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  • 1.
    Ahlqvist-Bjorkroth, Sari
    et al.
    Univ Turku, Dept Psychol & Speech Language Pathol, Turku, Finland.;Univ Turku, Dept Clin Med, Turku, Finland..
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning.
    Nyberg, Jenni
    Univ Turku, Dept Psychol & Speech Language Pathol, Turku, Finland..
    Normann, Erik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Axelin, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. Uppsala Univ, Dept Womens & Childrens Hlth, Uppsala, Sweden.;Univ Turku, Dept Nursing Sci, Turku, Finland..
    Improving NICU staff decision-making with parents in medical rounds: a pilot study of reflective group dialogue intervention2023Ingår i: Frontiers in Pediatrics , E-ISSN 2296-2360, Vol. 11, artikel-id 1249345Artikel i tidskrift (Refereegranskat)
    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.

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  • 2.
    Angelhoff, Charlotte
    et al.
    Linkoping Univ, Div Nursing Sci, Dept Social & Welf Studies, Norrkoping, Sweden;Linkoping Univ, Dept Clin & Expt Med, Linkoping, Sweden;Linkoping Univ, Dept Paediat, Linkoping, Sweden.
    Blomqvist, Ylva Thernström
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning.
    Helmer, Charlotte Sahlen
    Linkoping Univ, Div Nursing Sci, Dept Social & Welf Studies, Norrkoping, Sweden;Linkoping Univ, Dept Clin & Expt Med, Linkoping, Sweden;Linkoping Univ, Dept Paediat, Linkoping, Sweden.
    Olsson, Emma
    Orebro Univ, Dept Pediat, Orebro, Sweden;Orebro Univ, Ctr Hlth Care Sci, Orebro, Sweden.
    Shorey, Shefaly
    Natl Univ Singapore, Natl Univ Hlth Syst, Yong Loo Lin Sch Med, Alice Lee Ctr Nursing Studies, Singapore, Singapore.
    Frostell, Anneli
    Linkoping Univ, Div Psychol, Dept Behav Sci & Learning, Linkoping, Sweden.
    Mörelius, Evalotte
    Linkoping Univ, Div Nursing Sci, Dept Social & Welf Studies, Norrkoping, Sweden;Linkoping Univ, Dept Clin & Expt Med, Linkoping, Sweden.
    Effect of skin-to-skin contact on parents' sleep quality, mood, parent-infant interaction and cortisol concentrations in neonatal care units: study protocol of a randomised controlled trial2018Ingår i: BMJ Open, E-ISSN 2044-6055, Vol. 8, nr 7, artikel-id e021606Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Separation after preterm birth is a major stressor for infants and parents. Skin-to-skin contact (SSC) is a method of care suitable to use in the neonatal intensive care unit (NICU) to minimise separation between parents and infants. Less separation leads to increased possibilities for parent-infant interaction, provided that the parents' sleep quality is satisfactory. We aimed to evaluate the effect of continuous SSC on sleep quality and mood in parents of preterm infants born <33 weeks of gestation as well as the quality of parent-infant interaction and salivary cortisol concentrations at the time of discharge.

    Methods and analysis: A randomised intervention study with two arms-intervention versus standard care. Data will be collected from 50 families. Eligible families will be randomly allocated to intervention or standard care when transferred from the intensive care room to the family-room in the NICU. The intervention consists of continuous SSC for four consecutive days and nights in the family-room. Data will be collected every day during the intervention and again at the time of discharge from the hospital. Outcome measures comprise activity tracker (Actigraph); validated self-rated questionnaires concerning sleep, mood and bonding; observed scorings of parental sensitivity and emotional availability and salivary cortisol. Data will be analysed with pairwise, repeated measures, Mann Whitney U-test will be used to compare groups and analysis of variance will be used to adjust for different hospitals and parents' gender.

    Ethics and dissemination: The study is approved by the Regional Research Ethics Board at an appropriate university (2016/89-31). The results will be published in scientific journals. We will also use conferences and social media to disseminate our findings.

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  • 3.
    Arwehed, Sofia
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning.
    Axelin, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, SWEDESD - Centrum för forskning och utbildning om lärande för hållbar utveckling. Department of Nursing Science University of Turku, Turku, Finland.
    Björklund, Lars J.
    Department of Clinical Sciences, Lund, Paediatrics Lund University and Skåne University Hospital Lund Sweden.
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning.
    Heiring, Christian
    Department of Neonatology Copenhagen University Hospital Rigshospitalet Denmark.
    Jonsson, Baldvin
    Department of Women's and Children's Health Karolinska Institute and Karolinska University Hospital Stockholm Sweden.
    Klingenberg, Claus
    Paediatric Research Group, Faculty of Health Sciences UiT‐The Arctic University of Norway Tromsø Norway;Department of Pediatrics and Adolescence Medicine University Hospital of North Norway Tromsø Norway.
    Metsäranta, Marjo
    Department of Pediatrics University of Helsinki and Helsinki University Hospital (HUH) Helsinki Finland.
    Ågren, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning.
    Lehtonen, Liisa
    Department of Paediatrics and Adolescent Medicine Turku University, Hospital and University of Turku Turku Finland.
    Nordic survey showed wide variation in discharge practices for very preterm infants2023Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227Artikel i tidskrift (Refereegranskat)
    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.

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  • 4.
    Axelin, Anna
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, SWEDESD - Centrum för forskning och utbildning om lärande för hållbar utveckling. Department of Nursing Science, University of Turku, Turku, Finland.
    Feeley, Nancy
    Cambell-Yeo, Marsha
    Silnes Tandberg, Bente
    Szczapa, Tomasz
    Wielenga, Joke
    Weis, Janne
    Pavicic Bosnjak, Anita
    Jonsdottir, Rakel B
    George, Kendall
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning. Neonatal Intensive Care Unit, University Children’s Hospital, Uppsala, Sweden.
    Bohlin, Kajsa
    Lehtonen, Liisa
    Symptoms of depression in parents after discharge from NICU associated with family-centred care2022Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 78, nr 6, s. 1676-1687Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: The aim of this study was to examine the potential association of family-centred care as perceived by parents during a NICU stay with parents' depressive symptoms at discharge and at 4 months corrected for infant age.

    DESIGN: A longitudinal, multicentre cohort study was conducted from 2018 to 2020 in 23 NICUs across 15 countries.

    METHODS: Parents (n = 635 mothers, n = 466, fathers) of infants (n = 739) born before 35 weeks of gestation and admitted to the participating NICUs were enrolled to the study during the first weeks of their infants' hospitalizations. They responded to Digi-FCC daily text messages inquiring about their perception of family-centred care provided by NICU staff. In addition, they completed a questionnaire assessing their overall perception of family-centred care at discharge. Parents' depressive symptoms were measured by the Edinburgh Postnatal Depression Scale at discharge and again after discharge when their infants were at 4 months corrected for age.

    RESULTS: The mothers' and the fathers' perceptions of family-centred care were associated with their depressive symptoms at discharge and at 4 months corrected age, controlling for gestational age, multiple birth, parent education and relationship status. Parents' participation in infant care, care-related decisions and emotional support provided to parents by staff explained the variation in the parents' perceptions of family-centred care. The factors facilitating the implementation of family-centred care included unlimited access to the unit for the parents and for their significant others, as well as amenities for parents.

    CONCLUSIONS: Our study shows that family-centred NICU care associates with parents' depressive symptoms after a NICU stay.

    IMPACT: Depression is common in parents of preterm infants. The provision of family-centred care may protect the mental well-being of parents of preterm infants.

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  • 5.
    Baylis, Rebecca
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Ewald, Uwe
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Gradin, Maria
    Hedberg Nyqvist, Kerstin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Rubertsson, Christine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    First-time events between parents and preterm infants are affected by the designs and routines of neonatal intensive care units2014Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, nr 10, s. 1045-1052Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM:

    Early parental bonding with preterm babies is particularly important, and the aim of our study was to explore when parents experienced what they regarded as important events for the first time while their infant was in the neonatal intensive care unit (NICU).

    METHODS:

    The study was part of a longitudinal project on Kangaroo Mother Care at two Swedish university hospitals. The parents of 81 infants completed questionnaires during their infants' hospital stay.

    RESULTS:

    Most parents saw and touched their infants immediately after birth, but only a few could hold them skin to skin or swaddle them. Other important events identified by parents included the first time they performed care giving activities and did so independently, interaction and closeness with the infant, signs of the infant's recovery and integration into the family. The timing of the events depended on the physical design of the NICU, whether parents' could stay with their infant round-the-clock and when they were allowed to provide care under supervision and on their own.

    CONCLUSION:

    The design and routines of the NICU dictated when parents first interacted with their infants. Clinical guidelines that facilitate early contact with preterm babies can help parents to make the transition to their parental role.

  • 6.
    Biskop, Emilia
    et al.
    Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Paulsdotter, Therese
    Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Hellström-Westas, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Ågren, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Parental participation during therapeutic hypothermia for neonatal hypoxicischemic encephalopathy2019Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 20, s. 77-80Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: To examine parental participation in the care of newborn infants receiving therapeutic hypothermia, and to explore the possible impact of in-born vs out-born status, and location of hospital accommodation. Study design: Retrospective, quantitative and descriptive design. Main outcome measures: Infants medical charts were reviewed for defined aspects of parental participation (infant holding, tube feeding, and diaper change), and related to their in-born vs out-born status, and whether the parents were accommodated in the NICU or elsewhere. All infants have been cared for at the University Hospital Neonatal Intensive Care Unit, serving as a regional referral center for hypothermia treatment. This study is a part of a population-based regional cohort of asphyxiated newborn infants (n = 112) that received therapeutic hypothermia in 2007-2015. Results: Parents engaged in holding (60/112, 54%) or tube feeding (59/112, 53%) their infant. Parents of inborn infants (24/112, 21%) were more likely to check the placement of the feeding tube (11/24, 46% vs 15/88, 17%; p < 0.01) and change diapers (9/24, 38% vs 14/88, 16%; p < 0.05) than parents of out-born infants (88/112, 79%). A similar pattern of more extensive involvement was observed for both mothers and fathers who stayed at the neonatal intensive care compared to those accommodated elsewhere (p < 0.05). Conclusions: Active parental participation is feasible at the NICU even during therapeutic hypothermia. Timely postnatal transfer of parents of out-born/transported infants, and the provision of on-site accommodation may influence the quality of parental involvement.

