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  • 1.
    Andersson, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Ollas, Maja
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Barnmorskors erfarenheter och strategier i mötet med nyanlända kvinnor på förlossningsavdelning, med fokus på interaktion, tillit och sammanhang: En kvalitativ intervjustudie2018Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Supporting the woman and her partner is a major part of the midwifery role during delivery. As the number of newly arrived women increases in Sweden, with varied backgrounds and languages, the demands on midwives’ skills increase. Both migration and childbirth can be described as transitions, which can lead to positive development but also to increased challenges. Migration can be a stressful life process for newly arrived woman and the situation of childbirth can contribute to further vulnerability and uncertainty. The midwife has to understand the needs of newly arrived women in order to support and contribute to a positive experience.

    Aim:

    The aim of this study is to describe midwives' experiences and strategies in the meeting with newly arrived women at childbirth, focusing on interaction, trust and context.

    Method

    : Semi-structured interviews with eight midwives analyzed with qualitative content analysis with deductive approach.

    Results:

    The results of the study provided information on strategies that the midwives use to create interaction, trust and context, as well as their experiences. Common to all midwives was that they experienced that good communication with the patient was very important for creating interaction. Ahead of the meeting with a newly arrived woman, the midwives made sure of that they were well prepared. Strategies used to create trust were to show consideration, be present and take time to listen to the woman. By listening to the woman's wishes, providing information and trying to make the woman feel active and making active choices during her childbirth, midwife creates a context for the woman.

    Conclusion:

    The study has shown that midwives have conscious strategies for meetings with immigrated women. There is, however, a need for clearer routines

    regarding the work of immigrated women in the delivery room, increased cultural skills of midwives and more resources to allow more time for these women.

    Clinical application:

    This study, through the strategies of midwives, can guide other midwives to support newly arrived women during childbirth. The study provides suggestions for areas of improvement and aids to improve the meeting and hence the quality of care for these women.

  • 2.
    Crona, Malin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Bengtsson, Johanna
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Barnmorskor och undersköterskors behov av stöd vid möten med föräldrar som föder barn som inte lever: En kvalitativ intervjustudie med fokusgrupper2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    According to research health professionals are feeling grief, guilt and stress when they meet parents giving birth to stillborn babies. They are in need of support but research about what kind of support is limited.

    Aim:

    To identify midwives’ and assistant nurses’ need of support and what kind of support they need meeting parents giving birth to stillborn babies.

    Method:

    Eight midwives and five assistant nurses were interviewed and distributed in three focus groups. They were asked semi-structured questions based on a questionnaire. The analysis method was qualitative content analysis.

    Results:

    One theme and five categories were identified. The theme was: The will to do good. The categories were: Collegial support, Education, Support from the hospital management, Tutorial and Reflection and To be inexperienced.

    Conclusion:

    The need of support varied but all participants considered they were there for each other as a support and a need of continuity and education in their meetings with parents. They also wished for tutorials with regular occasions where they could meet with different professions in a group. Those participants with longer experience from childbirth care felt more secure in their meetings with parents giving birth to stillborn babies, compared with those with shorter experience.

    Clinical application:

    The study could lead to support being implemented in maternity units, which in the end could lead to better treatment for the affected parents.

  • 3.
    Domeij, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Lennström, Charlotte
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Barnmorskans erfarenhet av handläggning vid uppkommen grad II-bristning: Kvalitativ intervjustudie med barnmorskor verksamma vid förlossningsavdelning2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Many women sustain a second-degree tear when giving birth vaginally. The work field of a midwife includes managing these injuries. There is limited research regarding this field and the focus tend to be on third- and fourth-degree tears, even though second-degree tears may also result in long-term complications.

    Aim:

    The aim was to investigate the midwife’s experience of managing second-degree tears.

    Method:

    Eight semi-structured individual interviews were conducted with midwives working at a medium large maternity ward located in the middle of Sweden. Qualitative content analysis was used to analyze the material.

    Results:

    Four categories and two subcategories were identified. The categories were: Information, The support of colleagues, The need for follow-ups and Physical examination and the subcategories were: Feedback strategies and Documentation.

    Conclusion:

    The result show that midwives feel insecure when managing second-degree tears, especially the midwives with less experience. The midwives also requested more feedback from the women they sutured regarding their second-degree tears and the midwives also wished for a better follow-up for the women with second-degree tears. The result also showed that the midwives give different information to women regarding their tears. No pronounced routines were found regarding what information to give and in what way.

    Clinical application:

    The results of the study aim to increase the knowledge and to develop routines regarding second-degree tears. More knowledge is needed about information given about the tear and when it is the best time to give information.

