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  • 1.
    Aarts, Clara
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Greiner, Ted
    Regarding the review article by Erlanson-Albertsson and Zetterström, Acta Paediatr 2005;94:1523-312006In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 95, no 5, p. 623-624Article in journal (Refereed)
  • 2.
    Aarts, Clara
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Holm, Marta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Barnhälsoteam: ett exempel på framgångsfaktorer för god samverkan kring förebyggande arbete för barn2010In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 87, no 4, p. 274-281Article in journal (Refereed)
  • 3.
    Aarts, Clara
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Kylberg, Elisabeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Hofvander, Yngve
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Gebre-Medhin, Meharigm
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Growth under privileged conditions of healthy Swedish infants exclusively breastfed from birth to 4-6 months:  a longitudinal prospective study based on daily records of feeding2003In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 92, no 2, p. 145-151Article in journal (Refereed)
    Abstract [en]

    Aim:

    In most studies the methodology used to study growth in relation to breastfeeding patterns cannot ensure that exclusive breastfeeding has in fact occurred since birth. The aim of this study was to investigate the growth of healthy infants in Sweden in whom exclusive breastfeeding for the first 4–6 mo was ascertained through daily feeding records and to compare the results with the World Health Organization (WHO) “12-month breastfed pooled data set” and the Euro-Growth references for exclusively breastfed infants, as well as with the National Center for Health Statistics (NCHS)/WHO reference.

    Methods:

    147 exclusively breastfed infants and 325 non-exclusively breastfed Swedish infants, with a birthweight of ≥3 kg, were included. The mothers had previous breastfed at least one infant for at least 4 mo. Weight was recorded fortnightly and length monthly.

    Results:

    Infants exclusively breastfed since birth showed similar growth in weight and height to that of the non-exclusively breastfed infants. During the first 6 mo of life the growth of exclusively breastfed infants was also similar to that of the infants regularly receiving formula at 12–16 wk of age, mostly in addition to breast milk. The monthly growth increments were fairly similar to those of the “WHO pooled breastfed data set” and the Euro-Growth references for exclusively breastfed infants.

    Conclusion:

    In an affluent society truly exclusively breastfed infants seem to have the same growth during the first half year of life as non-exclusively breastfed infants with a high breastfeeding rate.

  • 4.
    Aarts, Clara
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Kylberg, Elisabeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Hornell, A
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Hofvander, Yngve
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Gebre-Medhin, Mehari
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Greiner, Ted
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    How exclusive is exclusive breastfeeding? A comparison of data since birth with current status data:  2000In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 29, no 6, p. 1041-1046Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    There is no accepted and widely used indicator for exclusive breastfeeding since birth. Indeed, the difference between 'current status' data on exclusive breastfeeding and data on 'exclusive breastfeeding since birth' is rarely recognized. We used data from a longitudinal study to examine this issue.

    METHODS:

    A descriptive longitudinal, prospective study design was used in which 506 mother-infant pairs were included. The mothers completed daily recordings on infant feeding during the first nine months after birth. A research assistant conducted fortnightly home visits with structured interviews. The resulting data on breastfeeding patterns are presented in two different ways: analysis of 'current status' data based on a single 24-hour recording of infant feeding at 2, 4 and 6 months of age, and analysis of data 'since birth', i.e. data on infant feeding for every day, starting from birth until the ages of 2, 4 and 6 months.

    RESULTS:

    A wide discrepancy between the results obtained from the two analyses was found. The difference in the exclusive breastfeeding rate was over 40 percentage points at both 2 and 4 months of age (92% versus 51% at 2 months and 73% versus 30% at 4 months) and 9 percentage points at 6 months (11% versus 1.8%).

    CONCLUSIONS:

    Current status indicators based on a 24-hour period may be inadequate and even misleading for many purposes. We propose that in many studies an indicator called 'exclusive breastfeeding since birth' could be added.