  • 7.
    Biskop Lindgren, Emilia
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrisk och reproduktiv hälsoforskning.
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning.
    Diderholm, Barbro
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning.
    Grandahl, Maria
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrisk och reproduktiv hälsoforskning.
    To Feel Abandoned in an Insecure Situation: Parents' Experiences of Separation From Their Newborn Due to the Mother Being COVID-19 Positive2023Ingår i: Advances in Neonatal Care, ISSN 1536-0903, E-ISSN 1536-0911, Vol. 23, nr 4, s. 304-310Artikel i tidskrift (Refereegranskat)
    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.

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  • 8.
    Blomqvist, Ylva Thernström
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Ewald, Uwe
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Gradin, Maria
    Örebro Medical Centre Hospital, Örebro, Sweden.
    Nyqvist, Kerstin Hedberg
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Rubertsson, Christine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Initiation and extent of skin-to-skin care at two Swedish neonatal intensive care units2013Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 102, nr 1, s. 22-28Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM:

    To describe initiation and extent of parents' application of skin-to-skin care (SSC) with their preterm infants at two Swedish neonatal intensive care units.

    METHODS:

    The duration of SSC was recorded in 104 infants' medical charts during their hospital stay, and the parents answered a questionnaire.

    RESULTS:

    Both parents were involved in the practice of SSC. Three infants experienced SSC directly after birth, 34 within 1 h, 85 within 24 h and the remaining 19 at 24-78 h postbirth. SSC commenced earlier (median age of 50 min) in infants whose first SSC was with their father instead of with their mother (median age of 649 min: p < 0.001). The earlier the SSC was initiated, the longer the infant was cared for skin-to-skin per day during his/her hospital stay (p < 0.001). The median daily duration of SSC was 403 min.

    CONCLUSION:

    Early initiation of SSC had positive impact on the extent of parents' application of SSC. Even though the infants in this study were cared for skin-to-skin to a high extent, there is a potential for extended use of SSC in this type of hospital setting for reducing separation between infants and parents.

  • 9.
    Blomqvist, Ylva Thernström
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Hedberg Nyqvist, Kerstin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Rubertsson, Christine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Funkquist, Eva-Lotta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Parents need support to find ways to optimise their own sleep without seeing their preterm infant's sleeping patterns as a problem2017Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, nr 2, s. 223-228Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: This study described how parents perceived their own sleep, and their infants', during neonatal intensive care unit (NICU) admission and after discharge. It also explored the infants' sleeping location at home.

    METHODS: The study was conducted in the NICUs of two Swedish university hospitals. The parents of 86 infants - 86 mothers and 84 fathers - answered questionnaires during their infants' hospital stay, at discharge and at the infants' corrected ages of two, six and 12 months. The parents' own sleep was explored with the Insomnia Severity Index.

    RESULTS: Mothers reported more severe insomnia than fathers during their infants' hospitalisation, and these higher insomnia severity scores were associated with more severe infant sleep problems at discharge (p = 0.027) and at two months (p = 0.006) and 12 months (p = 0.002) of corrected age. During the study period, 4%-10% of the parents reported severe or very severe infant sleeping problems. The bed-sharing rate was 75% after discharge and about 60% at the corrected age of 12 months.

    CONCLUSION: Maternal insomnia during an infant's hospital stay was associated with later perceptions of sleep problems in their children. Parents need support to find solutions for optimal sleep without seeing their child's sleeping patterns as a problem.

  • 10.
    Blomqvist, Ylva Thernström
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Nyqvist, Kerstin Hedberg
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Swedish mothers' experience of continuous Kangaroo Mother Care2011Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, nr 9-10, s. 1472-1480Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims. To characterise the first infants receiving continuous Kangaroo Mother Care from birth to discharge in a Swedish neonatal intensive care unit and to investigate their mothers' experiences of this model of care. Background.  Admission of a newborn infant to a neonatal intensive care unit commonly implies separation of the new mother from her infant. Kangaroo Mother Care is a model of neonatal care which supports the parental role as primary care-giver and contributes to minimising the separation between the infant and parents. Design. A retrospective survey design. Method. A purposive sample consisting of 23 mother-infant pairs. Relevant infant data were obtained from their medical records. A questionnaire with questions about the infant's care and regarding Kangaroo Mother Care was designed for this study. Results.  The infants were born at a gestational age of 31-41 weeks, birth weight ranging from 1715-3700 g. The mothers of these moderately preterm and ill newborn infants showed good acceptance of the idea of providing their infants with continuous Kangaroo Mother Care during their stay at the neonatal intensive care unit. The mothers' evaluations of this method were predominantly positive. Negative comments concerned lack of information about practical application of the method, and some mothers perceived their infants' care during the night as exhausting. No mother would have preferred not to perform continuous Kangaroo Mother Care or to terminate Kangaroo Mother Care earlier than they did. Conclusions. These mothers accepted this model of care very well, provided that they received the help and support they required. Relevance to clinical practice.  Mothers whose infants are admitted to an neonatal intensive care units in settings similar to the study setting should be offered opportunities to be present and provide Kangaroo Mother Care for their infants, to the extent that they are able and willing to do so and as permitted by the infant's medical condition and care.

  • 11.
    Blomqvist, Ylva Thernström
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Rubertsson, Christine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Nyqvist, Kerstin Hedberg
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Parent-infant skin-to-skin contact: how do parent records compare to nurse records?2011Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, nr 5, s. 773-775Artikel i tidskrift (Refereegranskat)
  • 12.
    Blomqvist, YlvaThernström
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Rubertsson, Christine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Kylberg, Elisabeth
    Jöreskog, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för forskning om funktionshinder.
    Hedberg Nyqvist, Kerstin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Kangaroo Mother Care helps fathers of preterm infants gain confidence in the paternal role2012Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 68, nr 9, s. 1988-1996Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim. 

    This article is a report on a descriptive study of fathers’ experiences of providing their preterm infants with Kangaroo Mother Care.

    Background. 

    During neonatal intensive care, fathers describe the incubator as a barrier and the separation from their infant as stressful. Fathers consider it important to be close to the infant, and performing Kangaroo Mother Care makes them feel an important participant in their infants’ care.

    Method. 

    Individual interviews conducted in 2009 with seven fathers who performed Kangaroo Mother Care were analysed using qualitative content analysis.

    Results. 

    The fathers’ opportunity for being close to their infants facilitated attainment of their paternal role in the neonatal intensive care unit. Kangaroo Mother Care allowed them to feel in control and that they were doing something good for their infant, although the infant’s care could be demanding and stressful. As active agents in their infant’s care, some fathers stayed with the infant during the whole hospital stay, others were at the neonatal intensive care unit all day long. Despite the un-wished-for situation, they adapted to their predicament and spent as much time as possible with their infants.

    Conclusion. 

    Fathers’ opportunities for Kangaroo Mother Care helped them to attain their paternal role and to cope with the unexpected situation. The physical environment and conflicting staff statements influenced their opportunity for, and experience of, caring for their preterm infants.

  • 13.
    Bäcke, Pyrola
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Bruschettini, Matteo
    Lund Univ, Skane Univ Hosp, Dept Clin Sci Lund, Paediat, Lund, Sweden.;Lund Univ, Skane Univ Hosp, Cochrane Sweden, Lund, Sweden..
    Sibrecht, Greta
    Poznan Univ Med Sci, Newborns Infect Dis Dept, Poznan, Poland..
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Olsson, Emma
    Örebro Univ, Fac Med & Hlth, Dept Pediat, Örebro, Sweden.;Örebro Univ, Sch Hlth Sci, Fac Med & Hlth, Örebro, Sweden..
    Pharmacological interventions for pain and sedation management in newborn infants undergoing therapeutic hypothermia2022Ingår i: Cochrane Database of Systematic Reviews, ISSN 1469-493X, E-ISSN 1469-493X, nr 11Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Background

    Newborn infants affected by hypoxic‐ischemic encephalopathy (HIE) undergo therapeutic hypothermia. As this treatment seems to be associated with pain, and intensive and invasive care is needed, pharmacological interventions are often used. Moreover, painful procedures in the newborn period can affect pain responses later in life, impair brain development, and possibly have a long‐term negative impact on neurodevelopment and quality of life.

    Objectives

    To determine the effects of pharmacological interventions for pain and sedation management in newborn infants undergoing therapeutic hypothermia. Primary outcomes were analgesia and sedation, and all‐cause mortality to discharge.

    Search methods

    We searched CENTRAL, PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and the trial register ISRCTN in August 2021. We also checked the reference lists of relevant articles to identify additional studies.

    Selection criteria

    We included randomized controlled trials (RCT), quasi‐RCTs and cluster‐randomized trials comparing drugs used for the management of pain or sedation, or both, during therapeutic hypothermia: any opioids (e.g. morphine, fentanyl), alpha‐2 agonists (e.g. clonidine, dexmedetomidine), N‐Methyl‐D‐aspartate (NMDA) receptor antagonist (e.g. ketamine), other analgesics (e.g. paracetamol), and sedatives (e.g. benzodiazepines such as midazolam) versus another drug, placebo, no intervention, or non‐pharmacological interventions. 

    Primary outcomes were analgesia and sedation, and all‐cause mortality to discharge.

