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Mårtensson, L. B., Gunnarsson, B.-M., Karlsson, S., Lee, N. & Bergh, I. (2022). Effect of topical local anaesthesia on injection pain associated with administration of sterile water injections - a randomized controlled trial. BMC Anesthesiology, 22(1), Article ID 35.
Open this publication in new window or tab >>Effect of topical local anaesthesia on injection pain associated with administration of sterile water injections - a randomized controlled trial
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2022 (English)In: BMC Anesthesiology, ISSN 1471-2253, E-ISSN 1471-2253, Vol. 22, no 1, article id 35Article in journal (Refereed) Published
Abstract [en]

Background

Sterile water injections can provide effective pain relief during childbirth, particularly for low back pain related to childbirth. However, the pain associated administering the injections can negatively impact women’s impressions of the procedure. It may discourage women from considering repeat doses despite the quality of analgesia experienced. Determining strategies to reduce the pain related to the administration of sterile water injections would improve the acceptability of the technique. Therefore, the aim of this study was to evaluate the effect of topical local anesthesia on the pain associated with administration of sterile water injections.

Methods

The study was designed as a multi-arm single-blind, randomized, controlled trial and 120 female healthy students were randomly divided according to one of four groups. The Intervention group received sterile water injections with topical local anesthesia. Control group 1 received sterile water injections without topical local anesthesia, control group 2 received injections of isotonic saline 0.9% with topical local anesthesia and control group 3 received injections of isotonic saline 0.9% without topical local anesthesia. Pain Immediately after the injections and subsidence in pain were recorded using a visual analogue scale. Sensations in the injection area were reported 15 min and the day after the injections.

Results

The main finding of this study was that local anesthesia with EMLA® reduces the pain associated with the administration of intracutaneous sterile water injections. There was a significant difference in the self-assessed pain score immediately following the injections between the control (73.3 mm) and intervention groups (50.0 mm), p = 0.001. No adverse side effects were reported.

Conclusion

Local anesthesia with EMLA® reduces the pain associated with intracutaneous administration of sterile water injections.

Place, publisher, year, edition, pages
Springer Nature, 2022
Keywords
Pain, Pain relief, Sterile water injections, Randomized controlled trial, Childbirth
National Category
Obstetrics, Gynecology and Reproductive Medicine Anesthesiology and Intensive Care
Research subject
Family-Centred Health
Identifiers
urn:nbn:se:his:diva-20877 (URN)10.1186/s12871-022-01573-0 (DOI)000749527700001 ()35105307 (PubMedID)2-s2.0-85123972699 (Scopus ID)
Note

CC BY 4.0

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http:// creat iveco mmons. org/ licen ses/ by/4. 0/. The Creative Commons Public Domain Dedication waiver (http:// creat ivecommons. org/ publi cdoma in/ zero/1. 0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Correspondence: lena.martensson@his.se School of Health Sciences, University of Skövde, P.O. Box 408, SE‑541 28 Skövde, Sweden

Open access funding provided by University of Skövde. Financial support for the study was provided by the University of Skövde, the School of Health Sciences, the research environment Digital Health Research (DHEAR) and the research group Family‑Centered Health (FamCeH).

The study was registered 08/07/2014 at ClinicalTrials.gov Identifier: NCT02213185.

Available from: 2022-02-01 Created: 2022-02-01 Last updated: 2022-04-21Bibliographically approved
Wennström, B., Johansson, A., Kalabic, S., E-son Loft, A.-L., Skullman, S. & Bergh, I. (2020). Patient experience of health and care when undergoing colorectal surgery within the ERAS program. Perioperative Medicine, 9, Article ID 15.
Open this publication in new window or tab >>Patient experience of health and care when undergoing colorectal surgery within the ERAS program
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2020 (English)In: Perioperative Medicine, E-ISSN 2047-0525, Vol. 9, article id 15Article in journal (Refereed) Published
Abstract [en]

Background

Several studies show that the enhanced recovery after surgery (ERAS) program reduces complications postoperatively and leads to faster recovery and shorter hospital stays. However, little is known about patients’ self-reported health in an enhanced recovery context. The aim of this study was firstly to describe patient experiences of health within the concept of ERAS after colorectal (CR) surgery during a hospital stay and within 2 weeks of discharge. Secondly, to explore whether the ASA classification/co-morbidity, sex, and surgical method affect the patient’s experience of health.

