thought basic body development was sufficiently covered. Insufficiently covered topics included sexual assault (96%), sexual harassment (94%), pornography (90%), abortion (81%), emergency contraception (80%), fertility (80%), and pregnancy (59%). Thirty percent received no information about chlamydia, and almost half reported that condyloma and human papillomavirus had not been addressed. The youngest respondents (13-19 years) were significantly more likely to have been told about emergency contraception, homosexuality, bisexuality, and transsexuality. Nearly half (46%) considered ''acceptable'' the knowledge gained from sex education provided at school whereas more than a third considered it ''poor'' or ''very poor''. Suggested improvements included more information, more discussion, greater emphasis on sexual diversity, and more knowledgeable teachers. Conclusions: Content and quality of sex education varied greatly. Most respondents thought many topics were insufficiently covered, sex education should be more extensive, and teachers better educated.
9.	Ekstrand Ragnar, Maria, et al. (författare) Development of an evidence-based website on Preconception health 2018 Ingår i: Upsala Journal of Medical Sciences. - : TAYLOR & FRANCIS LTD. - 0300-9734 .- 2000-1967. ; 123:2, s. 116-122 Tidskriftsartikel (refereegranskat)abstract Introduction: Many women and men lack knowledge about fertility, including timing of the fertile window, age-related decline, and lifestyle factors that may impair fertility. The Internet has become an important source of information, but evidence-based information on fertility and reproduction in Swedish on the Internet is limited. The present study aimed to develop and evaluate an evidence-based fertility awareness website, 'reproduktivlivsplan.se', to increase awareness of fertility and provide guidance for improved preconception health and care among individuals and healthcare providers. Methods: The website's content, design, and layout were evaluated qualitatively among a total of 20 nursing students. An expert group of researchers also provided feedback on the content. Finally, healthcare providers (n = 24) answered a questionnaire covering attitudes and views on the Reproductive Life Plan website as a tool for counselling. Results: The developing process resulted in a mobile-friendly website, 'reproduktivlivsplan.se' (in English: Reproductive Life Plan). The website, including the content and layout, was positively evaluated by most participants and was amended according to suggested improvements. Uppsala University was found to be a trustworthy source. Conclusion: The evidence-based website 'reproduktivlivsplan.se' was well received among users and healthcare providers and may provide guidance for improved preconception health and care if it becomes well known and frequently used.
10.	Gottvall, Maria, 1980-, et al. (författare) Challenges and opportunities of a new HPV immunization program : Perceptions among swedish school nurses 2011 Ingår i: Vaccine. - : Elsevier BV. - 0264-410X .- 1873-2518. ; 29, s. 4576-4583 Tidskriftsartikel (refereegranskat)abstract Aim To investigate school nurses’ perceptions of HPV immunization, and their task of administering the vaccine in a planned school-based program in Sweden. Method: Data were collected through five focus group interviews with school nurses (n = 30). The interviews were recorded, transcribed verbatim and analyzed using content analysis.Findings The theme Positive attitude to HPV immunization despite many identified problems and challenges summarizes the results. The school nurses saw the program as a benefit in that the free school-based HPV immunization program could balance out social inequalities. However, they questioned whether this new immunization program should be given priority given their already tight schedule. Some also expressed doubts regarding the effect of the vaccine. It was seen as challenging to obtain informed consent as well as to provide information regarding the vaccine. The nurses were unsure of whether boys and their parents should also be informed about the immunization.Conclusion Although some positive aspects of the new HPV immunization program were mentioned, the school nurses primarily identified problems and challenges; e.g. regarding priority setting, informed consent, culture and gender. In order to achieve a good work environment for the school nurses, and obtain a high coverage rate for the HPV immunization, these issues need to be taken seriously, be discussed and acted upon.
11.	Gottvall, Maria, 1980-, et al. (författare) Knowledge of human papillomavirus among high school students can be increased by an educational intervention 2010 Ingår i: International Journal of STD and AIDS (London). - : SAGE Publications. - 0956-4624 .- 1758-1052. ; 21:8, s. 558-562 Tidskriftsartikel (refereegranskat)abstract The aim of this study was to evaluate the effect of an educational intervention concerning human papillomavirus (HPV) directed at Swedish first year high school students. The intervention consisted of a class room lesson, a website and a folder. Outcome variables were knowledge of HPV and attitudes to preventive methods such as HPV vaccination, condom use and Pap smear testing. An intervention group (n = 92) was matched with two comparison groups (n = 184). At baseline, the median score for HPV knowledge was one out of 10 in both groups. At follow-up, the median knowledge score had increased to six in the intervention group, but was still one in the comparison group (P < 0.001). Attitudes to HPV vaccination, condom use and Pap smear testing remained the same (P > 0.05). In conclusion, a short school-based intervention can greatly increase the students' knowledge about HPV, but attitudes and behaviours are less easy to influence.
12.	Grandahl, Maria, et al. (författare) Catch-up HPV vaccination status of adolescents in relation to socioeconomic factors, individual beliefs and sexual behaviour 2017 Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 12:11 Tidskriftsartikel (refereegranskat)abstract In 2012, human papillomavirus (HPV) vaccination was introduced free of charge in the Swedish national school-based vaccination programme for 10-12-year-old girls, and as catch-up vaccination for young women. In Sweden, there is an ongoing discussion about including boys in the national vaccination programme. Few studies are undertaken about adolescents' knowledge, beliefs and HPV vaccination status in relation to socioeconomic status and sexual experience. Thus, the aim was to examine HPV catch-up vaccination status in adolescents in relation to 1) socioeconomic factors, 2) beliefs and knowledge about HPV prevention, and 3) sexual behaviour. The Health Belief Model was used as a theoretical framework. Upper secondary school students (n = 832) aged 16, randomly chosen from a larger sample, were invited to participate in conjunction with the general health interview with the school nurse. A total of 751/832 (90.3%), girls (n = 391, 52%) and boys (n = 360, 48%) completed the questionnaire. HPV vaccination was associated with ethnicity and the mothers' education level; i.e. girls with a non-European background and girls with a less educated mother were less likely to have received the vaccine (p<0.01 and p = 0.04 respectively). Vaccinated girls perceived HPV infection as more severe (p = 0.01), had more insight into women's susceptibility to the infection (p = 0.02), perceived more benefits of the vaccine as protection against cervical cancer (p<0.01) and had a higher intention to engage in HPV-preventive behaviour (p = 0.01). Furthermore, boys and girls were almost equally sexually experienced, although fewer girls had used condom during first intercourse with their latest partner (p = 0.03). Finally, HPV vaccinated girls were less likely to have unprotected sex (p<0.01). In summary, catch-up HPV vaccination among young girls was associated with a European background and high maternal education level, as well as more favourable beliefs towards HPV prevention and less sexual risk-taking. Further preventive measures should therefore be directed at the migrant population.
13.	Grandahl, Maria, et al. (författare) ‘I also want to be vaccinated!’ – adolescent boys’ awareness and thoughts, perceived benefits, information sources, and intention to be vaccinated against Human papillomavirus (HPV) 2019 Ingår i: Human Vaccines & Immunotherapeutics. - : Informa UK Limited. - 2164-5515 .- 2164-554X. ; 15:7-8, s. 1794-1802 Tidskriftsartikel (refereegranskat)abstract This study investigates boys’ awareness and thoughts about human papillomavirus (HPV) and HPV vaccination, perceived benefits of vaccinating men, information sources and intention to be vaccinated against HPV. We used a qualitative approach and interviews were conducted with 31 upper secondary school male students. Two main themes 1) Promotion of equal health and 2) Increased knowledge facilitates the decision about HPV vaccination emerged from the analysis. The informants believed that it was important and fair to protect boys and girls equally against HPV. If HPV vaccination could prevent both girls and boys against an HPV-related disease, there was nothing to question or to discuss. It was not a matter of sex; it was a matter of equal rights. Moreover, an important reason for vaccinating boys was to prevent the transmission of the virus. However, the boys felt unsure and stated that they needed to know more. The school nurse and the school health were considered suitable both for distributing information and for providing the vaccinations.In conclusion, the participants were in favor of introducing HPV vaccination also for boys in the national vaccination program. Sex-neutral HPV vaccinations were viewed both as a way to stop the virus transmission and a means to promote equal health for the entire population.
