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Thernström Blomqvist, YlvaORCID iD iconorcid.org/0000-0001-5955-1278
Publications (10 of 43) Show all publications
Starke, V., Diderholm, B., Heyman, M. & Thernström Blomqvist, Y. (2023). Being parents of extremely preterm children, from a long-term perspective: A qualitative study of parents' experiences. Early Human Development, 183, Article ID 105819.
Open this publication in new window or tab >>Being parents of extremely preterm children, from a long-term perspective: A qualitative study of parents' experiences
2023 (English)In: Early Human Development, ISSN 0378-3782, E-ISSN 1872-6232, Vol. 183, article id 105819Article in journal (Refereed) Published
Abstract [en]

Background

In recent decades, modern neonatal intensive care has improved, increasing the survival of extremely preterm children. Few studies have examined the experiences of parents of extremely preterm children from a long-term perspective.

Aim

To describe parents' experiences of parenting extremely preterm children during their childhood and transition to adulthood.

Study design

A qualitative interview study with a descriptive design.

Subjects

Thirteen parents of eleven children born at 24 gestational weeks in Sweden, 1990–1992, participated in individual semi-structured interviews.

Outcome measures

Data were analyzed using qualitative reflexive thematic analysis.

Result

Five themes forming a timeline were created in the analytic process: parenthood, at the NICU, young childhood, adolescence, and adulthood. Various aspects affecting parenthood were described throughout the timeline, and occasionally the parents experienced difficulties dealing with their children's special physical and/or mental needs. Today, some families have established a functioning situation despite their children's physical and/or mental difficulties, while some still struggle with their children's everyday life.

Conclusion

Having an extremely preterm family member profoundly affects the whole family for various lengths of time. Parents expressed a need for support from both healthcare and school throughout their children's childhood and in their transition to adulthood, although the need varies between parent–child pairs. By studying the parents' experiences, their need for support can be further recognized and understood, and developed and improved accordingly.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Adults born extremely preterm, Extremely preterm children, Neonatal intensive care, Parents' experiences, Parents' perspectives, Qualitative research
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-507570 (URN)10.1016/j.earlhumdev.2023.105819 (DOI)001034532800001 ()37393662 (PubMedID)
Funder
Gillbergska stiftelsenSolstickan Foundation
Available from: 2023-07-08 Created: 2023-07-08 Last updated: 2023-08-18Bibliographically approved
Sjömar, J., Ottesen, H., Banik, G., Rahman, A. E., Thernström Blomqvist, Y., Moshfiqur Rahman, S. & Målqvist, M. (2023). Exploring caregivers' experiences of Kangaroo Mother Care in Bangladesh: A descriptive qualitative study. PLOS ONE, 18(1), Article ID e0280254.
Open this publication in new window or tab >>Exploring caregivers' experiences of Kangaroo Mother Care in Bangladesh: A descriptive qualitative study
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2023 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 1, article id e0280254Article in journal (Refereed) Published
Abstract [en]

Background

Kangaroo Mother Care (KMC) is an evidence-based intervention recommended by the World Health Organization (WHO) to reduce preterm mortality and morbidity. The aim of this study was to explore caregivers’ experiences of providing KMC in hospital settings and after continuation at home in Bangladesh in order to assess enablers and barriers to optimal implementation.

Methods

Interviews with fifteen caregivers were conducted using an interview guide with semi-structured questions in August 2019 and March 2020. Convenience sampling was used to select hospitals and participants for the study. The inclusion criteria were being a caregiver currently performing KMC in the hospital or having been discharged one week earlier from the KMC ward. The interviews were audio recorded, transcribed verbatim, and translated. The data were analyzed using thematic analysis with an inductive approach.

Results

Three themes were identified as regards the caregivers’ experiences of providing KMC: conducive conditions, an empowering process, and suboptimal implementation. The results showed that there are supporting circumstances for caregivers performing KMC in Bangladesh, including social support structures and positive attitudes to the method of care. It also appeared that the caregivers felt strengthened in their roles as caregivers by learning and performing KMC. However, the implementation of KMC was suboptimal due to late initiation of KMC, difficulties with keeping the baby skin-to-skin, and pain after cesarean section hampering skin-to-skin practice.

Conclusions

The social and cultural conditions for the caregivers to perform KMC as well as the empowerment the parents felt in their roles as caregivers when performing KMC are facilitating factors for this method of care. Initial separation and late initiation of KMC, as well as disregard for the mothers’ needs for care and support, were barriers to optimal practice leading to missed opportunities. These facilitators and barriers need to be addressed in order to succeed in scaling up the national KMC program.

