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Publikasjoner (10 av 28) Visa alla publikasjoner
Wulcan, A.-C. & Nilsson, C. (2019). Midwives’ counselling of women at specialised fear of childbirth clinics: A qualitative study. Sexual and Reproductive Healthcare, 19, 24-30
Åpne denne publikasjonen i ny fane eller vindu >>Midwives’ counselling of women at specialised fear of childbirth clinics: A qualitative study
2019 (engelsk)Inngår i: Sexual and Reproductive Healthcare, ISSN 1877-5756, Vol. 19, s. 24-30Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Objective

Fear of childbirth is a well-known problem affecting women’s wellbeing and health. The prevalence of intense fear varies across countries from 4.8 to 14.8%. During the past 25 years in Sweden women with intense fear of childbirth have been offered counselling at specialised clinics staffed by midwives. Although the counselling demonstrates positive results, the training, education, supervision and organisation differ between clinics. It is still unclear which approaches and practices are the most beneficial. The aim was to explore and describe the counselling of women with intense fear of childbirth from the viewpoint of midwives who provide counselling in specialised fear of childbirth clinics in one region of Sweden.

Methods

A qualitative study of 13 midwives using focus group interviews and inductive content analysis.

Results

The midwives’ counselling of women with intense fear of childbirth is described as ‘striving to create a safe place for exploring fear of childbirth’, comprising the following categories: Providing a reliable relationship; Investigating previous and present fears; and A strong dedication to the women.

Conclusion

Although there are no guidelines for the counselling the midwives described similar frameworks. Some approaches were general, while others were specific and related to the individual woman’s parity. The midwives achieved professional and personal development through counselling experiences. The findings add to the existing literature on counselling and can be used to inform the development of midwife-led interventions for women with intense fear of childbirth and previous traumatic births, as well as for the formal education of midwives.

Emneord
Fear of childbirth, Midwifery, Experiences, Content analysis, Treatment, Counselling
HSV kategori
Forskningsprogram
Människan i vården
Identifikatorer
urn:nbn:se:hb:diva-15506 (URN)10.1016/j.srhc.2018.12.001 (DOI)2-s2.0-85058061104 (Scopus ID)
Tilgjengelig fra: 2018-12-18 Laget: 2018-12-18 Sist oppdatert: 2019-01-10bibliografisk kontrollert
Sundler, A. J., Lindberg, E., Nilsson, C. & Palmér, L. (2019). Qualitative thematic analysis based on descriptive phenomenology.. Nursing open, 6(3), 733-739
Åpne denne publikasjonen i ny fane eller vindu >>Qualitative thematic analysis based on descriptive phenomenology.
2019 (engelsk)Inngår i: Nursing open, ISSN 2054-1058, Vol. 6, nr 3, s. 733-739Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Aim: The aim of this paper was to discuss how to understand and undertake thematic analysis based on descriptive phenomenology. Methodological principles to guide the process of analysis are offered grounded on phenomenological philosophy. This is further discussed in relation to how scientific rigour and validity can be achieved.

Design: This is a discursive article on thematic analysis based on descriptive phenomenology.

Results: This paper takes thematic analysis based on a descriptive phenomenological tradition forward and provides a useful description on how to undertake the analysis. Ontological and epistemological foundations of descriptive phenomenology are outlined. Methodological principles are explained to guide the process of analysis, as well as help to understand validity and rigour. Researchers and students in nursing and midwifery conducting qualitative research need comprehensible and valid methods to analyse the meaning of lived experiences and organize data in meaningful ways.

