lnu.sePublications
Change search
Refine search result
12 1 - 50 of 95
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 1.
    Backman, Stina
    et al.
    Linköpings universitet.
    Samuelsson, Elisabeth
    Linköpings universitet.
    Engstrand, Åsa-Karin
    Linköpings universitet.
    Ljungemyr, Kristin
    Linköpings universitet.
    Swahnberg, Katarina
    Linköpings universitet.
    Gender equality, gender mainstreaming and equal opportunities – how to establish a sustainable model?2012In: Book of abstracts of the 7th European Conference on Gender Equality in Higher Education, Universitetet i Bergen, 2012, p. 9-9Conference paper (Refereed)
  • 2. Beausang, Angela
    et al.
    Berg, Lena
    Carlsson, Ninni
    Cederberg, Daniel
    Danielsson, Ingela
    Edin, Kerstin E.
    Eliasson, Mona
    Enander, Viveka
    Eriksson, Maria
    Jigmo, Kerstin
    Krantz, Gunilla
    Kruse, Anita
    Holmberg, Carin
    Lehtinen, Ullaliina
    Mannheimer, Moa
    Michel, Per-Olof
    Norlén, Anna
    Sundborg, Eva
    Svedin, Carl Göran
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Tingberg, Björn
    Ohlsson, Carina
    Wendt, Eva
    Westerståhl, Anna
    Wiklund, Ingela
    Åhlund, Agneta
    "Möjligheten att rädda några av dessa kvinnors liv har inte vägts in"2014In: Dagens MedicinArticle in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Namnet på Socialstyrelsens vägledning lyder: Hur upptäcka våldsutsatthet? Ja, det kan man verkligen fråga sig efter att ha läst detta föga vägledande dokument, skriver ett stort antal kritiska debattörer.

  • 3.
    Brüggemann, A. Jelmer
    et al.
    Linköpings universitet.
    Swahnberg, Katarina
    Linköpings universitet.
    Patients’ silence towards the healthcare system after ethical transgressions by staff: associations with patient characteristics in a cross-sectional study among Swedish female patients2012In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 2, no 6Article in journal (Refereed)
    Abstract [en]

    Objectives: To identify which patient characteristics are associated with silence towards the healthcare system after experiences of abusive or ethically wrongful transgressive behaviour by healthcare staff.

    Design: Cross-sectional questionnaire study using the Transgressions of Ethical Principles in Health Care Questionnaire.

    Setting: A women's clinic in the south of Sweden.

    Participants: Selection criteria were: consecutive female patients coming for an outpatient appointment, ≥18-year-old, with the ability to speak and understand the Swedish language, and a known address.

    Questionnaires were answered by 534 women (60%) who had visited the clinic, of which 293 were included in the present study sample.

    Primary outcome measure: How many times the respondent remained silent towards the healthcare system relative to the number of times the respondent spoke up.

    Results: Associations were found between patients’ silence towards the healthcare system and young age as well as lower self-rated knowledge of patient rights. Both variables showed independent effects on patients’ silence in a multivariate model. No associations were found with social status, country of birth, health or other abuse.

    Conclusions: The results offer opportunities for designing interventions to stimulate patients to speak up and open up the clinical climate, for which the responsibility lies in the hands of staff; but more research is needed.

  • 4.
    Brüggemann, A. Jelmer
    et al.
    Linköpings universitet.
    Swahnberg, Katarina
    Linköpings universitet.
    What contributes to abuse in health care?: A grounded theory of female patients’ stories2013In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 50, no 3, p. 404-412Article in journal (Refereed)
    Abstract [en]

    Background

    In Sweden, 20% of female patients have reported lifetime experiences of abuse in any health care setting. Corresponding prevalence among male patients is estimated to be 8%. Many patients report that they currently suffer from these experiences. Few empirical studies have been conducted to understand what contributes to the occurrence of abuse in health care.

    Objectives

    To understand what factors contribute to female patients’ experiences of abuse in health care.

    Design

    Constructivist grounded theory approach.

    Settings

    Women's clinic at a county hospital in the south of Sweden.

    Participants

    Twelve female patients who all had reported experiences of abuse in health care in an earlier questionnaire study.

    Methods

    In-depth interviews.

    Results

    The analysis resulted in the core category, the patient loses power struggles, building on four categories: the patient's vulnerability, the patient's competence, staff's use of domination techniques, and structural limitations. Participants described how their sensitivity and dependency could make them vulnerable to staff's domination techniques. The participants’ claim for power and the protection of their autonomy, through their competence as patients, could catalyze power struggles.

