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  • 1.
    Bergevi, Charlotte
    et al.
    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.
    Crang-Svalenius, Elizabeth
    Lund University.
    Oscarsson, Marie
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    From passive passenger to participating co-pilot - Pregnant women's expectations of being able to access their online journal from antenatal care2018In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 15, p. 35-39Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of the study was to describe pregnant women's expectations of being able to access their electronic health records from antenatal care. Methods: Nine pregnant women passing 25 full gestational weeks were interviewed individually. Collected data were analysed with an inductive approach using content analysis. The study was performed in antenatal care units in southern Sweden. Results: The following five categories emerged from the analysis: Being able to achieve increased participation, being able to have more control, being more knowledgeable about the pregnancy, identification of possible risks, and perceptions of one's own well-being can predict usage. The five categories led to one main category: 'Shift in power from passive passenger to participating co-pilot'. Conclusion: The pregnant women expected that having access to electronic health records would give them more control, make them more knowledgeable and increase their participation. Access to electronic health records may empower pregnant women and contribute to a more person-centred approach. This could provide greater knowledge for the woman and her partner about her health, thus, allowing them to make evidence-based choices in relation to the newborn baby and the woman's health.

  • 2.
    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.

  • 3.
    Grandahl, Maria
    et al.
    Uppsala universitet.
    Oscarsson, Marie
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Uppsala universitet.
    Stenhammar, Christina
    Uppsala universitet.
    Nevéus, Tryggve
    Uppsala universitet.
    Westerling, Ragnar
    Uppsala universitet.
    Tydén, Tanja
    Uppsala universitet.
    Not the right time: Why parents refuse to let their daughters have the human papillomavirus vaccination2014In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, no 4, p. 436-441Article in journal (Refereed)
    Abstract [en]

    Aim: To explore why parents refused to allow their ten to 12-year-old daughters to

    receive the human papillomavirus (HPV) vaccination from the Swedish schoolbased

    vaccination programme.

    Methods: Individual interviews with 25 parents who had been offered, but not

    consented to, their daughters receiving the HPV vaccination.

    Results: Five themes emerged through the interviews: 1) she is just a little girl, 2)

    inadequate information, 3) not compatible with our way of life, 4) scepticism about

    the vaccination and 5) who can you trust? The parents made their decisions with

    their child’s best interests in mind. This was not considered the right time and the

    vaccine was perceived as unnecessary and different from other vaccines. Mistrust in

    Government recommendations and a lack of evidence or information were other

    reasons to decline.

    Conclusion: The decision-making process was complex. These parents preferred

    to wait until their daughter was older and believed the information they received from

    the school health system was insufficient. The results indicate that a more flexible

    HPV vaccination schedule may improve vaccine uptake. This includes more

    transparent information about the virus and the vaccine and information about who

    to contact to get the daughter vaccinated at a later date.

  • 4.
    Grandahl, Maria
    et al.
    Uppsala university.
    Rosenblad, Andreas
    Uppsala University.
    Stenhammar, Christina
    Uppsala university.
    Tydén, Tanja
    Uppsala university.
    Westerling, Ragnar
    Uppsala university.
    Larsson, Margareta
    Uppsala university.
    Oscarsson, Marie
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Uppsala university.
    Andrén, Bengt
    Uppsala University.
    Dalianis, Tina
    Karolinska Institutet.
    Neveus, Tryggve
    Uppsala University.
    School-based intervention for the prevention of HPV among adolescents: a cluster randomised controlled study2016In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, no 1, article id e009875Article in journal (Refereed)
    Abstract [en]

    Objective: To improve primary prevention of human papillomavirus (HPV) infection by promoting vaccination and increased condom use among upper secondary school students. Design: Cluster randomised controlled trial. Setting: 18 upper secondary schools in Sweden. Participants: Schools were first randomised to the intervention or the control group, after which individual classes were randomised so as to be included or not. Of the 832 students aged 16 years invited to participate during the regular individual health interview with the school nurse, 751 (90.2%) agreed to participate and 741 (89.1%) students completed the study. Interventions: The intervention was based on the Health Belief Model (HBM). According to HBM, a person’s health behaviour can be explained by individual beliefs regarding health actions. School nurses delivered 30 min face-to-face structured information about HPV, including cancer risks and HPV prevention, by propagating condom use and HPV vaccination. Students in the intervention and the control groups completed questionnaires at baseline and after 3 months. Main outcome measures: Intention to use condom with a new partner and beliefs about primary prevention of HPV, and also specifically vaccinationstatus and increased condom use. Results: All statistical analyses were performed at the individual level. The intervention had a significant effect on the intention to use condom (p=0.004). There was also a significant effect on HBM total score ( p=0.003), with a 2.559 points higher score for the intervention group compared to the controls. The influence on the HBM parameters susceptibility and severity was also significant (p<0.001 for both variables). The intervention also influenced behaviour: girls in the intervention group chose to have themselves vaccinated to a significantly higher degree than the controls ( p=0.02). No harms were reported. Conclusions: The school-based intervention had favourable effects on the beliefs about primary prevention of HPV, and increased the HPV vaccination rates in a diverse population of adolescents.

  • 5.
    Grandahl, Maria
    et al.
    Uppsala university.
    Rosenblad, Andreas
    Centre for Clinical Research Västerås ; Uppsala university ; Västerås Central Hospital.
    Stenhammar, Christina
    Uppsala university.
    Tydén, Tanja
    Uppsala university.
    Westerling, Ragnar
    Uppsala university.
    Larsson, Margareta
    Uppsala university.
    Oscarsson, Marie
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Dalianis, Tina
    Karolinska University Hospital.
    Nevéus, Tryggve
    Uppsala university.
    School-based intervention for the prevention of HPV among adolescents: a randomised controlled study2016Conference paper (Refereed)
    Abstract [en]

    Background: Vaccination against human papillomavirus (HPV) is one important factor for preconception health and care. In Sweden a national vaccination programme for girls was implemented in 2012.

    Aim: To improve primary prevention of HPV infection by promoting vaccination and increased condom use among upper secondary school students at time for the general health interview with the school nurse.