    Data collection and analysis

    Two review authors independently assessed studies identified by the search strategy for inclusion. We planned to use the GRADE approach to assess the certainty of evidence. We planned to assess the methodological quality of included trials using Cochrane Effective Practice and Organisation of Care Group (EPOC) criteria (assessing randomization, blinding, loss to follow‐up, and handling of outcome data). We planned to evaluate treatment effects using a fixed‐effect model with risk ratio (RR) for categorical data and mean, standard deviation (SD), and mean difference (MD) for continuous data. 

    Main results

    We did not find any completed studies for inclusion. Amongst the four excluded studies, topiramate and atropine were used in two and one trial, respectively; one study used dexmedetomidine and was initially reported in 2019 to be a randomized trial. However, it was an observational study (correction in 2021). We identified one ongoing study comparing dexmedetomidine to morphine.

    Authors' conclusions

    We found no studies that met our inclusion criteria and hence there is no evidence to recommend or refute the use of pharmacological interventions for pain and sedation management in newborn infants undergoing therapeutic hypothermia.

    Plain language summary

    Drugs to manage pain and sedation during cooling in newborns following poor brain oxygenation at birth (hypoxic‐ischaemic encephalopathy)

    Review question

    Do drugs save lives, or improve pain and sedation, in newborns who have poor brain oxygenation at birth ('hypoxic‐ischaemic encephalopathy') and who are undergoing cooling?

    Background

    Lack of oxygen at birth may damage the brain of the newborn. Babies with less severe brain damage may make a full recovery or only have mild problems. For other babies with more serious damage, this may lead to death or to problems later in life. For instance, some of these babies develop cerebral palsy, intellectual disabilities, or other problems. We currently only have cooling as an approach to treat this condition. Cooling is achieved by the use of special helmets or, more frequently, of thermal mattresses. Cooling may cause pain, which can also have a long‐term negative impact on development and quality of life. The aim of this review was to assess if drugs can reduce pain, discomfort and mortality.

    Key results

    We have not identified any studies that addressed the review question. We identified four potential studies, but we excluded them due to the type of drug or study design. One study is ongoing. 

    How up to date is this review?

    We searched for studies that were available up to August 2021.

  • 14.
    Bäcke, Pyrola
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden..
    Bruschettini, Matteo
    Lund Univ, Dept Pediat, Lund, Sweden.;Skane Univ Hosp, Cochrane Sweden, Res & Dev, Lund, Sweden..
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden..
    Olsson, Emma
    Örebro Univ, Fac Med & Hlth, Dept Pediat, Örebro, Sweden.;Örebro Univ, Sch Hlth Sci, Fac Med & Hlth, S-70182 Örebro, Sweden..
    Interventions for the management of Pain and Sedation in Newborns undergoing Therapeutic hypothermia for hypoxic-ischemic encephalopathy (IPSNUT): protocol of a systematic review2022Ingår i: Systematic Reviews, E-ISSN 2046-4053, Vol. 11, nr 1, artikel-id 101Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Background: Clinical research has shown that therapeutic hypothermia after neonatal hypoxic-ischemic injury improves survival without disability. There is no consensus regarding pain relief or sedation during therapeutic hypothermia in newborns; however, therapeutic hypothermia seems to be associated with pain and stress, and adequate analgesia and sedation are central to maximize the effect of therapeutic hypothermia. Pain needs to be adequately managed in all patients, especially the newborn infant due to the potential short- and long-term negative effects of inadequately treated pain in this population. Methods: We will perform a systematic review of pharmacological and non-pharmacological interventions for the management of pain and sedation in newborn infants undergoing therapeutic hypothermia for hypoxic-ischemic encephalopathy. We will include randomized, quasi-randomized controlled trials and observational studies. The use of pharmacological or non-pharmacological interventions will be compared to other pharmacological and or non-pharmacological interventions or no intervention/placebo. The primary outcomes for this review will be analgesia and sedation assessed with validated pain scales, circulatory instability, mortality to discharge, and moderate-to-severe neurodevelopmental disability. We will search the following databases: CINAHL, ClinicalTrials.gov, Cochrane Library, Embase, PubMed, Scopus, and Web of Science. Two independent researchers will screen the records for inclusion, extract data using a data extraction form, and assess the risk of bias in the included trials. Discussion: The result of this review will summarize the knowledge regarding the management of pain and sedation in infants treated with therapeutic hypothermia and potentially provide clinicians with guidance on the effective and safe methods.

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  • 15.
    Bäcke, Pyrola
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden..
    Bruschettini, Matteo
    Lund Univ, Dept Pediat, Lund, Sweden.;Cochrane Sweden, Lund, Sweden.;Skane Univ Hosp, Res & Educ, Lund, Sweden..
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden..
    Sibrecht, Greta
    Poznan Univ Med Sci, Newborns Infect Dis Dept, Poznan, Poland..
    Olsson, Emma
    Örebro Univ, Fac Med & Hlth, Dept Pediat, Örebro, Sweden.;Örebro Univ, Fac Med & Hlth, Sch Hlth Sci, S-70182 Örebro, Sweden..
    Interventions for the Management of Pain and Sedation in Newborns Undergoing Therapeutic Hypothermia for Hypoxic-Ischemic Encephalopathy: A Systematic Review2023Ingår i: Pediatric Drugs, ISSN 1174-5878, E-ISSN 1179-2019, Vol. 25, nr 1, s. 27-41Artikel, forskningsöversikt (Refereegranskat)
    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.

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  • 16.
    Bäcke, Pyrola
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. Univ Childrens Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.;Uppsala Univ, Dept Womens & Childrens Hlth, S-75185 Uppsala, Sweden..
    Hjelte, Beatrice
    Univ Childrens Hosp, Neonatal Intens Care Unit, Uppsala, Sweden..
    Hellström-Westas, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning. Univ Childrens Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.;Uppsala Univ, Dept Womens & Childrens Hlth, S-75185 Uppsala, Sweden..
    Ågren, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning. Univ Childrens Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.;Uppsala Univ, Dept Womens & Childrens Hlth, S-75185 Uppsala, Sweden..
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning. Univ Childrens Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.;Uppsala Univ, Dept Womens & Childrens Hlth, S-75185 Uppsala, Sweden..
    When all I wanted was to hold my baby-The experiences of parents of infants who received therapeutic hypothermia2021Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 110, nr 2, s. 480-486Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim The knowledge is limited about how parents experience the time when their infant is receiving therapeutic hypothermia (TH) after severe perinatal asphyxia. The aim of this study was to explore parents' experience of closeness and involvement in their infant's care while in the neonatal intensive care unit (NICU) with their newborn undergoing TH. Methods Face-to-face, semi-structured interviews were conducted with parents (n = 11) whose infants (n = 8, aged 3-5 years at the time of the study) underwent TH at a level III Swedish NICU during 2013-2016. The interviews were analysed using qualitative content analysis. Results All the parents shared the trauma of being both physically and psychologically separated from their infant. They all described a need for information and emotional support, and reported that the NICU staff had influenced the extent to which they as parents had been able to be near and actively participate in the care. Parents described the wish to be closer to their infant and to be more actively involved in their infant's care. Conclusion Strategies to enable parent-infant closeness and active guidance from staff might help alleviate the emotional stress of parents and promote their participation during TH.

  • 17.
    Bäcke, Pyrola
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning. Neonatal Intensive Care Unit, University Hospital, Uppsala, Sweden.
    Thies-Lagergren, Li
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning. Neonatal Intensive Care Unit, University Hospital, Uppsala, Sweden.
    Neonatal resuscitation after birth – Swedish midwives’ experiences of, and perceptions about, separation between mothers and their newborn babies2023Ingår i: European Journal of Midwifery, E-ISSN 2585-2906, Vol. 7, s. 1-8Artikel i tidskrift (Refereegranskat)
    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.

  • 18.
    Gerhardsson, Emma
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Oras, Paola
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning.
    Mattsson, Elisabet
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Hälsovetenskap och e-hälsa.
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning.
    Funkquist, Eva-Lotta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning.
    Health care professionals report positive experience with a breastfeeding training program based on the Baby-Friendly Hospital Initiative for Neonatal Intensive Care2023Ingår i: Journal of Perinatal & Neonatal Nursing, ISSN 0893-2190, E-ISSN 1550-5073, Vol. 29, nr 1, s. 75-80Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Support from health care professionals (HCPs) with good knowledge and positive attitudes toward breastfeeding has been associated with better breastfeeding outcomes in the mothers of preterm infants. The aim of the study was to describe HCPs' experiences of a breastfeeding training program. A total of 48 specialist registered nurses, registered nurses, assistant nurses and physicians working at a neonatal intensive care unit attended a breastfeeding training program and answered a questionnaire including Likert scales and open-ended questions. The participants reported that their interest in breastfeeding had increased as a median (range) of 10 (8–10) on a 10-point scale and rated to what extent they had received new tools for breastfeeding support as a median of 10 (8–10) after training. There were no differences in the median between different professions' ratings. Qualitative content analysis of the open-ended questions resulted in two categories: Discussions of the case scenarios in the group and Knowledge regarding breastfeeding. The results showed that discussions based on breastfeeding scenarios were perceived as valuable; the health care professionals reported receiving new knowledge and useful practical skills. This program was shown to increase health care professionals’ interest in breastfeeding and is useful for different health care professions.

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  • 19.
    Gerhardsson, Emma
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Klinisk psykologi i hälso- och sjukvård.
    Oras, Paola
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning.
    Mattsson, Elisabet
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Klinisk psykologi i hälso- och sjukvård.
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning.
    Funkquist, Eva-Lotta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning.
    Rosenblad, Andreas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk diabetologi och metabolism.
    Developing the Preterm Breastfeeding Attitudes Instrument: a tool for describing attitudes to breastfeeding among health care professionals in neonatal intensive car2021Ingår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 94, artikel-id 102919Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The aim of this study was to develop an instrument that measures health care professionals' (HCPs) attitudes to breastfeeding and skin-to-skin contact in relation to the Baby-Friendly Hospital Initiative for neonatal intensive care.

