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  • 1.
    Bergh, Ingrid H. E.
    et al.
    University of Skövde, School of Life Sciences.
    Ek, Kristina
    University of Skövde, School of Life Sciences.
    Mårtensson, Lena B.
    University of Skövde, School of Life Sciences.
    Midwifery students attribute different quantitative meanings to "hurt", "ache" and "pain": A cross-sectional survey2013In: Women and Birth, ISSN 1871-5192, Vol. 26, no 2, 143-146 p.Article in journal (Refereed)
    Abstract [en]

    Background: Assessment of women's labor pain is seldom acknowledged in clinical practice or research. The words "aching" and "hurting" are frequently used by women to describe childbirth pain. The aim of this study was to determine the quantitative meanings midwifery students attribute to the terms "hurt", "ache" and "pain". Data was collected by self-administered questionnaire from students at seven Swedish midwifery programs. A total of 230 filled out and returned a completed questionnaire requesting them to rate, on a visual analog scale, the intensity of "hurt", "ache" or "pain" in the back, as reported by a fictitious parturient. Results: The midwifery students attributed, with substantial individual variation, different quantitative meanings to the studied pain descriptors. Conclusions: To be able to communicate about pain with a woman in labor, it is essential that the midwife be familiar with the value of different words and what they mean to her as this may affect her assessment when the woman describes her pain. © 2012.

  • 2.
    Bergh, Ingrid H. E.
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Johansson, Anna
    Univ Hosp Örebro, Dept Obstet, Örebro, Sweden.
    Bratt, Annelie
    Skaraborgs Hosp, Dept Obstet & Gynecol, Skövde, Sweden.
    Ekström, Anette
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Mårtensson, Lena B.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Assessment and documentation of women's labour pain: A cross-sectional study in Swedish delivery wards2015In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 28, no 2, E14-E18 p.Article in journal (Refereed)
    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.

  • 3.
    Bergh, Ingrid H. E.
    et al.
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg.
    Stener-Victorin, Elisabet
    Institute of Neuroscience and Physiology/Endocrinology, Sahlgrenska Academy, University of Gothenburg.
    Wallin, Gunnar
    Institute of Clinical Sciences, Department of Obstetrics and Gynaecology, Sahlgrenska Academy, University of Gothenburg.
    Mårtensson, Lena
    University of Skövde, School of Life Sciences.
    Comparison of the PainMatcher and the Visual Analogue Scale for assessment of labour pain following administered pain relief treatment2011In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 27, no 1, E134-E139 p.Article in journal (Refereed)
    Abstract [en]

    Objective: during childbirth, it is necessary to assess and monitor experienced pain and to evaluate the effect of pain relief treatment. The aim of this study was to compare the PainMatcher® (PM) with the Visual Analogue Scale (VAS) for the assessment of labour pain and the effect of pain relief treatment.Design: randomised controlled trial.Setting: labour ward with approximately 2500 childbirths per year in western Sweden.Participants: 57 women with labour pain treated with acupuncture or sterile water injections scored their electrical pain threshold and pain intensity with the PM. Pain intensity was also assessed with the VAS. Electrical pain threshold and pain intensity were assessed immediately after a uterine contraction before and 30, 60, 90, 120, 150 and 180 minutes after treatment.Measurements and findings: the results showed a weak correlation (r=0.13, p<0.05) between the pain intensity scores on the PM and the VAS. The PM detected changes (decrease) in pain intensity to a lower degree than the VAS. Surprisingly, in over 10% of sessions, women scored their pain intensity during a uterine contraction lower than their electrical pain threshold with the PM. However, electrical pain thresholds with the PM correlated well throughout all measurements.Conclusions: the PM is a reliable tool for the assessment of electrical pain threshold; however, the VAS is more sensitive than the PM for recording changes in pain intensity when assessing the effects of treatment on labour pain.Implications for practice: the PM and the VAS are not interchangeable in the case of labour pain, and there is still a need for research in this area to find a more suitable assessment instrument for the evaluation of labour pain.

  • 4.
    Bergh, Ingrid
    et al.
    University of Skövde, School of Life Sciences.
    Söderlund, Tina
    Department of Obstetrics and Gynaecology, Skaraborg Hospital, SE-541 85 Skövde, Sweden.
    Vinterskog, Linda
    Department of Obstetrics and Gynaecology, Skaraborg Hospital, SE-541 85 Skövde, Sweden.
    Mårtensson, Lena B.
    University of Skövde, School of Life Sciences.
    Reliability and validity of the Acceptance Symptom Assessment Scale in assessing labour pain2012In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 28, no 5, e684-e688 p.Article in journal (Refereed)
    Abstract [en]

    Objective: to investigate the reliability and validity of the Acceptance Symptom Assessment Scale (ASAS) in assessing labour pain.

    Design: a test-retest approach was used to assess reliability and validity.

    Setting: labour ward with approximately 2,400 deliveries annually in western part of Sweden.

    Participants: forty-seven pregnant women in the latent or active phase of labour.

    Methods: a total of five pain assessments with both the ASAS and the VAS were conducted in three sessions.

    Main outcome measures: correlation between ASAS and VAS.

    Findings: both scales demonstrated high and significant test–retest correlations (r=0.83–0.92; p<0.001). High and significant alternative-form reliability correlations (r=0.76–0.93, p<0.001) were found between ASAS and VAS ratings at all five assessments. Construct validity was established when both the ASAS and the VAS identified a pain reduction(p<0.001) 2 hrs after birth, compared to the previous assessment. Over two-thirds of the women preferred the ASAS to the VAS ,mainly(n=30) because the ASAS provided more choices relating to the pain experience, making it possible to label pain acceptable/unacceptable.

    Conclusions: the ASAS is interchangeable with the VAS for assessing labour pain. Over two-thirds of the women preferred it to the VAS.

  • 5.
    Blixt, Ingrid
    et al.
    Mälarhospital, Eskilstuna, Sweden.
    Mårtensson, Lena
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Ekström, Anette
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Process-oriented training in breastfeeding for health professionals decreases women’s experiences of breastfeeding challenges2014In: International Breastfeeding Journal, ISSN 1746-4358, Vol. 9, no 15Article in journal (Refereed)
    Abstract [en]

    Background: The World Health Organization recommends promoting exclusive breastfeeding for six months. Women much too often end breastfeeding earlier than they planned, but women who continue to breastfeed despite problems more often experience good support and counselling from health professionals. The aim in this study was to evaluate the effects of a process-oriented training in breastfeeding support counselling for midwives and child health nurses, in relation to women’s satisfaction with breastfeeding counselling, problems with insufficient breast milk, pain or nipple sores in relation to exclusive breastfeeding shorter or longer than 3 months.

    Methods: An intervention through process-oriented training for health professionals regarding support in childbearing and breastfeeding took part in the south west of Sweden. The present study was performed in Sweden, in 2000- 2003. Ten municipalities were paired, and within each pair, one was randomly assigned to the group of five intervention (IG) municipalities and one to the group of five control municipalities. Primiparas (n=540) were asked to participate in a longitudinal study to evaluate the care they received. A survey was distributed at 3 days, 3 months and 9 months postpartum. Data collection for control group A (n=162) started before the intervention was initiated. Data for control group B (n=172) were collected simultaneously with the intervention group (IG) (n=206).Women were also divided into two groups depending on whether they exclusive breastfed < 3 months or ≥ 3 months.

    Results: Women in IG were more satisfied with the breastfeeding counselling (p=0.008) and felt the breastfeeding counselling was more coherent (p=0.002) compared with control groups, when the exclusively breastfeeding was < 3 months. In addition fewer women in the IG, among the group exclusively breastfeeding < 3 months, had problems with insufficient breast milk compared to the control groups (p=0.01).

    Conclusion: A process-oriented training for health professionals in support influenced women's ability to solve breastfeeding problems such as the experience of insufficient breast milk production. Women with exclusive breastfeeding lasting ≥ 3 months more often had breastfeeding duration in conformity with their planned breastfeeding duration, compared with women who had breastfeeding duration < 3 months.

    Trial registration: ACTRN12611000354987

  • 6.
    Blixt, Ingrid
    et al.
    University of Skövde, School of Health and Education. Mälarsjukhuset Eskilstuna / Centrum för klinisk forskning i Sörmland, Uppsala universitet.
    Mårtensson, Lena
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Ekström, Anette
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Utbildning minskar amningsproblem2014In: Amningsnytt, ISSN 1102-7207, no 4, 4-5 p.Article in journal (Other (popular science, discussion, etc.))
  • 7.
    Bäckström, Caroline A.
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Skaraborg Hospital Skövde, Woman, Child (K3), Skövde, Sweden / Jönköping University, School of Health and Welfare, CHILD-Research Group, Jönköping, Sweden.
    Mårtensson, Lena B.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Golsäter, Marie H.
    Jönköping University, School of Health and Welfare, CHILD-Research Group, Jönköping, Sweden.
    Thorstensson, Stina A.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    "It's like a puzzle": Pregnant women's perceptions of professional support in midwifery care2016In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 29, no 6, e110-e118 p.Article in journal (Refereed)
    Abstract [en]

    ProblemPregnant women are not always satisfied with the professional support they receive during their midwifery care. More knowledge is needed to understand what professional support pregnant women need for childbirth and parenting.

