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Niemeyer Hultstrand, J., Tydén, T., Målqvist, M., Ekstrand Ragnar, M., Larsson, M. & Jonsson, M. (2020). Foreign-born women’s lifestyle and health before and during early pregnancy in Sweden. European journal of contraception & reproductive health care, 25(1), 20-27
Open this publication in new window or tab >>Foreign-born women’s lifestyle and health before and during early pregnancy in Sweden
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2020 (English)In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 25, no 1, p. 20-27Article in journal (Refereed) Published
Abstract [en]

Objectives: The aims of the study were to investigate foreign-born women’s lifestyle and health before and during early pregnancy and compare them with those of Nordic-born women.

Methods: Women recruited at antenatal clinics in Sweden answered a questionnaire in Swedish, English or Arabic or by telephone interview with an interpreter. Questions covered pregnancy planning and periconceptional lifestyle and health. The responses of women born in or outside Europe were compared with those of Nordic-born women. The impact of religiousness and integration on periconceptional lifestyle and health was also investigated.

Results: Twelve percent of participants (N = 3389) were foreign-born (n = 414). Compared with Nordic women, European and non-European women consumed less alcohol before conception (respectively, adjusted odds ratio [aOR] 0.38; 95% confidence interval [CI] 0.24, 0.58 and aOR 0.14; 95% CI 0.10, 0.19) and during early pregnancy (respectively, aOR 0.61; 95% CI 0.40, 0.91 and aOR 0.20; 95% CI 0.14, 0.29). Non-European women used less tobacco and were less physically active, but body mass index (BMI) did not differ between groups. Self-perceived health, stress and anxiety during early pregnancy did not differ, but non-European women more often had depressive symptoms (aOR 1.67; 95% CI 1.12, 2.51). Non-European women’s healthy lifestyle was associated with religiousness but not with the level of integration.

Conclusions: Non-European women were overall less likely to engage in harmful lifestyle habits before and during early pregnancy but were more likely to suffer from depressive symptoms in comparison with Nordic women.

Keywords
Foreign-born, immigrants, lifestyle, mental health, periconceptional health, preconception health, pregnancy, religiousness
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-404616 (URN)10.1080/13625187.2019.1706078 (DOI)000508862500003 ()31914332 (PubMedID)
Available from: 2020-02-24 Created: 2020-02-24 Last updated: 2020-03-06Bibliographically approved
Höglund, B. & Larsson, M. (2019). Ethical dilemmas and legal aspects in contraceptive counselling for women with intellectual disability: Focus group interviews among midwives in Sweden. JARID: Journal of applied research in intellectual disabilities, 32(6), 1558-1566
Open this publication in new window or tab >>Ethical dilemmas and legal aspects in contraceptive counselling for women with intellectual disability: Focus group interviews among midwives in Sweden
2019 (English)In: JARID: Journal of applied research in intellectual disabilities, ISSN 1360-2322, E-ISSN 1468-3148, Vol. 32, no 6, p. 1558-1566Article in journal (Refereed) Published
Abstract [en]

Background

Few studies have explored ethical and legal issues in contraceptive counselling among women with intellectual disability (ID). This study aimed to gain a deeper understanding of these issues during midwifery contraceptive counselling.

Method

The present authors interviewed 19 midwives in five focus groups in Sweden 2016 – 2017 and analysed data with content analysis.

Results

The participants expressed that women with intellectual disability have equal right to relationships and sexual expressions, but feared exposure to sexual exploitation/abuse. They experienced ethical dilemmas related to principles of fairness and autonomy, but strived to provide assistance in spite of the women's cognitive impairment, presence of supporting persons and uncertainty of optimal counselling. Organizational support was insufficient.

Conclusions

The midwives experienced ambivalence, uncertainty and ethical dilemmas in their counselling. They were, however, aware of legal aspects and strived for the women's best interest, right to self‐determination and autonomous choices. The participants wanted better professional teamwork and support.