  • 4.
    Hjortsberg, Linda
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Westerman, Lina
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Hur förändras tilliten till förmågan att amma hoskvinnor som deltagit i traditionellföräldraförberedande kurs via mödrahälsovården?: Ett studieprotokoll inför framtida pilotstudie med mätningav tillit till förmåga att amma med validerat mätinstrument.2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Breastfeeding is recommended by both international and national

    authorities. The breast milk contains all the nutrients the child needs during the

    first six months and has also been proven to protect against a number of diseases.

    Despite the recommendations, breastfeeding decreases. Studies that investigated

    why have shown that many factors fall under the concept of self-efficacy. Thus,

    women's breastfeeding self-efficacy is an important factor to study. Breastfeeding

    is under the midwife's area of competence and a majority of all first time parents in

    Sweden are preparing for parenting through parental prepatory course.

    Aim:

    The purpose of this study protocol was to formulate detailed project plan for

    a pilot study to investigate how breastfeeding self-efficacy change among women

    who participate in parental prepatory course through the maternity healthcare.

    Method:

    A quantitative approach with prospective longitudinal design. By

    Breastfeeding Self-Efficacy Scale Short Form (BSES-SF), a validated instrument

    for measuring breastfeeding self-efficacy, women's breastfeeding self-efficacy is

    planned to be measured before and after the course and eight weeks postpartum.

    Also socio-demographic data is planned to be collected.

    Discussion:

    A detailed method discussion was conducted to discuss the

    advantages and disadvantages of the chosen method. Also, the method discussion

    presents how other designs and plans for how future major studies may be

    conducted to investigate women's breastfeeding self-efficacy.

  • 5.
    Hultman, Elin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Skarp, Therese
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Barnmorskans upplevelser och uppfattningar av professionella, sociokulturella och hälsoekonomiska barriärer som hindrar kvinnor att bestämma över sin egen kropp.: En kvalitativ intervjustudie2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Sexual and reproductive health is a human right and involves the right to make decisions concerning your own body and care. The midwife mostly meets and care for women and have an important role in defending and advocating women’s rights. Today there are global political influences that restricts women’s rights even though Sweden is considered to be one of the world’s most equal countries, there can be structures and factors in the Swedish society that affects women’s ability to make decisions about their own bodies in a negative way.

    The aim:

    To investigate midwives perceptions and experiences concerning professional, sociocultural and health economic barriers for women regarding decisions about their own bodies.

    Method:

    A qualitative content analysis with a deductive approach. Data from eight semi structured interviews with Swedish registered midwifes, active in different areas of the midwife profession, was analyzed based on the framework "What Prevents Quality Midwifery Care".

    Result:

    The professional barriers that the midwives perceived resulted in three subcategories: "Laws, clinical guidelines and policies", "Knowledge, education and profession" and "Caretakers personal opinions and commitment". Sociocultural barriers were categorized in: "Politics, equality and the society’s ideals", "Culture, religion and family relations", "Language" and "Personal abilities". The health economic barriers were divided in to: "Lack of time and staff" and "Costs and resources".

    Conclusion and clinical applicability:

    This study shows that there are professional, sociocultural, and health economic barriers that affects women’s autonomy in the Swedish society according to the midwives’ perceptions. The study can help caretakers increase their understanding and competence in meeting with women in care and help them strengthening their position in the society as well as on a personal level. This study can give a greater understanding for the midwife’s role when it comes to helping individuals in an exposed situation, by strengthen the women’s autonomy and sense of control. The study can also help caretakers to increase critical thinking regarding themselves in their own cultural context and preunderstanding for other individuals.

  • 6.
    Jansson, Amanda
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Blomström, Monica
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Beskrivning av Sensus amningskurs för blivande föräldrar och förslag på en förbättrad studiedesign för att utvärdera kursen2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    The breast milk supplies the baby with all the nutrition it needs and according to the WHO, breastfeeding is recommended as the only food during the first six months of life. Breastfeeding gives the child proximity, security and strengthening the connection. Studies have shown that women began to breastfeed as a result of breastfeeding education. Studies have also shown that there is a need and demand for breastfeeding educations.

    The aim:

    The aim was to describe what the educational Sensus breastfeeding course for becoming parents contains, how the course is ment to be evaluated and difficulties with the design. The aim was further to propose an improved design for how an evaluation of the Sensus breastfeeding course can be designed to find out how women's self-efficacy in breastfeeding is affected by a breastfeeding course during pregnancy.

    Method:

    The original plan is presented as a quantitative method and a proposal for an improved study design is presented as a qualitative method.

    Conclusion:

    According to the plan an evaluation of the Sensus breastfeeding course is planned to be conducted with a quantitative design, not going to give a fair and objective picture of parents self-efficacy in breastfeeding. Deficiencies are found in the original plan and they will be identified in the essay. A proposal for an improved design for evaluation of the Sensus breastfeeding course for becoming parents has been proposed.

