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Molin, B., Zwedberg, S., Berger, A.-K., Sand, A. & Georgsson, S. (2024). “The ignored pain” - experiences of encounters with healthcare from the perspective of women with pain persisting after childbirth: a qualitative study. Sexual & Reproductive HealthCare, 39, 100929-100929, Article ID 100929.
Open this publication in new window or tab >>“The ignored pain” - experiences of encounters with healthcare from the perspective of women with pain persisting after childbirth: a qualitative study
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2024 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 39, p. 100929-100929, article id 100929Article in journal (Refereed) Published
Abstract [en]

Introduction: Although the prevalence of pain persisting after pregnancy or labour decreases with time, up to 35 % of women report pain 8 months to 12 years after childbirth. To prevent the development and reduce the impact of chronic pain, researchers and clinicians emphasize the importance of early diagnosis as well as timely and appropriate treatment. Previous studies have shown that when women with post-childbirth morbidities consult healthcare professionals during the first year following birth, their problems are often neglected, and they do not receive adequate treatment.

Objective: To explore how women with pain persisting for eight months after childbirth experienced encounters with healthcare.

Methods: A descriptive qualitative design with 20 face-to-face, semi-structured interviews. Data were analysed using inductive qualitative content analysis.

Results: “Pain ignored by healthcare” was identified as an essential theme and included four categories: “Questioned pain experience,” “Inadequate pain management,” “Lost in healthcare,” and “Insufficient postpartum care “

Conclusion: The women experienced that their pain was often not recognized or adequately treated, but instead ignored or trivialized. Recurring were descriptions of experienced knowledge gaps among the healthcare providers regarding pain and its management. There was an overall desire among women for a well-defined and well-functioning chain of care with better accessibility and scope.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Childbirth, Chronic pain, Experiences, Qualitative, Encounters, Healthcare
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-4726 (URN)10.1016/j.srhc.2023.100929 (DOI)
Projects
Långvarig smärta relaterad till graviditet och förlossning
Funder
Sophiahemmet University
Note

Funder: Capio Research Foundation (grant no. 2016–2900, 2017–2996)

Available from: 2023-12-13 Created: 2023-12-13 Last updated: 2023-12-13Bibliographically approved
Stern, J., Molin, M. S., Fernaeus, M., Georgsson, S. & Carlsson, T. (2022). Contraceptive counseling about adverse reactions of intrauterine contraception: Exploration of narratives found in web-based discussion boards.. Midwifery, 104, Article ID 103166.
Open this publication in new window or tab >>Contraceptive counseling about adverse reactions of intrauterine contraception: Exploration of narratives found in web-based discussion boards.
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2022 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 104, article id 103166Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: the possibility of experiencing adverse reactions is an important aspect of contraceptive decision-making and information about this topic is highlighted as an essential aspect of contraceptive counseling. The aim of this study was to explore experiences of contraceptive counseling about potential adverse reactions of intrauterine contraception.

DESIGN: exploratory qualitative study of messages in discussion boards, analyzed with inductive qualitative content analysis.

SETTING: two large public Swedish web-based discussion boards about sexual and reproductive health.

PARTICIPANTS: threads related to the aim were identified through searches in the discussion boards during 2019 and 2020, resulting in in 43 included posters who had written 140 messages in total.

FINDINGS: the themes 'difficulties making an informed decision due to insufficient and untrustworthy information about adverse reactions' and 'feeling dismissed when communicating about experienced adverse reactions' illustrate the results. Posters emphasized the importance of sufficient information about adverse reactions. However, professionals were perceived as overly optimistic regarding intrauterine contraception and focusing on mild or common reactions. The importance of feeling that their adverse reactions were acknowledged was articulated, but posters felt that some professionals dismissed the reactions when being told about it, resulting in frustration and dissatisfaction with care. The discussion boards contained narratives describing a resistance among professionals to send in a formal report about the adverse reaction.

KEY CONCLUSIONS: according to statements made by posters who have experience of adverse reactions of intrauterine contraception, contraceptive counseling have room for improvement in regard to inclusion of comprehensive information about adverse reactions. The findings illustrate the importance that clients who experience adverse reactions of intrauterine contraception feel they are acknowledged and offered adequate support.