    BackgroundChildbearing and the transition to becoming a parent is a sensitive period in one's life during which one should have the opportunity to receive professional support. Professional support does not always correspond to pregnant women's needs. To understand pregnant women's needs for professional support within midwifery care, it is crucial to further illuminate women's experiences of this support.

    AimTo explore pregnant women's perceptions of professional support in midwifery care.

    MethodsA qualitative study using semi-structured interviews. Fifteen women were interviewed during gestational weeks 36–38. Data was analysed using phenomenography.

    FindingsThe women perceived professional support in midwifery care to be reassuring and emotional, to consist of reliable information, and to be mediated with pedagogical creativity. The professional support facilitated new social contacts, partner involvement and contributed to mental preparedness. The findings of the study were presented in six categories and the category Professional support contributes to mental preparedness was influenced by the five other categories.

    ConclusionPregnant women prepare for childbirth and parenting by using several different types of professional support in midwifery care: a strategy that could be described as piecing together a puzzle. When the women put the puzzle together, each type of professional support works as a valuable piece in the whole puzzle. Through this, professional support could contribute to women's mental preparedness for childbirth and parenting.

  • 8.
    Bäckström, Caroline
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Skaraborg Hospital Skövde, Jönköping University, School of Health and Welfare, CHILD-research Group, Jönköping, Sweden.
    Larsson, Therese
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Närhälsan Midwifery Unit, Skövde, Sweden.
    Wahlgren, Emma
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Skaraborg Hospital Skövde.
    Golsäter, Marie
    Jönköping University, School of Health and Welfare, CHILD-research Group, Jönköping, Sweden.
    Mårtensson, Lena B.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Thorstensson, Stina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    ‘It makes you feel like you are not alone’: Expectant first-time mothers’ experiences of social support within the social network, when preparing for childbirth and parenting2017In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 12, 51-57 p.Article in journal (Refereed)
  • 9.
    Bäckström, Caroline
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Skaraborg Hospital Skövde, Woman, Child (K3), Skövde, Sweden / Jönköping University, School of Health and Welfare, CHILD-research group, Jönköping, Sweden.
    Thorstensson, Stina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Mårtensson, Lena B.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Grimming, Rebecca
    University of Skövde, School of Health and Education. Närhälsan Skaraborg, Young Persons Clinic, Skövde, Sweden.
    Nyblin, Yrsa
    University of Skövde, School of Health and Education. Danderyd Hospital AB, Women’s care, Gynecology ward, Stockholm, Sweden.
    Golsäter, Marie
    Jönköping University, School of Health and Welfare, CHILD-research group, Jönköping, Sweden.
    'To be able to support her, I must feel calm and safe': pregnant women's partners perceptions of professional support during pregnancy2017In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 17, 1-11 p., 234Article in journal (Refereed)
    Abstract [en]

    Background: Professional support does not always meet the needs of expectant fathers or co-mothers. The way in which professional support is offered during pregnancy varies internationally, depending on the country. In order to attain a greater understanding of partners' experiences of professional support, it is necessary to further illuminate their perceptions of it. The aim of this study was therefore to explore pregnant women's partners' perceptions of professional support during pregnancy. Methods: Qualitative research design. Partners of pregnant women were interviewed during gestational week 36-38. Individual semi-structured interviews were used to explore the partners' perceptions. The data was analysed using a phenomenographic approach. The study was performed in a county in south-western Sweden; the data collection was conducted from November 2014 to February 2015. Fourteen partners (expectant fathers and co-mothers) of women who were expectant first-time mothers with singleton pregnancies, were interviewed. Results: The findings of the study are presented through four descriptive categories: Ability to absorb adequate information; Possibility to meet and share with other expectant parents; Confirmation of the partner's importance; and Influence on the couple relationship. Using a theoretical assumption of the relationship between the categories showed that the fourth category was influenced by the other three categories. Conclusions: The partners perceived that professional support during pregnancy could influence the couple relationship. The partners' ability to communicate and to experience togetherness with the women increased when the expectant couple received professional support together. The support created also possibilities to meet and share experiences with other expectant parents. In contrast, a lack of support was found to contribute to partners' feelings of unimportance. It was essential that the midwives included the partners by confirming that they were individuals who had different needs for various types of professional support. The partners perceived it easier to absorb information when it was adequate and given with a pedagogic that made the partners become interested and emotionally engaged.

  • 10.
    Dalal, Koustuv
    et al.
    University of Skövde, School of Life Sciences.
    Shabnam, Jahan
    Independent Researcher, Copenhagen, Denmark.
    Andrews-Chavez, Johanna
    Tufts University, Boston, USA.
    Mårtensson, Lena B.
    University of Skövde, School of Life Sciences.
    Timpka, Toomas
    University of Skövde, School of Life Sciences. Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Economic empowerment of women and utilization of maternal delivery care in Bangladesh2012In: International Journal of Preventive Medicine, ISSN 2008-7802, E-ISSN 2008-8213, Vol. 3, no 9, 628-636 p.Article in journal (Refereed)
    Abstract [en]

    Objective: Maternal mortality is a major public health problem in low-income countries, such as Bangladesh. Women's empowerment in relation to enhanced utilization of delivery care is underexplored. This study investigates the associations between women's economic empowerment and their utilization of maternal health care services in Bangladesh. Methods: In total, 4925 women (15-49 years of age) with at least one child from whole Bangladesh constituted the study sample. Home delivery without skilled birth attendant and use of institutional delivery services were the main outcome variables used for the analyses. Economic empowerment, neighborhood socioeconomic status, household economic status, and demographic factors were considered as explanatory variables. The chi square test and unadjusted and adjusted logistic regression analyses were applied at the collected data. Results: In the adjusted model, respondent's and husband's education, household economic status, and residency emerged as important predictors for utilization of delivery care services. In the unadjusted model, economically empowered working and microfinanced women displayed more home delivery. Conclusion: The current study shows that use of delivery care services is associated with socioeconomic development and can be enhanced by societies that focus on general issues such as schooling, economic wellbeing, and gender-based discrimination.

  • 11.
    Ekström, Anette
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Abrahamsson, Hanna
    Department of Obstetrics and Gynecology, Central Hospital, Skövde, Sweden.
    Eriksson, Rose-Marie
    Department of Obstetrics and Gynecology, Central Hospital, Skövde, Sweden.
    Mårtensson, B. Lena
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Women’s use of nipple shields - their influence on breastfeeding duration after a process-oriented education for health professionals2014In: Breastfeeding Medicine, ISSN 1556-8253, E-ISSN 1556-8342, Vol. 9, no 9, 458-466 p.Article in journal (Refereed)
  • 12.
    Ekström, Anette C.
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Nilsson, Lena
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Apell, Caroline
    The Municipality of Alingsås, Sweden.
    Palmius, David
    Skaraborg Hospital Skövde, Skövde, Sweden.
    Mårtensson, Lena B.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Nurses challenges to support hospitalized patients regarding sexual-health issues2016In: Journal of Nursing & Care, ISSN 2167-1168, Vol. 5, no 3, 1000344Article in journal (Refereed)
    Abstract [en]

    Background: The approach to nursing should be characterized by a holistic view of the human being which includes sexual health. From a nursing perspective, it is therefore of most importance to have a dialogue about factors associated with sexual health also among hospitalized patients. However, to our knowledge there is a lack of qualitative studies regarding nurses attitudes about dialogue with patients about sexual health.

    Objective: To investigate nurses attitudes towards dialogue with hospitalized patients about sexual health.

    Methods: A qualitative method was used and interviews were conducted which then were analyzed using a qualitative content analysis. Eleven registered nurses were included, the inclusion criteria was: at least one year of experience as a nurse and working on a medical or surgical ward in a hospital in the southwest of Sweden. The participants were in the ages 25-65 and had worked as nurses between 2 and 30 years. Nine of the participants were women. The data were collected during 2011.

    Results: The nurses experiences of and reflections on dialogue with patients about sexual health were presented as a single main theme: Nurses challenges to support hospitalized patients with sexual health issues. This theme had three categories: Feeling uncomfortable, Feeling inadequate and Task-oriented care with related subcategories respectively.

    Conclusions: Nurses attitudes towards their dialogues about sexual health with hospitalized patients were less challenging if they were initiated by the patients or if the patients were men with medical causes related to sexual health. Lack of knowledge and support from colleagues became reasons why nurses felt inadequate about discussing sexual health with their patients.