    Conclusions

    Central to the participants’ stories was that their experiences of abuse in health care were preceded by lost power struggles, mainly through staff's use of domination techniques. For staff it could be important to become aware of the existence and consequences of such domination techniques. The results indicate a need for a clinical climate in which patients are allowed to use their competence.

  • 5.
    Brüggemann, A. Jelmer
    et al.
    Linköping University, Sweden.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University, Sweden.
    Wijma, Barbro
    Linköping University, Sweden.
    A first online intervention to increase patients’ perceived ability to act in situations of abuse in health care: reports of a Swedish pre-post study2015In: BMC Medical Ethics, ISSN 1472-6939, E-ISSN 1472-6939, Vol. 16, article id 35Article in journal (Refereed)
    Abstract [en]

    Background

    Efforts to counteract abuse in health care, defined as patient-experienced abuse, have mainly focused on interventions among caregivers. This study is the first to test an online intervention focusing on how patients can counteract such abuse. The intervention aimed at increasing patients’ intention and perceived ability to act in future situations where they risk experiencing abuse.

    Methods

    Participants were recruited through a nephrology clinic in Sweden. The intervention consisted of an online program that aimed to stimulate patients to think of possible actions in situations in which they risk experiencing abuse. The program comprised stories and exercises in text and comic form. The participants filled out a questionnaire immediately before and after going through the program, as well as during follow-up four to eight weeks later.

    Results

    Forty-eight patients (39 %) participated in the study and spent, on average, 41 min responding to questions and going through the program. Both men and women, of various ages and educational backgrounds, participated. An increase in participants' self-reported ability to identify opportunities to act in a given situation was seen immediately afterwards, as well as during follow up.

    Conclusion

    The current study suggests that it is feasible and most likely useful to a variety of patients to work with the provided material that has the aim of counteracting abuse in health care. It would be of interest to further develop ways of using comics and to test similar interventions in other health care settings.

  • 6.
    Brüggemann, Adrianus Jelmer
    et al.
    Linköpings universitet.
    Wijma, Barbro
    Linköpings universitet.
    Swahnberg, Katarina
    Linköpings universitet.
    Abuse in health care: a concept analysis2012In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, no 1, p. 123-132Article in journal (Refereed)
    Abstract [en]

    Aims and objectives:  To analyse the concept of abuse in health care. This analysis also covers how abuse in health care is different from the related concepts of medical error, patient satisfaction and personal identity threat.

    Background:  Abuse in health care is an emerging concept in need of a clear analysis and definition. At the same time, boundaries to the related concepts are not demarcated.

    Design:  Concept analysis as developed by Walker and Avant.

    Method:  The databases Cumulative Index to Nursing and Allied Health Literature, Medline, and Google Scholar were used to obtain articles published between 1997 and 2009. A total of eleven articles are referred to on abuse in health care, four on medical error, six on patient satisfaction and three on personal identity threat.

    Results:  Abuse in health care is defined by patients’ subjective experiences of encounters with the health care system, characterized by devoid of care, where patients suffer and feel they lose their value as human beings. The events are most often unintended. We also found differences with the aforementioned related concepts: medical error does not share the patients’ perspective, and patient satisfaction does not offer room for patients’ abusive experiences. The concept of personal identity threat shares all attributes with abuse in health care, but it lacks an antecedent that signifies the social structures underlying the phenomenon.

    Conclusions:  Abuse in health care covers a phenomenon that has severe consequences but is invisible if seen from a medical error or patient satisfaction perspective.

  • 7.
    Brüggemann, Jelmer
    et al.
    Linköping University.
    Swahnberg, Katarina
    Linköping University.
    Anmälningsplikt för kränkningar bör inkluderas i lex Maria2011In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 108, no 5, p. 217-217Article in journal (Other academic)
    Abstract [sv]

    Lex Maria bör bygga på ­samma filosofi som lex Sarah, och det systemtänkande som lex Maria är född ur bör gälla för ­kränkningar lika väl som för rent medicinska misstag.

  • 8.
    Brüggemann, Jelmer
    et al.
    Linköping University.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Hälsouniversitetet, Linköping.
    Staff silence about abuse in health care: an exploratory study at a Swedish women’s clinic2014In: Clinical Ethics, ISSN 1477-7509, E-ISSN 1758-101X, Vol. 9, no 2-3, p. 71-76Article in journal (Refereed)
    Abstract [en]

    Background It has been well documented that patients can feel abused in health care and that many patients suffer from these experiences. Insight lacks into contributing factors behind such events. Silence surrounding the abuse has been suggested as a possible mechanism. The present study explores silence surrounding the abuse as a possible contributing factor. We have explored whether this silence is connected with the staff’s hierarchical position and with the staff’s own experiences as patients abused in health care.

