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  • 1.
    Audulv, Åsa
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Ghahari, Setareh
    Queen’s University.
    Kephart, George
    Dalhousie University.
    Warner, Grace
    Dalhousie University.
    Packer, Tanya
    Dalhousie University; Radboud University Medical Center, Nijmegen, The Netherlands.
    The Taxonomy of Everyday Self-management Strategies (TEDSS): A framework derived from the literature and refined using empirical data2019In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 102, no 2, p. 367-375Article in journal (Refereed)
    Abstract [en]

    Objective: To extend our understanding of self-management by using original data and a recent concept analysis to propose a unifying framework for self-management strategies.

    Methods: Longitudinal interview data with 117 people with neurological conditions were used to test a preliminary framework derived from the literature. Statements from the interviews were sorted according to the predefined categories of the preliminary framework to investigate the fit between the framework and the qualitative data. Data on frequencies of strategies complemented the qualitative analysis.

    Results: The Taxonomy of Every Day Self-management Strategies (TEDSS) Framework includes five Goal-oriented Domains (Internal, Social Interaction, Activities, Health Behaviour and Disease Controlling), and two additional Support-oriented Domains (Process and Resource). The Support-oriented Domain strategies (such as information seeking and health navigation) are not, in and of themselves, goal focused. Instead, they underlie and support the Goal-oriented Domain strategies. Together, the seven domains create a comprehensive and unified framework for understanding how people with neurological conditions self-manage all aspects of everyday life.

    Conclusions: The resulting TEDSS Framework provides a taxonomy that has potential to resolve conceptual confusion within the field of self-management science.

    Practice Implications: The TEDSS Framework may help to guide health service delivery and research.

  • 2.
    Hansson, Jennifer
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Häggblad, Marie-Louise
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Sjuksköterskans upplevelse av att vara ny- de tre första åren inom professionen2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 3.
    Hansson, Jennifer
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Häggblad, Marie-Louise
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Sjuksköterskans upplevelse av att vara ny- de tre första åren inom professionen2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 4.
    Hildingsson, Ingegerd
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Uppsala universitet.
    Karlström, Annika
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Rubertsson, Christine
    Uppsala universitet; Lund universitet.
    Haines, Helen
    Uppsala universitet; University of Melbourne, Wangaratta, Victoria, Australia.
    Women with fear of childbirth might benefit from having a known midwife during labour2019In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 32, no 1, p. 58-63Article in journal (Refereed)
    Abstract [en]

    Aim: Having a known midwife at birth is valued by women across the world, however it is unusual for women with fear of childbirth to have access to this model of care. The aim of this study was to describe the prevalence and factors related to having access to a known midwife for women referred to counseling due to childbirth fear. We also wanted to explore if women's levels of childbirth fear changed over time. Methods: A pilot study of 70 women referred to counseling due to fear of birth in 3 Swedish hospitals, and where the counseling midwife, when possible, also assisted during labour and birth. Results: 34% of the women actually had a known midwife during labour and birth. Women who had a known midwife had significantly more counseling visits, they viewed the continuity of care as more important, were more satisfied with the counseling and 29% reported that their fear disappeared. Fear of birth decreased significantly over time for all women irrespective of whether they were cared for in labour by a known midwife or not. Conclusions: Although the women in the present study had limited access to a known midwife, the results indicate that having a known midwife whom the women met on several occasions made them more satisfied with the counseling and had a positive effect on their fear. Building a trustful midwife–woman relationship rather than counseling per se could be the key issue when it comes to fear of birth. 

  • 5.
    Jong, Miek C.
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Louis Bolk Institute, Bunnik, The Netherlands.
    Boers, I.
    Louis Bolk Institute, Bunnik, The Netherlands.
    van Wietmarschen, H. A.
    Louis Bolk Institute, Bunnik, The Netherlands.
    Tromp, E.
    St. Antonius Ziekenhuis, Nieuwegein, The Netherlands.
    Busari, J. O.
    Zuyderland Medisch Centrum, Heerlen, the Netherlands.
    Wennekes, R.
    Zuyderland Medisch Centrum, Heerlen, the Netherlands.
    Snoeck, I.
    Isala, Zwolle, The Netherlands.
    Bekhof, J.
    Isala, Zwolle, The Netherlands.
    Vlieger, A. M.
    St. Antonius Ziekenhuis, Nieuwegein, The Netherlands.
    Hypnotherapy or transcendental meditation versus progressive muscle relaxation exercises in the treatment of children with primary headaches: a multi-centre, pragmatic, randomised clinical study2019In: European Journal of Pediatrics, ISSN 0340-6199, E-ISSN 1432-1076, Vol. 178, no 2, p. 147-154Article in journal (Refereed)
    Abstract [en]

