mdh.sePublikasjoner
Endre søk
Begrens søket
12 1 - 50 of 53
RefereraExporteraLink til resultatlisten
Permanent link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Treff pr side
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sortering
  • Standard (Relevans)
  • Forfatter A-Ø
  • Forfatter Ø-A
  • Tittel A-Ø
  • Tittel Ø-A
  • Type publikasjon A-Ø
  • Type publikasjon Ø-A
  • Eldste først
  • Nyeste først
  • Skapad (Eldste først)
  • Skapad (Nyeste først)
  • Senast uppdaterad (Eldste først)
  • Senast uppdaterad (Nyeste først)
  • Disputationsdatum (tidligste først)
  • Disputationsdatum (siste først)
  • Standard (Relevans)
  • Forfatter A-Ø
  • Forfatter Ø-A
  • Tittel A-Ø
  • Tittel Ø-A
  • Type publikasjon A-Ø
  • Type publikasjon Ø-A
  • Eldste først
  • Nyeste først
  • Skapad (Eldste først)
  • Skapad (Nyeste først)
  • Senast uppdaterad (Eldste først)
  • Senast uppdaterad (Nyeste først)
  • Disputationsdatum (tidligste først)
  • Disputationsdatum (siste først)
Merk
Maxantalet träffar du kan exportera från sökgränssnittet är 250. Vid större uttag använd dig av utsökningar.
  • 1.
    Blix- Lindström, S.
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Christensson, Kyllike
    Karolinska Institutet, Stockholm, Sweden.
    Johansson, E.
    Karolinska Institutet, Stockholm, Sweden.
    Women's satisfaction with decision-making related to augmentation of labour2004Inngår i: Midwifery, ISSN 0266-6138, Vol. 20, nr 1, s. 104-112Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: to describe women's experiences of participating in decision-making related to augmentation of labour. DESIGN: a qualitative approach using modified grounded theory technique. Open-ended interviews were conducted 1-3 days after childbirth. SETTING: the interviews were performed in the postnatal wards in five hospitals (tertiary level) in Stockholm, Sweden. PARTICIPANTS: 20 newly delivered women who had received oxytocin infusion for augmentation of labour during childbirth. FINDINGS AND KEY CONCLUSIONS: support and guidance from midwives in combination with knowledge and expectations about the intervention seemed to be important for women's satisfaction with decision-making concerning augmentation of labour. Four patterns of decision-making were found. One group of women participated in the decision-making regarding augmentation of labour while a second group was invited, but refrained from participation. These women were satisfied with the decisions made. A third group of women did not participate, but wanted to and they were dissatisfied with the decisions made. The fourth group did not participate in the decision-making-and did not want to. These women accepted the decisions made. The desire for information exceeded the desire for involvement in decision-making and the majority of women had confidence in the midwives' assessment.

  • 2.
    Blix-Lindström, S
    et al.
    Karolinska Institutet, Stockholm,.
    Johansson, E
    Karolinska Institutet, Stockholm,.
    Christensson, Kyllike
    Karolinska Institutet, Stockholm,.
    Midwives' navigation and perceived power during decision-making related to augmentation of labour2007Inngår i: Midwifery, ISSN 0266-6138, Vol. 24, nr 2, s. 190-198Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: to explore and understand how midwives perceive and experience decision-making about augmentation of labour. DESIGN: focus-group discussions. SETTING: Stockholm, Sweden. PARTICIPANTS: 20 midwives experienced in working in labour wards. FINDINGS: five categories were identified that illustrate the factors considered by the midwives to influence decision-making during augmentation of labour: 'regulations and guidelines'; 'shortage of delivery rooms'; 'influence of obstetricians'; 'women in labour'; and 'midwives' professional selves'. The theme identified was how midwives managed to 'navigate' these factors, which provided midwives with a decisive influence during the decision-making process. KEY CONCLUSIONS AND IMPLICATIONS: midwife job satisfaction can result from a sense of professional power over the possibility of navigating factors that influence decision-making during augmentation of labour. This sense of power can subsequently influence co-operation with both obstetricians and women during labour.

  • 3.
    Christensson, Kyllike
    et al.
    Mälardalens högskola, Institutionen för vård- och folkhälsovetenskap. Karolinska Institutet, Stockholm, Sweden.
    Odberg Pettersson, K.
    Karolinska Institutet, Stockholm, Sweden.
    Bugalho, A.
    Maputo Central Hospital, Mozambique.
    Cunha, M.M.
    Maputo Central Hospital, Mozambique.
    Dgedge, C.
    Maputo Central Hospital, Mozambique.
    Johansson, E.
    Karolinska Institutet, Stockholm, Sweden.
    Bergstrom, S.
    Karolinska Institutet, Stockholm, Sweden.
    The challenge of improving perinatal care in settings with limited resources: Observations of midwifery practices in Mozambique2006Inngår i: African Journal of Reproductive Health, ISSN 1118-4841, Vol. 10, nr 1, s. 47-61Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to observe and analyse midwifery care routines related to asphyxia and hypothermia during the perinatal period and to investigate the effect of an in-service education program. A direct non-participant pre- and post-intervention observation study of midwifery a performance during childbirth was conducted at a labour ward in Maputo. The observed groups consisted of 702 and 616 midwifery-attended deliveries. Examination was also conducted of the partographs (702 vs. 616). The quality of midwifery care related to prevention and early detection of asphyxia and hypothermia was found to be inadequate and the intervention had no significant effect upon the midwives' performances. This could be attributed to the quality of the intervention itself or to failure of implementing managerial decisions such as transfer of partograph documentation from obstetricians to midwives. Change in professional performance does not automatically follow awareness of evidence-based midwifery practices, but requires behavioural change, which may be more difficult to achieve.

  • 4.
    Dsilna, Ann
    et al.
    Karolinska Institutet, Sweden.
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Karolinska Institutet, Sweden.
    Alfredsson, Lars
    Karolinska Institutet, Sweden.
    Lagercrantz, Hugo
    Karolinska Institutet, Sweden.
    Blennow, Mats
    Karolinska Institutet, Sweden.
    Continuous feeding promotes gastrointestinal tolerance and growth in very low birth weight infants2005Inngår i: Journal of Pediatrics, ISSN 0022-3476, E-ISSN 1097-6833, Vol. 147, nr 1, s. 43-49Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To compare the effects of continuous versus intermittent feeding on gastrointestinal tolerance and growth in very low birth weight (VLBW) infants. STUDY DESIGN: In a randomized, controlled trial conducted at 3 neonatal units, 70 premature infants with a gestational age 24 to 29 weeks and birth weight < 1200 g were assigned to 1 of 3 feeding methods: continuous nasogastric feeding, intermittent nasogastric feeding, or intermittent orogastric feeding. Feeding was initiated within 30 hours of birth. Daily enteral and parenteral volumes, caloric and protein intakes, growth, enteral intolerance, and clinical complications were recorded. Cox regression analysis was used to determine primary outcome, the time to achieve full enteral feeding. RESULTS: The continuously fed infants achieved full enteral feeding significantly faster than the intermittently fed infants (hazard ratio [HR] = 1.86; 95% confidence interval [CI] = 1.07 to 3.22). In stratified analysis according to birth weight, the improvement was even more pronounced in the smallest infants, those with birth weight < or = 850 g (adjusted HR = 4.13; 95% CI = 1.48 to 11.53). Growth rate was significantly faster in the continuously fed infants ( P = .002). CONCLUSION: In VLBW infants, continuous feeding seems to be better than intermittent feeding with regard to gastrointestinal tolerance and growth.

  • 5.
    Dsilna, Ann
    et al.
    Karolinska Institutet.
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Karolinska Institutet.
    Gustafsson, Ann-Sofi
    Karolinska Institutet.
    Lagercrantz, Hugo
    Alfredsson, Lars
    Karolinska Institutet.
    Behavioral stress is affected by the mode of tube feeding in very low birth weight infants2008Inngår i: The Clinical journal of pain, ISSN 1536-5409, Vol. 24, nr 5, s. 447-55Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To compare the effect of continuous versus bolus feeding on behavioral responses of stress in very low birth weight infants during early postnatal life. METHODS: In a randomized, controlled trial conducted at 3 neonatal units, 70 premature infants with gestational age 24 to 29 weeks and birth weight <1200 g were randomly assigned to 1 of 3 feeding methods: continuous nasogastric feeding, bolus nasogastric feeding, and bolus orogastric feeding. Behavioral responses were video recorded during feeding at 7 and 15 days of postnatal age and at 32 weeks of postmenstrual age. The odds ratio (OR) of manifest behavioral stress was calculated by means of logistic regression. RESULTS: A significantly higher risk of a behavioral stress response in bolus-fed infants compared with continuous-fed infants at 15 days of age was observed, [adjusted OR=4.1 (95% confidence interval: 1.1-15.4)]. A similar difference was observed at 32 weeks of postmenstrual age [adjusted OR=4.2 (95% confidence interval: 1.0-17.8)]. In addition, bolus-fed infants showed statistically significant higher need of behavioral and physiologic stabilization during feeding. DISCUSSION: This trial suggests that continuous feeding is associated with lower behavioral stress response as compared with bolus feeding among very low birth weight infants, in early postnatal life.