    Methods: Randomised controlled trial among upper secondary schools (n=18). Participant schools were first randomised to the intervention or the control group, after which individual classes were randomised to be included or not. 832 students, both boys and girls aged 16 were invited to participate and in the end, 741 (89.1%) students completed the study. The intervention was based on the Health Belief Model (HBM). According to HBM a person’s health behaviour can be explained by individual beliefs regarding health actions. School nurses delivered 30 minute face-to-face structured information about HPV, including cancer risks and HPV prevention, i.e. condom use and HPV vaccination. Students in both groups completed questionnaires at baseline and after three months.

    Results: The intervention had positive effect on behaviour: girls in the intervention group chose to have themselves vaccinated to a significantly higher degree than the controls (p=0.02). There was also a significant effect on HBM total score (p=0.003), students in the intervention group had more favourable beliefs compared to the controls. The influence on the HBM parameters susceptibility and severity were also significant (p<0.001 for both variables). In addition, the intervention had significant effect on the intention to use condom (p=0.004).

    Conclusion: The school-based intervention increased HPV vaccination rates and had favourable effects on beliefs towards primary prevention of HPV in a diverse population of adolescents. These resultss provide the scientific support for the implication of nation-wide educational interventions with the potential to improve preconception health.

  • 6.
    Grandahl, Maria
    et al.
    Uppsala university.
    Rosenblad, Andreas
    Centre for Clinical Research Västerås ; Uppsala university ; Västerås Central Hospital.
    Stenhammar, Christina
    Uppsala university.
    Westerling, Ragnar
    Uppsala university.
    Larsson, Margareta
    Uppsala university.
    Oscarsson, Marie
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Andrae, Bengt
    Uppsala University ; Region of Gävleborg.
    Dalianis, Tina
    Karolinska University Hospital.
    Nevéus, Tryggve
    Uppsala university.
    A school-based educational intervention can increase adolescents’ knowledge and awareness about HPV2016Conference paper (Refereed)
    Abstract [en]

    Background / Objectives

    Background: In Sweden HPV vaccination is offered to girls aged 10-12 years within the school-based vaccination program, while older girls (13-26 years) are offered the vaccine through the primary care. The vaccination rates are substantially lower (59%) among the catch-up group compared to the younger age group (82%). Adolescents have low awareness and knowledge about HPV, especially regarding cancer risks. The providers - school nurses - play a key role in providing such information. Upper secondary school students, aged 16 years, are by the school nurse offered a health interview, which includes a dialogue regarding their health, including sexual health. The health interview does however not include systematic information about HPV.

    Objectives: To improve adolescents’ knowledge and awareness about primary prevention of high risk HPV infection.

    Methods

    Methods: A cluster-randomised controlled trial among upper secondary schools (n=18) was performed. Schools were first randomised to an intervention or control group, after which individual classes were randomised. In total, 832 students, boys and girls aged 16 years attending theoretical or vocational programs were invited to participate. In the end, 741 (89.1%) students completed the256study. The intervention was based on the Health Belief Model (HBM). School nurses delivered 30 minutes of face-to-face structured information about HPV, including cancer risks and HPV prevention (i.e. condom use and HPV vaccination) to the intervention group. Students in both groups completed questionnaires at baseline and at follow-up after three months. The control group received standard treatment, i.e. the regular health interview with the school nurse. Generalized estimating equation analyses were used for examining the results of the intervention.

    Results

    Results: The intervention had positive effects on the adolescents’ knowledge (p<0.001), with a 0.582 higher score for the intervention group compared to the control group. There were no differences in knowledge due to sex (p=0.093) or immigrant background (p=0.592). The intervention also increased awareness (p<0.001), with a 0.590 higher score for the intervention compared to the control. Again, there were no differences in awareness due to sex (p=0.183) or immigrant background (p=0.319).

    Conclusion

    Conclusions: The school-based intervention delivered by school nurses, had favourable effects on knowledge and awareness about primary prevention of HPV among adolescents aged 16 years.

  • 7.
    Grandahl, Maria
    et al.
    Uppsala University.
    Tydén, Tanja
    Uppsala University.
    Gottvall, Maria
    Uppsala University.
    Westerling, Ragnar
    Uppsala University.
    Oscarsson, Marie
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Uppsala University.
    Immigrant women's experiences and views on 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.

     

  • 8.
    Grandahl, Maria
    et al.
    Institutionen för folkhälsa och vårdvetenskap, Uppsala Universitet.
    Tydén, Tanja
    Institutionen för folkhälsa och vårdvetenskap, Uppsala universitet.
    Gottvall, Maria
    Institutionen för folkhälsa och vårdvetenskap, Uppsala universitet.
    Westerling, Ragnar
    Institutionen för folkhälsa och vårdvetenskap, Uppsala .
    Oscarsson, Marie
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Immigrant women’s experiences and views onprevention of cervical cancer: a qualitative study2012Conference paper (Refereed)
    Abstract [en]

    BackgroundSweden is a multicultural country, nearly 20% of the population has an immigrant background. Certain ethnic groups have lower attendance rates in cervical cancer prevention programs.Recently a school-based HPV vaccination program free of charge was introduced for girls age 11-12.  The HPV vaccination raises questions and concerns about whether it will be accepted among all ethnic groups

    Aim.To explore immigrant women’s experiences and views on the prevention of cervical cancer.

    Methods. An exploratory qualitative study. Eight focus group interviews were conducted with 50 women aged 18-54, who studied Swedish for immigrants. Years in Sweden; 0-2 years N=17, 3-5  years N=30, > 6 years N=3. The women represented many countries from different geographic areas; Middle east N=24,  Africa N=16, Asia N=6 and East Europe N=4. Data were analysed by latent content analysis. The Health Belief Model (HBM) was used as a theoretical model; the results are discussed according to HBM.

    Results The women were positive to the prevention of cervical cancer. However, several barriers were identified: difficulties in contacting healthcare, limited knowledge of the relation between sexually transmitted infections (STI) and human papillomavirus virus (HPV), cultural aspects and not being used to regular health check-ups in home countries.

    ’When I came to Sweden I received a paper and I didn’t understand anything, after 4 month, I read it, and I understood that it was a cancer test, but I can’t call and make an appointment’  

    The women would accept HPV vaccine for their daughters but wanted adequate information before consent. The women spoke openly about sexual transmitted infections and emphasized both genders responsibility for prevention.