    Many children suffer from headaches. Since stress may trigger headaches, effective techniques to cope with stress are needed. We investigated the effectiveness of two mind-body techniques, transcendental meditation (TM) or hypnotherapy (HT), and compared them with progressive muscle relaxation (PMR) exercises (active control group). Children (9–18 years) suffering from primary headaches more than two times per month received either TM (N = 42), HT (N = 45) or PMR (N = 44) for 3 months. Primary outcomes were frequency of headaches and ≥ 50% reduction in headaches at 3 and 9 months. Secondary outcomes were adequate relief, pain coping, anxiety and depressive symptoms, somatisation and safety of treatment. Groups were comparable at baseline. Headache frequency was significantly reduced in all groups from 18.9 days per month to 12.5 and 10.5 at respectively 3 and 9 months (p < 0.001), with no significant differences between the groups. Clinically relevant headache reduction (≥ 50%) was observed in 41% and 47% of children at 3 and 9 months respectively, with no significant differences between the groups. No differences were observed in secondary outcome measures between the intervention groups. No adverse events were reported. Conclusion: All three techniques reduced primary headache in children and appeared to be safe. Trial registration: NTR 2955, 28 June 2011 (www.trialregister.nl)

    What is Known:

    • Stress may be an important trigger for both tension type headache and migraine in children.

    • Good data are lacking on the effect of transcendental meditation, hypnotherapy or progressive muscle relaxation as possible stress-reducing therapies in children with primary headaches.

    What is New:

    • Three non-pharmacological techniques, i.e., transcendental meditation, hypnotherapy and progressive muscle relaxation exercises, all result in a clinically significant reduction of headaches and use of pain medication.

    • No large differences between the three techniques were found, suggesting that children can choose either one of the three techniques based on personal preferences. 

  • 6.
    Kephart, George
    et al.
    Dalhousie University, Halifax, Canada.
    Packer, Tanya
    Dalhousie University, Halifax, Canada.
    Audulv, Åsa
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Warner, Grace
    Dalhousie University, Halifax, Canada.
    The structural and convergent validity of three commonly used measures of self-management in persons with neurological conditions2019In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 28, no 2, p. 545-556Article in journal (Refereed)
    Abstract [en]

    Purpose

    Self-management ability is commonly assessed in chronic disease research and clinical practice. The purpose of this study was to assess the structural and convergent validity of three commonly used self-management outcome measures in a sample of persons with neurological conditions.

    Methods

    We used data from a Canadian survey of persons with neurological conditions, which included three commonly used self-management measures: the Partners in Health Scale (PIH), the Patient Activation Measure (PAM), and the Self-Efficacy for Managing a Chronic Disease Scale (SEMCD). Confirmatory factor analysis was used to assess the structural and convergent validity of the three measures.

    Results

    When treated as single-factor constructs, none of the measurement models provided a good fit to the data. A four-domain version of the PIH was the best fitting model. Confirmatory factor analysis suggests that the three tools measure different, but correlated constructs.

    Conclusions

    While the PAM, PIH and SEMCD scales are all used as measures of patient self-management, our study indicates that they measure different, but correlated latent variables. None, when treated as single, uni-dimensional construct, provides an acceptable fit to our data. This is probably because self-management is multi-dimensional, as is consistently shown by qualitative evidence. While these measures may provide reliable summative measures, multi-dimensional scales are needed for clinical use and more detailed research on self-management.

  • 7.
    Larsson, Birgitta
    et al.
    Uppsala University; Sundsvall Hospital.
    Hildingsson, Ingegerd
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Uppsala University.
    Ternström, Elin
    Uppsala University.
    Rubertsson, Christine
    Uppsala University; Lund University.
    Karlström, Annika
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Women's experience of midwife-led counselling and its influence on childbirth fear: A qualitative study2019In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 32, no 1, p. e88-e94Article in journal (Refereed)
    Abstract [en]

    Background: Women with childbirth fear have been offered counseling by experienced midwives in Sweden for decades without evidence for its effectiveness, in terms of decrease in childbirth fear. Women are usually satisfied with the counselling. However, there is a lack of qualitative data regarding women's views about counselling for childbirth fear. Aim: To explore women's experiences of midwife-led counselling for childbirth fear. Method: A qualitative interview study using thematic analysis. Twenty-seven women assessed for childbirth fear who had received counselling during pregnancy at three different hospitals in Sweden were interviewed by telephone one to two years after birth. Findings: The overarching theme ‘Midwife-led counselling brought positive feelings and improved confidence in birth’ was identified. This consisted of four themes describing ‘the importance of the midwife’ and ‘a mutual and strengthening dialogue’ during pregnancy. ‘Coping strategies and support enabled a positive birth’ represent women's experiences during birth and ‘being prepared for a future birth’ were the women's thoughts of a future birth. Conclusions: In this qualitative study, women reported that midwife-led counselling improved their confidence for birth through information and knowledge. The women experienced a greater sense of calm and preparedness, which increased the tolerance for the uncertainty related to the birthing process. This, in turn, positively affected the birth experience. Combined with a feeling of safety, which was linked to the professional support during birth, the women felt empowered. The positive birth experience strengthened the self-confidence for a future birth and the childbirth fear was described as reduced or manageable. 

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