14.	Grandahl, Maria, et al. (författare) School nurses' attitudes towards and experiences of the Swedish school-based HPV vaccination programme - A repeated cross sectional study 2017 Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 12:4 Tidskriftsartikel (refereegranskat)abstract The aim was to investigate school nurses' attitudes towards, and experiences of vaccination against human papillomavirus (HPV), and compare the results with a similar study three years earlier. School nurses (n = 736) from all counties in Sweden completed a questionnaire in spring 2016, four years after the implementation of the national HPV vaccination programme, and three years after the previous survey. Overall, the school nurses had more favourable attitudes towards the HPV vaccination programme compared to the study in 2013 (p = 0.015). More than half of the nurses (n = 415, 56%) strongly agreed that boys should also be offered the vaccine (p<0.001). There were no differences in school nurses' perceived knowledge about HPV in order to inform and to answer questions about the vaccine from the girls or from the parents. More than half of the nurses (n = 409, 56%) reported that they needed more education about HPV. Almost all nurses (n = 659, 90%) had been contacted by parents with questions about the vaccine, and most questions were related to vaccine safety. School nurses have a more favourable attitude towards the vaccination programme against HPV compared to three years earlier, although almost all nurses had been contacted by parents with diverse questions and concerns. The nurses believed that they needed more education about HPV. Thus, it is essential to provide ongoing education and training for school nurses who are key healthcare professionals for providing information about HPV and HPV vaccination to parents and to pupils.
15.	Grandahl, Maria, et al. (författare) ‘To be on the safe side’ : a qualitative study regarding users’ beliefs and experiences of internet-based self-sampling for Chlamydia trachomatis and Neisseria gonorrhoeae testing 2020 Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 10:12 Tidskriftsartikel (refereegranskat)abstract Objectives: In Sweden, an increasing number of tests for sexually transmitted infections are conducted. Self-sampling services are provided free of charge at the national eHealth website. Our aim was to obtain a deeper understanding of users' beliefs and experiences of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) self-sampling services. Methods: This qualitative study is part of the national project 'Internet-based chlamydia and gonorrhoea self-sampling test', conducted in Sweden. Individuals ordering a CT/NG self-sampling test at home from the eHealth website were invited to participate. Of the 114 individuals who agreed, a purposeful sample including 20 women and men aged 18-49 years (mean, 30.8 years) participated in a telephone interview in 2019. Results: The test service for CT/NG was highly appreciated by men and women of different ages. Round-the-clock accessibility, avoiding clinical visits, ease of use, confidentiality and a rapid test result were reasons for this appreciation. Language, uncertainty about the correct sampling procedure, unreliable postal services and concerns about handling of personal data were mentioned as barriers. Reasons for testing were checking after unprotected sex, symptoms, checking a partner's fidelity or a regular routine-'to be on the safe side'. Knowledge about the infections and their consequences was limited; some considered them severe, especially if they could threaten fertility, and others were less concerned. Disclosing an infection was described as emotionally stressful. Participants had high self-efficacy in relation to the test and would not hesitate to use the service again, even if it involved a cost. Conclusions: Internet-based CT/NG self-sampling at home was highly appreciated and was used for individual health reasons, but also out of concern for others' health and for society as a whole. The benefits seem to outweigh the barriers, and the service may therefore continue to be widely offered.
16.	Grandahl, Maria, et al. (författare) Users' Opinions of Internet-based Self-sampling Tests for Chlamydia trachomatis and Neisseria gonorrhoeae in Sweden 2020 Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 100:18 Tidskriftsartikel (refereegranskat)abstract Internet-based testing for Chlamydia trachomatis and Neisseria gonorrhoeae is a public health service in Sweden. However, knowledge about users of the service is limited. This study examined experiences of using the C. trachomatis/N. gonorrhoeae self-sampling service. Individuals ordering a free-of-charge C. trachomatis/N. gonorrhoeae self-sampling test from an eHealth website in 2018/2019 were invited to complete a questionnaire. Of the 1,785 participants 69.4% were women. The majority of participants (77.1%) were single and heterosexual (88.2%) and 5.3% of samples tested positive. The self-sampling service was appreciated, with > 90% considering it good/very good. The main reason subjects gave for testing was to check their health after unprotected sex (72.9%). Almost half (44.7%) had regretted having sex after alcohol intake. Differences in attitudes were seen between categories: born vs not born in Sweden, employed vs student, single vs married/having a partner. Participants were happy with the self-sampling test service, and sexual risk behaviours motivated use of the test.
17.	Hellgren, Margareta, 1955, et al. (författare) C-Reactive Protein Concentrations and Level of Physical Activity in Men and Women With Normal and Impaired Glucose Tolerance: A Cross-Sectional Population-Based Study in Sweden 2016 Ingår i: Journal of Physical Activity & Health. - : Human Kinetics. - 1543-3080 .- 1543-5474. ; 13:6, s. 625-631 Tidskriftsartikel (refereegranskat)abstract Background: We aimed to explore the association between self-reported leisure time physical activity (LTPA) and C-reactive protein (CRP) concentrations in men and women with and without impaired glucose tolerance (IGT). Methods: In a cross-sectional study, a random sample (n = 2,816) was examined with an oral glucose tolerance test, CRP and information about LTPA. Those with IGT or normal glucose tolerance (NGT) and CRP value <= 10 mg/L were selected (n = 2,367) for the study. Results: An inverse association between LTPA and CRP concentrations was observed in the population (P < .001), though, only in men with IGT (P = .023) and in women with NGT. Men with IGT, reporting slight physical activity up to 4 hours a week presented significantly higher CRP concentrations than normoglycemic men (Delta 0.6 mg/L, P = .004). However, this difference could not be found in men with IGT reporting more intense physical activity (Delta 0.01 mg/L, P = .944). Conclusions: Physical inactivity seems to have greater inflammatory consequences for men (vs. women) with IGT. More importantly, although 4 hours of physical activity per week is more than the usual minimum recommendation, an even greater intensity of LTPA appears to be required to limit subclinical inflammation in men with IGT.
18.	Hellgren, Margareta, 1955, et al. (författare) Insulin resistance predicts early cardiovascular morbidity in men without diabetes mellitus, with effect modification by physical activity 2015 Ingår i: European Journal of Preventive Cardiology. - : Oxford University Press (OUP). - 2047-4873 .- 2047-4881. ; 22:7, s. 940-949 Tidskriftsartikel (refereegranskat)abstract Aim: to assess how well insulin resistance predicts cardiovascular disease (CVD) in non-diabetic men and women and to explore the influence of physical activity. Methods: in this prospective study 2563 men and women without diabetes were examined with an oral glucose tolerance test, anthropometric measurements and blood pressure assessment. Questionnaires about lifestyle and physical activity were completed. Insulin resistance was estimated by fasting concentrations of plasma insulin and by HOMA index for insulin resistance. Participants were followed up for cardiovascular morbidity and mortality during an 8-year period, using information from the National Swedish Inpatient and Mortality registers. Results: at follow-up, HOMAir predicted CVD morbidity in males (50 events) and females (28 events) combined (HRage/sex-adj 1.4, 95% CI 1.1-1.7); however, when stratified by gender HOMAir was predictive solely in men (HRage-adj 1.8, 95% CI 1.3-2.4), whereas no association was found in women (HRage-adj 1.1, 95% CI 0.8-1.5). When stratifying the data for high and low physical activity, the predictive value of insulin resistance became stronger in sedentary men (HRage-adj 2.3, 95% CI 1.5-3.4) but was abolished in men performing moderate to vigorous physical activity (HRage-adj 1.0, 95% CI 0.6-1.6). The results remained when step-wise adjusted also for BMI, ApoB/ApoA1 and hypertension, as well as for smoking, alcohol consumption and education. Outcome for fasting plasma insulin was similar to HOMAir. Conclusions: insulin resistance predicts CVD in the general population; however, men may be more vulnerable to increased insulin resistance than women, and physically inactive men seem to be at high risk.