  • 13.
    Hadjigeorgiou, Eleni
    et al.
    Department of Nursing, School of Health Sciences, Cyprus University of Technology, PO Box 12715, Code 2252, Latsia, Nicosia, Cyprus.
    Kouta, Christiana
    Department of Nursing, School of Health Sciences, Cyprus University of Technology, PO Box 12715, Code 2252, Latsia, Nicosia, Cyprus.
    Papastavrou, Evridiki
    Department of Nursing, School of Health Sciences, Cyprus University of Technology, PO Box 12715, Code 2252, Latsia, Nicosia, Cyprus.
    Papadopoulos, Irena
    Department of Nursing, School of Health Sciences, Cyprus University of Technology, PO Box 12715, Code 2252, Latsia, Nicosia, Cyprus.
    Mårtensson, Lena
    University of Skövde, School of Life Sciences.
    Women's perceptions of their right to choose the place of childbirth: an integrative review2012In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 28, no 3, 380-390 p.Article, review/survey (Refereed)
    Abstract [en]

    Objective: to provide a critical synthesis of published research concerning women's experiences in choosing where to give birth.

    Method: an integrative literature review was conducted using three databases (MEDLINE, CINAHL and Ovid) for 1997–2009. Inclusion criteria were: (1) publication in the English language; (2) research article; (3) focus on women's perceptions for their birthplace choices; and (4) data collected during pregnancy, at birth and post partum.

    Findings: twenty-one research-based papers met the inclusion criteria, and these used a range of approaches and methods. Four themes were derived from the data: choice of birthplace and medicalisation of childbirth; the midwifery model of care and the rhetoric of birthplace choices; perceptions of safety shaped women's preferences; and choice is related to women's autonomy.

    Conclusion: there is considerable evidence that women worldwide wish to be able to exercise their rights and make informed choices about where to give birth. The medical model remains a strong and powerful influence on women's decisions in many countries. The midwifery model offers birthplace choices to women, while policies and culture in some countries affect midwifery practise. Perceptions of safety shaped women's preferences, and women's autonomy facilitated birthplace choices.

    Implications for practise: these findings can be seen as a challenge for health professionals and policy makers to improve perinatal care based on women's needs. Local research is advisable due to cultural and health system differences.

  • 14.
    Hadjigeorgiou, Eleni
    et al.
    Department of Nursing, School of Health Sciences, Cyprus University of Technology, Nicosia, Cyprus.
    Kouta, Christiana
    Department of Nursing, School of Health Sciences, Cyprus University of Technology, Nicosia, Cyprus.
    Papastavrou, Evridiki
    Department of Nursing, School of Health Sciences, Cyprus University of Technology, Nicosia, Cyprus.
    Papadopoulos, Irena
    Department of Nursing, School of Health Sciences, Cyprus University of Technology, Nicosia, Cyprus.
    Mårtensson, Lena B.
    University of Skövde, School of Life Sciences. College of Nursing, University of Rhode Island, United States.
    Women's Perceptions of Their Right to Choose the Place of Childbirth: A Qualitative Study2012In: International journal of childbirth, ISSN 2156-5287, Vol. 2, no 4, 230-240 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To explore Greek Cypriot women's perceptions of their right to choose the place of childbirth.DESIGN: This study is qualitative and is based on Husserl's phenomenological approach. The field work extended over a 6-month period in 2010–2011.SETTING: In all cities of the Republic of Cyprus.PARTICIPANTS: Purposive sample of 55 women within 1 year after birth. Forty-eight women were recruited for semistructured interviews and six of them took place in first focus group. The second group consisted of seven women that did not participate in interviews.RESULTS: Women's perceptions were categorized into four themes: (a) informed choice for birth place, (b) trusting relationship with health professionals, (c) medicalization of childbirth, and (d) safety of the mother and baby.CONCLUSIONS: There is no equity and accessibility in Cyprus maternity care system because it does not provide correct information and accessibility to all birthplace choices. This study demonstrated the need to explore women's views before formulating policy for maternity care. These views will be helpful for the creation of an innovative evidence-based maternity care policy, taking into account women's needs, and will be helpful to raise awareness among health professionals for maternity care improvement.IMPLICATIONS FOR PRACTICE: Ensuring the right for birthplace choices is a social and political necessity that enhances the existing health care systems and health professionals to provide quality and holistic maternity care. Conducting more studies on maternity care in Cyprus will reinforce the aim for improving the health of the women, neonates, and society.

  • 15.
    Hermansson, Evelyn
    et al.
    University of Gothenburg.
    Mårtensson, Lena
    University of Skövde, School of Life Sciences.
    Empowerment in the midwifery context - a concept analysis2011In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 27, no 6, 811-816 p.Article in journal (Refereed)
    Abstract [en]

    Objective: the concept empowerment is difficult to understand, define and translate into different contexts. Therefore, the purpose of this paper was to analyze the empowerment concept in the midwifery context, focused on the childbearing period, aimed at clarifying its meaning in order to enable comprehension and use in clinical practice, education and research. Design: semi structured interviews and written text. Setting: prenatal clinics, delivery and maternity wards in western Sweden. Participants: nine midwives and 12 couples. Measurements and findings: a concept analysis was undertaken according to the hybrid model which consists of the theoretical, fieldwork and analytical phases. After a literature review, the concept was empirically elucidated in the fieldwork phase. The final step was to describe criteria and attributes, illustrative cases, antecedents and consequences of the concept. The following tentative criteria and attributes of empowerment in the midwifery context are described: developing a trustful relationship; starting an awareness process, making it possible to reflect on the changing situation; acting based on the parents' situation on their own terms, getting them involved and able to make informed choices; confirming the personal significance of becoming parents. Finally, empowerment in the midwifery context was redefined. Key conclusion: midwives use empowerment in education and research as well as strategies on both the micro and macro levels in practice. Implications for practice: empirical findings from the concept analysis confirm the concept's relevance in the midwifery context.

  • 16.
    Hermansson, Evelyn
    et al.
    Institute of Health and Care Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
    Mårtensson, Lena B.
    University of Skövde, School of Life Sciences.
    The evolution of midwifery education at the master's level: A study of Swedish midwifery education programmes after the implementation of the Bologna process2013In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 33, no 8, 866-872 p.Article in journal (Refereed)
    Abstract [en]

    In Europe, midwifery education has undergone a number of reforms in the past few decades. In several countries, it has shifted from vocational training to academic education. The higher education reform, known as the “Bologna process” aimed to create convergence in higher education among a number of European countries and enhance opportunities for mobility, employment and collaborative research. It also indicated a transparent and easily compared system of academic degrees, generating a new educational system in three cycles. This study explores the implementation of the process in Sweden when the midwifery education was transferred from diploma to postgraduate or master's level. The aim of this study was to analyse how the implementation of the Bologna process in the Swedish higher education system has impacted midwifery education programmes in the country. Descriptive statistics and content analysis were employed to analyse 32 questionnaire responses from teachers and the 2009–2010 curricula and syllabi of 11 postgraduate midwifery education programmes at Swedish universities and university colleges. The results revealed variations among the universities at the major subject into the three disciplines; midwifery, nursing and caring with different conceptualisations, even when the content was identical in the curricula to that of the midwifery professional knowledge base. Implementation of the new reform not only has accelerated the academisation process, but also puts higher demand on the students and requires higher competencies among teachers to involve more evidence-based knowledge, seminars, independent studies and a postgraduate degree project in the major subject. Thus the students earn not only a diploma in midwifery, but also a master's degree in the major subject, which affords the opportunity for an academic career. But still there is a tension between professional and academic education.

  • 17.
    Hutton, Eileen
    et al.
    McMaster University, Hamilton, Canada.
    Mårtensson, Lena
    University of Skövde, School of Life Sciences.
    Waterinjectie stilt bevallingspijn2013In: Medisch Contact, ISSN 0025-8245, Vol. 68, no 38, 1894-1897 p.Article in journal (Other (popular science, discussion, etc.))
  • 18.
    Kenne Sarenmalm, Elisabeth
    et al.
    Research and Development Centre, Skaraborg Hospital, Skövde, Sweden.
    Mårtensson, Lena B.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Andersson, Bengt A.
    Department of Clinical immunology and transfusion medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Karlsson, Per
    Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital,Sweden University of Gothenburg, Gothenburg, Sweden.
    Bergh, Ingrid
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Mindfulness and its efficacy for psychological and biological responses in women with breast cancer2017In: Cancer Medicine, ISSN 2045-7634, E-ISSN 2045-7634, Vol. 6, no 5, 1108-1122 p.Article in journal (Refereed)
    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.

