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  • 1.
    Dykes, Fiona
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Maternal and Infant Nutrition and Nurture Unit (MAINN), University of Central Lancashire, United Kingdom; Chinese University of Hong Kong, Hong Kong; University of Western Sydney, Australia .
    Flacking, RenéeHögskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Chinese University of Hong Kong, Hong Kong; Maternal and Infant Nutrition and Nurture Unit (MAINN), University of Central Lancashire, United Kingdom.
    Ethnographic research in maternal and child health2015Collection/Antologi (Annet vitenskapelig)
  • 2.
    Dykes, Fiona
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Maternal and Infant Nutrition and Nurture Unit (MAINN), University of Central Lancashire, United Kingdom; Chinese University of Hong Kong, Hong Kong; University of Western Sydney, Australia .
    Flacking, Renée
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Chinese University of Hong Kong, Hong Kong; Maternal and Infant Nutrition and Nurture Unit (MAINN), University of Central Lancashire, United Kingdom.
    Introducing the theory and practice of ethnography2015Inngår i: Ethnographic Research in Maternal and Child Health / [ed] Fiona Dykes and Renée Flacking, Taylor & Francis, 2015, s. 1-14Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 3.
    Dykes, Fiona
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. University of Central Lancashire, UK..
    Thomson, G
    Gardner, C
    Hall Moran, V
    Flacking, Renée
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Perceptions of European medical staff on the facilitators and barriers to physical closeness between parents and infants in neonatal units2016Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, nr 9, s. 1039-1046Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: Studies have provided insights into factors that may facilitate or inhibit parent-infant closeness in neonatal units, but none have specifically focused on the perspectives of senior neonatal staff. The aim of this study was to explore perceptions and experiences of consultant neonatologists and senior nurses in five European countries with regard to these issues.

    METHODS: Six small group discussions and three one-to-one interviews were conducted with 16 consultant neonatologists and senior nurses representing nine neonatal units from Estonia, Finland, Norway, Spain and Sweden. The interviews explored facilitators and barriers to parent-infant closeness and implications for policy and practice and thematic analysis was undertaken.

    RESULTS: Participants highlighted how a humanising care agenda that enabled parent-infant closeness was an aspiration, but pointed out that neonatal units were at different stages in achieving this. The facilitators and barriers to physical closeness included socio-economic factors, cultural norms, the designs of neonatal units, resource issues, leadership, staff attitudes and practices and relationships between staff and parents.

    CONCLUSION: Various factors affected parent-infant closeness in neonatal units in European countries. There needs to be the political motivation, appropriate policy planning, legislation and resource allocation to increase measures that support closeness agendas in neonatal units. This article is protected by copyright. All rights reserved.

  • 4.
    Flacking, Renée
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Maternal and Infant Nutrition and Nurture Unit (MAINN), School of Health, University of Central Lancashire, Preston, Lancashire, UK.
    Dykes, Fiona
    University of Central Lancashire.
    ‘Being in a womb’ or ‘playing musical chairs’: the impact of place and space on infant feeding in NICUs2013Inngår i: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 13, artikkel-id 179Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Becoming a parent of a preterm baby requiring neonatal care constitutes an extraordinary life situation in which parenting begins and evolves in a medical and unfamiliar setting. Although there is increasing emphasis within maternity and neonatal care on the influence of place and space upon the experiences of staff and service users, there is a lack of research on how space and place influence relationships and care in the neonatal environment. The aim of this study was to explore, in-depth, the impact of place and space on parents’ experiences and practices related to feeding their preterm babies in Neonatal Intensive Care Units (NICUs) in Sweden and England.

    Methods: An ethnographic approach was utilised in two NICUs in Sweden and two comparable units in England, UK. Over an eleven month period, a total of 52 mothers, 19 fathers and 102 staff were observed and interviewed. A grounded theory approach was utilised throughout data collection and analysis.

    Results: The core category of ‘the room as a conveyance for an attuned feeding’ was underpinned by four categories: the level of ‘ownership’ of space and place; the feeling of ‘at-homeness’; the experience of ‘the door or a shield’ against people entering, for privacy, for enabling a focus within, and for regulating socialising and the; ‘window of opportunity’. Findings showed that the construction and design of space and place was strongly influential on the developing parent-infant relationship and for experiencing a sense of connectedness and a shared awareness with the baby during feeding, an attuned feeding.

