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  • 1. Elfors, F. B.
    et al.
    Widarsson, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Department of Obstetrics and Gynecology, Örebro University Hospital, Örebro, Sweden.
    Velandia, Marianne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Midwives’ experiences of postpartum haemorrhage: A web-based survey in Sweden2024In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 129, article id 103902Article in journal (Refereed)
    Abstract [en]

    Objective: The objective was to describe midwives’ experiences of postpartum haemorrhage (PPH) >1000 ml in connection with childbirth. Design: A qualitative web-based survey with open-ended questions was used and the results were analysed with content analysis. Setting: Participants were recruited through convenience sampling from a national Facebook group for midwives. Participants: The study sample included 24 midwives with varying work experience at different maternity units in Sweden, all of whom had experience of postpartum haemorrhage >1000 ml. Findings: The midwives described that the treatment of PPH is limited by a lack of cooperation, knowledge, and assistance, as well as by staff inexperience. They also described how a high-pressure work environment contributed to feelings of inadequacy. Good cooperation, team training, having colleagues present, embodied knowledge, and good working conditions, led to successful handling of such situations, which contributed to feeling at ease with what had happened. Key conclusions and implications for practice: Good working conditions related to external contextual factors such as total load and support, as well as internal factors such as self-efficacy, can help midwives manage PPH while providing patient-safe care and feeling confident in their ability and at ease with the events. Therefore, midwives need to be given opportunities for emotional support, education, and team-based training to maintain the quality of midwifery care and avoid negative long-term effects for both midwives and patients.

  • 2.
    Erlandsson, Kerstin
    et al.
    Västerås Cty Hospital, Sweden.
    Widarsson, Margareta
    SAMVÅRD på neonatalavdelning: en svårfångad process i nuet2000In: Jordemodern, ISSN 0021-7468, Vol. 10, p. 17-18Article in journal (Other (popular science, discussion, etc.))
  • 3. Fängström, Karin
    et al.
    Sarkadi, Anna
    Smeds, Lisa
    Widarsson, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Åhman, Annika
    MÖDRAHÄLSOVÅRDENS DILEMMA: MEDICINSK ÖVERVAKNING ELLER STÖD UNDER GRAVIDITETEN PÅ FÖRÄLDRARNAS VILLKOR?2009In: FÖRÄLDRASTÖD I SVERIGE IDAG: VAD, NÄR OCH HUR? / [ed] Anna Sarkadi, 2009, p. 29-38Chapter in book (Other academic)
  • 4.
    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.

  • 5.
    Hess Engström, A.
    et al.
    Uppsala University, Center for Clinical Research, Västmanland County Hospital, Västerås, Sweden; Uppsala University, Department of Women's and Children's Health, Uppsala, Sweden.
    Bohm-Starke, N.
    Karolinska Institute, Department of Clinical Sciences, Division of Obstetrics and Gynecology, Solna, Sweden; Danderyd Hospital, Stockholm, Sweden.
    Kullinger, M.
    Uppsala University, Center for Clinical Research, Västmanland County Hospital, Västerås, Sweden; Uppsala University, Department of Women's and Children's Health, Uppsala, Sweden.
    Högberg, U.
    Uppsala University, Department of Women's and Children's Health, Uppsala, Sweden; Umeå University, Department of Epidemiology and Global Health, Umeå, Sweden.
    Buhrman, M.
    Uppsala University, Department of Psychology, Division of Clinical Psychology, Uppsala, Sweden.
    Skalkidou, A.
    Uppsala University, Department of Women's and Children's Health, Uppsala, Sweden.
    Widarsson, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Experiences of internet-based treatment for vulvodynia: A qualitative study2022In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 33, article id 100756Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to describe women's experiences before, under, and after a guided internet-based intervention for vulvodynia. Methods: The design was qualitative, based on content analysis. Participants were women who had undergone guided internet-based treatment for vulvodynia based on acceptance and commitment therapy principles (n = 13). Data were collected through in-depth interviews approximately-one month after participants completed treatment. Results: The analysis revealed the women's experiences of internet-based treatment for vulvodynia. Three themes emerged: “dealing with pain alone,” which was related to experiences of living with vulvodynia before internet-based treatment; “finding new ways,” which described the experiences of undergoing an internet-based treatment for vulvodynia and “feeling empowered to take control,” referring to the experiences of living with vulvodynia after the internet-based treatment. The women described a long search for a diagnosis, revealing a negative experience of healthcare. The internet-based treatment helped them find new ways to manage vulvodynia, but difficulties with the treatment were also experienced. After the intervention, the women reported improvements in wellbeing and having better strategies to manage pain, but also stated that the treatment was insufficient to perceive changes in vulvar pain. Conclusions: The guided internet-based treatment program for vulvodynia based on acceptance and commitment therapy principles was perceived as credible, helpful to manage vulvodynia, and could serve as a complement to regular care. Questions regarding the need for more support and optimal length of treatment need to be further evaluated. 