Methods

Data were collected through the ERAS-HEALTH questionnaire, including two open-ended questions, and through telephone interviews postoperatively. Qualitative and quantitative analysis was used. Patients undergoing CR surgery (n = 80) were included from October 2016 to June 2018.

Results

The patients had mainly positive experiences of their hospital stay as well as most of them felt comfortable coming home. However, experienced state of health is affected by factors like surgical method and co-morbidity. Improvements were desired concerning information, food/food intake, pain management, and environment. At home, the patients experienced a lack of information about food/food intake and ostomy care. Decreased appetite and difficulties with micturition were also described. The most troublesome symptom was postoperative fatigue (POF). Analysis of the ERAS-HEALTH questionnaire showed that patients with higher co-morbidity and those who underwent open surgery have a significantly worse experience of their health compared with patients who underwent laparoscopy. However, it seems that the surgical method affects postoperative health to a greater extent than co-morbidity.

Conclusions

The patients reported many positive aspects and challenges when being cared for within the ERAS program. However, several improvements are needed to satisfy patient wishes regarding their care both in hospital and at home. Laparoscopic surgery affects patient state of health positively in several respects compared with open surgery.

Place, publisher, year, edition, pages
Springer, 2020
Keywords
Colorectal surgery, ERAS, Patient experiences, Telephone follow-up, State of health
National Category
Nursing Surgery
Research subject
Wellbeing in long-term health problems (WeLHP)
Identifiers
urn:nbn:se:his:diva-18455 (URN)10.1186/s13741-020-00144-6 (DOI)000536585100001 ()32467753 (PubMedID)
Available from: 2020-05-20 Created: 2020-05-20 Last updated: 2021-06-07Bibliographically approved
Johansson, Y. A., Bergh, I., Ericsson, I. & Kenne Sarenmalm, E. (2018). Delirium in older hospitalized patients—signs and actions: a retrospective patient record review. BMC Geriatrics, 18(1), 1-11, Article ID 43.
Open this publication in new window or tab >>Delirium in older hospitalized patients—signs and actions: a retrospective patient record review
2018 (English)In: BMC Geriatrics, E-ISSN 1471-2318, Vol. 18, no 1, p. 1-11, article id 43Article, review/survey (Refereed) Published
Abstract [en]

Background

Delirium is common in older hospitalized patients, and is associated with negative consequences for the patients, next of kin, healthcare professionals and healthcare costs. It is important to understand its clinical features, as almost 40% of all cases in hospitals may be preventable. Yet, delirium in hospitalized patients is often unrecognized and untreated. Few studies describe thoroughly how delirium manifests itself in older hospitalized patients and what actions healthcare professionals take in relation to these signs. Therefore, the aim of this study was to describe signs of delirium in older hospitalized patients and action taken by healthcare professionals, as reported in patient records.

Methods

Patient records from patients aged ≥65 (n = 286) were retrospectively reviewed for signs of delirium, which was found in 78 patient records (27%). Additionally, these records were reviewed for action taken by healthcare professionals in relation to the patients’ signs of delirium. The identified text was analyzed with qualitative content analysis in two steps.

Results

Healthcare professionals responded only in part to older hospitalized patients’ needs of care in relation to their signs of delirium. The patients displayed various signs of delirium that led to a reduced ability to participate in their own care and to keep themselves free from harm. Healthcare professionals met these signs with a variation of actions and the care was adapted, deficient and beyond the usual care. A systematic and holistic perspective in the care of older hospitalized patients with signs of delirium was missing.

