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  • 1. Aanesen, Arthur
    et al.
    Westerbotn, Margareta
    Sophiahemmet Högskola.
    Prospective study of a Swedish infertile cohort 2005-08: population characteristics, treatments and pregnancy rates2014Inngår i: Family Practice, ISSN 0263-2136, E-ISSN 1460-2229, Vol. 31, nr 3, s. 290-7Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: We here report on results from a prospective study comprising 380 infertile couples undergoing infertility work-up and various treatments for infertility in our clinic. The aim was to investigate the overall birth rate as a result of different treatments, as well as spontaneous pregnancies.

    METHODS: Three hundred and eighty couples were consecutively included between December 2005 and May 2008. All couples underwent a fertility work-up, including hysterosalpingogram, hormonal characterization, clinical examination, screening for infectious diseases and semen analysis. The mean age of the women at the time of inclusion was 33.2 years. The mean duration of infertility prior to inclusion was 1.8 years. And 46.6% (n = 177) of the women had been pregnant prior to their first visit to the clinic and 30.0% (n = 114) had been pregnant earlier in their present relationship.

    RESULTS: As of November 2010, 57.3% (n = 218) of the women had given birth to a child when they were lost to follow up by the study. Spontaneous conception was observed in 11.3% (n = 43) of the women, 14.5% (n = 64) conceived after intrauterine insemination (IUI), 4.2% (n = 16) conceived after ovarian hyperstimulation and ovulation induction (OH/OI) and 28.4% (n = 113) after in vitro fertilization. There were 280 pregnancies and 58 spontaneous abortions (22.3%) in the group. Mean anti-mullerian hormone significantly correlated with antral follicle count and age and was significantly higher in the subgroup that became pregnant after IUI.

    CONCLUSIONS: Spontaneous pregnancies and IUI + OH/OI contributed significantly to the pregnancies observed in the total population. Predictive factors for pregnancy were anti-mullerian hormone in the group undergoing IUI treatment and in the age group ≥38-duration of infertility. Previous pregnancies, body mass index, estradiol, follicle stimulating hormone or having given birth prior to the infertility period were not predictive of pregnancy for the infertile couples in this study.

  • 2.
    Akselsson, Anna
    et al.
    Sophiahemmet Högskola.
    Georgsson, Susanne
    Sophiahemmet Högskola.
    Lindgren, H
    Pettersson, K
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Women's attitudes, experiences and compliance concerning the use of Mindfetalness: A method for systematic observation of fetal movements in late pregnancy2017Konferansepaper (Annet vitenskapelig)
  • 3.
    Akselsson, Anna
    et al.
    Sophiahemmet Högskola.
    Georgsson, Susanne
    Sophiahemmet Högskola.
    Lindgren, Helena
    Pettersson, Karin
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Women's attitudes, experiences and compliance concerning the use of Mindfetalness- a method for systematic observation of fetal movements in late pregnancy2017Inngår i: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 17, nr 1, artikkel-id 359Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Maternal perception of decreased fetal movements and low awareness of fetal movements are associated with a negative birth outcome. Mindfetalness is a method developed for women to facilitate systematic observations of the intensity, character and frequency of fetal movements in late pregnancy. We sought to explore women's attitudes, experiences and compliance in using Mindfetalness.

    METHODS: We enrolled 104 pregnant women treated at three maternity clinics in Stockholm, Sweden, from February to July of 2016. We educated 104 women in gestational week 28-32 by providing information about fetal movements and how to practice Mindfetalness. Each was instructed to perform the assessment daily for 15 min. At each subsequent follow-up, the midwife collected information regarding their perceptions of Mindfetalness, and their compliance. Content analyses, descriptive and analytic statistics were used in the analysis of data.

    RESULTS: Of the women, 93 (89%) were positive towards Mindfetalness and compliance was high 78 (75%). Subjective responses could be binned into one of five categories: Decreased worry, relaxing, creating a relationship, more knowledge about the unborn baby and awareness of the unborn baby. Eleven (11%) women had negative perceptions of Mindfetalness, citing time, and the lack of need for a method to observe fetal movements as the most common reasons.

    CONCLUSION: Women in late pregnancy are generally positive about Mindfetalness and their compliance with daily use is high. The technique helped them to be more aware of, and create a relationship with, their unborn baby. Mindfetalness can be a useful tool in antenatal care. However, further study is necessary in order to determine whether the technique is able to reduce the incidence of negative birth outcome.

  • 4.
    Akselsson, Anna
    et al.
    Sophiahemmet Högskola.
    Linde, Anders
    Sophiahemmet Högskola.
    Georgsson, Susanne
    Sophiahemmet Högskola.
    Lindgren, H
    Pettersson, K
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Structured daily observation of fetal movements and transfer to neonatal clinic2017Konferansepaper (Annet vitenskapelig)
  • 5.
    Akselsson, Anna
    et al.
    Sophiahemmet Högskola.
    Lindgren, Helena
    Georgsson, Susanne
    Pettersson, Karin
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Increased labor induction and women presenting with decreased or altered fetal movements: A population-based survey2019Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, nr 5, artikkel-id e0216216Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    INTRODUCTION: Women's awareness of fetal movements is important as perception of decreased fetal movements can be a sign of a compromised fetus. We aimed to study rate of labor induction in relation to number of times women seek care due to decreased or altered fetal movements during their pregnancy compared to women not seeking such care. Further, we investigated the indication of induction.

    MATERIAL AND METHODS: A prospective population-based cohort study including all obstetric clinics in Stockholm, Sweden. Questionnaires were distributed to women who sought care due to decreased or altered fetal movements ≥ 28 week's gestation in 2014, women for whom an examination did not indicate a compromised fetus that required induction of labor or cesarean section when they sought care. Women who gave birth at ≥ 28 weeks' gestation in 2014 in Stockholm comprises the reference group.

    RESULTS: Labor was induced more often among the 2683 women who had sought care due to decreased or altered fetal movements (RR 1.4, 95% CI 1.3-1.5). In women who presented with decreased or altered fetal movements induction of labor occurred more frequently for fetal indication than those with induction of labor and no prior fetal movement presentation (RR 1.6, 95% CI 1.4-1.8). The rate of induction increased with number of times a woman sought care, RR 1.3 for single presentation to 3.2 for five or more.

    CONCLUSIONS: We studied women seeking care for decreased or altered fetal movements and for whom pregnancy was not terminated with induction or caesarean section. Subsequent (median 20 days), induction of labor and induction for fetal indications were more frequent in this group compared to the group of women with no fetal movement presentations. Among women seeking care for altered or decreased fetal movements, the likelihood of induction of labor increased with frequency of presentation.