    ‘It [the vaccine] is really good, it is good for the future health.’

    ‘Yes, value not so good but the man is always first, second is woman. And think like this that diseases are not so important.’

    ‘Why must woman do everything? Doesn’t a man also infect?’

    Conclusion.The women wanted to participate in cervical cancer prevention programs and would accept HPV vaccination for their daughters, but expressed difficulties in understanding information from healthcare.Information about preventive programs needs to be in different languages and provided through different sources. Healthcare professionals should consider immigrant women’s difficulties concerning cultural norms and pay attention to their experiences.

  • 9.
    Grandahl, Maria
    et al.
    Uppsala university.
    Tydén, Tanja
    Uppsala university.
    Rosenblad, A.
    Uppsala university.
    Oscarsson, Marie
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Nevéus, Tryggve
    Uppsala university.
    Stenhammar, C.
    Uppsala university.
    A population based survey of school nurses' attitudes to the implemented HPV vaccination programme in Sweden2015In: Eurogin 2015: abstracts part 2, 2015, p. 168-168Conference paper (Refereed)
    Abstract [en]

    Objective: To investigate school nurses’ attitudes to, and experiences of the school-based HPV vaccination programme,one year after its implementation in Sweden.

    Methods: Data were collected using a web-based questionnaire in spring 2013, and 83.1% (851/1024) of the nursesanswered the questionnaire.

    Results: The majority (88.9%, n=756) agreed that HPV vaccinations should be the school nurses’ responsibility, and mostalso agreed (81.5%, n=693) that boys also should be offered the vaccine. Two thirds, 66.9% (n=570), stated that they hadexperienced difficulties with the vaccination and of these 59.1% (n=337) considered the task time-consuming. Three outof four nurses, 76.1% (n=648), had been contacted by parents who raised questions regarding the vaccine. The most commonquestions were related to side effects. There were strong associations between the nurses’ received education aboutthe HPV vaccine and perceived knowledge about the HPV vaccine and a favourable attitude towards vaccination (both p<0.001). A school nurse with a high level of received education was 9.8 times more likely to have a positive attitude to HPVvaccination compared to a nurse with a low level of received education (p<0.001). Nurses with high perceived knowledgewere 2.5 times more likely to have a positive attitude compared to those with a low level of perceived knowledge(p=0.006).

    Conclusions: HPV vaccination is a complex and time-consuming task and the school nurses need adequate knowledge,education, skills and time in order to address questions and concerns from parents, as well as informing about HPV.

  • 10.
    Grandahl, Maria
    et al.
    Uppsala University.
    Tydén, Tanja
    Uppsala University.
    Rosenblad, Andreas
    Uppsala University.
    Oscarsson, Marie
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Uppsala University.
    Nevéus, Tryggve
    Uppsala University.
    Stenhammar, Christina
    Uppsala University.
    School nurses' attitudes and experiences regarding the human papillomavirus vaccination programme in Sweden: a population-based survey2014In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, article id 540Article in journal (Refereed)
    Abstract [en]

    Background: Sweden introduced a school-based human papillomavirus (HPV) vaccination programme in 2012, and school nurses are responsible for managing the vaccinations. The aim of the present study was to investigate the attitudes and experiences of school nurses regarding the school-based HPV vaccination programme 1 year after its implementation. Methods: Data were collected using a web-based questionnaire in the spring of 2013, and 83.1% (851/1024) of nurses responded. Results: There were strong associations between the nurses' education about the HPV vaccine and their perceived knowledge about the vaccine and a favourable attitude towards vaccination (both p < 0.001). School nurses who received a high level of education were more likely to have a positive attitude to HPV vaccination compared with nurses with little education about HPV vaccination (adjusted odds ratio [OR] = 9.8; 95% confidence interval [CI]: 3.797-25.132). Nurses with high perceived knowledge were more likely to have a positive attitude compared with those with a low level of perceived knowledge (OR = 2.5; 95% CI: 1.299-4.955). If financial support from the government was used to fund an additional school nurse, nurses were more likely to have a positive attitude than if thefinancial support was not used to cover the extra expenses incurred by the HPV vaccination (OR = 2.1; 95% CI: 1.051-4.010). The majority, 648 (76.1%), had been contacted by parents with questions aboutthe vaccine, mostly related to adverse effects. In addition, 570 (66.9%) stated that they had experienced difficulties with the vaccinations, and 337 (59.1%) of these considered the task to be time-consuming. Conclusions: A high level of education and perceived good knowledge about HPV are associated with a positive attitude of school nurses to the HPV vaccination programme. Thus, nurses require adequate knowledge, education, skills and time to address the questions and concerns of parents, as well as providing information about HPV. Strategic financial support is required because HPV vaccination is a complex and time-consuming task.

  • 11.
    Grandahl, Maria
    et al.
    Uppsala University.
    Tydén, Tanja
    Uppsala University.
    Westerling, Ragnar
    Uppsala University.
    Nevéus, Tryggve
    Uppsala University.
    Rosenblad, Andreas
    Uppsala University.
    Hedin, EriK
    Uppsala University.
    Oscarsson, Marie
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Uppsala University.
    To consent or decline HPV vaccination: a pilot study at the start of the national school-based vaccination program in Sweden2017In: Journal of School Health, ISSN 0022-4391, E-ISSN 1746-1561, Vol. 87, no 1, p. 62-70Article in journal (Refereed)
    Abstract [en]

    BACKGROUND

    Parents' beliefs about human papillomavirus (HPV) vaccination influence whether they allow their daughters to be vaccinated. We examined the association between parents' refusal and sociodemographic background, knowledge and beliefs about HPV, and the HPV vaccination in relation to the Health Belief Model.

    METHODS

    The sample consisted of 200 (55%) parents of children aged 11-12 years in the Swedish national vaccination program. Data were collected using a self-reported questionnaire. Most parents (N = 186) agreed to the vaccination. Pearson's chi-square, Fisher's exact test, and the Mann-Whitney U test were used to analyze data.