  • 6.
    Ekéus, Cecilia
    et al.
    Karolinska Institute, Sweden.
    Christensson, Kyllike
    Karolinska Institute, Sweden.
    Hjern, Anders
    Uppsala University, Sweden.
    Unintentional and violent injuries among pre-school children of teenage mothers in Sweden: a national cohort study.2004Inngår i: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 58, nr 8, s. 680-685Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    STUDY OBJECTIVE: This study investigates the risk and mediating mechanisms of unintentional and violent injuries in pre-school children of teenage mothers. DESIGN: Cohort study based on Swedish national registers. Cox analyses of proportional hazard were used to estimate the relative risk of hospital admission and death attributable to injuries in analyses of data from national registers. PARTICIPANTS: The study population was a national cohort of 800,192 children born in Sweden during 1987-93 who were followed up prospectively from birth to their 7th birthday. MAIN RESULTS: Children of teenage mothers had higher relative risks (RRs) of hospital admissions for violent as well as unintentional injuries; age adjusted RRs of 2.7 (95% CI 1.2 to 6.1) and 1.6 (1.4 to 1.8), respectively, for children of mothers under 18 years of age and 2.5 (1.6 to 3.8) and 1.5 (1.4 to 1.6) of mothers aged 18-19 are compared with those with mothers aged at least 32 at the birth of the child. When the models were adjusted to socioeconomic variables and indicators of parental substance misuse and psychiatric illness the risk decreased slightly but remained well above that of children with older mothers. In addition, children of teenage mothers had an increased risk of death attributable to violent injuries (RR 6.7 (2.6 to 16.0), as well as to unintentional injuries (RR 3.5 (2.0 to 6.1). CONCLUSIONS: Maternal age is an important determinant of injuries in pre-school children in Sweden and the children of teenage mothers are at particular risk. Young parents should be given priority in injury prevention programmes.

  • 7.
    Erlandsson, Kerstin
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Dsilan, Ann
    Jonsson, Baldvin
    Do care-giving models after caesarean birth influence the infants' breathing adaptation? A pilot study.2008Inngår i: Journal of Children's and Young People's Nursing, ISSN 1753-1594, Vol. 2, nr 1, s. 7-12Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Cesarean birth is a mode of delivery that often minimizes the mothers’ possibility to handle her term baby skin-to-skin while the father takes care of the baby for part, or all, of the first hours. No attention has, as far as we know, been given to different caregiving models and their eventual effects on the adaptation of breathing for the term infant born by elective cesarean. Previous publications on breathing patterns in newborn infants have mostly been conducted on premature infants in kangaroo care. The aim of this pilot study was to compare the effects of two caregiving models on the adaptation of breathing and infant crying after elective cesarean section, in term infants during the first hours after birth. Term infants born by elective cesarean were held skin-to-skin on their father’s chest or cared-for in a cot during the mother’s post operative observation stay. Thirteen father-infant pairs participated in a pilot sub-study with a randomized control trial design. Data were collected both by respiratory inductance plethysmography (RIP) and by tape-recorded crying time. The data raises important questions about the effects on breathing adaptation in relation to caregiving models. The infants in the skin-to-skin group showed significantly higher inspiratory and expiratory air flows, larger breath volume (all p < 0.001) and minute ventilation as compared with the cot group. The infants in the skin-to-skin group cried less than the infants in the cot group (p < 0.001). A caregiving model where fathers hold their infants skin-to-skin in an upright position on their chest has a positive impact on the infants’ respiratory adaptation and reduced infant crying. Larger studies of caregiving models after elective cesarean birth on the adaptation of breathing need to be conducted.

  • 8.
    Erlandsson, Kerstin
    et al.
    Mälardalens högskola, Institutionen för vård- och folkhälsovetenskap.
    Christensson, Kyllike
    Mälardalens högskola, Institutionen för vård- och folkhälsovetenskap.
    Fagerberg, Ingegerd
    Mälardalens högskola, Institutionen för vård- och folkhälsovetenskap.
    Fatherhood as taking the child to oneself:: A phenomenological observation study after caesarean birth2006Inngår i: Indio-Pacific Journal of Phenomenology, ISSN 1445-7377, Vol. 6, nr 2, s. 1-9Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This paper describes the meaning of a father’s presence with a full-term healthy child delivered by caesarean section, as observed during the routine post-operative separation of mother and child. Videotaped observations recorded at a maternity clinic located in the metropolitan area of Stockholm, Sweden formed the basis for the study, in which fifteen fathers with their infants participated within two hours of elective caesarean delivery in the 37th - 40th week of pregnancy. A phenomenological analysis based on Giorgi’s method was conducted on the data. The description of the new father’s experiences that emerged pointed to a process of being and becoming in taking the child to himself. Fatherhood developed gradually as a result of recurrent experiences of the child’s expressions. There was an ebb and flow between taking on the role of being a father and physical withdrawal from the role. The findings of this study not only confirm previous accounts of new fathers’ experiences, but go further in revealing an ebb and flow variation in the fathers’ involvement. What this indicates is that the process of transition to fatherhood requires not only presence but time. The period required for this process thus must not be disturbed, but supported, trusting in the father’s ability to assume his role as a father. It is suggested that, in addition to their relevance in guiding the attitudes and expectations of those professionally involved in postnatal care and community health, these findings could be useful in antenatal courses for parents, and especially in instances when caesarean birth is planned, to highlight the meaning of the role of fathers as caregivers.

  • 9.
    Erlandsson, Kerstin
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Fagerberg, Ingegerd
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Fathers’ lived experiences of getting to know their baby while acting as primary caregivers immediately following birth2008Inngår i: The Journal of perinatal education., ISSN 1058-1243, Vol. 17, nr 2, s. 28-36Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim was to describe the meaning of the father’s lived experiences when taking care of his infant as the primary caregiver during the first hours after birth, when the infant was apart from the mother due to the mother’s postoperative care. Fifteen fathers were interviewed between 8 days to 6 weeks after birth. The results describe a movement towards father-child togetherness characterized by an immediate and gradual change within the father as he undertakes increasing responsibility while getting to know his child. The results can be reflected upon in antenatal classes in order to integrate the father’s important role in the care of his infant, in a situation where the mother-infant dyad has been interrupted.

  • 10.
    Erlandsson, Kerstin
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Dsilna, Ann
    Fagerberg, Ingegerd
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Skin-to-skin care with the father after cesarean birth and its effect on newborn crying and prefeeding behavior.2007Inngår i: Birth, ISSN 0730-7659, E-ISSN 1523-536X, Vol. 34, nr 2, s. 105-14Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Previous reports have shown that skin-to-skin care immediately after vaginal birth is the optimal form of care for full-term, healthy infants. Even in cases when the mother is awake and using spinal analgesia, early skin-to-skin contact between her and her newborn directly after cesarean birth might be limited for practical and medical safety reasons. The aim of the present study was to compare the effects of skin-to-skin contact on crying and prefeeding behavior in healthy, full-term infants born by elective cesarean birth and cared for skin-to-skin with their fathers versus conventional care in a cot during the first 2 hours after birth. METHODS: Twenty-nine father-infant pairs participated in a randomized controlled trial, in which infants were randomized to be either skin-to-skin with their father or next to the father in a cot. Data were collected both by tape-recording crying time for the infants and by naturalistic observations of the infants' behavioral response, scored every 15 minutes based on the scoring criteria described in the Neonatal Behavioral Assessment Scale (NBAS). RESULTS: The primary finding was the positive impact the fathers' skin-to-skin contact had on the infants' crying behavior. The analysis of the tape recordings of infant crying demonstrated that infants in the skin-to-skin group cried less than the infants in the cot group (p<0.001). The crying of infants in the skin-to-skin group decreased within 15 minutes of being placed skin-to-skin with the father. Analysis of the NBAS-based observation data showed that being cared for on the father's chest skin-to-skin also had an impact on infant wakefulness. These infants became drowsy within 60 minutes after birth, whereas infants cared for in a cot reached the same stage after 110 minutes. Rooting activity was more frequent in the cot group than in the skin-to-skin group (p<0.01), as were sucking activities (p<=0.001) and overall duration of wakefulness (p<0.01). CONCLUSIONS: The infants in the skin-to-skin group were comforted, that is, they stopped crying, became calmer, and reached a drowsy state earlier than the infants in the cot group. The father can facilitate the development of the infant's prefeeding behavior in this important period of the newborn infant's life and should thus be regarded as the primary caregiver for the infant during the separation of mother and baby.

  • 11.
    Flygare Wallén, Eva
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Müllersdorf, Maria
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Marcus, C
    Progress of cardiometabolic risk factors from adolescence to adulthood inindividuals with intellectual disabilities: A five-year follow-up studyArtikkel i tidsskrift (Annet vitenskapelig)
  • 12.
    Flygare Wallén, Eva
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Müllersdorf, Maria
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Marcus, Claude
    Karolinska institutet.
    A school-based intervention associated with improvements in cardiometabolic risk profiles in young people with intellectual disabilities2013Inngår i: Journal of Intellectual Disabilities, ISSN 1744-6295, E-ISSN 1744-6309, Vol. 17, nr 1, s. 38-50Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study evaluates a multifactorial school-based intervention with the aim of decreasing cardiometabolic risk factors by means of a healthy lifestyle, primarily with daily physical activity and healthy food during school hours, at an upper secondary school for students with intellectual disabilities. The outcome is measured in terms of cardiometabolic risk factors and cardiovascular fitness, both known to increase the risk of future cardiovascular disease, type 2 diabetes and cancer. Two years of intervention resulted in a positive trend in several measured cardiometabolic risk factors, with no increase in fat mass. Cardiovascular fitness levels were unchanged. We conclude that a healthy school environment can contribute to a deceleration of both fat mass gain and loss of cardiovascular fitness.