Emneord
healthcare research, lifeworld, lived experiences, meanings, midwifery, nursing, phenomenology, qualitative, thematic analysis
HSV kategori
Identifikatorer
urn:nbn:se:hb:diva-21890 (URN)10.1002/nop2.275 (DOI)000476917700008 ()31367394 (PubMedID)2-s2.0-85069758075 (Scopus ID)
Tilgjengelig fra: 2019-10-23 Laget: 2019-10-23 Sist oppdatert: 2019-10-29bibliografisk kontrollert
Nilsson, C., Dencker, A., Begley, C., Jangsten, E., Mollberg, M., Patel, H., . . . Sparud-Lundin, C. (2018). Causes and outcomes in studies of fear of childbirth: A systematic review. Women and Birth
Åpne denne publikasjonen i ny fane eller vindu >>Causes and outcomes in studies of fear of childbirth: A systematic review
Vise andre…
2018 (engelsk)Inngår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799Artikkel, forskningsoversikt (Fagfellevurdert) Epub ahead of print
Abstract [en]

PROBLEM:

Fear of childbirth negatively affects women during pregnancy and after birth.

AIM:

To summarise the findings of published studies regarding possible causes/predisposing factors and outcomes of fear of childbirth for childbearing women.

DESIGN:

A systematic review, searching five databases in March 2015 for studies on causes/predisposing factors and outcomes of fear of childbirth, as measured during pregnancy and postpartum. Quality of included studies was assessed independently by pairs of authors. Data were extracted independently by reviewer pairs and described in a narrative analysis.

FINDINGS:

Cross-sectional, register-based and case-control studies were included (n=21). Causes were grouped into population characteristics, mood-related aspects, and pregnancy and birth-related aspects. Outcomes were defined as mood-related or pregnancy and birth-related aspects. Differing definitions of fear of childbirth were found and meta-analysis could only be performed on parity, in a few studies.

CONCLUSIONS:

Stress, anxiety, depression and lack of social support are associated with fear during pregnancy. Need for psychiatric care and presence of traumatic stress symptoms are reported outcomes together with prolonged labour, longer labours, use of epidural and obstetric complications. Nulliparous and parous women have similar levels of fear but for different reasons. Since the strongest predictor for fear in parous women is a previous negative birth experience or operative birth, we suggest it is important to distinguish between fear of childbirth and fear after birth. Findings demonstrate the need for creating woman-centred birthing environments where women can feel free and secure with low risk of negative or traumatic birth experiences and consequent fear.

HSV kategori
Forskningsprogram
Människan i vården
Identifikatorer
urn:nbn:se:hb:diva-15305 (URN)10.1016/j.wombi.2018.07.004 (DOI)30115515 (PubMedID)2-s2.0-85051394322 (Scopus ID)
Tilgjengelig fra: 2018-11-12 Laget: 2018-11-12 Sist oppdatert: 2018-12-07bibliografisk kontrollert
Nilsson, C., Hessman, E., Sjöblom, H., Dencker, A., Jangsten, E., Mollberg, M., . . . Begley, C. (2018). Definitions, measurements and prevalence of fear of childbirth: a systematic review. BMC Pregnancy and Childbirth, 18(1), Article ID 29329526.
Åpne denne publikasjonen i ny fane eller vindu >>Definitions, measurements and prevalence of fear of childbirth: a systematic review
Vise andre…
2018 (engelsk)Inngår i: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 18, nr 1, artikkel-id 29329526Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background

Fear of Childbirth (FOC) is a common problem affecting women’s health and wellbeing, and a common reason for requesting caesarean section. The aims of this review were to summarise published research on prevalence of FOC in childbearing women and how it is defined and measured during pregnancy and postpartum, and to search for useful measures of FOC, for research as well as for clinical settings.

Methods

Five bibliographic databases in March 2015 were searched for published research on FOC, using a protocol agreed a priori. The quality of selected studies was assessed independently by pairs of authors. Prevalence data, definitions and methods of measurement were extracted independently from each included study by pairs of authors. Finally, some of the country rates were combined and compared.