Keywords
contraceptive counselling, ethical dilemma, intellectual disability, legal aspects, midwife, woman
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-398816 (URN)10.1111/jar.12651 (DOI)000481245200001 ()31397044 (PubMedID)
Available from: 2019-12-12 Created: 2019-12-12 Last updated: 2019-12-12Bibliographically approved
Jha, P., Larsson, M., Christensson, K. & Skoog Svanberg, A. (2019). Evaluation of the psychometric properties of Hindi-translated Scale for Measuring Maternal Satisfaction among postnatal women in Chhattisgarh, India. PLoS ONE, 14(1), Article ID e0211364.
Open this publication in new window or tab >>Evaluation of the psychometric properties of Hindi-translated Scale for Measuring Maternal Satisfaction among postnatal women in Chhattisgarh, India
2019 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 1, article id e0211364Article in journal (Refereed) Published
Abstract [en]

Satisfaction with childbirth services is a multi-dimensional phenomenon, providing relevant insights into women's opinion on quality of services received. Research studies report a dearth of standardised scales that quantify this phenomenon; and none have been tested in India to the best of authors' knowledge. The current study was undertaken to evaluate psychometric properties of Hindi version of the Turkish Scale for Measuring Maternal Satisfaction: Normal and Caesarean Births versions in order to fill this gap. A cross-sectional survey was conducted in selected public health facilities in Chhattisgarh, India. Healthy women (n = 1004) who gave birth to a single, live neonate, vaginally or via Caesarean section participated. Psychometric assessment was carried out in four steps: 1) scales translated from Turkish to Hindi; 2) Content Validity Index scores calculated for Hindi scales; 3) data collection; 4) statistical analyses for Hindi scales (Normal and Caesarean Birth).

A 10-factor model with 36 items emerged for both scales. The Hindi- translated Normal Birth and Caesarean Birth scales had good internal reliability (Cronbach’s α coefficients of 0.85 and 0.80, respectively).

The Hindi Scales for Measuring Maternal Satisfaction (Normal and Caesarean Birth) are valid and reliable tools for utilization in Indian health facilities. Their multi-dimensional nature presents an opportunity for the care providers and health administrators to incorporate women's opinions in intervention to improve quality of childbirth services. Having an international tool validated within India also provides a platform for comparing cross-country findings.

Place, publisher, year, edition, pages
PUBLIC LIBRARY SCIENCE, 2019
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-377700 (URN)10.1371/journal.pone.0211364 (DOI)000457046400030 ()30695046 (PubMedID)
Funder
Sida - Swedish International Development Cooperation Agency
Available from: 2019-02-25 Created: 2019-02-25 Last updated: 2019-02-25Bibliographically approved
Grandahl, M., Nevéus, T., Dalianis, T., Larsson, M., Tydén, T. & Stenhammar, C. (2019). ‘I also want to be vaccinated!’ – adolescent boys’ awareness and thoughts, perceived benefits, information sources, and intention to be vaccinated against Human papillomavirus (HPV). Human Vaccines & Immunotherapeutics, 15(7-8), 1794-1802
Open this publication in new window or tab >>‘I also want to be vaccinated!’ – adolescent boys’ awareness and thoughts, perceived benefits, information sources, and intention to be vaccinated against Human papillomavirus (HPV)
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2019 (English)In: Human Vaccines & Immunotherapeutics, ISSN 2164-5515, E-ISSN 2164-554X, Vol. 15, no 7-8, p. 1794-1802Article in journal (Refereed) Published
Abstract [en]

This study investigates boys’ awareness and thoughts about human papillomavirus (HPV) and HPV vaccination, perceived benefits of vaccinating men, information sources and intention to be vaccinated against HPV. We used a qualitative approach and interviews were conducted with 31 upper secondary school male students. Two main themes 1) Promotion of equal health and 2) Increased knowledge facilitates the decision about HPV vaccination emerged from the analysis. The informants believed that it was important and fair to protect boys and girls equally against HPV. If HPV vaccination could prevent both girls and boys against an HPV-related disease, there was nothing to question or to discuss. It was not a matter of sex; it was a matter of equal rights. Moreover, an important reason for vaccinating boys was to prevent the transmission of the virus. However, the boys felt unsure and stated that they needed to know more. The school nurse and the school health were considered suitable both for distributing information and for providing the vaccinations.