    Methods During January 2008, a paper questionnaire was sent to all staff members at a Swedish women’s clinic. The questionnaire included questions on sociodemography and profession and multiple questions about abuse in health care. After univariate testing, a binary logistic regression model including variables concerning profession and staff’s own experiences of abuse was built.

    Results Our data show that in contrast to midwives and gynaecologists, auxiliary nurses seldom report hearing about cases of abuse in health care. Staff who themselves experienced abuse in health care as patients, so-called wounded healers, were more likely to have heard about abuse in health care during the last 12 months.

    Conclusions This study suggests that a form of silence reigns over events of abuse in health care that is not randomly distributed over staff. Professional hierarchies and staff’s own experiences of abuse as patients could be considered in the design of interventions to break the silence surrounding patients’ experiences of abuse in health care.

  • 9.
    Brüggemann, Jelmer
    et al.
    Linköpings universitet.
    Wijma, Barbro
    Linköpings universitet.
    Swahnberg, Katarina
    Linköpings universitet.
    Patients’ silence following healthcare staff’s ethical transgressions2012In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 19, no 6, p. 750-763Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to examine to what extent patients remained silent to the health care system after they experienced abusive or wrongful incidents in health care. Female patients visiting a women’s clinic in Sweden (n = 530) answered the Transgressions of Ethical Principles in Health Care Questionnaire (TEP), which was constructed to measure patients’ abusive experiences in the form of staff’s transgressions of ethical principles in health care. Of all the patients, 63.6% had, at some point, experienced staff’s transgressions of ethical principles, and many perceived these events as abusive and wrongful. Of these patients, 70.3% had remained silent to the health care system about at least one transgression. This silence is a loss of essential feedback for the health care system and should not automatically be interpreted as though patients are satisfied.

  • 10.
    Colombini, Manuela
    et al.
    London Sch Hyg & Trop Med, UK.
    Mayhew, Susannah H.
    London Sch Hyg & Trop Med, UK.
    Lund, Ragnhild
    Norwegian Univ Sci & Technol, Norway.
    Singh, Navpreet
    AstraZeneca PLC, UK.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Infanti, Jennifer
    Norwegian Univ Sci & Technol, Norway.
    Schei, Berit
    Norwegian Univ Sci & Technol, Norway.
    Wijewardene, Kumudu
    Univ Sri Jayewardenepura, Sri Lanka.
    Factors shaping political priorities for violence against women-mitigation policies in Sri Lanka2018In: BMC International Health and Human Rights, ISSN 1472-698X, E-ISSN 1472-698X, Vol. 18, article id 22Article in journal (Refereed)
    Abstract [en]

    Background: Although violence against women (VAW) is a global public health issue, its importance as a health issue is often unrecognized in legal and health policy documents. This paper uses Sri Lanka as a case study to explore the factors influencing the national policy response to VAW, particularly by the health sector. Methods: A document based health policy analysis was conducted to examine current policy responses to VAW in Sri Lanka using the Shiffman and Smith (2007) policy analysis framework. Results: The findings suggest that the networks and influences of various actors in Sri Lanka, and their ideas used to frame the issue of VAW, have been particularly important in shaping the nature of the policy response to date. The Ministry of Women and Child Affairs led the national response on VAW, but suffered from limited financial and political support. Results also suggest that there was low engagement by the health sector in the initial policy response to VAW in Sri Lanka, which focused primarily on criminal legislation, following global influences. Furthermore, a lack of empirical data on VAW has impeded its promotion as a health policy issue, despite financial support from international organisations enabling an initial health systems response by the Ministry of Health. Until a legal framework was established (2005), the political context provided limited opportunities for VAW to also be construed as a health issue. It was only then that the Ministry of Health got legitimacy to institutionalise VAW services. Conclusion: Nearly a decade later, a change in government has led to a new national plan on VAW, giving a clear role to the health sector in the fight against VAW. High-level political will, criminalisation of violence, coalesced women's groups advocating for legislative change, prevalence data, and financial support from influential institutions are all critical elements helping frame violence as a national public health issue.

