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Maastrup, R., Haiek, L. N., Lubbe, W., Meerkin, D. Y., Wolff, L., Hatasaki, K., . . . O'Donoghue, D. (2019). Compliance with the "Baby-friendly Hospital Initiative for Neonatal Wards" in 36 countries. Maternal and Child Nutrition, 15(2), Article ID e12690.
Open this publication in new window or tab >>Compliance with the "Baby-friendly Hospital Initiative for Neonatal Wards" in 36 countries
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2019 (English)In: Maternal and Child Nutrition, ISSN 1740-8695, E-ISSN 1740-8709, Vol. 15, no 2, article id e12690Article in journal (Refereed) Published
Abstract [en]

In 2012, the Baby-friendly Hospital Initiative for Neonatal Wards (Neo-BFHI) began providing recommendations to improve breastfeeding support for preterm and ill infants. This cross-sectional survey aimed to measure compliance on a global level with the Neo-BFHI's expanded Ten steps to Successful Breastfeeding and three Guiding Principles in neonatal wards. In 2017 the Neo-BFHI Self-Assessment questionnaire was used in 15 languages to collect data from neonatal wards of all levels of care. Answers were summarized into compliance scores ranging from 0 to 100 at the ward, country and international levels. A total of 917 neonatal wards from 36 low, middle and high-income countries from all continents participated. The median international overall score was 77, and median country overall scores ranged from 52 to 91. Guiding Principle 1 (respect for mothers), Step 5 (breastfeeding initiation and support), and Step 6 (human milk use) had the highest scores, 100, 88, and 88, respectively. Steps 3 (antenatal information) and 7 (rooming-in) had the lowest scores, 63 and 67, respectively. High-income countries had significantly higher scores for Guiding principle 2 (family-centered care), Step 4 (skin-to-skin contact) and Step 5. Neonatal wards in hospitals ever-designated Baby-friendly had significantly higher scores than those never designated. Sixty percent of managers stated they would like to obtain Neo-BFHI designation. Currently, Neo-BFHI recommendations are partly implemented in many countries. The high number of participating wards indicates international readiness to expand Baby-friendly standards to neonatal settings. Hospitals and governments should increase their efforts to better support breastfeeding in neonatal wards.

Keywords
Baby-friendly Hospital Initiative, breastfeeding, compliance, lactation, monitoring, neonatal, preterm
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-28487 (URN)10.1111/mcn.12690 (DOI)000461886000007 ()30198645 (PubMedID)
Available from: 2018-09-17 Created: 2018-09-17 Last updated: 2019-04-11Bibliographically approved
Flacking, R., Breili C, C. & Eriksson, M. (2019). Facilities for presence and provision of support to parents and significant others in neonatal units.. Acta Paediatrica
Open this publication in new window or tab >>Facilities for presence and provision of support to parents and significant others in neonatal units.
2019 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227Article in journal (Refereed) Epub ahead of print
Abstract [en]

AIM: To describe parental facilities for staying in neonatal units, visiting policies, and access to emotional support during hospitalization.

METHODS: A cross-sectional design was used in which a survey was presented to all neonatal units in Sweden; 34 out of 38 units participated (89%).

RESULTS: The findings showed that in 50% of the units, parents could stay 24/7 for the infant's entire hospital stay. In 32% of the units, siblings could stay the night with their parents. Units had policies on restrictions for visits by siblings (80%), grandparents (59%), friends and relatives (71%). All units offered counselling to parents, and some units offered peer-to-peer groups (24%), diaries (35%), relaxation techniques (6%) or internet parental forums (6%). All units enabled parents to be at home with their infant and to visit the unit for check-ups (35%) or to have staff visits at home (65%).

CONCLUSION: Facilities for parents to stay with their infant during hospitalization and to have significant others visit are good, but there is room for improvement. During the transitional phase to being at home, parents are facilitated in being at home before the infant is discharged and are supported by the unit, which must be considered beneficial for parents. This article is protected by copyright. All rights reserved.