19.	Högberg, Hjördis, 1951-, et al. (författare) Two screening instruments for collecting alcohol-related information from expectant mothers and fathers : Testing the reliability of the Parent Alcohol Screening Questionnaire and the Social Support for an Alcohol-Free Pregnancy Questionnaire 2021 Ingår i: Health and Social Care in the Community. - : Hindawi Limited. - 0966-0410 .- 1365-2524. ; 29:6, s. 1896-1914 Tidskriftsartikel (refereegranskat)abstract The aim is to test the reliability of two alcohol screening instruments: (1) The Parent Alcohol Screening Questionnaire (PASQ5), and (2) the Social Support for an Alcohol-free Pregnancy (SSAFP) questionnaire. This is a cohort study from the south of Sweden using repeated surveys during pregnancy. To examine if responses differed according to different data collection methods, two cohorts consisting of 289 expectant mothers and 141 fathers completed the PASQ5 both verbally (weeks 6–7) and in writing (week 12) within regular antenatal visits. One of the cohorts (n = 137/64) also completed the SSAFP in week 12 and later in week 33. The third cohort, consisting of 179 and 133 expectant mothers and fathers, respectively, completed the PASQ5 and the SSAFP twice in late pregnancy (week 31 + 33). Eight of 10 items in the PASQ5 were stable for both expectant mothers and expectant fathers when comparing verbal versus written-delivered formats. Eight of 10 questions in the PASQ5 were stable when assessing the items in a test–retest analysis in late pregnancy for expectant mothers and nine of 10 questions were stable for fathers. The SSAFP items showed high internal consistency (0.86) for expectant mothers and excellent internal consistency (0.94) for expectant fathers. Most SSAFP items (17 of 21 for expectant mothers and 18 of 22 for expectant fathers) were also stable in a test–retest scenario in late pregnancy. Both the PASQ5 and SSAFP are reliable tools and may be helpful for clinicians who aim to have a deeper dialogue about alcohol consumption during pregnancy. These tools may also be helpful for researchers aiming to better understand a person's changes in alcohol intake and/or their social support network.
20.	Höglund, Berit, 1955-, et al. (författare) Ethical dilemmas and legal aspects in contraceptive counselling for women with intellectual disability : Focus group interviews among midwives in Sweden 2019 Ingår i: JARID. - : Wiley. - 1360-2322 .- 1468-3148. ; 32:6, s. 1558-1566 Tidskriftsartikel (refereegranskat)abstract BackgroundFew studies have explored ethical and legal issues in contraceptive counselling among women with intellectual disability (ID). This study aimed to gain a deeper understanding of these issues during midwifery contraceptive counselling.MethodThe present authors interviewed 19 midwives in five focus groups in Sweden 2016 – 2017 and analysed data with content analysis.ResultsThe participants expressed that women with intellectual disability have equal right to relationships and sexual expressions, but feared exposure to sexual exploitation/abuse. They experienced ethical dilemmas related to principles of fairness and autonomy, but strived to provide assistance in spite of the women's cognitive impairment, presence of supporting persons and uncertainty of optimal counselling. Organizational support was insufficient.ConclusionsThe midwives experienced ambivalence, uncertainty and ethical dilemmas in their counselling. They were, however, aware of legal aspects and strived for the women's best interest, right to self‐determination and autonomous choices. The participants wanted better professional teamwork and support.
21.	Höglund, Berit, 1955-, et al. (författare) Midwives’ knowledge of, attitudes towards and experiences of caring for women with intellectual disability during pregnancy and childbirth : a cross-sectional study in Sweden 2013 Ingår i: Midwifery. - : Elsevier BV. - 0266-6138 .- 1532-3099. ; 29:8, s. 950-955 Tidskriftsartikel (refereegranskat)abstract Objective: to investigate midwives' knowledge of, attitudes towards andexperiences of caring for women with intellectual disability (ID) during pregnancy andchildbirth. Design/setting: a cross-sectional study among six hundred midwives working at antenatal care and labour wards in Sweden. Results: more than four out of five (81.5%) midwives had experience of caring for womenwith ID. Almost all midwives (97.1%) reported that caring for women with ID is different fromcaring for women without ID. Almost one-half (47.3%) had not received any education aboutpregnancy and delivery of women with ID, and a majority of the midwives (95.4%) requested evidence-based knowledge of women with ID in relation to childbirth. High proportion (69.7%) of the midwives were of the opinion that women with ID cannot satisfactorily manage the mother role, and more than one-third (35.7%) of the midwives considered that womenwith ID should not be pregnant and give birth at all. Most midwives partly/totally agreed that children of women with ID should grow up with their parents supported by the social authorities, but nearly one-fifth (19.1%) partly/totally agreed that the children should grow up in foster care. Conclusions: even if the majority of midwives had experience of caring for women with ID, they were uncertain about how to adapt and give advice and they needed more knowledgeabout these women. Some midwives had negative attitudes towards childbearing amongwomen with ID. Health Service providers should encourage midwives to update theirknowledge and provide supportive supervision in midwifery care for women with ID.
22.	Höglund, Berit, 1955-, et al. (författare) Midwives' work and attitudes towards contraceptive counselling and contraception among women with intellectual disability : focus group interviews in Sweden 2019 Ingår i: European journal of contraception & reproductive health care. - : TAYLOR & FRANCIS LTD. - 1362-5187 .- 1473-0782. ; 24:1, s. 39-44 Tidskriftsartikel (refereegranskat)abstract Objectives: Family planning counselling is an essential part of sexual and reproductive health care; however, health care professionals often fail to offer sexual and reproductive health services to women with intellectual disability (ID), based on a misconception of inactive sexuality. The aims of this study were to gain a deeper understanding of midwives' perceptions of sexual health and contraceptive use of women with ID, and of midwives' practices in providing contraceptive counselling to women with ID.Methods: Five focus group interviews were conducted with 19 midwives at five antenatal/family planning clinics in central Sweden between December 2016 and February 2017.Results: The findings are presented in a paradigm model comprising the following components: context, causal conditions for women with ID needing contraception, intervening conditions, action and interaction strategies based on the midwives' approach and performance during the consultation, and finally consequences. Midwives strived to enhance informed choice, whenever possible, and tried to maintain a neutral attitude during counselling. They wanted to provide the most suitable contraceptive method balanced against any risk of long-term use and possible side effects. Midwives raised the need for teamwork and inter-professional support to improve health care, security and access to other related services for women with ID.Conclusions: Few women with ID request contraceptive counselling, which limits midwives' knowledge, experience and competence. Midwives, therefore, plan consultations carefully and strive to enable women with ID to make informed contraceptive choices. Increased teamwork could be a way to strengthen the role of midwives and thereby improve counselling.