  • 6.
    Kalliokoski, P.
    et al.
    Uppsala Univ, Dept Publ Hlth & Caring Sci, Family Med & Prevent Med Sect, Husargatan 3,Box 564, S-75122 Uppsala, Sweden..
    Widarsson, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Rodhe, N.
    Uppsala Univ, Dept Publ Hlth & Caring Sci, Family Med & Prevent Med Sect, Husargatan 3,Box 564, S-75122 Uppsala, Sweden..
    Lofvander, M.
    Uppsala Univ, Dept Publ Hlth & Caring Sci, Family Med & Prevent Med Sect, Husargatan 3,Box 564, S-75122 Uppsala, Sweden.;Uppsala Univ, Ctr Clin Res, Vasteras, Sweden..
    Positive impact on vitamin D related lifestyle of medical advice in pregnant Somali-born women and new mothers: a mixed method study in Swedish primary care2021In: BMC Public Health, E-ISSN 1471-2458, Vol. 21, no 1, article id 297Article in journal (Refereed)
    Abstract [en]

    BackgroundA previous study showed that pregnant women/new mothers especially Somali-born and some Swedish-born had extremely low vitamin D levels and poor physical performance. Our study aimed to examine vitamin D related lifestyle, attitudes and behaviour before and after brief information about vitamin D, with special long-term focus on Somali-born women.MethodsA cohort of 91 pregnant women/new mothers having serum hydroxyvitamin D (S-25-OHD)<= 50nmol/L (n=51 Somali-born with one third <10nmol/L of S-25-OHD) in primary health care in Sweden was targeted for intervention. Brief individual oral and visual information on vitamin D was given by doctors at baseline and after four and ten months. Questionnaires with ordinal scales on vitamin D related lifestyle of food, clothing, and outdoor activities were distributed on all occasions. Focus-group interviews with 15 women from the target-group were performed after two years. A Somali interpreter was available.ResultsVeiled clothing, indoor living, and a low intake of milk, cheese, and fatty fish were common in the target group. Consumption pattern had increased significantly among the Somali-born women at the four-month follow-up but declined to non-significant levels at the ten-month follow-up. The focus-group interviews showed improved understanding of vitamin D deficiency, symptoms and attitudes, but varying applied behaviours related to sun exposure. Sun exposure for the children and increased fish consumption was the most evident positive results.ConclusionsVitamin D related lifestyle, attitudes and behaviour improved in a Somali-born group of pregnant women/new mothers with severe vitamin D deficiency. The preventive measures suggested in our study may have impact on public health in relation to bone and muscle strength and immunity especially in vitamin D deficiency risk groups.Trial registrationClinicalTrials.gov Identifier: NCT02922803. Date of registration: 28 September 2016.