Conclusion

Improved knowledge about delirium in hospitals is needed in order to reduce human suffering, healthcare utilization and costs. It is important to enable older hospitalized patients with signs of delirium to participate in their own care and to protect them from harm. Delirium has to be seen as a preventable adverse event in all hospitals units. To improve the prevention and management of older hospitalized patients with signs of delirium, person-centered care and patient safety may be important issues.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
Signs of delirium, Neurocognitive disorders, Older hospitalized patients, Person-centered care, Patient safety, Patient participation, Action by healthcare professionals, Qualitative content analysis
National Category
Nursing
Research subject
Wellbeing in long-term health problems (WeLHP)
Identifiers
urn:nbn:se:his:diva-14726 (URN)10.1186/s12877-018-0731-5 (DOI)000424758800002 ()29409468 (PubMedID)2-s2.0-85041523709 (Scopus ID)
Available from: 2018-02-07 Created: 2018-02-07 Last updated: 2024-07-04
Mårtensson, L. B., Hutton, E. K., Lee, N., Kildea, S., Gao, Y. & Bergh, I. (2018). Sterile water injections for childbirth pain: An evidenced based guide to practice. Women and Birth, 31(5), 380-385
Open this publication in new window or tab >>Sterile water injections for childbirth pain: An evidenced based guide to practice
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2018 (English)In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 31, no 5, p. 380-385Article in journal (Refereed) Published
Abstract [en]

Background: About 30% of women in labour suffer from lower back pain. Studies of sterile water injectionsfor management of low back pain have consistently shown this approach to be effective. The objective ofthis evidence-based guide is to facilitate the clinical use of sterile water injections to relieve lower backpain in labouring women.Methods: To identify relevant publications our search strategy was based on computerised literaturesearches in scientific databases. The methodological quality of each study was assessed using themodified version of the Jadad scale, 12 studies were included.Findings: Recommendations regarding the clinical use of sterile water injections for pain relief in labourare reported in terms of the location of injection administration, various injection techniques, number ofinjections used, amount of sterile water in each injection and adverse effects.Discussion: Both injection techniques provide good pain relief for lower back pain during labour. Thesubcutaneous injection technique is possibly less painful than the intracutaneous techniqueadministered, but we are unsure if this impacts on effectiveness. The effect seems to be related tothe number of injections and the amount of sterile water in each injection.Conclusion: The recommendation at present, based on the current state of knowledge, is to give fourinjections. Notwithstanding the differences in injection technique and number of injections the methodappears to provide significant levels of pain relief and can be repeated as often as required with noadverse effect (apart from the administration pain) on the woman or her foetus.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
sterile water injections, childbirth, low back pain, pain relief, guidelines
National Category
Nursing
Research subject
Woman, Child and Family (WomFam)
Identifiers
urn:nbn:se:his:diva-14619 (URN)10.1016/j.wombi.2017.12.001 (DOI)000445117700015 ()29241699 (PubMedID)2-s2.0-85037572405 (Scopus ID)
Note

© 2017 Published by Elsevier Ltd on behalf of Australian College of Midwives. The RightsLink Digital Licensing and Rights Management Service (including RightsLink for Open Access) is available (A) to users of copyrighted works found at the websites of participating publishers who are seeking permissions or licenses to use those works, and (B) to authors of articles and other manuscripts who are seeking to pay author publication charges in connection with the submission of their works to publishers

Available from: 2018-01-05 Created: 2018-01-05 Last updated: 2021-01-07Bibliographically approved
Melin-Johansson, C., Österlind, J., Henoch, I., Ek, K., Bergh, I., Hagelin, C. L. & Browall, M. (2018). Undergraduate nursing students' transformational learning during clinical training. International Journal of Palliative Nursing, 24(4), 184-192
Open this publication in new window or tab >>Undergraduate nursing students' transformational learning during clinical training
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2018 (English)In: International Journal of Palliative Nursing, ISSN 1357-6321, E-ISSN 2052-286X, Vol. 24, no 4, p. 184-192Article in journal (Refereed) Published
Abstract [en]

Background: Undergraduate nursing students encounter patients at the end of life during their clinical training. They need to confront dying and death under supportive circumstances in order to be prepared for similar situations in their future career.