  • 19.
    Kenne Sarenmalm, Elisabeth
    et al.
    Research and Development Centre, Skaraborg Hospital, Skövde, Sweden / Institute of Health and Caring Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden / Palliative Research Centre, Ersta Sköndal University College and Ersta Hospital, Stockholm, Sweden.
    Mårtensson, Lena B.
    University of Skövde, School of Life Sciences.
    Holmberg, Stig B.
    Department of Surgery, SU/Sahlgrenska University Hospital, Gothenburg, Sweden.
    Andersson, Bengt A.
    Microbiology and Immunology, Göteborg University, Göteborg, Sweden.
    Odén, Anders
    Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden.
    Bergh, Ingrid
    University of Skövde, School of Life Sciences.
    Mindfulness based stress reduction study design of a longitudinal randomized controlled complementary intervention in women with breast cancer2013In: BMC Complementary and Alternative Medicine, ISSN 1472-6882, Vol. 13, 248Article in journal (Refereed)
    Abstract [en]

    Background: The stress of a breast cancer diagnosis and its treatment can produce a variety of psychosocial sequelae including impaired immune responses. Mindfulness Based Stress Reduction (MBSR) is a structured complementary program that incorporates meditation, yoga and mind-body exercises. Despite promising empirical evidence for the efficacy of MBSR, there is a need for randomized controlled trials (RCT). There is also a need for RCTs investigating the efficacy of psychosocial interventions on mood disorder and immune response in women with breast cancer. Therefore, the overall aim is to determine the efficacy of a Mindfulness Based Stress Reduction (MBSR) intervention on well-being and immune response in women with breast cancer.Methods and design: In this RCT, patients diagnosed with breast cancer, will consecutively be recruited to participate. Participants will be randomized into one of three groups: MBSR Intervention I (weekly group sessions + self-instructing program), MBSR Intervention II (self-instructing program), and Controls (non-MBSR). Data will be collected before start of intervention, and 3, 6, and 12 months and thereafter yearly up to 5 years. This study may contribute to evidence-based knowledge concerning the efficacy of MBSR to support patient empowerment to regain health in breast cancer disease.Discussion: The present study may contribute to evidence-based knowledge concerning the efficacy of mindfulness training to support patient empowerment to regain health in a breast cancer disease. If MBSR is effective for symptom relief and quality of life, the method will have significant clinical relevance that may generate standard of care for patients with breast cancer.Trial registration: ClinicalTrials.gov: NCT01591915. © 2013 Kenne Sarenmalm et al.; licensee BioMed Central Ltd.

  • 20.
    Larsson, Christel
    et al.
    Department of Otorhinolaryngology, Central Hospital, S-541 85 Skövde, Sweden.
    Mårtensson, Lena
    University of Skövde, School of Life Sciences.
    Experiences of problems in individuals with hypersensitivity to odours and chemicals2009In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 18, no 5, 737-744 p.Article in journal (Refereed)
    Abstract [en]

    Aim. The purpose of the study was to describe how individuals with hypersensitivity to odours and chemicals handle their problems.

    Background. One group of patients we often encounter consists of those with upper and lower respiratory problems who also have a pronounced sensitivity to odours and chemicals. Earlier studies have shown that these symptoms can be related to sensory hyperreactivity (SHR). This hyperreactivity is characterised by respiratory tract symptoms triggered by odours and chemicals, along with high sensitivity to inhaled capsaicin and a positive score on the chemical sensitivity scale for SHR. However, there is still a lack of studies in which SHR sufferers describe their situations in their own words.

    Design. The study was conducted using a qualitative approach.

    Methods. Eight individuals with confirmed SHR were selected from a population-based epidemiological study and interviewed. A qualitative content analysis was performed on the data.

    Results. Four themes emerged from the data analysis: Limitations in one's life situation, Lack of understanding from others, Concern that the symptoms will develop into a serious disease and Disparagement of one's own personal experience. The results show how individuals manage their daily lives with the help of various strategies, how they relate to other people, how they cope with their concerns and the fact that they sometimes choose to disparage their own experience of their problems.

    Conclusion. The results indicate that people with SHR experience limitations in their life situations. These limitations consist of the adjustments they make to avoid triggering factors.

    Relevance to clinical practice. To improve care, nurses need to know how people experience SHR and how they cope with their hypersensitivity to odours and chemicals.

  • 21.
    Lee, Nigel
    et al.
    Mater Medical Research Institute, Mater Health Services, Brisbane, QLD, Australia / Faculty of Health Sciences, Australian Catholic University, Brisbane, QLD, Australia.
    Mårtensson, Lena B.
    University of Skövde, School of Life Sciences.
    Homer, Caroline
    Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
    Webster, Joan
    Centre for Clinical Nursing, Royal Brisbane and Women's Hospital, Herston, QLD, Australia.
    Gibbons, Kristen
    Mater Medical Research Institute, Mater Health Services, Brisbane, QLD, Australia.
    Stapleton, Helen
    Mater Medical Research Institute, Mater Health Services, Brisbane, QLD, Australia / Faculty of Health Sciences, Australian Catholic University, Brisbane, QLD, Australia.
    Dos Santos, Natalie
    Mater Medical Research Institute, Mater Health Services, Brisbane, QLD, Australia / Faculty of Health Sciences, Australian Catholic University, Brisbane, QLD, Australia.
    Beckmann, Michael
    Mater Medical Research Institute, Mater Health Services, Brisbane, QLD, Australia.
    Gao, Yu
    University Centre for Rural Health, University of Sydney, Lismore, NSW, Australia.
    Kildea, Sue
    Mater Medical Research Institute, Mater Health Services, Brisbane, QLD, Australia / Faculty of Health Sciences, Australian Catholic University, Brisbane, QLD, Australia.
    Impact on Caesarean section rates following injections of sterile water (ICARIS): a multicentre randomised controlled trial2013In: BMC Pregnancy and Childbirth, ISSN 1471-2393, Vol. 13, 105Article in journal (Refereed)
    Abstract [en]

    Background: Sterile water injections have been used as an effective intervention for the management of back pain during labour. The objective of the current research is to determine if sterile water injections, as an intervention for back pain in labour, will reduce the intrapartum caesarean section rate. Methods/design: Design: A double blind randomised placebo controlled trial Setting: Maternity hospitals in Australia Participants: 1866 women in labour, >= 18 years of age who have a singleton pregnancy with a fetus in a cephalic presentation at term (between 37 + 0 and 41 + 6 weeks gestation), who assess their back pain as equal to or greater than seven on a visual analogue scale when requesting analgesia and able to provide informed consent. Intervention: Participants will be randomised to receive either 0.1 to 0.3 millilitres of sterile water or a normal saline placebo via four intradermal injections into four anatomical points surrounding the Michaelis' rhomboid over the sacral area. Two injections will be administered over the posterior superior iliac spine (PSIS) and the remaining two at two centimetres posterior, and one centimetre medial to the PSIS respectively. Main outcome measure: Proportion of women who have a caesarean section in labour. Randomisation: Permuted blocks stratified by research site. Blinding (masking): Double-blind trial in which participants, clinicians and research staff blinded to group assignment. Funding: Funded by the National Health and Medical Research Council Trial registration: Australian New Zealand Clinical Trials Registry (No ACTRN12611000221954). Discussion: Sterile water injections, which may have a positive effect on reducing the CS rate, have been shown to be a safe and simple analgesic suitable for most maternity settings. A procedure that could reduce intervention rates without adversely affecting safety for mother and baby would benefit Australian families and taxpayers and would reduce requirements for maternal operating theatre time. Results will have external validity, as the technique may be easily applied to maternity populations outside Australia. In summary, the results of this trial will contribute High level evidence on the impact of SWI on intrapartum CS rates and provide evidence of the analgesic effect of SWI on back pain.

  • 22.
    Lee, Nigel
    et al.
    Australian Catholic University, Qld 4014, Australia.
    Mårtensson, Lena B.
    University of Skövde, School of Life Sciences.
    Kileda, Sue
    Australian Catholic University, Qld 4014, Australia / Mater Medical Research Institute, Qld 4101, Australia.
    Cross sectional study of Australian midwives knowledge and use of sterile water injections for pain relief in labour2012In: Women and Birth, ISSN 1871-5192, Vol. 25, no 4, e75-e80 p.Article in journal (Refereed)
    Abstract [en]

    Background: The effectiveness of sterile water injections (SWI) to relieve back pain in labour is supported by a number of randomised controlled trials. Although the procedure is available in a number of Australian maternity units, there is no information regarding the use of SWI by midwives, in terms of knowledge and availability, clinical application or technique used. Neither is there any data on midwives who do not use SWI nor the specific challengers and barriers encountered by midwives introducing SWI.

    Method: An invitation to participate in an online survey was emailed to 4700 members of the Australian College of Midwives (ACM) and 484 members of CRANAplus (Remote Health Organisation). Nine hundred and seventy midwives completed the survey (19%).

    Results: Four hundred and seven (42.5%) midwives currently used SWI in their practice and five hundred and fifty-one (57.5%) indicated they did not. Eighty-six percent (n = 478/548) indicated they would consider using SWI and 90% (n = 500/547) were interested in obtaining further information about SWI. The main reasons cited for not using SWI was the lack of a policy or guideline (n = 271, 57.5%) and being unable to access workshops or resource material (n = 68, 14.4%).