23.	Höglund, Berit, 1955-, et al. (författare) Newborns of mothers with intellectual disability have a higher risk of perinatal death and being small-for-gestational age 2012 Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 91:12, s. 1409-1414 Tidskriftsartikel (refereegranskat)abstract Objective.To study mode of birth, perinatal health and death in children born to mothers with intellectual disability (ID) in Sweden.Design. Population based register study.Setting. National registers; the National Patient Register linked to the Medical Birth Register.Sample. Children of first-time mothers with ID (n = 326) (classified in the ICD 8–10) were identified and compared to 340 624 children of first-time mothers without ID or any other psychiatric diagnosis during 1999 and 2007.Methods. Population-based data were extracted from the National Patient Register and the Medical Birth Register.Main Outcome Measures. Mode of birth, preterm birth, small-for-gestational age, Apgar score, stillbirth and perinatal death.Results. Children born to mothers with ID were more often stillborn (1.2% vs. 0.3%) or died perinatally (1.8% vs. 0.4%) than children born to mothers without ID. They had a higher proportion of cesarean section birth (24.5% vs. 17.7%), preterm birth (12.2% vs. 6.1%), were small-for-gestational age (8.4% vs. 3.1%) and had lower Apgar scores <7 points at 5 minutes (3.7% vs 1.5%), compared to children born to mother without ID. Logistic regression adjusted for maternal characteristics confirmed an increased risk of small-for-gestational age (odds ratio 2.25), stillbirth (odds ratio 4.53) and perinatal death (odds ratio 4.25) in children born to mothers with ID.Conclusions. Unborn and newborn children of mothers with ID should be considered a risk group, and their mothers may need better individual-based care and support.
24.	Höglund, Berit, 1955-, et al. (författare) Pregnancy and birth outcomes of women with intellectual disability in Sweden : a national register study between 1999 and 2007 2012 Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 91:12, s. 1381-1387 Tidskriftsartikel (refereegranskat)abstract Objective. To investigate the antenatal health and demographic factors as well as pregnancy and delivery outcomes in women with intellectual disability (ID) in Sweden.Design. A population-based register study.Setting. The National Patient Register (NPR) linked to the Medical Birth Register (MBR). Sample. Women with ID classified as International Classification of Diseases (ICD) 8–10 who gave birth in 1999–2007 (n = 326), identified from the NPR linked to the MBR, were compared with all first-time, singleton mothers without ID or any other psychiatric diagnoses during this period in Sweden (n = 340 624).Methods. Population-based data were extracted from the NPR and the MBR.Main outcome measures. Health and socio-demography at first antenatal visit, mode of delivery, pain relief during labor, preterm birth and discharge from hospital.Results. A higher proportion of women with ID were teenagers (18.4 vs. 3.3%), obese (20.1 vs. 8.6%) and single (36.6 vs. 6.2%) compared with women without ID, and women with ID smoked more often (27.9 vs. 7.9%). Women with ID had more often a preterm birth (12.2 vs. 6.1%), a cesarean section (CS) (24.5 vs. 17.7%) and used less nitrous oxide as pain relief during labor (59.5 vs. 75.8%). Women with ID had a higher risk for preterm birth [odds ratio (OR) 1.68], CS (OR1.55), non-use of nitrous oxide (OR 1.89) and discharge from hospital to a place other than home (OR 2.24). Conclusion. Pregnant women with ID should be considered a risk group suggesting that better tailored pre- and intrapartum care and support are needed for these women.
25.	Höglund, Berit, et al. (författare) Struggling for motherhood with an intellectual disability : a qualitative study of women's experiences in Sweden 2013 Ingår i: Midwifery. - : Elsevier BV. - 0266-6138 .- 1532-3099. ; 29:6, s. 698-704 Tidskriftsartikel (refereegranskat)abstract Objectiveto gain a deeper understanding of the experiences of childbearing in women with intellectual disabililty (ID).Design/settingten women with ID, who had given birth within seven years, were interviewed twice and data were analysed with content analysis.Findingsthe overarching theme was: Struggling for motherhood with an ID. The significance of having an intellectual disability became evident when the women encountered mixed reactions from partners and relatives, who sometimes suggested an induced abortion. The women disclosed their diagnosis if they believed it was beneficial for them. Throughout the process the women also felt anxious and distressed about the custody of the child. Women experienced the pregnancy as a physical and psychological transition. It was mostly a happy and responsible life event, and the women were aware of physical signs in their bodies and contact with the unborn child. Parent education was considered important but not adequately adapted to their needs. The women described the delivery as hard and painful work, sometimes difficult to understand and they had different strategies to handle the pain and strain of labour. The child was welcomed with warmth and curiosity by the women, who cared for and breast fed the child even if the hospital environment could be confusing and continued custody not taken for granted.Conclusionswomen with ID struggle for motherhood and fear losing custody of the child. Professionals need to identify and support these women, who may not always disclose their diagnosis. Since pregnancy, delivery and the transition into motherhood can be difficult to understand, information and support should be better tailored to their needs.
26.	Janeslätt, Gunnel, 1952-, et al. (författare) An intervention using the preparing for Parenting Toolkit : "Children - what does it involve?" and the Real-Care-Baby simulator among students with ID - a feasibility study 2018 Ingår i: JARID. - : Wiley. - 1360-2322 .- 1468-3148. ; 31:4, s. 598-598 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
27.	Janeslätt, Gunnel, 1952-, et al. (författare) An Intervention using the Tool-kit ”Children – what does it involve?” and the Real-Care-Baby simulator among students with ID - a feasibility study 2019 Ingår i: JARID. - : Wiley. - 1360-2322 .- 1468-3148. ; 32:2, s. 380-389 Tidskriftsartikel (refereegranskat)abstract Background There is limited knowledge about how young people with intellectual disability (ID) can be facilitated in their process of deciding about parenthood. This study aimed to evaluate the feasibility of an upcoming trial to evaluate an intervention using the Toolkit ”Children – what does it involve?” and the “Real-Care-Baby” (RCB) simulator among students with ID. Methods Six students with ID participated in an intervention with eight educational sessions and a three-day caring-session with the RCB simulator. Data were collected with questionnaires and interviews. Results The study showed that it is possible to evaluate an intervention using these instruments among students with ID in order to provide them with further insights about parenthood. Conclusion It is feasible to evaluate the Toolkit and the RCB in a cluster-randomized study and that such a study could add to our knowledge about possible intervention strategies regarding reproduction and parenting among students with ID.
28.	Jha, Paridhi, et al. (författare) Evaluation of the psychometric properties of Hindi-translated Scale for Measuring Maternal Satisfaction among postnatal women in Chhattisgarh, India 2019 Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 14:1 Tidskriftsartikel (refereegranskat)abstract Satisfaction with childbirth services is a multi-dimensional phenomenon, providing relevant insights into women's opinion on quality of services received. Research studies report a dearth of standardised scales that quantify this phenomenon; and none have been tested in India to the best of authors' knowledge. The current study was undertaken to evaluate psychometric properties of Hindi version of the Turkish Scale for Measuring Maternal Satisfaction: Normal and Caesarean Births versions in order to fill this gap. A cross-sectional survey was conducted in selected public health facilities in Chhattisgarh, India. Healthy women (n = 1004) who gave birth to a single, live neonate, vaginally or via Caesarean section participated. Psychometric assessment was carried out in four steps: 1) scales translated from Turkish to Hindi; 2) Content Validity Index scores calculated for Hindi scales; 3) data collection; 4) statistical analyses for Hindi scales (Normal and Caesarean Birth).A 10-factor model with 36 items emerged for both scales. The Hindi- translated Normal Birth and Caesarean Birth scales had good internal reliability (Cronbach’s α coefficients of 0.85 and 0.80, respectively).The Hindi Scales for Measuring Maternal Satisfaction (Normal and Caesarean Birth) are valid and reliable tools for utilization in Indian health facilities. Their multi-dimensional nature presents an opportunity for the care providers and health administrators to incorporate women's opinions in intervention to improve quality of childbirth services. Having an international tool validated within India also provides a platform for comparing cross-country findings.