Results

In total, 12,188 citations were identified and screened by title and abstract; 11,698 were excluded and full-text of 490 assessed for analysis. Of these, 466 were excluded leaving 24 papers included in the review, presenting prevalence of FOC from nine countries in Europe, Australia, Canada and the United States. Various definitions and measurements of FOC were used. The most frequently-used scale was the W-DEQ with various cut-off points describing moderate, severe/intense and extreme/phobic fear. Different 3-, 4-, and 5/6 point scales and visual analogue scales were also used. Country rates (as measured by seven studies using W-DEQ with ≥85 cut-off point) varied from 6.3 to 14.8%, a significant difference (chi-square = 104.44, d.f. = 6, p < 0.0001).

Conclusions

Rates of severe FOC, measured in the same way, varied in different countries. Reasons why FOC might differ are unknown, and further research is necessary. Future studies on FOC should use the W-DEQ tool with a cut-off point of ≥85, or a more thoroughly tested version of the FOBS scale, or a three-point scale measurement of FOC using a single question as ‘Are you afraid about the birth?’ In this way, valid comparisons in research can be made. Moreover, validation of a clinical tool that is more focussed on FOC alone, and easier than the longer W-DEQ, for women to fill in and clinicians to administer, is required.

Emneord
FOBS, Fear of childbirth, Prevalence, Request for caesarean section, Systematic review, W-DEQ
HSV kategori
Forskningsprogram
Människan i vården
Identifikatorer
urn:nbn:se:hb:diva-13554 (URN)10.1186/s12884-018-1659-7 (DOI)000422729400003 ()29329526 (PubMedID)2-s2.0-85040361801 (Scopus ID)
Tilgjengelig fra: 2018-01-17 Laget: 2018-01-17 Sist oppdatert: 2018-12-07
Sundler, A. J., Lindberg, E., Nilsson, C. & Palmér, L. (2018). Qualitative thematic analysis – based on phenomenology. In: : . Paper presented at The Nordic Conference in Nursing Research, Oslo, 13-15 June, 2018.
Åpne denne publikasjonen i ny fane eller vindu >>Qualitative thematic analysis – based on phenomenology
2018 (engelsk)Konferansepaper, Poster (with or without abstract) (Fagfellevurdert)
Emneord
Thematic analysis, phenomenology
HSV kategori
Forskningsprogram
Människan i vården
Identifikatorer
urn:nbn:se:hb:diva-15021 (URN)
Konferanse
The Nordic Conference in Nursing Research, Oslo, 13-15 June, 2018
Tilgjengelig fra: 2018-08-24 Laget: 2018-08-24 Sist oppdatert: 2018-09-06bibliografisk kontrollert
Nilsson, C., van Limbeek, E., Vehvilainen-Julkunen, K. & Lundgren, I. (2017). Vaginal birth after caesarean - Views of women from countries with high VBAC rate. Qualitative Health Research, 27(3), 325-340
Åpne denne publikasjonen i ny fane eller vindu >>Vaginal birth after caesarean - Views of women from countries with high VBAC rate
2017 (engelsk)Inngår i: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 27, nr 3, s. 325-340Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Despite the consequences for women’s health, a repeat cesarean section (CS) birth after a previous CS is common in Western countries. Vaginal Birth After Cesarean (VBAC) is recommended for most women, yet VBAC rates are decreasing and vary across maternity organizations and countries. We investigated women’s views on factors of importance for improving the rate of VBAC in countries where VBAC rates are high. We interviewed 22 women who had experienced VBAC in Finland, the Netherlands, and Sweden. We used content analysis, which revealed five categories: receiving information from supportive clinicians, receiving professional support from a calm and confident midwife/obstetrician during childbirth, knowing the advantages of VBAC, letting go of the previous childbirth in preparation for the new birth, and viewing VBAC as the first alternative for all involved when no complications are present. These findings reflect not only women’s needs but also sociocultural factors influencing their views on VBAC.