  • 7.
    Kerstis, Birgitta
    et al.
    Uppsala University, Sweden.
    Engström, Gabriella
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sundquist, Kristina
    Lund University, Malmö, Sweden.
    Widarsson, Margareta
    Uppsala University, Sweden.
    Rosenblad, Andreas
    Uppsala University, Sweden.
    The association between perceived relationship discord at childbirth and parental postpartum depressive symptoms: a comparison of mothers and fathers in Sweden.2012In: Upsala Journal of Medical Sciences, Supplement, ISSN 0300-9726, Vol. 117, p. 430-438Article in journal (Refereed)
    Abstract [en]

    Aim. To examine whether mothers' and fathers' levels of perceived relationship discord at childbirth were associated with postpartum depressive symptoms when the child was 3 months old. Another aim was to examine parents' levels of self-reported depressive symptoms. The hypothesis was that parents with high levels of perceived relationship discord have higher levels of postpartum depressive symptoms than parents with low levels of perceived relationship discord. Method. One week after childbirth, 305 couples' perceived level of relationship discord was measured using the Dyadic Consensus Subscale (DCS) of the Dyadic Adjustment Scale (DAS). At 3 months postpartum, the same couples answered the Edinburgh Postnatal Depression Scale (EPDS) questionnaire. The relations between perceived level of relationship discord and postpartum depressive symptoms were analysed using standard non-parametric statistical methods. Results. The mothers and fathers partly differed regarding which areas of their relationship they perceived that they disagreed with their partners about. Furthermore, 16.5% of the mothers and 8.7% of the fathers reported postpartum depressive symptoms, and there was a moderate level of correlation between the DCS and EPDS scores. Conclusion. These results may be useful for professionals in antenatal care and child health centres as well as for family caregivers who need to be aware that mothers and fathers may have different views on relationship discord and of the high level of depressive symptoms in recent parents. Further research is needed to examine perceived relationship discord and the development of depressive symptoms postpartum over a longer term.

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  • 8.
    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. 

  • 9.
    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.

  • 10.
    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)
  • 11.
    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)
  • 12.
    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)
  • 13.
    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)
  • 14.
    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.

  • 15.
    Källestedt, M. -LS.
    et al.
    Källestedt Clinical Skills Center, Region Västmanland, Västerås, Sweden.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Letterstål, Anna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
    Widarsson, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    When caring becomes an art - how clinical gaze are perceived to be developed2023In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 18, no 1, article id 2156659Article in journal (Refereed)
    Abstract [en]

    PURPOSE: This qualitative study describes nurses' experiences and perceptions of how they develop the clinical gaze. METHODS: This qualitative study used an inductive approach and content analysis to assess the experiences of newly graduated nurses, nurse managers, and nursing teachers. Nineteen interviews were conducted. To achieve credibility, the study followed the guidelines of the Consolidated Criteria for Reporting Qualitative research (COREQ). RESULTS: Two themes emerged: nurses' personal abilities and the learning culture. Learning culture was considered the foundation of the development of the clinical gaze. The clinical gaze was found to be developed in relationships with patients and when learning together with colleagues, in which the opportunities for reflection are central. To develop the clinical gaze, structures for learning activities, such as reflection, communication exercises, and simulation, are needed so that they become a natural part of daily work. This can also be achieved through supervision and skills training both at university and in a care context. CONCLUSIONS: Prerequisites for the development of the clinical gaze include physical presence with the patient combined with learning activities such as conscious reflection with others in a safe learning culture.

  • 16. Letterstål, Anna
    et al.
    Kallestedt, M L S
    Reg Vastmanland, Västerås, Sweden.
    Widarsson, Margareta
    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.
    Nursing Faculties' Perceptions of Integrating Theory and Practice to Develop Professional Competence2022In: Journal of Nursing Education, ISSN 0148-4834, E-ISSN 1938-2421, Vol. 61, no 5, p. 236-241Article in journal (Refereed)
    Abstract [en]

    Background: Nursing faculties??? perceptions influence nursing education. This article describes how nursing faculty perceive nursing students??? development of professional competence by integrating theory and practice, and by examining how this context influences this integration. Method: With a phenomenographic approach, interviews were conducted with nine participants and analyzed into qualitatively different categories of description. Results: The integration of theoretical and practical knowledge is perceived as a challenge or as naturally intertwined in the entire education, focusing mainly on individual prerequisites for learning. Perceptions of a common mission create coherence for students. Evident learning structures are needed, and there is a perceived discrepancy between nurses??? competence and expectations in health care. Conclusion: If the theory and practice gap could be perceived as a driving force for continuous learning, it could become an incentive for closer collaboration by creating structures for competence development that include individuals, teams, and organizations. [J Nurs Educ. 2022;61(5):236-241.]