Place, publisher, year, edition, pages
Public Library of Science (PLoS), 2023
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-499899 (URN)10.1371/journal.pone.0280254 (DOI)000945400200001 ()36689433 (PubMedID)
Funder
Insamlingsstiftelsen Födelsefonden - Perinatalmedicinska forskningsfonden i UppsalaGillbergska stiftelsen
Note

De två första författarna delar förstaförfattarskapet

Available from: 2023-04-06 Created: 2023-04-06 Last updated: 2024-03-20Bibliographically approved
Ahlqvist-Bjorkroth, S., Thernström Blomqvist, Y., Nyberg, J., Normann, E. & Axelin, A. (2023). Improving NICU staff decision-making with parents in medical rounds: a pilot study of reflective group dialogue intervention. Frontiers in Pediatrics , 11, Article ID 1249345.
Open this publication in new window or tab >>Improving NICU staff decision-making with parents in medical rounds: a pilot study of reflective group dialogue intervention
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2023 (English)In: Frontiers in Pediatrics , E-ISSN 2296-2360, Vol. 11, article id 1249345Article in journal (Refereed) Published
Abstract [en]

Introduction: The communication skills of healthcare professionals play a crucial role in successful shared decision-making with parents in neonatal intensive care. Improving communication skills can be achieved through practice and reflection on personal experiences after authentic interaction events with parents. The process of reflection typically involves three phases: description, reflection, and critical reflection. In this study, our aim was to explore the acceptability of the Reflective Group Dialogue intervention and its effectiveness in supporting the reflective process.

Methods: This qualitative pilot study was conducted in the neonatal intensive care unit at Uppsala University Children's Hospital, Sweden. The sample consisted of nine medical rounds with seven families, five neonatologists, seven registered nurses, and five assistant nurses. Purposive sampling was used to collect the data. The intervention comprised four elements: (1) before the intervention, a recorded presentation on shared decision-making was given to the entire unit staff, (2) an observation of a normal medical round discussion with parents, (3) an interview with parents about their experience after the same round, and (4) a reflective discussion with the participating health care professionals after the round. The parent interviews and reflective discussions were audio-recorded and transcribed verbatim. They were analyzed using thematic analysis as a theoretical strategy.

Results: Both parents and staff widely accepted the intervention and found it beneficial. We identified four discussions that remained in the descriptive phase of the reflection process, four that reached the reflective phase, and one that reached the critical reflection phase. The descriptive discussions were characterized by using a single perspective to reflect, often based on personal opinions. The reflective discussions included analyzing interaction sequences from both staff and parent perspectives and were primarily based on actual observations of communication during medical rounds. The critical discussion led to a new awareness of current practices concerning parental involvement in decision-making. These discussions also utilized "what-if" thinking to evaluate potential new practices and their pros and cons.

Conclusions: The intervention seems promising as it was perceived as beneficial by the recipients and facilitated reflection in most cases. However, to enhance the feasibility of the intervention, some improvements are discussed.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2023
Keywords
family-centered care, parental involvement, communication, reflective practice, medical round
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-514364 (URN)10.3389/fped.2023.1249345 (DOI)001072845300001 ()37772036 (PubMedID)
Available from: 2023-10-24 Created: 2023-10-24 Last updated: 2023-10-24Bibliographically approved
Bäcke, P., Bruschettini, M., Thernström Blomqvist, Y., Sibrecht, G. & Olsson, E. (2023). Interventions for the Management of Pain and Sedation in Newborns Undergoing Therapeutic Hypothermia for Hypoxic-Ischemic Encephalopathy: A Systematic Review. Pediatric Drugs, 25(1), 27-41
Open this publication in new window or tab >>Interventions for the Management of Pain and Sedation in Newborns Undergoing Therapeutic Hypothermia for Hypoxic-Ischemic Encephalopathy: A Systematic Review
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2023 (English)In: Pediatric Drugs, ISSN 1174-5878, E-ISSN 1179-2019, Vol. 25, no 1, p. 27-41Article, review/survey (Refereed) Published
Abstract [en]

Background

Newborn infants undergoing therapeutic hypothermia (TH) are exposed to multiple painful and stressful procedures. The aim of this systematic review was to assess benefits and harms of pharmacological and non-pharmacological interventions for the management of pain and sedation in newborn infants undergoing TH for hypoxic-ischemic encephalopathy.