National Category
Nursing
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-30593 (URN)10.1111/apa.14948 (DOI)31350769 (PubMedID)
Available from: 2019-08-06 Created: 2019-08-06 Last updated: 2019-08-06Bibliographically approved
Osman, F., Flacking, R., Klingberg-Allvin, M. & Schön, U.-K. (2019). Qualitative study showed that a culturally tailored parenting programme improved the confidence and skills of Somali immigrants. Acta Paediatrica, 108(8), 1482-1490
Open this publication in new window or tab >>Qualitative study showed that a culturally tailored parenting programme improved the confidence and skills of Somali immigrants
2019 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 8, p. 1482-1490Article in journal (Refereed) Published
Abstract [en]

AIM: Parenting programmes tailored to immigrant parents have been reported to improve the mental health of the children and parents, as well as parents' sense of competence in parenting. However, research on parents' experiences of programmes tailored to their needs is scarce. This qualitative study aimed to describe Somali parents' experiences of how a culturally sensitive programme affected their parenting.

METHODS: The study was conducted in a middle-sized city in Sweden in 2015. Data were collected through semi-structured interviews with 50 participants two months after they took part in a parenting support programme. Inductive and deductive qualitative content analyses were used.

RESULTS: A light has been shed was a metaphor that emerged from the analysis and that captured the knowledge the parents gained from the parenting system in Sweden. Parents gained confidence in their parenting role and became emotionally aware of their child's social and emotional needs and how to respond to them. Holding the sessions in the participant's native language was important for the parents' participation and acceptance of the programme.

CONCLUSION: Parenting programmes should be tailored to the specific needs of the participants and cultural sensitivity should be factored into programmes to attract immigrant parents. This article is protected by copyright. All rights reserved.

Keywords
cultural sensitivity, effective parenting, family relationships, immigrants, parenting programmes
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29761 (URN)10.1111/apa.14788 (DOI)000474935600019 ()30896042 (PubMedID)2-s2.0-85064519588 (Scopus ID)
Available from: 2019-03-26 Created: 2019-03-26 Last updated: 2019-07-29Bibliographically approved
Joffer, J., Flacking, R., Bergström, E., Randell, E. & Jerdén, L. (2019). Self-rated health, subjective social status in school and socioeconomic status in adolescents: a cross-sectional study. BMC Public Health, 19, Article ID 785.
Open this publication in new window or tab >>Self-rated health, subjective social status in school and socioeconomic status in adolescents: a cross-sectional study
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2019 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, article id 785Article in journal (Refereed) Published
Abstract [en]

Background: Social position, traditionally measured by objective data on socioeconomic status (SES), is linked to health status in adults. In adolescents, the association is more uncertain and there are some studies suggesting that subjective social status (SSS) might be more adequate in relation to health. This study aimed to examine associations between SSS in school, SES and self-rated health (SRH) in adolescent boys and girls.

Methods: A descriptive cross-sectional research design with quantitative survey data was used. The study involved 705 Swedish adolescents in upper secondary school (17–18-year-olds). SRH was measured with a single-item question and SSS by a question where adolescents were asked to assess their social position within their school. Formal education level of the parents was used as a proxy for objective SES. Univariable and multivariable ordinal regression analyses were conducted to assess the associations between SRH and SSS in school and SES.

Results: In the multivariable analysis, SSS in school was positively associated with SRH, whereas no significant association between SES and SRH was found. The proportion of adolescents with high SRH increased with higher steps on the SSS ladder. Significant gender differences were found in that boys rated their SRH and SSS in school higher than girls did.

Conclusions: The study shows that self-rated health in adolescents is related to perceived social position in school. Subjective social status in school seems to be a useful health-related measure of social position in adolescents.