IMPLICATIONS FOR PRACTICE: echoing guidelines for high-quality contraceptive counseling, the narratives provide further weight that professionals need to have adequate training and resources to offer comprehensive information about adverse reactions of intrauterine contraception. The findings call attention to the importance of follow-up services for clients who experience adverse reactions.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Adverse effects, Contraception, Counseling, Drug-related side effects and adverse reactions, Intrauterine devices, Pharmacovigilance, Social networking
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-4130 (URN)10.1016/j.midw.2021.103166 (DOI)000712890500002 ()34717242 (PubMedID)
Available from: 2021-11-02 Created: 2021-11-02 Last updated: 2023-02-22Bibliographically approved
Molin, B., Zwedberg, S., Berger, A.-K., Sand, A. & Georgsson, S. (2022). Disempowering women - a mixed methods study exploring informational support about pain persisting after childbirth and its consequences. BMC Pregnancy and Childbirth, 22(1), Article ID 510.
Open this publication in new window or tab >>Disempowering women - a mixed methods study exploring informational support about pain persisting after childbirth and its consequences
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2022 (English)In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 22, no 1, article id 510Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Access to information is essential to achieving individual empowerment; meaning the ability to exercise control, manage one's own condition and make informed decisions. However, studies have shown that information provided to women regarding physiological changes during the postpartum period and postpartum health was inadequate, incorrect, or inconsistent.

METHODS: The aim of this study was to explore informational support about pain persisting after childbirth and its consequences. A sequential explanatory mixed methods design was used. In the first, quantitative phase, 1,171 women, who gave birth eight months earlier, completed a self-administered questionnaire. In the second, qualitative phase, 20 women who experienced chronic pain were interviewed. Descriptive statistics and qualitative content analysis were used to analyse the data.

RESULTS: The majority of the women did not receive information about pain persisting after childbirth, or the information was insufficient or incorrect. They did not know when and where to seek help and did not consult health care professionals. In addition, the lack of information had a negative impact on women's psychological well-being. All women expressed the need to be informed by health care professionals, irrespective of the individual risk of developing chronic pain.

CONCLUSIONS: Health services should ensure availability of information to give the women opportunity to achieve empowerment to make good health decisions, increase control over their health and well-being as well as to enhance their self-efficacy. We propose that a booklet or leaflet with relevant information about the risk of developing chronic pain, symptoms and treatment, along with advice about appropriate health care settings should be provided as part of antenatal or postnatal care.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2022
Keywords
Childbirth, Chronic pain, Empowerment, Information, Mixed methods
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:rkh:diva-4348 (URN)10.1186/s12884-022-04841-6 (DOI)35739466 (PubMedID)
Available from: 2022-07-07 Created: 2022-07-07 Last updated: 2023-12-13Bibliographically approved
Wright, S. J., Dalal, G., Vass, C. M., Georgsson, S. & Payne, K. (2022). How do women want to receive information about non-invasive prenatal testing?: Evidence from a discrete choice experiment. Prenatal Diagnosis, 42(11), 1377-1389
Open this publication in new window or tab >>How do women want to receive information about non-invasive prenatal testing?: Evidence from a discrete choice experiment
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2022 (English)In: Prenatal Diagnosis, ISSN 0197-3851, E-ISSN 1097-0223, Vol. 42, no 11, p. 1377-1389Article in journal (Refereed) Published
Abstract [en]

Objective: Non-invasive prenatal testing (NIPT) identifies the risk of abnormalities in pregnancy, potentially reducing the risk of miscarriage associated with invasive tests. This study aimed to understand the preferences of current and future mothers about the content, format and timing of information provision about NIPT.

Methods: An online discrete choice experiment (DCE) was designed comprising four attributes: when in the pregnancy information is provided (4 levels); degree of detail (2 levels); information format (6 levels); cost to women for gathering information (5 levels). Respondents included women identified by an online-panel company in Sweden. The mathematical design was informed by D-efficient criteria. Choice data were analysed using uncorrelated random parameters logit (RPL) and latent class models.

Results: One thousand Swedish women (56% current mothers) aged 18 to 45 years completed the survey. On average, women preferred extensive information provided at/before 9 weeks of pregnancy. There was heterogeneity in preferences about the desired format of information provision (website, mobile app or individual discussion with a midwife) in the population.