  • 13.
    Hallden, Britt-Marie
    et al.
    Högskolan Borås.
    Lundgren, Ingela
    Göteborgs Univ.
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Ten Swedish Midwives' Lived Experiences of the Care of Teenagers' Early Induced Abortions2011Inngår i: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 32, nr 5, s. 420-440Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This phenomenological hermeneutic study of 10 Swedish midwives illuminates the internal conflicts of values that arise when midwives' professional and personal belief systems clash in encounters with teenagers. Midwives may react emotionally in situations where teenagers ignore advice on contraception by rejecting the use of contraceptives and preferring early abortions as a contraceptive method. The results strengthen the suggestion that caregivers need support in reflecting on how to deal with conflicts of values that may otherwise hinder them in communicating effectively with teenagers and encounter their life-worlds and in challenging their individual assumptions on the shortcomings of using contraceptives.

  • 14.
    Halldén, B. -M
    et al.
    Karolinska Institutet.
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Swedish young men's lived experiences of a girlfriend's early induced abortion2010Inngår i: International Journal of Men's Health, ISSN 1532-6306, E-ISSN 1933-0278, Vol. 9, nr 2, s. 126-143Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Abortion rates worldwide suggest that a large number of young men are in fact exposed to the experience of an abortion. This phenomenological hermeneutic study illuminates ten young men's experiences of the abortion process including the abortion itself. In view of their different cultural backgrounds and their stable or merely casual relationship with the girlfriend, their experiences are illuminated in four main themes as; having interrupted a life-giving process, having wished to relieve the girlfriend's pain, having struggled with feelings of helplessness, and standing up for made decisions. The interpreted whole is expressed as; a wish to compensate the girlfriend for her suffering and share with her the responsibility for the abortion. With a view to promoting gender equality in reproductive health the results are discussed in the light of relational ethics and contribute to reflections on current praxis in health-care settings. 

  • 15.
    Halldén, Britt-Marie
    et al.
    Karolinska Institutet.
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Olsson, Pia
    Uppsala University.
    Early abortion as narrated by young Swedish women2009Inngår i: Scandinavian journal of caring sciences, ISSN 1471-6712, Vol. 23, nr 2, s. 243-250Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Scand J Caring Sci; 2008 Early abortion as narrated by young Swedish womenAim: The aim of the study was to illuminate meanings of having had an induced abortion among young Swedish women. Methods: Narrative interviews were conducted with ten 18-20-year-old women 2-6 weeks after a medical or surgical abortion in the sixth to twelfth week of pregnancy. Data were analysed according to a phenomenological hermeneutic method. Results: The study disclosed a multitude of complex meanings in the young women's lived experiences of induced abortion. Four themes were revealed: having cared for and protected the unimagined pregnancy, taking the life of my child-to-be with pain, being sensitive to the approval of others and imagining the taken away child-to-be. The results are discussed in light of Nussbaum's theory of development ethics. The young women's ability to be responsible for their choices regarding their own welfare and others' well-being in a life cycle perspective was disclosed, despite the pain inherent in the responsibility of taking the life of their own child-to-be. Conclusions: The young women's narratives were replete with ethical reasoning regarding existential matters related to their responsibility of choosing between induced abortion and parenthood and how to live their lives with this experience. Health-care professionals could promote young women's capability to be responsible, as well as the development of trust in their own fertility and constructive relationships with significant others. In the development of the prevention of unintended pregnancies and the sexual education of young people in Sweden existential dimensions of undergoing an abortion should be given attention.

  • 16.
    Halldén, Britt-Marie
    et al.
    University College of Borås, Borås, Sweden.
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Karolinska Institutet, Stockholm, Sweden .
    Olsson, Pia
    Uppsala University, Uppsala, Sweden.
    Meanings of being pregnant and having decided on abortion: young Swedish women's experiences.2005Inngår i: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 26, nr 9, s. 788-806Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In-depth interviews about the experience of being pregnant and having decided on abortion were conducted with 10 young Swedish women. A phenomenological-hermeneutic study disclosed a complex life world summarised as "I'm happy about my fertility but I choose not to give life now." Four themes were revealed: encountering an unexpected understanding of oneself and one's fertility, desiring to be understood by trusted others, trying out different positions in relation to pregnancy and abortion, and approaching planned adult motherhood. The results indicate that addressing young women's concerns about fertility might be important in reproductive care.

  • 17.
    Harder, Maria
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Christensson, Kyllike
    Kvinnor och Barns Hälsa Karolinska Institutet.
    Preschool children's expressions of engagement in Primary Child Health Care2008Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Preeschool children’s expressions of engagement in primary child health care

    Children have their right to give their voice and participate in situations which they are engaged in, according to The Convention on the Rights of Child. The aim of this study was to explore and describe 3 year old children’s expressions of engagement during annual child health care visit.

    A qualitative research design with video-observations was used. Twenty-nine 3 year old children’s actions were focused when interplaying with the nurse. A hermeneutic analysis was carried out to grasp the children’s varied expressions.

    The findings demonstrate how 3 year old children, when invited to the health care activity, are preparing themselves to readiness for engagement. They arrange their bodies in different positions, ask questions, seek contact with parent or are absorbed in thoughtfulness. Then the children direct their attention towards the nurse and/or the health care activity with spoken and/or bodily readiness. Children’s engagement occupies the whole body or separate parts of the body. Further, findings demonstrate how bodily expressions replace each other in a rapid process and how the same expressions can have different meaning depending on actual situation. The children’s spoken expressions: strengthen bodily expressions, are responding to nurses’ invitations or are spontaneously conversation.

    This research project will continue to study expressions of engagement and perceived participation of the children at 4 and 5,5 years of age at their annual primary child health care visits. To take preschool children’s engagement in primary child health care settings into consideration can contribute to promote their participation when interacting with the nurse.

     

  • 18.
    Harder, Maria
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Coyne, Imelda
    Trinity College Dublin, Ireland.
    Söderbäck, Maja
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Five-year-old Children's Tuning-in and Negotiation Staregies in an Immunization Situation2011Inngår i: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 21, nr 6, s. 818-829Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In this article, we have explored 5-year-old children's expressions when they as actors took part in an immunization situation in the Primary Child Health Care (PCHC) service in Sweden. Although children's health and development are the main concern in the PCHC service, their perspectives in such a setting have not been explored fully. To capture children's perspectives we used a hermeneutic design and video observations. The findings revealed children as competent and active participants, contributing to the construction of the PCHC situation in mutuality with the nurse and the parent. The conceptualization of children's expressions and actions revealed how they influenced and dealt with a PCHC situation by using strategies of tuning-in, affirmative negotiation, and delaying negotiation. Understanding children's actions will assist nurses to act with sensitivity when they encounter and support children.

  • 19.
    Harder, Maria
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Karolinska Institutet, Sweden.
    Söderbäck, Maja
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Exploring three-year-old children in a primary child health care situation2009Inngår i: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 13, nr 4, s. 383-400Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In the Swedish Primary Child Health Care (PCHC) children participate in regular health visits. In these visits children as actors demonstrate their subjective maturity through bodily and verbal expressions. The aim of this study was to explore three-year-old children's expressions when they take part as actors in a PCHC situation. An explorative design with a hermeneutic approach and video observations was used. Twenty-nine children participated. The findings exhibit a variation of expressions in the situation conceptualized as actions in a progression of states: from a state of getting ready to a state of being ready and further to a state where the child strengthens their own self. This progression is dynamic and coloured with the states of not being ready or of being adverse. The conceptualization of children's expressions can contribute towards encouraging nurses' sensitivity when inviting and guiding children in PCHC situations.

  • 20.
    Harder, Maria
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Christensson, Kyllike
    Kvinnor och barns hälsa, Karolinska Institutet.
    Söderbäck, Maja
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Four year old children's negotiation strategies to influence and deal with a Primary Health Care situation2013Inngår i: Children & society, ISSN 0951-0605, E-ISSN 1099-0860, Vol. 27, nr 1, s. 35-47Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In Sweden, children’s health and development are promoted through Primary Child Health Care (PCHC) visits. The children participate in these visits from their own perspective through bodily and verbal expressions. This study explores four-year-old children’s expressions when they as actors take part in a PCHC situation. The conceptualisation of the children’s expressions reveals various actions that exhibit their affirmative and delaying negotiation strategies to influence and deal with these situations. For PCHC nurses, these findings may encourage to view children as negotiating participants and inspire to sensitivity when inviting children and guiding them through health visits

  • 21.
    Harder, Maria
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Christensson, Kyllike
    Kvinnor och Barns Hälsa, Karolinska Institutet.
    Söderbäck, Maja
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Four year old Children’s strategies of negotiation when they are holding a Primary Child Health Care situation2009Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Four year old Children’s strategies of negotiation when they are holding a Primary Child Health Care situation

    The Swedish Primary Child Health Care (PCHC) is assigned to promote children’s (age 0-5) health and development through regular health visits. A child’s first year involves several health checkups, then planned health visits take place at 3, 4 and 5,5 years of age. These health visits is a part of a monitory program to examine the child’s speech development, motor and cognitive functions. During the health visit the child and the parent will meet a PCHC nurse. Recently, the child’s perspective as an actor in the health visit was explored. The result demonstrated how three year old children exhibit various actions in a progression of states. The child progress from a state of getting ready to a state of being ready and further to a state where the child strengthens the own self. This progression is dynamic and coloured with the states of not being ready or of being adverse. The aim of present study is to describe the four year old children’s strategies when they are holding a PCHC situation. The study has an explorative design with a hermeneutic approach and video-observations are used. Twenty-nine children participate and the selection is strategically. Informed consent was gained in writing from all children, parents and nurses. The findings exhibit how the children use various strategies of negotiation when they are holding a PCHC situation. Illuminating children’s perspective by conceptualizing their expressions and strategies may contribute towards encouraging the PCHC nurse’s sensitivity when inviting and guiding children in the health visit.

