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  • 1.
    Ahmed, Mobyen Uddin
    et al.
    Mälardalen University, School of Innovation, Design and Engineering, Embedded Systems.
    Begum, Shahina
    Mälardalen University, School of Innovation, Design and Engineering, Embedded Systems.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Petrovic, Nikola
    Mälardalen University, School of Innovation, Design and Engineering, Embedded Systems.
    Sandborgh, Maria
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Third Eye: An Intelligent Assisting Aid for Visual Impairment Elderly2016In: Medicinteknikdagarna 2016 MTF, 2016Conference paper (Refereed)
    Abstract [en]

    Background Visually impaired older persons need support in daily activities, e.g. moving around inside the house; making and eating food and taking medicine independently. A system that simulates the environment based on both dynamic and static objects, identify obstacles, navigates and translates sensory information in voice would be valuable to support their daily activities. Today several sensors and camera-based systems are popular as ambient-assisted living tools for older adults. However, intelligent assisting aid (IAA) to support older individuals with a recently acquired visual impairment is limited. The proposed system ‘Third Eye’ focuses on the advanced research and development of an IAA to support older individuals with a recently acquired visual impairment. The main goal in this system is to provide a usable, feasible and cost-effective solution for older persons to support their daily activities using intelligent sensor based system. Method The system consists of the following five phases to meet several central challenges in developing IAA in such domain. • User-perspective, focuses on user-driven technical development, investigating needs of potential users. The study will have a participatory design with focus group interviews of lead users. • Sensor-based system, focuses on the identification obstacles based on ultrasounds and/or radio frequencies embedded in white-cane or weaker. • Camera-based system, focuses on image based information translation into voice embedded in white-cane or weaker or glasses. • System of systems, focuses on integration of above systems where knowledge is engineered and suitable representations are learned and reasoning for decisions are made [9]. • Experimental, focuses on usability and feasibility of the IAA, with idiographic and group studies Results The initial results have shown the necessity of the proposed AAI systems for older individuals with a recently acquired visual impairment. However, more extension work e.g., process and analyze the information and synthesize it with existing literature for developing the system is ongoing.

  • 2.
    Begum, Shahina
    et al.
    Mälardalen University, School of Innovation, Design and Engineering, Embedded Systems.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Barua, Shaibal
    Mälardalen University, School of Innovation, Design and Engineering, Embedded Systems.
    Westerlund, Hanna
    Camanio Care AB, Sweden.
    Hjortsberg, Cecilia
    Västerås stad, Sweden.
    Food4You: A Personalized System for Adaptive Mealtime Situations for Elderly2017In: Medicinteknikdagarna 2017 MTD 2017, 2017Conference paper (Refereed)
  • 3.
    Dahlen, Micael
    et al.
    Stockholm School of Economics, Sweden.
    Thorbjørnsen, Helge
    Norwegian School of Economics, Bergen, Norway.
    Sjåstad, Hallgeir
    Norwegian School of Economics, Bergen, Norway.
    von Heideken Wågert, Petra
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Hellström, Charlotta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Lindberg, Daniel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Stier, Jonas
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Elvén, Maria
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Changes in Physical Activity Are Associated with Corresponding Changes in Psychological Well-Being: A Pandemic Case Study2021In: International Journal of Environmental Research and Public Health, E-ISSN 1660-4601, Vol. 20, p. 1-9, article id 10680Article in journal (Refereed)
    Abstract [en]

    Societal crises and personal challenges are often followed by substantial changes in physicalactivity. Is there a link between such changes and psychological well-being? Seeking to answerthis question, we conducted a correlational study on a representative sample in Sweden during thefirst year of the COVID-19 pandemic (N = 1035). About 49% of the sample had decreased theirphysical activity compared to their self-reported activity level prior to the pandemic, whereas 32%had increased it. The results showed a positive and robust association between changes in dailyactivity level and corresponding changes in psychological well-being. Specifically, individuals whohad reduced their physical activity over the last year reported lower life satisfaction than before, andindividuals who had increased their physical activity reported higher life satisfaction than before.The amount of complete physical inactivity (sitting) showed a similar pattern as the exercise data,meaning that individuals who reported increasing inactivity per day also reported a greater declinein life satisfaction. Additional analyses showed that the association between daily activity level andlife satisfaction was somewhat stronger for men than for women, but there was no difference whencomparing individual versus organized activities. The current study was based on a cross-sectionaldesign, measuring self-reported change over time. Recent work from other research teams have usedlongitudinal data and experience-sampling in different settings, finding similar results. We concludethat there is good reason to recommend physical exercise as a coping strategy in difficult times.

  • 4.
    Dahlen, Micael
    et al.
    Stockholm School of Economics, Sweden.
    Thorbjørnsen, Helge
    Norwegian School of Economics, Norway.
    von Heideken Wågert, Petra
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Hellström, Charlotta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Lindberg, Daniel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Stier, Jonas
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Elvén, Maria
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    The comeback effect: How happy are people who have recovered from a COVID-19 infection?2022In: International Journal of Wellbeing, E-ISSN 1179-8602, Vol. 12, no 2, p. 114-133Article in journal (Refereed)
    Abstract [en]

    There is already a large body of research on the dramatic negative effects of COVID-19 on peoples’ mental and physical health. Millions of people have died, and the pandemic has negatively influenced the lives of billions of people. Luckily however, the vast majority of people infected with the virus, recovers. The happiness and wellbeing of these people have not been extensively studied. In the current paper, we ask the question: Are people who have recovered from a COVID-19 infection happier than those who have not been infected at all? Building on previous research on hedonic adaptation and counterfactual thinking, we hypothesize, and find, that those who have had an infection appear slightly happier than others.  The study relies on two surveys conducted in Sweden during the pandemic in 2020 (n=1029) and 2021 (n=1788).