  • 5.
    Aarts, Clara
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Nordstrom, P. M.
    Koskinen, L.
    Juhansoo, T.
    Mitchell, M. P.
    Marquis, F.
    Chasse, F.
    Critchley, K.
    Campbell, B.
    Hemingway, A.
    Enabling nursing students to focus on the Ottawa Charter and the nurses role in tackling inequalities in health through international exchange2010In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 30, no 5, p. 448-452Article in journal (Refereed)
    Abstract [en]

    Student nurses in a transatlantic exchange program explored the role of registered nurses in five countries' public health systems. The Ottawa Charter provided a framework for students to examine the nurse's responsibilities in public health. Students took practice placements in geographically rural areas on another continent and explored inequalities in health care. If nurses are to understand their role in the health care system then they must be taught the scope of their practice including their role in health promotion, public health practice and community development. For this project nursing instructors developed an assignment relevant to the aims and suitable for students in all five nursing programs. Only three of 48 students offered an assignment which focused on building healthy public policy. Nurse educators need to explore this further to ensure nurses of the future are aware of their role and responsibilities in this area and have skills to work effectively to influence and build healthy policy. The international student exchange supported the students' developing understanding of the breadth of initiatives around the globe where nurses are actively engaged in addressing inequalities of health. Findings from an analysis of their assignments are presented in this evaluative report.

  • 6.
    Akbarin, Morvarid
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Aarts, Clara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Being a close relative of a patient with a left ventricular assist device2013In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 12, no 1, p. 64-68Article in journal (Refereed)
    Abstract [en]

    Background: Every year in Sweden, between five and ten patients receive a mechanical heart pump due to grave heart failure. One such pump is the left ventricle assist device (LVAD). At home they need much support from their family. Aim: To investigate the close relatives' experience of their role in relation to patients with an LVAD. Methods: An exploratory study using unstructured interviews with six close relatives of patients with an LVAD. The interviews consisted of one open question: 'What is it like to be the close relative of a patient with an LVAD?' The interviews were analysed using thematic content analysis. Results: The time before LVAD surgery was described as a time of emotional ups and downs, and compared to 'being on an emotional rollercoaster ride'. The nearest relatives were in shock, felt anxiety and uncertainty, and wished to be near the patient. The time after surgery was described as a period in which they had to 'cope with the new situation.' During this period, the staff was experienced as a resource and the relatives described feelings of gratitude, willpower, and acceptance. The stay at home with a person with an LVAD was described as a 'new orientation phase' with limited freedom and the need for respite care. The interviewees expressed the need for support, especially once the patient was at home. Conclusion: It is important to also offer long-term professional support to the nearest relatives of patients with an LVAD.

  • 7. Critchley, Kim A
    et al.
    Richardson, Eileen
    Aarts, Clara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Campbell, Barbara
    Hemmingway, Ann
    Koskinen, Liisa
    Mitchell, Maureen P
    Nordstrom, Pam
    Student experiences with an international public health exchange project2009In: Nurse educator, ISSN 0363-3624, Vol. 34, no 2, p. 69-74Article in journal (Refereed)
    Abstract [en]

    With growing interconnectivity of healthcare systems worldwide and increased immigration, inappropriate cultural and role assumptions are often seen when cultures clash within a country or when there is practice across country boundaries in times of disaster and during international travel. To increase students' multicultural awareness and work experiences abroad, the authors describe a 7-school, 5-country international student exchange project. The authors also share the students' evaluations of their experiences as they are challenged to erase boundaries and embrace nursing across countries. Participating faculty describe the process, challenges, and keys to success found in creating and living this international project. Students involved in the exchange process evaluate the learning opportunities and challenges and the joy of coming together as newfound colleagues and friends.

  • 8. Hemingway, Ann
    et al.
    Aarts, Clara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Koskinen, Liisa
    Campbell, Barbara
    Chassé, France
    A European Union and Canadian Review of Public Health Nursing Preparation and Practice2013In: Public Health Nursing, ISSN 0737-1209, E-ISSN 1525-1446, Vol. 30, no 1, p. 58-69Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: This study explores the preparation and role of the public health nurse (PHN) across European Union (EU) countries (Finland, Sweden, and the United Kingdom) and Canadian provinces (Alberta, New Brunswick, and Prince Edward Island).