In conclusion, the participants were in favor of introducing HPV vaccination also for boys in the national vaccination program. Sex-neutral HPV vaccinations were viewed both as a way to stop the virus transmission and a means to promote equal health for the entire population.

Keywords
Awareness, boys, equal health, gender neutral vaccination, health belief model, human
National Category
Public Health, Global Health, Social Medicine and Epidemiology Obstetrics, Gynecology and Reproductive Medicine
Research subject
Pediatrics
Identifiers
urn:nbn:se:uu:diva-371524 (URN)10.1080/21645515.2018.1551670 (DOI)000482271400045 ()30481108 (PubMedID)
Funder
Swedish Cancer Society, 130744
Available from: 2018-12-21 Created: 2018-12-21 Last updated: 2019-10-18Bibliographically approved
Höglund, B. & Larsson, M. (2019). Midwives' work and attitudes towards contraceptive counselling and contraception among women with intellectual disability: focus group interviews in Sweden. European journal of contraception & reproductive health care, 24(1), 39-44
Open this publication in new window or tab >>Midwives' work and attitudes towards contraceptive counselling and contraception among women with intellectual disability: focus group interviews in Sweden
2019 (English)In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 24, no 1, p. 39-44Article in journal (Refereed) Published
Abstract [en]

Objectives: Family planning counselling is an essential part of sexual and reproductive health care; however, health care professionals often fail to offer sexual and reproductive health services to women with intellectual disability (ID), based on a misconception of inactive sexuality. The aims of this study were to gain a deeper understanding of midwives' perceptions of sexual health and contraceptive use of women with ID, and of midwives' practices in providing contraceptive counselling to women with ID.

Methods: Five focus group interviews were conducted with 19 midwives at five antenatal/family planning clinics in central Sweden between December 2016 and February 2017.

Results: The findings are presented in a paradigm model comprising the following components: context, causal conditions for women with ID needing contraception, intervening conditions, action and interaction strategies based on the midwives' approach and performance during the consultation, and finally consequences. Midwives strived to enhance informed choice, whenever possible, and tried to maintain a neutral attitude during counselling. They wanted to provide the most suitable contraceptive method balanced against any risk of long-term use and possible side effects. Midwives raised the need for teamwork and inter-professional support to improve health care, security and access to other related services for women with ID.

Conclusions: Few women with ID request contraceptive counselling, which limits midwives' knowledge, experience and competence. Midwives, therefore, plan consultations carefully and strive to enable women with ID to make informed contraceptive choices. Increased teamwork could be a way to strengthen the role of midwives and thereby improve counselling.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2019
Keywords
Contraceptive counselling, informed choice, intellectual disability, midwife, Sweden
National Category
Obstetrics, Gynecology and Reproductive Medicine Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:uu:diva-381202 (URN)10.1080/13625187.2018.1555640 (DOI)000461893000009 ()30633574 (PubMedID)
Available from: 2019-04-10 Created: 2019-04-10 Last updated: 2019-04-10Bibliographically approved
Sjömark, J., Parling, T., Jonsson, M., Larsson, M. & Skoog Svanberg, A. (2018). A longitudinal, multi-centre, superiority, randomized controlled trial of internet-based cognitive behavioural therapy (iCBT) versus treatment-as-usual (TAU) for negative experiences and posttraumatic stress following childbirth: the JUNO study protocol. BMC Pregnancy and Childbirth, 18, Article ID 387.
Open this publication in new window or tab >>A longitudinal, multi-centre, superiority, randomized controlled trial of internet-based cognitive behavioural therapy (iCBT) versus treatment-as-usual (TAU) for negative experiences and posttraumatic stress following childbirth: the JUNO study protocol
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2018 (English)In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 18, article id 387Article in journal (Refereed) Published
Abstract [en]