  • 22.
    Harder, Maria
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Christensson, Kyllike
    Kvinnor och Barns Hälsa, Karolinska Institutet.
    Söderbäck, Maja
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Preschool children's expression of participation in Primary Child Health Care2008Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Preschool children's expression of participation in primary child health care

    Introduction

    According to The Convention on the Rights of Child children have the right to have their voice heard and to participate in situations that involve them.

    Aim of the study

    The aim of this study was to explore and describe the expression of participation of 3-year old children during their annual primary health care visit.

    Methods

    The study employed qualitative research design using video-observation, and focused on the actions of twenty-nine 3-year olds in their interaction with the nurse. The varying expressions of the children were captured using hermeneutic analysis.

    Results

    The findings demonstrate how 3-year old children prepare themselves for particiaption prior to their health care visit. They arrange their bodies in different positions, ask questions, seek contact with their parent or are absorbed in their thoughts. The children then direct their attention towards the health care activity, by using bodily and/or spoken expressions they respond to the nurse´s invitations. When the children have replyed to the invitation they confirm them self. Findings also show children´s expressions of unpreparedness and reluctance in the health care situation.

    Conclusion / discussion

    Children’s participation occupies either all or part of the body and bodily expressions replace each other in a rapid progression. Children´s spoken expression strengthens their bodily expression.

    Practical relevance

    Studying pre-school children’s expressions in the child health care environment can contribute to promote their participation in their interaction with nursing staff.

    Research implications

    This research project will continue by studying the expression of perceived participation of children at 4 and 5,5 years of age during their annual primary health care visit.

    References

    Allmark, P. (2002). The ethics of research with children. Nurse researcher, 10 (2), 7-20.

    Bronfenbrenner, U. (1979). The ecology of Human Development. Cambridge, Mass. Harward university press.

    FA, Ministry for Foreign Affairs, (1989). The Convention on the Rights of the Child.

    Fraser, S., Lewis, V., Ding, S., Kellet, M. & Robinsson, C. (2004). Doing research with children and young people. London: Sage Publications.

    Hammersley, M. & Atkinson, P. (1995). Ethnography. Principles in Practice. London: Routledge

    Ministry for Health and Social Affairs. (2005). Mötet med barnet. Barnkompetens inom hälso-och sjukvården. 2005.031

    National Board of Health and Welfare. (1991). Allmänna råd från socialstyrelsen 1991:8. Hälsoundersökningar inom barnhälsovården. Stockholm: Allmänna förlaget.

    Schutz, A. (1967). The phenomenology of the Social World. Evanston: North-western Univ. Press.

  • 23.
    Lindberg, I
    et al.
    Luleå University of Technology, Sweden.
    Christensson, Kyllike
    Karolinska Institute, Stockholm, Sweden .
    Öhrling, K
    Luleå University of Technology, Sweden.
    Parents' experiences of using videoconferencing as a support in early discharge after childbirth.I2009Inngår i: Midwifery, ISSN 0266-6138, Vol. 25, nr 4, s. 357-365Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: to describe parents' experiences of using videoconferencing (VC) when discharged early from a maternity unit. DESIGN: a combination of quantitative and qualitative methods was used to describe parents' experiences. Data were collected via questionnaires and interviews. SETTING: a pilot study involving a maternity department and new parents in their homes was conducted. Through VC, parents discharged early were able to maintain follow-up contact with the midwife via sound and picture at the department. PARTICIPANTS: nine couples/new parents participated. FINDINGS: the analysis revealed four categories of responses: 'feeling confident with the technology'; 'feeling confident of having control of their privacy'; 'feeling confident being face-to-face on the VC'; and 'feeling confident when worries and concerns were met and answers were received'. KEY CONCLUSIONS: using VC as a support in cases of early discharge after childbirth can facilitate a meeting that makes it possible for new parents to be guided by the midwife in their transition into parenthood. IMPLICATIONS FOR PRACTICE: the findings of this study indicate that VC equipment may be helpful for parents discharged from hospital early after childbirth. The findings can also be used as a foundation for further development of the application of VC within maternal health care and in health care in rural areas.

  • 24.
    Lindberg, I
    et al.
    Luleå University of Technology, Luleå, Sweden.
    Öring, K
    Luleå University of Technology, Luleå, Sweden.
    Christensson, Kyllike
    Karolinska Institutet, Stockholm, Sweden.
    Midwives' experience of using videoconferencing to support parents who were discharged early after childbirth2007Inngår i: Journal of Telemedicine and Telecare, ISSN 1357-633X, Vol. 13, nr 4, s. 202-205Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Videoconferencing was used to support parents who were discharged early after childbirth. In a one-year pilot study, 23 videoconferences took place between midwives and parents at home. To ensure good picture quality, a high-speed, 10 Mbit/s broadband connection was used. We used a combination of quantitative and qualitative research methods to describe the participants' experience. Seven midwives with experience of supporting nine couples/new parents completed a questionnaire. The 20 responses (87%) showed that the main reason for contact was routine and the most frequent advice concerned breastfeeding. The quality of sound and picture were judged to be good and very good, respectively. The experience of communicating with the parents via videoconferencing was also investigated through semi-structured interviews. Analysis of the interviews revealed that videoconferencing was: easy to handle and useful for making assessments; a valuable and functional complement to usual practice; almost like a real-life encounter. The results suggest that videoconferencing may be a useful tool in postpartum care.

  • 25.
    Lindberg, Inger
    et al.
    Luleå University of Technology, Sweden.
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Öhrling, Kerstin
    Luleå University of Technology, Sweden.
    Midwives' experience of organisational and professional change2005Inngår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 21, nr 4, s. 355-364Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: to describe midwives' experiences of changes in their caring role and professional function in postpartum wards in the northern part of Sweden. In this part of the country, three out of eight maternity departments have been closed over the last 5 years. During the same period, hospital stays have reduced in length, and an early discharge model has been introduced. DESIGN: focus-group discussions. SETTING: four focus groups at two hospitals in northern Sweden. PARTICIPANTS: 21 midwives experienced in midwifery practice in maternity wards. FINDINGS: the analysis revealed four categories of comments: 'to have limited time when caring for the mother and the baby'; 'no longer being valued as the expert'; 'a wish to have responsibility for childbirth in its entirety'; 'to see future possibilities in the development of the profession'. The theme identified is 'being ahead in ideas about caring but still partly caught up in the past'. KEY CONCLUSIONS AND IMPLICATIONS: the identified theme of being ahead in ideas about caring but still partly caught up in the past can be understood as representing a transition. The midwives experienced loss and grief over their former midwifery practice, but had ideas and visions for developing and expanding their future professional role. A healthy transition requires support, participation and skilled management.

  • 26.
    Lindberg, Inger
    et al.
    Luleå University of Technology.
    Ohrling, Kerstin
    Luleå University of Technology.
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Karolinska Institutet, Stockholm, Sweden .
    Expectations of post-partum care among pregnant women living in the north of Sweden2008Inngår i: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 67, nr 5, s. 472-483Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: To describe expectations of post-partum care among pregnant women living in the north of Sweden and whether personality determines preference for care systems. The time for post-partum care on maternity wards has been reduced in Western countries. This, along with the reduction in special medical treatments offered and the closure of small hospitals has affected pregnant women and their families. STUDY DESIGN: Data was extracted from a questionnaire and a personality instrument (SSP) that were completed during November 2002. METHODS: In the northernmost county of Sweden, 140 pregnant women completed the questionnaire; of these, 120 completed the SSP instrument. RESULTS: Of the women who participated, 61.3% wanted to be discharged 72 hours after childbirth, irrespective of the distance between the hospital and home. To have access to maternity ward staff and the decision to be discharged were described as being the most important issues in maternity ward care. The infant's father was expected to be the most important person in the post-partum period. CONCLUSIONS: Women ranked the opportunity to decide for themselves when to be discharged from the maternity ward as important, which can be interpreted as a strong signal that the women want to be in control of the care they receive. Midwives have to focus more on the woman and her family's individual needs, and to include the father as a person who also needs support and to provide resources for him.