Keywords
Adolescents, Gender Health status, Self-rated health, Socioeconomic status, Subjective social status
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-30374 (URN)10.1186/s12889-019-7140-3 (DOI)000472845800005 ()31221114 (PubMedID)2-s2.0-85067561580 (Scopus ID)
Available from: 2019-06-24 Created: 2019-06-24 Last updated: 2019-07-23Bibliographically approved
Tandberg, B. S., Frøslie, K. F., Markestad, T., Flacking, R., Grundt, H. & Moen, A. (2019). Single-family room design in the neonatal intensive care unit did not improve growth. Acta Paediatrica, 108(6), 1028-1035
Open this publication in new window or tab >>Single-family room design in the neonatal intensive care unit did not improve growth
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2019 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 6, p. 1028-1035Article in journal (Refereed) Published
Abstract [en]

AIM: The aim was to compare growth in very premature infants cared for in a single-family room and an open-bay unit. We recorded duration of parental presence and skin-to-skin contact as proxies for parental involvement in care of their infants.

METHODS: We consecutively included infants with gestational ages 28+0 through 32+0 weeks at two hospitals in Norway, one single-family room unit (n=35) and one open-bay unit (n=42). Weight, length, and head circumference were followed from birth to four months after term date. Both units adhered to the same nutritional protocol and methods of recording events.

RESULTS: The single-family room mothers spent a mean (standard deviation) of 111 (38) hours and the open bay mothers 33 (13) hours with their infants during the first week and 21 (5) versus 7 (3) hours per day later. The respective duration of skin-to-skin care was 21 (10) versus 12 (8) hours during the first week and 4.2 (2) versus 3.0 (2) hours per day later. The differences were similar, but less pronounced for the fathers. The growth trajectories did not differ between the groups.

CONCLUSION: Single-family room care was associated with more parental involvement, but not with better growth. This article is protected by copyright. All rights reserved.

Keywords
Family-centred care, Growth, Single-family room, Skin-to-skin contact, Very premature infant
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29461 (URN)10.1111/apa.14746 (DOI)000467867900010 ()30729563 (PubMedID)2-s2.0-85062990829 (Scopus ID)
Available from: 2019-02-11 Created: 2019-02-11 Last updated: 2019-06-03Bibliographically approved
Ahrne, M., Adan, A., Schytt, E., Andersson, E., Small, R., Flacking, R. & Byrskog, U. (2018). Antenatal care for Somali born women in Sweden – perspectives from mothers, fathers and midwives. In: European Journal of Public Health, Volume 28, Issue suppl_1, May 2018: . Paper presented at 1st World Congress on Migration, Ethnicity, Race and Health, 17-19 May 2018, Edinburgh. , 28
Open this publication in new window or tab >>Antenatal care for Somali born women in Sweden – perspectives from mothers, fathers and midwives
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2018 (English)In: European Journal of Public Health, Volume 28, Issue suppl_1, May 2018, 2018, Vol. 28Conference paper, Oral presentation with published abstract (Refereed)
Series
European Journal of Public Health, ISSN 1101-1262
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-30423 (URN)10.1093/eurpub/cky047.252 (DOI)
Conference
1st World Congress on Migration, Ethnicity, Race and Health, 17-19 May 2018, Edinburgh
Available from: 2019-06-26 Created: 2019-06-26 Last updated: 2019-06-26Bibliographically approved
Ericson, J., Eriksson, M., Hoddinott, P., Hellström-Westas, L. & Flacking, R. (2018). Breastfeeding and risk for ceasing in mothers of preterm infants - long-term follow-up. Maternal and Child Nutrition, 14(4), Article ID e12618.
Open this publication in new window or tab >>Breastfeeding and risk for ceasing in mothers of preterm infants - long-term follow-up
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2018 (English)In: Maternal and Child Nutrition, ISSN 1740-8695, E-ISSN 1740-8709, Vol. 14, no 4, article id e12618Article in journal (Refereed) Published
Abstract [en]