  • 6.
    Akselsson, Anna
    et al.
    Sophiahemmet Högskola.
    Lindgren, Helena
    Georgsson, Susanne
    Sophiahemmet Högskola.
    Pettersson, Karin
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Mindfetalness - a systematic method for observing fetal movements: A randomized controlled trial2019Konferansepaper (Annet vitenskapelig)
  • 7.
    Akselsson, Anna
    et al.
    Sophiahemmet Högskola.
    Lindgren, Helena
    Georgsson, Susanne
    Sophiahemmet Högskola.
    Pettersson, Karin
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Mindfetalness: A useful tool when informing pregnant women about fetal movements2019Konferansepaper (Annet vitenskapelig)
  • 8.
    Akselsson, Anna
    et al.
    Sophiahemmet Högskola.
    Lindgren, Helena
    Georgsson, Susanne
    Sophiahemmet Högskola.
    Pettersson, Karin
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Mindfetalness: En metod som kan stärka kvinnors uppmärksamhet av fosterrörelser2018Konferansepaper (Annet vitenskapelig)
  • 9.
    Akselsson, Anna
    et al.
    Sophiahemmet Högskola.
    Lindgren, Helena
    Georgsson, Susanne
    Sophiahemmet Högskola.
    Warland, Jane
    Pettersson, Karin
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Daily structured approach to awareness of fetal movements and pregnancy outcome - a prospective study2019Inngår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 20, s. 32-37, artikkel-id S1877-5756(18)30321-5Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: We investigated how women, seeking care due to decreased movements, had paid attention to fetal movements and if the method of monitoring was associated with pregnancy outcome.

    METHODS: A questionnaire was distributed to women from gestational week 28, who had sought care due to decreased fetal movements in Stockholm between January 1st and December 31st, 2014. Women were included in the study if the examination did not reveal any signs of a compromised fetus requiring immediate intervention. Birth outcome and sociodemographic data were collected from the obstetric record register.

    RESULTS: There were 29166 births in Stockholm in 2014, we have information from 2683 women who sought care for decreased fetal movements. The majority (96.6%) of the women stated that they paid attention to fetal movements. Some women observed fetal movements weekly (17.2%) and 69.5% concentrated on fetal movements daily (non-structured group). One in ten (9.9%) used counting methods daily for observing fetal movements (structured group). Women in the structured group more often had caesarean section before onset of labor (RR 1.6, 95% CI 1.2-2.2) and a lower risk of their baby being transferred to neonatal nursery (RR 0.25, 95% CI 0.03-0.94) compared to women in the non-structured group.

    CONCLUSIONS: Women, who had a daily and structured approach to awareness of fetal movements, were more likely to have a caesarean section but their babies were less likely to be transferred to a neonatal nursery as compared with women who used a non-structured method daily.

  • 10.
    Asplin, Nina
    Sophiahemmet Högskola.
    Women's experiences and reactions when a fetal malformation is detected by ultrasound examination2013Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Background: Second trimester ultrasound examination among pregnant women in Sweden is almost universal. The detection of a fetal malformation on ultrasound puts health care providers and pregnant women in a difficult and precarious situation. What information and how it is communicated is crucial to women’s decision-making about continuing or terminating at pregnancy. The main aim of this thesis was to describe and analyze women’s experiences and reactions following the detection of a fetal malformation on an ultrasound scan. Methods: Two semi-structured in-depth interviews were performed, with women informed of a fetal malformation following an ultrasound scan. A total of 27 women took part in the first round of interviews: women continuing their pregnancy were interviewed, either in gestational week 30 or three weeks after the diagnosis; those terminating their pregnancy were interviewed two to four weeks after termination (Paper I). A second interview with 11 women who terminated their pregnancy was conducted six months after termination (Paper III). Two questionnaires were also administered. The first, answered by 99 women (Paper II) and comprising 22 study- specific questions along with emotional well-being and socio-demographics variables and medical and obstetric history, was conducted at the same time as the first stage of interviews. The other questionnaire, answered by 56 women incorporated common self- report instruments and was performed three times: first in gestational week 30, and then two respectively six months postpartum (Paper IV). Qualitative data were analyzed through content analysis, and quantitative data were analyzed through descriptive statistics. Results: The timing, duration, and manner of women’s initial counseling and ongoing support were shown to be important in the interaction between women and caregivers. Positive interactions improved the women’s ability to understand the information and fostered feelings of trust and safety, which in turn reduced their anxiety. Most of the women who expected a baby with an abnormality expressed their need for information on several occasions to help them make this difficult decision. They also wished for information from different specialists and continuity of care. These needs were even stronger in women who chose to terminate their pregnancy. We found women continuing their pregnancy to be at high risk of depressive symptoms, major worries, and high anxiety levels, both in mid-pregnancy, and at two months and one year postpartum. Despite these findings, the results of the maternal-fetal attachment scale for women who continued their pregnancy with a fetus diagnosed with a malformation indicated a high level of attachment. Conclusions and Clinical Implications: Effective communication, empathy and compassion, and consistent follow-up routines are important to ensure good treatment and care of this group of women. Taking these results into account may improve caregivers’ ability to counsel these vulnerable patients and to ensure that their needs are properly met.

  • 11.
    Asplin, Nina
    et al.
    Sophiahemmet Högskola.
    Dellgren, Annika
    Conner, Peter
    Education in obstetrical ultrasound - an important factor for increasing the prenatal detection of congenital heart disease2013Inngår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 92, nr 7, s. 804-808Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To evaluate the effects of postgraduate education in obstetrical ultrasound on the prenatal detection rate of congenital heart disease. SETTING: Tertiary care center. POPULATION: Experienced and less experienced midwives performing ultrasound scans. METHODS: Number of fetuses and live born children with severe congenital heart malformations were extracted from patient records. The detection rates of experienced and less experienced midwives were compared following a postgraduate training program in obstetrical ultrasound. MAIN OUTCOME MEASURES: The prenatal detection rate of complex congenital heart malformations. RESULTS: The prenatal detection rate for the entire unit increased significantly during the study period (32 vs. 69%, p<0.05). Following education, we observed a significant increase in detection rates (21 vs. 67%, p<0.01) among experienced midwives. In the group of less experienced midwives, we found a positive effect of training with considerably higher detection rates compared to results achieved by their more experienced colleagues prior to the program (40 vs. 21%). CONCLUSION: There is a clear improvement in the prenatal detection rates of complex heart malformations following a postgraduate education in obstetrical ultrasound. Similar training should be offered to both midwives and doctors performing routine scans to increase the standards of antenatal screening for congenital heart disease. © 2013 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

  • 12. Asplin, Nina
    et al.
    Wessel, Hans
    Marions, Lena
    Georgsson Öhman, Susanne
    Sophiahemmet Högskola.
    Maternal emotional wellbeing over time and attachment to the fetus when a malformation is detected2015Inngår i: Sexual & Reproductive Healthcare, ISSN 1877-5756, Vol. 6, nr 3, s. 191-195Artikkel i tidsskrift (Fagfellevurdert)
  • 13.
    Asplin, Nina
    et al.
    Sophiahemmet Högskola.
    Wessel, Hans
    Marions, Lena
    Georgsson Öhman, Susanne
    Sophiahemmet Högskola.
    Pregnancy termination due to fetal anomaly: women's reactions, satisfaction and experiences of care2014Inngår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 30, nr 6, s. 620-627Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE:

    to explore what women who have had a pregnancy terminated due to a detected fetal malformation perceived as having been important in their encounters with caregivers for promoting their healthy adjustment and well-being.

    METHOD:

    an exploratory descriptive design was used. Semi-structured interviews were audiotaped, and the information pathway described. The text was processed through qualitative content analysis in six steps.

    SETTING:

    four fetal care referral centres in Stockholm, Sweden.

    PARTICIPANTS:

    11 women opting for pregnancy termination due to fetal malformation.