29.	Jha, Paridhi, et al. (författare) Fear of Childbirth and Depressive Symptoms among Postnatal Women : A Cross-sectional Survey from Chhattisgarh, India 2018 Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 31:2, s. 122-133 Tidskriftsartikel (refereegranskat)abstract Background: Prevalence rates of Fear of Birth and postnatal depressive symptoms have not been explored in Chhattisgarh, India.Objective: To validate Hindi Wijma Delivery Experience Questionnaire and to study the prevalence of Fear of Birth and depressive symptoms among postnatal women.Methods: A cross-sectional survey at seventeen public health facilities in two districts of Chhattisgarh, India among postnatal women who gave birth vaginally or through C-section to a live neonate. Participants were recruited through consecutive sampling based on health facility records of daily births. Data were collected through one-to-one interviews using the Wijma Delivery Experience Questionnaire Version B and the Edinburgh Postnatal Depression Scale. Non-parametric associations and linear regression data analyses were performed.Results: The Hindi Wijma Delivery Experience Questionnaire Version B had reliable psychometric properties. The prevalence of Fear of Birth and depressive symptoms among postnatal women were 13.1% and 17.1%, respectively, and their presence had a strong association (p < 0.001). Regression analyses revealed that, among women having vaginal births: coming for institutional births due to health professionals' advice, giving birth in a district hospital and having postnatal depressive symptoms were associated with presence of FoB; while depressive symptoms were associated with having FoB, perineal suturing without pain relief, and giving birth to a low birth-weight neonate in a district hospital.Conclusion: The prevalence of Fear of Birth and depressive symptoms is influenced by pain management during childbirth and care processes between women and providers. These care practices should be improved for better mental health outcomes among postnatal women.
30.	Jha, Paridhi, et al. (författare) Satisfaction with childbirth services provided in public health facilities : results from a cross-sectional survey among postnatal women in Chhattisgarh, India 2017 Ingår i: Global Health Action. - : Taylor & Francis Group. - 1654-9716 .- 1654-9880. ; 10:1 Tidskriftsartikel (refereegranskat)
31.	Jha, Paridhi, et al. (författare) “The balancing act”: Maintaining the quality of childbirth services in low-resource settings- a Grounded Theory study exploring nurse-midwives’ perceptions and experiences of providing services in public health facilities of Chhattisgarh, India 2017 Tidskriftsartikel (refereegranskat)
32.	Larsson, Margareta, 1950-, et al. (författare) Do pregnant women want to know the sex of the expected child at routine ultrasound and are they interested in sex selection? 2017 Ingår i: Upsala Journal of Medical Sciences. - : Taylor & Francis Group. - 0300-9734 .- 2000-1967. ; 122:4, s. 254-259 Tidskriftsartikel (refereegranskat)abstract Background: The aim of the study was to investigate if expecting parents wanted to know the sex of the fetus during ultrasound examination and if they had discussed it with the midwife. Another aim was to explore any interest in sex selection. Methods: A longitudinal survey in early and late pregnancy among 2393 women in Sweden. Results: Almost all (95.8%, n = 2289) women had discussed sex determination with the partner before the ultrasound scan, and 57% (n = 1356) of women and their partners wanted to find out the fetal sex. The expecting parents mostly initiated a discussion with the midwife (46%, n = 1088), but 10% (n = 229) stated that the midwives initiated the discussion. Few (5%, n = 118) expressed a potential interest in selecting sex of a baby. Women who were interested in sex determination did not differ from those who were not, with respect to age, origin, education, parity, level of pregnancy planning, or importance of religion, but women who had chosen another fetal diagnostic method were more interested in sex determination and in potential sex selection. Conclusions: Half of women and their partners wanted to know the fetal sex, and 5% were interested in sex selection. This high interest in sex determination is a challenge, since present national guidelines do not include sex determination as an option.
33.	Larsson, Margareta, et al. (författare) [Increasing number of teenage pregnancies--multicultural approach in the preventive work is needed]. : Tonårsgraviditeterna ökar--mångkulturell inriktning behövs i förebyggande arbetet. 2003 Ingår i: Läkartidningen. - 0023-7205. ; 100:39 Tidskriftsartikel (refereegranskat)
34.	Larsson, Margareta, 1950- (författare) The Adoption of a New Contraceptive Method – Surveys and Interventions Regarding Emergency Contraception 2004 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract The overall aim of this thesis was to examine the adoption of emergency contraceptive pills (ECP) in Sweden. Two cross-sectional surveys and two quasi-experimental studies were used. Reasons for induced abortion, contraceptive practices and contraceptive failure were examined in a group of abortion applicants with a waiting-room questionnaire (I) and knowledge, use and practices of ECP were assessed with a postal questionnaire in a population-based sample of young women (II). One community-based information campaign was evaluated with a repeated postal questionnaire (III) and a school-based education intervention was evaluated with repeated class-room questionnaires (IV). Abortion applicants had inadequate contraceptive practices and a low use of ECP. One year after the deregulation of ECP women were highly aware of the method and preferred the pharmacy for the purchase of ECP. Correct knowledge and positive attitudes influenced the willingness to use ECP in the future. The information campaign was noticed by two-thirds of the women and there was an overall trend towards better knowledge, improved attitudes and increased use among all women at follow-up. The school-based intervention improved the students’ knowledge of, and attitudes to, ECP without jeopardizing condom use. The adoption of ECP in Sweden seems to have gone through the first stages of diffusion of an innovation, i.e., developement, dissemination, and adoption, and has reached the stage of implementation since the studies indicated a general awareness of more than 90%, an intention to use in case of need of more than 70%, and womens’ own experience of use of around 30%. The most cited information channels were media, friends and the local Youth Clinic. ECP is gradually becoming a more widely known, accepted and used contraceptive method in Sweden, but must be considered as being only one of many tools in the prevention of unintended pregnancies.
35.	Liljas Stålhandske, Maria, 1970-, et al. (författare) Existential experiences and needs related to induced abortion in a group of Swedish women : a quantitative investigation 2012 Ingår i: Journal of Psychosomatic Obstetrics and Gynaecology. - 0167-482X .- 1743-8942. ; 33:2, s. 53-61 Tidskriftsartikel (refereegranskat)abstract Objective: To investigate the prevalence of existential experiences and needs among women involved in induced abortion. Methods: A questionnaire was used to collect information from 499 women requesting an induced abortion. A principle component analysis resulted in three components of existential experiences and needs, labelled: existential thoughts, existential practices, and humanisation of foetus. These components were analysed in relation to background data and other data from the questionnaire. Results: Existential experiences and needs were common. Existential thoughts about life and death, meaning and morality were related to abortion experience for 61% of women. Almost 50% of women, reported a need for special acts in relation to the abortion; and, 67% of women considered the pregnancy in terms of a child. A higher degree of existential components correlated to difficulty in making the abortion decision and poor psychological wellbeing after the abortion. Conclusion: Women’s experiences of abortion can include existential thoughts about life, death, meaning and morality, feelings of connectedness to the foetus, and the need for symbolic expression. This presents a challenge for abortion personnel, as the situation involves complex aspects beyond medical procedures and routines.