    METHODS: A literature review including relevant peer reviewed articles from 2000 on, in conjunction, with critical debate was undertaken. The results were considered in relation to the three essential areas of PHN practice, outlined in the World Health Organization (Moving on from Munich: A reference guide to the implementation of the declaration on nurses and midwives: A force for health, 2001b) recommendations, family oriented care, public health action, and policy making.

    RESULTS: The major challenge the review revealed across a variety of international education and practice environments was the lack of consistent preparation for and engagement with leadership and policy making in practice.

  • 9.
    Johansson, Katarina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Aarts, Clara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Darj, Elisabeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    First-time parents' experiences of home-based postnatal care in Sweden2010In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 115, no 2, p. 131-137Article in journal (Refereed)
    Abstract [en]

    Aim. To gain a deeper understanding of first-time parents’ experiences of early discharge from hospital after delivery andhome-based postnatal care.Material and methods. The study was comprised of focus group interviews, interviews with couples and with fathers. Twentyoneparents participated. Inclusion criteria: healthy women who have given birth to their first child after a normal pregnancyand delivery, the women’s partners, healthy and full term babies, Swedish-speaking, discharge from the delivery ward within24 hours, resident in the Uppsala community, the parents cohabited at the time of the delivery. The material was analysed byqualitative content analysis.Results. Three themes emerged: The family’s strategy, which describes the family’s expectations of postnatal care and theirexperiences of the real situation. Some are flexible concerning going home early, and others have decided in advance. Selfrelianceand strength, which explores the parents’ feelings of security and uncertainty, freedom and independence, and sharedresponsibility. Breast-feeding is described as the ‘main thing’, an interactive learning process. Professional support in the homesummarizes the parents’ experience of the midwife’s support at home. While conflicting feelings may be revealed during thefirst days, the midwife confirms their new roles as parents. The midwife is seen as a support and adviser to the parents.Conclusion. This study shows that parents welcome home-based postnatal care with professional support from midwives. Weconclude that this care suits healthy families. We think it will be more important in the future to discriminate between healthyfamilies and those in need of hospital care, than to focus on the moment when they leave the hospital, early or late.

  • 10.
    Kerstis, Birgitta
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Aarts, Clara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Tillman, Carin
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Persson, Hanna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Engström, Gabriella
    5Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida, USA.
    Edlund, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Öhrvik, John
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. karolinska Institutet.
    Sylven, Sara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Skalkidou, Alkistis
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Association between parental depressive symptoms and impaired bonding with the infant2016In: Archives of Women's Mental Health, ISSN 1434-1816, E-ISSN 1435-1102, Vol. 19, no 1, p. 87-94Article in journal (Refereed)
    Abstract [en]

    Impaired bonding with the infant is associated with maternal postpartum depression but has not been investigated extensively in fathers. The primary study aim was to evaluate associations between maternal and paternal depressive symptoms and impaired bonding with their infant. A secondary aim was to determine the associations between parents’ marital problems and impaired bonding with the infant. The study is part of a population-based cohort project (UPPSAT) in Uppsala, Sweden. The Edinburgh Postnatal Depression Scale (EPDS) at 6 weeks and 6 months postpartum and the Postpartum Bonding Questionnaire at 6 months postpartum were completed by 727 couples. The prevalence of impaired bonding was highest among couples in which both spouses had depressive symptoms. Impaired bonding was associated with higher EPDS scores in both mothers and fathers, as well as with experiencing a deteriorated marital relationship. The association between maternal and paternal impaired bonding and the mothers’ and fathers’ EPDS scores remained significant even after adjustment for relevant confounding factors. Depressive symptoms at 6 weeks postpartum are associated with impaired bonding with the infant at 6 months postpartum for both mothers and fathers. It is critical to screen for and prevent depressive symptoms in both parents during early parenthood.