  • 5.
    Danielsson, Lena
    et al.
    Vastmanlands Sjukhus, Reg Vastmanland, Vasteras, Sweden..
    Lundstrom, Marie-Louise
    Vastmanlands Sjukhus, Reg Vastmanland, Vasteras, Sweden..
    Holmström, Inger K.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Anaesthetizing children-From a nurse anaesthetist's perspective-A qualitative study2018In: Nursing Open, E-ISSN 2054-1058, Vol. 5, no 3, p. 393-399Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to describe nurse anaesthetists' experiences of encountering and caring for children in connection to anaesthesia. Design: Qualitative design. Methods: Sixteen written narratives based on eight nurse anaesthetists' experiences of meeting children was analysed using qualitative content analysis. Results: The overarching theme was: "anaesthetizing children is a complex caring situation, including interactions with the child and parents as well as ensuring patient safety, affected by the perioperative team and organizational prerequisites". The nurses stated that in their interaction with the family, their goal was to ensure that children and parents felt secure and calm. "Striving to work in confidence" underlined the team and organizational influences. Encountering children involves more than knowledge about technical equipment, procedures and drugs. Knowledge about children's development and fears and parents' needs are essential for an optimal caring situation. Organizations need to realize that extra time, skills and resources are needed to safely anaesthetize children.

  • 6.
    Danielsson, Lena
    et al.
    Region Västmanland, Sweden.
    Lundström, Louisa
    Region Västmanland, Sweden.
    Holmström, Inger K.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Uppsala universitet.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Anaesthetizing children from a nurse anaethetist's perspective2019In: Barnveckan, Örebro, 2019Conference paper (Refereed)
  • 7.
    Elvén, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Stier, Jonas
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Hellström, Charlotta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    von Heideken Wågert, Petra
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Dahlen, M.
    Department of Marketing and Strategy, Stockholm School of Economics, Sweden.
    Lindberg, Daniel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Changes in Physical Activity and Sedentary Behavior before and during the COVID-19 Pandemic: A Swedish Population Study2022In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 5, article id 2558Article in journal (Refereed)
    Abstract [en]

    Governments have enforced measures to limit the spread of COVID-19 with varying degrees of success, which could affect people’s physical activity (PA) and sedentary behavior. This study aimed to examine changes in PA levels, types of PA, and sedentary behavior in the Swedish population before and during the COVID-19 pandemic. Associations between changed PA levels and demographical and behavioral determinants were also investigated. In December 2020, 1035 individuals (18–79 years old) completed a survey about their PA and sedentary behavior before and during the pandemic. Factors influencing their PA were also explored. Fifty-one percent of the sample reported reduced total PA, 18% had no change, and 31% increased their PA. Overall, organized PA decreased the most and sedentary behavior increased. The youngest and oldest age groups reported the greatest reduction in PA, while middle-aged groups reported the most increased PA. Men reported a larger increase in sedentary behavior than women. Mental and physical capability was associated with change in PA. In conclusion, this study indicates that, during the COVID-19 pandemic, the majority of the Swedish population have decreased PA levels with a concurrent increase in sedentary behavior, which may have negative health consequences. Interventions are recommended to address both PA and sedentary behavior, specifically to strengthen people’s ability to perform PA and focusing on the youngest and oldest age groups. 

  • 8.
    Elvén, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Stier, Jonas
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Hellström, Charlotta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    von Heideken Wågert, Petra
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Dahlen, Mikael
    Stockholm School of Economics. Department of Marketing and Strategy. Stockholm, Sweden..
    Lindberg, Daniel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    The impact of the COVID-19 pandemic on Swedes’ physical activity and sedentary behaviour2022Conference paper (Refereed)
    Abstract [en]

    Background: Despite the proven health benefits of physical activity (PA), more than a quarter of the world’s adult population is insufficiently physically active, which increases the risk of diseases and premature death. During the COVID-19 pandemic governments have implemented enforced measures to limit the spread of the virus, which could affect people’s PA.  Aim: This study aimed to examine changes in PA levels, types of PA, and sedentary behavior in the Swedish population before and during the COVID-19 pandemic. Associations between demographical and behavioral determinants, and changes in PA were also investigated. Method: In December 2020, 1.035 individuals (18-79 y) completed a survey about PA and sedentary behavior, at present and before the pandemic. Factors influencing their PA were also explored.  Results: Fifty-one percent of the sample reduced total PA, 18% had no change and 31% increased PA. Overall, organized PA, for example at fitness centers and sport training, decreased the most, and sedentary behavior increased. The youngest and the oldest age groups reported the greatest reduction of PA, while the middle age groups reported the most increased PA. Mental and physical capability was associated with PA change. Conclusion: During the pandemic, most of the Swedish population have decreased PA levels with a concurrent increase in sedentary behavior. This may have both a short-and long-term negative health impact on individuals’ and populations’ health.  Implications for caring in a changing world: As physical inactivity already is a global public health problem during non-pandemic circumstances this study’s findings call for further actions during and after the pandemic to support people in maintaining or increasing daily PA and decreasing sedentary behavior. Interventions in health care are recommended to strengthen peoples’ ability to perform PA, focus on the youngest and oldest age groups, and be applied on an individual basis as well as in organizational contexts.

  • 9.
    Gripewall, Emelie
    et al.
    Åbo Akademi University, Department of Caring Science, Vaasa, Finland .
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Bjorling, Gunilla
    Karolinska Institute, Department of Neurobiology, Care Sciences and Society. Stockholm, Sweden.
    Fagerström, Lisbeth
    Åbo Akademi University, Department of Caring Science, Vaasa, Finland .
    Mattson, Janet
    Karolinska University Hospital, Stockholm, Sweden.
    Widarsson, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Nyholm, Linda
    Åbo Akademi University, Department of Caring Science, Vaasa, Finland.
    Intensive Care Nurses’ Experiences of Caring during the Organ Donor Process in Sweden – a Qualitative Study2022In: International Journal of Caring Sciences, ISSN 1791-5201, E-ISSN 1792-037X, Vol. 15, no 2, p. 720-726Article in journal (Refereed)
    Abstract [en]