    Conclusion: This study indicates that SWI is not being used by the majority of midwives participating in the study, although there is a strong desire by midwives to learn about and explore its use. Greater access to information and workshops on SWI is highlighted. In response to the findings of this survey the authors are currently developing an online resource and training to support units to introduce SWI.

  • 23.
    Mårtensson, Lena
    University of Skövde, School of Life Sciences.
    Livslångt lärande: hur undervisar vi vuxna?2005In: Jordemodern, ISSN 0021-7468, Vol. 118, no 11, 4-6 p.Article in journal (Other (popular science, discussion, etc.))
  • 24.
    Mårtensson, Lena
    University of Skövde, School of Life Sciences.
    Måste sterilvattenkvaddlar göra så ont?2005In: Konferens Reproduktiv Hälsa, 2005Conference paper (Refereed)
  • 25.
    Mårtensson, Lena
    University of Skövde, School of Life Sciences.
    Smärtlindring - vilken metod skall man välja?: evidensbaserad medicin2007In: Folkvett: Organ för Vetenskap och folkbildning, ISSN 0283-0795, no 1, 22-35 p.Article in journal (Other (popular science, discussion, etc.))
  • 26.
    Mårtensson, Lena
    University of Skövde, School of Life Sciences.
    Sterile water injections and acupuncture as treatment for labour pain2007In: Smärta, ISSN 1402-1048, Vol. 12, no 2, 16-19 p.Article in journal (Other (popular science, discussion, etc.))
  • 27.
    Mårtensson, Lena
    University of Skövde, School of Life Sciences.
    Sterile water injections and acupuncture as treatment for labour pain2006Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Most women experience pain during labour. Complementary pain relief methods such as sterile water injections and acupuncture are two alternatives for the child birthing women. The lack of knowledge about the use of these methods in clinical practice creates the need to develop and evaluate them.

    Aims and methods: To elucidate whether the new subcutaneous method of administering sterile water, as well as the previously described intracutaneous injection method, were effective for the relief of labour pain. Ninety-nine women in labour were randomized to either intracutaneous- , subcutaneous injections of sterile water or to placebo (Paper I). To investigate if there was any difference in perceived pain between the intracutaneous and subcutaneous techniques during injection of sterile water. One hundred female volunteers were given injections with both techniques in a cross-over trial (Paper II). To elucidate the clinical use of acupuncture and sterile water injections as pain relief and relaxation during childbirth in Swedish delivery wards. Five hundred and sixty-five midwives answered a questionnaire about their use of these methods (Paper III). To elucidate if there were any differences between acupuncture and sterile water injections in terms of pain relief and relaxation during labour. One hundred and twenty-eight pregnant women in childbirth were randomized to either sterile water injections or acupuncture (Paper IV).

    Results: Paper I: VAS pain scores were significantly lower in both treatment groups 10 minutes (p=0.001) and 45 minutes (p=0.005) after treatment, compared with the placebo group. Paper II: subcutaneous injections were still perceived as less painful than intracutaneous injections after trial, day and injection location were taken into consideration (p<0.001). Paper III: the midwives’ estimated frequency of administration of acupuncture was much higher than that of sterile water injections, 25 % versus 2 %. The intracutaneous injection technique was more common in clinical practice than the subcutaneous technique. Sterile water injections were used exclusively for pain relief during labour while acupuncture was used for both pain relief and relaxation during labour. Paper IV: women given sterile water injections experience significantly less labour pain and a higher degree of relaxation in labour, compared to women given acupuncture (p<0.001).

    Conclusions: The results indicate that the subcutaneous injection technique is preferable when using sterile water injections for low back pain during labour. Sterile water injections seem to provide more pain relief and a higher degree of relaxation, compared to acupuncture. However, acupuncture is a more common pain relief method in clinical practice.

  • 28.
    Mårtensson, Lena
    University of Skövde, School of Life Sciences.
    Sterilt vatten behöver inte göra ont2006In: Jordemodern, ISSN 0021-7468, Vol. 119, no 1-2, 14-18 p.Article in journal (Other (popular science, discussion, etc.))
  • 29.
    Mårtensson, Lena
    University of Skövde, School of Life Sciences.
    The Patient Observer: Sterile Water Injections for Labor Pain2010In: Birth, ISSN 0730-7659, E-ISSN 1523-536X, Vol. 37, no 4, 334-336 p.Article in journal (Refereed)
    Abstract [en]

    Several studies have reported a good pain relief effect from sterile water injections, especially for low back pain, during labor. The aim of this paper was to illustrate the use of the method in a clinical childbirth situation by means of a descriptive case report. The woman in the report described that the method provided a powerful pain relief effect, measured by a visual analog scale, and that her experience was highly positive.

  • 30.
    Mårtensson, Lena B.
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Ek, Kristina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Ekström, Anette
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Bergh, Ingrid H. E.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Midwifery students' conceptions of worst imaginable pain2014In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 27, no 2, 104-107 p.Article in journal (Refereed)
    Abstract [en]

    Background: The Visual Analogue Scale (VAS) is one of the most widely used pain assessment scales in clinical practice and research. However, the VAS is used less frequently in midwifery than in other clinical contexts. The issue of how people interpret the meaning of the VAS endpoints (i.e. no pain and worst imaginable pain) has been discussed. The aim of this study was to explore midwifery students' conceptions of 'worst imaginable pain'. Methods: A sample of 230 midwifery students at seven universities in Sweden responded to an open-ended question: 'What is the worst imaginable pain for you?' This open-ended question is a part of a larger study. Their responses underwent manifest content analysis. Results: Analysis of the midwifery students' responses to the open-ended question revealed five categories with 24 sub-categories. The categories were Overwhelming pain, Condition-related pain, Accidents, Inflicted pain and Psychological suffering. Conclusions: The midwifery students' conceptions of 'worst imaginable pain' are complex, elusive and diverse. © 2014 Australian College of Midwives.

  • 31.
    Mårtensson, Lena
    et al.
    University of Skövde, School of Life Sciences.
    Bergh, Ingrid
    University of Rhode Island.
    Effect of treatment for labor pain: Verbal reports versus visual analogue scale scores - A prospective randomized study2011In: International Journal of Nursing and Midwifery, ISSN 2141-2456, Vol. 3, no 4, 43-47 p.Article in journal (Refereed)
    Abstract [en]

    Assessing pain in relation to childbirth is one of the midwife’s more important tasks. However, pain research shows that health care professionals often assess patients’ pain inaccurately. The Visual Analogue Scale (VAS) is one of the most used instruments for assessing pain and pain relief both in research and clinical practice. On the other hand, a patient’s verbal report is considered to be the single most reliable indicator of how much pain the patient is experiencing. The aim of this study was to compare women’s verbally reported effect of treatment for labor pain with changes in VAS scores. This comparative prospective study was carrying out on a labor ward with approximately 2,500 deliveries annually in western part of Sweden. Women (n=122) at gestational week 37 to 42 with spontaneous onset of labor, requesting pain relief, were randomized to one of two treatments: acupuncture or sterile water injections. Pain was assessed on a VAS before as well as 30, 60, 90, 120, 150 and 180 min after treatment. Within two hours after delivery the women were asked to verbally report the effectiveness with the treatment. Main outcome measure was agreement between VAS scores and verbal reports. Non-parametric tests were used. All tests were two-tailed at the significance level p< 0.05. The distribution of the VAS scores 30 min after administration of pain relief showed that the women verbally responding that treatment was “very effective”, also rated their pain significantly lower (p< 0.001) on the VAS, compared to the women verbally reporting otherwise. A moderate correlation (r = 0.56; p< 0.001) was obtained between VAS-scored pain change after 30 min and verbally reported pain relief effect. The women who stated that treatment was “very effective” also rated their pain significantly lower at 30, 60 and 90 min on the VAS, compared to baseline. This study confirms that verbal reports and changes in VAS scores are reliable indicators of treatment effect for labor pain. It might, however, be valuable to combine VAS scores with verbal reports for a more extensive assessment of treatment effect.

  • 32.
    Mårtensson, Lena
    et al.
    University of Skövde, School of Life Sciences.
    Kvist, Linda
    Barn-familj-kvinnosjukvård, Helsingborgs lasarett.
    Akupunktur i barnmorskans verksamhetsområde - rapport från en workshop2008In: Jordemodern, ISSN 0021-7468, Vol. 121, no 1-2, 28-30 p.Article in journal (Other (popular science, discussion, etc.))
  • 33.
    Mårtensson, Lena
    et al.
    University of Skövde, School of Life Sciences.
    Kvist, Linda J.
    Department of Health Sciences, Lund University, Lund, Sweden / Department of Obstetrics & Gynaecology, Helsingborg Hospital, Helsingborg, Sweden.
    Hermansson, Evelyn
    Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Box 457, SE-405 30 Göteborg, Sweden.
    A national survey of how acupuncture is currently used in midwifery care at Swedish maternity units2011In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 27, no 1, 87-92 p.Article in journal (Refereed)
    Abstract [en]

    Objective: it is known how acupuncture is used in midwifery care in Sweden and what kind of requirements health-care providers have for midwives and acupuncture training programmes. The aims of this study were to survey indications for the use of acupuncture in midwifery care in Sweden, and to examine the criteria and requirements used for purchase of acupuncture education programmes.