  • 27.
    Lindgren, Helena E
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Hildingsson, Ingegerd M
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Rådestad, Ingela J
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Transfers in planned home births related to midwife availability and continuity: a nationwide population-based study.2008Inngår i: Birth, ISSN 0730-7659, E-ISSN 1523-536X, Vol. 35, nr 1, s. 9-15Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Planning a home birth does not necessarily mean that the birth will take place successfully at home. The object of this study was to describe reasons and risk factors for transfer to hospital during or shortly after a planned home birth. METHODS: A nationwide study including all women who had given birth at home in Sweden between January 1, 1992, and July 31, 2005. A total of 735 women had given birth to 1,038 children. One questionnaire for each planned home birth was sent to the women. Of the 1,038 questionnaires, 1,025 were returned. Reasons for transfer and obstetric, socioeconomic, and care-related risk factors for being transferred were measured using logistic regression. RESULTS: Women were transferred in 12.5 percent of the planned home births. Transfers were more common among primiparas compared with multiparas (relative risk [RR] 2.5; 95% CI 1.8-3.5). Failure to progress and unavailability of the chosen midwife at the onset of labor were the reasons for 46 and 14 percent of transfers, respectively. For primiparas, the risk was four times greater if a midwife other than the one who carried out the prenatal checkups assisted at the birth (RR 4.4; 95% CI 2.1-9.5). A pregnancy exceeding 42 weeks increased the risk of transfer for both primiparas (RR 3.0; 95% CI 1.1-9.4) and multiparas (RR 3.4; 95% CI 1.3-9.0). CONCLUSIONS: The most common reasons for transfer to hospital during or shortly after delivery were failure to progress followed by the midwife's unavailability at the onset of labor. Primiparas whose midwife for checkups during pregnancy was different from the one who assisted at the home birth were at increased risk of being transferred.

  • 28.
    Lindgren, Helena E
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Karolinska Institutet.
    Rådestad, Ingela J
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Christensson, Kyllike
    Karolinska Institutet; Stockholm, Sweden.
    Hildingsson, Ingegerd M
    Mid Sweden University.
    Outcome of planned home births compared to hospital births in Sweden between 1992 and 2004. A population-based register study.2008Inngår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 87, nr 7, s. 751-759Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: The aim of this population-based study was to measure the risk of adverse outcome for mother and child in planned home births in a Swedish population irrespective of where the birth actually occurred, at home or in hospital after transfer. DESIGN: A population-based study using data from the Swedish Medical Birth Register. SETTING: Sweden 1992-2004. PARTICIPANTS: A total of 897 planned home births were compared with a randomly selected group of 11,341 planned hospital births. MAIN OUTCOME MEASURES: Prevalence of mortality and morbidity among mothers and children, emergency conditions, instrumental and operative delivery and perineal lacerations were compared. RESULTS: During this period in Sweden the neonatal mortality rate was 2.2 per thousand in the home birth group and 0.7 in the hospital group (RR 3.6, 95% CI 0.2-14.7). No cases of emergency complications were found in the home birth group. The risk of having a sphincter rupture was lower in the planned home birth group (RR 0.2, 95% CI 0.0-0.7). The risk of having a cesarean section (RR 0.4, 95% CI 0.2-0.7) or instrumental delivery (RR 0.3, 95% CI 0.2-0.5) was significantly lower in the planned home birth group. CONCLUSION: In Sweden, between 1992 and 2004, the intrapartum and neonatal mortality in planned home births was 2.2 per thousand. The proportion is higher compared to hospital births but no statistically significant difference was found. Women in the home birth group more often experienced a spontaneous birth without medical intervention and were less likely to sustain pelvic floor injuries.

  • 29.
    Lindgren, Helena E
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Rådestad, Ingela J
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Wally-Byström, Kristina
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Hildingsson, Ingegerd M
    Karolinska Institutet.
    Perceptions of risk and risk management among 735 women who opted for a home birth2010Inngår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 26, nr 10, s. 163-172Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: home birth is not included in the Swedish health-care system and the rate for planned home births is less than one in a thousand. The aim of this study was to describe women's perceptions of risk related to childbirth and the strategies for managing these perceived risks. DESIGN AND SETTING: a nationwide study including all women who had given birth at home in Sweden was conducted between 1 January 1992 and 31 July 2005. PARTICIPANTS: a total of 735 women had given birth to 1038 children. Of the 1038 questionnaires sent to the women, 1025 (99%) were returned. MEASUREMENTS: two open questions regarding risk related to childbirth and two questions answered using a scale were investigated by content analysis. FINDINGS: regarding perceived risks about hospital birth, three categories, all related to loss of autonomy, were identified: (1) being in the hands of strangers; (2) being in the hands of routines and unnecessary interventions; and (3) being in the hands of structural conditions. Perceived risks related to a home birth were associated with a sense of being beyond help: (1) worst-case scenario; and (2) distance to the hospital. The perceived risks were managed by using extrovert activities and introvert behaviour, and by avoiding discussions concerning risks with health-care professionals. CONCLUSION: women who plan for a home birth in Sweden do consider risks related to childbirth but they avoid talking about the risks with health-care professionals. IMPLICATIONS FOR PRACTICE: to understand why women choose to give birth at home, health-care professionals must learn about the perceived beneficial effect of doing so.

  • 30.
    Lugina, Helen I
    et al.
    School of Nursing, Muhimbili Univ. Coll. of Hlth. Sci., Dar es Salaam, Tanzania .
    Nyström, Lennarth
    Umeå University, Umeå, Sweden .
    Christensson, Kyllike
    Karolinska Institute, Stockholm, Sweden.
    Lindmark, Gunilla
    Uppsala University, Uppsala, Sweden.
    Assessing mothers' concerns in the postpartum period: methodological issues.2004Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 48, nr 3, s. 279-290Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: This paper reports a study evaluating the sensitivity of a semi-structured interview schedule and card sort methods in assessing postpartum concerns of women. BACKGROUND: Several methods have been used to assess postpartum maternal concerns and the process of becoming a mother, but few studies have evaluated the methods with respect to their sensitivity for obtaining information. METHOD: A cohort of mothers was followed-up at one (n = 110) and 6 weeks (n = 83) after childbirth in Dar es Salaam, Tanzania. Women with a minimum of 7 years of primary education were interviewed and they also sorted cards. Those with less fewer than 7 years of primary education were interviewed only. The methods were used in alternate order to assess method interaction. RESULTS: In the interviews at 1 week, mothers more often expressed worry and interest related to the baby or themselves when they had sorted cards first. The extent to which women expressed worry and interest about specific baby- and mother-related topics was generally higher for women who had sorted cards before the interview at both 1 and 6 weeks. Independent of whether they were interviewed only, interviewed after sorting cards or before, mothers more often expressed a higher degree of interest than of worry about the baby and self at both 1 and 6 weeks. The order of the data collection methods did not influence the way women sorted cards as being worries and interests. CONCLUSION: Compared to interview using a semi-structured interview schedule, our findings suggest that the card sort is more sensitive in obtaining information about women's concerns. Although the interview method has the advantage of reaching less educated people, the card sort is a technique that is associated with fewer barriers and is a more participatory method for those who can use it.

  • 31.
    Mbekenga, Columba K
    et al.
    School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania .
    Christensson, Kyllike
    Division of Reproductive and Perinatal Health Care, Karolinska Institute, Stockholm, Sweden.
    Lugina, Helen I
    School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
    Olsson, Pia
    Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
    Joy, struggle and support: postpartum experiences of first-time mothers in a Tanzanian suburb2011Inngår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 24, nr 1, s. 24-31Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: To explore and describe postpartum experiences of first-time mothers in a Tanzanian, multiethnic, low-income suburb. METHODS: Individual qualitative interviews with 10 first-time mothers, 4-10 weeks postpartum in Ilala suburb, Dar es Salaam, Tanzania. RESULTS: The first-time mothers enjoyed motherhood and the respectful status it implied. To understand and handle the infant's needs and own bodily changes were important during postpartum. The tradition of abstaining from sex up to 4 years during breastfeeding was a concern as male's faithfulness was questioned and with HIV a threat to family health. Partner relationship changed towards shared parental and household work and the man's active participation was appreciated. Support from family members and others in the neighbourhood were utilised as a resource by the mothers. In instances of uncertainties on how to handle things, their advice was typically followed. The new mothers generally had good experiences of health care during the childbearing period. However, they also experienced insufficiencies in knowledge transfer, disrespectful behaviour, and unofficial fees. KEY CONCLUSIONS AND IMPLICATION FOR PRACTICE: The mothers' perspective of postpartum revealed that they actively searched for ways to attain infants' and own health needs, and family health in general. Prolonged sexual abstinence was considered a risk for the partner having other sexual partners and contracting HIV. The mothers relied heavily on the informal support network, which sometimes meant risking family health due to misinformation and harmful practices. Health care and informal support systems should complement each other to attain adequate support for the families postpartum.

