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  • 1.
    Bjelke, Maria
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Department of Research and Development, Region Kronoberg.
    Martinsson, Anna-Karin
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Department of Research and Development, Region Kronoberg.
    Lendahls, Lena
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Department of Research and Development, Region Kronoberg.
    Oscarsson, Marie
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Using the internet as a source of information during pregnancy: a descriptive cross-sectional study in Sweden2016In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 40, p. 187-191Article in journal (Refereed)
    Abstract [en]

    Objective

    The Internet plays a major role for pregnant women in seeking knowledge and for getting in touch with like-minded women. The information is available at all hours and can be accessed anywhere. The information provides the women with a sense of control and confidence but the large amount of information available can also be overwhelming. The aim of this study was to identify how women use the Internet as a source of information during their pregnancy and how it affects them.

    Design and setting

    A descriptive cross-sectional study was conducted.Data were collected through a questionnaire at antenatal clinics in the southern Sweden. The data were analyzed descriptively

    Participants

    A total of 193 Swedish women, pregnant at least 34 weeks, participated in the study. The response rate was 94%.

    Findings

    Almost all (95%) of the women in the study used the Internet as a source of information. The main reason was to find information and read about people in the same situation. Reading pregnancy-related information on the Internet was seen as positive. However, a majority of the woman experienced feelings of worry due to something they read online. These feelings were most commonly coped with by talking to a partner, relatives, and friends or by asking the midwife at their next appointment. Eleven per cent of the women contacted the general healthcare services because of their feelings of worry.

    Conclusion

    Almost all women in this study searched the Internet to find pregnancy-related information, despite being satisfied with the information they received from the ANC. Using the Internet was seen as complementary to the information from professionals. It also caused feelings of worry, which could lead to the woman contacting healthcare services for support. ANC could help to reduce these feelings for some women by informing about the advantages and disadvantages with online information and recommending suitable web pages.

  • 2.
    Higginbottom, Gina M. A.
    et al.
    University of Alberta, Canada.
    Safipour, Jalal
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. University of Alberta, Canada.
    Yohani, Sophie
    University of Alberta, Canada.
    O’Brien, Beverley
    University of Alberta, Canada.
    Mumtaz, Zubia
    University of Alberta, Canada.
    Paton, Patricia
    Alberta Health Services, Canada.
    An ethnographic study of communication challenges in maternity care for immigrant women in rural Alberta2015In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 31, no 2, p. 297-304Article in journal (Refereed)
    Abstract [en]

    Background

    many immigrant and ethno-cultural groups in Canada face substantial barriers to accessing health care including language barriers. The negative consequences of miscommunication in health care settings are well documented although there has been little research on communication barriers facing immigrant women seeking maternity care in Canada. This study identified the nature of communication difficulties in maternity services from the perspectives of immigrant women, health care providers and social service providers in a small city in southern Alberta, Canada.

    Methods

    a focused ethnography was undertaken incorporating interviews with 31 participants recruited using purposive and snowball sampling. A community liaison and several gatekeepers within the community assisted with recruitment and interpretation where needed (n=1). All interviews were recorded and audio files were transcribed verbatim by a professional transcriptionist. The data was analysed drawing upon principles expounded by Roper and Shapira (2000) for the analysis of ethnographic data, because of (1) the relevance to ethnographic data, (2) the clarity and transparency of the approach, (3) the systematic approach to analysis, and (4) the compatibility of the approach with computer-assisted qualitative analysis software programs such as Atlas.ti (ATLAS.ti Scientific Software Development GmbH, Germany). This process included (1) coding for descriptive labels, (2) sorting for patterns, (3) identification of outliers, (4) generation of themes, (5) generalising to generate constructs and theories, and (6) memoing including researcher reflections.

    Findings

    four main themes were identified including verbal communication, unshared meaning, non-verbal communication to build relationships, and trauma, culture and open communication. Communication difficulties extended beyond matters of language competency to those encompassing non-verbal communication and its relation to shared meaning as well as the interplay of underlying pre-migration history and cultural factors which affect open communication, accessible health care and perhaps also maternal outcomes.

    Conclusion

    this study provided insights regarding maternity health care communication. Communication challenges may be experienced by all parties, yet the onus remains for health care providers and for those within health care management and professional bodies to ensure that providers are equipped with the skills necessary to facilitate culturally appropriate care.