    Background: The organ donor process is challenging, not at least for intensive care nurses. The situation changesradically, from intensively working to save the patient’s life to instead caring for the donor patient’s organs so thatthose, in turn, can save another patient’s life. The donation process challenges nurses’ view on what dignifiedcaring at end-of-life entails. The inner core of caring comprises love, mercy and compassion. Dignified caring isrelated to treating the patient as a unique human being and respecting human value, rooted in the theory of caritativecaring that is the framework for this study.Aim: The aim was to illuminate intensive care nurses’ experiences of caring during the organ donor process, froma caring science perspective.Methodology: A descriptive research design including inductive qualitative content analysis of interviews withtwelve intensive care nurses in Sweden about their experiences of caring during the donor process.Results: The theme The complexity of caring during the organ donor process with two categories and fivesubcategories was generated. Intensive care nurses experienced caring during the donor process as being complexin relation to the potential donor patient and patient’s family as well as communication, teamwork andorganization. Caring affects not only the patient and families, but also the nurses and receivers of the donatedorgans. Intensive care nurses perceive the other’s life situation as if it were their own and recognize the importanceof shared humanity.Conclusion: The present study can increase knowledge from intensive care nurses and the caring team, in orderto provide better conditions such as the development of effective intervention strategies in the process of organdonor care as well as caring for the families and members of the team.

  • 10.
    Hjalmarsson, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Holmberg, Mats
    Linneuniversitetet, Sweden.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Nilsson, Kent W.
    Region Västmanland, Sweden.
    Östlund, Gunnel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Characteristic Patterns of Emergency Ambulance Assignments for Older Adults Compared with Adults Requiring Emergency Care at Home in Sweden: A Total Population Study2020In: BMC Emergency Medicine, ISSN 1471-227X, E-ISSN 1471-227X, Vol. 20, article id 94Article in journal (Refereed)
    Abstract [en]

    Background: Since the vast majority of older adults in Sweden live in their private homes throughout life, the emergency medical services need to adapt accordingly. Hence, we aimed to describe characteristic patterns of dyadic staffed emergency ambulance assignments for older adults aged > 70 years compared with adults aged 18–69 years requiring emergency care at home in Sweden. Methods: A descriptive retrospective study was performed using anonymized registry data from the emergency medical services in a region of Sweden during 2017–2018. One-sample χ2 test, one-way analysis of variance, and binary logistic regression models were used for investigating group differences. Variables for analysis were age, gender, clinical assessments, on-scene time, priority levels, result of response, and temporal patterns. Results: Of all included emergency ambulance assignments (n = 28,533), 59.9% involved older adults, of which 53.8% were women. The probability for older adults to receive the highest priority was decreased for both dispatch (p < 0.001, odds ratio [OR] 0.63, 95% confidence interval [CI] 0.59–0.66), and transport priorities (p < 0.001, OR 0.74, 95% CI 0.68–0.80). Older adults were more likely to receive dispatch priority levels 2 (p < 0.001, OR 1.48, 95% CI 1.40–1.56), and 3 (p < 0.001, OR 1.73, 95% CI 1.46–2.06). The older adults were similarly more likely to receive transport priority level 3 (p < 0.001, OR 1.40, 95% CI 1.28–1.52) compared with adults. Age had a small but additive effect in relation to on-scene time (p < 0.001, R2 = 0.01, F = 53.82). Distinguishing initial clinical assessments for older adults were circulatory, respiratory, trauma, infection, and nonspecific assessments. Emergency ambulance assignments for older adults were more frequently occurring on Mondays (p < 0.001, χ2 = 232.56), and in the 08:00–11:59 interval (p < 0.001, χ2 = 1224.08). Conclusion: The issues of the lower priority level preponderance, and the decreased probability for receiving the highest priority warrant further attention in future research and clinical practice. 

  • 11.
    Hjalmarsson, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Östlund, Gunnel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Holmberg, Mats
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Linneaus Univ, Fac Hlth & Life Sci, Växjö, Sweden.;Uppsala Univ, Ctr Clin Res Sormland, Eskilstuna, Sweden.;Region Sormland, Dept Ambulance Serv, Eskilstuna, Sweden..
    A matter of participation?: A critical incident study of municipal care personnel in situations involving care-dependent older persons and emergency medical services2022In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 17, no 1, article id 2082062Article in journal (Refereed)
    Abstract [en]

    Purpose This study aimed at describing municipal care personnel's experiences of and actions in situations when older persons need emergency medical services (EMS) at home. Methods An inductive descriptive design adhering to critical incident technique (CIT) was used. Data were collected through interviews and free text written questionnaires, analysed in accordance with CIT procedure. Results Experiences related to the main areas of Lifesaving competence and Collaborative care. Lifesaving competence involved having sufficient knowledge to guide older persons in emergencies without organizational support. The lack of care alternatives carries dependence on inter-organizational collaboration, as well as having to accept the collaborative conditions provided by the EMS. Actions meant Adjusting to situational needs and EMS authority, which involved safeguarding the person while being directed by the EMS. Conclusions Lack of organizational support, care alternatives, and structured collaboration jeopardize care-dependent older persons' health, and ability to influence care when emergency situations occur at home. Municipal care personnel's actions as the older person's representative support human agency, allowing older persons to become active participants in care despite acute suffering. This study underlines the importance of further developing welfare policies that facilitate and regulate inter-organizational responsibilities of health and social care to favour older people.