  • 11.
    Kerstis, Birgitta
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Berglund, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Engström, Gabriella
    5Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida, USA.
    Edlund, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Sylven, Sara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Aarts, Clara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Depressive symptoms postpartum among parents are associated with marital separation: A Swedish cohort study2014In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, no 7, p. 660-668Article in journal (Refereed)
    Abstract [en]

    Aims: To study whether there is an association between dyadic consensus, depressive symptoms, and parental stress during early parenthood and marital separation 6–8 years after childbirth, among couples in Sweden.

    Methods: At baseline, 393 couples were included. The couples answered three questionnaires, including: Dyadic consensus at 1 week post-partum, depressive symptoms at 3 months post-partum and parental stress at 18 months post-partum. The parents’ addresses were followed up after 6–8 years, to study the marital separation rate.

    Results: We found, 6–8 years after childbirth, that 20% of study couples were separated. Separation was associated with less dyadic consensus (mothers p < 0.001; fathers p < 0.001), depressive symptoms (mothers p = 0.022; fathers p = 0.041) and parental stress (mothers p = 0.002; fathers p = 0.040). The hazard ratio (HR) for marital separation was related to dyadic consensus for fathers (HR 0.51; 95% CI 0.28–0.92), depressive symptoms for mothers (HR 1.69; 95% CI 1.01–2.84) and fathers (HR 1.92; 95% CI 1.12–3.28), and the mother’s parental stress (HR 2.16; 95% CI 1.14–4.07).

    Conclusions: Understanding how dyadic consensus, depressive symptoms and parental stress are associated with marital separation is important for health professionals. It could be useful in developing interventions to provide parents with adequate support during pregnancy and early parenthood. This knowledge is also important for the public. Parents should get support in pregnancy and while bringing up children, which may help prevent marital separation and optimize conditions for the children.

  • 12.
    Kerstis, Birgitta
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Engstrom, Gabriella
    Edlund, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Aarts, Clara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Association between mothers' and fathers' depressive symptoms, sense of coherence and perception of their child's temperament in early parenthood in Sweden2013In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 41, no 3, p. 233-239Article in journal (Refereed)
    Abstract [en]

    Aims: To examine whether there was any association between mothers' and fathers' post-partum depressive symptoms and sense of coherence and perception of their child's temperament. The hypotheses were that parents with depressive symptoms: 1) have more often a poor sense of coherence, and 2) perceive their child's temperament to be more difficult than parents without depressive symptoms. Methods: A total of 401 Swedish-speaking couples, who were the parents of children born through the years 2004-2006 in the northern part of the county of Vastmanland, Sweden, were invited to participate in the study. The parents answered 3 questionnaires including: at inclusion of the study: demographic data (n = 393 couples); at 3 months: the Edinburgh Postnatal Depression Scale and the Sense of Coherence Scale (n = 308 couples); and at 18 months: the Infant Characteristics Questionnaire (n = 272 couples). Results: Depressive symptoms measured at 3 months, were reported by 17.7% of mothers and 8.7% of fathers, and correlated significantly between mothers and fathers within couples (rho = 0.165, p = 0.003). Mothers and fathers with depressive symptoms had a poorer sense of coherence (p < 0.001, p < 0.001) and perceived their child's temperament as more difficult than mothers and fathers without depressive symptoms at 3 (p = 0.028, p < 0.001) and 18 months (p = 0.145, p = 0.012 respectively). Conclusions: Early parenthood has been studied thoroughly in mothers, but few studies have included fathers. Identifying problems in early parenthood could help predict later problems exhibited by the preschool child, which might be prevented by supportive programmes.