    Design: a postal survey using a structured questionnaire.

    Setting: 45 maternity units in Sweden.

    Participants: the midwife-in-charge of the units.

    Measurements and findings: the most common indications for the use of acupuncture were relaxation, pain relief, retained placenta, after pains, milk stasis during lactation, hyperemesis and pelvic instability. Specific requirement for acupuncture education were provision of a short course during weekdays including a follow-up course.

    Key conclusion: acupuncture is widely used for many indications in Swedish maternity units despite weak or no evidence to support effectiveness in midwifery care. Requirements for acupuncture education did not seem to be in accordance with what might be expected for this type of qualified intervention.

    Implications for practice: the use of acupuncture in midwifery care should not persist until systematic evaluation of the effect of this method is carried through.

  • 34.
    Mårtensson, Lena
    et al.
    University of Skövde, School of Life Sciences.
    Kvist, Linda J.
    Department of Health Sciences, Lund University, Lund, Sweden / Department of Obstetrics and Gynaecology, Helsingborg Hospital, Helsingborg, Sweden.
    Hermansson, Evelyn
    Institute of Health and Care Sciences, Sahlgrenska Academy at University of Gothenburg, Box 457, SE-405 30 Göteborg, Sweden.
    National survey of how acupuncture education is organised for Swedish midwives2011In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 27, no 1, 93-98 p.Article in journal (Refereed)
    Abstract [en]

    Objective: In Sweden, acupuncture education is required before midwives can use the method in clinical practice. Courses in acupuncture are usually organised by private individuals or companies, and each health facility decides on the adequacy of the educational package. Therefore, there is no overall standard or quality control for free-standing courses of acupuncture education for midwives. The aim of this study was to survey the education given to Swedish midwives in the use of acupuncture treatment in the obstetric area. Design:  a postal survey using a structured questionnaire. Setting:  organisers of acupuncture education. Participants:  18 acupuncture instructors. Measurements  and  findings:  acupuncture  courses  were  usually  organised  outside  universities  and colleges. The courses were similar in terms of extent and content, and were mainly based on a Western medical approach. The recommended indications were extensive despite a lack of scientific evidence.The most common instructor profile was a midwife without any academic degree. Key conclusions and implications for practice:  courses differed considerably in the extent to which they were research based. Continuing professional education for midwives should be given at the same academic level, at least, as basic midwifery education.

  • 35.
    Mårtensson, Lena
    et al.
    University of Skövde, School of Life Sciences.
    Lilja, Lena
    Södertälje sjukhus.
    Injektioner med sterilt vatten: en "gammal" smärtlindringsmetod på frammarsch2008In: Jordemodern, ISSN 0021-7468, no 11, 30-31 p.Article in journal (Other (popular science, discussion, etc.))
  • 36.
    Mårtensson, Lena
    et al.
    University of Skövde, School of Life Sciences.
    McSwiggin, Maureen
    Alivio Med Ctr, Chicago, IL USA.
    Mercer, Judith S.
    Univ Rhode Isl, Providence, RI 02908 USA / Brown Univ, Providence, RI 02912 USA.
    US Midwives' Knowledge and Use of Sterile Water Injections for Labor Pain2008In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 53, no 2, 115-122 p.Article in journal (Refereed)
    Abstract [en]

    The purpose of this research study was to identify and describe US midwives' knowledge and use of sterile water injections to relieve pain during labor. Research studies have shown that injections of sterile water to relieve low back pain during labor are effective with good maternal satisfaction. However, no knowledge is available about their use by midwives in the United States. Questionnaires were mailed to a random sample (N = 450) of midwives who were members of the American College of Nurse-Midwives (ACNM). One hundred thirty-two respondents (29%) returned the questionnaire. One-fourth (26%) of the midwives use sterile water injections, although infrequently. More than half of the midwives use the intracutaneous injection technique, and most use a total of four injections. Most midwives give the injections between contractions, with the assistance of another person, and report very good pain relief. Of those not using sterile water injections, most had no experience or training in use of the method and were interested in learning more about their use. While sterile water injections are a good treatment for back pain during labor, there is a lack of knowledge among midwives about this method of pain relief during labor and an interest in knowing more.

  • 37.
    Mårtensson, Lena
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Mogren, Lisa
    Sahlgrenska University Hospital, Mölndal, Sweden.
    Lindblom, Emma
    Södra Älvsborg Hospital, Borås, Sweden.
    Thorstensson, Stina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    What helps? A description of experiences of support among primiparous women with fear of childbirth: An interview study2014In: International Journal of Nursing and Midwifery, E-ISSN 2141-2456, Vol. 6, no 5, 67-73 p.Article in journal (Refereed)
  • 38.
    Mårtensson, Lena
    et al.
    University of Skövde, School of Life Sciences.
    Nyberg, Karin
    Wallin, Gunnar
    Subcutaneous versus intracutaneous injections of sterile water for labour analgesia: a comparison of perceived pain during administration2000In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 107, no 10, 1248-1251 p.Article in journal (Refereed)
    Abstract [en]

    Objective To investigate whether, during injections of sterile water, there is any difference in perceived pain between intracutaneous and subcutaneous injections.

    Design Blind controlled trial with cross-over design.

    Setting Göteborg and Skövde, Sweden.

    Participants One hundred healthy female volunteers.

    Methods The women were randomised into two groups and subjected to two trials, within one week of each other. During the first trial one group ( n= 50 ) received the intracutaneous injection first, followed by the subcutaneous injection. The second group ( n= 50 ) was given the subcutaneous injection first, followed by intracutaneous injection. In both groups all the injections were given in reverse order during the second trial.

    Main outcome measures Experienced pain during the administration of sterile water injections, measured by visual analogue scale.

    Results The analysis showed intracutaneous injections to be significantly more painful than subcutaneous injections, even after adjusting for injection day and for left/right site of injection (mean 60.8 vs 41.3,  P < 0.001 ).

    Conclusions The findings suggest that the less painful subcutaneous injection technique should be used.

  • 39.
    Mårtensson, Lena
    et al.
    University of Skövde, School of Life Sciences.
    Stener-Victorin, Elisabet
    Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci Physiol Endocrinol, Gothenburg, Sweden.
    Wallin, Gunnar
    Univ Gothenburg, Sahlgrenska Acad, Dept Obstet & Gynecol, Gothenburg, Sweden.
    Acupuncture versus subcutaneous injections of sterile water as treatment for labour pain2008In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 87, no 2, 171-177 p.Article in journal (Refereed)
    Abstract [en]

    Two methods for pain relief and relaxation during labour are sterile water injections and acupuncture. In several studies, sterile water injections have been shown to provide good pain relief, particularly for low back pain during labour. The acupuncture studies for pain relief during labour are not as concordant. Therefore, the aim of this study was to explore if there were any differences between acupuncture and sterile water injections regarding pain relief and relaxation during labour. METHODS: A randomised controlled trial. Some 128 pregnant women at term were randomly assigned to receive acupuncture (n=62) or sterile water injections (n=66). The primary endpoint was to compare the differences between pre-treatment pain levels and maximum pain in the 2 groups. RESULTS: The main results of this study were that sterile water injections yielded greater pain relief (p<0.001) during childbirth compared to acupuncture. The secondary outcome showed that women in the sterile water group had a higher degree of relaxation (p<0.001) compared to the acupuncture group. The women's own assessment of the effects also favoured sterile water injections (p<0.001). There were no significant differences regarding requirements for additional pain relief after treatment between the 2 groups. CONCLUSIONS: Women given sterile water injection experience less labour pain compared to women given acupuncture.

  • 40.
    Mårtensson, Lena
    et al.
    University of Skövde, School of Life Sciences.
    Wallin, Gunnar
    University of Skövde, School of Life Sciences.
    Labour pain treated with cutaneous injections of sterile water: a randomised controlled trial1999In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 106, no 7, 633-637 p.Article in journal (Refereed)
    Abstract [en]

    Objective To evaluate the relief of pain in labour with subcutaneous and intracutaneous injections of sterile water, compared with placebo.

    Design Randomised controlled trial.

    Setting Labour ward with approximately 3000 deliveries annually in a suburban area near Gothenburg, Sweden.

    Participants Ninety-nine pregnant women at term, requiring pain relief for severe lower back pain during the first stage of labour. The women were randomised to receive four injections of 0.1 mL sterile water (without salt) intracutaneously ( n= 33 ), four injections of 0.5 mL sterile water subcutaneously ( n= 33 ) or placebo treatment ( n= 33 ).