Breastfeeding is challenging for mothers of preterm infants. The aim of this paper is to describe risk factors for ceasing breastfeeding and methods of feeding until 12 months postnatal age in mothers who breastfed their preterm infants at discharge from neonatal intensive care units (NICUs). The data come from a randomised controlled trial, which evaluated the effectiveness on exclusive breastfeeding at 8 weeks of proactive telephone support compared with reactive support offered to mothers of preterm infants following discharge from NICU. Six NICUs across Sweden randomised a total of 493 mothers. We used regression and survival analyses to assess the risk factors for ceasing breastfeeding and the long-term outcomes of the intervention. The results showed that 305 (64%) of the infants were breastfed at 6 months and 49 (21%) at 12 months. Partial breastfeeding at discharge, low maternal educational level, and longer length of stay in the NICU increased the risk for ceasing breastfeeding during the first 12 months. Furthermore, the Kaplan-Meier analysis showed that the proportion of mothers who ceased breastfeeding did not differ between the intervention (n = 231) and controls (n = 262) during the first 12 months (log-rank test p = .68). No difference was found between groups on method of feeding. More than 85% of the infants were fed directly at the breast. These findings provide important insights for health professionals who are supporting mothers of preterm infants to breastfeed long term.

Registered in www.clinicaltrials.gov (NCT01806480).

Keywords
RCT, bottle, breast milk, feeding, mother, neonatal
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-27651 (URN)10.1111/mcn.12618 (DOI)000448900800013 ()29733102 (PubMedID)2-s2.0-85046532136 (Scopus ID)
Note

Open Access APC beslut 11/2018

Available from: 2018-05-09 Created: 2018-05-09 Last updated: 2018-11-15Bibliographically approved
Tandberg, B. S., Frøslie, K. F., Flacking, R., Grundt, H., Lehtonen, L. & Moen, A. (2018). Parent-infant closeness, parents' participation, and nursing support in single-family room and open bay NICUs. Journal of Perinatal & Neonatal Nursing, 32(4), E22-E32
Open this publication in new window or tab >>Parent-infant closeness, parents' participation, and nursing support in single-family room and open bay NICUs
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2018 (English)In: Journal of Perinatal & Neonatal Nursing, ISSN 0893-2190, E-ISSN 1550-5073, Vol. 32, no 4, p. E22-E32Article in journal (Refereed) Published
Abstract [en]

This was a prospective survey study, comparing parent-infant closeness, parents' perceptions of nursing support, and participation in medical rounds in single-family room (SFR) and an open bay (OB) neonatal intensive care units. Nurses' assessments of provided support were also measured. In total, 115 parents of 64 preterm infants less than 35 weeks' gestational age and 129 nurses participated. Parents recorded the presence and skin-to-skin care. Parents were sent 9 text message questions in random order. Nurses answered corresponding Internet-based questions. SFR mothers were more present, 20 hours daily (median) versus 7 hours (P < .001), initiated skin-to-skin contact (SSC) at 4 versus 12 hours (P = .03), and preformed SSC 180 min/24 h versus 120 min/24 h for mothers in the OB unit (P = .02). SFR fathers were also more present, 8 versus 4 hours (P < .001), initiated SSC at 3 versus 40 hours (P = .004), and performed SSC 67 min/24 h versus 31 min/24 h (P = .05). SFR parents rated participation in medical rounds and emotional support higher than OB parents. Parental trust was rated higher by nurses in the OB unit (P = .02). SFR facilitated parent-infant closeness, parents' participation in medical rounds, and increased support from nurses.

National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-28848 (URN)10.1097/JPN.0000000000000359 (DOI)000450894700003 ()30358674 (PubMedID)2-s2.0-85055610909 (Scopus ID)
Available from: 2018-10-29 Created: 2018-10-29 Last updated: 2019-02-19Bibliographically approved
Randell, E., Joffer, J., Flacking, R., Starrin, B. & Jerdén, L. (2018). Pride, shame and health among adolescents – a cross-sectional survey. International Journal of Adolescent Medicine and Health, 30(6), Article ID 20160107.
Open this publication in new window or tab >>Pride, shame and health among adolescents – a cross-sectional survey
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2018 (English)In: International Journal of Adolescent Medicine and Health, ISSN 0334-0139, E-ISSN 2191-0278, Vol. 30, no 6, article id 20160107Article in journal (Refereed) Published
Abstract [en]

Background

Pride and shame are important emotions known to influence identity development and psychological well-being in adolescence. Research evidence indicates that self-rated health (SRH) is a strong predictor of future health. This cross-sectional study, conducted during 2008–2009, aimed to investigate the associations between pride, shame and SRH among adolescent boys and girls.

