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  • 1.
    Gottvall, Maria
    et al.
    Uppsala universitet, Vårdvetenskap.
    Grandahl, Maria
    Uppsala universitet, Vårdvetenskap.
    Höglund, Anna T.
    Uppsala universitet, Centrum för forsknings- och bioetik.
    Larsson, Margareta
    Uppsala universitet, Obstetrik & gynekologi.
    Stenhammar, Christina
    Uppsala universitet, Vårdvetenskap.
    Andrae, Bengt
    Uppsala universitet, Centrum för klinisk forskning, Gävleborg.
    Tydén, Tanja
    Uppsala universitet, Vårdvetenskap.
    Trust versus concerns: how parents reason when they accept HPV vaccination for their young daughter2013In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 118, no 4, p. 263-270Article in journal (Refereed)
    Abstract [en]

    Background. From spring of 2012, human papillomavirus (HPV) vaccine against cervical cancer is offered free of charge to all girls aged 10-12 years through a school-based vaccination programme in Sweden. The aim of this study was to explore how parents reason when they accept HPV vaccination for their young daughter and also their views on HPV-related information. Methods. Individual interviews with parents (n = 27) of 11-12-year-old girls. The interviews were recorded, transcribed verbatim, and analysed using thematic content analysis. Results. Three themes emerged through the analysis: Trust versus concern, Responsibility to protect against severe disease, and Information about HPV and HPV vaccination is important. The parents expressed trust in recommendations from authorities and thought it was convenient with school-based vaccination. They believed that cervical cancer was a severe disease and felt a responsibility to protect their daughter from it. Some had certain concerns regarding side effects and vaccine safety, and wished for a dialogue with the school nurse to bridge the information gaps. Conclusions. Trust in the recommendations from authorities and a wish to protect their daughter from a severe disease outweighed concerns about side effects. A school-based vaccination programme is convenient for parents, and the school nurse has an important role in bridging information gaps. The findings from this qualitative study cannot be generalized; however, it can provide a better understanding of how parents might reason when they accept the HPV vaccination for their daughter.

  • 2.
    Gottvall, Maria
    et al.
    Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap.
    Tydén, Tanja
    Uppsala universitet, Vårdvetenskap.
    Höglund, Anna T
    Uppsala universitet, Centrum för forsknings- och bioetik.
    Larsson, Margareta
    Uppsala universitet, Institutionen för kvinnors och barns hälsa.
    Knowledge of human papillomavirus among high school students can be increased by an educational intervention2010In: International Journal of STD and AIDS (London), ISSN 0956-4624, E-ISSN 1758-1052, Vol. 21, no 8, p. 558-562Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to evaluate the effect of an educational intervention concerning human papillomavirus (HPV) directed at Swedish first year high school students. The intervention consisted of a class room lesson, a website and a folder. Outcome variables were knowledge of HPV and attitudes to preventive methods such as HPV vaccination, condom use and Pap smear testing. An intervention group (n = 92) was matched with two comparison groups (n = 184). At baseline, the median score for HPV knowledge was one out of 10 in both groups. At follow-up, the median knowledge score had increased to six in the intervention group, but was still one in the comparison group (P < 0.001). Attitudes to HPV vaccination, condom use and Pap smear testing remained the same (P > 0.05). In conclusion, a short school-based intervention can greatly increase the students' knowledge about HPV, but attitudes and behaviours are less easy to influence.

  • 3.
    Gottvall, Maria
    et al.
    Uppsala universitet, Vårdvetenskap.
    Tydén, Tanja
    Uppsala universitet, Vårdvetenskap.
    Larsson, Margareta
    Uppsala universitet, Obstetrik & gynekologi.
    Stenhammar, Christina
    Uppsala universitet, Vårdvetenskap.
    Höglund, Anna T
    Uppsala universitet, Centrum för forsknings- och bioetik.
    Informed Consent for HPV Vaccination: A Relational Approach2015In: Health Care Analysis, ISSN 1065-3058, E-ISSN 1573-3394, Vol. 23, no 1, p. 50-62Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore the relational aspects of the consent process for HPV vaccination as experienced by school nurses, based on the assumption that individuals have interests related to persons close to them, which is not necessarily to be apprehended as a restriction of autonomy; rather as a voluntary and emotionally preferred involvement of their close ones. Thirty Swedish school nurses were interviewed in five focus groups, before the school based vaccination program had started in Sweden. The empirical results were discussed in light of theories on relational autonomy. The school nurses were convinced that parental consent was needed for HPV vaccination of 11-year-old girls, but problems identified were the difficulty to judge when a young person is to be regarded as autonomous and what to do when children and parents do not agree on the decision. A solution suggested was that obtaining informed consent in school nursing is to be seen as a deliberative process, including the child, the parents and the nurse. The nurses described how they were willing strive for a dialogue with the parents and negotiate with them in the consent process. Seeing autonomy as relational might allow for a more dialogical approach towards how consent is obtained in school based vaccination programs. Through such an approach, conflicts of interests can be made visible and become possible to deal with in a negotiating dialogue. If the school nurses do not focus exclusively on accepting the individual parent's choice, but strive to engage in a process of communication and deliberation, the autonomy of the child might increase and power inequalities might be reduced.

  • 4.
    Grandahl, Maria
    et al.
    Uppsala universitet, Vårdvetenskap.
    Tyden, Tanja
    Uppsala universitet, Vårdvetenskap.
    Gottvall, Maria
    Uppsala universitet, Vårdvetenskap.
    Westerling, Ragnar
    Uppsala universitet, Socialmedicin.
    Oscarsson, Marie
    Uppsala universitet, Vårdvetenskap / School of Health and Caring, Linnaeus University,.
    Immigrant women’s experiences and views on the prevention of cervical cancer: a qualitative study2015In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 18, no 3, p. 344-354Article in journal (Refereed)
    Abstract [en]

    Background

    Many Western countries have cervical cancer screening programmes and have implemented nation-wide human papillomavirus (HPV) vaccination programmes for preventing cervical cancer.

    Objective

    To explore immigrant women's experiences and views on the prevention of cervical cancer, screening, HPV vaccination and condom use.

    Design

    An exploratory qualitative study. The Health Belief Model (HBM) was used as a theoretical framework.

    Setting and participants

    Eight focus group interviews, 5–8 women in each group (average number 6,5), were conducted with 50 women aged 18–54, who studied Swedish for immigrants. Data were analysed by latent content analysis.

    Results

    Four themes emerged: (i) deprioritization of women's health in home countries, (ii) positive attitude towards the availability of women's health care in Sweden, (iii) positive and negative attitudes towards HPV vaccination, and (iv) communication barriers limit health care access. Even though the women were positive to the prevention of cervical cancer, several barriers were identified: difficulties in contacting health care due to language problems, limited knowledge regarding the relation between sexual transmission of HPV and cervical cancer, culturally determined gender roles and the fact that many of the women were not used to regular health check-ups.

    Conclusion

    The women wanted to participate in cervical cancer prevention programmes and would accept HPV vaccination for their daughters, but expressed difficulties in understanding information from health-care providers. Therefore, information needs to be in different languages and provided through different sources. Health-care professionals should also consider immigrant women's difficulties concerning cultural norms and pay attention to their experiences.

1 - 4 of 4
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