Conclusion: Women had clear preferences about the desired content, format and timing of information provision about NIPT. It is important to tailor information provision to enable informed choices about NIPT.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:rkh:diva-4383 (URN)10.1002/pd.6243 (DOI)36146928 (PubMedID)
Projects
Mind the Risk
Funder
Riksbankens Jubileumsfond
Available from: 2022-09-27 Created: 2022-09-27 Last updated: 2022-10-25Bibliographically approved
Ulfsdottir, H., Saltvedt, S., Edqvist, M. & Georgsson, S. (2022). Management of the active second stage of labor in waterbirths compared with conventional births - a prospective cohort study. Midwifery, 107, Article ID 103283.
Open this publication in new window or tab >>Management of the active second stage of labor in waterbirths compared with conventional births - a prospective cohort study
2022 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 107, article id 103283Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The management of the active second stage in labor and perineal protection varies between countries and is rarely described regarding waterbirths. The objective of this study was to describe how midwives manage the active second stage of labor in waterbirths compared to conventional births. A secondary aim was to compare clinical outcomes between the two groups.

METHODS: A prospective cohort study, based on 323 women who gave birth at three clinics in Sweden, between Dec 2015-May 2019. The women were both primiparous and multiparous; 153 gave birth in water and 170 had a conventional uncomplicated birth. A protocol was completed by the attending midwife after birth, describing characteristics and management of the active second stage of labor as well as perineal protection.

RESULTS: The active second stage of labor differed in several aspects between waterbirths and conventional births. Maternal pushing was spontaneous to a higher extent among women giving birth in water and the use of manual perineal protection was lower. The technique of manual perineal protection differed as well as birth positions. Giving birth in water was associated with less second-degree tears among primiparous women but with no differences among multiparas.

CONCLUSIONS: In waterbirth, the midwife took the role of a more watchful attendee, making less interventions. Waterbirths were associated with less directed pushing and less manual perineal protection. However, there was still a widespread use of manual perineal protection, showing it is possible to use in the same way as in conventional births if needed.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
birth, perineal protection, midwifery, perineal tears, waterbirth
National Category
Nursing Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:rkh:diva-4218 (URN)10.1016/j.midw.2022.103283 (DOI)35172265 (PubMedID)2-s2.0-85124453360 (Scopus ID)
Available from: 2022-02-21 Created: 2022-02-21 Last updated: 2023-02-22Bibliographically approved
Stern, J., Georgsson, S. & Carlsson, T. (2022). Quality of web-based information about the coronavirus disease 2019: a rapid systematic review of infodemiology studies published during the first year of the pandemic. BMC Public Health, 22(1), Article ID 1734.
Open this publication in new window or tab >>Quality of web-based information about the coronavirus disease 2019: a rapid systematic review of infodemiology studies published during the first year of the pandemic
2022 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 22, no 1, article id 1734Article, review/survey (Refereed) Published
Abstract [en]

Background Following the outbreak of the coronavirus disease 2019, adequate public information was of outmost importance. The public used the Web extensively to read information about the pandemic, which placed significant responsibility in, for many, an unfamiliar situation as the disease spread across the globe. The aim of this review was to synthesize the quality of web-based information concerning the coronavirus disease 2019 published during the first year of the pandemic.

Materials and methodsA rapid systematic review was undertaken by searching five electronic databases (CINAHL, Communication & Mass Media Complete, PsycINFO, PubMed, Scopus). Empirical infodemiology reports assessing quality of information were included (n = 22). Methodological quality and risk of bias was appraised with tools modified from previous research, while quality assessment scores were synthesized with descriptive statistics. Topics illustrating comprehensiveness were categorized with content analysis.

ResultsThe included reports assessed text-based content (n = 13) and videos (n = 9). Most were rated good overall methodological quality (n = 17). In total, the reports evaluated 2,654 websites or videos and utilized 46 assessors. The majority of the reports concluded that websites and videos had poor quality (n = 20). Collectively, readability levels exceeded the recommended sixth grade level. There were large variations in ranges of the reported mean or median quality scores, with 13 of 15 total sample scores being classified as poor or moderate quality. Four studies reported that ≥ 28% of websites contained inaccurate statements. There were large variations in prevalence for the six categories illustrating comprehensiveness.