Background: About one-third of women report their childbirth as traumatic and up to 10% have severe traumatic stress responses to birth. The prevalence of Posttraumatic stress disorder following childbirth (PTSD FC) is estimated to 3%. Women with PTSD FC report the same symptoms as other patients with PTSD following other types of trauma. The effect of psychological treatment for women with PTSD FC has only been studied in a few trials. Similarly, studies on treatment needs for women not diagnosed as having PTSD FC but who nevertheless face psychological problems are lacking. Methods/design: Women who rate their overall birth experience as negative on a Likert scale, and/or had an immediate caesarean section and/or a major postpartum haemorrhage are randomized to either internet delivered cognitive behaviour therapy (iCBT) plus treatment as usual (TAU) or TAU. The iCBT is to be delivered in two steps. The first step consists of six weekly modules for both the woman and her partner (if they wish to participate) with minimal therapeutic support. Step 2 consists of eight weekly modules with extended therapeutic support and will be offered to participants whom after step 1 report PTSD FC. Assessments will be made at baseline, 6 weeks, 14 weeks, and at follow-ups at 1, 2, 3 and 4 years after baseline. The primary outcome measures are symptoms of posttraumatic stress and depression. Secondary outcomes are quality of life, parent-child bonding, marital satisfaction, coping strategies, experience regarding the quality of care received, health-related quality of life, number of re-visits to the clinic and number of appointments for counselling during the 4 years' period after the negative childbirth experience, time until the woman gets pregnant again, and the type of birth in the subsequent pregnancy. A health economic evaluation in the form of a cost utility analysis will be conducted. Discussion: This study protocol describes a randomized controlled trial that will provide information about the effectiveness of iCBT in women with negative experiences, posttraumatic stress, and PTSD FC.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
Study protocol, iCBT, Immediate caesarean section, Negative birth experience, Postpartum haemorrhage, Posttraumatic stress following childbirth, PTSD following childbirth, PTSD
National Category
Obstetrics, Gynecology and Reproductive Medicine Psychiatry
Identifiers
urn:nbn:se:uu:diva-367411 (URN)10.1186/s12884-018-1988-6 (DOI)000446222700001 ()30285758 (PubMedID)
Funder
Swedish Research Council
Available from: 2018-12-03 Created: 2018-12-03 Last updated: 2018-12-03Bibliographically approved
Janeslätt, G., Larsson, M. & Höglund, B. (2018). An intervention using the preparing for Parenting Toolkit: "Children - what does it involve?" and the Real-Care-Baby simulator among students with ID - a feasibility study. Paper presented at 5th International IASSIDD Europe Congress, 17–20 July, 2018, Athens, Greece.. JARID: Journal of applied research in intellectual disabilities, 31(4), 598-598
Open this publication in new window or tab >>An intervention using the preparing for Parenting Toolkit: "Children - what does it involve?" and the Real-Care-Baby simulator among students with ID - a feasibility study
2018 (English)In: JARID: Journal of applied research in intellectual disabilities, ISSN 1360-2322, E-ISSN 1468-3148, Vol. 31, no 4, p. 598-598Article in journal, Meeting abstract (Other academic) Published
National Category
Other Social Sciences not elsewhere specified Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-366824 (URN)10.1111/jar.12488 (DOI)000435941500398 ()
Conference
5th International IASSIDD Europe Congress, 17–20 July, 2018, Athens, Greece.
Note

Meeting Abstract: 5451

Available from: 2018-11-26 Created: 2018-11-26 Last updated: 2019-10-11Bibliographically approved
Bodin, M., Tydén, T., Käll, L. & Larsson, M. (2018). Can Reproductive Life Plan-based counselling increase men's fertility awareness?. Upsala Journal of Medical Sciences, 123(4), 255-263
Open this publication in new window or tab >>Can Reproductive Life Plan-based counselling increase men's fertility awareness?
2018 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 123, no 4, p. 255-263Article in journal (Refereed) Published
Abstract [en]

Background: Many men have limited knowledge about reproductive health and fertility. The aim of the study was to evaluate if Reproductive Life Plan (RLP)-based counselling during a sexual health visit could increase men’s fertility awareness.

Material and methods: The study was a randomized controlled trial including 201 men aged 18–50 who visited either of two participating sexual health clinics in Sweden for sexually transmitted infection testing during 2014–2016. All men received standard care, and men in the intervention group (IG) also received oral and written RLP-based information about lifestyle and fertility. Awareness about fertility and lifestyle-related factors were the main outcomes, measured through a questionnaire before the intervention and through a telephone survey after three months. Impressions from the counselling were also assessed at follow-up.