  • 12.
    Hjalmarsson, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Östlund, Gunnel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Holmberg, Mats
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden; Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden; Department of Ambulance Services, Region Sörmland, Katrineholm, Sweden.
    Balancing power: Ambulance personnel's lived experience of older persons' participation in care in the presence of municipal care personnel2023In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article in journal (Refereed)
    Abstract [en]

    Background: Patient participation is considered to promote well-being and is, therefore, central in care contexts. Care-dependent older persons living at home constitute a vulnerable population with increased ambulance care needs. Care transfers risk challenging participation in care, a challenge that can be accentuated in situations involving acute illness.Aim: To illuminate meanings of older persons' participation in ambulance care in the presence of municipal care personnel from the perspective of ambulance personnel.Method: A phenomenological hermeneutical method was used to analyse transcripts of narrative interviews with 11 ambulance personnel.Results: The ambulance personnel's lived experience of older persons' participation includes passive and active dimensions and involves a balancing act between an exercise of power that impedes participation and equalisation of power that empowers participation. The main theme 'Balancing dignity in relation to manipulating the body' included the themes Providing a safe haven and Complying with bodily expressions, which means shouldering responsibility for existential well-being and being guided by reactions. The main theme 'Balancing influence in relation to perceived health risks' included the themes Agreeing on a common perspective, Directing decision-making mandate, and Sharing responsibility for well-being, which means shouldering responsibility for health focusing on risks. Influence is conditional and includes performance requirements for both the older person and municipal care personnel.Conclusion: Care-dependent older persons' participation in care from the perspective of ambulance personnel means recognising passive and active dimensions involving human dignity, the ability to influence care, and optimising care efforts through collaboration. This study provides a deepened understanding of the balancing of power involved in ambulance care determining participation, where power is equalised or exercised depending on personal engagement, health risks, and available care options. The knowledge provided holds the potential to improve ambulance care to benefit older persons in critical life situations.

  • 13.
    Hjalmarsson, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Östlund, Gunnel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Holmberg, Mats
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Faculty of Health and Life Sciences Linnaeus University, Växjö, Sweden; Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden; Department of Ambulance Services, Region Sörmland, Katrineholm, Sweden.
    Entrusting life to professionals: A phenomenological hermeneutical study of older persons' participation in prehospital emergency care involving municipal home care and ambulance services2023In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article in journal (Refereed)
    Abstract [en]

    Background: Participation in care is considered to promote safe and qualitative care. Care-dependent older persons ageing in place have increased emergency care needs, which initiate inter-organisational collaboration involving municipal home care and ambulance services. Previous research concludes that uncertainties exist regarding what participation in care means in clinical practice, which necessitates the need to illuminate the phenomenon for older persons in critical life situations.

    Aim: This study aimed to illuminate meanings of participation in prehospital emergency care from the perspective of care-dependent older persons experiencing acute illness at home.

    Design: This study has a qualitative design with a lifeworld approach.

    Method: A phenomenological hermeneutical method was used to analyse transcribed telephone interviews with eleven care-dependent persons aged 70–93 years.

    Results: Care-dependent older persons' participation in prehospital emergency care means ‘Entrusting life to professional caregivers’ when being in helpless solitude and existentially unsafe, which emphasises a deepened interpersonal dependence. Meanings of participation in care from the perspective of older persons involve Being reassured in togetherness, Being pliant in trust of emergency expertise, Being enabled through the agency of professional caregivers, and Encountering readiness in the emergency care chain.

    Conclusion: Care-dependent older persons' participation in prehospital emergency care is existential and involves interpersonal dependence. Togetherness brings reassurance, safety and opportunity for emotional rest while accessing the professional caregivers' power, competence and abilities which provide opportunities for existence and movement towards well-being and continued living.

    Implications for practice: Prehospital emergency care from the perspective of care-dependent older persons transcends organisational boundaries and includes the municipal mobile safety alarm service. The involved municipal and regional organisations need to provide support by implementing lifeworld-led care models and care alternatives that enable professionals to recognise the existential dimension of participation in care.

  • 14.
    Hjalmarsson, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Östlund, Gunnel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Holmberg, Mats
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Entrusting life to professionals: Older persons’ lived experience of participation in prehospital emergency care involving municipal home care and ambulance services.Manuscript (preprint) (Other academic)
  • 15.
    Karlsson, Jenny
    et al.
    Karolinska Institute, Stockholm Health Care Services, Stockholm, Sweden.
    Marmstål Hammar, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Dalarna University, Sweden; Karolinska Institute, Huddinge, Sweden.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Capturing the Unsaid: Nurses’ Experiences of Identifying Mental Ill-Health in Older Men in Primary Care—A Qualitative Study of Narratives2021In: Nursing Reports, ISSN 2039-439X, E-ISSN 2039-4403, Vol. 11, no 1, p. 152-163Article in journal (Refereed)
    Abstract [en]

    This study describes nurses’ experiences in identifying mental ill-health in older men in primary care. The aging population is growing in Sweden and life expectancy is increasing. Age is a risk factor for mental ill-health. Older men are over-represented in deaths from suicide. When older men seek primary care, it is often because of somatic symptoms and rarely for mental health issues. A questionnaire with five open questions was answered by 39 nurses from 10 primary care centres and subjected to inductive qualitative content analysis. The results revealed a main theme—capturing the unsaid—and two categories: (1) feeling secure in the role, with three subcategories (building trust, daring to ask and interpreting signs); and (2) the need for resources, with two subcategories (time and continuity, and finding support in collaboration). The results confirm that nurses in primary care play a key role in identifying mental ill-health in older men. There is a need for resources in the form of time, competence and collaboration with other professionals and patients’ relatives. This strategy will establish best practice and provide evidence-based care to facilitate improvements in older men’s mental health and prevent suicide.

