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  • 1.
    Gerhardsson, Emma
    et al.
    Pediatric Specialist Outpatient Department, University Hospital, Uppsala.
    Hedberg Nyqvist, Kerstin
    Department of Women's and Children's Health, Uppsala University, Uppsala.
    Mattsson, Elisbeth
    Department of Women's and Children's Health, Uppsala University, Uppsala.
    Volgsten, Helena
    Department of Women's and Children's Health, Uppsala University, Uppsala.
    Hildingsson, Ingegerd
    Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden..
    Funkquist, Eva-Lotta
    Department of Women's and Children's Health, Uppsala University, Uppsala.
    The Swedish Version of the Breastfeeding Self-Efficacy Scale-Short Form: Reliability and Validity Assessment2014In: Journal of Human Lactation, ISSN 0890-3344, E-ISSN 1552-5732, Vol. 30, no 3, p. 340-345Article in journal (Refereed)
  • 2.
    Kaplan-Sturk, Rebecka
    et al.
    Department of Clinical Science and Education, Section of Obstetrics and Gynecology, Karolinska Institute, Soder Hospital, Stockholm, Sweden.
    Åkerud, Helena
    Uppsala universitet, Obstetrik & gynekologi.
    Volgsten, Helena
    Uppsala universitet, Obstetrik & gynekologi.
    Hellström-Westas, Lena
    Uppsala universitet, Pediatrik.
    Wiberg-Itzel, Eva
    Department of Clinical Science and Education, Section of Obstetrics and Gynecology, Karolinska Institute, Soder Hospital, Stockholm, Sweden.
    Outcome of deliveries in healthy but obese women: obesity and delivery outcome2013In: BMC Research Notes, ISSN 1756-0500, E-ISSN 1756-0500, Vol. 6, no 50Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Obesity among fertile women is a global problem. 25% of pregnant Swedish women are overweight at admission to the antenatal clinic and 12% of them are considered as obese. Previous studies have shown an increased risk of delivery complications with an elevated maternal BMI. The aim of this study was to evaluate delivery outcomes in relation to maternal BMI on admission to the antenatal clinic.

    A healthy group of 787 women with full-term pregnancies and spontaneous onset of labor were included in the study. Delivery outcome was assessed in relation to maternal BMI when attending the antenatal clinic.

    RESULTS:

    The results indicated that in deliveries where the maternal BMI was >30 a high frequency of abnormal CTG trace during the last 30 minutes of labor was shown. A blood sample for evaluation of risk of fetal hypoxia was performed in only eight percent of these deliveries. A spontaneous vaginal delivery without intervention was noted in 85.7%, and 12% of neonates were delivered with an adverse fetal outcome compared to 2.8% in the group with a maternal BMI<30 (p<0.001).

    CONCLUSION:

    These results indicate an increased risk at delivery for healthy, but obese women in labor. Furthermore, the delivery management may not always be optimal in these deliveries.

  • 3.
    Mattsson, Elisabet
    et al.
    Department of Public Health and Caring Sciences, Uppsala University.
    Funkquist, Eva-Lotta
    Department of Women׳s and Children׳s Health, Uppsala University.
    Wickström, Maria
    Children׳s Hospital, Uppsala University Hospital.
    Nyqvist, Kerstin H
    Department of Women׳s and Children׳s Health, Uppsala University.
    Volgsten, Helena
    Department of Women׳s and Children׳s Health, Uppsala University.
    Healthy late preterm infants and supplementary artificial milk feeds: Effects on breast feeding and associated clinical parameters.2015In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 31, no 4, p. 426-431Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: to compare the influence of supplementary artificial milk feeds on breast feeding and certain clinical parameters among healthy late preterm infants given regular supplementary artificial milk feeds versus being exclusively breast fed from birth.

    DESIGN: a comparative study using quantitative methods. Data were collected via a parental diary and medical records.

    METHODS: parents of 77 late preterm infants (34 5/7-36 6/7 weeks), whose mothers intended to breast feed, completed a diary during the infants׳ hospital stay.

    FINDINGS: infants who received regular supplementary artificial milk feeds experienced a longer delay before initiation of breast feeding, were breast fed less frequently and had longer hospital stays than infants exclusively breast fed from birth. Exclusively breast-fed infants had a greater weight loss than infants with regular artificial milk supplementation. A majority of the mothers (65%) with an infant prescribed artificial milk never expressed their milk and among the mothers who used a breast-pump, milk expression commenced late (10-84 hours after birth). At discharge, all infants were breast fed to some extent, 43% were exclusively breast fed.

    KEY CONCLUSIONS: clinical practice and routines influence the initiation of breast feeding among late preterm infants and may act as barriers to the mothers׳ establishment of exclusive breast feeding.