    FINDINGS:

    in-depth understanding and compassion are important factors in providing the feeling of support people need so they are able to adapt to crisis. The women emphasised that the caregivers have to communicate a sense of responsibility, hope and respect and provide on-going care for them to feel assured of receiving good medical care and treatment. Aside from existing psychological conditions, the women identified as having emotional distress directly after termination and for at least the following three months. Most women experienced a range of negative emotions after pregnancy termination, including sadness, meaninglessness, loneliness, tiredness, grief, anger and frustration. Still some of this group had positive reactions because they experienced empathy and well-organised care.

    CONCLUSION AND IMPLICATIONS FOR PRACTICE:

    The most important factors associated with satisfaction regarding pregnancy termination due to a fetal malformation are the human aspects of care, namely state-dependent communication and in-depth understanding and compassion. The changes in care most often asked for were improvements in the level of standards and provision of adequate support through state-dependent communication, in-depth understanding and compassion, and complete follow-up routines and increased resources. Targeted education for the caregivers may be suited to ensuring that they properly meet needs of their patients.

  • 14.
    Asplin, Nina
    et al.
    Sophiahemmet Högskola.
    Wessel, Hans
    Marions, Lena
    Georgsson Öhman, Susanne
    Sophiahemmet Högskola.
    Pregnant women's experiences, needs, and preferences regarding information about malformations detected by ultrasound scan2012Inngår i: Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives, ISSN 1877-5764, Vol. 3, nr 2, s. 73-8Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: The aim of the study was to explore pregnant women's experiences of received information in relation to fetal malformation detected on ultrasound.

    METHOD: An exploratory descriptive design was used. Semi-structured interviews with women who continued their pregnancy and women who chose to terminate were audiotaped, the information pathway described, and the text subjected to qualitative content analysis.

    RESULTS: Most of the women who expected a baby with an abnormality experienced the information given as insufficient, often misleading, conflicting, or incoherent, and sometimes negative. Important factors for interaction between women and caregivers were timing, duration, and manner of the initial dialog and ongoing support. Positive interactions improved the women's ability to understand the information, fostered feelings of trust and safety which reduced their anxiety.

    CONCLUSION: Women expressed dissatisfaction both regarding the care-givers' methods of giving information and apply for information from different specialists and continuity. The study highlights important factors which may be helpful to the professionals for improving the information to this vulnerable group of women.

  • 15.
    Asplin, Nina
    et al.
    Sophiahemmet Högskola.
    Wessel, Hans
    Marions, Lena
    Georgsson Öhman, Susanne
    Sophiahemmet Högskola.
    Pregnant women's perspectives on decision-making when a fetal malformation is detected by ultrasound examination2013Inngår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 4, nr 2, s. 79-84Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives

    The aims of the study were to explore factors influencing the decision to continue or terminate pregnancy due to detection of fetal malformation following ultrasound examination, to elucidate the need for more information or other routines to facilitate the decision-making process and to assess satisfaction with the decision made.

    Design

    Descriptive study.

    Setting

    Four fetal care referral centres in Stockholm, Sweden.

    Population

    Pregnant women with a detected fetal malformation.

    Methods

    Data was collected by questionnaires. 134 women participated, 99 completing the questionnaire. Descriptive statistical analysis was performed.

    Results

    Both women who continued and those who terminated pregnancy based their decision on the severity of the malformation. Other reasons for terminating the pregnancy were aspects including socioeconomic considerations. None stated religious factors. The doctor at the fetal care unit also had an influence on the decision-making. The timeframe receiving information was regarded as long enough in duration but not the number of occasions. In both groups the women made the decision by themselves or together with their partners. The majority experienced that they had made the right decision. Women who terminated their pregnancy had a significant higher rate (51.2%) (p⩽ 0.004) of previous abortions than those in the continuing group (23.2%).

    Conclusion

    The decision to continue or terminate the pregnancy was to a great extent based on the severity of the malformation. Religious aspects did not seem to influence the decision. Many women expressed a need for additional occasion of information. The vast majority of women were satisfied with their decision.

  • 16. Avelin, Pernilla
    et al.
    Erlandsson, Kerstin
    Hildingsson, Ingegerd
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Swedish parents' experiences of parenthood and the need for support to siblings when a baby is stillborn2011Inngår i: Birth, ISSN 0730-7659, E-ISSN 1523-536X, Vol. 38, nr 2, s. 150-8Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: It has been argued that having a stillborn baby in the family affects older siblings more than parents realize. The aim of this study was to describe parenthood and the needs of siblings after stillbirth from the parents' perspective.

    METHODS: Six focus groups were held with 27 parents who had experienced a stillbirth and who had had children before the loss. The discussion concerned parents' support to the siblings, and the sibling's meeting, farewell, and memories of their little sister or brother. Data were analyzed using qualitative content analysis.

    RESULTS: The overall theme of the findings was parenthood in a balance between grief and everyday life. In the analysis, three categories emerged that described the construction of the theme: support in an acute situation, sharing the experiences within the family, and adjusting to the situation.

    CONCLUSIONS: The siblings' situation is characterized by having a parent who tries to maintain a balance between grief and everyday life. Parents are present and engaged in joint activities around the stillbirth together with the siblings of the stillborn baby. Although parents are aware of the sibling's situation, they feel that they are left somewhat alone in their parenthood after stillbirth and therefore need support and guidance from others.

  • 17. Avelin, Pernilla
    et al.
    Hildingsson, Ingegerd
    Davidsson-Bremborg, Anna
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Make the stillborn baby and the loss real for the siblings: parents' advice on how the siblings of a stillborn baby can be supported2012Inngår i: Journal of Perinatal Education, ISSN 1058-1243, EISSN 1548-8519, Vol. 21, nr 2, s. 90-98Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study aimed to investigate parents' advice to other parents on the basis of their own experiences of siblings' taking leave of a stillborn sister or brother. The study was a Web questionnaire study of 411 parents. The thematic content analysis resulted in two categories: "Make the stillborn baby and the loss real for the siblings" and "Take the siblings' resources and prerequisites into account." Parents' advised that siblings should see and hold the stillborn baby and, thus, be invited and included into the leave-taking process with respect to the siblings' feelings, resources, and prerequisites. Based on these findings, professional caregivers can usefully be proactive in their approach to facilitate and encourage the involvement of siblings.

  • 18. Avelin, Pernilla
    et al.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Säflund, Karin
    Wredling, Regina
    Erlandsson, Kerstin
    Parental grief and relationships after the loss of a stillborn baby2013Inngår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 29, nr 6, s. 668-673Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: to describe the grief of mothers and fathers and its influence on their relationships after the loss of a stillborn baby. DESIGN: a postal questionnaire at three months, one year and two years after stillbirth. SETTING: a study of mothers and fathers of babies stillborn during a one-year period in the Stockholm region of Sweden. PARTICIPANTS: 55 parents, 33 mothers and 22 fathers. FINDINGS: mothers and fathers stated that they became closer after the loss, and that the feeling deepened over the course of the following year. The parents said that they began grieving immediately as a gradual process, both as individuals, and together as a couple. During this grieving process their expectations, expressions and personal and joint needs might have threatened their relationship as a couple, in that they individually felt alone at this time of withdrawal. While some mothers and fathers had similar grieving styles, the intensity and expression of grief varied, and the effects were profound and unique for each individual. KEY CONCLUSIONS: experiences following a loss are complex, with each partner attempting to come to terms with the loss and the resultant effect on the relationship with their partner. IMPLICATIONS FOR PRACTICE: anticipating and being able to acknowledge the different aspects of grief will enable professionals to implement more effective intervention in helping couples grieve both individually and together.