    Clinical applicability:

    It is important to evaluate whether different interventions and programs can give the woman any benefit, if a breastfeeding course like in this case is recommended in the standard healthcare can give the woman an increased self-efficacy in her breastfeeding. It should also be reflected in whether the breastfeeding course should be recommended to all pregnant women enrolled in the maternal healthcare center by midwife despite the fact that the breastfeeding course not only is based on evidence.

  • 7.
    Johansson, Isabelle
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Westin, Linn
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Att vårda kvinnor i samband med inducerad abort - Barnmorskors och sjuksköterskors erfarenheter: En kvalitativ metasyntes2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background

    : Midwives and nurses all over the world meet with and care for women who, for various reasons, are undergoing induced abortion. It may be a challenge that requires both knowledge and support for those working in abortion care.Objective: To describe midwives and nurses’ experiences of caring for women who undergo induced abortion. The word experience includes perceptions based on experiences. Method: The study was conducted as a qualitative metasynthesis using meta-ethnography as analysis of data. Twenty-seven (27) peer-reviewed scientific articles were included in the result. Result: Three main categories and ten different patterns highlighted the midwives and nurses' experiences of caring for women undergoing an induced abortion. These were doing a good job by being supportive, putting own values aside and with the goal to create good experiences for the woman. Barriers to qualitative abortion care included negative attitudes from the surroundings, own feelings, receiving the fetus and various issues at the abortion care clinics. The third category was the caregivers’ needs which included support and knowledge. Conclusion: The abortion-seeking woman is in need of support and non-judgmental attitudes from caregivers. Midwives and nurses need knowledge and support in the work of abortion care. Lack of support and knowledge can affect midwives and nurses’ attitudes towards induced abortion as a woman’s right, which in turn can affect the women in need of abortion care.

  • 8.
    Linde, Maria
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Karlsson, Synnöve
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Mötet med barnmorskan - gravida kvinnors utsatthet för våld i nära relationer och barnmorskans roll i omvårdnaden av dessa kvinnor: En kvalitativ metasyntes2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Intimate partner violence is a serious threat against women's security, well-being and health. Women all over the world are subject to different kinds of violence and pregnant women are no exception. The violence can increase during pregnancy among the women that earlier has endured violence, with a risk for both the women’s and unborn baby's health. Midwives have a unique opportunity to care for and support these abused women.

    Purpose:

    To describe pregnant women’s encounter with the midwife with focus on exposure to partner violence and the role of the midwife.

    Method:

    A meta-synthesis which included both qualitative literature studies and quantitative studies with qualitative elements were used in the result. Articles were searched through databases as PubMed, CINAHL, PsycInfo and Web of Science and these were analysed through meta-ethnography.

    Results:

    The study showed that time, knowledge and confidence were important factors that could cause women in revealing to midwives about violence during pregnancy. Both women and midwives had to the most part the same patterns that they spoke about as both obstacles and help for disclosure of violence in care for women in pregnancy.

    Conclusion:

    The pattern matched well between women’s and midwive’s perceptions of the problems seen in violence during pregnancy. Trusting the midwife’s encounter and knowledge, were seen as the most important issues for women to feel safe in revealing violence during pregnancy.

    Clinical implications

    : Basic education about violence that is already under the supervision of midwives can be a way to give midwives a better prerequisite for their new role. In order to maintain and develop knowledge of violence, continuing education should be continued for legitimate midwives, which in turn provides better conditions for midwives to meet women who are pregnant with violence.

  • 9.
    Sandbäck, Evelina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Selin, Jonna
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    "Det väcker fler etiska funderingar när det gäller äldre personer": En kvalitativ studie om socialsekreterares upplevelser kring den etiska synen på äldre med alkoholmissbruk2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of the study was to investigate how social workers looked at the possibility that their ethical view of elderly with alcohol abuse affects their assessments. We used semi structured interview, where we interviewed six social workers that works with addiction. The result showed that the social workers felt that the biggest difference between people over and under the age of 65 was the needs, which meant that the assessments of contribution differed. The result showed that the social workers resonated very much about LVM, since coercion in relation to older people created many ethical dilemmas. The personal values of the social workers did not affect the assessment themselves, but they were always there, both in private and working life. In order to avoid their own values affecting their assessments, this was frequently discussed between colleagues. The result showed that ageism is both in structure and jargon, but that there was no opportunity for ageism to influence the social security assessments.