  • 11.
    Dahal, Pranab
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Joshi, Sunil Kumar
    Kathmandu Medical College, Nepal.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    'We are looked down upon and rejected socially': a qualitative study on the experiences of trafficking survivors in Nepal2015In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 8, p. 1-9, article id 29267Article in journal (Refereed)
    Abstract [en]

    Background: The successful reintegration of sexual trafficking survivors into Nepalese society is challenging. This paper aims to explore the trafficking process, abuses faced during sexual slavery, and the challenges faced by women and girl survivors for successful reintegration. Method: This exploratory study used qualitative methods to identify that poverty, illiteracy, lack of opportunities, and varied social stigma initiate the victimization process, and continuity of this vicious circle increases the risk for (re) entrapment. Result: The reasons for sexual trafficking have also become the reasons for restricting survivors from opportunities for growth and mainstreaming. Conclusion: Non-existent support systems, detachment from familial ties, being outcast by society, and an uncertain livelihood make reintegration difficult for survivors.

  • 12.
    Davidsson Simmons, Johanna
    et al.
    Linköpings universitet.
    Benjaminsson, Gabriella
    Linköpings universitet.
    Wijma, Barbro
    Linköpings universitet.
    Swahnberg, Katarina
    Linköpings universitet.
    Association between experiencing rape, police reporting, and self-reported health among women visiting three gynecology clinics in Sweden2009In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 88, no 9, p. 1000-1005Article in journal (Refereed)
    Abstract [en]

    Objective. To describe the frequency of police reporting among rape victims based on two hypotheses: (1) victims of rape more often report poor health than those who have not been victims of any abuse, and (2) victims who report abuse to the police are more likely to state poor self-reported health than those who do not report any abuse. Design. Cross-sectional questionnaire study. Setting. Three Swedish departments of obstetrics and gynecology. Sample. From an original sample of 2,439 women, those who had experienced rape and those who had no history of abuse were included (n = 1,319). Method. Analysis of associations between self-reported poor health, rape, and police reporting among rape victims were assessed by multivariate models adjusted for type of abuse, perpetrator, and sociodemographic factors. Main outcome measures. Odds ratios (ORs) for poor health among rape victims. Results. Rape was seldom reported to the police (23.5%, 44/187). Both hypotheses were confirmed; rape victims more often state poor health than non-abused women (adjusted OR 3.9; 95% confidence interval (CI) 2.4–6.3), and women who had reported abuse to the police stated poor health more often than those who had not reported abuse to the police (adjusted OR 3.0; 95% CI 1.1–8.1). Conclusions. Three of four rape victims had not reported any abuse to the police, and those who had were more likely to report poor health. Rape myths are prevalent in society and affect how victims of sexual abuse are treated both by formal and informal support providers, which in turn may affect the recovery and health of victims. Our results send an urgent message to the current debate on sexual abuse against women: Why do women not report rape to the police?

  • 13. Elmerstig, E.
    et al.
    Wijma, Barbro
    Swahnberg, Katarina
    Hälsouniversitetet, Linköping.
    Why continue to have vaginal intercourse despite pain?: Reasons and associated factors among young Swedish women2011In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 8, no Supplement s3, p. 121-121Article in journal (Other academic)
  • 14. Elmerstig, Eva
    et al.
    Wijma, Barbro
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping Univ, Fac Hlth Sci, Dept Clin & Expt Med, Unit Gender & Med, S-58183 Linköping.
    Prioritizing the partner's enjoyment: a population-based study on young Swedish women with experience of pain during vaginal intercourse2013In: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 34, no 2, p. 82-89Article in journal (Refereed)
    Abstract [en]

    The present study examines the prevalence of women who continue to have vaginal intercourse (VIC) despite pain, avoid telling the partner, and feign enjoyment. It also considers the reasons for this behavior. A sample of 1566 female senior high school students (aged 18-22 years) completed a questionnaire concerning their experiences and attitudes toward their body and sexuality. Forty-seven percent (270/576) of those women who reported pain during VIC continued to have VIC despite the pain. The most common reasons were that they did not want to spoil sex for or hurt the partner by interrupting VIC. Feigning enjoyment and not telling the partner about their pain were reported by 22 and 33%, respectively. Continuing to have VIC despite pain was associated with feelings of being inferior to the partner during sex, dissatisfaction with their own sex lives and feigning enjoyment while having pain. Pain during VIC is reported by every third young Swedish woman, and almost half of those still continue to have VIC. The major reason given is noteworthy - prioritizing the partner's enjoyment before their own - and indicates that young women who continue to have VIC despite pain take a subordinate position in sexual interactions.