  • 19. Barimani, M
    et al.
    Jonas, W
    Zwedberg, Sofia
    Sophiahemmet Högskola.
    Parents' experiences when students are present during labour and childbirth: A cross-sectional survey of parents in Sweden2019Inngår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 77, s. 130-136, artikkel-id S0266-6138(19)30188-3Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: Various student groups participate in clinical intrapartum care, but limited data are available on parents' perceptions of student presence during labour and childbirth. This study explored parents' experiences of having a student present during labour and childbirth.

    DESIGN AND PARTICIPANTS: Qualitative study based on an analysis of 362 parents' responses to one open-ended question from a cross-sectional survey.

    RESULTS: When they experienced students as interactive and supportive, parents reacted positively to student participation. Parents displayed clear willingness to contribute to students' learning. Some parents, however, reported unexpected, uncomfortable, or inappropriate experiences that they attributed to insufficient autonomy or undergoing many vaginal examinations.

    KEY CONCLUSIONS: Parents, clinical supervisors, and students can benefit from clinical learning situations, but women's needs must be prioritised and student involvement balanced with women's right to choose who is with them during labour and childbirth.

  • 20. Björklund, Ulla
    et al.
    Marsk, Anna
    Georgsson Öhman, Susanne
    Sophiahemmet Högskola.
    Does an information film about prenatal testing in early pregnancy affect women's anxiety and worries?2013Inngår i: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 34, nr 1, s. 9-14Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Abstract Objective: To explore if an information film about prenatal examinations affects pregnant women's worry and anxiety. Methods: Randomized controlled study. The intervention was an information film about prenatal examinations. Data was collected in gestational week 26 by a questionnaire including the STAI (State-Trait Anxiety Inventory) instrument and further questions about worry. A total of 184 women in the intervention group and 206 in the control group filled in the questionnaire. Results: There were no statistically significant differences between the groups neither in state nor trait anxiety. Regarding worry about the possibility of something being wrong with the baby and worry about giving birth, there were no statistically significant differences between the groups. The women stated that to see the film increased their worry rather than decreased it. Conclusion: An informational film as additional information to complement written and verbal information about prenatal testing does not appear to increase women's anxiety and worries. However, the informational film may cause worry at the time of viewing which should be taken into consideration.

  • 21. Björklund, Ulla
    et al.
    Marsk, Anna
    Levin, Charlotta
    Georgsson Öhman, Susanne
    Sophiahemmet Högskola.
    Audiovisual information affects informed choice and experience of information in antenatal Down syndrome screening: a randomized controlled trial2012Inngår i: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 86, nr 3, s. 390-395Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To evaluate the effects of an information film on making an informed choice regarding Down syndrome screening, and women's knowledge and experiences of information. METHODS: Randomized controlled trial including 184 women in the intervention group and 206 controls recruited from maternity units in Stockholm, Sweden. The intervention was an information film presented as a complement to written and verbal information. Data were collected via a questionnaire in gestational week 27. Three different measures were combined to measure informed choice: attitudes towards Down syndrome screening, knowledge about Down syndrome and Down syndrome screening, and uptake of CUB (combined ultrasound and biochemical screening). RESULTS: In the intervention group 71.5% made an informed choice versus 62.4% in the control group. Women in the intervention group had significantly increased knowledge, and to a greater extent than the control group, experienced the information as being sufficient, comprehensible, and correct. CONCLUSIONS: An information film tended to increase the number of women who made an informed choice about Down syndrome screening. Participants were more satisfied with the information received. PRACTICE IMPLICATIONS: Access to correct, nondirective, and sufficient information is essential when making a choice about prenatal diagnostics. It is essential with equivalent information to all women.

  • 22. Bodin, Maja
    et al.
    Käll, Lisa
    Tydén, Tanja
    Stern, Jenny
    Sophiahemmet Högskola.
    Drevin, Jennifer
    Larsson, Margareta
    Exploring men's pregnancy-planning behaviour and fertility knowledge: a survey among fathers in Sweden2017Inngår i: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 122, nr 2, s. 127-135Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    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.

  • 23.
    Carlsson, Tommy
    Sophiahemmet Högskola.
    Management of physical pain during induced second-trimester medical abortions: a cross-sectional study of methodological quality and recommendations in local clinical practice guidelines at Swedish hospitals2019Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 33, nr 1, s. 111-118Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: The aim was to assess the methodological quality and describe recommendations for pain management in local clinical practice guidelines about induced second-trimester medical abortions at Swedish university and county hospitals.

    METHODS: In 2017, Swedish university and county hospitals that provided abortion care in the second trimester of pregnancy were contacted (n = 29), and guidelines from 25 were received (university: n = 6, county: n = 19). Guideline quality was assessed according to two systematic instruments. Recommendations were systematically assessed regarding frequency and tools for pain measurement, prophylactic pharmacologic treatment, as needed pharmacologic treatment and nonpharmacologic treatment.

    RESULTS: Overall methodological quality was poor across both instruments, as the majority of the guidelines did not fulfil the investigated quality criteria. For pain measurements, no guideline recommended measurement frequency and four recommended specific measurement tools. Prophylactic pharmacologic treatment, described in 23 (92%) guidelines, included paracetamol (n = 23, 92%), anti-inflammatory drugs (n = 23, 92%) and opioids (n = 18, 72%). As needed pharmacologic treatment, described in 23 (92%) guidelines, included anaesthetics (n = 21, 84%), opioids (n = 21, 84%) and paracetamol (n = 1, 4%). Recommendations for as needed anaesthetics included paracervical block (n = 21, 84%), epidural analgesia (n = 16, 64%) and inhalation of nitrous oxide (n = 5, 20%). Nonpharmacologic treatments were recommended in nine (36%) guidelines.

    CONCLUSIONS: The findings indicate that local clinical practice guidelines about induced second-trimester medical abortions are of inadequate methodological quality and that a large majority lack recommendations concerning systematic pain measurements. Although most recommend prophylactic and as needed pharmacologic management, national inconsistencies exist in Sweden with regard to recommendations of epidural analgesia, nitrous oxide and nonpharmacologic methods. In Sweden, there is room for improvement in the development of these guidelines.

  • 24.
    Carlsson, Tommy
    et al.
    Sophiahemmet Högskola.
    Balbas, Banaz
    Mattsson, Elisabet
    Written narratives from immigrants following a prenatal diagnosis: qualitative exploratory study2019Inngår i: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 19, nr 1, artikkel-id 154Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Expectant parents often have optimistic expectations of the obstetric ultrasound examination and are unprepared for a diagnosis of foetal anomaly. Research that gives voice to the experiences of immigrants faced with a prenatal diagnosis is scarce, and there is a need for more exploratory research that provides insights into the experiences of these persons. The aim of this study was to explore narratives of experiences of immigrants with Arabic or Sorani interpreter needs when presented with a prenatal diagnosis of foetal anomaly.

    METHODS: A web-based tool with open-ended questions was distributed via Arabic and Kurdish non-profit associations and general women's associations in Sweden. Responses were received from six women and analysed with qualitative content analysis.