  • 10.
    Skogh, Thérése
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Todal, Kristin
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Föräldrars upplevelser och uppfattningar i samband med intrauterin fosterdöd: En kvalitativ metasyntes2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Losing a baby can be the hardest thing that happens to a parent. Every year, about 2.6 million babies die in intrauterine fetal death (IUFD). The majority occur in low-income countries, in Sweden approximately 440 children die per year. High Body Mass Index (BMI), age over 35 years and smoking are risk factors that can lead to IUFD. The cause is sometimes unclear and parents need support and confirmation from close associates and healthcare professionals. The midwife is responsible for meeting the parents' needs. Purpose: The purpose was to highlight parents’ experiences and perceptions associated with IUFD. Methods: Qualitative meta-synthesis. In total, 29 scientific studies were analyzed and compiled for this study. Data was analyzed by meta-ethnography with inductive approach. Results: Women often felt that something was wrong. Parents perceived that support from close associates and healthcare professionals as well as clear information and communication was important. This was not always experienced and sometimes it was difficult to talk about the IUFD. Making memories with their child was important and many felt alone after an IUFD. The way back was often long and complicated. Conclusion: IUFD is a traumatic experience for parents and the care they received during this time can have a lasting impact on their well-being. Clinical applicability: The study can help to develop and improve education- and work routines for midwives.

  • 11.
    Stenmark, Christel
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Johansson, Madelene
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Prenatal förberedelse och förlossningsrädsla: En metasyntes2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Fear of childbirth is not uncommon and may adversely affect the woman and her partner. Through prenatal preparation, the woman and her partner are offered the opportunity for education, information and physical and psychological training before childbirth. During pregnancy, the midwife's professional role is to provide information, counseling and call support in all aspects of sexual and reproductive health. Midwife should be able to identify women who are in need of additional support in connection with childbirth. Aim: To describe the importance of prenatal preparation in childbirths based on the perspective of women, partners and midwives. Method: The method has been inspired by qualitative metasynthesis with meta-ethography as the analytical method. Result: The women experienced a community with other participants when they participated in prenatal preparation, they perceived that they could better manage the delivery. The preparation made the women gain self-confidence and they could be more present during childbirth. The preparations also gave them a better delivery experience. The result indicates that there are pros and cons of prenatal preparation. Women can, in addition to the above-described benefits, also experience disadvantages of participating in prenatal preparation. They could experience the preparations as scary and this could strengthen their fear of childbirth. Conclusion: Prenatal preparation during pregnancy can provide support for women with fear of childbirth, but it can also enhance fear. Clinical applicability: It is important as midwife to invite all pregnant women to participate in the parental care programs offered in maternity care. It is also important that the partner is included in the prenatal preparations offered in maternity care.

  • 12.
    Tinnerholm Hultman, Liselott
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Westman, Alexandra
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Förstföderskors förlossningsupplevelse och deras uppfattning av barnmorskans stöd2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim

    The aim of this study was to describe primiparas birth experience, their perception of the midwives support and describe correlation between birth experience and midwifery support.

    Method

    The study was carried out as a quantitative cohort study where chosen variables was studied and described in relation to the aim and question formulations. The data was obtained from an earlier performed survey and was presented in charts and within the text of the study. The analysis was done in SPSS programme of statistics.

    Results

    The result showed that half of the women included in the study felt mixed feelings about their labour, closely followed by women with a positive birth experience. Almost all women (98,7%) had a positive perception of the midwife and felt support from the midwife. Within the results there is no significant correlation between primiparas positive and negative birth experience and the perception of the midwives attributes and support.

    Conclusion

    The results indicate that the midwives attributes and support contributed to a positive birth experience for primiparas. The midwives support was also important for women regardless of feelings related to their birth experience. However, no significant correlation was found between primiparas birth experience and their perception of the midwives support. Further studies are needed to explore potential association between negative birth experience and midwifery support.

  • 13.
    Wennerlund Abdelli, Céline
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Dahlström, Sara
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Upplevd förberedelse inför mötet med föräldrar som förlorat barn på grund av intrauterin fosterdöd: En kvalitativ studie med barnmorskestudenter2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Every year 440 intrauterine fetal deaths are reported in Sweden. Practicing midwives may encounter parents who have lost children due to intrauterine fetal death. Therefore, midwives need knowledge and understanding on how to, in the best way possible, work with parents who have been affected. Studies describe that student midwives are not always given adequate education to care for parents who have lost children due to intrauterine fetal death.

    Aim:

    To investigate whether student midwives perceives that they are prepared to care for parents who has lost children due to intrauterine fetal death.

    Method:

    A digital survey containing three open questions was sent to student midwives who was undergoing the final term of midwifery education in Sweden. A qualitative content analysis with inductive approach was chosen to analyze the study result.

    Results:

    After processing the data and further analyzing, five categories were identified who which answered to the purpose of the study. One overall theme emerged from the categories and its content: "It does not feel good to be unprepared".

    Conclusion:

    The student midwives did not feel prepared to meet parents affected by intrauterine fetal death. This was mainly due to the fact that they were not given the opportunity to participate in the care of parents who give birth to non-living children. There was a clear wish from the student midwives to receive practical preparation, supervision and support during the education's obstetric practice. Previous work in the field of care gave some of the student midwives some preparation to care for parents who lost children due to intrauterine fetal death.

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