    Design: The study was part of a larger project aiming to revive the Ten Steps to Successful Breastfeeding for both full-term and preterm infants. The study had a pre-test/post-test design using online questionnaires distributed by email before and after a training programme.

    Setting and participants: A total of 70 specialist registered nurses, registered nurses, assistant nurses and physicians working at a Swedish neonatal intensive care unit answered 55 breastfeeding attitudes questions online before the training. The Preterm Breastfeeding Attitudes Instrument (PreBAI) consists of twelve of these 55 items/questions, selected using exploratory factor analysis.

    Measurements and findings: Higher scores indicated more positive attitudes and the median total PreBAI score was 42 points (out of 48), on both the preand the post-test questionnaires, showing no significant difference. In the pre-test questionnaire, the majority of HCPs (84%) stated that they needed further breastfeeding training. They also stated that they perceived breastfeeding as very important, scoring a median of 10 (range 5-10) points on a 10-point scale. Three separate underlying dimensions were identified in the questionnaire, indicating different attitudes: Facilitating (five items), Regulating (four items), and Breastfeedingand skin-to-skin contact-friendly (three items). A positive correlation was found between how many years the HCPs had worked in neonatal care, and their PreBAI score (r(s) = 0.383, p = 0.001). Those who had previously received extra breastfeeding education scored higher on the instrument.

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  • 20.
    Karlsson, Lina
    et al.
    Cent Hosp Karlstad, Neonatal Intens Care Unit, Karlstad, Sweden.;Jönköping Univ, Sch Hlth & Welf, Dept Nursing Sci, Jönköping, Sweden..
    Gustafsson, Ulrica
    Cent Hosp Karlstad, Neonatal Intens Care Unit, Karlstad, Sweden.;Jönköping Univ, Sch Hlth & Welf, Dept Nursing Sci, Jönköping, Sweden..
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning. Univ Hosp Uppsala, Neonatal Intens Care Unit, Uppsala, Sweden..
    Wallström, Linda
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. Univ Hosp Uppsala, Neonatal Intens Care Unit, Uppsala, Sweden..
    Brostrom, Anders
    Jönköping Univ, Sch Hlth & Welf, Dept Nursing Sci, Jönköping, Sweden.;Linköping Univ Hosp, Dept Clin Neurophysiol, Linköping, Sweden..
    Neonatal Resuscitation A Critical Incident Technique Study Exploring Pediatric Registered Nurses' Experiences and Actions2023Ingår i: Advances in Neonatal Care, ISSN 1536-0903, E-ISSN 1536-0911, Vol. 23, nr 3, s. 220-228Artikel i tidskrift (Refereegranskat)
    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.

  • 21.
    Karlsson, Victoria
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning.
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning.
    Ågren, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning.
    Nursing care of infants born extremely preterm2022Ingår i: Seminars in Fetal & Neonatal Medicine, ISSN 1744-165X, E-ISSN 1878-0946, Vol. 27, nr 3, artikel-id 101369Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    With improving survival at the lowest gestations an increasing number of tiny and vulnerable infants are being cared for, and optimal outcomes require an approach to care that takes their specific characteristics into account. These include immature organ function and a risk for iatrogenic injury, and parental/familial strain due to the high degree of uncertainty, infant-mother separation, and long hospital stay. While the challenges in providing nursing care to these infants are obvious it is also clear that this field has tremendous potential to influence both short and long-term outcomes of this population. This mini-review discusses aspects of the nursing care provided to infants born at the very lowest gestations and their families, with focus on doing less harm by establishing an adequate care environment, actively promoting parental closeness and care-giving, and conservative skin care.

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    FULLTEXT01
  • 22.
    Larsson, Christina
    et al.
    Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Karlsson, Victoria
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Blomqvist, Ylva Thernström
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Nurse Decision Making and Attitudes About Circuit Disconnection During Ventilator Therapy at a Swedish Neonatal Intensive Care Unit2018Ingår i: Advances in Neonatal Care, ISSN 1536-0903, E-ISSN 1536-0911, Vol. 18, nr 6, s. E13-E20Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: There are many challenges to providing care to infants in need of ventilator therapy. Yet, few studies describe the practical handling of the ventilator circuit during nursing care.

    Purpose: To describe neonatal intensive care unit (NICU) nurses' decision making regarding whether or not to disconnect the ventilator circuit when changing the infant's position and to investigate the grounds for their decisions.

    Methods: A descriptive questionnaire study with both quantitative and qualitative elements was conducted. In 2015, a convenience sample of nurses working in an NICU completed a questionnaire including both closed-ended and open-ended, free-text questions. Answers to the closed-ended questions were analyzed with descriptive statistics, whereas answers to the free-text questions were analyzed using qualitative content analysis.

    Results: Nurses' decisions on whether to disconnect or keep the ventilator circuit closed were based on the infant's needs for ventilator support. The nurses gave several reasons and motivations both for why they disconnected the circuit and for why they did not. The handling of the circuit and the reasons and motivations given were inconsistent among the nurses.

    Implications for Practice: This study highlights the need for continuous, repetitive education and training for NICU nurses, as well as demonstrating the importance of clear and distinct guidelines and working methods regarding the care of infants on ventilator support.

    Implications for Research: Future research should continue to find ways of working and handling an infant on ventilator support that are least harmful to the infant.

  • 23.
    Larsson, Christina
    et al.
    Univ Hosp, Neonatal Intens Care Unit, S-75185 Uppsala, Sweden..
    Wågstrom, Ulrika
    Univ Hosp, Neonatal Intens Care Unit, S-75185 Uppsala, Sweden..
    Normann, Erik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik. Univ Hosp, Neonatal Intens Care Unit, S-75185 Uppsala, Sweden..
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik. Univ Hosp, Neonatal Intens Care Unit, S-75185 Uppsala, Sweden..
    Parents experiences of discharge readiness from a Swedish neonatal intensive care unit2017Ingår i: Nursing Open, E-ISSN 2054-1058, Vol. 4, nr 2, s. 90-95Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: The aim of this study was to describe how parents experienced the support at, and preparation for discharge from, the NICU and how they experienced the first time at home. Design: A qualitative design with quantitative elements was applied. Methods: A questionnaire study. Data were analysed using qualitative content analysis with quantitative elements. Results: The majority of included parents felt adequately prepared for going home and sufficiently supported during the first period home. Negative experiences were related to lack of time for preparation, lack of support and information, especially about the infant's food intake, breastfeeding, and tube feeding, and lack of follow-up counselling post discharge. This study supports that parents who are closely involved in their infant's care at the NICU, and who stay with the infant at the NICU around the clock, are well prepared for the transition to home.

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  • 24. Linnér, Agnes
    et al.
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning.
    Jonsson, Kristina
    Lilliesköld, Siri
    Norman, Mikael
    Parental Experiences of Neonatal Care: A Nationwide Study on Determinants of Excellence2023Ingår i: Neonatology, ISSN 1661-7800, E-ISSN 1661-7819, s. 1-10Artikel i tidskrift (Refereegranskat)
  • 25.
    Misic, Martina Carlsen
    et al.
    Örebro Univ, Fac Med & Hlth, Dept Pediat, Örebro, Sweden.;Örebro Univ, Sch Hlth Sci, Fac Med & Hlth, Örebro, Sweden..
    Eriksson, Mats
    Örebro Univ, Sch Hlth Sci, Fac Med & Hlth, Örebro, Sweden..
    Normann, Erik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden..
    Pettersson, Miriam
    Örebro Univ, Fac Med & Hlth, Dept Pediat, Örebro, Sweden.;Örebro Univ, Sch Med Sci, Fac Med & Hlth, Örebro, Sweden..
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden..
    Olsson, Emma
    Örebro Univ, Fac Med & Hlth, Dept Pediat, Örebro, Sweden.;Örebro Univ, Sch Hlth Sci, Fac Med & Hlth, Örebro, Sweden..
    Clonidine as analgesia during retinopathy of prematurity screening in preterm infants (cloROP): protocol for a randomised controlled trial2022Ingår i: BMJ Open, E-ISSN 2044-6055, Vol. 12, nr 9, artikel-id e064251Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Preterm infants are at risk of negative consequences from stress and pain at the same time as they often are in need of intensive care that includes painful interventions. One of the frequent painful procedures preterm infants undergo is eye examination screening to detect early signs of ROP (retinopathy of prematurity). These examinations are both stressful and painful, and despite a multitude of research studies, no conclusive pain-relieving treatment has been demonstrated. The main aim of this trial is to investigate the analgesic effect of clonidine during ROP eye examinations.

    Methods and analysis: The planned study is a multicentre randomised controlled trial with a crossover design. Infants will be recruited from two different neonatal intensive care units (NICUs) in Sweden. Infants born before gestation week 30 (and therefore eligible for ROP screening) and cared for in either of the NICUs will be eligible for inclusion in the study. The primary outcome will be Premature Infant Pain Profile-Revised score within 30 s after starting the examination. Secondary outcomes will be changes in the galvanic skin response parameters (area small peaks, area huge peaks, peaks per second and average rise time) within 30s after starting the eye examination, together with the number and evaluation of adverse events reported within 72 hours after the examination and the examining physician's assessment of how easy the infant was to examine.

    Ethics and dissemination: Approval from the Swedish Ethical Review Authority and the Swedish Medical Products Agency has been obtained for the study. Parents of eligible infants will be getting both verbal and written information about the study including that participation is voluntary. Data will be collected and treated in accordance with the European general data protection regulations. The results will be reported on group level and published in a scientific journal.