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  • 16.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Anaesthetizing children from a nurse anaesthetist’s perspective - A qualitative study2019Conference paper (Other academic)
  • 17.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Association between adolescences depressive symptoms and attachment to the parents.2019Conference paper (Other academic)
  • 18.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Association between parental depressive symptoms and impaired bonding with the infant2016Conference paper (Refereed)
  • 19.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Attachment security to mother and father figures and association with bully/victim behaviour in a large adolescent sample2017Conference paper (Refereed)
  • 20.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Barn och hot och våld2021Conference paper (Other academic)
  • 21.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Father Group leaders' experiences of creating an arena for father support - A qualitative study2017Conference paper (Refereed)
  • 22.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Father Group leaders' experiences of creating an arena for father support - A qualitative study2019Conference paper (Refereed)
  • 23.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Långvarig smärta hos barn2022In: Långvarig smärta ur ett vårdande perspektiv / [ed] Helena Lööf, Studentlitteratur AB, 2022, p. 101-122Chapter in book (Other academic)
  • 24.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Vikten av pappagrupper2021Conference paper (Other academic)
  • 25.
    Kerstis, Birgitta
    et al.
    Uppsala University, Uppsala, Sweden.
    Aarts, C.
    Uppsala University, Uppsala, Sweden.
    Tillman, C.
    Uppsala University, Uppsala, Sweden.
    Persson, H.
    Uppsala University, Uppsala, Sweden.
    Engström, G.
    Florida Atlantic University, Boca Raton, FL, United States.
    Edlund, B.
    Uppsala University, Uppsala, Sweden.
    Öhrvik, J.
    Karolinska Institute, Stockholm, Sweden.
    Sylvén, D.
    Uppsala University, Uppsala, Sweden.
    Skalkidou, A.
    Uppsala University, Uppsala, Sweden.
    Association between parental depressive symptoms and impaired bonding with the infant.2016In: Archives of Women's Mental Health, ISSN 1434-1816, E-ISSN 1435-1102, Vol. 19, no 1, p. 87-94Article in journal (Refereed)
  • 26.
    Kerstis, Birgitta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Aslund, Cecilia
    Uppsala Univ, Vastmanland Cty Hosp, Ctr Clin Res Vasteras, Vasteras, Sweden..
    Sonnby, Karin
    Uppsala Univ, Vastmanland Cty Hosp, Ctr Clin Res Vasteras, Vasteras, Sweden..
    More secure attachment to the father and the mother is associated with fewer depressive symptoms in adolescents2018In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 123, no 1, p. 62-67Article in journal (Refereed)
    Abstract [en]

    Aim: To investigate whether more secure attachment to the father and the mother is associated with less depressive symptoms among adolescents, and to explore possible sex differences. Method: A population-based sample of adolescents completed a school-based survey assessing demographic data, attachment to father and mother, as well as depressive symptoms. Participation rate was 80% of the eligible population, and 3,988 adolescents (1,937 boys and 2,051 girls) had complete data for the analyses. Results: Paired samples t tests showed that participants rated their attachment to mothers as slightly more secure than their attachment to fathers (t = 15.94, P < 0.001; boys: t = 5.23, P < 0.001; girls: t = 16.16, P < 0.001). In linear regression analyses there was an association between the outcome, number of depressive symptoms, and more secure attachment to the mother for boys (B=-0.532; 95% confidence interval [CI] -0.656, -0.407, P < 0.001) and for girls (B = -0.623; 95% CI -0.730, -0.516, P < 0.001). Analogous results were found for more secure attachment to the father for boys (B = -0.499; 95% CI -0.608, -0.391, P < 0.001) and for girls (B = -0.494; 95% CI -0.586, -0.401, P < 0.001). Conclusions: Understanding the relationship between attachment to both father and mother and depressive symptoms in adolescent boys and girls is essential for further development of strategies for prevention and treatment of depression.

  • 27.
    Kerstis, Birgitta
    et al.
    Uppsala University, Uppsala, Sweden.
    Berglund, A.
    Uppsala University, Uppsala, Sweden.
    Engström, C.
    Florida Atlantic University, Boca Raton, United States.
    Edlund, B.
    Uppsala University, Uppsala, Sweden.
    Aarts, C.
    Uppsala University, Uppsala, Sweden.
    Sylvén, S.
    Uppsala University, Uppsala, Sweden.
    Depressive symptoms postpartum among parents are associated with marital separation: a Swedish cohort study2014In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, no 7, p. 660-668Article in journal (Refereed)
  • 28.
    Kerstis, Birgitta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Giannotta, Fabrizia
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Stockholm Univ, Dept Publ Hlth Sci, S-10691 Stockholm, Sweden..
    von Heideken Wågert, Petra
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Hellström, Charlotta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Lindberg, Daniel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Stier, Jonas
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Elvén, Maria
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Changes in Mental Health and Views on Communication and Activities of Public Institutions among Swedes during the COVID-19 Pandemic-A Cross-Sectional Repeated Measures Design2021In: Healthcare, E-ISSN 2227-9032, Vol. 9, no 11, article id 1498Article in journal (Refereed)
    Abstract [en]

    Although many studies have been conducted on the effects of COVID-19 on individual lives, only a few focus on the changes in mental health and views of public institutions during the pandemic. This study aimed to investigate how mental health, i.e., life satisfaction, worries, and psychological distress, and views on public institutions' communication and activities have changed among Swedes during the COVID-19 pandemic, and whether this was moderated by age and sex. In April-May 2020 (survey 1) and in January-February 2021 (survey 2), 2554 adults and 1904 newly recruited adults, respectively, anonymously completed online surveys. We found that life satisfaction and psychological distress did not change from survey 1 to survey 2. However, the level of worries increased, and the positive views of the public institutions decreased. Moreover, worries and psychological distress increased more in young adults than older adults. Finally, the change in the views of the public institutions was not related to the change in worries. Our results highlight the COVID-19 long-term impacts on individual mental health and call for the need for future research concerning the consequences for the population, especially among young adults. The results also indicate that the views on activities of public authorities decreased over time, especially among men. Given that loss of this trust can have vastly negative effects, for instance, on the vaccine campaign, it is important to monitor this trend, to increase awareness among Swedish authorities. The results also stress for institutions to provide adequate support both during the COVID-19 pandemic and in a future crisis.

  • 29.
    Kerstis, Birgitta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. School of Health, Care and Social Welfare, Mälardalen University, 722 20 Västerås, Sweden.
    Herlofson, Jorgen
    Empatica AB, 752 20 Uppsala, Sweden.
    Wiklund, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Department of Health and Care Sciences, UiT The Arctic University of Norway, Campus Narvik, 8514 Narvik, Norway.
    Study Circles as a Possible Arena to Support Self-Care—A Swedish Pilot Study2024In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 21, no 4, article id 483Article in journal (Refereed)
    Abstract [en]

    Today, issues related to people’s mental health and well-being have been described as a challenge for society, globally as well as in Sweden. This calls for new approaches to mental health promotion. The aim was to evaluate the adequacy of its content and structure, describing experiences of study circles as a means of supporting participants’ self-care and self-compassion. The overall design is a descriptive QUAL + quan design, where the quantitative and qualitative results are integrated. Five participants participated in a focus group interview, of whom four completed questionnaires. One individual interview was conducted with the study circle leader. Study circles can be an arena for mental health promotion, as learning and sharing of experience contributes to a sense of coherence, as well as self-compassion and a genuine concern for one’s own and others’ well-being, but are not considered an alternative to psychiatric care for those in need of professional services. Study circles can be a possible means to support self-care and thereby promote mental health in the general population and are a valuable contribution to public health. However, in addition to modifications of the content, further research is needed on the qualifications for study circle leaders, as well as the dissemination of study circles.