Methods

We included randomized and observational studies reporting any intervention (either drugs or non-pharmacological interventions) to manage pain and sedation in newborn infants (> 33 weeks' gestational age) undergoing TH. We included any dose, duration and route of administration. We also included any type and duration of non-pharmacological interventions. Our prespecified primary outcomes were analgesia and sedation assessed using validated pain scales in the neonatal population; circulatory instability; mortality to discharge; and neurodevelopmental disability. A systematic literature search was conducted in the PubMed, Embase, CINAHL, Cochrane CENTRAL, Scopus, and Web of Science databases, with no language restrictions. Included studies underwent risk-of-bias assessment (Cochrane risk-of-bias tool and ROBINS-I) and data extraction performed by two authors independently. The plan had been to use effect measures such as mean difference for continuous outcomes and risk ratio for dichotomous outcomes, however the included studies are presented in a narrative synthesis due to their paucity and heterogeneity.

Results

Ten studies involving 3551 infants were included-one trial and nine observational studies. Most studies examined the use of phenobarbital or other antiepileptic drugs with primary outcomes related to seizure activity. The single trial that was included compared pentoxifylline with placebo. Among the primary outcomes, six studies reported circulatory instability and five reported mortality to discharge without relevant differences; two studies reported on neurodevelopmental disability and one study reported on pain scale. Three studies were ongoing.

Conclusions

We found limited evidence to establish the benefits and harms of the interventions for the management of pain and sedation in newborn infants undergoing TH. Long-term outcomes were not reported. Given the very low certainty of evidence-due to imprecision of the estimates, inconsistency and limitations in study design (all nine observational studies with overall serious risk of bias)-for all outcomes, clinical trials are required to determine the most effective interventions in this population.

Systematic Review Registration

PROSPERO registration number: CRD42020205755.

Place, publisher, year, edition, pages
Springer Nature, 2023
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-497515 (URN)10.1007/s40272-022-00546-7 (DOI)000895633200001 ()36481984 (PubMedID)
Funder
Örebro University
Available from: 2023-03-01 Created: 2023-03-01 Last updated: 2023-03-01Bibliographically approved
Norrgrann, M., Hörnfeldt, M., Latheef, F., Thernström Blomqvist, Y., Larsson, A., Paulsson, M. & Diderholm, B. (2023). Lipid Peroxidation and Antioxidative Capacity Are Unaltered in Transitional Breast Milk Exposed to Light from Women Giving Birth to Preterm Infants before 32 Weeks of Gestation. Nutrients, 15(12), Article ID 2818.
Open this publication in new window or tab >>Lipid Peroxidation and Antioxidative Capacity Are Unaltered in Transitional Breast Milk Exposed to Light from Women Giving Birth to Preterm Infants before 32 Weeks of Gestation
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2023 (English)In: Nutrients, E-ISSN 2072-6643, Vol. 15, no 12, article id 2818Article in journal (Refereed) Published
Abstract [en]

Breast milk (BM) is the primary nutrition for infants and has a high content of lipids. Preterm infants receive expressed BM via tube feeding, and they are frequently treated with phototherapy. When parenteral nutrition (PN) is exposed to light and/or phototherapy, lipid peroxidation (LPO) increases. By light-protecting PN, morbidity and mortality are reduced in preterm infants through the reduction of oxidative stress. We aimed to investigate whether light-protecting breast milk could reduce LPO. Twelve mothers giving birth to a preterm infants of less than 32 weeks of gestational age were included. Transitional BM was collected and divided into three study groups; light-protected, ward light and phototherapy light. Baseline samples were collected after expression and the exposures started within one hour. Feeding syringe samples were exposed to light for 30 up to 360 min. Nasogastric tube samples were run through a tube under the same light conditions. Samples were stored in -80 °C until analyses of malondialdehyde (MDA), 4-hydroxynonenal (4-HNE) and total antioxidant capacity (TAC). There were no significant differences in MDA, 4-HNE or TAC levels observed between the different study groups. This study indicates that the light exposure of expressed transitional BM does not affect LPO and the levels of MDA, 4-HNE or TAC.

Place, publisher, year, edition, pages
MDPI, 2023
Keywords
4-hydroxynonenal, enteral nutrition, human breast milk, light protection, lipid peroxidation, malondialdehyde, naso-gastric tube feeding, phototherapy, preterm infants, total antioxidant capacity
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-507422 (URN)10.3390/nu15122818 (DOI)001014786100001 ()37375721 (PubMedID)
Available from: 2023-07-06 Created: 2023-07-06 Last updated: 2023-08-28Bibliographically approved
Karlsson, L., Gustafsson, U., Thernström Blomqvist, Y., Wallström, L. & Brostrom, A. (2023). Neonatal Resuscitation A Critical Incident Technique Study Exploring Pediatric Registered Nurses' Experiences and Actions. Advances in Neonatal Care, 23(3), 220-228
Open this publication in new window or tab >>Neonatal Resuscitation A Critical Incident Technique Study Exploring Pediatric Registered Nurses' Experiences and Actions
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2023 (English)In: Advances in Neonatal Care, ISSN 1536-0903, E-ISSN 1536-0911, Vol. 23, no 3, p. 220-228Article in journal (Refereed) Published
Abstract [en]