    Main outcome measures Reduction of labour pain measured by visual analogue scale.

    Results The median visual analogue scale pain score for labour pain was significantly lower compared with initial values in the two study groups and compared with placebo at 10 and 45 minutes after treatment. The median reductions in visual analogue scores after 10 minutes were 5.0 cm and 4.5 cm in the intracutaneous and subcutaneous injection groups, respectively; women in the placebo group scored a median reduction of 1.7 cm. After 45 minutes the median reductions in the visual analogue scores were 4.9 cm and 4.0 cm in the intracutaneous and subcutaneous injection groups, respectively, compared with 1.0 cm for women in the placebo group. No significant differences in analgesic effect or pain experienced during administration were found between the two study groups.

    Conclusion The new subcutaneous method of administering sterile water, as well as the earlier described intracutaneous injection method, were effective for the relief of pain in labour.

  • 41.
    Mårtensson, Lena
    et al.
    University of Skövde, School of Life Sciences.
    Wallin, Gunnar
    Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Obstet & Gynecol, Gothenburg, Sweden.
    Sterile water injections as treatment for low-back pain during labour: A review2008In: Australian and New Zealand journal of obstetrics and gynaecology, ISSN 0004-8666, E-ISSN 1479-828X, Vol. 48, no 4, 369-374 p.Article, review/survey (Refereed)
    Abstract [en]

    Background: Some women have severe low-back pain during childbirth. It has been shown that sterile water injections reduce this pain. This method, which is easy to learn and very cheap can be a good pain relief alternative primarily in countries with limited available pain relief options. Aims: The aim of this article was to describe published research concerning sterile water injections for treatment of low-back pain during labour. Methods: Three databases were searched from their inception until February, 2008. The inclusion criteria were trials elucidating the pain relief effect of sterile water injections during childbirth. The search terms were labour, birth, obstetrics, parturient, pregnancy, pain relief, analgesia, injection, papules, blocks and sterile water. The computerised literature searches yielded 64 trials, 55 of which failed to meet our inclusion criteria. We used the Jadad Score Instrument to assess the quality of the remaining nine articles, of which six were of adequate quality. Results: All studies in this review had similar alms, designs and measurement instruments and they reported good pain relief particularly, for low-back pain during childbirth. In all studies the pain score reduction is approximately, 60% and the effect remains up to two hours. Conclusions: Sterile water injections seem to be a good alternative for low-back pain during childbirth.

  • 42.
    Mårtensson, Lena
    et al.
    University of Skövde, School of Life Sciences.
    Wallin, Gunnar
    University of Skövde, School of Life Sciences.
    Use of Acupuncture and Sterile Water Injection for Labor Pain: A Survey in Sweden2006In: Birth, ISSN 0730-7659, E-ISSN 1523-536X, Vol. 33, no 4, 289-296 p.Article in journal (Refereed)
    Abstract [en]

    Acupuncture and sterile water injections are nonpharmacological pain relief methods used for labor pain in Swedish delivery wards. Their use has changed over time, the reasons for which are unclear, and acupuncture is currently in more common use than sterile water injections. The aim of this study was to elucidate the clinical use of acupuncture and sterile water injections as pain relief and relaxation during childbirth in Sweden. Methods: Twelve hundred questionnaires were sent out to all delivery wards in Sweden. Nine hundred sixty midwives fulfilled the inclusion criteria, and the response rate was 565 (59%). Results: Acupuncture was used for both pain relief and relaxation, whereas sterile water injections were used almost exclusively for pain relief. The midwives' own choice of pain relief during childbirth for a possible future delivery was similar to their choice of method in clinical practice. Conclusions: Our study shows that acupuncture was used for both pain relief and relaxation, whereas sterile water injections were used almost exclusively for pain relief. The results also indicate a weakness in midwives' awareness and use of scientific knowledge and general recommendations about these methods

  • 43.
    Rilby, Linda
    et al.
    Sahlgrens Univ Hosp, Dept Obstet & Gynecol, Ostra, Sweden.
    Jansson, Solveig
    Sahlgrens Univ Hosp, Dept Obstet & Gynecol, Ostra, Sweden.
    Lindblom, Britta
    Sahlgrens Univ Hosp, Dept Obstet & Gynecol, Ostra, Sweden.
    Mårtensson, Lena B.
    University of Skövde, School of Life Sciences.
    A Qualitative Study of Women's Feelings About Future Childbirth: Dread and Delight2012In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 57, no 2, 120-125 p.Article in journal (Refereed)
    Abstract [en]

    Introduction: There is extensive knowledge about expectations of and thoughts about childbirth among women who have not given birth. When it comes to women who have given birth to at least 1 child, on the other hand, knowledge about their expectations for a future birth is limited. The purpose of this study is thus to describe the emotions of this group concerning future childbirth. Methods: Participants were 908 women in Sweden who had given birth to at least 1 child. This study is based on responses to the following request in the questionnaire sent out to women 4 to 7 years after they had given birth vaginally: "Please describe your feelings when you think about giving birth in the future." Results: One-third of the women responded that they were mostly frightened of future childbirth, while the remaining two-thirds had mostly positive feelings. The qualitative analysis resulted in 3 categories and 8 subcategories and an overall theme: a mixture of dread and delight. Even with negative feelings/fears about future childbirth, many women want to give birth to more children. Discussion: Despite experiences of severe pain or complications during a previous birth, many women nonetheless looked forward to future childbirth, primarily since they were motivated by having another child and encouraged by having been given good support by the midwife.

  • 44.
    Rosén, Helena I.
    et al.
    University of Skövde, School of Life Sciences.
    Bergh, Ingrid H. E.
    University of Skövde, School of Life Sciences.
    Lundman, Berit M.
    University of Skövde, School of Life Sciences.
    Mårtensson, Lena B.
    University of Skövde, School of Life Sciences.
    Patients' experiences and perceived causes of persisting discomfort following day surgery2010In: BMC Nursing, ISSN 1472-6955, Vol. 9, artikelnummer 16- p.Article in journal (Refereed)
    Abstract [en]

    Background: The aim of this study was to describe patients’ experiences and perceived causes of persisting discomfort following day surgery. Earlier research has mainly covered symptoms and signs during a recovery period of up to one month, and not dealt with patients’ perceptions of what causes persisting, longer-term discomfort. Methods: This study is a part from a study carried out during the period May 2006 to May 2007 with a total of 298 day surgery patients. Answers were completed by 118 patients at 48 hours, 110 at seven days and 46 at three months to one open-ended question related to discomfort after day surgery constructed as follows: If you are stillexperiencing discomfort related to the surgery, what is the reason, in your opinion? Data was processed, quantitatively and qualitatively. Descriptive, inferential, correlation and content analyses were performed. Results: The results suggest that patients suffer from remaining discomfort e.g. pain and wound problem, with effects on daily life following day surgery up to three months. Among patients’ perceptions of factors leading to discomfort may be wrongful or suboptimal treatment, type of surgery or insufficient access to provider/information. Conclusions: The results have important implications for preventing and managing discomfort at home followingday surgery, and for nursing interventions to help patients handle the recovery period better.

  • 45.
    Rosén, Helena I.
    et al.
    University of Skövde, School of Health and Education.
    Bergh, Ingrid H. E.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Schwartz-Barcott, Donna
    Nursing College, University of Rhode island, Kingstown, RI.
    Mårtensson, Lena B.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    The Recovery Process After Day Surgery Within the Symptom Management Theory2014In: Nursing Forum, ISSN 1744-6198, Vol. 49, no 2, 100-109 p.Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim was to illustrate two cases in a postoperative situation following day surgery within the framework of the symptom management theory. Method: Template analysis using the symptom management theory. Result: Neither the woman nor the man was able to return to their normal activities, health status or functional status, within a week. Conclusion: The results illustrate how a postoperative situation may involve personal suffering up to 3 months. Practical Implication: To obtain an outcome following day surgery, as optimal as possible, improving clinical practices and routines, such as discharge criteria, guidelines, and care pathways, is necessary. © 2014 Wiley Periodicals, Inc.

  • 46.
    Rosén, Helena I.
    et al.
    University of Skövde, School of Life Sciences.
    Bergh, Ingrid H.
    University of Skövde, School of Life Sciences.
    Odén, Anders
    Mårtensson, Lena B.
    University of Skövde, School of Life Sciences.
    Patients´ Experiences of Pain Following Day Surgery - At 48 Hours, Seven Days and Three Months2011In: Open Nursing Journal, ISSN 1874-4346, Vol. 5, 52-59 p.Article in journal (Refereed)
    Abstract [en]

    Recent studies indicate that patients experience pain after day surgery for a longer period than previously known. This requires verification. This was a prospective, descriptive correlational study. A convenience sample of 298 day surgery patients undergoing various surgical procedures was asked to report pain intensity and its interference with daily function 48 hours, seven days and three months after day surgery. Correlation and regression analyses were performed. On a NRS, 55% (n=230) reported pain (≥4) 48 hours after surgery, as did 43% (n=213) at seven days. Pain interfered with normal activities at ≥4 NRS at 48 hours and at seven days, after which it decreased.