    RESULTS: The analysis resulted in three themes: (1) an unexpected hurricane of emotions, (2) trying to understand the situation though information in an unfamiliar language, and (3) being cared for in a country with accessible obstetric care and where induced abortion is legal.

    CONCLUSIONS: Immigrant women described an unexpected personal tragedy when faced with a prenatal diagnosis of foetal anomaly, and emphasised the importance of respectful and empathic psychological support. Their experiences of insufficient and incomprehensible information call attention to the importance of tailored approaches and the use of adequate medical interpreting services. There is a need for more descriptive studies that investigate decision-making and preparedness for induced abortion among immigrants faced with a prenatal diagnosis.

  • 25. Davidsson-Bremborg, Anna
    et al.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Memory triggers and anniversaries of stillborn children2013Inngår i: Nordic Journal of Religion and Society, ISSN 0809-7291, E-ISSN 1890-7008, Vol. 26, nr 2, s. 157-174Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Care after stillbirths has changed radically within the last twenty years, not least because of research. However, less attention has been given to memorialization in the longer perspective. This is a qualitative study based on a web questionnaire with the aim to uncover memorialization practices on anniversary days. 596 bereaved mothers of stillborn children provided an answer to an open question on how they observed the anniversary. The inductive analysis resulted in six categories of memorialization: (1) internal memorialization; (2) home-based memorialization; (3) traditional grave visits; (4) extended memorialization rituals; (5) alternative activities; and (6) coincidental activities. Different memory triggers – gifts, objects, food, and places – were used to evoke memories, honour the child, and strengthen the bonds with the child and within the family.

  • 26. Drevin, Jennifer
    et al.
    Kristiansson, Per
    Stern, Jenny
    Sophiahemmet Högskola.
    Rosenblad, Andreas
    Measuring pregnancy planning: A psychometric evaluation and comparison of two scales2017Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, nr 11, s. 2765-2775Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS: To psychometrically test the London Measure of Unplanned Pregnancy and compare it with the Swedish Pregnancy Planning Scale.

    BACKGROUND: The incidence of unplanned pregnancies is an important indicator of reproductive health. The London Measure of Unplanned Pregnancy measures pregnancy planning by taking contraceptive use, timing, intention to become pregnant, desire for pregnancy, partner agreement, and pre-conceptual preparations into account. It has, however, previously not been psychometrically evaluated using confirmatory factor analysis. The Likert-scored single-item Swedish Pregnancy Planning Scale has been developed to measure the woman's own view of pregnancy planning level.

    DESIGN: Cross-sectional design.

    METHODS: In 2012-2013, 5493 pregnant women living in Sweden were invited to participate in the Swedish Pregnancy Planning study, of whom 3327 (61%) agreed to participate and answered a questionnaire. A test-retest pilot study was conducted in 2011-2012. Thirty-two participants responded to the questionnaire on two occasions 14 days apart. Data were analysed using confirmatory factor analysis, Cohen's weighted kappa and Spearman's correlation.

    RESULTS: All items of the London Measure of Unplanned Pregnancy contributed to measuring pregnancy planning, but four items had low item-reliability. The London Measure of Unplanned Pregnancy and Swedish Pregnancy Planning Scale corresponded reasonably well with each other and both showed good test-retest reliability.

    CONCLUSION: The London Measure of Unplanned Pregnancy may benefit from item reduction and its usefulness may be questioned. The Swedish Pregnancy Planning Scale is time-efficient and shows acceptable reliability and construct validity, which makes it more useful for measuring pregnancy planning.

  • 27. Edqvist, Malin
    et al.
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Lundgren, Ingela
    Mollberg, Margareta
    Lindgren, Helena
    Practices used by midwives during the second stage of labor to facilitate birth - Are they related to perineal trauma?2018Inngår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 15, s. 18-22, artikkel-id S1877-5756(17)30103-9Artikkel i tidsskrift (Fagfellevurdert)
  • 28. Ekstrand Ragnar, Maria
    et al.
    Grandahl, Maria
    Stern, Jenny
    Sophiahemmet Högskola.
    Mattebo, Magdalena
    Important but far away: adolescents' beliefs, awareness and experiences of fertility and preconception health2018Inngår i: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 23, nr 4, s. 265-273Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: The aim was to explore adolescents' beliefs and awareness regarding fertility and preconception health, as well as their views and experiences of information about fertility and preconception health directed at their age group.

    METHODS: We performed seven semi-structured focus group interviews among upper secondary school students (n = 47) aged 16-18 years in two Swedish counties. Data were analysed by qualitative content analysis.

    RESULTS: One theme ('important but far away') and five categories ('starting a family far down on the list'; 'high awareness but patchy knowledge of fertility and preconception health'; 'gender roles influence beliefs about fertility and preconception health'; 'wish to preserve fertility and preconception health in order to keep the door to procreation open'; 'no panacea - early and continuous education about fertility and preconception health') emerged from the interviews. Participants recognised the importance of preconception health and were highly aware of the overall importance of a healthy lifestyle. Their knowledge, however, was patchy and they had difficulties relating to fertility and preconception health on a personal and behavioural level. Participants wanted more information but had heterogeneous beliefs about when, where and how this information should be given.

    CONCLUSION: The adolescents wanted information on fertility and preconception health to be delivered repeatedly as well as through different sources.

  • 29. Erlandsson, Kerstin
    et al.
    Lindgren, Helena
    Davidsson-Bremborg, Anna
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Women's premonitions prior to the death of their baby in utero and how they deal with the feeling that their baby may be unwell2012Inngår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 91, nr 1, s. 28-33Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective. To identify whether mothers of stillborn babies had had a premonition that their unborn child might not be well and how they dealt with that premonition. Design. A mixed method approach. Setting. One thousand and thirty-four women answered a web questionnaire. Sample. Six hundred and fourteen women fulfilled the inclusion criteria of having a stillbirth after the 22nd gestational week and answered questions about premonition. Methods. Qualitative content analysis was used for the open questions and descriptive statistics for questions with fixed alternatives. Main Outcome Measure. The premonition of an unwell unborn baby. Results. In all, 392 of 614 (64%) of the women had had a premonition that their unborn baby might be unwell; 274 of 614 (70%) contacted their clinic and were invited to come in for a check-up, but by then it was too late because the baby was already dead. A further 88 of 614 (22%) decided to wait until their next routine check-up, believing that the symptoms were part of the normal cycle of pregnancy, and that the fetus would move less towards the end of pregnancy. Thirty women (8%) contacted their clinic, but were told that everything appeared normal without an examination of the baby. Conclusions. Women need to know that a decrease in fetal movements is an important indicator of their unborn baby's health. Healthcare professionals should not delay an examination if a mother-to-be is worried about her unborn baby's wellbeing.

  • 30. Erlandsson, Kerstin
    et al.
    Lindgren, Helena
    Malm, Mari-Cristine
    Davidsson-Bremborg, Anna
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Mothers' experiences of the time after the diagnosis of an intrauterine death until the induction of the delivery: a qualitative Internet-based study2011Inngår i: Journal of obstetrics and gynaecology research, ISSN 1341-8076, E-ISSN 1447-0756, Vol. 37, nr 11, s. 1677-84Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: This study aims to describe how mothers spend the period of time between being diagnosed with a dead baby in utero and the induction of the delivery.