  • 32.
    Mbekenga, Columba K
    et al.
    Muhimbili Univ.
    Lugina, Helen I
    Muhimbili Univ.
    Christensson, Kyllike
    Karolinska Inst.
    Olsson, Pia
    Uppsala Univ.
    Postpartum experiences of first-time fathers in a Tanzanian suburb: A qualitative interview study.2010Inngår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 27, nr 2, s. 174-180Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: to explore postpartum experiences of first-time fathers in a multicultural, low-income, suburban Tanzanian setting. DESIGN, SETTING AND PARTICIPANTS: individual qualitative interviews with ten first-time fathers, four to ten weeks post partum in Ilala suburb, Dar es Salaam, Tanzania. FINDINGS: these first-time fathers enjoyed fatherhood and revealed a sincere concern for the well-being of the mother and infant during the postpartum period. They described themselves as active in mother and infant care and household chores; however, they were limited by breadwinning responsibilities. The families were supported by relatives or laypersons. The mothers' and infants' nutrition had high priority but poverty was an obstacle. Timing of resumption of sex after childbirth was problematic as traditions prescribed abstinence while the woman is breast feeding. The risk of contracting HIV to the family was a concern. Reproductive and child health care often excluded fathers and gave unclear information. CONCLUSION: these new fathers struggled to gain confidence and experience while engaging in family matters during post partum. Changing gender roles in the suburban Tanzanian society in general and their personal experiences of transition to fatherhood both facilitated and made the postpartum period problematic. The health sector does not respond with respect to fathers' concerns for family health and needs for support. RECOMMENDATIONS: these findings call for programmes on gender relations, which are supporting constructive masculinities and facilitate new fathers' active participation and responsibilities in parenting, family health and their relations with their partners. Such programmes should not only target people in childbearing age but also their potential support persons. Health workers should welcome fathers and discuss strategies for good family health during post partum. Counselling couples together could facilitate their support for each other in optimising health post partum.

  • 33.
    Nisell, Margret
    et al.
    Karolinska Institutet.
    Brodin, Ulf
    Karolinska Institutet.
    Christensson, Kyllike
    Karolinska Institutet.
    Rydelius, Per-Anders
    Karolinska Institutet.
    The Imperforate Anus Psychosocial Questionnaire (IAPSQ): its construction and psychometric properties.2009Inngår i: Child and adolescent psychiatry and mental health, ISSN 1753-2000, Vol. 3, nr 1, s. article number: 15-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The origin of the present study was to develop the liaison work between the disciplines of child and adolescent psychiatry and paediatric surgery and nursing, so as to improve the quality of treatment and care of a group of children with imperforate anus (IA) and their families. Imperforate anus is a congenital disease involving a deformity of the anorectum. The early surgery and invasive follow-up treatment associated with IA may affect the child psychosocially, including the child-parent relationship. By developing and testing a questionnaire for children born with anorectal anomalies, a tool for measuring psychosocial functioning can be realized. METHODS: First, a literature review on "Imperforate Anus" was performed. Second, an exploratory interview study was conducted with patients/adolescents with IA and their parents. The findings from these interviews were the foundation for construction of the questionnaire. The Imperforate Anus Psychosocial Questionnaire (IAPSQ) was tested and revised three times before its completion. It contains 45 items on Likert scales. A total of 87 children completed the IAPSQ: 25 children with IA and two comparison groups. Face and content validity were considered. The Rasch approach, an item response theory model, was used to evaluate the psychometric properties of the IAPSQ, where item difficulty and person ability are concurrently approximated. RESULTS: The findings of the Rasch analysis revealed that the psychological dimension was reasonable, and that person reliability (0.83) was moderate and item reliability (0.95) was sufficient. The social dimension showed satisfactory item reliability (0.87). The person reliability (0.52) of the social dimension was weak. Content validity seemed to be established and construct validity was recognized on the psychological dimension. CONCLUSION: The IAPSQ provides a reasonably valid and reliable measure of psychosocial functioning for clinical use among children with IA, although some revisions are suggested for the next version of the IAPSQ. By using the Rasch model, we discovered that specific items should be discarded and other items should be reformulated to make the questionnaire more "on target". The social dimension has to be expanded with further items to reasonably capture a social dimension.

  • 34.
    Nisell, Margret
    et al.
    Karolinska Institutet.
    Igl, Wilmar
    Karolinska Institutet.
    Öjmyr-Joelsson, Maria
    Karolinska Institutet.
    Frenckner, Björn
    Rydelius, Per-Anders
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Karolinska Institutet.
    Social issues among children with high or intermediate imperforate anus: a proxy perspective.2009Inngår i: Journal of child and adolescent psychiatric nursing : official publication of the Association of Child and Adolescent Psychiatric Nurses, Inc, ISSN 1744-6171, Vol. 22, nr 3, s. 132-142Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PROBLEM: Children with imperforate anus (IA) may be psychosocially affected. METHODS: Parents of children with IA and parents in two comparison groups rated their children using a study-specific questionnaire and the Competence Scales in the Child Behavior Checklist (CBCL). Teachers rated Academic and Adaptive Functioning Scales in the Teacher's Report Form (TRF). FINDINGS: School items were rated favorably by the fathers of children with IA, and mothers reported less expression of their children's will. Children with IA were socially competent according to CBCL, although they received lower ratings on the TRF. CONCLUSIONS: Psychosocial issues seem to be challenging for children with IA, and this needs attention in care management.

  • 35.
    Nisell, Margret
    et al.
    Red Cross University College, Sweden.
    Öjmyr-Joelsson, Maria
    Frenckner, Björn
    Rydelius, Per-Anders
    Christensson, Kyllike
    Karolinska Institutet.
    Psychosocial experiences of parents of a child with imperforate anus2009Inngår i: Journal for specialists in pediatric nursing : JSPN, ISSN 1744-6155, Vol. 14, nr 4, s. 221-229Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: This study aims to examine the psychosocial experiences of parents of children with imperforate anus (IA) and to describe their potential positive experiences. DESIGN AND METHODS: Parents of IA children and a comparison group answered a questionnaire, which was analyzed quantitatively and with manifest content analysis. RESULTS: Social relationships and respect for the child's will were more affected among IA mothers. Positive experiences were revealed in relation to the child, the parent, and the family. PRACTICE IMPLICATIONS: Support to parents in caring for a child with IA should be individualized and occasionally undertaken through collaboration with experts from child and adolescent psychiatry.

  • 36.
    Nisell, Margret
    et al.
    Karolinska Institutet, Sweden.
    Öjmyr-Joelsson, Maria
    Karolinska Institutet, Sweden.
    Frenckner, Björn
    Karolinska Institutet, Sweden.
    Rydelius, Per-Anders
    Karolinska Institutet, Sweden.
    Christensson, Kyllike
    Karolinska Institutet, Sweden.
    Views on psychosocial functioning: responses from children with imperforate anus and their parents.2008Inngår i: Journal of Pediatric Health Care, ISSN 0891-5245, E-ISSN 1532-656X, Vol. 22, nr 3, s. 166-174Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    INTRODUCTION: High and intermediate imperforate anus (IA) is a congenital malformation that may entail psychosocial consequences. The objective was to examine disagreement on psychosocial functioning in reports between children with high and intermediate IA and their mothers. METHOD: Twenty-five children with IA and their mothers participated, including two groups for comparison. The responses on 15 psychosocial variables were compared on pair-level, between the mothers and their child, within each group. RESULTS: Statistically significant differences were found on the psychological variables in all groups, for example, feelings of sadness. For responses related to the social variables, few statistical discrepancies were found, except for the items "bullied" and "teased." Two specific discrepancies emerged in responses from children with IA and their mothers, the child's self-confidence and the mothers' thinking about their child's disability. DISCUSSION: It is vital to gather information from both the child and the parents in order to obtain a complete assessment of the child. The course of disagreement can give valuable information for future care, including where to exert extra effort.

  • 37. Ojmyr-Joelsson, Maria
    et al.
    Nisell, Margret
    Frenckner, Björn
    Rydelius, Per-Anders
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Parental experiences: care of children with high and intermediate imperforate anus.2006Inngår i: Clinical Nursing Research, ISSN 1054-7738, E-ISSN 1552-3799, Vol. 15, nr 4, s. 290-305Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In this study parental experiences of care of children with high and intermediate imperforate anus were evaluated. A group of 45 parents of children with high and intermediate imperforate anus and two control groups participated. Data collection with individual questionnaires concerning the child's hospital care, information to the parent and the child, and involvement in the care of the child were performed. Parents of children with imperforate anus reported being less satisfied with the care of their child, and they were less content with information about their child's treatment compared with the control groups. The parents had been extremely involved in the follow-up treatment. Constipation and fecal incontinence are common and involve suffering for the children and their parents. Parents have to be motivated and supportive and have a great deal of patience to be able to put up with caring for these children, and it seems as if health care professionals have underestimated their problems.

  • 38.
    Pettersson, Karen Odberg
    et al.
    Karolinska Institutet, Sweden.
    Christensson, Kyllike
    Karolinska Institutet, Sweden.
    de Freitas, Engracia da Gloria Gomes
    Halmstad University College, Halmstad, Sweden .
    Johansson, Eva
    Midwifery School, Luanda, Angola.
    Adaptation of health care seeking behavior during childbirth: focus group discussions with women living in the suburban areas of Luanda, Angola.2004Inngår i: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 25, nr 3, s. 255-280Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to explore how various factors influenced women's decisions regarding place of confinement in Luanda, Angola. Ten focus group discussions were conducted with pregnant and nonpregnant women residing in suburban areas of Luanda and the data were analyzed using the grounded theory technique. Four patterns of action of the main theme, "the molding of women's care-seeking behavior during childbirth," were identified: (I) the "labor process 'on-course' avoiding pattern"; (II) the "labor process 'off-course' avoiding pattern"; (III) the "labor process 'on-course' approaching pattern"; and (IV) the "labor process 'off-course' approaching pattern." Our findings indicate that personal "courage" and social support empowered women and impacted on their preference for home birth, whereas demand for informal user fees and perceived low quality of care influenced women to avoid institutional care during childbirth, sometimes even in spite of complications. Ability to meet demands for informal user fees and knowledge of childbirth influenced women to seek institutional care. The study highlights the need to improve the quality of available maternal health care addressing the implicit educational, attitudinal, and ethical issues.