  • 15.
    Elmerstig, Eva
    et al.
    Linköpings universitet.
    Wijma, Barbro
    Linköpings universitet.
    Swahnberg, Katarina
    Linköpings universitet.
    Young Swedish women's experience of pain and discomfort during sexual intercourse2009In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 88, no 1, p. 98-103Article in journal (Refereed)
    Abstract [en]

    Objective. To study experience and prevalence of (1) pain related to first sexual intercourse; (2) pain and/or discomfort associated with sexual intercourse during the previous month; and (3) associations between these experiences. Design. Cross-sectional study. Setting. A youth center in southeast Sweden. Sample. Three hundred consecutive women, aged 13–21 (response rate 98%). Method. During a two-month period, women consulting a youth center, participated in a questionnaire study. Main outcome measures. Pain and/or discomfort during sexual intercourse. Results. The majority of the participants, 98%, had had sexual intercourse and of those, 65% reported pain related to first sexual intercourse. Forty-nine percent (99/203) of those who reported sexual intercourse during the previous month had experienced coital pain and/or discomfort during that period, and for almost every second woman (46/99), those experiences constituted a problem. We found no association between experience of pain during first sexual intercourse and pain and/or discomfort during the previous month. Conclusions. Prevalence of pain and/or discomfort associated with sexual intercourse is high among women visiting a youth center. Our results show that coital pain in young women is a problem which needs to be further explored.

  • 16.
    Elmerstig, Eva
    et al.
    Malmö University.
    Wijma, Barbro
    Linköping University.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Being “good in bed”: body concerns, self-perceptions and gender expectations among Swedish heterosexual female and male senior high-school students2017In: Journal of sex & marital therapy, ISSN 0092-623X, E-ISSN 1521-0715, Vol. 43, no 4, p. 326-342Article in journal (Refereed)
    Abstract [en]

    We investigated gender differences regarding body perceptions, self-perceptions, values and expectations in sexual situations, and factors associated with expectations, among Swedish heterosexual female and male high-school students. A total of 2,765 students (aged 18 to 22) completed questionnaires. Women reported lower satisfaction with themselves and their body appearance (p < 0.001), and felt more inferior to their partner (p < 0.001). Men felt more superior to their partner, and felt higher expectations (p < 0.001). Male sex, difficulty saying no to sex, dissatisfaction with the body, feeling inferior or superior to partner, and considering partner's satisfaction as more important, were all associated with feeling expectations during sex.

  • 17. Hilden, Malene
    et al.
    Schei, Berit
    Swahnberg, Katarina
    Hälsouniversitetet, Linköping.
    Halmesmäki, Erja
    Langhoff-Roos, Jens
    Offerdal, Kristin
    Pikarinen, Ulla
    Sidenius, Katrine
    Steingrimsdottir, Tora
    Stoum-Hinsverk, Hildegun
    Wijma, Barbro
    A history of sexual abuse and health: a Nordic multicentre study2004In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 111, no 10, p. 1121-1127Article in journal (Refereed)
    Abstract [en]

    Objectives  To determine if a history of sexual abuse is associated with objective and subjective indicators of health and if certain abusive incidents had a stronger impact on health than others.

    Design  A cross-sectional, multicentre study.

    Setting  Five gynaecological departments in the five Nordic countries.

    Sample  Three thousand five hundred and thirty-nine gynaecology patients.

    Methods  The NorVold Abuse Questionnaire (NorAQ) on abuse history and current health was mailed to all patients who consented to participate.

    Main outcome measures  Reason for index visit at the gynaeocological clinic as well as several questions on health were recorded. General health status was measured as self-estimated health, psychosomatic symptoms (headache, abdominal pain, muscle, weakness, dizziness), number of health care visits and number of periods on sick leave.

    Result  A history of sexual abuse was reported by 20.7% of respondents. A history of sexual abuse was significantly associated with chronic pelvic pain as reason for index visit (P < 0.01), laparoscopic surgery (P < 0.01), psychosomatic symptoms (P < 0.01), self-estimated poor health (P < 0.01), many health care visits (P < 0.01) and high incidence of sick leave (P < 0.01). Several subgroups within the group of sexually abused women were more likely to report poor health: women abused as both children and adults, women who experienced additional emotional and/or physical abuse and women abused by a person they knew.

    Conclusion  Sexual abuse has a profound impact on women's health. Taking a history of sexual abuse seems particularly warranted when the patient presents with chronic pelvic pain or symptoms of a vague and diffuse nature.