36.	Makenzius, Marlene, 1965-, et al. (författare) Repeat induced abortion - a matter of individual behaviour or societal factors? : A cross-sectional study among Swedish women 2011 Ingår i: European journal of contraception & reproductive health care. - : Informa UK Limited. - 1362-5187 .- 1473-0782. ; 16:5, s. 369-377 Tidskriftsartikel (refereegranskat)abstract Background: Almost 40% of all induced abortions in Sweden are repeat abortions; little is known about the risk factors.Objective: To investigate differences between women who had a first-time abortion and those with repeat abortion, and to identify factors associated with repeat abortion.Methods: A questionnaire was answered by 798 abortion-seeking women in Sweden during 2009. A regression model was used to assess risk factors for repeat abortions.Results: In the age range 20-49 years, 41% of women had experienced at least one previous abortion. Risk factors for repeat abortion were parity (OR 2.57), lack of emotional support (OR 2.09), unemployment or sick leave (OR 1.65), tobacco use (OR 1.56), and low educational level (OR 1.5). Some women (n = 55) considered economic support and work opportunities could have enabled them to continue the pregnancy. Increased Sex and Relationship Education (SRE), easy access to high-quality contraception and counselling, were suggested (n = 86) as interventions for preventing unintended pregnancies.Conclusions: Even in a country with long established SRE and a public health policy to enhance sexual and reproductive health over a third of women requesting abortion have experienced one previously and the rate is maintained. Some specific factors are identified but, overall, a picture of vulnerability among women seeking repeat abortion stands out that needs to be considered in the prevention of unintended pregnancies.
37.	Makenzius, Marlene, 1965-, et al. (författare) Risk factors among men who have repeated experience of being the partner of a woman who requests an induced abortion 2012 Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 40:2, s. 211-216 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: Prevention of unintended pregnancies is a public health objective; however, the profiles of male partners of women who choose to abort are relatively unexplored. OBJECTIVE: To investigate risk factors among men who have repeated experience of being the partner of a woman electing an induced abortion. METHODS: A questionnaire was used to collect information from 590 men recruited through their pregnant partner who applied for an abortion in Sweden during 2009. A binary logistic regression model assessed risk factors associated with repeated experience of abortion. RESULTS: One-third of the men had previous experience of a pregnant partner electing an induced abortion. Univariate analysis indicated these men were older, had a lower educational level and less emotional support, and were more often tobacco users than men for whom it was the first experience of a partner choosing to abort. Independent risk factors were being a victim of physical, psychological, or sexual violence or abuse over the past year (OR 2.62, 95% CI 1.36-5.08), unemployment or sick leave (OR 2.58, 95% CI 1.57-4.25), and having children (OR 2.00, 95% CI 1.22-3.28). The men suggested improved sex and relationship education in school and lower unemployment rates could prevent unintended pregnancies and abortions. Conclusions: Men with experience of repeat abortions present a picture of vulnerability that should be recognised in the prevention of unintended pregnancies. Increased work opportunities might be one important intervention to reduce the number of abortions.
38.	Makenzius, Marlene, 1965-, et al. (författare) Sverige har Nordens höögsta aborttal : Oönskade graviditeter bör ses i helhetsperspektiv - individer, vård, samhålle 2013 Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 110:38, s. 1658-1661 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
39.	Makenzius, Marlene, et al. (författare) Women's decision-making related to induced abortion : a cross sectional study during a period of Covid-19 pandemic, in Sweden. 2023 Ingår i: European journal of contraception & reproductive health care. - : Taylor & Francis Group. - 1362-5187 .- 1473-0782. ; 28:1, s. 44-50 Tidskriftsartikel (refereegranskat)abstract OBJECTIVES: To investigate women's decision-making on induced abortion.MATERIALS AND METHODS: A multi-centre cross-sectional survey among 623 abortion-seeking women in Sweden (2021). The perceived difficulty to decide on abortion was measured using a 7-point Likert scale, and analysed with univariate and multivariate analysis (odds ratios [OR], 95% confidence intervals [CI]).RESULTS: About half (n = 322;52%) scored 1-4, suggesting the decision was perceived as easier compared to those (n = 292;48%) who scored 5-7. Reasons for the abortion were: poor economy (n = 166;27%), too early in the relationship (n = 154;25.1%), want to work first (n = 147;23.9%), want to study first (n = 132;21.5%), uncertain about the relationship (104;16.9%), and too young (n = 104;16.9%). Predictors for perceiving the decision as difficult: partner's hesitance (OR = 3.18, CI:1.76-5.73), being born outside the Nordic countries (OR = 2.23, CI:1.28-3.87), having discussed the decision with someone (OR = 2.42, CI:1.67-3.50), age ≥30 (OR = 2.22, CI:1.03-4.76), the Covid-19 pandemic (OR = 2.08, CI:1.20-3.59), and the desire to have children in the future (OR = 1.96, CI:1.18-3.28). After confirmed pregnancy, poor mental well-being was more common among those who scored 5-7 (n = 140;47.9%) compared to those who scored 1-4 (n = 122;37.9), p = .029.CONCLUSION: Women's decision-making on abortion is complex; in times of crises, the decision procedure may be even more difficult. This valuable knowledge could be used to improve and promote satisfactory counselling beyond medical routines.
40.	Massae, Agnes Fredrick, et al. (författare) Patterns and predictors of fear of childbirth and depressive symptoms over time in a cohort of women in the Pwani region, Tanzania 2022 Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 17:11 Tidskriftsartikel (refereegranskat)abstract Background: Fear of childbirth (FoB) and depressive symptoms (DS) are experienced by many women and can negatively affect women during and after pregnancy. This study assessed patterns of FoB and DS over time and associations of postpartum FoB and DS with sociodemographic and obstetric characteristics.Methods: We conducted a longitudinal study at six health facilities in Tanzania in 2018-2019. Pregnant women were consecutively assessed for FoB and DS before and after childbirth using the Wijma Delivery Expectancy/Experience Questionnaire versions A & B and the Edinburgh antenatal and postnatal depressive scale. This paper is based on 625 women who completed participation.Results: The prevalence rates of FoB and DS during pregnancy were 16% and 18.2%, respectively, and after childbirth, 13.9% and 8.5%. Some had FoB (6.4%) and DS (4.3%) at both timepoints. FoB was strongly associated with DS at both timepoints (p < 0.001). Both FoB (p = 0.246) and DS (p < 0.001) decreased after childbirth. Never having experienced obstetric complications decreased the odds of postpartum and persisting FoB (adjusted odds ratio (aOR) 0.44, 95% confidence interval (CI) 0.23-0.83). Giving birth by caesarean section (aOR 2.01, 95% CI 1.11-3.65) and having more than 12 hours pass between admission and childbirth increased the odds of postpartum FoB (aOR 2.07, 95% CI 1.03-4.16). Postpartum DS was more common in women with an ill child/stillbirth/early neonatal death (aOR 4.78, 95% CI 2.29-9.95). Persisting DS was more common in single (aOR 2.59, 95% CI 1.02-6.59) and women without social support from parents (aOR 0.28, 95% 0.11-0.69).Conclusions: FoB and DS coexist and decrease over time. Identifying predictors of both conditions will aid in recognising women at risk and planning for prevention and treatment. Screening for FoB and DS before and after childbirth and offering psychological support should be considered part of routine antenatal and postnatal care. Furthermore, supporting women with previous obstetric complications is crucial. Using interviews instead of a self-administered approach might have contributed to social desirability. Also, excluding women with previous caesarean sections could underestimate FoB and DS prevalence rates.
41.	Massae, Agnes, et al. (författare) Fear of childbirth : validation of the Kiswahili version of Wijma delivery expectancy/experience questionnaire versions A and B in Tanzania 2022 Ingår i: BMC Pregnancy and Childbirth. - : Springer Nature. - 1471-2393 .- 1471-2393. ; 22 Tidskriftsartikel (refereegranskat)abstract Background: Fear of childbirth is common both before and after childbirth, often leading to complications in mother and new-born. The Wijma Delivery Expectancy/Experience Questionnaires (W-DEQ) are commonly used to measure fear of childbirth among women before (version A) and after childbirth (version B). The tools are not yet validated in the Tanzanian context. This study aimed to validate the reliability, validity, and factorial structure of their Kiswahili translations.Methods: A longitudinal study was conducted in six public health facilities in the Pwani region, Tanzania. In all, 694 pregnant and 625 postnatal women were concurrently selected and responded to W-DEQ-A and W-DEQ-B. Validation involved: translating the English questionnaires into Kiswahili; expert rating of the relevancy of the Kiswahili versions' items; computing content validity ratio; piloting the tools; data collection; statistical analysis with reliability evaluated using Cronbach's alpha and the intraclass correlation coefficient. Tool validity was assessed using factor analysis, convergent and discriminant validity. Exploratory factor analysis and confirmatory factor analysis were conducted on data collected using W-DEQ-A and W-DEQ-B, respectively.Results: Exploratory factor analysis revealed seven factors contributing to 50% of the total variation. Four items did not load to any factor and were deleted. The factors identified were: fear; lack of self-efficacy; lack of positive anticipation; isolation; concerns for the baby; negative emotions; lack of positive behaviour. The factors correlated differently with each other and with the total scores. Both Kiswahili versions with 33 items had good internal consistency, with Cronbach's alphas of .83 and .85, respectively. The concerns for the baby factor showed both convergent and discriminant validity. The other six factors showed some problems with convergent validity. The final model from the confirmatory factor analysis yielded 29 items with good psychometric properties (chi(2)/df = 2.26, p = < .001, RMSEA = .045, CFI = .90 and TLI = .81).Conclusions: The Kiswahili W-DEQ-A-Revised and W-DEQ-B-Revised are reliable tools and measure fear of childbirth with a multifactorial structure, encompassing seven factors with 29 items. They are recommended for measuring fear of childbirth among pregnant and postnatal Tanzanian women. Further studies are needed to address the inconsistent convergent validity in the revised versions and assess the psychometric properties of W-DEQ-A among pregnant women across gestational ages.
42.	Massae, Agnes, et al. (författare) Predictors of fear of childbirth and depressive symptoms among pregnant women : a cross-sectional survey in Pwani region, Tanzania 2021 Ingår i: BMC Pregnancy and Childbirth. - : BioMed Central (BMC). - 1471-2393 .- 1471-2393. ; 21:1 Tidskriftsartikel (refereegranskat)abstract Background Many women experience fear of childbirth (FoB) and depressive symptoms (DS) during pregnancy, but little is known about FoB among Tanzanian women. The current study aimed to assess the prevalence of FoB and DS among pregnant women and determine predictors of each and both, focusing on sociodemographic and obstetric predictors. Methods A cross-sectional study was conducted at six health facilities in two districts in Tanzania between 2018 and 2019. In total, 694 pregnant women with gestational age between 32 and 40 weeks and expecting vaginal delivery were consecutively recruited and assessed for FoB and DS. We collected data through interviews using 6 and 4-points Likert Scale of the Wijma Delivery Expectancy Questionnaire Version A and Edinburgh Postnatal Depression Scale, respectively. Women who scored >= 66 and >= 10 were categorised as having FoB and DS, respectively. We performed multivariable logistic regression to investigate the predictors of FoB and DS. Results The prevalence rates of FoB and DS among pregnant women were 15.1 and 17.7%, respectively. FoB and DS were more likely in women aged above 30 years [Adjusted Odds Ratio (AOR) 6.29, 95%CI 1.43-27.84] and in single mothers (AOR 2.57, 95%CI 1.14-5.78). Women with secondary education and above (AOR 0.22, 95%CI 0.05-0.99) and those who had given birth previously (AOR 0.27, 95% CI 0.09-0.87) were less likely to have FoB in combination with DS Women who had previous obstetric complications, and those who did not receive any social support from male partners in previous childbirth were more likely to have FoB and DS. FoB was strongly associated with DS (AOR 3.42, 95%CI 2.12-5.53). DS only was more common in women who had inadequate income (AOR 2.35, 95%CI 1.38-3.99) or had previously experienced a perineal tear (AOR 2.32, 95%CI 1.31-4.08). Conclusions Not having a formal education, having only primary education, being aged above 30 years, being single, being nulliparous, having experienced obstetric complications, and having a lack of social support from a male partner during previous pregnancy and childbirth were predictors of FoB and DS during pregnancy. FoB and DS were strongly associated with each other. It is vital to identify at-risk women early, to offer support during pregnancy and childbirth.
43.	Mattebo, Magdalena, 1976-, et al. (författare) Hercules and Barbie? : Reflections on the influence of pornography and its spread in the media and society in groups of adolescents in Sweden 2012 Ingår i: European journal of contraception & reproductive health care. - : Informa UK Limited. - 1362-5187 .- 1473-0782. ; 17:1, s. 40-49 Tidskriftsartikel (refereegranskat)abstract ObjectivesTo describe and get a deeper understanding of how groups of young women and men reflect on and discuss pornography and its spread in the media and society, and its possible influence on sexual behaviour and relationships.MethodsSix focus group interviews were conducted with teenagers, three with women (n = 17) and three with men (n = 18). Open questions about pornography and its spread in the media and society were discussed. The interviews were tape-recorded and transcribed verbatim. Data were analysed according to Grounded Theory.ResultsThe core category 'A discriminatory sexuality' illustrates how participants felt regarding the messages conveyed by pornography portraying a man's role as dominant and a woman's role as subordinate. Pornographic messages were described as 'Fiction' depicting a distorted reality. Feelings of ambivalence towards pornography were expressed: anxiety and fear, but also inspiration. Participants said pornography occurred everywhere in the media and society, and felt pressured by messages relating to looks and sexual techniques.ConclusionsPornography and its spread in the media and society were considered as presenting a discriminatory image of body ideals, sexuality and relationships. Despite this awareness, both men and women considered pornography as sources of knowledge and inspiration: an apparent paradox.
44.	Mattebo, Magdalena, 1976-, et al. (författare) Pornography consumption and psychosomatic and depressive symptoms among Swedish adolescents: a longitudinal study 2018 Ingår i: Upsala Journal of Medical Sciences. - : Taylor & Francis Group. - 0300-9734 .- 2000-1967. ; 123:4, s. 237-246 Tidskriftsartikel (refereegranskat)abstract Background: The aims of this longitudinal study were to identify predictors for continued pornography consumption and to investigate pornography consumption in relation to psychosomatic and depressive symptoms among a group of adolescents in Sweden.Methods and materials: A longitudinal study in classroom environment in 53 randomly selected senior high school classes in mid-Sweden in years 2011 and 2013. Out of 477 participating boys and 400 girls in 2011, 224 boys (47%) and 238 girls (60%) participated in 2013.Results: Higher pornography consumption at baseline and being born outside Sweden predicted continued pornography consumption at follow-up (adjusted R2 = 0.689).Psychosomatic symptoms at follow-up were predicted by higher pornography consumption at baseline (adjusted R2 = 0.254), being a girl, living with separated parents, and attending a vocational high school program. By contrast, depressive symptoms at follow-up were predicted by less pornography consumption at baseline (adjusted R2 = 0.122) and being a girl.Conclusions: Pornography consumption may, for some individuals, be associated to mental health issues. Differences between teenage boys and girls and between adolescents with diverse ethnic backgrounds imply that counseling and discussion about pornography need to be adjusted and individualized.
45.	Mattebo, M., et al. (författare) Sexual experiences in relation to HPV vaccination status in female high school students in Sweden 2014 Ingår i: European Journal of Contraception and Reproductive Health Care. - : Informa UK Limited. - 1362-5187 .- 1473-0782. ; 19:2, s. 86-92 Tidskriftsartikel (refereegranskat)abstract Objectives To investigate sexual experiences, sexually transmitted infections (STIs) and use of condoms in relation to human papillomavirus (HPV)-vaccination status in female high school students. Methods In 2013, 355 female students with a median age of 18 years from randomly selected high schools in Sweden answered a classroom questionnaire on sexual experiences and HPV-vaccination status. Results In total 227/348 (65%) of the women reported having received at least one HPV vaccine dose. Median age at first intercourse was 15 and 16 years respectively, in the 141/227 (62%) vaccinated after, and the 86/227 (38%) vaccinated before their sexual debut. There were no differences between the HPV-vaccinated and non-vaccinated groups regarding condom use, STIs, and experiences of oral and anal sex, or friends- with-benefit relationships. However, having had sexual intercourse and 'one-night stands' were more common in the vaccinated group (both p < 0.05). Conclusion Many students (62%) were vaccinated against HPV, with two-thirds after their sexual debut. There were no differences in condom use and STIs, and only a few differences in sexual experiences between the HPV-vaccinated and non-vaccinated groups. Initiating HPV vaccination before sexual debut is important, as is information about the link between HPV, sexual behaviour and cancer.
46.	Målqvist, Mats, 1971-, et al. (författare) High levels of unmet need for family planning in Nepal. 2018 Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 17, s. 1-6 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: Providing access to family planning services is a basic component and a cost-effective intervention to reduce maternal mortality worldwide. It is closely linked to women's decision-making power and female emancipation. Unmet need for family planning is thus an indicator going beyond maternal health with far reaching societal implications. This study examines the level of unmet need for family planning in Nepal and its distribution along structural determinants.METHODS: Data from the Multiple Indicator Cluster Survey 2014 was utilized for analysis. Prevalence of unmet need for family planning was calculated and logistic regression models used to ascertain inequity.RESULTS: A total unmet need for family planning of 40.9% among the 10,688 included women was observed. No major differences between socioeconomic groups could be detected, except for a somewhat higher rate of unmet need among the least educated. Total fertility rate among the women included was 2.59. Contraceptive use among adolescents was alarmingly low, with almost none reporting using any type of contraception.CONCLUSION: The lack of major inequity implies that the high level of unmet need for contraception is a general problem in society and must be addressed broadly. A special focus on education and provision for adolescents is needed in Nepal.
47.	Niemeyer Hultstrand, Jenny, et al. (författare) Contraceptive use among women seeking an early induced abortion in Sweden 2023 Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 102:11, s. 1496-1504 Tidskriftsartikel (refereegranskat)abstract Introduction: In spite of societal efforts to strengthen women's sexual and reproductive health in Sweden, many women have unmet contraceptive needs and the abortion rate remains high. The aim of this study was to investigate contraceptive use among abortion-seeking women. Material and methods: Swedish-speaking women seeking an induced abortion up to the end of gestational week 12 at seven hospitals filled out an anonymous paper questionnaire between January and June 2021. Data were analyzed using frequencies and cross-tabulations, and the Chi-square test was used to compare age-groups. Valid percentages are presented. Results: In total, 623 women participated. Median age was 29 years and 13% were born outside the Nordic countries. In the year preceding the abortion, condoms (37%, n = 228) were the most commonly used contraceptive method, followed by short-acting reversible contraception (SARC) (35%, n = 213) and withdrawal (25%, n = 152). Around one in five (n = 113) had not used any method in the year preceding the abortion. Sixteen percent (n = 96) had changed contraceptive method in the last year. At the time around conception, 15% (n = 90) reported use of SARC and 2% (n = 12) of long-acting reversible contraception (LARC). Four out of 10 women (n = 268) reported non-use of contraception at the time around conception, with a higher proportion among adolescents (70%, n = 30, P = 0.001). Among the women who responded to why they had not used any method (n = 387), the main reasons were that they did not believe they could become pregnant at that time (37%, n = 144) or had negative experiences from using contraceptives (32%, n = 123). A majority (88%, n = 527) planned to use contraception after the abortion. Of the women who had decided on method, 55% (n = 271) planned to use LARC, and 38% (n = 188) planned to use SARC. Conclusion: The unmet need for contraception appears to be high among abortion-seeking women in Sweden. Many had discontinued contraception use during the last year, and the main reasons for avoidance were beliefs that one could not become pregnant and negative experiences of contraceptives. The underestimation of pregnancy risk indicates limited fertility awareness, thus our recommendation would be to strengthen the sexual and reproductive knowledge among this group.
48.	Niemeyer Hultstrand, Jenny, et al. (författare) Foreign-born women’s lifestyle and health before and during early pregnancy in Sweden 2020 Ingår i: European journal of contraception & reproductive health care. - : Informa UK Limited. - 1362-5187 .- 1473-0782. ; 25:1, s. 20-27 Tidskriftsartikel (refereegranskat)abstract Objectives: The aims of the study were to investigate foreign-born women’s lifestyle and health before and during early pregnancy and compare them with those of Nordic-born women.Methods: Women recruited at antenatal clinics in Sweden answered a questionnaire in Swedish, English or Arabic or by telephone interview with an interpreter. Questions covered pregnancy planning and periconceptional lifestyle and health. The responses of women born in or outside Europe were compared with those of Nordic-born women. The impact of religiousness and integration on periconceptional lifestyle and health was also investigated.Results: Twelve percent of participants (N = 3389) were foreign-born (n = 414). Compared with Nordic women, European and non-European women consumed less alcohol before conception (respectively, adjusted odds ratio [aOR] 0.38; 95% confidence interval [CI] 0.24, 0.58 and aOR 0.14; 95% CI 0.10, 0.19) and during early pregnancy (respectively, aOR 0.61; 95% CI 0.40, 0.91 and aOR 0.20; 95% CI 0.14, 0.29). Non-European women used less tobacco and were less physically active, but body mass index (BMI) did not differ between groups. Self-perceived health, stress and anxiety during early pregnancy did not differ, but non-European women more often had depressive symptoms (aOR 1.67; 95% CI 1.12, 2.51). Non-European women’s healthy lifestyle was associated with religiousness but not with the level of integration.Conclusions: Non-European women were overall less likely to engage in harmful lifestyle habits before and during early pregnancy but were more likely to suffer from depressive symptoms in comparison with Nordic women.
49.	Niemeyer Hultstrand, Jenny, et al. (författare) Induced abortion and access to contraception in Sweden during the COVID-19 pandemic 2022 Ingår i: BMJ Sexual and Reproductive Health. - : BMJ. - 2515-1991 .- 2515-2009. ; 48:4, s. 311-312 Tidskriftsartikel (refereegranskat)
50.	Nilsson, Evalill, et al. (författare) SF-36 predicts 13-year CHD incidence in a middle-aged Swedish general population 2020 Ingår i: Quality of Life Research. - : Springer. - 0962-9343 .- 1573-2649. ; 29, s. 971-975 Tidskriftsartikel (refereegranskat)abstract PurposeTo study the predictive ability of each of the eight scales of SF-36 on 13-year all-cause mortality and incident coronary heart disease (CHD) in a general middle-aged population.MethodsThe population-based, longitudinal “Life-conditions, Stress and Health” study, in 2003–2004 enrolled 1007 persons aged 45–69 years (50% female), randomly sampled from the general population in Östergötland, Sweden. Variables at baseline included the SF-36 (health-related quality of life, HRQoL) and self-reported disease. Incident CHD (morbidity and mortality) and all-cause mortality data for the study population during the first 13 years from baseline were obtained from national Swedish registries.ResultsSeven of the eight SF-36 scales predicted CHD (sex- and age-adjusted Hazard Ratios up to 2.15; p ≤ 0.05), while only the Physical Functioning scale significantly predicted all-cause mortality. Further adjustments for presence of (self-reported) disease did not, in most cases, alter these significant predictions.ConclusionLow SF-36 scores predict risk of CHD, also after adjustment for present disease, supporting the biopsychosocial model of health and disease. Measures of HRQoL yield important information and can add to the cardiopreventive toolbox, including primary prevention efforts, as it is such a simple and relatively inexpensive tool.

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