  • 30.
    Kerstis, Birgitta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Karlsson, J.
    Psykisk ohälsa hos äldre män2021Conference paper (Other academic)
  • 31.
    Kerstis, Birgitta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Lindberg, Daniel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Förändringar av oro, psykisk hälsa och förtroende för samhällsfunktioner under Covid-192022In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 99, no 2, p. 191-200Article in journal (Other academic)
    Abstract [sv]

    Syftet var att beskriva människors oro, psykisk hälsa och förtroende för sam-hällsfunktioner under covid-19 i relation till kön och ålder, utifrån två datain-samlingar; april–maj, 2020 och februari-mars, 2021. Kvinnorna skattade mer rädsla än männen, gällande att själv eller någon nära anhörig skulle bli allvar-ligt sjuk eller få ekonomiska konsekvenser till följd av covid-19. Unga vuxna skattade mer psykiska besvär vid båda mättillfällena jämfört med de andra åldersgrupperna. Förtroende för samhällsfunktioner minskade vid andra un-dersökningen oavsett kön. Kvinnorna hade dock högre förtroende än männen. Förtroendet minskade för samtliga åldersgrupper, men var högst hos de äldre. Kunskaper om hur gruppers oro, psykiska hälsa och förtroende påverkas är viktiga för att identifiera riskgrupper, samt att utveckla anpassade stödinsatser till de med störst behov vid eventuella kommande kriser.

  • 32.
    Kerstis, Birgitta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Nohlert, E.
    Uppsala University, Västmanland County Hospital, Västerås.
    Öhrvik, J.
    Uppsala University, Västmanland County Hospital, Västerås.
    Widarsson, Margareta
    Uppsala University, Västmanland County Hospital, Västerås.
    Association between depressive symptoms and parental stress among mothers and fathers in early parenthood: A Swedish cohort study2016In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 121, no 1, p. 60-64Article in journal (Refereed)
    Abstract [en]

    Aim: To determine whether there is an association between depressive symptoms and parental stress among mothers and fathers during early parenthood in Sweden. Methods: In this study, 401 mothers and 396 fathers (393 couples) were included; the Edinburgh Postnatal Depression Scale and the Sense of Coherence Scale were measured 3 months after childbirth, and the Swedish Parenthood Stress Questionnaire and the Sense of Coherence Scale after 18 months. Complete data for multivariable analysis were available for 264 mothers and 252 fathers. Results: The mothers estimated greater total depressive symptoms and parental stress than the fathers did. Both the mothers and the fathers had the greatest level of stress in the sub-area Role restriction. The mothers had the lowest level of stress in the sub-area Social isolation and the fathers in the sub-area Incompetence. The mothers perceived greater levels of stress than the fathers did in all sub-areas except for Social isolation, where the fathers perceived higher stress. There was an association between the parents depressive symptoms and parental stress. The parents own depressive symptoms at 3 months and sense of coherence and the partners parental stress at 18 months were positively associated with the parental stress at 18 months in univariable and multivariable analyses. Conclusions: Understanding the relationship between depressive symptoms and parental stress is important for health professionals so they can offer parents adequate support in early parenthood to optimize the conditions for raising a child. This knowledge should also be communicated to the parents. 

  • 33.
    Kerstis, Birgitta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Richardsson, Anna
    Örebro University Hospital, S-701 85 Örebro, Sweden.
    Stenström, Alexandra
    Örebro University Hospital, S-701 85 Örebro, Sweden.
    Widarsson, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    An Overview of Guidelines for Supplemental Feeding of Infants in Swedish Maternity Clinics2021In: Nursing Reports, ISSN 2039-439X, E-ISSN 2039-4403, no 1, p. 95-104Article in journal (Refereed)
    Abstract [en]

    This study aims to describe the local guidelines for the supplemental feeding of infants of Swedish women’s clinics with maternity wards. Purposeful sampling was used during a four-week data collection time in 2019. Guidelines from 41 of the 43 Swedish women’s clinics with maternity wards were analysed using qualitative and quantitative content analysis. The information provided, and length of the guidelines varied widely in 38 guidelines. Feeding methods were included in 28 guidelines, but 10 provided no information about feeding methods. The most common feeding methods were cup feeding and feeding probes. Suggestions for supplemental feeding included infant formula (32), breast milk (27) and no suggestions (6). The methods to support breastfeeding were skin-to-skin contact (25), breastfeeding freely (22), a caring plan (18), extra supervision (3), optimising the caring environment (2), supplying a breast pump (1) and breastfeeding observation (1). Twenty-two guidelines included information about how long formula should be given and that the feeding should be phased out gradually. We conclude that a national guideline for the supplemental feeding of infants is needed to ensure equal best practice care for infant safety and the support of parents to increase the breastfeeding rate. More national guidelines are needed in general because it is easier to update only one set of guidelines.