  • 17.
    Malmström, B.
    et al.
    Uppsala Univ, Sweden; Vastmanland Cty Hosp, Vasteras, Sweden.
    Nohlert, E.
    Uppsala Univ, Vastmanland Cty Hosp, Vasteras, Sweden.
    Ewald, U.
    Uppsala Univ, Sweden.
    Widarsson, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Uppsala Univ, Sweden; Vastmanland Cty Hosp, Vasteras, Sweden.
    Simulation-based team training improved the self-assessed ability of physicians, nurses and midwives to perform neonatal resuscitation2017In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 8, p. 1273-1279Article in journal (Refereed)
    Abstract [en]

    The use of simulation-based team training in neonatal resuscitation has increased in Sweden during the last decade, but no formal evaluation of this training method has been performed. This study evaluated the effect of simulation-based team training on the self-assessed ability of personnel to perform neonatal resuscitation. Methods: We evaluated a full-day simulation-based team training course in neonatal resuscitation, by administering a questionnaire to 110 physicians, nurses and midwives before and after the training period. The questionnaire focused on four important domains: communication, leadership, confidence and technical skills. The study was carried out in Sweden from 2005 to 2007. Results: The response rate was 84%. Improvements in the participants self-assessed ability to perform neonatal resuscitation were seen in all four domains after training (p < 0.001). Professionally inexperienced personnel showed a significant improvement in the technical skills domain compared to experienced personnel (p = 0.001). No differences were seen between professions or time since training in any of the four domains. Personnel with less previous experience with neonatal resuscitation showed improved confidence (p = 0.007) and technical skills (p = 0.003). Conclusion: A full-day course on simulation-based team training with video-supported debriefing improved the participants' self-assessed ability to perform neonatal resuscitation.

  • 18.
    Södersved Kallestedt, Marie-Louise
    et al.
    Mälardalen University, School of Health, Care and Social Welfare. Uppsala Univ, Sweden.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Letterstål, Anna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Karolinska Inst, Dept Med Solna, Stockholm, Sweden..
    Widarsson, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Perceptions of managers regarding prerequisites for the development of professional competence of newly graduated nurses: A qualitative study2020In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 29, no 23-24, p. 4784-4794Article in journal (Refereed)
    Abstract [en]

    Aim and objectives To describe perceptions of managers regarding prerequisites for professional competence development of newly graduated nurses following a 1-year residency programme. Background In general, managers are unsatisfied with the professional competence of newly graduated nurses. Therefore, they have been involved in residency programmes to support the nurses' transition from being nursing students to professional nurses. However, perceptions of managers regarding the professional competence development of nurses have been sparingly studied. Design/Methods Qualitative, descriptive study with a data-driven inductive approach with content analysis to obtain an understanding of the perceptions of nine managers through interviews. EQUATOR checklist COREQ is used (see FileS1). Results Three themes emerged: (a) the nurses' relationships with their teams and patients, (b) expectations regarding the development of practical skills and leadership skills and (c) prerequisites for continuing learning by supportive structures and a mutual responsibility between the manager and the nurse. Reflection was perceived by the managers as a cornerstone in the learning and development of professional competence. Learning theory was important, but learning practical clinical skills was essential for the nurses to develop competence and be able to perform their work, including being a leader of the team. Some structures discouraged continued learning in the development of professional competence, indicating a gap between the healthcare settings and the basic nursing programme. Conclusions There is a gap between the university and the healthcare settings in maintaining a structure for continued learning, which requires cooperation. This gap and tension can be a driving force for the learning process of competence development. Relationships with team members and patients are considered fundamental for developing professional competence. Relevance to clinical practice To overcome the gap between the university and the healthcare settings, the managers can facilitate nurses' continued learning by creating structures for reflection.