  • 18.
    Jonsdottir, Sigridur Sia
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Univ Akureyri, Iceland.
    Steingrimsdottir, Thora
    Landspitali Univ Hosp, Iceland;Univ Iceland, Iceland.
    Thome, Marga
    Univ Iceland, Iceland.
    Oskarsson, Guomundur Kristjan
    Univ Akureyri, Iceland.
    Lydsdottir, Linda Bara
    Univ Iceland, Iceland;VIRK Vocat Rehabil Fund, Iceland.
    Olafsdottir, Halldora
    Landspitali Univ Hosp, Iceland.
    Sigurdsson, Jon Fridrik
    Univ Iceland, Iceland;Landspitali Univ Hosp, Iceland;Reykjav Univ, Iceland.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Pain management and medical interventions during childbirth among perinatal distressed women and women dissatisfied in their partner relationship: A prospective cohort study2019In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 69, p. 1-9Article in journal (Refereed)
    Abstract [en]

    Objective: The purpose of this study was to investigate possible associations between distress in pregnant women and their use of pain management and medical interventions. Furthermore, we assessed the effects of reported dissatisfaction in relationship with their partner, or weak social support. Design: This was a prospective cohort study. Setting: Women were invited to participate while attending prenatal care at participating Icelandic health care centres. Birth outcome data were obtained from the hospitals where these women gave birth. Participants: Women in this study participated in a research project where 2523 women were screened three times during pregnancy for anxiety and depression. Women who had positive results at screening were invited to a semi-structured interview during pregnancy as well as every fourth woman who had negative results. Five hundred and sixty-two women participated in the interviews and the final sample was 442 women. Measurements: Distress was defined as symptoms of anxiety, stress and depression. The Edinburgh Post-partum Depression Scale (EPDS) and the Depression, Anxiety and Stress Scales (DASS) were used for screening purposes. During the interview, the women answered the Dyadic Adjustment Scale (DAS), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Adverse Experienced Interview (AEI). The main outcome variables that were obtained from the women's childbirth records were: (1) use of pain management, categorized as: epidural analgesia, non-pharmacological pain management, nitrous oxide, pharmacological medication, or no pain management; (2) medical interventions categorized as: induction, stimulation, and episiotomy; and (3) mode of childbirth. A logistic regression analysis, adjusted for significant covariates, was conducted. Findings: A significant association was found between perinatal distress at 16 weeks gestation and use of epidural as single pain management. Overall, distressed women were 2.6 times more likely than non-distressed women to use epidural as a single pain management. They were also less likely to go through childbirth without use of any pain management method. Women who were dissatisfied in their relationship were significantly more likely to undergo induction of childbirth, an episiotomy and/or a vacuum extraction than those who were satisfied in their relationship, regardless if they were distressed or not. No association was found between social support and the outcome variables. Key conclusions: Women with perinatal distress were more likely to use an epidural than non-distressed women. The use of an epidural might help them manage pain and uncertainties related to childbirth. Women who were dissatisfied in their partner relationship may be more likely to undergo induction of childbirth, episiotomy and/or vacuum extraction. Implication for practice: Midwives need to acknowledge the possible association of distress and use of an epidural during childbirth and screen for distress early in pregnancy. It is important to offer counselling and help during pregnancy for expectant parents who are distressed or dissatisfied in their relationship. (C) 2018 Elsevier Ltd. All rights reserved.

  • 19.
    Jonsdottir, Sigridur Sia
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. University of Akureyri, Iceland.
    Thome, Marga
    University of Iceland, Iceland.
    Steingrimsdottir, Thora
    Landspitali University Hospital, Iceland ; University of Iceland, Iceland.
    Lydsdottir, Linda Bara
    University of Iceland, Iceland.
    Sigurdsson, Jon Fridrik
    University of Iceland, Iceland ; Landspitali University Hospital, Iceland ; Reykjavik University, Iceland.
    Olafsdottir, Halldora
    Landspitali University Hospital, Iceland.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Partner relationship, social support and perinatal distress among pregnant Icelandic women2017In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 30, no 1, p. e46-e55Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: It is inferred that perinatal distress has adverse effects on the prospective mother and the health of the foetus/infant. More knowledge is needed to identify which symptoms of perinatal distress should be assessed during pregnancy and to shed light on the impact of women's satisfaction with their partner relationship on perinatal distress.

    AIM: The current study aimed to generate knowledge about the association of the partner relationship and social support when women are dealing with perinatal distress expressed by symptoms of depression, anxiety and stress.