    RESULTS

    Declining parents saw more risks and fewer benefits of HPV vaccination but no differences in beliefs regarding the severity or young girls' susceptibility to HPV were found. There was an association between refusing the HPV vaccine and lower acceptance of previous childhood vaccinations, and their main source of information was the Internet. Parents who declined the vaccine believed it could adversely affect condom use, the age of their daughter's sexual debut, and the number of sexual partners.

    CONCLUSION

    Parents should have the possibility to discuss HPV and HPV vaccine with a school nurse or other health care professionals, and should have access to evidence-based information on the Internet.

  • 12.
    Holmberg, Karin
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Peterson, Ulla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Karolinska institutet.
    Oscarsson, Marie
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Uppsala universitet.
    A two-decade perspective on mothers’ experiences and feelings related to breastfeeding initiation in Sweden2014In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 5, no 3, p. 125-130Article in journal (Refereed)
    Abstract [en]

    Objective

    The purpose was to examine mothers’ experiences and feelings related to breastfeeding initiation from a two-decade perspective.

    Methods

    A repeated cross-sectional survey was conducted at a maternity ward before and after introduction of Baby Friendly Hospital Initiative (BFHI) and in a follow-up survey. Women participated in 1992 (n = 83), 1993 (n = 74) and 2011 (n = 94).

    Results

    The duration of time at the first suckling differed; in 2011, the baby sucked 24.4 minutes compared to 12.7 minutes in 1992 (p < .001) and 13.6 minutes in 1993 (p < .001). In 1992, 34.6% of the women reported using supplementary formula compared with 5.9% in 1993 and 9.3% in 2011 (p < .001). The mothers’ contacts with the child or the father as well as their moods did not vary during the years. Mothers rated their feelings towards breastfeeding as being lower in 2011 than in 1992 and 1993 (p = .008). In 2011, mothers experienced breastfeeding as being more difficult and reported a higher degree of tension, insecurity and anxiety.

    Conclusions

    Supplementation was given to healthy newborn infants, which does not conform to BFHIs intentions. Routines and support in relation to breastfeeding initiation need to be continuously evaluated in order to strengthen and sustain the BFHI.

  • 13.
    Lendahls, Lena
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Oscarsson, Marie
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Midwifery students´ experiences of simulation- and skills training2017In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 50, p. 12-16Article in journal (Refereed)
    Abstract [en]

    Background

    In Sweden, simulation- and skills training are implemented in midwifery education in order to prepare students for clinical practice. Research regarding the use of both low to high levels of fidelity in simulation in midwifery programme is limited.

    Aim

    The aim of this study was to explore midwifery students' experiences of simulation- and skills training.

    Methods

    Midwifery students (n = 61), at advanced level, were interviewed in 13 group interviews from 2011 to 2105. A semi-structured interview guide was used, and data were analysed by content analysis.

    Results

    The results are presented in four main categories: develops hands on skills and communication, power of collaborative learning, highly valued learning environment and facilitates clinical practice. The majority of students felt that the simulation- and skills training were necessary to become familiar with hands on skills. Having repetitive practices in a safe and secure environment was viewed as important, and students highly valued that mistakes could be made without fear of comprising patient safety. Student's collaboration, reflections and critical thinking increased learning ability. Simulation- and skills training created links between theory and practice, and the lecturer had an important role in providing instructions and feedback. Students felt prepared and confident before their clinical practice, and simulation- and skills training increased safety for all involved, resulting in students being more confident, as patients in clinical practice became less exposed. Furthermore, mentors were satisfied with students' basic skills.

    Conclusion

    Simulation- and skills training support the development of midwifery skills. It creates links between theory and practice, which facilitates students' learning ability. Training needs to include reflections and critical thinking in order to develop their learning. The lecturer has an important role in encouraging time for reflections and creating safe environment during the skills and simulation training.

  • 14.
    Oscarsson, Marie
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Barnmorska2014In: Att bli specialistsjuksköterska eller barnmorska: utbildningar för framtiden / [ed] Lena Nordgren och Sofia Almerud Österberg, Lund: Studentlitteratur AB, 2014, 1, p. 219-233Chapter in book (Other academic)
  • 15.
    Oscarsson, Marie
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Etiska dilemman i samband med vaccination mot HPV2015In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 92, no 6, p. 707-716Article in journal (Refereed)
    Abstract [en]

    Human papillomavirus (HPV) is one of the world´s most common sexually transmitted infections. HPV can cause cell changes and cervical cancer in women, but the virus is also one of the causes of anal, head and neck cancer. Several problem areas have been identified in connection with the introduc­tion of the HPV vaccination in the childhood immunisation programme. One problem is the difficulty to obtain informed consent for HPV vaccination. From a gender perspective, it is a problem that only girls are offered the HPV vac­cination in the childhood vaccination programme. By only vaccinating girls, the image of girls being carriers is stigmatised. Boys do not have access to free vaccinations, although they are carriers of HPV and may get cancer. By excluding boys from the general vaccination programme, vulnerable groups are discriminated against, for example, men who have sex with men.

  • 16.
    Oscarsson, Marie
    University of Kalmar, School of Human Sciences.
    Friska kvinnor eller riskpatienter? Icke-deltagare i gynekologisk cellprovskontroll2007In: Forskningsstafetten, Kalmar, 2007Conference paper (Other academic)
  • 17.
    Oscarsson, Marie
    University of Kalmar, School of Human Sciences.
    Friska kvinnor eller riskpatienter? Icke-deltagare i gynekologisk screening2008Conference paper (Other academic)
  • 18.
    Oscarsson, Marie
    University of Kalmar, School of Human Sciences.
    Jag behöver inte…Jag vill inte…Jag prioriterar inte…”2008Conference paper (Other academic)
  • 19.
    Oscarsson, Marie
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Psychological Adjustment of Women in Cervical Cancer Screening2011In: Current Women's Health Reviews, ISSN 1573-4048, E-ISSN 1875-6581, Vol. 7, no 4, p. 353-357Article in journal (Refereed)
    Abstract [en]

    Since the widespread introduction of cervical cancer screening programs the incidence and mortality of cervical cancer has declined. In general, cervical cancer screening programs are viewed as a valuable component of preventive health services, but are also associated with negative effects for participants. The side effects of cervical cancer screening include anxiety, false reassurance and overdiagnosis. The purpose of the present review was to study the research literature on psychological adjustment among women undergoing cervical cancer screening. The review revealed two main areas with barriers to cervical cancer screening, the pelvic examination and Pap smear results. Women felt anxiety and embarrassment during the pelvic examination and highlighted the importance of a suitable examiner. Fear of negative results played a major role in women's decisions to participate. Fearing results of the Pap smear could be a source of distress.