Background:Teamwork during neonatal resuscitation is essential. Situations arise quickly and unexpectedly and are highly stressful, requiring pediatric registered nurses (pRN) to respond effectively and in a structured manner. In Sweden, pRNs work in all pediatric settings including the neonatal intensive care unit. The experience and actions of pRNs are seldom explored, and studies within this area could develop and improve strategies for neonatal resuscitation situations.

Purpose:To describe pRNs' experiences and actions during neonatal resuscitation.

Methods:A qualitative interview study based on the critical incident technique was performed. Sixteen pRNs from 4 neonatal intensive care units in Sweden were interviewed.

Results:Critical situations were divided into 306 experiences and 271 actions. pRNs' experiences were divided into 2 categories: individual- and team-focused experiences. Critical situations were managed by individual- or team-focused actions.Experiences revealed were variation of alarms, psychological impact, parental presence, structured working methods, the team's interactions, professional experience and resource availability, and the impact of the environment. Actions revealed were being prepared, managing the psychological impact, adopting a professional attitude toward parents, working in a structured way, and competence/resource reinforcement.

Implications for Practice: Developing a structured role distribution within the neonatal resuscitation program and ensuring clear communication in the team during simulation training and in intense situations can increase pRNs' feeling of safety and allow them to further develop their professional role in neonatal resuscitation situations.

Place, publisher, year, edition, pages
Ovid Technologies (Wolters Kluwer Health), 2023
Keywords
infant, interview, neonatal intensive care, neonatal resuscitation, neonatology, nursing, pediatric nurses qualitative research, teamwork
National Category
Nursing Pediatrics
Identifiers
urn:nbn:se:uu:diva-505225 (URN)10.1097/ANC.0000000000001063 (DOI)000994386700009 ()36905225 (PubMedID)
Available from: 2023-06-26 Created: 2023-06-26 Last updated: 2023-06-26Bibliographically approved
Bäcke, P., Thies-Lagergren, L. & Thernström Blomqvist, Y. (2023). Neonatal resuscitation after birth – Swedish midwives’ experiences of, and perceptions about, separation between mothers and their newborn babies. European Journal of Midwifery, 7, 1-8
Open this publication in new window or tab >>Neonatal resuscitation after birth – Swedish midwives’ experiences of, and perceptions about, separation between mothers and their newborn babies
2023 (English)In: European Journal of Midwifery, E-ISSN 2585-2906, Vol. 7, p. 1-8Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION This study aimed to investigate midwives' experiences of and perceptions about mother-baby separation during resuscitation of the baby following birth. METHODS A qualitative study was conducted using an author-designed questionnaire. Fifty-four midwives from two Swedish birth units with different working methods regarding neonatal resuscitation - at the mother's bedside in the birth room or in a designated resuscitation room outside the birth room - completed the questionnaire. Data were analyzed using qualitative content analysis. RESULTS Most midwives had experience of removing a newborn baby in need of critical care from the birth room, thus separating the mother and baby. The midwives identified the difficulties and challenges involved in carrying out emergency care in the birth room after birth and had divergent opinions about what they considered possible in these birth situations. They agreed on the benefits, for both mother and baby, in performing emergency care in the birth room and avoiding a separation altogether, if possible. CONCLUSIONS There are good opportunities to reduce separation of mother and baby after birth; training, knowledge, education and the right environmental conditions are important factors in successfully implementing new ways of working. It is possible to work towards reducing separation and this work should continue and strive to eliminate separation as far as possible.

Place, publisher, year, edition, pages
European Publishing, 2023
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-507571 (URN)10.18332/ejm/162319 (DOI)001004751000001 ()
Available from: 2023-07-08 Created: 2023-07-08 Last updated: 2023-07-20Bibliographically approved
Arwehed, S., Axelin, A., Björklund, L. J., Thernström Blomqvist, Y., Heiring, C., Jonsson, B., . . . Lehtonen, L. (2023). Nordic survey showed wide variation in discharge practices for very preterm infants. Acta Paediatrica
Open this publication in new window or tab >>Nordic survey showed wide variation in discharge practices for very preterm infants
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2023 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aim

We aimed to describe clinical practices and criteria for discharge of very preterm infants in Nordic neonatal units.