    METHODS: A structured interview was conducted with 562 Icelandic women who were screened three times during pregnancy with the Edinburgh Depression Scale and the Depression, Anxiety, Stress Scale. Of these, 360 had symptoms of distress and 202 belonged to a non-distress group. The women answered the Multidimensional Scale of Perceived Social Support and the Dyadic Adjustment Scale. The study had a multicentre prospective design allowing for exploration of association with perinatal distress.

    FINDINGS: Women who were dissatisfied in their partner relationship were four times more likely to experience perinatal distress. Women with perinatal distress scored highest on the DASS Stress Subscale and the second highest scores were found on the Anxiety Subscale.

    CONCLUSION: Satisfaction in partner relationship is related to perinatal distress and needs to be assessed when health care professionals take care of distressed pregnant women, her partner and her family. Assessment of stress and anxiety should be included in the evaluation of perinatal distress, along with symptoms of depression.

  • 20. Josephson, Agneta
    Praktisk kunskap i att förhindra kränkningar. Rapport om dramapedagogiskt arbete med vårdpersonal.2011Report (Other academic)
  • 21.
    Joshi, Sunil Kumar
    et al.
    Kathmandu Medical College.
    Kharel, Jagannath
    Suwal, Bhim
    Wijma, Barbro
    Linköpings universitet.
    Swahnberg, Katarina
    Linköpings universitet.
    I have been to hell: rescued Nepalese girls and women’s experiences of trafficking to brothels in India2012In: GEXcel work in progress report volume XII: getting rid of violence : TRANSdiciplinary, TRANSnational and TRANSformative feminist dialogues on embodiment, emotions and ethics: GEXcel theme 7: Getting rid of violence, autumn 2010 / [ed] Barbro Wijma, Alp Biricik and Ulrica Engdahl, Linköping: Institute of Thematic Gender Studies, Department of Gender Studies, Linköping University , 2012, 1, p. 101-115Chapter in book (Other academic)
    Abstract [en]

    The interview study described in this chapter was performed in cooperation with two Nepalese non government organizations called Community Action Nepal (CAC Nepal) and Shakti Samuha. Informants were eight trafficking survivors who were independently living in various parts of Kathmandu Valley and six trafficking survivors who were currently staying at a rehabilitation centre. After being rescued, five of the informants now earned their living as prostitutes, one was a housewife, one had her own shop, and five were at a rehab centre. Most of the informants had been tricked into being trafficked. The most commonly used bait was a nice job in Kathmandu or abroad with a good salary, which would allow the informant to buy 'nice clothes' and eat 'good food'. To this need to be added that the migration decision of the informants (which turns out to be trafficking) takes place in an interface between economic hardships, the informant’s own desire for better work and a better life, and pressure on her to assist sustaining her family.The trafficker was most often a known person, male or female, who had spent time and efforts in building a good relationship with the informant before taking off for the ‘good job’. Life at the brothel was described as a prison, where the informants instantly and at any time of the day and night had to obey the brothel owner (who often was a woman, and sometimes Nepalese), and her 'guards' (male or female). If they refused or did not act accordingly they were severely punished often by physical means. The informant’s life was reduced into one purpose ‘how to satisfy brothel’s customers’. The owners of the brothels were usually sitting at the main entrance and other guards were always around. The doors were always locked when the informants had some time off. Most informants had not been allowed to leave the house, and a few of them did not understand where they were until they later on could ask someone.The relief of finally returning home to Nepal was often clouded by difficulties. Only one of the informants could go directly back home to her family. She was well accepted by her husband and in-laws, but she had to face a lot of resistance from other community members. Later on she decided to leave her husband, as she realized that he was also to blame for her being trafficked.The informants revealed that their experiences while being trafficked were usually kept a secret during and after trafficking. According to several studies, the trauma of having been trafficked is often complicated by societal refusal upon return from the brothels. Survivors know who the traffickers are, but their reputation for cruelty and the failure of the police and legal system to enforce the law, contribute to creating an attitude that there is no point in making official reports.A puzzling fact is finally presented: during the last two decades Nepal has made great improvements in designing anti-trafficking programmes and implementing new anti-trafficking laws. Yet, trafficking seems to have become an increasing problem in Nepal during the same period. This poses an urgent challenge on both researchers and society.