  • 19.
    Widarsson, Margareta
    Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap.
    Journey from Pregnancy to Early Parenthood: Perceived Needs of Support, Fathers’ Involvement, Depressive Symptoms and Stress2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Aims: The overall aim was to describe the perceived needs for support and fathers’ involvement among expectant parents, and to examine depressive symptoms and parental stress in early parenthood among mothers and fathers.

    Methods: Two qualitative studies using focus groups and individual interviews, and three quantitative comparative studies using three questionnaires were conducted.

    Results: The expectant parents had different needs and suggestions for health-care improvement. One improvement of these was better involvement of expectant fathers, as fathers were described as the mothers’ best means of support and also had needs of their own. The fathers used different strategies to get involved during the pregnancy, but sometimes found it difficult to know what was expected of them. The mothers perceived more depressive symptoms and parental stress than the fathers. The mothers also perceived higher dyadic consensus than the fathers. Parents with depressive symptoms reported lower consensus than those without. There was a negative correlation between dyadic consensus and depressive symptoms in both mothers and fathers. Mothers perceived higher parental stress than fathers in the sub-areas ‘Incompetence regarding parenthood’, ‘Role restriction’, ‘Spouse relationship problems’, and ‘Health problems’, and overall. In contrast, fathers perceived higher stress than mothers in the sub-area ‘Social isolation’. Low education, lack of a role model and poor sense of coherence promoted more stress in mothers in the sub-areas ‘Social isolation’ and ‘Spouse relationship problems’, while lack of a role model and low sense of coherence promoted stress in fathers in the sub-area ‘Social isolation’.

    Conclusions and clinical implications: The expectant parents’ needs of support were not consistent with the support offered from health care services. These services need to become more client-centred, for example by offering customized individual support and peer support in groups. Further, they should also meet the needs of expectant fathers which can benefit the whole family. To promote parents’ health and family stability, health professionals should consider depressive symptoms and parental stress. They should also take gender norms into account so that parents become prepared for parenthood and get adequate support during early parenthood.

  • 20.
    Widarsson, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Newly graduated nurses’ development of professional competence2022Conference paper (Other academic)
  • 21.
    Widarsson, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Newly graduated Swedish nurses´ inadequacy to develop competence in their professional role as practicing nurses2019Conference paper (Other academic)
  • 22.
    Widarsson, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Nyutexaminerade sjuksköterskors strävan att utveckla professionell kompetens2019Conference paper (Other academic)
  • 23.
    Widarsson, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Simulatorbaserad teamträning ökade den självskattade förmågan hos barnmorskor, läkare och sjuksköterskor att utföra hjärt-lungräddning på nyfödda2019Conference paper (Other academic)
  • 24.
    Widarsson, Margareta
    et al.
    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.
    Letterstål, Anna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Karolinska Institutet, Stockholm, Sweden.
    Södersved Kallestedt, Marie-Louise
    Mälardalen University, School of Health, Care and Social Welfare. Uppsala University, Region Västmanland, Västerås, Sweden.
    Newly graduated swedish nurses’ inadequacy in developing professional competence2020In: Journal of Continuing Education in Nursing: Continuing Competence for the Future, ISSN 0022-0124, E-ISSN 1938-2472, Vol. 51, no 2, p. 65-74Article in journal (Refereed)
    Abstract [en]

    Background: The learning process for student and recently graduated nurses during their transition to professional nursing is stressful and challenging. The aim of this study was to describe recent graduates’ experiences of developing professional competence in their basic nursing program and during their first year. Method: A qualitative descriptive design with an inductive approach based on interviews with 11 nurses, with a qualitative content analysis. Results: Recently graduated nurses experience shortages and struggle to develop their professional competence. They find that reflection is a fundamental tool in the process of professional competence development. The competence gap is not between theoretical and practical knowledge, but rather between the university and health care organizations. Conclusion: Focusing on the intertwining of theoretical and practical knowledge can bridge the gap between these two organizations and create a foundation for lifelong learning of professional competence. Creating opportunities for reflection is central to the learning process. 