    Conclusions: If our proposed model is valid, it is vital that these findings are considered when developing or reconfiguring NICUs so that account is taken of the influences of spatiality upon parent’s experiences. Even without redesign there are measures that may be taken to make a positive difference for parents and their preterm babies.

  • 5.
    Flacking, Renée
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Chinese University of Hong Kong, Hong Kong; Maternal and Infant Nutrition and Nurture Unit (MAINN), University of Central Lancashire, United Kingdom.
    Dykes, Fiona
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Maternal and Infant Nutrition and Nurture Unit (MAINN), University of Central Lancashire, United Kingdom; Chinese University of Hong Kong, Hong Kong; University of Western Sydney, Australia .
    Cross-national ethnography in neonatal intensive care units2015Inngår i: Ethnographic Research in Maternal and Child Health / [ed] Fiona Dykes and Renée Flacking, Taylor & Francis, 2015, s. 89-116Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 6.
    Flacking, Renée
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Dykes, Fiona
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Encouraging breastfeeding: a relational perspective2010Inngår i: Early Human Development, ISSN 0378-3782, E-ISSN 1872-6232, Vol. 86, nr 11, s. 733-736Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Despite the WHO recommendations that babies should be breastfed exclusively for six months and thereafter for up to two years and beyond this pattern of feeding is far from the global norm. Although breastfeeding is triggered through biological mechanisms which have not changed with time, the perception of breastfeeding as a phenomenon is variable, as it not only reflects cultural values of motherhood but is also negotiable from the perspective of the individual. This paper argues that relationships are central to encouraging breastfeeding at an organisational, family and staff–parent level. This shifts our conceptualisations away from the primary focus of breastfeeding as nutrition which, in turn, removes the notion of breastfeeding as a productive process, prone to problems and failure.

  • 7.
    Flacking, Renée
    et al.
    Department of Women's and Children's Health, Uppsala University, SE-751 85 Uppsala, Sweden; Center for Clinical Research Dalarna, SE-791 82 Falun, Sweden; Department of Paediatrics, Falun Hospital, SE-791 82 Falun Sweden.
    Dykes, Fiona
    Maternal and Infant Nutrition and Nurture Unit (MAINN), School of Public Health and Clinical Sciences, University of Central Lancashire, Preston, PR1 2HE, UK.
    Ewald, Uwe
    Department of Women's and Children's Health, Uppsala University, SE-751 85 Uppsala, Sweden.
    The influence of fathers’ socioeconomic status and paternity leave on breastfeeding duration: a population based cohort study2010Inngår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 38, s. 337-343Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: The propensity to breastfeed is a matter of public concern because of the favourable effects for infants. However, very few studies have described the influence of paternal variables upon duration of breastfeeding. The aim of this study was to describe the effects of fathers’ socioeconomic status and their use of paternity leave on breastfeeding duration for infants up to 1 year of age. Methods: A prospective population-based cohort study was undertaken. Data on breastfeeding, registered in databases in two Swedish counties for 1993—2001, were matched with data on socioeconomic status and paternity leave obtained from Statistics Sweden. Fathers of 51,671 infants were identified and included. Results: Infants whose fathers had a lower level of education, were receiving unemployment benefit and/or had a lower equivalent disposable household income were significantly less likely to be breastfed at 2, 4, 6, 9, and 12 months of age. Infants whose fathers did not take paternity leave during the infant’s first year were significantly less likely to be breastfed at 2 (p < 0.001), 4 (p < 0.001), and 6 months (p < 0.001). Conclusions: This paper shows that an enabling of an increased involvement from fathers during the infants’ first year of life, such as by paid paternity leave, may have beneficial effects on breastfeeding up to 6 months of age. A more systematic approach to supporting fathers’ involvement may be particularly valuable to those infants whose fathers have a lower socioeconomic status.