  • 3.
    Higginbottom, Gina M.A
    et al.
    Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
    Hadziabdic, Emina
    Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
    Yohani, Sophie
    Paton, Patricia
    Immigrant women's experience of maternity services in Canada: A meta-ethnography2014In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 30, no 5, p. 544-559Article in journal (Refereed)
    Abstract [en]

    Objective

    to synthesise data on immigrant women's experiences of maternity services in Canada.

    Design

    a qualitative systematic literature review using a meta-ethnographic approach

    Methods

    a comprehensive search strategy of multiple databases was employed in consultation with an information librarian, to identify qualitative research studies published in English or French between 1990 and December 2011 on maternity care experiences of immigrant women in Canada. A modified version of Noblit and Hare's meta-ethnographic theoretical approach was undertaken to develop an inductive and interpretive form of knowledge synthesis. The seven-phase process involved comparative textual analysis of published qualitative studies, including the translation of key concepts and meanings from one study to another to derive second and third-order concepts encompassing more than that offered by any individual study. ATLAS.ti qualitative data analysis software was used to store and manage the studies and synthesise their findings.

    Findings

    the literature search identified 393 papers, of which 22 met the inclusion criteria and were synthesised. The literature contained seven key concepts related to maternity service experiences including social (professional and informal) support, communication, socio-economic barriers, organisational environment, knowledge about maternity services and health care, cultural beliefs and practices, and different expectations between health care staff and immigrant women. Three second-order interpretations served as the foundation for two third-order interpretations. Societal positioning of immigrant women resulted in difficulties receiving high quality maternity health care. Maternity services were an experience in which cultural knowledge and beliefs, and religious and traditional preferences were highly relevant as well but often overlooked in Canadian maternity settings.

    Key conclusions and implications for practice

    in order to implement woman-centered care, to enhance access to maternity services, and to promote immigrant women's health, it is important to consider these women's social position, cultural knowledge and beliefs, and traditional customs in the health care.

  • 4.
    Hjelm, Katarina
    et al.
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Bard, Karin
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Berntorp, Kerstin
    Apelqvist, Jan
    Beliefs about health and illness postpartum in women born in Sweden and the Middle East.2009In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 25, no 5, p. 564-575Article in journal (Refereed)
    Abstract [en]

    The aim was to explore beliefs about health and illness three months postpartum in women born in Sweden and the Middle East, and to study whether they perceive gestational diabetes mellitus (GDM) as a prediabetic condition. Methods: an explorative study using semi-structured interviews 3 months postpartum. Interviews were held three months after birth. Consecutive sample of women with GDM; 13 born in Sweden and 14 born in the Middle East. The results showed that irrespective of origin, health was focused on well-being and being able to care for the baby. Many Middle Eastern women did not know how long GDM would last or said that they had been informed by staff about its transience. They worried about still having diabetes mellitus, and the disease directed them to self-monitoring of blood glucose and the desire for health-care staff to verify the disease. They showed tendencies to dietary changes. Swedish-born women feared development of type 2 DM and had undertaken active health-related behaviour. In conlusion, beliefs about health and illness differ, change and affect awareness of risk and self-care practice postpartum. Swedish women showed high risk awareness with changes in life style and the desire for more information to avoid developing DM. Middle Eastern women showed increased risk awareness and sought help from staff in checking whether GDM was present in the postpartum period. For clinical practice it is important to recognise that Middle Eastern women, in contrast to Swedish-born women, have not incorporated the message that GDM is a risk marker for future development of DM. Health professionals have a significant role in supporting women and their families undergoing the transition to motherhood, particularly migrants in a new country. Identifying individual beliefs is of utmost importance. Pre-existing baby health clinics can be developed to address mothers' needs as well as the health of the baby.

  • 5.
    Hjelm, Katarina
    et al.
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Berntorp, Kerstin
    Frid, Anders
    Åberg, Anders
    Lunds universitet.
    Apelqvist, Jan
    Beliefs about health and illness in women managed for gestational diabetes in two organisations.2008In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 24, no 2, p. 168-192Article in journal (Refereed)
    Abstract [en]

    The aim was to explore beliefs about health, illness and health care in women with gestational diabetes mellitus (GDM) managed in two different organisations based on diabetology or obstetrics.