HSV kategori
Identifikatorer
urn:nbn:se:hb:diva-13440 (URN)10.1177/1049732315612041 (DOI)000394093500003 ()26531882 (PubMedID)2-s2.0-85009814134 (Scopus ID)
Tilgjengelig fra: 2018-01-14 Laget: 2018-01-14 Sist oppdatert: 2018-04-20bibliografisk kontrollert
Nilsson, C., Lalor, J., Begley, C., Carroll, M., Gross, M. M., Grylka-Baeschlin, S., . . . Healy, P. (2017). Vaginal birth after caesarean: Views of women from countries with low VBAC rates. Women and Birth, 30(6), 481-490, Article ID 28545775.
Åpne denne publikasjonen i ny fane eller vindu >>Vaginal birth after caesarean: Views of women from countries with low VBAC rates
Vise andre…
2017 (engelsk)Inngår i: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 30, nr 6, s. 481-490, artikkel-id 28545775Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

PROBLEM AND BACKGROUND:Vaginal birth after caesarean section is a safe option for the majority of women. Seeking women's views can be of help in understanding factors of importance for achieving vaginal birth in countries where the vaginal birth rates after caesarean is low.AIM:To investigate women's views on important factors to improve the rate of vaginal birth after caesareanin countries where vaginal birth rates after previous caesarean are low.

METHODS:A qualitative study using content analysis. Data were gathered through focus groups and individual interviews with 51 women, in their native languages, in Germany, Ireland and Italy. The women were asked five questions about vaginal birth after caesarean. Data were translated to English, analysed together and finally validated in each country.

FINDINGS:Important factors for the women were that all involved in caring for them were of the same opinion about vaginal birth after caesarean, that they experience shared decision-making with clinicians supportive of vaginal birth, receive correct information, are sufficiently prepared for a vaginal birth, and experience a culture that supports vaginal birth after caesarean.DISCUSSION AND

CONCLUSION:Women's decision-making about vaginal birth after caesarean in these countries involves a complex, multidimensional interplay of medical, psychosocial, cultural, personal and practical considerations. Further research is needed to explore if the information deficit women report negatively affects their ability to make informed choices, and to understand what matters most to women when making decisions about vaginal birth after a previous caesarean as a mode of birth.

Emneord
Caesarean section, Content analysis, Focus groups, Vaginal birth after caesarean, Women’s views
HSV kategori
Identifikatorer
urn:nbn:se:hb:diva-13555 (URN)10.1016/j.wombi.2017.04.009 (DOI)000418296300010 ()28545775 (PubMedID)2-s2.0-85019567233 (Scopus ID)
Tilgjengelig fra: 2018-01-17 Laget: 2018-01-17 Sist oppdatert: 2018-04-16bibliografisk kontrollert
Lundgren, I., Healy, P., Carroll, M., Begley, C., Matterne, A., Gross, M. M., . . . Lalor, J. (2016). Clinicians' views of factors of importance for improving the rate of VBAC (vaginal birth after caesarean section): a study from countries with low VBAC rates.. BMC Pregnancy and Childbirth, 16(1), Article ID 350.
Åpne denne publikasjonen i ny fane eller vindu >>Clinicians' views of factors of importance for improving the rate of VBAC (vaginal birth after caesarean section): a study from countries with low VBAC rates.
Vise andre…
2016 (engelsk)Inngår i: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 16, nr 1, artikkel-id 350Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

BACKGROUND: Caesarean section (CS) rates are increasing worldwide and the most common reason is repeat CS following previous CS. For most women a vaginal birth after a previous CS (VBAC) is a safe option. However, the rate of VBAC differs in an international perspective. Obtaining deeper knowledge of clinicians' views on VBAC can help in understanding the factors of importance for increasing VBAC rates. Focus group interviews with clinicians and women in three countries with high VBAC rates (Finland, Sweden and the Netherlands) and three countries with low VBAC rates (Ireland, Italy and Germany) are part of "OptiBIRTH", an ongoing research project. The study reported here aims to explore the views of clinicians from countries with low VBAC rates on factors of importance for improving VBAC rates.