  • 39.
    Pettersson, Karen Odberg
    et al.
    Lund University, Sweden; Karolinska Institutet, Sweden.
    Christensson, Kyllike
    Karolinska Institutet, Solna, Sweden .
    de Freitas, Engracia da Gloria Gomes
    Midwifery School, Luanda, Angola.
    Johansson, Eva
    Karolinska Institutet, Sweden.
    Strategies applied by women in coping with ad-hoc demands for unauthorized user fees during pregnancy and childbirth. A focus group study from Angola.2007Inngår i: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 28, nr 3, s. 224-246Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Our aim in this study was to explore women's responses to reported ad-hoc demands for unauthorized user fees during pregnancy and childbirth in Luanda, Angola. Ten focus group discussions were conducted and data were analysed using grounded theory. Women were found to apply six strategies as they "endeavored to cope with demands for unauthorized user fees" (core category): (i) blowing the whistle, (ii) searching for comprehension, (iii) manipulating the system, (iv) bargaining, (v) extending the limits, and (vi) balancing. The system of unauthorized user fees appears to be a symptom of a deeper structural problem, which requires multifaceted and long-term interventions such as insti-tutional reforms and clear policies on accountability and transparency. Better resource availability for the MHC sector is required in order to secure adequate salaries to maternal health care providers. The fact that unethical behavior is unveiled implies that interventions also need to target the national midwifery training.

  • 40.
    Pettersson, Karen Odberg
    et al.
    Halmstad University, Sweden.
    Johansson, Eva
    Karolinska Institutet, Stockholm, Sweden .
    Pelembe, Maria de Fatima M
    Maputo Central Hospital, Maputo, Mozambique.
    Dgedge, Clemencia
    Maputo Central Hospital, Maputo, Mozambique.
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Karolinska Institutet, Stockholm, Sweden .
    Mozambican midwives' views on barriers to quality perinatal care2006Inngår i: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 27, nr 2, s. 145-168Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Our purpose in this study was to explore the midwives' perception of factors obstructing or facilitating their ability to provide quality perinatal care at a central labor ward in Maputo. In-depth interviews were undertaken with 16 midwives and were analyzed according to grounded theory technique. Barriers to provision of quality perinatal care were identified as follows: (i) the unsupportive environment, (ii) nonempowering and limited interaction with women in labor, (iii) a sense of professional inadequacy and inferiority, and (iv) nonappliance of best caring practices. A model based on the midwives' reflections on barriers to quality perinatal care and responses to these were developed. Actions aimed at overcoming the barriers were improvising and identifying areas in need of change. Identified evading actions were holding others accountable and yielding to dysfunction and structural control. In order to improve perinatal care, the midwives need to see themselves as change agents and not as victims of external and internal causal relationships over which they have no influence. It is moreover essential that the midwives chose actions aiming at overcoming barriers to quality perinatal care instead of choosing evading actions, which might jeopardize the health of the unborn and newborn infant. We suggest that local as well as national education programs need to correspond with existing reality, even if they provide knowledge that surpasses the present possibilities in practice. Quality of intrapartum and the immediate newborn care requires a supportive environment, however, which in the context of this study presented such serious obstacles that they need to be addressed on the national level. Structural and administrative changes are difficult to target as these depend on national organization of maternal health care (MHC) services and national health expenditures.

  • 41.
    Skjutar, Åsa
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Müllersdorf, Maria
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Exploring indicators for pain rehabilitation: A Delphi study using a multidisciplinary expert panel2009Inngår i: Musculoskeltal Care, ISSN 1478-2189, Vol. 7, nr 4, s. 227-242Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

     Objective: Lack of referral guidelines can cause delayed or even nonexistent rehabilitation for chronic pain patients. Indicators signalling the need for interventions could counteract this delay for pain rehabilitation and thereby prevent deteriorating patient health. This study aimed to explore the indicators of need for pain rehabilitation using a multidisciplinary expert panel working with pain rehabilitation. 

    Methods: A three-round Delphi study was conducted with a multidisciplinary expert panel (n=23), each representing one pain rehabilitation unit in Sweden. The expert panel produced indicators, which were then ranked using a four-point Likert scale. 

    Results: Twenty multifaceted indicators for pain rehabilitation were identified. A major part concerned patient problems with activity level, catastrophizing, coping, existential problems, fear avoidance, high pain rating, medication, mental health, motivation, no pain relief, pain spread/increase, psychosocial problems combined with activity problems, psychosocial problems, recovery, and reduced physical function. Furthermore, indicators concerned demographic factors, sick leave, situation in primary health care, and work. Finally, tacit knowledge was pointed out as an indicator. The results support previous research but also bring out less quantifiable indicators, such as relying on tacit knowledge while assessing a patient’s need for rehabilitation.

    Conclusion: The indicators for pain rehabilitation were comprehensive, pointing out that needs assessment is complex. Despite reaching consensus on 19 out of 20 indicators, further research is needed to deepen knowledge in this area and to secure a fair assessment of a patient’s need for pain rehabilitation.

     

  • 42.
    Skjutar, Åsa
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Schult, Marie-Louise
    Karolinska Institutet, Stockholm, Sweden.
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Müllersdorf, Maria
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Indicators of need for occupational therapy in patients with chronic pain: occupational therapists' focus groups.2010Inngår i: Occupational therapy international, ISSN 0966-7903, Vol. 17, nr 2, s. 93-103Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study explores occupational therapists' (OT) perceptions of indicators for occupational therapy interventions among patients with chronic pain. An exploratory design was applied to six focus groups of OTs (n = 25) for data collection. Analysis was performed using content analysis through identification of meaning units, codes, categories and themes. Limitations of occupational performance was a major theme that included participant restrictions caused by physical, emotional and environmental barriers. Five subthemes of need were identified: 1) pain behaviour that prevented engagement in activities; 2) lack of knowledge about pain mechanisms and strategies to deal with pain; 3) occupational imbalance in work, leisure and home; 4) emotional stress and depression due to pain; and 5) physical or environmental strain resulting in limitations in occupational performance. Because of the variety and the diverse trends of approaches towards interventions for patients with chronic pain that exist in different cultures and settings, this study should be replicated in other contexts to increase the transferability of the findings. Copyright (c) 2009 John Wiley & Sons, Ltd.

  • 43.
    Söderberg, Malin
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Lundgren, Ingela
    Göteborgs Univ.
    Olsson, Pia
    Uppsala Univ.
    Christensson, Kyllike
    Karolinska Inst.
    A Burden and a Blessing - Young Swedish Women's Experience of Fertility. A Study Among Women Lacking Experience of Pregnancy and Parenthood2011Inngår i: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 32, nr 5, s. 402-419Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    We used, phenomenological method to describe fertility as it was experienced by young women who have chosen to take contraceptive pills. The women lacked experience from pregnancy and parenthood. We interviewed ten women aged 23-27 years. We found that fertility was experienced as paradoxical, as follows: fertility as a power that has to be suppressed, experiencing fertility in the present time and as a future finite possibility, and having one's own fertile responsibility governed by society. Striving for a perfect life was a central aspect of fertility. Expectations on female fertility seem to influence young women's planning in life.

  • 44.
    Söderbäck, Maja
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Care of hospitalized children in Mozambique: nurses' beliefs and practice regarding family involvement2007Inngår i: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 11, nr 1, s. 53-69Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study aims to describe nurses' beliefs and practice regarding family involvement in the care of hospitalized children in Mozambique. Ethnographic fieldwork was used. The data production consisted of field descriptions from observations and interviews with 36 nurses. Through qualitative content analysis the findings show that nurses' practice of family involvement reflects a society that is poor, hierarchical, family-oriented but at the same time still adaptive. Four themes are identified: family members' presence in order to assist the nurses in care; nurses' support and education of family members to be involved in care; nurses' shielding of family members from family involvement; difficulties and conditional dilemmas in the nurses' involvement of families. It is concluded that emphasizing culturally congruent nursing care is necessary if families' way of life is to be accommodated. However, to empower family involvement in everyday practice, the Mozambican nurses themselves need to be empowered.

  • 45.
    Söderbäck, Maja
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Family involvement in the care of a hospitalised child: a questionnaire survey of Mozambican family caregivers.2008Inngår i: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 45, nr 12, s. 1778-1788Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Previous research from Western and Eastern countries shows that parents of a sick child want to be involved and to participate during a child's hospitalisation. However, the stay can be stressful and parents have their own needs. Conditions and cultural constructs are different among countries. No published study on parents' or close family caregivers' involvement and participation during paediatric hospitalization has been found for an African population. OBJECTIVE: The aim of this study was to articulate Mozambican family caregivers' expressed needs, expectations and experiences of hospital care and hospital staff. SETTING AND PARTICIPANTS: The study was conducted at the Paediatric Clinic at the Central Hospital in Maputo, Mozambique. A sample of 100 family caregivers was chosen, representing one third of all family caregivers of hospitalised children over a one-month period. DESIGN AND METHOD: A cross-sectional study was conducted, using a questionnaire. RESULTS: Participating Mozambican family caregivers have, for the most part, a low level of education and reduced socio-economic conditions. This made the admission to and the time in hospital hard to cope with, and difficult for them to understand. The study showed that they were badly informed of anything to do with hospitalisation. They needed explanation and support to make the hospital situation less intimidating. Hospital staff's behaviour was to some extent characterised by attentiveness, kindness, and sympathy, but it was also shown that the family caregivers had experiences of communication difficulties and of being neglected. CONCLUSION: The result, in this Sub-Saharan African context, shows that parents or family caregivers have a desire to be involved in the care of their hospitalised child, much the same as has been shown in studies in Western and Eastern countries. But Mozambican family caregivers' expectations, needs and experiences are rooted not only in poverty, their household situation and the health system, but also in the hierarchical construct of their culture. All these factors influence their communication and relationships. Hospital staff is perceived to be superior. To empower the family caregivers to take part in the caring process in a cultural sensitive way is therefore of great importance.