  • 4.
    Volgsten, Helena
    The Swedish Red Cross University College, Department of Public Health and Medicine.
    Barnmorskeutbildning på masternivå i Tanzania2015In: Jordemodern, ISSN 0021-7468, no 4, p. 26-29Article in journal (Other academic)
  • 5.
    Volgsten, Helena
    Uppsala universitet, Institutionen för kvinnors och barns hälsa.
    Mood Disorders, Personality and Grief in Women and Men undergoing in vitro Fertilization Treatment2009Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Psychological problems are common in infertile women undergoing in vitro fertilization (IVF) treatment.  The aim of this thesis was to determine the prevalence of psychiatric disorders, such as mood and anxiety disorders, and related risk factors and personality traits in women and men undergoing IVF.

    Participants were 1090 consecutive women and men, 545 couples, attending a fertility clinic in Sweden during a two-year period. The Primary Care Evaluation of Mental Disorders (PRIME-MD), based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), was used for evaluating mood and anxiety disorders. The participation rate was 862 (79 %) subjects.

    Any psychiatric disorder was present in 31 % of females and in 10 % of males. Major depression was prevalent in 11 % of females and 5 % of males. Only 21 % of the subjects with a psychiatric disorder had some form of treatment. A negative pregnancy test and obesity (BMI ≥ 30) were risk factors for mood disorders in women and the only risk factor for depression in men was unexplained infertility. Anxiety disorders were less common than in the general population and no IVF-related risk factors were identified. The Swedish universities Scales of Personality (SSP), a self-rating questionnaire, was used for evaluation of personality traits. High scores of personality traits related to neuroticism were associated with mood and/or anxiety disorders among both women and men.

    Another objective was to explore the experience of childlessness three years after unsuccessful IVF by a qualitative-approach, assessing data by interviews. Failure after IVF was experienced by women in terms of grief, whereas men took upon themselves a supportive role not expressing grief. A need for professional support and counselling in how to handle grief was described. An unstructured end after IVF treatment left unanswered questions. Three years after the end of treatment, men and women were still processing and had not adapted to childlessness, indicating the grieving process was unresolved.

  • 6.
    Volgsten, Helena
    et al.
    Uppsala universitet, Institutionen för kvinnors och barns hälsa.
    Ekselius, Lisa
    Uppsala universitet, Psykiatri, Akademiska sjukhuset.
    Sundström Poromaa, Inger
    Uppsala universitet, Institutionen för kvinnors och barns hälsa.
    Skoog Svanberg, Agneta
    Uppsala universitet, Institutionen för kvinnors och barns hälsa.
    Personality traits associated with depressive and anxiety disorders in infertile women and men undergoing in vitro fertilization treatment2010In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 89, no 1, p. 27-34Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To assess which personality traits are associated with depressive and/or anxiety disorders in infertile women and men undergoing in vitro fertilization (IVF). DESIGN: Prospective study. SETTING: A university hospital in Sweden. POPULATION: A total of 856 eligible women and men, 428 couples, were approached to participate. Overall 643 (75.1%) subjects filled out the Swedish Universities Scales of Personality (SSP) questionnaire. The response rates were 323 women (75.5%) and 320 men (74.8%). METHODS: The SSP, a self-rating personality trait questionnaire, was used for evaluation. Main outcome measures. Personality traits associated with depression and/or anxiety disorders. RESULTS: Higher mean scores on all neuroticism-related personality traits were found in women and men with depressive and/or anxiety disorders compared to women and men with no diagnosis. High scores of neuroticism and a negative pregnancy test after IVF were associated with depressive and/or anxiety disorders among women. Among men, high scores of neuroticism and unexplained or male infertility factor were associated with depressive and/or anxiety disorders. High neuroticism scores were negatively associated with live birth (p < 0.05). CONCLUSION: High scores on neuroticism-related personality traits were associated with depressive and/or anxiety disorders in women and men undergoing IVF.