ConclusionThe results highlight quality deficits of web-based information about COVID-19 published during the first year of the pandemic, suggesting a high probability that this hindered the general population from being adequately informed when faced with the new and unfamiliar situation. Future research should address the highlighted quality deficits, identify methods that aid citizens in their information retrieval, and identify interventions that aim to improve the quality of information in the online landscape.

Place, publisher, year, edition, pages
Springer, 2022
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:rkh:diva-4426 (URN)10.1186/s12889-022-14086-9 (DOI)36096783 (PubMedID)
Available from: 2022-12-05 Created: 2022-12-05 Last updated: 2023-08-28Bibliographically approved
Georgsson, S. & Carlsson, T. (2022). Readability, understandability and language accessibility of Swedish websites about the coronavirus disease 2019: a cross-sectional study. BMC Medical Informatics and Decision Making, 22(1), Article ID 131.
Open this publication in new window or tab >>Readability, understandability and language accessibility of Swedish websites about the coronavirus disease 2019: a cross-sectional study
2022 (English)In: BMC Medical Informatics and Decision Making, E-ISSN 1472-6947, Vol. 22, no 1, article id 131Article in journal (Refereed) Published
Place, publisher, year, edition, pages
BioMed Central, 2022
National Category
Media and Communications Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:rkh:diva-4266 (URN)10.1186/s12911-022-01873-y (DOI)000795505200002 ()
Funder
Uppsala University
Available from: 2022-05-25 Created: 2022-05-25 Last updated: 2022-05-30Bibliographically approved
Molin, B., Zwedberg, S., Berger, A.-K., Sand, A. & Georgsson, S. (2021). Grieving over the past and struggling forward - a qualitative study of women's experiences of chronic pain one year after childbirth. Midwifery, 103, Article ID 103098.
Open this publication in new window or tab >>Grieving over the past and struggling forward - a qualitative study of women's experiences of chronic pain one year after childbirth
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2021 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 103, article id 103098Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To describe women's experiences of chronic pain related to childbirth approximately one year after labour.

DESIGN: A qualitative design with face-to-face interviews analysed using inductive qualitative content analysis.

PARTICIPANTS: Twenty women who reported chronic pain, with onset during pregnancy and/or following labour, approximately one year after childbirth.

FINDINGS: The analysis revealed an essential theme, "Grieving over the past and struggling forward", and three categories "Mourning the losses", "Struggling with the present" and "Managing the future".

CONCLUSIONS: This study provides new knowledge about women's experiences of chronic pain one year after childbirth. The pain severely reduced women´s previous ability to perform physical and social activities, negatively impacted psychological well-being and altered their self-image. Most of the women adopted a positive attitude and hoped for improved health in the future, although constantly struggling with the pain and its consequences.

IMPLICATIONS FOR PRACTICE: This knowledge is particularly important as chronic pain may not diminish with time in predisposed individuals who may need help and support from health professionals in their endeavour to manage their pain. Healthcare providers, i.e. midwives, gynaecologists and general practitioners need to understand women´s experiences of chronic pain from their own perspective to improve identification and treatment of pain following childbirth, thus preventing women's suffering and potential long-term health problems. Future studies are warranted to further explore and discuss women's coping strategies, health seeking behaviour and experiences of health care.

Place, publisher, year, edition, pages
Elsevier, 2021
Keywords
Pregnancy, childbirth, chronic pain, experiences, labour, qualitative
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-4089 (URN)10.1016/j.midw.2021.103098 (DOI)000703774300007 ()34339902 (PubMedID)
Note

This study was supported by a grant from the Capio Research Foundation [grant no. 2016-2900, 2017- 2996] and funding from Sophiahemmet University, Stockholm.