  • 25.
    Widarsson, Margareta
    et al.
    Uppsala University, Uppsala, Sweden.
    Engström, G.
    Florida Atlantic University, United States.
    Tydén, T.
    Uppsala University, Uppsala, Sweden.
    Lundberg, P.
    Uppsala University, Uppsala, Sweden.
    Marmstål Hammar, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    'Paddling upstream': Fathers' involvement during pregnancy as described by expectant fathers and mothers2015In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 7-8, p. 1059-1068Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To describe the perspectives of expectant mothers and fathers on fathers' involvement during pregnancy. Background: Becoming a father is a major life event and paternal involvement during pregnancy has a positive influence on the family. However, research into both expectant mothers' and fathers' perspectives on fathers' involvement during pregnancy is relatively scarce. Design: A descriptive qualitative study was used. Methods: Thirty expectant parents (20 women and 10 men) were interviewed either as part of one of four focus groups or in an individual interview. Qualitative content analysis was performed on the interview transcripts. Results: A theme of 'Paddling upstream' emerged as an expression of the latent content of the interviews concerning perspectives on fathers' involvement. Five sub-themes described the manifest content: trying to participate, trying to be understanding, trying to learn, trying to be a calming influence and trying to find a balanced life. Expectant parents suggested several ways to improve fathers' involvement and to meet parents' need for shared involvement. Conclusion: Expectant mothers and fathers wanted the father to be more involved in the pregnancy. Although fathers attempted different strategies, they did not always perceive what was expected of them and encountered many barriers as they tried to navigate through this unique experience. The best support for the father was the mother. Expectant parents wanted their healthcare to include the father more thoroughly and to focus on the whole family. Relevance to clinical practice: Prenatal care professionals can overcome barriers that prevent paternal involvement. Although fathers are not able to engage in the pregnancy on the same level as the mother, we suggest that their specific needs also be recognised through an increased awareness of gender norms in healthcare.

  • 26.
    Widarsson, Margareta
    et al.
    Uppsala universitet, Sweden.
    Engström, Gabriella
    Uppsala universitet, Sweden; Florida Atlantic University, USA.
    Berglund, Anders
    Uppsala universitet, Sweden.
    Tydén, Tanja
    Uppsala universitet, Sweden.
    Lundberg, Pranee
    Uppsala universitet, Sweden.
    Parental stress and dyadic consensus in early parenthood among mothers and fathers in Sweden2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 4, p. 689-699Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Parental stress can negatively affect the parent-child relationship and reduce the well-being of the whole family. Family disagreement is associated with parental divorce and with psychological problems in children.

    AIMS: The aim was to examine perceived parental stress and draw comparisons among mothers and among fathers, in relation to educational level, parental experience, existence of a parental role model and sense of coherence. The aim was also to examine perceived dyadic consensus and its association with perceived parental stress within couples.

    METHODS: Questionnaires were completed by 320 mothers and 315 fathers at 1 week and 18 months post-partum. The Swedish Parenthood Stress Questionnaire, the Sense of Coherence Scale and the Dyadic Consensus Subscale were used.

    RESULTS: Low education, lack of a role model and poor sense of coherence promoted stress in mothers in the subareas social isolation and spouse relationship problems, while lack of a role model and poor sense of coherence promoted stress in fathers in the subarea social isolation. Furthermore, parental experiences promoted stress among mothers in the subarea incompetence while this was not seen among fathers. Mothers perceived a higher level of dyadic consensus than fathers in the items recreational activities, friends, aims and life goals, time spent together, and decisions regarding career and personal development. Household tasks was the only item where fathers perceived a higher level of dyadic consensus than mothers. Additionally, there were associations between perceived parental stress and dyadic consensus in several items and in the total score.

    CONCLUSIONS: To promote parents' health and family stability, health professionals should consider factors affecting stress and stress reactions, and take gender roles into account.

  • 27.
    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. 

  • 28.
    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)
  • 29.
    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. 

  • 30.
    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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