  • 34.
    Kerstis, Birgitta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Richardsson, Anna
    Universitetssjukhuset Örebro, Sweden.
    Widarsson, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Stenström, Alexandra
    Universitetssjukhuset Örebro, Sweden.
    Stärks amning av en nationell riktlinje om tillmatning av nyfödda barn?2021In: Barnbladet, ISSN 0349-1994, no 3, p. 24-26Article in journal (Other academic)
  • 35.
    Kerstis, Birgitta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wells, M.
    Karolinska Institute, Stockholm, Sweden.
    Andersson, E.
    Karolinska Institute, Stockholm, Sweden.
    Father group leaders' experience of creating an arena for father support: A qualitative study2018In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 2, p. 943-950Article in journal (Refereed)
  • 36.
    Kerstis, Birgitta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Widarsson, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Barn med stort vårdbehov2022In: Omvårdnad i hemmet vid komplexa vårdbehov / [ed] Gustafsson, Lena-Karin; Söderman, Mirkka, Studentlitteratur AB, 2022, p. 189-206Chapter in book (Other academic)
  • 37.
    Kerstis, Birgitta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Widarsson, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Utveckling av samvård på neonatalavdelning samt nationellt föräldrastöd2019Conference paper (Other academic)
  • 38.
    Kerstis, Birgitta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Widarsson, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Våld vid hälso- och sjukvård i hemmet2022In: Omvårdnad i hemmet vid komplexa vårdbehov / [ed] Gustafsson, Lena-Karin; Söderman, Mirkka, Studentlitteratur AB, 2022, p. 85-104Chapter in book (Other academic)
  • 39.
    Kerstis, Birgitta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Widarsson, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    When Life Ceases: Relatives’ Experiences When a Family Member Is Confirmed Brain Dead and Becomes a Potential Organ Donor—A Literature Review2020In: Sage Open Nursing, E-ISSN 2377-9608, Vol. 6, article id 2377960820922031Article in journal (Refereed)
    Abstract [en]

    Introduction: Most healthcare professionals rarely experience situations of a request for organ donation being made to thepatient’s family and need to have knowledge and understanding of the relatives’ experiences.Objective: To describe relatives’ experiences when a family member is confirmed brain dead and becomes a potentialorgan donor.Methods: A literature review and a thematic data analysis were undertaken, guided by the Preferred Reporting Items forSystematic Reviews and Meta-Analyses reporting process. A total of 18 papers, 15 qualitative and 3 quantitative, publishedfrom 2010 to 2019, were included. The electronic search was carried out in January 2019.Results: The overarching theme When life ceases emerged as a description of relatives’ experiences during the donationprocess, including five subthemes: cognitive dissonance and becoming overwhelmed with emotions, interacting with healthcareprofessionals, being in a complex decision-making process, the need for proximity and privacy, and feeling hope for thefuture. The relatives had different needs during the donation process. They were often in shock when the declaration ofbrain death was presented, and the donation request was made, which affected their ability to assimilate and understandinformation. They had difficulty understanding the concept of brain death. The healthcare professionals caring for the patienthad an impact on how the relatives felt after the donation process. Furthermore, relatives needed follow-up to processtheir loss.Conclusion: Caring science with an explicit relative perspective during the donor process is limited. The grief process isindividual for every relative, as the donation process affects relatives’ processing of their loss. We assert that intensive careunit nurses should be included when essential information is given, as they often work closest to the patient and her or hisfamily. Furthermore, the relatives need to be followed up afterwards, in order to have questions answered and to processthe grief, together with healthcare professionals who have insight into the hospital stay and the donation process.

  • 40.
    Lindberg, Daniel
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Elvén, Maria
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Nilsson, Kent W.
    Center for Clinical Research, Central Hospital of Västerås, Uppsala University, SE-75236 Uppsala, Sweden;Division of Public Health Sciences, School of Health, Care and Social Welfare, Mälardalen University, SE-72134 Västerås, Sweden.
    von Heideken Wågert, Petra
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Stier, Jonas
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Dahlen, Micael
    Department of Marketing and Strategy, Stockholm School of Economics, SE-11383 Stockholm, Sweden.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    How Have Physical Activity and Sedentary Behavior, Changed during the COVID-19 Pandemic? A Swedish Repeated Cross-Sectional Design Study2023In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 20, no 4, p. 3642-3642Article in journal (Refereed)
    Abstract [en]

    Physical activity (PA) and sedentary behavior (SB) affect people’s physical and mental health. The aim was to examine changes in PA and SB in a Swedish population: at three time points: 2019, 2020, and 2022, i.e., before and during the COVID-19 pandemic. Pre-pandemic PA and SB, i.e., 2019, were assessed retrospectively in 2020. Associations between PA and SB with sex, age, occupation, COVID-19 history, weight change, health, and life satisfaction were also examined. The design was repeated cross-sectionally. The main findings demonstrate the PA levels decreased between 2019 and 2020, and between 2019 and 2022, but not between 2020 and 2022. The SB increase was most evident between 2019 and 2020. Between 2020 and 2022, results showed a decrease in SB, but SB did not reach pre-pandemic levels. Both sexes decreased their PA over time. Although men reported more PA sex, they did not have any association with PA changes. Two age groups, 19–29 years and 65–79 years, decreased their PA over time. Both PA and SB were associated with COVID-19, occupation, age, life satisfaction, health, and weight change. This study underlines the importance of monitoring changes in PA and SB as they have relevance for health and well-being. There is a risk that the levels of PA and SB do not return to pre-pandemic levels in the population.

  • 41.
    Wells, M.B
    et al.
    Uppsala universitet, Sweden.
    Varga, G.
    Uppsala universitet, Sweden.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Uppsala universitet, Sweden.
    Sarkadi, A.
    Uppsala universitet, Sweden.
    Swedish child health nurses' views of early father involvement: a qualitative study2013In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 102, no 7, p. 755-761Article in journal (Refereed)
  • 42.
    Wells, Michael B.
    et al.
    Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden..
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Andersson, Ewa
    Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden..
    Impacted family equality, self-confidence and loneliness: a cross-sectional study of first-time and multi-time fathers' satisfaction with prenatal and postnatal father groups in Sweden2021In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 35, no 3, p. 844-852Article in journal (Refereed)
    Abstract [en]