METHODS: Focus group interviews were held in Ireland, Italy and Germany. In total 71 clinicians participated in nine focus group interviews. Five central questions about VBAC were used and interviews were analysed using content analysis. The analysis was performed in each country in the native language and then translated into English. All data were then analysed together and final categories were validated in each country.

RESULTS: The findings are presented in four main categories with several sub-categories: 1) "prameters for VBAC", including the importance of the obstetric history, present obstetric factors, a positive attitude among those who are centrally involved, early follow-up after CS and antenatal classes; 2) "organisational support and resources for women undergoing a VBAC", meaning a successful VBAC requires clinical expertise and resources during labour; 3) "fear as a key inhibitor of successful VBAC", including understanding women's fear of childbirth, clinicians' fear of VBAC and the ways that clinicians' fear can be transferred to women; and 4) "shared decision making - rapport, knowledge and confidence", meaning ensuring consistent, realistic and unbiased information and developing trust within the clinician-woman relationship.

CONCLUSIONS: The findings indicate that increasing the VBAC rate depends on organisational factors, the care offered during pregnancy and childbirth, the decision-making process and the strategies employed to reduce fear in all involved.

Emneord
CS, Clinicians, Content analysis, Focus groups, Midwifery, Qualitative study, VBAC
HSV kategori
Identifikatorer
urn:nbn:se:hb:diva-12861 (URN)10.1186/s12884-016-1144-0 (DOI)27832743 (PubMedID)
Forskningsfinansiär
EU, FP7, Seventh Framework Programme
Tilgjengelig fra: 2017-10-13 Laget: 2017-10-13 Sist oppdatert: 2018-04-16
Lundgren, I., Smith, V., Nilsson, C., Vehvilainen-Julkunen, K., Nicoletti, J., Devane, D., . . . Begley, C. (2015). Clinician-centred interventions to increase vaginal birth after caesarean section (VBAC): a systematic review.. BMC Pregnancy and Childbirth, 15(16)
Åpne denne publikasjonen i ny fane eller vindu >>Clinician-centred interventions to increase vaginal birth after caesarean section (VBAC): a systematic review.
Vise andre…
2015 (engelsk)Inngår i: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 15, nr 16Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

BACKGROUND: The number of caesarean sections (CS) is increasing globally, and repeat CS after a previous CS is a significant contributor to the overall CS rate. Vaginal birth after caesarean (VBAC) can be seen as a real and viable option for most women with previous CS. To achieve success, however, women need the support of their clinicians (obstetricians and midwives). The aim of this study was to evaluate clinician-centred interventions designed to increase the rate of VBAC.

METHODS: The bibliographic databases of The Cochrane Library, PubMed, PsychINFO and CINAHL were searched for randomised controlled trials, including cluster randomised trials that evaluated the effectiveness of any intervention targeted directly at clinicians aimed at increasing VBAC rates. Included studies were appraised independently by two reviewers. Data were extracted independently by three reviewers. The quality of the included studies was assessed using the quality assessment tool, 'Effective Public Health Practice Project'. The primary outcome measure was VBAC rates.

RESULTS: 238 citations were screened, 255 were excluded by title and abstract. 11 full-text papers were reviewed; eight were excluded, resulting in three included papers. One study evaluated the effectiveness of antepartum x-ray pelvimetry (XRP) in 306 women with one previous CS. One study evaluated the effects of external peer review on CS birth in 45 hospitals, and the third evaluated opinion leader education and audit and feedback in 16 hospitals. The use of external peer review, audit and feedback had no significant effect on VBAC rates. An educational strategy delivered by an opinion leader significantly increased VBAC rates. The use of XRP significantly increased CS rates.

CONCLUSIONS: This systematic review indicates that few studies have evaluated the effects of clinician-centred interventions on VBAC rates, and interventions are of varying types which limited the ability to meta-analyse data. A further limitation is that the included studies were performed during the late 1980s-1990s. An opinion leader educational strategy confers benefit for increasing VBAC rates. This strategy should be further studied in different maternity care settings and with professionals other than physicians only.