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  • 26. Mode, R. Ignell
    et al.
    Mard, E.
    Nyqvist, Kerstin Hedberg
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Blomqvist, Ylva Thernström
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Fathers' perception of information received during their infants' stay at a neonatal intensive care unit2014Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 5, nr 3, s. 131-136Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To explore fathers' perception of information received during their infants' care at a neonatal intensive care unit (NICU). Methods: An inductive, qualitative and descriptive study. Eight fathers in two units were interviewed. The infants' gestational age at birth ranged between 23 and 36 weeks. Data were collected through semi-structured, individual interviews and were analyzed by qualitative content analysis. Results: Three categories were identified: perception of information, perception of the source of information, and circumstances influencing the perception of information. Information had an important impact; comprehensible and adequate information increased the fathers' knowledge, which generated a sense of control. Early information about the infant's care was particularly important and positively affected father and infant bonding. Conclusion and practical implications: Ensuring a high quality of information is an important task for NICU staff. Fathers' perception of the quality of information depended on the contents of the information and how it was conveyed. Comprehensible information at the onset of the infant's hospital stay increased the fathers' sense of security, and made them feel in control. It is important that the staff strive to identify what information the father requires, and prevent situations when fathers feel uncertainty about what the staff expect from them.

  • 27.
    Mörelius, Evalotte
    et al.
    Linköping Univ, Dept Hlth Med & Caring Sci, Linköping, Sweden.;Edith Cowan Univ, Sch Nursing & Midwifery, Joondalup, WA, Australia..
    Olsson, Emma
    Örebro Univ, Sch Hlth Sci, Örebro, Sweden.;Univ Hosp Örebro, Dept Pediat, Örebro, Sweden..
    Sahlen Helmer, Charlotte
    Linköping Univ, Dept Hlth Med & Caring Sci, Linköping, Sweden..
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning.
    Angelhoff, Charlotte
    Linköping Univ, Crown Princess Victorias Child & Youth Hosp, Linköping, Sweden.;Linköping Univ, Dept Biomed & Clin Sci, Linköping, Sweden..
    External barriers for including parents of preterm infants in a randomised clinical trial in the neonatal intensive care unit in Sweden: a descriptive study2020Ingår i: BMJ Open, E-ISSN 2044-6055, Vol. 10, nr 12, artikel-id e040991Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: Performing randomised controlled trials (RCTs) in neonatal intensive care is challenging in many ways. While restrictive inclusion criteria or busy study protocols are obvious barriers, external barriers leading to termination of a study are seldom discussed. The aim of this study was to describe barriers for inclusion of families in neonatal intensive care in an RCT aiming to evaluate the effects of continuous skin-to-skin contact on mood and sleep quality in parents of preterm infants, as well as the quality of parent-infant interaction and salivary cortisol concentrations at the time of discharge.

    Design: A descriptive study.

    Setting: Three out of seven tertiary neonatal intensive care units in Sweden participated in a two-arm RCT that was terminated because of low inclusion rate.

    Participants: Before termination of the study, 11 out of 242 families assessed for eligibility were included for participation. Results The major barriers for inclusion in this RCT were external due to (1) lack of intensive care beds in the neonatal ward, causing medically stable infants to be transferred back to the referring hospital quicker than expected, (2) moving directly from the delivery room to a family room without passing an open bay intensive care room or (3) transferring from one neonatal ward to another with the same care level to increase availability of intensive care beds where needed. Other barriers were the inclusion criteria 'single-birth' and 'Swedish-speaking parent'.

    Conclusions: The major barriers for including participants were external constituted by transferals between neonatal wards and cities due to lack of intensive care beds. This is a multifactorial issue related to organisational structures. However, since this affects the possibilities to perform research this study highlights some suggestions to consider when planning prospective intervention studies within a neonatal setting.

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    FULLTEXT01
  • 28.
    Noren, Josefine
    et al.
    Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Hedberg Nyqvist, Kerstin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Pediatrisk inflammationsforskning.
    Rubertsson, Christine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning. Lund Univ, Dept Hlth Sci, Lund, Sweden.
    Blomqvist, Ylva Thernström
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Becoming a mother: Mothers' experience of Kangaroo Mother Care2018Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 16, s. 181-185Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To describe mothers' experiences of providing their preterm infants with Kangaroo Mother Care (KMC).

    Study design: A qualitative descriptive design.

    Setting: Two level III neonatal intensive care units (NICUs) in Sweden.

    Participants: Thirteen mothers of preterm infants.

    Methods: The mothers were interviewed when their infant had reached a corrected age of 4 months +/- 2 weeks. The interviews were recorded and transcribed and data were analyzed using qualitative content analysis.

    Results: The mothers described the skin-to-skin contact with, and closeness to, the preterm infant as something they valued, and involuntary physical separation as something they had to accept and adapt to. Providing the infant with breast milk by expressing and tube feeding was experienced as time-consuming and as impinging on the skin-to-skin contact.

    Conclusion: Mothers want to stay close to their preterm infant. The NICU environment and staff can facilitate KMC by providing a private space for parents and infants, and enable mothers to breastfeed and express breast milk by giving them support based on science and proven experience.

  • 29.
    Norman, Mikael
    et al.
    Karolinska Inst, Div Pediat, Dept Clin Sci Intervent & Technol, Stockholm, Sweden;Karolinska Univ Hosp, Dept Neonatal Med, Stockholm, Sweden;Vasterbotten Cty Council, Swedish Neonatal Qual Register SNQ, Umea, Sweden.
    Källén, Karin
    Vasterbotten Cty Council, Swedish Neonatal Qual Register SNQ, Umea, Sweden;Lund Univ, Ctr Reprod Epidemiol, Lund, Sweden.
    Wahlström, Erik
    Natl Board Hlth & Welf, Stockholm, Sweden.
    Håkansson, Stellan
    Vasterbotten Cty Council, Swedish Neonatal Qual Register SNQ, Umea, Sweden;Umea Univ, Dept Clin Sci, Div Pediat, Umea, Sweden.
    Skiöld, Beatrice
    Swedish Neonatal Soc, Stockholm, Sweden;Karolinska Inst, Stockholm, Sweden.
    Navér, Lars
    Karolinska Inst, Stockholm, Sweden.
    Domellöf, Magnus
    Umea Univ, Umea, Sweden.
    Abrahamsson, Thomas
    Linkoping Univ, Linkoping, Sweden.
    Stigson, Lennart
    Gothenburg Univ, Gothenburg, Sweden.
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning.
    Nyholm, Annika
    Umea Univ, Umea, Sweden.
    Ingemansson, Fredrik
    Jonkoping Acad, Jonkoping, Sweden.
    Holmström, Gerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Söderberg: Oftalmiatrik.
    Björklund, Lars
    Lund Univ, Lund, Sweden.
    Wikström, Anna-Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Klinisk obstetrik.
    Wallin-Gyökeres, Annica
    Parent Representat, Stockholm, Sweden.
    The Swedish Neonatal Quality Register - contents, completeness and validity2019Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, nr 8, s. 1411-1418Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To describe the Swedish Neonatal Quality Register (SNQ) and to determine its completeness and agreement with other registers.

    Methods: SNQ collects data for infants admitted to neonatal units during the first four postnatal weeks. Completeness and registers' agreement were determined cross-linking SNQ data with Swedish population registers (the Inpatient, Medical Birth and Cause of Death Registers) for a study period of five years.

    Results: In total, 84 712 infants were hospitalised. A total of 52 806 infants occurred in both SNQ and the population registers; 28 692 were only found in the population registers, and 3214 infants were only found in SNQ. Between gestational weeks 24-34, completeness of SNQ was 98-99%. Below and above these gestational ages, completeness was lower. Infants missing in SNQ were term or near-term in 99% of the cases, and their diagnoses indicated conditions managed in maternity units, or re-admissions for acute infections, managed in paediatric units. For most diagnoses, the agreement between SNQ and population registers was high, but some (bronchopulmonary dysplasia and grade of hypoxic-ischaemic encephalopathy) were often missing in the population registers.

    Conclusion: SNQ completeness and agreement against other registers, especially for preterm infants, is excellent. SNQ is a valid tool for benchmarking, quality improvement and research.

  • 30.
    Norrgrann, Moa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Hörnfeldt, Malin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Latheef, Faiza
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Larsson, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk kemi.
    Paulsson, Mattias
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Diderholm, Barbro
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    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 Gestation2023Ingår i: Nutrients, E-ISSN 2072-6643, Vol. 15, nr 12, artikel-id 2818Artikel i tidskrift (Refereegranskat)
    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.

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    fulltext
  • 31.
    Nylund, Anna Grundvig
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Blom Johansson: Logopedi. KOM‐X, County Council of Gävleborg, Region Hospital, Gävle, Sweden.
    Gonzalez Lindh, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Blom Johansson: Logopedi. Speech Pathology Department, Gävle Hospital, Gävle, Sweden.
    Ahlsson, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning. Neonatal Intensive Care Unit, University Hospital, Uppsala, Sweden.
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning. Neonatal Intensive Care Unit, University Hospital, Uppsala, Sweden.
    Parents experiences of feeding their extremely preterm children during the first 2‐3 years – A qualitative study2020Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 109, nr 5, s. 976-981Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim To describe parents of extremely preterm children experiences regarding feeding of their children during the first 3 years of the child's life. Methods This is a qualitative study involving interviews conducted with 12 parents of nine children who had been cared for at one neonatal intensive care unit in Sweden. The interviews were conducted between May and September 2018; the data were analysed using qualitative content analysis. Results All parents experienced some difficulties with their child's eating development and described feeding their child as sometimes both difficult and frustrating. Variation in when these difficulties arose made it hard for the parents to obtain the individual support they wanted and needed. Parents experienced a need for more support - from both staff members and parents with similar experiences - during and after their child's stay at the NICU. Conclusion All parents participating in the study experienced difficulties during some phase of their child's feeding development. They expressed the need for more specialised support both during and after their child's time at the hospital.