  • 20.
    Oscarsson, Marie
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Steget före- cerviccancerscreening utifrån kvinnans perspektiv: Varför väljer kvinnor att intedelta i screening av cervixcancer2011In: Svenska Barnmorskeförbundets Jubileumskonferens, 2011Conference paper (Other academic)
  • 21.
    Oscarsson, Marie
    University of Kalmar, School of Human Sciences.
    Tonåriga flickors upplevelse av första gynekologiska undersökning2004Conference paper (Other academic)
  • 22.
    Oscarsson, Marie
    University of Kalmar, School of Human Sciences.
    Tonåriga flickors upplevelse av sin första gynekologiska undersökning2003Conference paper (Other academic)
  • 23.
    Oscarsson, Marie
    University of Kalmar, School of Human Sciences.
    Uteblivande kvinnor2004Conference paper (Other academic)
  • 24.
    Oscarsson, Marie
    University of Kalmar, School of Human Sciences.
    Varför avstår kvinnor gynekologisk cellprovskontroll2003Conference paper (Other academic)
  • 25.
    Oscarsson, Marie
    University of Kalmar, School of Human Sciences.
    Varför avstår kvinnor gynekologisk cellprovskontroll?2005Conference paper (Other academic)
  • 26.
    Oscarsson, Marie
    et al.
    University of Kalmar, School of Human Sciences.
    Benzein, Eva
    University of Kalmar, School of Human Sciences.
    Women's experiences of pelvic examination: an interview study2002In: Journal of psychosomatic obstetrics and gynaecology, Vol. 23, no 1, p. 17-25Article in journal (Refereed)
  • 27.
    Oscarsson, Marie
    et al.
    University of Kalmar, School of Human Sciences.
    Benzein, Eva
    University of Kalmar, School of Human Sciences.
    Wijma, Barbro
    Den första gynekologiska undersökningen2004In: Forskningskonferens, reproduktiv och perinatal omvårdnad, Svenska  Barnmorskeförbundet, Uppsala / [ed] Svenska Barnmorskeförbundet,, Uppsala Universitet, 2004Conference paper (Refereed)
  • 28.
    Oscarsson, Marie
    et al.
    University of Kalmar, School of Human Sciences.
    Benzein, Eva
    University of Kalmar, School of Human Sciences.
    Wijma, Barbro
    Därför  väljer kvinnor att avstå gynekologisk cellprovskontroll2007In: Reproduktiv och perinatal omvårdnad, SvenskabBarnmorskeförbundet, Stockholm / [ed] Svenska Barnmorskeförbundet, Stockholm, 2007Conference paper (Refereed)
  • 29.
    Oscarsson, Marie
    et al.
    Linköpings University, Genus and Medicin.
    Benzein, Eva
    Linköpings University, Genus and Medicin.
    Wijma, Barbro
    Linköpings University, Genus and Medicin.
    Helathy women or risk patients-non-attendees in a cervical cancer screening program2007Doctoral thesis, monograph (Other academic)
  • 30.
    Oscarsson, Marie
    et al.
    University of Kalmar, School of Human Sciences.
    Benzein, Eva
    University of Kalmar, School of Human Sciences.
    Wijma, Barbro
    Reasons for non-attendance at cervical screening as reported by non.attendees in Sweden2008In: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 29, no 1, p. 23-31Article in journal (Refereed)
  • 31.
    Oscarsson, Marie
    et al.
    University of Kalmar, School of Human Sciences.
    Benzein, Eva
    University of Kalmar, School of Human Sciences.
    Wijma, Barbro
    Carlsson, Per
    Promotion of cervical screening among non-attendees - A partial cost-effectiveness analysis2007In: European Journal of Cancer Prevention, ISSN 0959-8278, E-ISSN 1473-5709, Vol. 16, no 6, p. 559-63Article in journal (Refereed)
  • 32.
    Oscarsson, Marie
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Dahlberg, Annica
    Institutionen för folkhälsa och vårdvetenskap, Uppsala Universitet.
    Tydén, Tanja
    Institutionen för folkhälsa och vårdvetenskap, Uppsala Universitet.
    Midwives role in cervical cancer prevention and their attitude to HPV vaccination2011In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 2, no 4, p. 137-142Article in journal (Refereed)
    Abstract [en]

    Objective: To explore youth clinic midwives role in cervical cancer prevention and their attitude to HPV vaccination.

    Study design:Individual interviews with 13 midwives working at youth clinics in Sweden. The interviews were recorded, transcribed, and analysed by qualitative content analysis.

    Results: Three themes were identified in the qualitative content analysis: “Cervical cancer prevention not a prioritised area”, “Ambivalence to the HPV vaccine”, andGender and socioeconomic controversies”. Few midwives talked spontaneously about cervical cancer prevention. The responsibility for providing information about HPV vaccination was considered as primarily that of school health nurses and parents. Midwives were positive about the HPV vaccination, but recognised certain risks, such as its potential negative impact on cervical cancer screening and increased sexual risk taking. The midwives expressed concerns with medical risks, such as side effects and unknown long-term effects of the HPV vaccine. The midwives in the study had ethical concerns that boys were not included in the program and not all families had the financial resources to vaccinate their children. Thus, weak socioeconomic groups might be excluded.

    Conclusion: The midwives considered cervical cancer prevention as important, but did not integrate information on the HPV vaccine into their routine work, mainly because young people visiting youth clinics had had their sexual debut and they were concerned about the medical risks and that the vaccine was too expensive.

  • 33.
    Oscarsson, Marie
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Gottvall, Tomas
    Linköping University.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    When fetal hydronephrosis is suspected antenatally: a qualitative study2015In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 15, no 349Article in journal (Refereed)
    Abstract [en]

    Background: The information about fetal malformation findings during the ultrasound examination often comes unexpectedly, and the women and their partners may not necessarily receive any conclusive statement on the prognosis. A finding such as fetal hydronephrosis range from being a soft markers or mild anomaly, to a serious condition associated with neonatal morbidity and mortality. The aim of this study was to explore women’s reactions to the discovery of fetal hydronephrosis in the context of uncertainty regarding the prognosis.