HSV kategori
Identifikatorer
urn:nbn:se:hb:diva-13989 (URN)10.1186/s12884-015-0441-3 (DOI)25652550 (PubMedID)
Prosjekter
OptiBIRTH
Forskningsfinansiär
EU, FP7, Seventh Framework Programme
Tilgjengelig fra: 2018-04-20 Laget: 2018-04-20 Sist oppdatert: 2018-04-23bibliografisk kontrollert
Lundgren, I., van Limbeek, E., Vehvilainen-Julkunen, K. & Nilsson, C. (2015). Clinicians' views of factors of importance for improving the rate of VBAC (vaginal birth after caesarean section): a qualitative study from countries with high VBAC rates.. BMC Pregnancy and Childbirth, 15, Article ID 196.
Åpne denne publikasjonen i ny fane eller vindu >>Clinicians' views of factors of importance for improving the rate of VBAC (vaginal birth after caesarean section): a qualitative study from countries with high VBAC rates.
2015 (engelsk)Inngår i: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 15, artikkel-id 196Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

BACKGROUND: The most common reason for caesarean section (CS) is repeat CS following previous CS. Vaginal birth after caesarean section (VBAC) rates vary widely in different healthcare settings and countries. Obtaining deeper knowledge of clinicians' views on VBAC can help in understanding the factors of importance for increasing VBAC rates. Interview studies with clinicians and women in three countries with high VBAC rates (Finland, Sweden and the Netherlands) and three countries with low VBAC rates (Ireland, Italy and Germany) are part of 'OptiBIRTH', an ongoing research project. The study reported here is based on interviews in high VBAC countries. The aim of the study was to investigate the views of clinicians working in countries with high VBAC rates on factors of importance for improving VBAC rates.

METHODS: Individual (face-to-face or telephone) interviews and focus group interviews with clinicians (in different maternity care settings) in three countries with high VBAC rates were conducted during 2012-2013. In total, 44 clinicians participated: 26 midwives and 18 obstetricians. Five central questions about VBAC were used and interviews were analysed using content analysis. The analysis was performed in each country in the native language and then translated into English. All data were then analysed together and final categories were validated in each country.

RESULTS: The findings are presented in four main categories with subcategories. First, a common approach is needed, including: feeling confident with VBAC, considering VBAC as the first alternative, communicating well, working in a team, working in accordance with a model and making agreements with the woman. Second, obstetricians need to make the final decision on the mode of delivery while involving women in counselling towards VBAC. Third, a woman who has a previous CS has a similar need for support as other labouring women, but with some extra precautions and additional recommendations for her care. Finally, clinicians should help strengthen women's trust in VBAC, including building their trust in giving birth vaginally, recognising that giving birth naturally is an empowering experience for women, alleviating fear and offering extra visits to discuss the previous CS, and joining with the woman in a dialogue while leaving the decision about the mode of birth open.

CONCLUSIONS: This study shows that, according to midwives and obstetricians from countries with high VBAC rates, the important factors for improving the VBAC rate are related to the structure of the maternity care system in the country, to the cooperation between midwives and obstetricians, and to the care offered during pregnancy and birth. More research on clinicians' perspectives is needed from countries with low, as well as high, VBAC rates.

HSV kategori
Identifikatorer
urn:nbn:se:hb:diva-12862 (URN)10.1186/s12884-015-0629-6 (DOI)000360275900001 ()26314295 (PubMedID)2-s2.0-84940378961 (Scopus ID)
Forskningsfinansiär
EU, FP7, Seventh Framework Programme
Tilgjengelig fra: 2017-10-13 Laget: 2017-10-13 Sist oppdatert: 2018-04-26bibliografisk kontrollert
Organisasjoner
Identifikatorer
ORCID-id: ORCID iD iconorcid.org/0000-0002-3195-5702