  • 32.
    Olsson, Emma
    et al.
    Örebro Univ, Sch Hlth Sci, Fac Med & Hlth, S-70182 Örebro, Sweden.;Örebro Univ, Fac Med & Hlth, Dept Pediat, Örebro, Sweden..
    Carlsen Misic, Martina
    Örebro Univ, Sch Hlth Sci, Fac Med & Hlth, S-70182 Örebro, Sweden.;Örebro Univ, Fac Med & Hlth, Dept Pediat, Örebro, Sweden..
    Dovland Andersen, Randi
    Telemark Hosp Trust, Dept Res, Skien, Norway.;Univ Oslo, Inst Hlth & Soc, Res Ctr Habilitat & Rehabil Serv & Models CHARM, Oslo, Norway..
    Ericson, Jenny
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning Dalarna. Dalarna Univ, Sch Educ Hlth & Social Studies, Falun, Sweden.;Falun Cent Hosp, Dept Pediat, Falun, Sweden..
    Eriksson, Mats
    Örebro Univ, Sch Hlth Sci, Fac Med & Hlth, S-70182 Örebro, Sweden..
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden..
    Ullsten, Alexandra
    Örebro Univ, Sch Hlth Sci, Fac Med & Hlth, S-70182 Örebro, Sweden.;Ctr Clin Res, Karlstad, Sweden..
    Study protocol: parents as pain management in Swedish neonatal care - SWEpap, a multi-center randomized controlled trial2020Ingår i: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 20, nr 1, artikel-id 474Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: During the first period of life, critically ill as well as healthy newborn infants experience recurrent painful procedures. Parents are a valuable but often overlooked resource in procedural pain management in newborns. Interventions to improve parents’ knowledge and involvement in infants’ pain management are essential to implement in the care of the newborn infant. Neonatal pain research has studied a range of non-pharmacological pain alleviating strategies during painful procedures, yet, regarding combined multisensorial parent-driven non-pharmacological pain management, research is still lacking.

    Methods/design: A multi-center randomized controlled trial (RCT) with three parallel groups with the allocation ratio 1:1:1 is planned. The RCT “Parents as pain management in Swedish neonatal care – SWEpap”, will investigate the efficacy of combined pain management with skin-to-skin contact, breastfeeding and live parental lullaby singing compared with standard pain care initiated by health care professionals, during routine metabolic screening of newborn infants (PKU-test).

    Discussion: Parental involvement in neonatal pain management enables a range of comforting parental interventions such as skin-to-skin contact, breastfeeding, rocking and soothing vocalizations. To date, few studies have been published examining the efficacy of combined multisensorial parent-driven interventions. So far, research shows that the use of combined parent-driven pain management such as skin-to-skin contact and breastfeeding, is more effective in reducing behavioral responses to pain in infants, than using the pain-relieving interventions alone. Combined parental soothing behaviors that provide rhythmic (holding/rocking/vocalizing) or orogustatory/orotactile (feeding/pacifying) stimulation that keep the parent close to the infant, are more effective in a painful context. In the SWEpap study we also include parental live lullaby singing, which is an unexplored but promising biopsychosocial, multimodal and multisensory pain alleviating adjuvant, especially in combination with skin-to-skin contact and breastfeeding.

    Trial registration: ClinicalTrials.gov (NCT04341194) 10 April 2020.

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  • 33.
    Olsson, Emma
    et al.
    Örebro Univ, Fac Med & Hlth, Dept Pediatricsm, Örebro, Sweden.;Örebro Univ, Sch Hlth Sci, Fac Med & Hlth, Örebro, Sweden..
    Diderholm, Barbro
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.;Uppsala Univ, Dept Womens & Childrens Hlth, S-75185 Uppsala, Sweden..
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.;Uppsala Univ, Dept Womens & Childrens Hlth, S-75185 Uppsala, Sweden..
    "Paying it Forward" - Swedish Women's Experiences of Donating Human Milk2021Ingår i: Journal of Human Lactation, ISSN 0890-3344, E-ISSN 1552-5732, Vol. 37, nr 1, s. 87-94, artikel-id 0890334420979245Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Human milk is recommended as the only nutritional source during the first 6 months of life. For preterm infants, the benefits of human milk are even more important and can alleviate the negative influences of preterm birth. Research aim To describe how Swedish human milk donors experienced the donation process. Method A prospective mixed methods mail survey was designed. It was sent to human milk donors (N = 72) at two Swedish hospitals. Quantitative data are presented with descriptive statistics and qualitative data were analyzed using qualitative content analysis. Results The infants were between newborn and 17 weeks of age when the participants started their human milk donations, and the duration of the donation period lasted 1-24 weeks. The overall theme identified was the participants' strong desire to help infants, often expressed as being involved in saving infants' lives. Many participants experienced difficulties getting the information needed to become human milk donors; for others, expressing milk required both time and energy that they could otherwise spend with their own newborn infants. Conclusion Donating human milk can be experienced as a demanding and strenuous task. Therefore, it is important that women who donate human milk receive the practical help from health care staff that they feel they need. Furthermore, information and knowledge about the possibility of donating human milk, and how important human milk is for preterm and/or sick infants, are important in order to increase the number of women willing to donate human milk.

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  • 34.
    Oras, Paola
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Hedberg Nyqvist, Kerstin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Gradin, Maria
    Rubertsson, Christine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Hellström-Westas, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Funkquist, Eva-Lotta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Breastfeeding Patterns in Preterm Infants Born at 28-33 Gestational Weeks2015Ingår i: Journal of Human Lactation, ISSN 0890-3344, E-ISSN 1552-5732, Vol. 31, nr 3, s. 377-385Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    Studies of breastfeeding patterns during preterm infants' first year of life are scarce but are important for providing breastfeeding mothers of preterm infants with optimal support.

    OBJECTIVE:

    This study aimed to describe breastfeeding patterns in preterm infants up to 1 year of corrected age.

    METHODS:

    As part of a larger study on kangaroo mother care in Sweden, a 24-hour breastfeeding diary was sent home after discharge from hospital, and at 2, 6, and 12 months of the infant's corrected age. Eighty-three mothers responded to the follow-up questionnaires, and the number of respondents to the breastfeeding diary was 48 at discharge, 43 at 2 months, 22 at 6 months, and 8 at 12 months. Infants were born at a median (range) gestational age of 32 (28-33) weeks. Breastfeeding patterns were analyzed according to durations, frequencies per 24 hours, and intervals between sessions.

    RESULTS:

    In exclusively breastfed infants, the median (range) breastfeeding session frequency was 14 (8-26) times per 24 hours including 4 (1-9) times per night after discharge (n = 24) and 10 (6-25) times per 24 hours including 2 (0-5) times per night at 2 months (n = 23). In partially breastfed infants, the median (range) frequency was 5 (1-14) times per 24 hours including 2 (0-4) times per night at 6 months (n = 20) and 5.5 (1-12) times per 24 hours including 2 (0-3) times per night at 12 months (n = 8).

    CONCLUSION:

    Mothers reported large variations in breastfeeding patterns, with higher median breastfeeding session frequencies than previously described in term infants in affluent settings.

  • 35.
    Oras, Paola
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Hedberg Nyqvist, Kerstin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Gradin, Maria
    Rubertsson, Christine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Hellström-Westas, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Funkquist, Eva-Lotta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Skin-to-skin contact is associated with earlier breastfeeding attainment in preterm infants2016Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, nr 7, s. 783-789Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM:

    This study investigated the effects of skin-to-skin contact on breastfeeding attainment, duration and infant growth in preterm infants, as this has not been sufficiently explored.

    METHODS:

    A prospective longitudinal study on Kangaroo mother care was carried out, comprising 104 infants with a gestational age of 28+0 to 33+6 and followed up to one year of corrected age. Parents and staff recorded the duration of skin-to skin contact during the stay in the neonatal intensive care unit (NICU). Medical data were collected through patient records and follow-up questionnaires were filled in by parents.

    RESULTS:

    The 53 infants who attained full breastfeeding in the NICU did so at a median (range) of 35+0 (32+1 to 37+5) weeks of postmenstrual age and skin-to-skin contact was the only factor that influenced earlier attainment in the regression analysis (R(2) 0.215 p<0.001). The daily duration of skin-to-skin contact during the stay in the NICU did not affect the duration of breastfeeding or infant growth after discharge. Furthermore, infant growth was not affected by the feeding strategy of exclusive, partial breastfeeding or no breastfeeding.

    CONCLUSION:

    A longer daily duration of skin-to-skin contact in the NICU was associated with earlier attainment of exclusive breastfeeding.

  • 36.
    Sjömar, Johanna
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, SWEDESD - Centrum för forskning och utbildning om lärande för hållbar utveckling.
    Ottesen, Hedda
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell barnhälsa och nutrition.
    Banik, Goutum
    Int Ctr Diarrhoeal Res, Maternal & Child Hlth Div, Dhaka, Bangladesh..
    Rahman, Ahmed Ehsanur
    Int Ctr Diarrhoeal Res, Maternal & Child Hlth Div, Dhaka, Bangladesh..
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning.
    Moshfiqur Rahman, Syed
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell barnhälsa och nutrition.
    Målqvist, Mats
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, SWEDESD - Centrum för forskning och utbildning om lärande för hållbar utveckling.
    Exploring caregivers' experiences of Kangaroo Mother Care in Bangladesh: A descriptive qualitative study2023Ingår i: PLOS ONE, E-ISSN 1932-6203, Vol. 18, nr 1, artikel-id e0280254Artikel i tidskrift (Refereegranskat)
    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.

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  • 37.
    Starke, Veronica
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning.
    Diderholm, Barbro
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning.
    Heyman, Maria
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning.
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning.
    Being parents of extremely preterm children, from a long-term perspective: A qualitative study of parents' experiences2023Ingår i: Early Human Development, ISSN 0378-3782, E-ISSN 1872-6232, Vol. 183, artikel-id 105819Artikel i tidskrift (Refereegranskat)
    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.