  • 47.
    Rosén, Helena
    et al.
    University of Skövde, School of Life Sciences.
    Lauzon Clabo, Laurie M.
    College of Nursing, University of Rhode Island, United States.
    Mårtensson, Lena
    University of Skövde, School of Life Sciences.
    Symptoms following day surgery: a review of the literature2009In: Journal of Advanced Perioperative Care, ISSN 1470-5664, Vol. 4, no 1, 7-18 p.Article, review/survey (Refereed)
    Abstract [en]

    Aim: The purpose of this paper is to provide a broad-based overview of the current literature regarding patients’ experiences of symptoms following day surgery. Background: The advent of new anaesthetic and anti-emetic agents, advanced surgical techniques and the need for reduced costs for inpatient hospital services, has resulted in about 70% of all surgical procedures being undertaken as day surgery (Mattila et al 2005, Qureshi et al 2006) in many countries such as the United Kingdom (UK) (Aylin et al 2005) and Europe, Australia and North America (Jarrett 2001). As more and more types of surgery, including increasingly complex procedures, are undertaken as day surgery and with the expansion of day surgery for patients who are older, frail or who have multiple co-morbidities, there is a need to expand the knowledge base regarding patients’ symptom experience at home following day surgery. In particular, there is a need to examine the patients’ experience of symptoms longitudinally and to examine the impact of these on the return to activities of daily living (Gudex et al 2006). Method: Nursing and health care papers published in English between 1992 and April 2008 were sought, using the Cumulative Index of Nursing and Allied Health Literature (CINAHL) database. Thirty six papers were selected and critiqued. A checklist was used to review the included studies for their type of method and the way they were designed and implemented (Goodman 1993). Findings: The wide range of studies reviewed provided further understanding of incidence, intensity and duration of symptoms experienced by patients after day surgery. Patients almost invariably report that pain and other symptoms were at their peak up to 24 hours after discharge and frequently persisted for six days or more. However, a clear picture of the symptom experience following day surgery failed to emerge because methodological differences make comparison across studies difficult. While there has been little exploration of the symptom experience longitudinally, those studies that have examined symptoms over time suggest that the patient's experience of them does have a significant impact on their ability to function in their normal social and work roles for a prolonged period of time following day surgery. In the studies reviewed when day surgery patients´ activity levels were reduced postoperatively, return to usual activity was delayed and activities of daily living were reported as difficult to manage. Conclusion: This review demonstrates that patients' experience of symptoms in the recovery period at home following day surgery is more profound than clinicians expect, lasts for a longer period and interferes with the ability to return to normal activities. However there are still gaps in knowledge particularly concerning the extent to which patients continue to experience symptoms after six days and beyond. Further research needs to explore multidimensional perspectives on symptoms together with an additional and more thorough evaluation of the impact of symptoms on daily living. Recommendations: Further research regarding these gaps in knowledge is necessary in order to develop a deeper understanding of patients’ symptom experience following day surgery and to develop appropriate assessment and intervention strategies for this population. The perioperative nurse with his or her specialised knowledge is well suited to face these challenges.

     

  • 48.
    Schytt, Erica
    et al.
    Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden / Centre for Clinical Research, Dalarna, Falun, Sweden.
    Halvarsson, Anna
    Dalarna University, Mora Hospital, Dalarna, Sweden.
    Pedersen-Draper, Christina
    Dalarna University, Mora Hospital, Dalarna, Sweden.
    Mårtensson, Lena
    University of Skövde, School of Life Sciences.
    Incompleteness of Swedish local clinical guidelines for acupuncture treatment during childbirth2011In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 90, no 1, 77-82 p.Article in journal (Refereed)
    Abstract [en]

    Objective. To investigate the presence and content of local clinical guidelines for acupuncture treatment in Swedish labor and postnatal wards. Design. A Swedish national survey. Main Outcome Measures. Presence and content of clinical guidelines for acupuncture. Setting. All Swedish labor and postnatal wards at the time of data collection (April 2007–March 2008). Material and Methods. Enquiry was made on local clinical guidelines for acupuncture treatment at 50 labor and 50 postnatal wards. The standards for reporting interventions in controlled trials of acupuncture document was used to identify core aspects of acupuncture treatment and the proportion of wards with guidelines on these aspects was evaluated. Results. Guidelines were obtained from 27 labor wards and 22 postnatal wards. Descriptions of the core aspects of acupuncture treatment, such as acupuncture rationale, needling details and treatment regimens, were limited in most. All local guidelines included indications for treatment, but these were not based on scientific evidence of effect, and only two mentioned the importance of achieving de-qi – a feeling of soreness reflecting an effective treatment. Few clinical guidelines required that the practitioners’ acupuncture education should be on an academic level and relevant references based on clinical trials were lacking in all guidelines. Conclusion. Swedish local clinical guidelines on acupuncture for childbirth-related symptoms lack sufficient information to support midwives and obstetricians in administering acupuncture treatment. The content of the guidelines was unclear, inconclusive and, in some cases, irrelevant, and a majority lacked important information on indications and technique.

  • 49.
    Svensson, Ann-Marie
    et al.
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Mårtensson, Lena
    University of Skövde, School of Life Sciences. College of Nursing, University of Rhode Island, USA.
    Hellström Muhli, Ulla
    Department of Sociology, Uppsala University, Sweden.
    Well-being dialogue: Elderly women’s subjective sense of well-being from their course of life perspective2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, Article Number: 19207- p.Article in journal (Refereed)
    Abstract [en]

    In this article, we are concerned with narratives of elderly women’s well-being from their perspectives of the latter parts of their life, living at special housing accommodation (SHA) in the context of Swedish elderly care. In focusing on narratives about well-being, we have a two-fold focus: (1) how the elderly women create their own identity and meaning-making based on lifetime experience; and (2) how narratives of well-being are reflected through the filter of life in situ at the SHA. Based on empirical data consisting of well-being narratives, a dialogical performance analysis was undertaken. The results show how relationships with important persons during various stages of life, and being together and enjoying fellowship with other people as well as enjoying freedom and self-determination, are central aspects of well-being. The conclusions drawn are that the characteristic phenomena of well-being (the what) in the narratives are continuity, identity, and sociality for the elderly person, and this is manifested (the how) as a question of contrasting the state of self-management and self-decline.

  • 50.
    Vixner, Linda
    et al.
    Division of Reproductive Health, Department of Women's and Children's Health, Karolinska Institutet, Retzius väg 13A, 171 77 Stockholm, Sweden / School of Health and Social Studies, Dalarna University, Högskolan Dalarna, 791 88 Falun, Sweden.
    Mårtensson, Lena B.
    University of Skövde, School of Life Sciences.
    Stener-Victorin, Elisabet
    Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden / Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150040, China.
    Schytt, Erica
    Karolinska Inst, Div Reprod Hlth, Dept Womens & Childrens Hlth, S-17177 Stockholm, Sweden / Ctr Clin Res Dalarna, S-79182 Falun, Sweden / Division of Reproductive Health, Department of Women's and Children's Health, Karolinska Institutet, Retzius väg 13A, 171 77 Stockholm, Sweden / Centre for Clinical Research Dalarna, Nissers väg 3, 791 82 Falun, Sweden.
    Manual and Electroacupuncture for Labour Pain: Study Design of a Longitudinal Randomized Controlled Trial2012In: Evidence-based Complementary and Alternative Medicine, ISSN 1741-427X, E-ISSN 1741-4288, Article ID 943198- p.Article in journal (Refereed)
    Abstract [en]

    Introduction. Results from previous studies on acupuncture for labour pain are contradictory and lack important information on methodology. However, studies indicate that acupuncture has a positive effect on women's experiences of labour pain. The aim of the present study was to evaluate the efficacy of two different acupuncture stimulations, manual or electrical stimulation, compared with standard care in the relief of labour pain as the primary outcome. This paper will present in-depth information on the design of the study, following the CONSORT and STRICTA recommendations. Methods. The study was designed as a randomized controlled trial based on western medical theories. Nulliparous women with normal pregnancies admitted to the delivery ward after a spontaneous onset of labour were randomly allocated into one of three groups: manual acupuncture, electroacupuncture, or standard care. Sample size calculation gave 101 women in each group, including a total of 303 women. A Visual Analogue Scale was used for assessing pain every 30 minutes for five hours and thereafter every hour until birth. Questionnaires were distributed before treatment, directly after the birth, and at one day and two months postpartum. Blood samples were collected before and after the first treatment. This trial is registered at ClinicalTrials.gov:NCT01197950.

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