  • 13. Koskinen, L.
    et al.
    Campell, A.
    Aarts, Clara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Chassé, F.
    Hemmingway, A.
    Juhansoo, T.
    Mitchell, M.
    Marquis, F.
    Critcley, K.
    Enhancing cultural competence: trans-atlantic experiences of European and Canadian nursing students2009In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 15, no 6, p. 502-509Article in journal (Refereed)
    Abstract [en]

    This paper describes the enhancement of cultural competence through   trans-Atlantic rural community experiences of European and Canadian   nursing students using critical incident technique (CIT) as the   students' reflective writing method. The data generated from 48   students' recordings about 134 critical incidents over a 2-year project   were analysed by qualitative content analysis. Five main learning   categories were identified as: cross-cultural ethical issues; cultural   and social differences; health-care inequalities; population health   concerns; and personal and professional awareness. Four emergent   cultural perspectives for the health sector that became apparent from   the reflections were: health promotion realm; sensitivity to social and   cultural aspects of people's lives; channels between the health sector   and society; cultural language and stories of local people. CIT was   successfully used to foster European and Canadian undergraduate   students' cultural reflections resulting in considerations and   suggestions for future endeavours to enhance cultural competence in   nursing education.

  • 14.
    Larsson, Margareta
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Aldegarmann, Ulrike
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Aarts, Clara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Professional role and identity in a changing society: three paradoxes in Swedish midwives' experiences2009In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 25, no 4, p. 373-381Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: to explore how experienced midwives understand and experience their professional role and identity after the continuing changes that have taken place within their working domain over the last 20-25 years. DESIGN: four focus group interviews with 20 a total of participants in total were conducted and analysed by thematic content analysis. SETTING: one university hospital in mid-Sweden. FINDINGS: two main themes were conceptualised: (1) organisation of and situation at the workplace; and (2) the societal context. Three paradoxes became apparent. The midwives felt that their professional role in childbirth care had decreased in favour of other professionals, but they had a better dialogue with physicians and auxiliary nurses, which led to better teamwork and joint decisions. Secondly, the midwives expressed a strong professional identity on the basis of self-confidence and long experience, but their handcraft skills and clinical experience have become less valued due to increased medical technology and organisational changes that contributed to loss of locus of control. Finally, the midwives described a more humanised childbirth care and better collaboration with women/couples over the last decades. The couples are, however, more knowledgeable and enquiring, and the midwives expressed a fear that professional competency could be set aside. Furthermore, lack of trust in the normal birth process among women also affects midwives and the risk of litigation influences practice. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: the midwives had experienced both positive and negative changes, but generally felt that their role had become more limited and their professional identity challenged by technology, other professionals and contemporary parents. A loss of locus of control may increase the risk of illness and burn-out symptoms, and must be considered by supervisors and managers.

  • 15. Mbwilo, G. S. K.
    et al.
    Smide, Bibbi
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Aarts, Clara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Family perceptions in caring for children and adolescents with mental disabilities: a qualitative study from Tanzania2010In: Tanzania Journal of Health Research, ISSN 1821-6404, Vol. 12, no 2, p. 1-12Article in journal (Refereed)
    Abstract [en]

     

    Observations have shown that the provision of services to children and adolescents withmental disability (CAMDs) is not responding to the needs of this population. This community based study was carried out in Temeke Municipality in Tanzania and aimed to explore factors that influence family perspectives in the provision of care to CAMDs. This is a qualitative study of 52 respondents from 29 families involved in the daily care of CAMDs, chosen through convenient sampling. A semistructured questionnaire was used in the interviews. The text was analysed using thematic content analysis. The results of the study revealed family characteristics; deficient knowledge about mentaldisability (MD); and lack of health care facilities and resources for caring for CAMDs. The communityand families of CAMDs had poor knowledge on MD and appropriate care, and about availability of resources and quality care. Families were not supported in the care of their children. Some children inconsequence did not receive adequate health care. Some suffered from physical problems due to inadequate care; others were being locked in their room during periods when no‐one was able to look after them. These factors were related to socio‐economic characteristics of the families as well as t olacking service facilities. “Patient”‐oriented, community/family‐based health services to support management of chronic or life‐long conditions such as MD are needed. The support of caregivers to children with MDs has to be improved. A well worked‐out strategy would improve health care of CAMDs through provision of guidance and supervision to the families. Community and family/home‐based care in the study area would benefit families of CAMDs.