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  • 38. Strand, H
    et al.
    Blomqvist, Ylva Thernström
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Gradin, M
    Nyqvist, Kerstin Hedberg
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Kangaroo mother care in the neonatal intensive care unit: staff attitudes and beliefs and opportunities for parents2014Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, nr 4, s. 373-378Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: To compare attitudes towards Kangaroo mother care (KMC) among staff in two high-tech neonatal intensive care units, which provided parents with different opportunities to get involved in their infants' care.

    METHOD: Questionnaires were completed by healthcare staff in Unit A, which provided parents with unrestricted access so that they could provide continuous KMC, and Unit B, where parents could only practice KMC intermittently.

    RESULTS: Unit A staff were more positive about the benefits and use of KMC, including its use in unstable infants, and rated their knowledge and practical skills more highly than staff in the other unit. Unit B staff also appreciated the method, but expressed more hesitation in using it with unstable infants. In particular, they stressed the need to adapt the physical environment of the NICU to enable parents to stay with their infants and practice the method.

    CONCLUSION: Staff working in the NICU that gave parents unrestricted access were more positive about KMC than staff in the NICU that offered limited opportunities for parents to stay with their children. This finding suggests that it is important to eliminate unjustifiable obstacles to the presence of parents in the NICU, so that they can provide KMC.

  • 39.
    Thernström Blomqvist, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Kangaroo Mother Care: Parents’ experiences and patterns of application in two Swedish neonatal intensive care units2012Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Kangaroo Mother Care (KMC) is an alternative model of care that prevents parent-infant separation when preterm infants need neonatal intensive care by skin-to-skin contact between infants and their parents. KMC is also a strategy that involves parents in their infants’ care and enables them to assume the responsibility for the care. Furthermore, KMC promotes parent-infant bonding and attachment.

    The overall aim of this thesis was to gain a deeper understanding and knowledge about parents’ capacity, willingness, and experiences of KMC and to which extent parents choose to use KMC throughout their infants' hospital stay. These studies were conducted in the NICUs at two Swedish university hospitals (NICU A and NICU B).

    Mothers of infants cared for at NICU A (n=17) answered a questionnaire about their experiences of KMC (Paper I). Twenty parents of infants cared for at NICU A recorded the duration of each KMC session during a period of 24 hours and the identity the KMC provider (Paper II). Seven fathers were interviewed about their experiences of KMC (Paper III) and 76 mothers and 74 fathers completed a questionnaire about what facilitated or rendered it difficult to perform KMC (Paper IV). The time of initiation of KMC and duration in minutes, and the identity of the KMC providers was recorded continuously during the infants’ (n=104) hospital stay: 83 mothers and 80 fathers also completed a questionnaire during their infants’ hospital stay (Paper V).

    This thesis provides new knowledge about parents’ practice of KMC, also continuously day and night, in a high tech NICU in an affluent society, with good resources for infant care in an incubator by trained staff. The accuracy of parents’ records of KMC were comparable to nurses’ records. The results indicate that parents want to be together with their infant in the NICU and be actively involved in the infants’ care. Although parents may experience KMC as exhausting and uncomfortable, they still prefer KMC to conventional neonatal intensive care as it supports their parental role. Early initiation of KMC after birth appears to result in a longer total duration of KMC during the infants’ hospital stay.

    Delarbeten
    1. Swedish mothers' experience of continuous Kangaroo Mother Care
    Öppna denna publikation i ny flik eller fönster >>Swedish mothers' experience of continuous Kangaroo Mother Care
    2011 (Engelska)Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, nr 9-10, s. 1472-1480Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Aims. To characterise the first infants receiving continuous Kangaroo Mother Care from birth to discharge in a Swedish neonatal intensive care unit and to investigate their mothers' experiences of this model of care. Background.  Admission of a newborn infant to a neonatal intensive care unit commonly implies separation of the new mother from her infant. Kangaroo Mother Care is a model of neonatal care which supports the parental role as primary care-giver and contributes to minimising the separation between the infant and parents. Design. A retrospective survey design. Method. A purposive sample consisting of 23 mother-infant pairs. Relevant infant data were obtained from their medical records. A questionnaire with questions about the infant's care and regarding Kangaroo Mother Care was designed for this study. Results.  The infants were born at a gestational age of 31-41 weeks, birth weight ranging from 1715-3700 g. The mothers of these moderately preterm and ill newborn infants showed good acceptance of the idea of providing their infants with continuous Kangaroo Mother Care during their stay at the neonatal intensive care unit. The mothers' evaluations of this method were predominantly positive. Negative comments concerned lack of information about practical application of the method, and some mothers perceived their infants' care during the night as exhausting. No mother would have preferred not to perform continuous Kangaroo Mother Care or to terminate Kangaroo Mother Care earlier than they did. Conclusions. These mothers accepted this model of care very well, provided that they received the help and support they required. Relevance to clinical practice.  Mothers whose infants are admitted to an neonatal intensive care units in settings similar to the study setting should be offered opportunities to be present and provide Kangaroo Mother Care for their infants, to the extent that they are able and willing to do so and as permitted by the infant's medical condition and care.

    Nyckelord
    babies, midwifery, mothers, nurses, nursing, Sweden
    Nationell ämneskategori
    Omvårdnad
    Identifikatorer
    urn:nbn:se:uu:diva-140796 (URN)10.1111/j.1365-2702.2010.03369.x (DOI)000289630400029 ()21118321 (PubMedID)
    Tillgänglig från: 2011-01-10 Skapad: 2011-01-10 Senast uppdaterad: 2019-06-28Bibliografiskt granskad
    2. Parent-infant skin-to-skin contact: how do parent records compare to nurse records?
    Öppna denna publikation i ny flik eller fönster >>Parent-infant skin-to-skin contact: how do parent records compare to nurse records?
    2011 (Engelska)Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, nr 5, s. 773-775Artikel i tidskrift (Refereegranskat) Published
    Nationell ämneskategori
    Omvårdnad
    Identifikatorer
    urn:nbn:se:uu:diva-152867 (URN)10.1111/j.1651-2227.2011.02160.x (DOI)000289250200030 ()21375581 (PubMedID)
    Tillgänglig från: 2011-05-02 Skapad: 2011-05-02 Senast uppdaterad: 2019-06-28Bibliografiskt granskad
    3. Kangaroo Mother Care helps fathers of preterm infants gain confidence in the paternal role
    Öppna denna publikation i ny flik eller fönster >>Kangaroo Mother Care helps fathers of preterm infants gain confidence in the paternal role
    Visa övriga...
    2012 (Engelska)Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 68, nr 9, s. 1988-1996Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Aim. 

    This article is a report on a descriptive study of fathers’ experiences of providing their preterm infants with Kangaroo Mother Care.

    Background. 

    During neonatal intensive care, fathers describe the incubator as a barrier and the separation from their infant as stressful. Fathers consider it important to be close to the infant, and performing Kangaroo Mother Care makes them feel an important participant in their infants’ care.

    Method. 

    Individual interviews conducted in 2009 with seven fathers who performed Kangaroo Mother Care were analysed using qualitative content analysis.

    Results. 

    The fathers’ opportunity for being close to their infants facilitated attainment of their paternal role in the neonatal intensive care unit. Kangaroo Mother Care allowed them to feel in control and that they were doing something good for their infant, although the infant’s care could be demanding and stressful. As active agents in their infant’s care, some fathers stayed with the infant during the whole hospital stay, others were at the neonatal intensive care unit all day long. Despite the un-wished-for situation, they adapted to their predicament and spent as much time as possible with their infants.

    Conclusion. 

    Fathers’ opportunities for Kangaroo Mother Care helped them to attain their paternal role and to cope with the unexpected situation. The physical environment and conflicting staff statements influenced their opportunity for, and experience of, caring for their preterm infants.

    Nyckelord
    father, infant, Kangaroo Mother Care, neonatal intensive care unit, nursing
    Nationell ämneskategori
    Omvårdnad
    Identifikatorer
    urn:nbn:se:uu:diva-164073 (URN)10.1111/j.1365-2648.2011.05886.x (DOI)000306806000009 ()22111919 (PubMedID)
    Tillgänglig från: 2011-12-15 Skapad: 2011-12-15 Senast uppdaterad: 2019-06-28
    4. Provision of Kangaroo Mother Care: supportive factors and barriers perceived by parents
    Öppna denna publikation i ny flik eller fönster >>Provision of Kangaroo Mother Care: supportive factors and barriers perceived by parents
    2013 (Engelska)Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, nr 2, s. 345-353Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Background:

    Kangaroo Mother Care supports parents’ role at the neonatal intensive care unit. To enhance parents’ provision of Kangaroo Mother Care, it is essential to obtain knowledge of what parents perceive as supportive factors and barriers regarding their opportunities to perform Kangaroo Mother Care.

    Aim:

    To identify factors that parents of preterm infants perceived as supportive factors or barriers for their performance of Kangaroo Mother Care and to explore the timing of and reasons for parents’ discontinuation of Kangaroo Mother Care.

    Methods:

    A descriptive study performed at two neonatal intensive care units in Sweden with 76 mothers and 74 fathers of preterm infants born at gestational ages ranging from 28 to 33 weeks. Data on infant characteristics were obtained from the infants’ medical records. A questionnaire, based on scientific literature and the researchers’ clinical experience, was completed by the mothers and the fathers separately, shortly after the infant’s discharge from the hospital. The data was analyzed with qualitative content analysis and descriptive statistic.

    Results:

    Four categories were identified in parents’ responses regarding support and barriers for their performance of KMC: Parent related factors, Time, Infants related factors and The NICU and home environment. The hospital staff and environment were described by the parents as both supportive and barriers for their application of Kangaroo Mother Care. Some mothers described the infants’ feeding process as an obstacle to Kangaroo Mother Care. Sleeping with the infant skin-to-skin in the same position throughout the night could be difficult, as an uncomfortable sleeping position caused insufficient sleep. A majority of both mothers and fathers continued providing their infant with Kangaroo Mother Care to some extent after discharge.