    Methods: Ten women were interviewed and the interviews were conducted six to twelve months after the women gave birth. They had experience of suspected fetal hydronephrosis in gestational week 18–20. The interviews were recorded, transcribed verbatim and analysed using constant comparative analysis.

    Results: The core category, ‘Going through crisis by knowing that you are doing the right thing’ illustrates the meaning of women’s reactions and feelings. It illuminates the four categories: ‘When the unexpected happens’– on the one hand, women had positive views that the suspicious malformation could be discovered; however, on the other hand, women questioned the screening. ‘To live in suspense during pregnancy’ – the suspicious malformation caused anxiety and was a stressful situation. ‘Difficulties in understanding information’ – the women thought they had limited knowledge and had difficulties in understanding the information. ‘Suppress feelings and hope for the best’ – the women tried to postpone the problem and thought they should deal with it after delivery.

    Conclusions: Women are worried irrespective of suspicious or severe malformations, and in need of information and counselling tailored to their individual needs. Other sources of support could be: written information, links to reliable sources on the Internet and possibilities for ongoing follow-ups.

  • 34.
    Oscarsson, Marie
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Hannerfors, Anna-Karin
    Institutionen för folkhlsa och vårdvetenskap, Uppsala Universitet.
    Tyden, Tanja
    Institutionen för folkhlsa och vårdvetenskap, Uppsala Universitet.
    HPV vaccinated young women´s decision-making process2011In: Svenska Barnmorskeförbundets Jubileumskonferens, Stockholm / [ed] Svenska Barnmorskeförbundet, 2011Conference paper (Refereed)
    Abstract [en]

    Purpose: The aim was to explore young women’s decision-making process for HPV vaccination

    Method: This study employed a qualitative design. Data were collected by tape-recorded interviews with 17 Swedish women aged 17-26 years. Data were analysed by latent content analysis.

    Findings: In general, the young women had confidence in the vaccination and emphasised vaccination against cancer. Mother’s support and sponsor of costs initiated the HPV vaccination. Other trigger factors were advertisements and friends. Despite having been vaccinated, they were unaware of the association between sexual behaviour and HPV. They believed that HPV vaccination would not affect their future sexual behaviour.

    Conclusion: Health care professionals at youth clinics and schools have to initiate discussion for clarifying the association between cervical cancer and a sexually transmitted virus.

     

  • 35.
    Oscarsson, Marie
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Hannerfors, Anna-Karin
    Institutionen för folkhälsa och vårdvetenskap, Uppsala Universitet.
    Tydén, Tanja
    Institutionen för folkhälsa och vårdvetenskap, Uppsala Universitet.
    HPV vaccination en angelägenhet för familjen2010In: Familjefokuserad omvårdnad / [ed] Familjefokus, Linnéuniversitetet, 2010Conference paper (Refereed)
  • 36.
    Oscarsson, Marie
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Hannerfors, Anna-Karin
    Institutionen för folkhlsa och vårdvetenskap, Uppsala Universitet.
    Tydén, Tanja
    Institutionen för folkhlsa och vårdvetenskap, Uppsala Universitet.
    Unga kvinnors tilltro och beslut om sin HPV vaccination2010In: Medicinska Riksstämman, Göteborg, 2010Conference paper (Refereed)
  • 37.
    Oscarsson, Marie
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Hannerfors, Anna-Karin
    Institutionen för folkhälsa och vårdvetenskap, Uppsala Universitet.
    Tydén, Tanja
    Institutionen för folkhälsa och vårdvetenskap, Uppsala Universitet.
    Young women’s decision-making process for HPV vaccination2012In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 3, no 4, p. 141-146Article in journal (Refereed)
    Abstract [en]

    Objectives

    To explore young women’s decision-making process for HPV vaccination and to identify their beliefs about HPV vaccination.

    Methods

    This study employs a qualitative design. Data was collected by audio-taped interviews with 16 HPV vaccinated Swedish women, 17–26 years old. The data was analysed using latent content analysis.

    Results

    Three themes emerged from the data: “Fear of cancer”, “Reliance on vaccination” and “Mother – the main motivational factor”. One of the major reasons for taking the decision to be HPV vaccinated was fear of cancer: vaccination was seen as a way to protect oneself against this. The young women’s decision-making surrounding HPV vaccination was based on reliance on vaccination and trust in health care. Support from the mothers of the young women and mothers’ sponsorship of costs initiated HPV vaccination. Other motivational factors were advertisements and friends. Despite having been vaccinated, the young women were unaware of the relation between cervical cancer, sexual behaviour and HPV.

    Conclusion

    These HPV vaccinated young women had limited knowledge about HPV. Therefore it is important that health professionals provide comprehensible information about HPV vaccination in attaining informed consent. In order to avoid misunderstandings, health care professionals in youth clinics and schools need to initiate discussion with young women, clarifying the relation between cervical cancer, HPV and sexual transmission.

  • 38.
    Oscarsson, Marie
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Haug, Trude
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Holmberg, Karin
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Two decades of family friendly hospital: What have we learnt about breastfeeding patterns?2010In: Nordisk Jordemor Kongress . International confederation of midwives, Köpenhamn Danmark / [ed] International confederation of midwives, 2010Conference paper (Refereed)
    Abstract [en]

    Background.

    Successful long-term breastfeeding depends on a successful start. With this in mind The Baby Friendly Hospital Initiative (BFHI) was launched by UNICEF and the WHO. The initiative is a global effort to implement practices that protect, promote and support breastfeeding. In 1992,KalmarCountyHospitalwas certified as Baby Friendly Hospital (BFH). The hospital is an academic teaching hospital serving primarily middleclass families. We evaluated breastfeeding patterns during their implementation (1993). Since BFHI have been introduced, several studies have evaluated breastfeeding rates. However, as far as we know breastfeeding patterns have not been in focus. Therefore, the purpose of this presentation is to compare breastfeeding patterns from the introduction ofBabyFriendlyHospital1993 with year 2010

     MethodSampleThe inclusion criteria’s are; speaking Swedish, PN

    Target group: A consecutive sample of mothers, Oct 2009-March 2010.