Aim: To explore undergraduate nursing students' descriptions of caring situations with patients at the end of life during supervised clinical training.

Methods: A qualitative study using the critical incident technique was chosen. A total of 85 students wrote a short text about their experiences of caring for patients at the end of life during their clinical training. These critical incident reports were then analysed using deductive and inductive content analysis.

Findings: The theme 'students' transformational learning towards becoming a professional nurse during clinical training' summarises how students relate to patients and relatives, interpret the transition from life to death, feel when caring for a dead body and learn end-of-life caring actions from their supervisors.

Implications: As a preparation for their future profession, students undergoing clinical training need to confront death and dying while supported by trained supervisors and must learn how to communicate about end-of-life issues and cope with emotional stress and grief.

Place, publisher, year, edition, pages
Mark Allen Group, 2018
Keywords
Palliative, End-of-life, Nursing education, Clinical training, Learning approach
National Category
Nursing
Research subject
Wellbeing in long-term health problems (WeLHP)
Identifiers
urn:nbn:se:his:diva-15172 (URN)10.12968/ijpn.2018.24.4.184 (DOI)000430497200006 ()29703111 (PubMedID)2-s2.0-85046256440 (Scopus ID)
Available from: 2018-05-25 Created: 2018-05-25 Last updated: 2019-11-21Bibliographically approved
Kenne Sarenmalm, E., Mårtensson, L. B., Andersson, B. A., Karlsson, P. & Bergh, I. (2017). Mindfulness and its efficacy for psychological and biological responses in women with breast cancer. Cancer Medicine, 6(5), 1108-1122
Open this publication in new window or tab >>Mindfulness and its efficacy for psychological and biological responses in women with breast cancer
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2017 (English)In: Cancer Medicine, E-ISSN 2045-7634, Vol. 6, no 5, p. 1108-1122Article in journal (Refereed) Published
Abstract [en]

Many breast cancer survivors have to deal with a variety of psychological andphysiological sequelae including impaired immune responses. The primary purposeof this randomized controlled trial was to determine the efficacy of amindfulness-basedstress reduction (MBSR) intervention for mood disorders inwomen with breast cancer. Secondary outcomes were symptom experience, healthstatus, coping capacity, mindfulness, posttraumatic growth, and immune status.This RTC assigned 166 women with breast cancer to one of three groups: MBSR(8 weekly group sessions of MBSR), active controls (self-instructingMBSR) andnon-MBSR.The primary outcome measure was the Hospital Anxiety and DepressionScale. Secondary outcome measures were: Memorial Symptom AssessmentScale, SF-36,Sense of Coherence, Five Facets of Mindfulness Questionnaire,and Posttraumatic Growth Index. Blood samples were analyzed using flow cytometryfor NK-cellactivity (FANKIA) and lymphocyte phenotyping; concentrationsof cytokines were determined in sera using commercial high sensitivityIL-6and IL-8ELISA (enzyme-linkedimmunosorbent assay) kits. Results provideevidence for beneficial effects of MBSR on psychological and biological responses.Women in the MBSR group experienced significant improvements in depressionscores, with a mean pre-MBSRHAD-scoreof 4.3 and post-MBSRscore of 3.3(P = 0.001), and compared to non-MBSR(P = 0.015). Significant improvementson scores for distress, symptom burden, and mental health were also observed.Furthermore, MBSR facilitated coping capacity as well as mindfulness and posttraumaticgrowth. Significant benefits in immune response within the MBSRgroup and between groups were observed. MBSR have potential for alleviatingdepression, symptom experience, and for enhancing coping capacity, mindfulnessand posttraumatic growth, which may improve breast cancer survivorship.MBSR also led to beneficial effect on immune function; the clinical implicationsof this finding merit further research.