Results: A majority (71%) of men wanted children in the future. General fertility awareness increased from a mean score of 4.6 to 5.5 out of 12 (P = 0.004) in the IG. The mean number of accurate lifestyle factors (that could affect fertility) mentioned increased from 3.6 to 4.4 (P < 0.001) in the IG. There were no improvements in the control group. Among the men in the IG, 76% had a positive experience of the counselling, and 77% had received new information.

Conclusion: The intervention managed to increase different aspects of men’s fertility awareness. In the future, the format for preconception care for men needs further development. Including men in preconception health policy guidelines and identifying suitable actors for care provision would be important first steps.

Keywords
Counselling, fertility awareness, lifestyle, men, preconception care, reproduction
National Category
Obstetrics, Gynecology and Reproductive Medicine Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-347734 (URN)10.1080/03009734.2018.1541948 (DOI)000455891100001 ()30541376 (PubMedID)
Available from: 2018-04-06 Created: 2018-04-06 Last updated: 2019-03-01Bibliographically approved
Ekstrand Ragnar, M., Hultstrand, J. N., Tydén, T. & Larsson, M. (2018). Development of an evidence-based website on Preconception health. Upsala Journal of Medical Sciences, 123(2), 116-122
Open this publication in new window or tab >>Development of an evidence-based website on Preconception health
2018 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 123, no 2, p. 116-122Article in journal (Refereed) Published
Abstract [en]

Introduction: Many women and men lack knowledge about fertility, including timing of the fertile window, age-related decline, and lifestyle factors that may impair fertility. The Internet has become an important source of information, but evidence-based information on fertility and reproduction in Swedish on the Internet is limited. The present study aimed to develop and evaluate an evidence-based fertility awareness website, 'reproduktivlivsplan.se', to increase awareness of fertility and provide guidance for improved preconception health and care among individuals and healthcare providers. Methods: The website's content, design, and layout were evaluated qualitatively among a total of 20 nursing students. An expert group of researchers also provided feedback on the content. Finally, healthcare providers (n = 24) answered a questionnaire covering attitudes and views on the Reproductive Life Plan website as a tool for counselling. Results: The developing process resulted in a mobile-friendly website, 'reproduktivlivsplan.se' (in English: Reproductive Life Plan). The website, including the content and layout, was positively evaluated by most participants and was amended according to suggested improvements. Uppsala University was found to be a trustworthy source. Conclusion: The evidence-based website 'reproduktivlivsplan.se' was well received among users and healthcare providers and may provide guidance for improved preconception health and care if it becomes well known and frequently used.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2018
Keywords
Fertility awareness, health behaviour, internet-based information, preconception health, reproductive life plan
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-360561 (URN)10.1080/03009734.2018.1476423 (DOI)000438159000007 ()29909720 (PubMedID)
Available from: 2018-09-14 Created: 2018-09-14 Last updated: 2018-09-14Bibliographically approved
Akhter, T., Wikström, G., Larsson, M., Bondesson, U., Hedeland, M. & Naessén, T. (2018). Dimethylarginines correlate to common carotid artery wall layer dimensions and cardiovascular risk factors in pregnant women with and without preeclampsia. Paper presented at 86th Congress of the European-Atherosclerosis-Society (EAS), MAY 05-08, 2018, Lisbon, PORTUGAL. Atherosclerosis, 275, E69-E70
Open this publication in new window or tab >>Dimethylarginines correlate to common carotid artery wall layer dimensions and cardiovascular risk factors in pregnant women with and without preeclampsia
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2018 (English)In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 275, p. E69-E70Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
ELSEVIER IRELAND LTD, 2018
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-367146 (URN)10.1016/j.atherosclerosis.2018.06.192 (DOI)000442512600206 ()
Conference
86th Congress of the European-Atherosclerosis-Society (EAS), MAY 05-08, 2018, Lisbon, PORTUGAL
Available from: 2018-11-28 Created: 2018-11-28 Last updated: 2018-11-28Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-8050-621x

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