    Background Fathers often feel secondary or invisible in traditional parent groups. Gender-specific parent groups, referred to as father groups, may be inclusive spaces for fathers to discuss their transition into parenthood. Objective To quantitatively assess fathers' perceptions and satisfaction of father groups in Sweden during the prenatal and postnatal periods. Method A cross-sectional quantitative study design was used to report fathers' satisfaction of father groups, including how the groups impacted their personal outcomes, as well as their relationship with their partner and child. Further analyses were completed on if their depressive symptoms, via EPDS, and/or parity affected their satisfaction and personal outcomes. Setting and participants Fathers were recruited through father group leaders, who then provided the researchers with their contact information. In total, 87 fathers were contacted via email and 67 fathers from two geographical areas, including urban and suburban settings, completed the survey. Findings Most fathers had a university education, a good household economy and were married/cohabiting, while almost 60% were first-time fathers and almost 25% had depressive symptoms. Overall, fathers were generally satisfied with both the prenatal and postnatal father groups, although fathers attended prenatal father groups to a lesser extent. The participants rated the father groups as moderately impacting their equality in the family, self-confidence, feelings of loneliness, social network and being able to express their own opinions, as well as positively affected their relationship with their partner and child, respectively. While there were no differences based on fathers' parity, those who self-estimated depressive symptoms were less satisfied and rated the father groups less impactfully. Father groups may help encourage fathers to meet policy goals, such as childrearing equality, and can be an important arena for screening fathers for depression.

  • 43.
    Widarsson, Margareta
    et al.
    Uppsala University, Sweden.
    Engström, Gabriella
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Rosenblad, Andreas
    Uppsala University, Sweden.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Uppsala University, Sweden.
    Edlund, Birgitta
    Uppsala University, Sweden.
    Lundberg, Pranee
    Uppsala University, Sweden.
    Parental stress in early parenthood among mothers and fathers in Sweden2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 4, p. 839-847Article in journal (Refereed)
    Abstract [en]

    Parental stress affects parenting behaviour and the quality of dyadic parent-child interactions. Mothers generally show higher parental stress than fathers. Aims: Our aims were to assess the perceived level of parental stress in early parenthood and examine the differences between mothers and fathers within couples in relation to their levels of education, parental experience, existence of a parental role model and sense of coherence. Methods: In total, 307 mothers and 301 fathers of 18-month-old children answered the Swedish Parenthood Stress Questionnaire (SPSQ); and 318 mothers and 311 fathers answered the Sense of Coherence (SOC-3) scale; 283 couples answered both the SPSQ and SOC-3. Results: Mothers perceived higher levels of stress than fathers in the sub-areas incompetence (p < 0.001), role restriction (p < 0.001), spouse relationship problems (p = 0.004) and health problems (p = 0.027), and in total (p = 0.001). In contrast, fathers perceived higher stress than mothers in the sub-area social isolation (p < 0.001). When the data were stratified with respect to education, parental experience, existence of a parental role model and sense of coherence, significant results were observed in some of these sub-areas. Conclusions: Mothers and fathers experience stress in different areas during their early parenthood. Healthcare professionals should be aware of the differences in stress that exist between mothers and fathers, so that parents can be adequately prepared for parenthood and avoid parental stress. 

  • 44.
    Widarsson, Margareta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Barn i behov av neonatalvård2022In: Omvårdnad i hemmet vid komplexa vårdbehov / [ed] Gustafsson, Lena-Karin; Söderman, Mirkka, Studentlitteratur AB, 2022, p. 161-188Chapter in book (Other academic)
  • 45.
    Widarsson, Margareta
    et al.
    Uppsala University, Sweden.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sundquist, Kristina
    Lund University, Sweden.
    Engström, Gabriella
    Mälardalen University, School of Health, Care and Social Welfare.
    Sarkadi, Anna
    Uppsala Universitet, Sweden.
    Support Needs of Expectant Mothers and Fathers: A Qualitative Study2012In: The Journal of Perinatal Education, ISSN 1058-1243, Vol. 21, no 1, p. 36-44Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe expectant mothers' and fathers' perceived needs of support during pregnancy. Twenty-two women and 10 men were interviewed in four focus groups and 13 individual interviews. Systematic text condensation was performed to analyze the data. Parents described not only a broad spectrum of social support needs but also needs of psychological and physical support. They also requested to share their experiences with others. The foci of care and parents' needs of support are more harmonized with medical support than with psychological and emotional support. Mothers' needs were predominately addressed in the health services, but fathers often felt “invisible.“ Antenatal services may need to offer more customized individual support and emphasize peer support in groups; the challenge is to involve both parents through communication and encouragement so they can support each other. 

  • 46.
    Widarsson, Margareta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Nohlert, E.
    Centre for Clinical Research, Uppsala University Västmanland County Hospital, Sweden.
    Öhrvik, J.
    Uppsala Univ, Vastmanland Cty Hosp, Ctr Clin Res, Uppsala, Sweden; Department of Medicine, Karolinska Institutet, Sweden.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Parental stress and depressive symptoms increase the risk of separation among parents with children less than 11 years of age in Sweden.2019In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 47, p. 207-214Article in journal (Refereed)
    Abstract [en]

    Aims: Parental separations have become more frequent in recent decades. In Western countries, about 25% of children experience parental separation. There is a need to explore the risk factors for separation to give children an optimal childhood. The objective of the present study was to examine parental stress and depressive symptoms during early parenthood and their association with parental separation. Methods: Four hundred and seven couples completed questionnaires on depressive symptoms for 3 months and parental stress for 18 months after childbirth. Total parental stress and five sub-areas were investigated. To study the separation rate, parents’ addresses were recorded 9 to 11 years after childbirth. Results: Twenty-nine percent of the parents were separated 9 to 11 years after childbirth. Separation was associated with depressive symptoms at 3 months (mothers p =.002, fathers p =.025) and total parental stress at 18 months after childbirth (mothers p =.010, fathers p =.005). The sub-areas of parental stress, Spouse relationship problems (mothers p = <.001, fathers p =.001) and fathers’ Social isolation (p =.005), were associated with separation. In multivariable regression analyses of the parents’ separation rate 9 to 11 years after childbirth, the only significant predictor was mothers’ Spouse relationship problems (p <.001). Conclusions: The knowledge that parental stress and depressive symptoms are risk factors for separation may simplify professional support for parents in early parenting. Courses for new and expectant parents can use this knowledge to increase parents’ awareness

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