Place, publisher, year, edition, pages
John Wiley & Sons Ltd., 2017
Keywords
Breast cancer, immune response, mindfulness-based stress reduction, randomized clinical trial
National Category
Nursing
Research subject
Woman, Child and Family (WomFam)
Identifiers
urn:nbn:se:his:diva-13514 (URN)10.1002/cam4.1052 (DOI)000401330300023 ()28421677 (PubMedID)2-s2.0-85018595351 (Scopus ID)
Available from: 2017-04-20 Created: 2017-04-20 Last updated: 2024-01-17
Henoch, I., Melin-Johansson, C., Bergh, I., Strang, S., Ek, K., Hammarlund, K., . . . Browall, M. (2017). Undergraduate nursing students' attitudes and preparedness toward caring for dying persons: A longitudinal study. Nurse Education in Practice, 26, 12-20, Article ID S1471-5953(17)30384-0.
Open this publication in new window or tab >>Undergraduate nursing students' attitudes and preparedness toward caring for dying persons: A longitudinal study
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2017 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 26, p. 12-20, article id S1471-5953(17)30384-0Article in journal (Refereed) Published
Abstract [en]

Nursing education needs to prepare students for care of dying patients. The aim of this study was to describe the development of nursing students' attitudes toward caring for dying patients and their perceived preparedness to perform end-of-life care. A longitudinal study was performed with 117 nursing students at six universities in Sweden. The students completed the Frommelt Attitude Toward Care of the Dying Scale (FATCOD) questionnaire at the beginning of first and second year, and at the end of third year of education. After education, the students completed questions about how prepared they felt by to perform end-of-life care. The total FATCOD increased from 126 to 132 during education. Five weeks' theoretical palliative care education significantly predicted positive changes in attitudes toward caring for dying patients. Students with five weeks' theoretical palliative care training felt more prepared and supported by the education to care for a dying patient than students with shorter education. A minority felt prepared to take care of a dead body or meet relatives.

Place, publisher, year, edition, pages
Elsevier, 2017
Keywords
Attitudes, FATCOD, Longitudinal, Nurse education, Palliative care education
National Category
Nursing
Research subject
Wellbeing in long-term health problems (WeLHP)
Identifiers
urn:nbn:se:his:diva-14026 (URN)10.1016/j.nepr.2017.06.007 (DOI)000412249800004 ()28648955 (PubMedID)2-s2.0-85021136719 (Scopus ID)
Available from: 2017-08-23 Created: 2017-08-23 Last updated: 2017-11-27Bibliographically approved
Hagelin, C. L., Melin-Johansson, C., Henoch, I., Bergh, I., Ek, K., Hammarlund, K., . . . Browall, M. (2016). Factors influencing attitude toward care of dying patients in first-year nursing students. International Journal of Palliative Nursing, 22(1), 28-36
Open this publication in new window or tab >>Factors influencing attitude toward care of dying patients in first-year nursing students
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2016 (English)In: International Journal of Palliative Nursing, ISSN 1357-6321, E-ISSN 2052-286X, Vol. 22, no 1, p. 28-36Article in journal (Refereed) Published
Abstract [en]

AIM: To describe Swedish first-year undergraduate nursing students' attitudes toward care of dying patients. Possible influences such as age, earlier care experiences, care education, experiences of meeting dying patients and place of birth were investigated.

METHOD: The Frommelt Attitude Toward Care of the Dying Scale (FATCOD) was used in six universities. Descriptive statistics and regression analysis were used.

RESULTS: Some 371 students (67.3%) reported overall positive attitude toward caring for dying patients (total mean FATCOD 119.5, SD 10.6) early in their first semester. Older students, students with both earlier care experience and earlier education, those with experience of meeting a dying person, and students born in Sweden reported the highest scores, a more positive attitude.

CONCLUSION: Age, earlier care experience and education, experiences of meeting a dying person and place of birth seems to affect students' attitudes toward care of the dying and need to be considered among nursing educators.