    Semi-structured interviews were made in two different clinics. clinic A: a specialist diabetes clinic with regular contact with a diabetologist and antenatal care provided by a midwife

    clinic B: a specialist maternity clinic providing regular contact with a midwife, a structured programme for self-monitoring of blood glucose and insulin treatment, and a 1-day diabetes class by an obstetrician, a diabetologist, a midwife and a dietician. The clinics were located at two different university hospitals in Sweden.

    Participants were a consecutive sample of Swedish women diagnosed with GDM; 13 managed in clinic A and 10 managed in clinic B.

    The findings showed that women described their perceptions of as well-being, being healthy and freedom from disease. All respondents reported a delay in the provision of information about GMD and an information gap about GDM and the management of the condition, from diagnosis until the start of treatment at the specialist clinic. Respondents from clinic A expressed fear about future development of type 2 diabetes. Women from clinic B discussed different causes of GDM, and many claimed that health-care staff informed them that GDM was a transient condition during pregnancy. Respondents from clinic A reported a conflict in their treatment of pregnancy and GDM as two different conditions.

    Beliefs differed and were related to the health-care model chosen.

  • 6.
    Nilsson, Christina
    et al.
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Lundgren, Ingela
    University College of Borås.
    Women's lived experience of fear of childbirth2009In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 25, no 2, p. e1-e9Article in journal (Refereed)
    Abstract [en]

    Objective: to describe women’s lived experience of fear of childbirth.

    Design: a qualitative study using a phenomenological approach and a lifeworld perspective. Data were collected via tape-recorded interviews.

    Setting: Sahlgrenska University Hospital, Go¨teborg, Sweden in 2003.

    Participants: eight pregnant women (24–37 gestational weeks) seeking help within an outpatient clinic for women with severe fear of childbirth. Two of the women were primiparous.

    Findings: four constituents were identified: feeling of danger that threatens and appeals; feeling trapped; feeling like an inferior mother-to-be and on your own. The essential structure was described as ‘to lose oneself as a woman into loneliness’.

    Key conclusions: fear of childbirth affects women in such a way that they start to doubt themselves and feel uncertain of their ability to bear and give birth to a child. Previous birth experience was central to the multiparous women. They described their experiences of suffering in relation to the care they received during childbirth. This mainly concerned pain and negative experiences with staff.

    Implications for practice: pregnant women who fear childbirth are an exposed group in need of much support during pregnancy and childbirth. The encounter between the woman and the midwife can be a way of breaking down the feeling of loneliness and restoring the woman’s trust in herself as a childbearing woman.

  • 7.
    Oscarsson, Marie
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Medin, Erica
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Holmström, Ida
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Lendahls, Lena
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Region Kronoberg.
    Using the Internet as source of information during pregnancy: a descriptive cross-sectional study among fathers-to-be in Sweden2018In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 62, p. 146-150Article in journal (Refereed)
    Abstract [en]

    Objective

    The aim of this study was to identify how fathers-to-be used the Internet as a source of information during their partners' pregnancy and how it affected them.

    Design and setting

    A descriptive cross-sectional study was conducted. Data were collected through a questionnaire and distributed at a maternity clinic in south of Sweden. The data were analysed descriptively.

    Participants

    Ninety-two Swedish fathers participated in the study, and the response rate was 98.9%.

    Findings

    Of all the fathers-to-be, 76% sought pregnancy-related information on the Internet. One sought information on a daily basis, 40.6% every week and 58% every month or more rarely. The fathers-to-be who participated at all/most visits at antenatal care searched for information on the Internet more often than those who only attended few/no visits (p = 0.012). A total of 33.4% of fathers-to-be had been recommended a web page by the midwife at the antenatal care. The main reason for using the Internet was to find information about pregnancy related subjects and read about people in similar situations. More than half of the fathers-to-be (61.8%) had at some point been worried by something they read online. These concerns were commonly addressed by asking the midwife at their next appointment (33.9%). Almost 26% of the fathers-to-be chose not to take any action at all to address their concerns.

    Conclusion

    The majority of all fathers-to-be searched for information on the Internet, and more than half of the fathers were, at some point, worried about the information they read on the Internet. One way to address questions and concerns could be for the fathers-to-be to ask and discuss with the midwives what they read online so that midwives can recommend appropriate and credible websites. To achieve this, there must be opportunities for midwives to gain knowledge on how best to use the Internet as a tool.

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