Methods

Medical directors of all 89 level-2 and level-3 units in Denmark, Finland, Iceland, Norway and Sweden were invited by e-mail to complete a web-based multiple-choice survey with the option to make additional free-text comments.

Results

We received responses from 83/89 units (93%). In all responding units, discharge readiness was based mainly on clinical assessment with varying criteria. In addition, 36% used formal tests of cardiorespiratory stability and 59% used criteria related to infant weight or growth. For discharge with feeding tube, parental ability to speak the national language or English was mandatory in 45% of units, with large variation among countries. Post-discharge home visits and video-consultations were provided by 59% and 51%, respectively. In 54% of units, parental preparation for discharge were not initiated until the last two weeks of hospital stay.

Conclusion

Discharge readiness was based mainly on clinical assessment, with criteria varying among units despite similar population characteristics and care structures. This variation indicates a lack of evidence base and may unnecessarily delay discharge; further studies of this matter are needed. Earlier parental preparation and use of interpreters might facilitate earlier discharge.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
early discharge, length of stay, neonatal home care, preterm infant, telemedicine
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-512706 (URN)10.1111/apa.16934 (DOI)001047084900001 ()37540833 (PubMedID)
Available from: 2023-09-28 Created: 2023-09-28 Last updated: 2023-09-28Bibliographically approved
Linnér, A., Thernström Blomqvist, Y., Jonsson, K., Lilliesköld, S. & Norman, M. (2023). Parental Experiences of Neonatal Care: A Nationwide Study on Determinants of Excellence. Neonatology, 1-10
Open this publication in new window or tab >>Parental Experiences of Neonatal Care: A Nationwide Study on Determinants of Excellence
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2023 (English)In: Neonatology, ISSN 1661-7800, E-ISSN 1661-7819, p. 1-10Article in journal (Refereed) Published
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-516765 (URN)10.1159/000533900 (DOI)
Available from: 2023-11-29 Created: 2023-11-29 Last updated: 2023-11-29
Lindgren, E. B., Thernström Blomqvist, Y., Diderholm, B. & Grandahl, M. (2023). To Feel Abandoned in an Insecure Situation Parents' Experiences of Separation From Their Newborn Due to the Mother Being COVID-19 Positive. Advances in Neonatal Care, 23(4), 304-310
Open this publication in new window or tab >>To Feel Abandoned in an Insecure Situation Parents' Experiences of Separation From Their Newborn Due to the Mother Being COVID-19 Positive
2023 (English)In: Advances in Neonatal Care, ISSN 1536-0903, E-ISSN 1536-0911, Vol. 23, no 4, p. 304-310Article in journal (Refereed) Published
Abstract [en]

Background:The COVID-19 pandemic resulted in changes in neonatal care, sometimes resulting in a separation between parents and their newborn. Knowledge about parents' experiences of this separation is limited. Purpose:To explore parents' experiences of separation from their newborn due to COVID-19.

Methods:Interviews with parents (n = 11) separated from their newborn.

Results:The parents' experiences of being separated from their newborn were expressed under 3 themes: "To create a sense of safety in an insecure situation"; "Unexpected start to parenthood"; and "To be reunited." Parents felt abandoned and alone, even if they had support from significant others. Although they considered the separation as undesired, wanting to be with their newborn infant, it was secondary to not wanting to infect the infant with COVID-19. Furthermore, lacking information about a potentially lethal virus adds to the uncertainty that comes with having a newborn. The separation affected the whole family, some for a long time afterward.

Implications for Practice and Research:If a new situation with potentially life-threatening effects, like the COVID-19 pandemic, occurs again, considering the experiences of these parents is paramount. Precautions should be taken to minimize the potential harm. If a separation between newborns and parents is inevitable, parents need preparation and transparent information prior to the separation and before the reunion. Well-thought-out policies must be in place to minimize the impact of a separation on both parties. Parents should be able to have a deputy parent present during an undesired but necessary separation from their newborn.

Place, publisher, year, edition, pages
Ovid Technologies (Wolters Kluwer Health), 2023
Keywords
COVID-19, neonatal intensive care unit, parents, perinatal, separation
National Category
Pediatrics Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-509999 (URN)10.1097/ANC.0000000000001073 (DOI)001039213900006 ()36999904 (PubMedID)
Funder
Swedish Research Council, 19040/19046H.R.H. Crown Princess Lovisa's Association for Child CareGillbergska stiftelsen
Available from: 2023-08-28 Created: 2023-08-28 Last updated: 2023-08-28Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0001-5955-1278

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