Methods

The study sample comprised 705 adolescents in Sweden aged 17–18 years (318 boys and 387 girls) who completed a questionnaire that included items on SRH, shame and pride (participation rate 67%). Logistic regression analyses (univariable and multivariable) were used to investigate the associations between pride and shame as separate and combined constructs on SRH, adjusting for potential confounders (country of birth, parental educational level, school experience, having enough friends, mood in family and being active in associations).

Results

Pride and shame separately were significantly associated with SRH in both genders. Logistic regression analysis of the pride-shame model showed that the odds of having lower SRH were highest in boys and girls with lower pride-higher shame. In a multivariable logistic regression analysis of the pride-shame model the odds of having lower SRH remained significant in boys and girls with lower pride-higher shame [boys: odds ratio (OR) 3.51, confidence interval (CI) 1.40–8.81; girls: OR 2.70, CI 1.22–5.96] and in girls with lower pride-lower shame (OR 2.16, CI 1.02–4.56).

Conclusion

The emotions of shame and pride are associated with SRH in adolescence. Experiencing pride seems to serve as a protective mechanism in SRH in adolescents exposed to shame. We believe that this knowledge should be useful in adolescent health promotion.

Keywords
adolescent, health status, pride, priding, self-rated health, shame, shaming, Sweden
National Category
Health Sciences
Research subject
Health and Welfare, Hälsa ur ett ungdomsperspektiv
Identifiers
urn:nbn:se:du-25270 (URN)10.1515/ijamh-2016-0107 (DOI)2-s2.0-85059687925 (Scopus ID)
Available from: 2017-06-21 Created: 2017-06-21 Last updated: 2019-01-21Bibliographically approved
Ericson, J., Eriksson, M., Hellström-Westas, L., Hoddinott, P. & Flacking, R. (2018). Proactive telephone support provided to breastfeeding mothers of preterm infants after discharge: a randomised controlled trial. Acta Paediatrica, 107(5), 791-798
Open this publication in new window or tab >>Proactive telephone support provided to breastfeeding mothers of preterm infants after discharge: a randomised controlled trial
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2018 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, no 5, p. 791-798Article in journal (Refereed) Published
Abstract [en]

AIM: The aim was to evaluate the effectiveness of proactive telephone support provided to breastfeeding mothers of preterm infants after discharge from neonatal intensive care units (NICU).

METHODS: Between March 2013 and December 2015, a randomised controlled trial was conducted at six NICUs across Sweden. At each NICU, a breastfeeding support team recruited, randomised and delivered the support to participating mothers. The intervention group received a daily proactive telephone call up to 14 days after discharge from the support team. The control group could initiate telephone contact themselves. Primary outcome was exclusive breastfeeding eight weeks after discharge. Secondary outcomes were maternal satisfaction with breastfeeding, attachment, quality of life and parental stress.

RESULTS: In total, 493 mothers were randomised, 231 to intervention group and 262 to control group. There were no differences between the groups for exclusive breastfeeding, odds ratio 0.96, 95% CI 0.66-1.38, nor for maternal satisfaction with breastfeeding, attachment or quality of life. The intervention group reported significantly less parental stress than the controls, t=2.44, 95% CI 0.03-0.23, effect size d=0.26.

CONCLUSION: In this trial, proactive telephone support was not associated with increased exclusive breastfeeding prevalence eight weeks following discharge. However, intervention group mothers showed significantly lower parental stress. This article is protected by copyright. All rights reserved.

Keywords
Breast milk, discharge, neonatal, person-centred, preterm births
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-27209 (URN)10.1111/apa.14257 (DOI)000430115100012 ()29405368 (PubMedID)2-s2.0-85045438738 (Scopus ID)
Note

Open Access APC beslut 3/2018

Available from: 2018-02-14 Created: 2018-02-14 Last updated: 2018-12-13Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-4013-1553

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