     

  • 16. Ndoma, Asteria L. M.
    et al.
    Smide, Bibbi
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Aarts, Clara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Preventing IUC infections in Tanzanian patients; nurses´knowledge, clinical practice and patients´views2008In: International Journal of Urological Nursing, ISSN 1749-7701, Vol. 2, no 1, p. 33-41Article in journal (Refereed)
    Abstract [en]

    Nosocomial infections related to indwelling urinary catheters (IUC) are   a worldwide problem. While this is true in areas of the globe where   care facilities are optimal, it is even more the case that in countries   where care conditions are compromised or when practice is lacking a   substantial knowledge base. The primary aim of this study was to   investigate nurses' knowledge and clinical practise regarding care of patients with IUC in preventing nosocomial infections in four hospitals   in Tanzania. Additionally, the study investigated patients' views about   received care relating to the presence of an IUC. Registered and   enrolled nurses (n = 135) working in four hospitals in Dar-es-Salaam   municipality completed a questionnaire about IUC procedures. Four nurse   students performed bedside observations of nurses (n = 127) on the care   for patients with IUC. Sixty patients were interviewed about their   views of the care given in relation to IUC. The nurses' overall   knowledge was good, but there was a discrepancy between knowledge and   clinical practice. Hand washing prior to care for patients with IUC was   poor due to lack of water and soap. Half of the patients experienced   problems; haematuria, offensive smell, pus around the catheter and   swelling of the scrotum in male patients. Patients expressed   frustration regarding the care of IUC. There was a shortage of trained   hospital staff, shortage of beds to the extent that patients had to   share beds and appropriate equipment was not available. Although the   nurses' knowledge in IUC care was relatively good, the nursing care for   patients with IUC in the studied hospitals ought to be improved. This   can be done by developing evidence-based, culturally congruent   guidelines for assurance of quality care. Many of the problems that   were considered to increase the risk of nosocomial infections were   identified as being related to the logistics of the wards and lack of   staff. Therefore, on the strength of these findings, it is recommended   that unnecessary use of IUC should be avoided particularly where weak   infrastructure has been identified.

  • 17.
    Stern, Jenny
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Salih Joelsson, Lana
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Tydén, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Berglund, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Ekstrand, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Hegaard, Hanne
    Aarts, Clara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Rosenblad, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Larsson, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Kristiansson, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Is pregnancy planning associated with background characteristics and pregnancy planning behavior?2016In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 95, no 2, p. 182-189Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Prevalence of planned pregnancies varies between countries but is often measured in a dichotomous manner. The aim of this study was to investigate to what level pregnant women had planned their pregnancies and whether pregnancy planning was associated with background characteristics and pregnancy planning behavior.

    MATERIAL AND METHODS: A cross-sectional study that utilized the baseline measurements from the Swedish Pregnancy Planning (SWEPP) study. Pregnant women (n= 3390) recruited at antenatal clinics answered a questionnaire. Data were analyzed with multinomial logistic regression, Kruskal-Wallis H and χ(2) tests.

    RESULTS: Three out of four pregnancies were very or fairly planned and 12 % fairly or very unplanned. Of women with very unplanned pregnancies, 32 % had considered an induced abortion. Women with planned pregnancies were more likely to have a higher level of education, higher household income, to be currently working ≥50 %, and to have longer relationships than women with unplanned pregnancies. The level of pregnancy planning was associated with planning behavior, such as information seeking and intake of folic acid, but without a reduction in alcohol consumption. One third of all women took folic acid one month prior to conception, 17 % used tobacco daily and 11 % used alcohol weekly three months before conception.

    CONCLUSIONS: A majority rated their pregnancy as very or fairly planned, with socio-economic factors as explanatory variables. The level of pregnancy planning should be queried routinely to enable individualized counselling, especially for women with unplanned pregnancies. Preconception recommendations need to be established and communicated to the public to increase health promoting planning behavior.