Place, publisher, year, edition, pages
Mark Allen Group, 2016
National Category
Nursing
Research subject
Medical sciences; Woman, Child and Family (WomFam)
Identifiers
urn:nbn:se:his:diva-12098 (URN)10.12968/ijpn.2016.22.1.28 (DOI)000389316300006 ()26804954 (PubMedID)2-s2.0-84960500345 (Scopus ID)
Available from: 2016-04-05 Created: 2016-04-05 Last updated: 2019-11-21Bibliographically approved
Österlind, J., Prahl, C., Westin, L., Strang, S., Bergh, I., Henoch, I., . . . Ek, K. (2016). Nursing students' perceptions of caring for dying people, after one year in nursing school. Nurse Education Today, 41, 12-16
Open this publication in new window or tab >>Nursing students' perceptions of caring for dying people, after one year in nursing school
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2016 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 41, p. 12-16Article in journal (Refereed) Published
Abstract [en]

Aim: To describe Swedish nursing students' perceptions of caring for dying people after the first year of a three year in a nursing programme at three university nursing schools in Sweden. Methods: Interviews (n = 17) were undertaken with nursing students at the end of their first year. A phenomenographic approach was used to design and structure the analysis of the nursing students' perceptions. Results: The analysis resulted in five categories: 1) from abstract to reality, 2) from scary to natural, 3) increased knowledge can give bad conscience, 4) time limits versus fear of end-of-life conversations, and 5) meeting with relatives. Conclusion: Nursing students need to be prepared both theoretically and within practice to encounter death and dying and to care for dying persons. By combining their theoretical knowledge of dying and death with their own encounters of death and dying people in practice, the students can be supported to develop an understanding of dying and death as a natural part of life rather than something frightening. 

Place, publisher, year, edition, pages
Elsevier, 2016
Keywords
Death, Dying, End-of-life care, Nursing education, Nursing students, Perceptions
National Category
Nursing
Research subject
Woman, Child and Family (WomFam)
Identifiers
urn:nbn:se:his:diva-12569 (URN)10.1016/j.nedt.2016.03.016 (DOI)000376705500003 ()27138476 (PubMedID)2-s2.0-84962339581 (Scopus ID)
Available from: 2016-06-22 Created: 2016-06-22 Last updated: 2019-08-28Bibliographically approved
Bergh, I. H. E., Johansson, A., Bratt, A., Ekström, A. & Mårtensson, L. B. (2015). Assessment and documentation of women's labour pain: A cross-sectional study in Swedish delivery wards. Women and Birth, 28(2), E14-E18
Open this publication in new window or tab >>Assessment and documentation of women's labour pain: A cross-sectional study in Swedish delivery wards
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2015 (English)In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 28, no 2, p. E14-E18Article in journal (Refereed) Published
Abstract [en]

Background: A woman's pain during labour plays a dominant role in childbirth. The midwife's role is to assess the degree of pain experienced during labour. When professionals respond to labour pain with acknowledgement and understanding, the woman's sense of control and empowerment is increased, which could contribute to a positive experience of childbirth. The aim of this study is to describe how labour pain in Swedish delivery wards is assessed and documented. Methods: This quantitative descriptive study was designed as a national survey performed through telephone interviews with the representatives of 34 delivery wards in Sweden. Results and conclusion: The majority of the participating delivery wards assessed and documented women's labour pain, but in an unstructured manner. The wards differed in how the assessments and documentation were performed. In addition, almost all the delivery wards that participated in the survey lacked guidelines for the assessment and documentation of the degree of pain during labour. The findings also showed that the issue of labour pain was sometimes discussed in the delivery wards, but not in a structured or consistent way. (C) 2015 Australian College of Midwives. Published by Elsevier Australia (a division of Reed International Books Australia Pty Ltd). All rights reserved.

Place, publisher, year, edition, pages
Elsevier, 2015
Keywords
Pain assessment, Childbirth, Documentation, Midwifery, Visual analogue scale
National Category
Obstetrics, Gynecology and Reproductive Medicine Nursing
Research subject
Woman, Child and Family (WomFam); Age and Ageing
Identifiers
urn:nbn:se:his:diva-13587 (URN)10.1016/j.wombi.2015.01.010 (DOI)000358011700003 ()25686875 (PubMedID)2-s2.0-84937523315 (Scopus ID)
Available from: 2017-05-23 Created: 2017-05-23 Last updated: 2017-11-27Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-9771-6640

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