    MATERIAL AND METHODS: Data were collected using a web questionnaire. Five hundred and fifteen women who had experienced a stillbirth after the 22nd week of gestation answered the open question: 'What did you do between the diagnosis of the child's death and the beginning of the delivery?' A qualitative content analysis method was used.

    RESULTS: The results show that some mothers received help to adapt to the situation, while for others, waiting for the induction meant further stress and additional psychological trauma in an already strained situation.

    CONCLUSION: There is no reason to wait with the induction unless the parents themselves express a wish to the contrary. Health care professionals, together with the parents, should try to determine the best time for the induction of the birth after the baby's death in utero. That time may vary, depending on the parents' preferences.

  • 31. Erlandsson, Kerstin
    et al.
    Säflund, Karin
    Wredling, Regina
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Support after stillbirth and its effect on parental grief over time2011Inngår i: Journal of social work in end-of-life & palliative care, ISSN 1552-4264, Vol. 7, nr 2-3, s. 139-52Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In this study the authors describe parents' experiences of support over a 2-year period after a stillbirth and its effect on parental grief. Data was collected by questionnaire from 33 mothers and 22 fathers at 3 months, 1 year, and 2 years after a stillbirth. Midwives, physicians, counselors, and priests--at the hospital where the stillbirth occurred--are those on the front line providing professional support. The support from family and friends was seen to be important 2 years after the stillbirth. The need for professional support after stillbirth can differ, depending on the support provided by family, friends, and social networks. They may not fully realize the value of their support and how to be supportive. Printed educational materials given to individuals in the social network or family might therefore be helpful.

  • 32. Erlandsson, Kerstin
    et al.
    Warland, Jane
    Cacciatore, Joanne
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Seeing and holding a stillborn baby: mothers' feelings in relation to how their babies were presented to them after birth-findings from an online questionnaire2013Inngår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 29, nr 3, s. 246-250Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: to determine if the way caregivers offer opportunities to see and hold a stillborn baby impacts a mother's feelings about the experience of seeing and holding her newborn. DESIGN AND SETTING: a web questionnaire hosted by the Swedish National Infant Foundation from March 2008 to April 2010. PARTICIPANTS: 840 eligible participants who had experienced a stillbirth after the 22nd gestational week from 1955 to 2010 and completed an online questionnaire about their experiences. METHODS: descriptive and inferential statistics. FINDINGS: when mothers were presented the baby as a normal part of birth without being asked if they wanted to see, they more often reported that the experience was comfortable compared to mothers who were asked if they wanted to see the baby 86% vs. 76% (p=<0.01). The incitation of fear in mothers was 70% vs. 80% (p=0.02) in favour of mothers who were not asked. Furthermore the mothers who were not asked more often stated that it felt natural and good when compared to those who said staff asked if the mother wanted to see, 73% vs. 61% (p=0.07) and (78%) vs. (69%) p=0.19, respectively. A trend was seen toward more mothers feeling natural, good, comfortable, and less frightened if the provider engaged in 'assumptive bonding', that is the baby is simply and naturally presented to the mother without asking her to choose. KEY CONCLUSIONS: mothers of stillborn babies felt more natural, good, comfortable and less frightened if the staff supported assumptive bonding by simply offering the baby to the mother. IMPLICATIONS FOR PRACTICE: care providers should approach caring for grieving mothers with tenderness and humility, assuming that they will wish to see and hold their stillborn baby.

  • 33. Fjellvang, Hanne
    et al.
    Ulfsdottir, Hanna
    Sophiahemmet Högskola.
    Richter, Linn
    Föda barn: Barnmorskornas guide till din förlossning2019Bok (Annet (populærvitenskap, debatt, mm))
  • 34. Flenady, Vicki
    et al.
    Ellwood, David
    Bradford, Billie
    Coory, Michael
    Middleton, Philippa
    Gardener, Glenn
    Rådestad, Ingela
    Sophiahemmet Högskola.
    Homer, Caroline
    Davies-Tuck, Miranda
    Forster, Della
    Gordon, Adrienne
    Groom, Katie
    Crowther, Caroline
    Walker, Sue
    Foord, Claire
    Warland, Jane
    Murphy, Margaret
    Said, Joanne
    Boyle, Fran
    O'Donoghue, Keelin
    Cronin, Robin
    Sexton, Jessica
    Weller, Megan
    McCowan, Lesley
    Beyond the headlines: Fetal movement awareness is an important stillbirth prevention strategy2018Inngår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, artikkel-id S1871-5192(18)31666-4Artikkel i tidsskrift (Fagfellevurdert)
  • 35. Flenady, Vicki
    et al.
    Wojcieszek, Aleena M
    Middleton, Philippa
    Ellwood, David
    Erwich, Jan Jaap
    Coory, Michael
    Khong, T Yee
    Silver, Robert M
    Smith, Gordon C S
    Boyle, Frances M
    Lawn, Joy E
    Blencowe, Hannah
    Leisher, Susannah Hopkins
    Gross, Mechthild M
    Horey, Dell
    Farrales, Lynn
    Bloomfield, Frank
    McCowan, Lesley
    Brown, Stephanie J
    Joseph, K S
    Zeitlin, Jennifer
    Reinebrant, Hanna E
    Ravaldi, Claudia
    Vannacci, Alfredo
    Cassidy, Jillian
    Cassidy, Paul
    Farquhar, Cindy
    Wallace, Euan
    Siassakos, Dimitrios
    Heazell, Alexander E P
    Storey, Claire
    Sadler, Lynn
    Petersen, Scott
    Frøen, J Frederik
    Goldenberg, Robert L
    Stillbirths: recall to action in high-income countries.2016Inngår i: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 387, nr 10019, s. 691-702Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Variation in stillbirth rates across high-income countries and large equity gaps within high-income countries persist. If all high-income countries achieved stillbirth rates equal to the best performing countries, 19,439 late gestation (28 weeks or more) stillbirths could have been avoided in 2015. The proportion of unexplained stillbirths is high and can be addressed through improvements in data collection, investigation, and classification, and with a better understanding of causal pathways. Substandard care contributes to 20-30% of all stillbirths and the contribution is even higher for late gestation intrapartum stillbirths. National perinatal mortality audit programmes need to be implemented in all high-income countries. The need to reduce stigma and fatalism related to stillbirth and to improve bereavement care are also clear, persisting priorities for action. In high-income countries, a woman living under adverse socioeconomic circumstances has twice the risk of having a stillborn child when compared to her more advantaged counterparts. Programmes at community and country level need to improve health in disadvantaged families to address these inequities.

  • 36. Fooladi, Ensieh
    et al.
    Weller, Carolina
    Salehi, Maryam
    Abhari, Farideh Rezaee
    Stern, Jenny
    Sophiahemmet Högskola.
    Using reproductive life plan-based information in a primary health care center increased Iranian women's knowledge of fertility, but not their future fertility plan: A randomized, controlled trial2018Inngår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 67, s. 77-86, artikkel-id S0266-6138(18)30286-9Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: Reproductive Life Plan (RLP)-based information in counseling has been reported in the USA and Sweden to increase women's knowledge of fertility and informed decision making about future fertility plans. This study examined if utilizing the RLP tool would have the same impact on Iranian women.