  • 7.
    Volgsten, Helena
    et al.
    Uppsala universitet, Institutionen för kvinnors och barns hälsa.
    Skoog Svanberg, Agneta
    Uppsala universitet, Institutionen för kvinnors och barns hälsa.
    Ekselius, Lisa
    Uppsala universitet, Institutionen för neurovetenskap.
    Lundkvist, Örjan
    Uppsala universitet, Institutionen för kvinnors och barns hälsa.
    Sundström Poromaa, Inger
    Uppsala universitet, Institutionen för kvinnors och barns hälsa.
    Prevalence of psychiatric disorders in infertile women and men undergoing in vitro fertilization treatment2008In: Human Reproduction, ISSN 0268-1161, E-ISSN 1460-2350, Vol. 23, no 9, p. 2056-2063Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: This study was undertaken to determine the prevalence of psychiatric disorders in infertile women and men undergoing in vitro fertilization (IVF) treatment. METHODS: Participants were 1090 consecutive women and men, 545 couples, attending a fertility clinic in Sweden during a two-year period. The Primary Care Evaluation of Mental Disorders (PRIME-MD), based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV), was used as the diagnostic tool for evaluating mood and anxiety disorders. RESULTS: Overall, 862 (79.1%) subjects filled in the PRIME-MD patient questionnaire. Any psychiatric diagnosis was present in 30.8% of females and in 10.2% of males in the study sample. Any mood disorder was present in 26.2% of females and 9.2% of males. Major depression was the most common mood disorder, prevalent in 10.9% of females and 5.1% of males. Any anxiety disorder was encountered in 14.8% of females and 4.9% males. Only 21% of the subjects with a psychiatric disorder according to DSM-IV received some form of treatment. CONCLUSIONS: Mood disorders are common in both women and men undergoing IVF treatment. The majority of subjects with a psychiatric disorder were undiagnosed and untreated.

  • 8.
    Volgsten, Helena
    et al.
    Uppsala universitet, Institutionen för kvinnors och barns hälsa.
    Skoog Svanberg, Agneta
    Uppsala universitet, Institutionen för kvinnors och barns hälsa.
    Ekselius, Lisa
    Uppsala universitet, Psykiatri, Akademiska sjukhuset.
    Lundkvist, Örjan
    Uppsala universitet, Institutionen för kvinnors och barns hälsa.
    Sundström Poromaa, Inger
    Uppsala universitet, Institutionen för kvinnors och barns hälsa.
    Risk factors for psychiatric disorders in infertile women and men undergoing in vitro fertilization treatment2010In: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 93, no 4, p. 1088-1096Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To identify risk factors associated with depression and anxiety in infertile women and men undergoing in vitro fertilization (IVF). DESIGN: Prospective study. SETTING: A university hospital in Sweden during a 2-year period. PATIENT(S): 825 participants (413 women and 412 men). INTERVENTION(S): Primary Care Evaluation of Mental Disorders (PRIME-MD), based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), as the diagnostic tool for evaluating mood and anxiety disorders, and fertility history and outcome of IVF treatment collected from the patients' medical records. MAIN OUTCOME MEASURE(S): Risk factors associated with depression and anxiety disorders. RESULT(S): A negative pregnancy test and obesity were the independent risk factors for any mood disorders in women. Among men, the only independent risk factor for depression was unexplained infertility. No IVF-related risk factors could be identified for any anxiety disorder. CONCLUSION(S): A negative pregnancy test is associated with an increased risk for depression in women undergoing IVF, but no risk of developing anxiety disorders is associated with the pregnancy test result after IVF. Pregnancy test results were not a risk factor for depression or anxiety among men.

  • 9.
    Volgsten, Helena
    et al.
    Uppsala universitet, Institutionen för kvinnors och barns hälsa.
    Skoog Svanberg, Agneta
    Uppsala universitet, Institutionen för kvinnors och barns hälsa.
    Olsson, Pia
    Uppsala universitet, Institutionen för kvinnors och barns hälsa.
    Unresolved grief in women and men in Sweden three years after undergoing unsuccessful in vitro fertilization treatment2010In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 89, no 10, p. 1290-1297Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Grief is a common reaction in women after a diagnosis of infertility. The study explored the experience of childlessness in both women and men three years after undergoing unsuccessful in vitro fertilization (IVF).

    METHODS: Participants (10 women and 9 men) who had attended a fertility clinic in Sweden were interviewed individually. The methodological approach was qualitative with semi-structured interviews and qualitative content analysis.

    RESULTS: Unsuccessful IVF was experienced by women in terms of grief, whereas men took upon themselves a supportive role and did not express grief. A need for professional support and counselling in how to handle grief was described. An unstructured end after IVF treatment left unanswered questions. Partner relations were affected in both positive and negative ways and an experience of being excluded with no understanding and lack of support from their social network was revealed. Three years after the end of IVF treatment, both men and women were still processing childlessness and had not adapted to being childless, indicating the grieving process was unresolved.

    CONCLUSIONS: The grieving process after unsuccessful IVF treatment was hampered among both men and women. The provision of additional individual support during IVF is recommended as men and women in this study experienced childlessness differently. Support and counselling concerning grief reactions following IVF failure, and a structured end after IVF may facilitate the grieving process after unsuccessful IVF treatment.

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