    Comparison group: A consecutive sample of mothers (n=69), Oct 1992-March 1993.

    Procedure

    The data collection from this project has started in October 2009 and is similar to the study design from 1993.

    A specific questionnaire was developed in 1993 which comprises background characteristics, delivery data, first suckling, breastfeeding patterns, supplementation, patterns of sleep and questions concerning support from health care professionals. Mothers kept a logbook registering times of breastfeeding during her stay at maternity ward.

    The questionnaire, the logbook and an information letter will be given to the mothers when they arrive to the maternity ward. They are also informed to return the completed questionnaire and diary to the researcher in an enclosed pre-stamped envelope.

    Analyze

    Data will be analyzed using The Statistical Package for Social Sciences (SPSS). In addition to descriptive data, differences between groups are going to be tested using Student’s t-test and Fischer’s Exact Test or Pearson’s Chi square test for two independent samples on nominal data

     

  • 39.
    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.

  • 40.
    Oscarsson, Marie
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Department of Public Health and Caring Sciences, Uppsala University.
    Qvarnström, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Tydén, Tanja
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala,.
    Attitude to cervical cancer screening and sexual behavior among HPV vaccinated young women: a qualitative pilot study2013In: Health, ISSN 1949-4998, E-ISSN 1949-5005, Vol. 5, no 7A4, p. 13-18Article in journal (Refereed)
    Abstract [en]

    Objectives: To explore attitudes to cervical cancer screening and sexual behaviour among human papillomavirus (HPV)-vaccinated young women in southern Sweden. Methods: Sixteen women aged 17-26 years who had received the HPV vaccine were submitted to an individual semi-structured interview. Interviews were recorded and transcribed verbatim. The data were analysed qualitatively by means of latent content analysis. Results: The interviewees had a poor understanding of cervical cancer screening. After it was explained to them, they stated that they were willing to participate in the screening. The young women thought their future sexual behaviour would not be affected by the vaccination. They considered themselves to be more aware of it and less likely to engage in risky behaviour than their peers. They knew little about the relation among HPV, sexual transmission and cervical cancer, and they expressed a desire for more information. Conclusions: These young women who recently had been administered HPV vaccine had a limited understanding of the importance of participating in future cervical cancer screening. It is necessary that more and more appropriate information of cervical cancer screening be given on the occasion of the HPV vaccination.

  • 41.
    Oscarsson, Marie
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Qvarnström, Anna
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Tydén, Tanja
    Uppsala Unversitet.
    Possible effects on participation in cervical cancer screening and sexual behaviour following HPV vaccination in Sweden2012In: 28th International Papillomavirus Conference & Clinical and Public Health Workshops: abstracts book - epidemiology / public health, 2012, p. 405-405Conference paper (Refereed)
    Abstract [en]

    Objective. To illustrate attitudes towards future cervical cancer screening and future sexual behavior among young HPV vaccinated women and parents of HPV vaccinated girls.

    Design. Study with qualitative approach.

    Setting. Mid-sized cities in the south of Sweden.

    Sample. Young women aged 17 to 26 years (n=17) and parents of girls aged 13 to 17 years (n=6) vaccinated against HPV.

    Method. Individual semi-structured interviews were analyzed with qualitative content analysis.

    Results. The attitudes towards future participation in cervical cancer screening was positive in both groups, but nearly half of the young women did not know what cervical cancer screening meant. Among the young women, there was a lack of understanding about the relation between sexual transmission, HPV and cervical cancer. The parents had better understanding. Future sexual behavior was thought would not be affected by the vaccination, but participants discussed the possibility of it leading to increased sexual risk taking among others. We could also see that discussions prior to the vaccination increased knowledge about sexually transmitted infections and encouraged conversations about safe sex between parents and daughters.

    Conclusions. Young HPV vaccinated women are unaware of cervical cancer screening and to what extent HPV vaccination offers protection. Accurate information about HPV, sexual transmission and cervical cancer is important to prevent possible negative effects on participation in cervical cancer screening and on future sexual behavior.

  • 42.
    Oscarsson, Marie
    et al.
    University of Kalmar, School of Human Sciences.
    Wijma, Barbro
    “I do not need to… I do not want to… I do not give it priority …” – why women choose not to attend cervical cancer screening2008In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 11, p. 26-34Article in journal (Refereed)
  • 43.
    Oscarsson, Marie
    et al.
    University of Kalmar, School of Human Sciences.
    Wijma, Barbro
    Hälsouniversitetet, Linköping.
    Benzein, Eva
    University of Kalmar, School of Human Sciences.
    "I do not needto... I do not want to... I do not give it priority...": why women choose not to attend cervical cancer screening2008In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 11, no 1, p. 26-34Article in journal (Refereed)
    Abstract [en]

    Objective  To describe and interpret why women with no cervical smear taken during the previous 5 years choose not to attend a cervical cancer screening (CCS) programme.

    Background  CCS programme is a service for early detection of cervical cancer. Today, some women choose not to attend the programme.

    Design  Data were collected by tape-recorded interviews and analysed by qualitative inductive content analysis.

    Setting and participants  Purposive sample of 14 women in southeast Sweden, who had chosen not to attend CCS during the previous 5 years.

    Findings  The following themes were revealed: I do not need to…, I do not want to… and I do not give it priority…. The women had a positive attitude to CCS but as long as they felt healthy, they chose not to attend. A negative body image, low self-esteem, feelings of discomfort when confronted with the gynaecological examination and fear of the results also influenced their non-attendance. The women prioritized more important things in life and reported various degrees of lack of trust in health-care.

    Conclusion  Women’s choice not to attend CCS were complex and influenced by present and earlier intra- and inter-personal circumstances. They had a positive attitude to CCS, but other things in life were more important. Health-care professionals have to facilitate a co-operative discussion with the women in order to contribute to a mutual understanding for the perspectives of the women and the professionals.

  • 44.
    Oscarsson, Marie
    et al.
    University of Kalmar, School of Human Sciences.
    Wijma, Barbro
    Benzein, Eva
    University of Kalmar, School of Human Sciences.
    Individuellt utformade åtgärder ökar deltagandet i gynekologisk cellprovskontroll2007In: Nordisk Jordemor Kongress, International confederation of midwives, Åbo Finland / [ed] International confederation of midwives, Åbo, Finland, 2007Conference paper (Refereed)
  • 45.
    Oscarsson, Marie
    et al.
    University of Kalmar, School of Human Sciences.
    Wijma, Barbro
    Benzein, Eva
    University of Kalmar, School of Human Sciences.
    Non-attendance in a cervical cancer screening program - What happens if women’s requirements are met2008In: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 29, no 2, p. 183-197Article in journal (Refereed)
  • 46.
    Oscarsson, Marie
    et al.
    University of Kalmar, School of Human Sciences.
    Wijma, Barbro
    Benzein, Eva
    University of Kalmar, School of Human Sciences.
    The first pelvic examination – a transition into womanhood2007In: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 28, p. 7-12Article in journal (Refereed)
  • 47.
    Petersson, Carina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Peterson, Ulla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Oscarsson, Marie
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Health and sexual behavior among exchange students2016In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 44, no 7, p. 671-677Article in journal (Refereed)
    Abstract [en]

    Aim: The objective was to describe the exchange students’ health and sexual behaviour associated with their exchange studies, and examine the extent to which they had received preventive efforts against human immunodeficiency virus (HIV)/sexually transmitted infection (STI) and safer sex before departure. 

    Methods: A cross-sectional study was conducted based on a web survey with questions about sexual behaviour, self-esteem and psychological well-being. Data were analysed using descriptive and analytical statistics. 

    Results: A total of 136 outgoing exchange students from a Swedish University participated. Most of the exchange students rated their health as good, had psychological well-being and rated their self-esteem as being high. Approximately half of the exchange students had sex with a new partner during the exchange semester, and 87% of them had sexually risky behaviour. More than half (61%) of the exchange students had received preventive efforts before departure. No statistically significant difference regarding preventive information was found between those who reported sexually risky behaviour and those who did not. The group that had sexually risky behaviour desired free condoms and access to clinics for sexual health. 

    Conclusions: Exchange students rated their health as good, and the majority of them participated in information sessions that addressed preventive efforts on HIV/STI and safer sex before departure. Sexually risky behaviour during exchange studies was reported and highlights the need for more effective preventive measures; for example, a recollection of reading STI information.

  • 48.
    Qvarnström, Anna
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Oscarsson, Marie
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    An Internet based survey on how Swedish men who have sex with men percieve pre-travel prevention efforts on HIV/STIs2014Conference paper (Refereed)
    Abstract [en]

    Background: Overseas travellers and men who have sex with men (MSM) are prioritised groups when it comes to HIV/STI prevention. Travelling increases sexually risky behaviour and sexual contacts abroad are common; among MSM, there is a high prevalence of HIV/STIs.

    Objective: To investigate the experiences of and attitudes towards prevention efforts against HIV/STI before travelling abroad among MSM.

    Methods: The study had a cross sectional design and is based on survey responses from 656 MSM, recruited through a Nordic website, who had travelled abroad during the preceding year of the survey. Analysis is primarily descriptive, but bivariate analyses were also performed, and statistically significant differences between groups were investigated using the chi-square test. The level of significance was p <. 05.

    Results: Very few of the men felt that they encountered prevention efforts against HIV/STIs in Sweden (4.9%) and abroad (22.7%), and a majority (58.4%) felt that more should be offered, in particular to younger men. They felt that it was easy to find out information(79%), and most of them would use the Internet (87%). As to prevention efforts, a majority (68.3%) preferred free access to condoms and lubrications or written information/travel advice (59%).

    Conclusion: Prevention efforts aimed at overseas travellers can involve links to information on the Internet about sexual health. The results suggest that it is primarily younger men who should be prioritised. It is important that the information is conveyed respectfully since this group may have the experience of feeling stigmatised or discriminated against.

  • 49.
    Qvarnström, Anna
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Oscarsson, Marie
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Erfarenheter och attityder till preventionsarbete mot hiv/STI inför utlandsresor2014Report (Other academic)
    Abstract [sv]

    Rapporten består av två delstudier:

    I Information man inte kan få för mycket av. En kvalitativ intervjustudie med unga vuxna 20-29 år som rest utomlands senaste året.

    II Mycket viktigt, men eget ansvar? En webbaserad kvantitativ studie om preventionsarbete riktat mot MSM som rest utomlands senaste året.

  • 50.
    Qvarnström, Anna
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Oscarsson, Marie
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Experiences of and attitudes towards HIV/STI prevention among holidaymaking men who have sex with men living in Sweden: A cross-sectional Internet survey2015In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, no 5, p. 490-496Article in journal (Refereed)
    Abstract [en]

    Aim: Foreign travellers and men who have sex with men (MSM) are prioritised groups for human immunodeficiency virus/sexually transmitted infection (HIV/STI) prevention efforts in Sweden because of high prevalence of sexual risk-taking. This study aims to describe experiences of and attitudes towards HIV/STI prevention efforts, prior to travelling abroad, among MSM, and to investigate the kinds of prevention efforts that are desirable.

    Methods: The study is based on survey responses from 656 MSM who had travelled abroad. recruitment took place through a Nordic website, and had a cross-sectional design.The analysis has mainly been descriptive, but bivariate analyses were performed using the chi-square test.The level of significance was p <.05.

    Results: Only a few of the participants had encountered HIV/STI prevention efforts in Sweden (5%) and abroad (23%), and a majority (58%) felt that it should be more prevalent. Having free access to condoms and lubricants was preferred among 68% of the men. Furthermore, having written information, as opposed to oral, was also preferred (68% vs. 26%). MSM felt that it was easy to find out information (79%) and claimed they would use the Internet to do so (87%).

    Conclusions: Service providers who offer their services to travellers are encouraged to provide helpful links to information about sexual health. Information that is geared towards risk groups such as young adults should be presented with awareness that MSM are also part of that group. It is important for information to be conveyed respectfully to everyone, but perhaps MSM in particular, since they may have experienced feelings of being stigmatised or discriminated against previously. 

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