    DESIGN: A randomized, three-armed, controlled trial. 181 women were randomly allocated to the intervention group (IG, n = 61), control group 1 (CG1, n = 60) or control group 2 (CG2, n = 60).

    SETTING: A primary health care center in the Sari city, the Provincial capital of Mazandaran, Iran.

    PARTICIPANTS: Women of reproductive age who were able to conceive.

    INTERVENTIONS: The intervention group received oral and written information about fertility based on the RLP tool. Participants were contacted 2 months after the intervention. The primary outcome measure was the change in women's knowledge of fertility, particularly folic acid intake prior to pregnancy, over a 2 month period. The change in women's family planning intentions were also assessed. The participants in the IG shared their experiences at follow-up.

    FINDINGS: At baseline, there was no difference between the groups regarding the mean knowledge of fertility score. At 2 months, after adjustment for age, history of pregnancy and baseline values, the between group difference in change from baseline was 5.8 (p < 0.001). While there was no significant difference between the IG and CG1 for folic acid intake prior to pregnancy at baseline, the group difference for folic acid intake prior to pregnancy post intervention was statistically significant (85% vs 25%, p < 0.001). At follow-up, women's desire to have more children, preferred age to conceive the last child and the desired age gap between children in the IG and CG1 did not significantly change over time. Women reported the RLP counseling tool used by midwives as useful.

    KEY CONCLUSIONS: Provision of RLP-based information for Iranian women with a clear pregnancy intention in the context of a stable relationship, increased knowledge of fertility without changing their future fertility plan. The RPL counseling tool was appreciated by study participants. The lack of improvement in women's fertility intentions over time may reflect the involvement of other factors influencing decision making about childbearing in Iran. Whether the RLP can change women's behavior is yet to be established.

    IMPLICATIONS FOR PRACTICE: The RLP can be used by health care professionals, especially midwives, as a tool to increase women's fertility knowledge, which may result in fertility behavior change.

  • 37.
    Georgsson, Susanne
    Sophiahemmet Högskola.
    Fosterundersökningar: En självklarhet? En möjlighet? En rättighet?2017Konferansepaper (Annet vitenskapelig)
  • 38.
    Georgsson, Susanne
    Sophiahemmet Högskola.
    Information och psykologiska aspekter kring fosterdiagnostik2016Inngår i: Reproduktiv hälsa: barnmorskans kompetensområde / [ed] Helena Lindgren, Kyllike Christensson & Anna-Karin Dykes, Lund: Studentlitteratur AB, 2016, 1, s. 289-298Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 39.
    Georgsson, Susanne
    Sophiahemmet Högskola.
    Är det "mission impossible"?: information om fosterdiagnostik2016Konferansepaper (Annet vitenskapelig)
  • 40. Georgsson, Susanne
    et al.
    Carlsson, Tommy
    Sophiahemmet Högskola.
    Pain and pain management during induced abortions: a web-based exploratory study of recollections from previous patients2019Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS: To explore recollections of pain and pain management during induced abortions.

    DESIGN: Mixed-methods exploratory study in Sweden.

    METHODS: A web-based survey was distributed between October 2017 - July 2018 via Swedish discussion boards and social media. Open-ended questions were asked about recollection of pain and pain management, followed by self-report ratings. The survey was answered by 185 participants, responses analyzed with qualitative content analysis.

    FINDINGS: Recollections of pain intensity illustrated considerable pain and a traumatic event, described in temporal aspects and likened to other painful conditions such as dysmenorrhea and childbirth. Recollections of pain management illustrated experiences of insufficient treatment of pain and dissatisfaction with pain management, including inefficient treatment and lack of professional attendance. Psychological aspects and consequences illustrated that participants related psychological distress to physical pain, felt unprepared for the physical pain and emphasized the importance of psychological support. Those who experienced intense pain described long-term psychological consequences, including fear of childbirth.

    CONCLUSION: Physical pain and psychological distress can manifest as considerable challenges during induced abortion. Abortion-related pain is a multidimensional phenomenon involving physical and psychological components that needs to be rigorously treated. When physical pain is unsuccessfully treated, women may experience long-term psychological consequences after an abortion.

    IMPACT: The results illustrate the importance of holistic abortion care where the multidimensional components of abortion-related pain are considered. Patients need to be offered sufficient preparatory information about potential physical pain and psychological distress. This study indicates that there is room for improvement in pain management. Larger studies are needed. This article is protected by copyright. All rights reserved.

  • 41. Georgsson, Susanne
    et al.
    Krautmeyer, Stina
    Sundqvist, Emilia
    Carlsson, Tommy
    Sophiahemmet Högskola.
    Abortion-related worries, fears and preparedness: a Swedish Web-based exploratory and retrospective qualitative study2019Inngår i: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, s. 1-10Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: A survey was conducted to explore worries, fears and preparedness relating to the recollected experience of having an induced abortion. Methods: The Web-based survey was carried out in Sweden among 185 women. Respondents answered open-ended questions and gave retrospective self-reported ratings about their abortion-related worries, fears, preparedness and satisfaction with information obtained from health professionals and the Web. Data were analysed using qualitative content analysis and descriptive statistics. Results: Worries and fears included the abortion process, physical reactions and psychosocial aspects. The abortion was associated with unexpected events, including the abortion process, poor health professional treatment and support, and side effects and complications. Respondents described a lack of preparatory information, leading to uncertainties due to insufficient information. Many searched for Web-based information, but respondents experienced difficulties finding high-quality sources. Respondents also recounted that the preparatory information received did not reflect the actual abortion experience. Conclusion: There is room for improvement with regard to informing, preparing and supporting women who seek an abortion. The results emphasise the importance of health professionals' giving sufficient preparatory information to enable preparedness and lessen the impact of possible unexpected events. There is a need for the development of a trustworthy Web-based service that contains honest and high-quality information.

  • 42.
    Georgsson, Susanne
    et al.
    Sophiahemmet Högskola.
    Sahlin, Ellika
    Iwarsson, Moa
    Nordenskjöld, Magnus
    Gustavsson, Peter
    Iwarsson, Erik
    Knowledge and attitudes regarding non-invasive prenatal testing (NIPT) and preferences for risk information among high school students in Sweden2017Inngår i: Journal of Genetic Counseling, ISSN 1059-7700, E-ISSN 1573-3599, Vol. 26, nr 3, s. 447-454Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Non-invasive prenatal testing (NIPT) was recently introduced for prenatal testing of genetic disorders. Cell-free fetal DNA is present in maternal blood during pregnancy and enables detection of fetal chromosome aberrations in a maternal blood sample. The public perspective to this new, simple method has not been illuminated. The views of young people (i.e. future parents) are important to develop suitable counseling strategies regarding prenatal testing. The aim was to explore Swedish high school students' attitudes, knowledge and preferences regarding NIPT. A questionnaire was completed by 305 students recruited from one high school in Stockholm, November and December 2014. Most students (80 %) considered prenatal testing as good. The majority (65 %) was positive or very positive towards NIPT and 62 % stated that they potentially would like to undergo the test if they or their partner was pregnant. The vast majority (94 %) requested further information about NIPT. Most students (61 %) preferred verbal information, whereas 20 % preferred information via the Internet. The majority of the high school students was positive towards prenatal testing and most was positive towards NIPT. Further, information was requested by the vast majority before making a decision about NIPT. Most of the students preferred verbal information and to a lesser extent information via the Internet. The attitudes, knowledge and preferences for risk information concerning NIPT in young adults are important, in order to increase knowledge on how to educate and inform future parents.