  • 46.
    Söderbäck, Maja
    et al.
    Mälardalens högskola, Institutionen för vård- och folkhälsovetenskap.
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Mozambican Nurses’ Beliefs and Practice regarding Family Involvement in Hospital Care.2007Inngår i: Royal college of Nursing of the United Kingdom Research Society: The 2007 International Nursing Research Conference, 2007Konferansepaper (Fagfellevurdert)
    Abstract [en]

    This study describes nurses’ beliefs and practice regarding family involvement in the care of hospitalised children in Mozambique. Cultural circumstances influence nurses’ everyday practice that is shaped by community culture, organisational hospital culture, nursing culture with a personal view of generic care captured by traditions in families and a professional view of care learned through nursing training. Influences of the institutional culture of a workplace and values inherent in medical science complicate relations in health care settings. The social understanding within a specific workplace with its special characteristics implies that staff share beliefs and ideas as ‘common thinking,’ which then influences the way they understand and act in everyday situations. In order to address social-cultural conditions and shared thinking we investigated Mozambican nurses’ beliefs and practice regarding family involvement in the care of hospitalised children. Ethnographic fieldwork was used to explore nurses’ involvement of family members in their everyday work. The data production consisted of field descriptions from observations and interviews with 36 nurses. Qualitative content analysis was used. The findings show that nurses’ practice of family involvement reflects a society that is poor, hierarchical, family-oriented but at the same time still adaptive. Four themes were identified: family members’ presence in order to assist the nurses in the caring, nurses’ support and education of family members to be involved in the caring, nurses’ shielding of family members from family involvement and difficulties and conditional dilemmas in the nurses’ involvement of families. In conclusion the authors state that emphasising culturally congruent nursing care is necessary if Mozambican families’ way of life is to be accommodated. However, to empower family involvement, the nurses themselves need to be empowered. The desired opportunity for nurses to develop culturally congruent family involvement is also closely connected to community awareness and empowerment of children’s rights.

  • 47.
    Tham, Vibeke
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Christensson, Kyllike
    Karolinska Institutet, Stockholm, Sweden.
    Ryding, Elsa Lena
    Karolinska Institutet, Stockholm, Sweden.
    Sense of coherence and symptoms of post-traumatic stress after emergency caesarean section2007Inngår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 86, nr 9, s. 1090-1096Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: In this study of women who had undergone an emergency caesarean section (EmCS), the aim was to examine the associations between, on the one hand, the new mother's sense of coherence (SOC) and obstetric and demographic variables a few days postpartum, and on the other hand, post-traumatic stress symptoms 3 months' postpartum. METHODS: In a prospective study, 122 Swedish- or English-speaking new mothers completed 2 self-assessment questionnaires, at 2 days and 3 months after an EmCS. To measure SOC, we used the Sense of Coherence Scale (SOC-13), and to measure reactions to traumatic events, the Impact of Event Scale (IES-15). RESULTS: Independent risk factors associated with post-traumatic stress symptoms were: imminent fetal asphyxia as an indication for the operation, and low SOC in the woman. The group of women with low SOC were those with an intense fear of childbirth during pregnancy, immigrants, and socially underprivileged women. CONCLUSIONS: Symptoms of post-traumatic stress following EmCS are associated both with the new mother's personal coping style and with the circumstances of the event. We recommend that women who belong to groups who more often report a low SOC or who had imminent asphyxia as an indication for the operation should be offered support and follow-up.

  • 48.
    Wallén, Eva Flygare
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Karolinska Institutet, Stockholm, Sweden.
    Müllersdorf, Maria
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Karolinska Institutet, Stockholm, Sweden.
    Malm, Gunilla
    Karolinska Institutet, Stockholm, Sweden.
    Ekblom, Orjan
    Karolinska Institutet, Stockholm, Sweden; Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    Marcus, Claude
    Karolinska Institutet, Stockholm, Sweden.
    High prevalence of cardio-metabolic risk factors among adolescents with intellectual disability2009Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 98, nr 5, s. 853-859Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Abstract Adults with intellectual disabilities (IDs) have poor lifestyle-related health compared with the general population. Our aim was to study whether such differences are present already in adolescents. Aim: To compare the prevalence and severity of cardio-metabolic risk factors and cardio-vascular fitness in adolescents with and without IDs. Methods: Intellectual disability (ID) students (n = 66) and non-intellectual disability (non-ID) students from practical (non-ID-p) (n = 34) and theoretical (non-ID-t) (n = 56) programmes were recruited from three upper secondary schools. Anthropometric data, blood pressure, body composition, fasting-insulin, fasting-glucose, fasting-lipids and cardio-vascular fitness were measured. Results: Participants with and without ID differed significantly in the prevalence of cardio-metabolic risk factors with participants with ID having a higher percentage of total fat mass, wider waist circumferences (WCs), lower levels of fat-free mass (FFM), lower bone mineral density (BMD) and higher insulin and homeostasis model assessment of insulin resistance (HOMA) levels and poorer cardio-vascular fitness. The healthiest levels were found in the non-ID-t group compared to the group with ID and the group with non-ID-p in between. Conclusion: The prevalence of cardio-metabolic risk factors and poor cardio-vascular fitness was found to be high in this young population with intellectual disabilities. Measures should be taken to improve the health messages directed towards children and adolescents with intellectual disabilities.

  • 49.
    Wallén, Eva Flygare
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Müllersdorf, Maria
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Christensson, Kyllike
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Marcus, C.
    Karolinska Institutet.
    Eating patterns among students with intellectual disabilities after a multifactorial school intervention using the plate model2013Inngår i: Journal of Policy and Practice in Intellectual Disabilities, ISSN 1741-1122, E-ISSN 1741-1130, Vol. 10, nr 1, s. 45-53Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Adolescents with intellectual disabilities (ID) have an increased prevalence of being overweight and having cardiometabolic diseases as adults, in part due to poor eating habits with an inadequate intake of vegetables. The aim of this study was to evaluate whether a multifactorial school intervention using the "Plate Model" results in improved healthy food choices with recommended ≥37.5% of vegetables. Participants with mild/moderate intellectual disabilities from an intervention school (n=27) were compared with controls (n=62) from two other upper secondary schools for students with ID. All were offered a test buffet lunch with meatballs, potatoes, sauce, and eight different vegetables presented in identical bowls. Their servings and food intake were evaluated from digital images and video films. The majority (88%) of the total group filled their plate with ≥37.5% of vegetables. The mean energy intake did not differ between the groups (576kcal (min 196-max 1444)). The intervention participants had a lower intake of fat (21% (SD 6) vs. 24% (SD 7), p=031), a higher intake of carbohydrates (57% (SD 7) vs. 53% (SD 8), p=035), less plate waste (5 (SD 10) grams vs. 25 (SD 43) grams, p=021), and more participants took only one portion (56% vs. 32%, p=039) compared with the control group. The participants from the intervention school made healthier food choices. In this setting, most adolescents with ID ate a sufficient amount of vegetables.

  • 50.
    Zander, V.
    et al.
    Karolinska Institutet.
    Müllersdorf, Maria
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Christensson, Kyllike
    Karolinska Institutet.
    Eriksson, Henrik
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Struggling for sense of control: Everyday life with chronic pain for women of the Iraqi diaspora in Sweden2013Inngår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 41, nr 8, s. 799-807Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: As dispersed ethnic populations in Swedish society expand, the healthcare system need to adapt rehabilitation services according to their needs. The experiences of trauma and forced resettlement have a continuing impact on health and musculoskeletal pain, as well as the intersecting structures that prerequisite the possibilities in the new country. To understand the specific needs of women from the Iraqi diaspora in Sweden, there is a need to elucidate the effects of pain on their everyday life. Aims: To elucidate everyday life with chronic pain from the perspective of women from the Iraqi diaspora in Sweden. Methods: Qualitative interview study according to Glaser's grounded theory. Results: The results from 11 interviews suggest that pain was associated with dependency on society as well as on family. It resulted in a struggle for sense of control, framed by faith in God, influenced by the healthcare system, and with support from family. The women's testimony of lack of continuity of care, resulting in recollection of lived traumas in every visit, is a vital sign of the unconscious power relations within health care and how representatives from health care, instead of being the ones who help the women forward, become the ones who hold them back. Conclusions: The results show the importance of challenging the normative assumptions embedded in health care and treatment for patients with chronic pain and of including the voice of "others". © 2013 the Nordic Societies of Public Health.

12 1 - 50 of 53
RefereraExporteraLink til resultatlisten
Permanent link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf