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Publications (10 of 73) Show all publications
Persson, C., Ericson, J., Salari, R., Eriksson, M. H. & Flacking, R. (2023). NICU parents' mental health: A comparative study with parents of term and healthy infants. Acta Paediatrica, 112(5), 954-966
Open this publication in new window or tab >>NICU parents' mental health: A comparative study with parents of term and healthy infants
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2023 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 112, no 5, p. 954-966Article in journal (Refereed) Published
Abstract [en]

AIM: To compare mental health in parents of preterm/ill infants and parents of term and healthy infants before birth and 1 month after hospital discharge.

METHODS: A comparative cohort design was used. In total 439 parents from six neonatal intensive care units (NICUs) and 484 parents from four maternity units (MUs) in Sweden answered a survey 1 month after discharge.

RESULTS: Parents in neonatal units experienced significantly more psychologically traumatic births and rated their health and the health of their infants less favourably the first week after delivery than parents in MUs. In the neonatal units, both parents had better possibilities to stay together with the infant during hospital stay. There was no difference between the NICU and MU groups in postpartum depressive symptoms 1 month after discharge. Experiencing a traumatic birth was not related to an increased risk of perinatal depressive symptoms (Edinburgh Postnatal Depression Scale ≥13) for mothers in NICUs. In contrast, the risk of depression increased for mothers in MUs.

CONCLUSION: Family togetherness, parent-infant closeness and emotional support at NICUs may contribute to the positive outcome. Further studies are needed to assess the long-term effects of how family togetherness and closeness influence families long-term.

Keywords
NICU, mental health, neonatal care, parents, preterm infants
National Category
Nursing
Identifiers
urn:nbn:se:du-45612 (URN)10.1111/apa.16735 (DOI)000952489900001 ()36853186 (PubMedID)2-s2.0-85150763413 (Scopus ID)
Available from: 2023-03-09 Created: 2023-03-09 Last updated: 2023-04-24Bibliographically approved
Tandberg, B. S., Grundt, H., Moen, A., Niela-Vilén, H. & Flacking, R. (2023). Prospective longitudinal comparative study showed that breastfeeding outcomes were comparable in preterm twins and singleton infants. Acta Paediatrica, 112(8), 1689-1695
Open this publication in new window or tab >>Prospective longitudinal comparative study showed that breastfeeding outcomes were comparable in preterm twins and singleton infants
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2023 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 112, no 8, p. 1689-1695Article in journal (Refereed) Published
Abstract [en]

AIM: We compared milk volumes, skin-to-skin contact and breastfeeding by the mothers of very preterm twins and singleton infants born at 28-32 weeks of gestation.

METHODS: This Norwegian longitudinal prospective comparative study was carried out in two neonatal intensive care units: one with single family rooms and one open bay unit. It comprised 49 singleton infants, 28 twins and their mothers. The mothers' milk volume and direct breastfeeding were recorded from birth until four months' of corrected age. They also answered the Breastfeeding Self-Efficacy Scale and skin-to-skin contact was recorded.

RESULTS: The mothers of preterm twins produced doubled the volume of expressed milk at day 14, compared to the mothers of singletons (mean 816±430 ml versus 482±372 ml, p<0.05) and this difference was still sustained at 34+0 weeks/days (p<0.02). Mothers of twins had their first breastfeeding attempt later than mothers of singletons (median of 133 hours compared to 56 (<0.002). Preterm twins received less daily skin-to-skin contact (mean 157 ±66 minutes each versus 244±109) (<0.001). There were no differences in receiving mother's own milk, exclusively direct breastfeeding or perceived breastfeeding self-efficacy.

CONCLUSION: Breastfeeding was initiated as successfully in preterm twins as singletons as the mothers' milk production doubled.

Keywords
breast milk, breastfeeding, neonatal intensive care, preterm, twins
National Category
Pediatrics
Identifiers
urn:nbn:se:du-46007 (URN)10.1111/apa.16811 (DOI)000988204900001 ()37151109 (PubMedID)2-s2.0-85159161448 (Scopus ID)
Available from: 2023-05-10 Created: 2023-05-10 Last updated: 2023-08-03Bibliographically approved
Jonsdottir, R. B., Flacking, R. & Jonsdottir, H. (2022). Breastfeeding initiation, duration, and experiences of mothers of late preterm twins: a mixed-methods study. International Breastfeeding Journal, 17(1), Article ID 68.
Open this publication in new window or tab >>Breastfeeding initiation, duration, and experiences of mothers of late preterm twins: a mixed-methods study
2022 (English)In: International Breastfeeding Journal, ISSN 1746-4358, E-ISSN 1746-4358, Vol. 17, no 1, article id 68Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Twins and late preterm (LPT) infants are at an increased risk of being breastfed to a lesser extent than term singletons. This study aimed to describe the initiation and duration of any and exclusive breastfeeding at the breast for mothers of LPT twins and term twins during the first 4 months and to explore the breastfeeding experiences of mothers of LPT twins.

METHODS: A sequential two-sample quantitative-qualitative explanatory mixed-methods design was used. The quantitative data were derived from a longitudinal cohort study in which 22 mothers of LPT twins and 41 mothers of term twins answered questionnaires at one and four months after birth (2015-2017). The qualitative data were obtained from semi-structured interviews with 14 mothers of LPT twins (2020-2021), based on results from the quantitative study and literature. Analysis included descriptive statistics of quantitative data and deductive content analysis of the qualitative data, followed by condensation and synthesis.

RESULTS: All mothers of LPT twins (100%) and most mothers of term twins (96%) initiated breastfeeding. There was no difference in any breastfeeding during the first week at home (98% versus 95%) and at 1 month (88% versus 85%). However, at 4 months, the difference was significant (44% versus 75%). The qualitative data highlighted that mothers of LPT twins experienced breastfeeding as complex and strenuous. Key factors influencing mothers' experiences and decisions were their infants' immature breastfeeding behaviors requiring them to express breast milk alongside breastfeeding, the burden of following task-oriented feeding regimes, and the lack of guidance from healthcare professionals. As a result, mothers started to question the worth of their breastfeeding efforts, leading to changes in breastfeeding management with diverse results. Support from fathers and grandparents positively influenced sustained breastfeeding.

CONCLUSIONS: Mothers of LPT twins want to breastfeed, but they face many challenges in breastfeeding during the first month, leading to more LPT twins' mothers than term twins' mothers ceasing breastfeeding during the following months. To promote and safeguard breastfeeding in this vulnerable group, care must be differentiated from routine term infant services, and healthcare professionals need to receive proper education and training.

Keywords
Breastfeeding, Late preterm, Mixed-methods, Twins
National Category
Health Sciences
Identifiers
urn:nbn:se:du-42698 (URN)10.1186/s13006-022-00507-3 (DOI)000852391000001 ()36076279 (PubMedID)2-s2.0-85137547147 (Scopus ID)
Available from: 2022-09-13 Created: 2022-09-13 Last updated: 2023-03-17Bibliographically approved
Kalid, M., Flacking, R., Sulaiman, M. & Osman, F. (2022). Effects of Nutrition Counselling and Unconditional Cash Transfer on Child Growth and Family Food Security in Internally Displaced Person Camps in Somalia: A Quasi-Experimental Study. International Journal of Environmental Research and Public Health, 19(20), Article ID 13441.
Open this publication in new window or tab >>Effects of Nutrition Counselling and Unconditional Cash Transfer on Child Growth and Family Food Security in Internally Displaced Person Camps in Somalia: A Quasi-Experimental Study
2022 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 20, article id 13441Article in journal (Refereed) Published
Abstract [en]

The effects of nutrition counselling (NC) and unconditional cash transfer (UCT) in improving growth in children under five and household food security are poorly understood in humanitarian settings. Therefore, this study aimed to evaluate the effects of NC and NC combined with unconditional cash transfer (NC + UCT) on children’s growth and food security in Somalia. The study was performed with a quasi-experimental design in two districts in the Banadir region of Somalia. Caregivers (n = 255) with mildly to moderately malnourished children aged 6 to 59 months old (n = 184) were randomized to the NC, NC + UCT and control groups. The interventions consisted of weekly NC for three months alone or in combination with UCT. The outcome variables were wasting, underweight, stunting, and food security. Difference-indifferences analysis was used to estimate the effect of the interventions. Our study did not find any significant impacts of NC or NC + UCT on child wasting, underweight, stunting, food security or household expenses. In conclusion, NC, alone or in combination with UCT, did not impact children’s growth or household food security. Thus, a culturally tailored NC programme over a longer period, supplemented with cash transfer, could be beneficial to consider when designing interventions to reduce malnutrition and food insecurity.

Place, publisher, year, edition, pages
MDPI, 2022
Keywords
counselling; cash transfer; humanitarian setting; IDP; nutrition; underweight; wasting
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:du-42919 (URN)10.3390/ijerph192013441 (DOI)000873306400001 ()36294019 (PubMedID)2-s2.0-85140909057 (Scopus ID)
Available from: 2022-10-24 Created: 2022-10-24 Last updated: 2023-03-17Bibliographically approved
Saade, S., Flacking, R. & Ericson, J. (2022). Parental experiences and breastfeeding outcomes of early support to new parents from family health care centres: a mixed method study. BMC Pregnancy and Childbirth, 22(1), Article ID 150.
Open this publication in new window or tab >>Parental experiences and breastfeeding outcomes of early support to new parents from family health care centres: a mixed method study
2022 (English)In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 22, no 1, article id 150Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Early parenthood is a sensitive period for parents. Parents may feel uncertain about their new roles and unsure about where to find trusted information and support. The aim of this study was to explore the association between breastfeeding and early home visits and a proactive telephone support intervention and to describe parental experiences.

METHOD: This study was conducted as a mixed method study with a convergent design using qualitative data from the written comments of parents, and the quantitative data consisted of demographics, breastfeeding, and Likert questions about parents' satisfaction with the early home visit and telephone support. Historic control (2017-2018) and intervention (2019-2020) data were collected from one family health care centre, and control (2019-2020) data were collected from another family health care centre.

RESULTS: In total, 838 infants, 42 mothers and 38 fathers contributed to the data in the study. The intervention group had a statistically significantly earlier home visit than the control groups. Early home visits and proactive telephone support to parents with newborn infants were not associated with breastfeeding outcomes up to six months after birth, but we could not exclude the possibility that this was a consequence of our observational study design. However, the early home visit was appreciated by the parents where they received both practical and emotional support.

CONCLUSIONS: Although the intervention was not associated with breastfeeding, the parents appreciated the service. This shows the importance of continuing to investigate how and which support parents of newborn infants need and the effects of such support, including interventions to provide optimal support to facilitate continued breastfeeding.

National Category
Nursing
Identifiers
urn:nbn:se:du-39725 (URN)10.1186/s12884-022-04469-6 (DOI)000760206600001 ()35197015 (PubMedID)2-s2.0-85125154337 (Scopus ID)
Available from: 2022-03-01 Created: 2022-03-01 Last updated: 2023-04-14Bibliographically approved
Flacking, R., Haslund-Thomsen, H., Jonsdottir, R., Poropudas, S. & Axelin, A. (2022). Parents' friends and families in neonatal intensive care units: A cross-national qualitative study on staff perceptions and experiences. Journal of Clinical Nursing, 31, 3120-3129
Open this publication in new window or tab >>Parents' friends and families in neonatal intensive care units: A cross-national qualitative study on staff perceptions and experiences
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2022 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 31, p. 3120-3129Article in journal (Refereed) Published
National Category
Health Sciences
Identifiers
urn:nbn:se:du-39002 (URN)10.1111/jocn.16139 (DOI)000721774900001 ()34816522 (PubMedID)2-s2.0-85119666794 (Scopus ID)
Available from: 2021-12-16 Created: 2021-12-16 Last updated: 2023-04-27Bibliographically approved
Kainiemi, E., Flacking, R., Lehtonen, L., Pasanen, M. & Axelin, A. (2022). Psychometric Properties of an Instrument to Measure the Quality of Family-Centered Care in NICUs. Journal of Obstetric, Gynecologic and Neonatal Nursing, 51(4), 461-472
Open this publication in new window or tab >>Psychometric Properties of an Instrument to Measure the Quality of Family-Centered Care in NICUs
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2022 (English)In: Journal of Obstetric, Gynecologic and Neonatal Nursing, ISSN 0884-2175, E-ISSN 1552-6909, Vol. 51, no 4, p. 461-472Article in journal (Refereed) Published
Abstract [en]

Objective: To examine the psychometric properties of the Digi Family-Centered Care-Parent Version (DigiFCC-P), which was developed to measure parents' perceptions of family-centered care (FCC) in NICUs. Design: Cross-sectional psychometric study. Setting: Twenty-three NICUs in 15 countries in Europe, Canada, and Australia. Participants: Mothers (n = 565) and fathers (n = 406) of preterm infants hospitalized in NICUs. Methods: Participants reported their perceptions of the quality of FCC during their infants' hospitalizations by answering one DigiFCC-P question delivered to their mobile phones every evening. Nine questions rotated in random order. Participants responded on a 7-point Likert scale. We evaluated the instrument's internal consistency, construct and concurrent validity, and sensitivity. Results: The internal consistency of the DigiFCC-P was satisfactory; the Cronbach's alpha coefficient was .74 (95% confidence interval [.71, .77]), and all the corrected item-total correlations were greater than .30. We identified that the items formed two factors, support from staff and the parent's active participation, and observed no strong item cross-loadings on the two factors. We discovered some items with weak interitem correlations, and the two factors explained 35.2% of the variance. Scores on the DigiFCC-P and Family-Centered Care Questionnaire were significantly correlated (r = .59, p < .001) and supported the convergent validity of the instrument. In addition, changes were discovered in the participants' ratings over time, which indicated that the instrument was sensitive to detect changes in their evaluations. Conclusion: The psychometric testing of the DigiFCC-P provided initial support for the convergent validity and reliability of the instrument. The instrument was also sensitive in detecting changes in the evaluations of FCC over time. However, there is a need for further development of the content validity of the instrument.

Keywords
exploratory factor analysis, family-centered care, instrument assessment, NICU, psychometric properties, reliability, validity
National Category
Health Sciences
Identifiers
urn:nbn:se:du-42879 (URN)10.1016/j.jogn.2022.04.004 (DOI)000861802500012 ()35598704 (PubMedID)2-s2.0-85132912977 (Scopus ID)
Available from: 2022-10-24 Created: 2022-10-24 Last updated: 2023-03-17Bibliographically approved
Osman, F., Schön, U.-K., Klingberg-Allvin, M., Flacking, R. & Tistad, M. (2022). The implementation of a culturally tailored parenting support programme for Somali immigrant parents living in Sweden: A process evaluation. PLOS ONE, 17(9), Article ID e0274430.
Open this publication in new window or tab >>The implementation of a culturally tailored parenting support programme for Somali immigrant parents living in Sweden: A process evaluation
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2022 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 17, no 9, article id e0274430Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Parental support programmes aim to strengthen family functioning and the parent-child relationship and to promote the mental health of children and parents. However, there is a lack of knowledge on how parenting support programmes can be implemented for newly arrived immigrant parents. This process evaluation describes the implementation of a successful parenting programme for immigrant parents from Somalia and identifies key components of the implementation process with a focus on Reach, Adaptation, and Fidelity of Ladnaan intervention.

METHOD: This process evaluation considered context, implementation and mechanism of impact, in accordance with the Medical Research Council's guidance. Data were collected through focus group discussions, a questionnaire, attendance lists, field and reflection notes and observations of the sessions. The data were then analysed using content analysis and descriptive statistics.

RESULTS: Of the 60 parents invited to the parenting programme, 58 participated in the sessions. The study showed that involving key individuals in the early stage of the parenting programme's implementation facilitated reaching Somali-born parents. To retain the programme participants, parents were offered free transportation. The programme was implemented and delivered as intended. A majority of the parents were satisfied with the programme and reported increased knowledge about children's rights and the support they could seek from social services.

CONCLUSIONS: This study illustrates how a parenting support programme can be implemented for Somali-born parents and provides guidance on how to attract immigrant parents to and engage them in participating in parenting support programmes.

National Category
Health Sciences Social Work
Identifiers
urn:nbn:se:du-42741 (URN)10.1371/journal.pone.0274430 (DOI)000954759700001 ()36103499 (PubMedID)2-s2.0-85138088838 (Scopus ID)
Available from: 2022-09-22 Created: 2022-09-22 Last updated: 2023-04-24Bibliographically approved
Jonsdottir, R. B., Jonsdottir, H., Orlygsdottir, B. & Flacking, R. (2021). A shorter breastfeeding duration in late preterm infants than term infants during the first year. Acta Paediatrica, 110(4), 1209-1217
Open this publication in new window or tab >>A shorter breastfeeding duration in late preterm infants than term infants during the first year
2021 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 110, no 4, p. 1209-1217Article in journal (Refereed) Published
National Category
Health Sciences
Identifiers
urn:nbn:se:du-35226 (URN)10.1111/apa.15596 (DOI)000575839500001 ()2-s2.0-85092162694 (Scopus ID)
Available from: 2020-10-19 Created: 2020-10-19 Last updated: 2023-04-14Bibliographically approved
Grundt, H., Tandberg, B. S., Flacking, R., Drageset, J. & Moen, A. (2021). Associations Between Single-Family Room Care and Breastfeeding Rates in Preterm Infants. Journal of Human Lactation, 37(3), 593-602
Open this publication in new window or tab >>Associations Between Single-Family Room Care and Breastfeeding Rates in Preterm Infants
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2021 (English)In: Journal of Human Lactation, ISSN 0890-3344, E-ISSN 1552-5732, Vol. 37, no 3, p. 593-602Article in journal (Refereed) Published
National Category
Health Sciences
Identifiers
urn:nbn:se:du-35237 (URN)10.1177/0890334420962709 (DOI)000579267000001 ()33035125 (PubMedID)2-s2.0-85092266873 (Scopus ID)
Available from: 2020-10-19 Created: 2020-10-19 Last updated: 2023-04-14Bibliographically approved
Projects
Barns och ungdomars psykiska hälsa i Somaliland, CHAMPS: ett samarbete mellan Somaliland och Sverige för att bygga partnerskap och kapacitet
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-4013-1553

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