  • 43.
    Georgsson, Susanne
    et al.
    Sophiahemmet Högskola.
    Stenström Bohlin, Katja
    Den gravida patienten2016Inngår i: Omvårdnad & kirurgi / [ed] Christine Kumlien & Jenny Rystedt, Lund: Studentlitteratur AB, 2016, 1, s. 507-520Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 44.
    Georgsson, Susanne
    et al.
    Sophiahemmet Högskola.
    Stenström Bohlin, Katja
    Gynekologi2016Inngår i: Omvårdnad & kirurgi / [ed] Christine Kumlien & Jenny Rystedt, Lund: Studentlitteratur AB, 2016, 1, s. 477-491Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 45. Georgsson, Susanne
    et al.
    van der Spoel, Linde
    Ferm, Johanna
    Carlsson, Tommy
    Sophiahemmet Högskola.
    Quality of web pages about second-trimester medical abortion: A cross-sectional study of readability, comprehensiveness, and transparency2019Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS: To investigate the readability, comprehensiveness and transparency of web pages about medical abortion in the second trimester of pregnancy.

    DESIGN: A cross-sectional descriptive study of Swedish web pages.

    METHODS: Six systematic searches were performed in Google during January 2017. The first 10 hits of each search were screened, resulting in 46 included Swedish web pages. The web pages were analyzed with readability index (LIX) to investigate readability, inductive manifest content analysis to investigate comprehensiveness, and Journal of the Medical Association benchmarks to investigate transparency.

    RESULTS: Median LIX was 29.0 and the largest proportion had LIX 31-40 (N = 17), indicating moderate readability. Visual components were observed in 13 websites. Content analysis resulted in 12 categories illustrating comprehensiveness, but eight of these were only included in ≤50% web pages. With regard to transparency, 29 (63%) adhered to no benchmark, 15 (33%) adhered to one benchmark, and 2 (4%) adhered to two benchmarks. Most web pages were written or reviewed by laypersons (N = 25) and health professionals (N = 11).

    CONCLUSION: The results indicate that web pages about medical abortion have moderate readability, varied comprehensiveness and poor transparency.

    IMPACT: Health professionals need to acknowledge the risk of contact with web-based information about poor quality. There is a need for research that aims to increase the chances that patients encounter high-quality web-based information about medical abortion in the second trimester of pregnancy.

  • 46.
    Georgsson Öhman, Susanne
    Sophiahemmet Högskola.
    Fosterdiagnostik2009 (oppl. 1)Bok (Annet vitenskapelig)
  • 47.
    Georgsson Öhman, Susanne
    Sophiahemmet Högskola.
    Övriga fosterdiagnostiska undersökningar samt psykologiska aspekter2009Inngår i: Lärobok för barnmorskor / [ed] Annette Kaplan et al., Lund: Studentlitteratur , 2009, 3, s. 214-15Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 48.
    Georgsson Öhman, Susanne
    et al.
    Sophiahemmet Högskola.
    Björklund, Ulla
    Marsk, Anna
    Does an informational film increase women's possibility to make an informed choice about second trimester ultrasound?2012Inngår i: Prenatal Diagnosis, ISSN 0197-3851, E-ISSN 1097-0223, Vol. 32, nr 9, s. 833-9Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To evaluate effects of an informational film on making an informed choice regarding second trimester ultrasound.

    METHOD: Randomized controlled study. The intervention was an informational film about prenatal examinations. Data were collected at gestational week 26.

    RESULTS: A total of 184 women in the intervention group and 206 women in the control group participated in the study. Of those in the intervention group, 81.3% made an informed choice regarding second trimester ultrasound examination compared with 76.1% in the control group (p = 0.21). Women making an informed choice scored higher in knowledge about the examination (p < 0.001), had higher degree of education (p < 0.001), and spoke more frequently Swedish as mother tongue (89.5% vs 74.7%, p = 0.01).

    CONCLUSIONS: An informational film does not increase women's knowledge or the number of women making an informed choice about the second trimester ultrasound. Women who did not make an informed choice about the second trimester ultrasound had a lower level of education and less knowledge about second trimester ultrasound screening.

  • 49.
    Georgsson Öhman, Susanne
    et al.
    Sophiahemmet Högskola.
    Grunewald, Charlotta
    Waldenström, Ulla
    Perception of risk in relation to ultrasound screening for Down's syndrome during pregnancy2009Inngår i: Midwifery, ISSN 1532-3099, Vol. 25, nr 3, s. 264-76Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: to explore how information about being at risk of carrying a fetus with Down's syndrome was understood, and whether the actual risk and the woman's perception of risk was associated with worry or depressive symptoms during and after pregnancy. DESIGN AND SETTING: observational study. The sample was drawn from the intervention group of a Swedish randomised controlled trial of ultrasound screening for Down's syndrome by nuchal translucency measurement. MEASUREMENTS: data were collected by three questionnaires. Questions were asked about recall of the risk score and perception of risk. The Cambridge Worry Scale and the Edinburgh Postnatal Depression Scale measured worry and depressive symptoms, respectively, on all three occasions. FINDINGS: of the 796 women who provided data for this study, one in five was unaware that the risk score was noted in her case record. In total, 620 women stated that they had received a risk score, but only 64% of them recalled the figure exactly or approximately. The actual risk was associated with the perceived risk, but of the 31 women who perceived the risk to be high, only 14 were actually at high risk. A high-risk score was not associated with worry or depressive symptoms in mid-pregnancy, in contrast to a woman's own perception of being at high risk. Two months postpartum, no associations were found between maternal emotional well-being and actual or perceived risk. CONCLUSIONS: information about fetal risk is complicated and women's perception of risk does not always reflect the actual risk, at least not when presented as a numerical risk score. The possibility that the information may cause unnecessary emotional problems cannot be excluded. IMPLICATIONS FOR PRACTICE: caregivers should ascertain that information about fetal risk is interpreted correctly by pregnant women.

  • 50.
    Georgsson Öhman, Susanne
    et al.
    Sophiahemmet Högskola.
    Grunewald, Charlotta
    Waldenström, Ulla
    Women's worries during pregnancy: testing the Cambridge Worry Scale on 200 Swedish women2003Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 17, nr 2, s. 148-52Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The Cambridge Worry Scale (CWS) is an instrument including 16 items measuring women's major worries during pregnancy. The aim of the study was to test the scale, translated into Swedish, on pregnant women in Stockholm. We also wanted to explore whether these women were worried about any item not included in the scale. An additional aim was to study possible variation in women's worries related to gestational week. Two hundred women were recruited. The average age was 31 years and 56% were primiparas. Gestational age ranged from 8 to 42 weeks, with a median of 28 weeks. The reliability of the scale was satisfactory (Cronbach's alpha coefficient 0.81). The major worries were about the baby's health, giving birth and miscarriage. These items, all related to pregnancy outcomes, were followed by worries about financial matters. An additional concern not included in the scale was about the maternity services in Stockholm, i.e. that the hospital would be overbooked, the staff being too busy or the medical safety not being guaranteed. Few women worried about their relationship with their partner or if he would be present at birth. Some of the items showed a pattern with a period of less worry in midpregnancy.

123 1 - 50 of 141
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