  • 8.
    Flacking, Renée
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Lehtonen, Liisa
    Thomson, Gill
    Axelin, Anna
    Ahlqvist, Sari
    Hall Moran, Victoria
    Ewald, Uwe
    Dykes, Fiona
    Closeness and separation in neonatal intensive care2012Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 101, nr 10, s. 1032-1037Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In this paper, we highlight the need for acknowledging the importance and impact of both physical and emotional closeness between the preterm infant and parent in the neonatal intensive care unit. Physical closeness refers to being spatially close and emotional closeness to parental feelings of being emotionally connected to the infant (experiencing feelings of love, warmth and affection). Through consideration of the literature in this area, we outline some of the reasons why physical closeness and emotional closeness are crucial to the physical, emotional and social well-being of both the infant and the parent. These include positive effects on infant brain development, parent psychological well-being and on the parent–infant relationship. The influence of the neonatal unit environment and culture on physical and emotional closeness is also discussed.

    Conclusions:  Culturally sensitive care practices, procedures and the physical environment need to be considered to facilitate parent–infant closeness, such as through early and prolonged skin-to-skin contact, family-centred care, increased visiting hours, family rooms and optimization of the space on the units. Further research is required to explore factors that facilitate both physical and emotional closeness to ensure that parent–infant closeness is a priority within neonatal care.

  • 9. Thomson, Gill
    et al.
    Moran, Victoria Hall
    Axelin, Anna
    Dykes, Fiona
    Flacking, Renée
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Integrating a sense of coherence into the neonatal environment2013Inngår i: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 13, artikkel-id 84Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Family centred care (FCC) is currently a valued philosophy within neonatal care; an approach that places the parents at the heart of all decision-making and engagement in the care of their infant. However, to date, there is a lack of clarity regarding the definition of FCC and limited evidence of FCCs effectiveness in relation to parental, infant or staff outcomes.

    Discussion: In this paper we present a new perspective to neonatal care based on Aaron Antonovksy's Sense of Coherence (SOC) theory of well-being and positive health. Whilst the SOC was originally conceptualised as a psychological-based construct, the SOCs three underpinning concepts of comprehensibility, manageability and meaningfulness provide a theoretical lens through which to consider and reflect upon meaningful care provision in this particular care environment. By drawing on available FCC research, we consider how the SOC concepts considered from both a parental and professional perspective need to be addressed. The debate offered in this paper is not presented to reduce the importance or significance of FCC within neonatal care, but, rather, how consideration of the SOC offers the basis through which meaningful and effective FCC may be delivered. Practice based implications contextualised within the SOC constructs are also detailed.

    Summary: Consideration of the SOC constructs from both a parental and professional perspective need to be addressed in FCC provision. Service delivery and care practices need to be comprehensible, meaningful and manageable in order to achieve and promote positive well-being and health for all concerned.

  • 10.
    Östlund, Åsa
    et al.
    Falun Cent Hosp, Neonatal Unit, Falun, Sweden.
    Nordström, Maria
    Falun Cent Hosp, Paediat Unit, Dept Paediat, Falun, Sweden.
    Dykes, Fiona
    Univ Cent Lancashire, Maternal & Infant Nutr & Nurture Unit, Preston PR1 2HE, Lancs, England.
    Flacking, Renée
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Univ Childrens Hosp, Dept Womens & Childrens Hlth, Uppsala, Sweden.
    Breastfeeding in preterm and term twins - maternal factors associated with early cessation: a population based study2010Inngår i: Journal of Human Lactation, ISSN 0890-3344, E-ISSN 1552-5732, Vol. 26, nr 3, s. 235-241Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    There is an increasing trend in Australia and elsewhere for mothers to express breast milk. The purpose of this study was to explore breastfeeding women’s experiences of expressing breast milk. An anonymous online questionnaire was sent to Victorian members of the Australian Breastfeeding Association via an e-mail link. Response fraction was 903 of 3024 (29.9%). The most common reason for expressing milk was to “store extra breast milk” (57%, 479/836). The most important reason was “not enough milk”/“to make more milk” (15%, 118/771). The majority of women (65%, 666/843) used an electric breast pump, and this method of expressing was preferred by 59% (454/769) of women. Adverse effects of pumps were pain (17%, 126/737) and damage to nipples (11%, 86/737). Breast pumps may have a role in enabling women to extend the duration of breast milk feeding, but further research is needed. J Hum Lact. 26(3):258-265.

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