Available from: 2021-08-17 Created: 2021-08-17 Last updated: 2023-12-13
Rådestad, I., Doveson, S., Lindgren, H., Georgsson, S. & Akselsson, A. (2021). Midwives’ experiences of using the Mindfetalness method when talking with pregnant women about fetal movements. Women and Birth, 34(5), e498-e504
Open this publication in new window or tab >>Midwives’ experiences of using the Mindfetalness method when talking with pregnant women about fetal movements
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2021 (English)In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 34, no 5, p. e498-e504Article in journal (Refereed) Published
Abstract [en]

Background: Information given to pregnant women about fetal movements is important in maternity care and decreased fetal movements is associated with fetal growth restriction and stillbirth. The fetal movement pattern is different for every fetus and women perceive different types of movements. Mindfetalness is a self-assessment method for a woman to use to become familiar with her unborn baby's fetal movement pattern. Aim: We aimed to explore midwives’ perceptions about informing pregnant women about fetal movements and their experiences of working with Mindfetalness in their daily work. Methods: A web-questionnaire was distributed to midwives who participated in a randomized controlled trial evaluating Mindfetalness, a method for the observation of fetal movements. In total, 67 maternity clinics in Stockholm, Sweden, were randomized to Mindfetalness or routine care. Of the 144 midwives working in maternity clinics randomized to Mindfetalness, 80% answered the questionnaire. Findings: The midwives thought that the leaflet about Mindfetalness was supportive in their work when informing women about fetal movements and the majority wanted to continue to distribute the leaflet when the trial ended. The midwives also expressed that the study increased their own knowledge about fetal movements. Women embraced the information about Mindfetalness positively and appreciated the written material. The midwives thought that talking about fetal movements in maternity care is an important but challenging task. Conclusion: Mindfetalness is a useful tool to use in maternity clinics when informing pregnant women about fetal movements. The written information was appreciated by both pregnant women and midwives.

Place, publisher, year, edition, pages
Elsevier, 2021
Keywords
Mindfetalness; Fetal movements; Awareness; Fetal well-being; Self-assessment method
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-3488 (URN)10.1016/j.wombi.2020.10.007 (DOI)33309478 (PubMedID)
Available from: 2020-11-10 Created: 2020-11-10 Last updated: 2021-08-23Bibliographically approved
Stern, J., Georgsson, S. & Carlsson, T. (2021). Quality of web-based information at the beginning of a global pandemic: a cross-sectional infodemiology study investigating preventive measures and self care methods of the coronavirus disease 2019. BMC Public Health, 21(1), Article ID 1141.
Open this publication in new window or tab >>Quality of web-based information at the beginning of a global pandemic: a cross-sectional infodemiology study investigating preventive measures and self care methods of the coronavirus disease 2019
2021 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 21, no 1, article id 1141Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: reducing the spread and impact epidemics and pandemics requires that members of the general population change their behaviors according to the recommendations, restrictions and laws provided by leading authorities. When a new epidemic or pandemic emerges, people are faced with the challenge of sorting through a great volume of varied information. Therefore, the dissemination of high-quality web-based information is essential during this time period. The overarching aim was to investigate the quality of web-based information about preventive measures and self care methods at the beginning of the COVID-19 pandemic.

METHODS: in May 2020, consumer-oriented websites written in Swedish were identified via systematic searches in Google (n = 76). Websites were assessed with inductive content analysis, the JAMA benchmarks, the QUEST tool and the DISCERN instrument.

RESULTS: seven categories and 33 subcategories were identified concerning preventive measures (md = 6.0 subcategories), with few specifying a method for washing hands (n = 4), when to sanitize the hands (n = 4), and a method for sanitizing the hands (n = 1). Eight categories and 30 subcategories were identified concerning self care methods (md = 3.0 subcategories), with few referring to the national number for telephone-based counseling (n = 20) and an online symptom assessment tool (n = 16). Overall, the median total quality scores were low (JAMA = 0/4, QUEST =13/28, DISCERN = 29/80).

CONCLUSIONS: at the beginning of the pandemic, substantial quality deficits of websites about COVID-19 may have counteracted the public recommendations for preventive measures. This illustrates a critical need for standardized and systematic routines on how to achieve dissemination of high-quality web-based information when new epidemics and pandemics emerge.

Place, publisher, year, edition, pages
BioMed Central, 2021
Keywords
COVID-19, Consumer health information, Primary prevention, Self care, Severe acute respiratory syndrome coronavirus 2, World wide web
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:rkh:diva-4068 (URN)10.1186/s12889-021-11141-9 (DOI)34126962 (PubMedID)
Available from: 2021-06-22 Created: 2021-06-22 Last updated: 2023-08-28Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-2626-2335

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