  • 18.
    Tydén, Tanja
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Hegaard, H.
    Rigshosp Copenhagen, Copenhagen, Denmark..
    Hedegaard, M.
    Rigshosp Copenhagen, Copenhagen, Denmark..
    Kristiansson, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Stern, Jenny
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Aarts, Clara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Ekstrand, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Larsson, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Berglund, A.
    Natl Ctr Knowledge Mens Violence Women, Uppsala, Sweden..
    Rosenblad, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Pregnancy planning and among women attending antenatal care in Sweden and Denmark2015In: Human Reproduction, ISSN 0268-1161, E-ISSN 1460-2350, Vol. 30, no Suppl. 1, p. 444-444Article in journal (Other academic)
  • 19.
    Tydén, Tanja
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Stern, Jenny
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Berglund, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Larsson, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Rosenblad, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Aarts, Clara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Pregnancy planning in Sweden: a pilot study among 270 women attending antenatal clinics2011In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 90, no 4, p. 408-412Article in journal (Refereed)
    Abstract [en]

    Objective

    Health status and lifestyle before and at the time of conception could affect the health of both mother and child, but there is a lack of knowledge about the degree to which pregnancies are planned. The aim of this pilot study was to investigate whether and how women plan their pregnancies.

    Material and methods

    The main outcome measures were use of timetables, ovulation tests and lifestyle changes. Women (n = 322) visiting four antenatal clinics were asked to fill out a questionnaire (participation rate = 83.9%, n = 270).

    Results

    Three of four pregnancies (n = 202) were very or rather well planned, whereas 4.4% (n = 12) were totally unplanned. During the planning period, 37.1% (n = 100) made up a timetable for getting pregnant, 23% (n = 62) used ovulation tests, 20.7% (n = 56) took folic acid and 10.4% (n = 28) changed alcohol consumption.

    Conclusion

    Although a majority of these women had planned pregnancies, only one in five had taken folic acid during the planning period.

  • 20. Waldenström, U
    et al.
    Aarts, Clara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Duration of breastfeeding and breastfeeding problems in relation to length of postpartum stay: a longitudinal cohort study of a national Swedish sample.2004In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 93, no 5, p. 669-676Article in journal (Refereed)
    Abstract [en]

    Aim

    To investigate the association between length of postpartum stay and duration of breastfeeding and breastfeeding problems, with special focus on early hospital discharge. Methods: Swedish-speaking women were recruited from all antenatal clinics in Sweden during 3 wk evenly spread over 1 y in 1999 to 2000. In total, 3293 women (71% of those who were eligible) consented to participate in the study. Data were collected by questionnaires in early pregnancy, 2 mo and 1 y postpartum, and from the Swedish Medical Birth Register. For the purpose of this study, only data from the 2709 women (82%) who filled in the question about length of stay in the 2-mo questionnaire were analysed. Women were divided into six groups according to length of postpartum stay (day 1: < 24h to day 6: ± 120h). Results: The median duration of any breastfeeding was 7 mo in women discharged on day 1, and 8 mo in women discharged on any of the following days; a non-significant difference (p= 0.66). Besides hospital policies regarding length of stay (residential area) and number of domiciliary visits, early discharge was associated with the following maternal characteristics, which could be divided into three categories: (1) older, multipara, many children; (2) positive experience of the first breastfeeding after birth; (3) low education, economic problems, smoking, lack of support from partner. Late discharge was associated with operative delivery, preterm birth and low infant birthweight. When these factors were controlled for by Cox regression analysis, no statistical differences were found between the six groups in the relative risk of discontinuing to breastfeed. Breastfeeding problems, such as engorgement and mastitis, did not differ, but women discharged on day 6 or later had fewer problems with sore or cracked nipples during the first week and more problems 4–8 wk postpartum.

    Conclusion

    Maternal characteristics may be more important predictors of the duration of breastfeeding than length of stay in hospital after the birth. The effect of domiciliary support needs further research.

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