    Nyckelord
    Kangaroo Mother Care, Neonatal, Preterm Infants, Parents
    Nationell ämneskategori
    Pediatrik
    Forskningsämne
    Pediatrik
    Identifikatorer
    urn:nbn:se:uu:diva-179516 (URN)10.1111/j.1471-6712.2012.01040.x (DOI)000318815700018 ()22816503 (PubMedID)
    Tillgänglig från: 2012-08-17 Skapad: 2012-08-17 Senast uppdaterad: 2019-06-28Bibliografiskt granskad
    5. Kangaroo Mother Care in two Swedish NICUs
    Öppna denna publikation i ny flik eller fönster >>Kangaroo Mother Care in two Swedish NICUs
    Visa övriga...
    2012 (Engelska)Artikel i tidskrift (Övrigt vetenskapligt) Submitted
    Abstract [en]

    Aim:

    To describe initiation and the extent of parents’ application of Kangaroo Mother Care (KMC).

    Methods:

    The exact duration of which 104 preterm infants were cared for skin-to-skin was recorded in the infants’ medical charts during their hospital stay: the parents answered a questionnaire.

    Results:

    Both parents were involved in the practice of KMC. Three infants experienced KMC directly after birth, 34 within one hour, 85 within 24 hours, and the remaining 19 infants at 24 – 78 h post birth. KMC commenced earlier (median age of 50 minutes) in infants whose first KMC contact was with their father than with their mother (median age of 649 minutes: p < 0.000). The earlier KMC was initiated, the more the infant was cared for with KMC per day during his/her hospital stay (p < 0.000). The median daily duration of KMC was 403 minutes.

    Conclusion:

    Early initiation of KMC had a positive impact on the extent of parents’ application of the method. Even though the infants in this study were cared for with KMC to a high extent there is a potential for extended use of KMC in this type of hospital setting for reducing separation between infants and parents.

    Nyckelord
    Kangaro Mother Care, Parenting, Neonatal Intensive Care Unit
    Nationell ämneskategori
    Pediatrik
    Forskningsämne
    Pediatrik
    Identifikatorer
    urn:nbn:se:uu:diva-179517 (URN)
    Tillgänglig från: 2012-08-17 Skapad: 2012-08-17 Senast uppdaterad: 2022-01-28Bibliografiskt granskad
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  • 40.
    Thernström Blomqvist, Ylva
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Frölund, Lovisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Rubertsson, Christine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Hedberg Nyqvist, Kerstin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Provision of Kangaroo Mother Care: supportive factors and barriers perceived by parents2013Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, nr 2, s. 345-353Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:

    Kangaroo Mother Care supports parents’ role at the neonatal intensive care unit. To enhance parents’ provision of Kangaroo Mother Care, it is essential to obtain knowledge of what parents perceive as supportive factors and barriers regarding their opportunities to perform Kangaroo Mother Care.

    Aim:

    To identify factors that parents of preterm infants perceived as supportive factors or barriers for their performance of Kangaroo Mother Care and to explore the timing of and reasons for parents’ discontinuation of Kangaroo Mother Care.

    Methods:

    A descriptive study performed at two neonatal intensive care units in Sweden with 76 mothers and 74 fathers of preterm infants born at gestational ages ranging from 28 to 33 weeks. Data on infant characteristics were obtained from the infants’ medical records. A questionnaire, based on scientific literature and the researchers’ clinical experience, was completed by the mothers and the fathers separately, shortly after the infant’s discharge from the hospital. The data was analyzed with qualitative content analysis and descriptive statistic.

    Results:

    Four categories were identified in parents’ responses regarding support and barriers for their performance of KMC: Parent related factors, Time, Infants related factors and The NICU and home environment. The hospital staff and environment were described by the parents as both supportive and barriers for their application of Kangaroo Mother Care. Some mothers described the infants’ feeding process as an obstacle to Kangaroo Mother Care. Sleeping with the infant skin-to-skin in the same position throughout the night could be difficult, as an uncomfortable sleeping position caused insufficient sleep. A majority of both mothers and fathers continued providing their infant with Kangaroo Mother Care to some extent after discharge.

  • 41.
    Thernström Blomqvist, Ylva
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning. University Hospital, Neonatal Intensive Care Unit, Uppsala, Sweden.
    Gradin, Maria
    Department of Pediatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Olsson, Emma
    Department of Pediatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
    Pain Assessment and Management in Swedish Neonatal Intensive Care Units2020Ingår i: Pain Management Nursing, ISSN 1524-9042, E-ISSN 1532-8635, Vol. 21, nr 4, s. 354-359Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: To investigate registered nurses' (RNs') and physicians' knowledge, attitudes, and experiences regarding assessing and managing pain in infants at seven level III neonatal intensive care units (NICUs) in Sweden.

    DESIGN: Descriptive and explorative study using an online questionnaire.

    METHODS: A researcher-developed online questionnaire with 34 items about knowledge, attitudes, and experiences regarding pain assessment and management was emailed to 306 RNs and 79 physicians working at seven neonatal intensive care units (NICUs) in Sweden.

    RESULTS: Most NICUs had pain assessment guidelines, but there was a discrepancy regarding interprofessional discussions of pain assessments. A total of seven different pain assessment instruments were reported from the included NICUs and RNs were reportedly those who usually performed the pain assessments. Most respondents expressed a positive attitude toward pain assessment but recognized a lack of intervention after the assessment. Forty-six percent (n = 11) of the physicians said they had sufficient knowledge of assessing pain using pain assessment instruments, versus 75% (n = 110) of the RNs. Difficulties assessing pain in certain populations of infants, such as the most premature infants and infants receiving sedative medicines, were recognized.

    CONCLUSIONS: RNs in this study reported that their pain assessments did not lead to appropriate pain management interventions. They were thus discouraged from further pain assessments or advocating for ethical pain management. An interprofessional team effort is needed to effectively assess and manage pain in neonates.

  • 42.
    Thernström Blomqvist, Ylva
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning.
    Karlsson, Victoria
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning.
    Dawit, Feven
    Astrid Lindgrens Children Hospital, Karolinska University Hospital, Stockholm, Sweden.
    Sindelar, Richard
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning.
    Ågren, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Perinatal, neonatal och barnkardiologisk forskning.
    Physiological Stability in Very Preterm Infants During Skin-to-Skin Contact as Assessed by Near-Infrared Spectroscopy2020Ingår i: Advances in Neonatal Care, ISSN 1536-0903, E-ISSN 1536-0911, Vol. 20, nr 6, s. 495-498Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: 

    Skin-to-skin contact (SSC) has been demonstrated to allow adequate thermal stability in high-technology settings with extremely preterm infants, while other aspects on how SSC influences basic physiological parameters have been less extensively investigated.

    Purpose: 

    To evaluate physiological stability during SSC and incubator care in a group of preterm infants born at a gestational age (GA) of 32 weeks or less and receiving respiratory support.

    Methods: 

    Descriptive, observational study including 10 preterm infants (GA 22-32 weeks, postnatal age 2-48 days) were evaluated during SSC compared with flanking time periods in the incubator. Cerebral and systemic regional oxygen saturation (rSao2), pulse oximetry (Spo2), heart rate (HR), and body temperature were recorded, and the fractional tissue oxygen extraction (fTOE) was calculated.

    Results: 

    A total of 16 periods of SSC (mean duration 3 hours 30 minutes) were evaluated, 9 during nasal continuous positive airway pressure and 7 during mechanical ventilation. Cerebral rSao2 was 68% ± 4% (SE) and 69% ± 4% during incubator care and SSC, respectively (P = .56). Somatic rSao2 was 64% ± 4% during incubator care and 66% ± 4% during SSC (P = .54). Also, fTOE, HR, and Spo2 was similar during the 2 modes of care. Body temperature increased during SSC (P < .01).

    Implications for Practice: 

    The present study reveals no differences in cerebral and somatic tissue oxygenation between periods of SSC and care in the incubator. The findings indicate that SSC supports physiological stability also during management of very preterm infants receiving respiratory support.

    Implications for Research: 

    Further studies directed to further optimize SSC performance should enable its safe implementation at gradually lower gestational and postnatal ages.

  • 43.
    Thernström Blomqvist, Ylva
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning. Univ Childrens Hosp, Neonatal Intens Care Unit, Uppsala, Sweden..
    Ågren, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning. Univ Childrens Hosp, Neonatal Intens Care Unit, Uppsala, Sweden..
    Karlsson, Victoria
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Perinatal, neonatal och barnkardiologisk forskning. Univ Childrens Hosp, Neonatal Intens Care Unit, Uppsala, Sweden..
    The Swedish approach to nurturing extremely preterm infants and their families: A nursing perspective2022Ingår i: Seminars in Perinatology, ISSN 0146-0005, E-ISSN 1558-075X, Seminars in perinatology, ISSN 0146-0005, Vol. 46, nr 1, artikel-id 151542Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Nurturing extremely premature infants is a complicated task that not only necessitates a systematic approach to the immature physiology and its medical management, but also to the needs of the family. Infants born at 22-24 weeks require many weeks of intensive care including a long duration of mechanical ventilation, numerous stressful medical interventions, and for the parents to spend a lot of time in the Neonatal Intensive Care unit (NICU). This paper aims to outline the Swedish nursing approach to nurturing these infants and their families. The nursing care is structured so the parents are the primary caregivers supported by the staff and is based on: timely expression and provision of mother's own breast milk, early and prolonged skin-to-skin contact and close collaboration with the family. While this presentation is based on a single-center's experience, it well represents the general features of nursing provided to extremely preterm infants in Swedish NICUs.

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