  • 22.
    Joshi, Sunil Kumar
    et al.
    Kathmandu Medical College.
    Swahnberg, Katarina
    Linköpings universitet.
    Trafficking of women and girls from Nepal to India for prostitution: what is known about its history, nurturing factors, health effects and prevention?2012In: GEXcel work in progress report volume XII: getting rid of violence : TRANSdiciplinary, TRANSnational and TRANSformative feminist dialogues on embodiment, emotions and ethics: GEXcel theme 7: getting rid of violence, autumn 2010 / [ed] Barbro Wijma, Alp Biricik and Ulrica Engdahl, Linköping: Institute of Thematic Gender Studies, Department of Gender Studies, Linköping University , 2012, 1, p. 89-99Chapter in book (Other academic)
  • 23.
    Karim, K.M. Rabiul
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. University of Rajshahi, Bangladesh.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Does female authority prevent male marital violence?: Evidence from rural Bangladesh2019In: Journal of Interpersonal Violence, ISSN 0886-2605, E-ISSN 1552-6518, article id 886260518801023Article in journal (Refereed)
    Abstract [en]

    While relative resource status between husband and wife is widely discussed in the explanation of male marital violence (MMV) behaviors, the influence of relative family authority between husband and wife on the violence has been generally overlooked in previous studies. An examination can provide a better understanding of the issue. This study examined how various levels of female authority within the family are associated with MMV against women in rural Bangladesh. The study adopted a cross-sectional design and included 342 married men randomly selected from five northwest villages. Negative binomial regression was performed to predict the frequency of self-reported MMV behaviors in a 1-year recall period which estimated the ratios comparing absolute male authority to egalitarian authority within the family. Of the sample, 37.4% were the egalitarian/fair female authority, 41.2% were the higher male authority, and 21.4% were absolute male authority families; 71.1% of the men revealed that they had resorted to at least one incident of MMV (psychological or physical or sexual) against their wives in the year preceding the survey. The mean of yearly MMV occurrences was 6.29 ( SD = 7.58), ranging from 0 to 42. The study revealed that the frequency of MMV against women was 1.96 times higher among absolute male authority families than in egalitarian families. It further revealed that the frequency of psychological abuse was 1.63 times, physical attack 2.89 times, and sexual coercion 1.88 times higher among absolute male authority families than among egalitarian/fair female authority families. Higher male authority did not appear to be different from egalitarian authority in MMV occurrences. The study suggests that increased female authority within the family unit may prevent women from being exposed to MMV in a patriarchal social order.

  • 24. Leander, Karen
    et al.
    Berlin, M
    Danielsson, M
    Eriksson, A
    Gillander Gådin, K
    Hensing, G
    Krantz, G
    Swahnberg, Katarina
    Hälsouniversitetet, Linköping.
    Våld2009In: Fokhälsorapporten 2009 / [ed] Maria Danielsson, Stockholm: Socialstyrelsen , 2009, p. 339-367Chapter in book (Refereed)
  • 25.
    Leander, Karen
    et al.
    karolinska Institutet.
    Berlin, Marie
    Eriksson, Annika
    Gillander Gådin, Katja
    Göteborgs universitet.
    Hensing, Gunnel
    Göteborgs universitet.
    Krantz, Gunilla
    Göteborgs universitet.
    Swahnberg, Katarina
    Hälsouniversitetet, Linköping.
    Danielsson, Maria
    Violence: Health in Sweden: The National Public Health Report 2012. Chapter 122012In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, no 9 suppl, p. 229-254Article in journal (Refereed)
    Abstract [en]

    In Sweden and in other countries, it has become increasingly common to view violence from a public health perspective. This chapter presents a description of interpersonal violence with an emphasis on violence in close relations, particularly in partner relationships.

    According to the Swedish Crime Survey 2010, approximately one in ten inhabitants was exposed to violence, threats or harassment of some kind in 2009. Young people and single mothers with small children are particularly vulnerable to violence. According to Statistics Sweden’s ULF surveys (Survey on Living Conditions) for 2004–2005, 17 per cent of men and 12 per cent of women aged 16–24 years reported having been subjected to violence or serious threats at some time in the previous 12 months.

    Boys and men are more frequently subjected to lethal violence and to violence resulting in hospitalisation than girls and women. Similarly, men also make up a majority of the victims of assaults reported to the police. On the other hand, domestic violence and work-related violence more often involve women than men, and sexual violence is chiefly directed at girls and women. Most women and children who are subjected to assault are acquainted with the perpetrator, while this only applies to a minority of male victims. Women are four to five times as likely to be killed by a partner as men. Partner assaults against women, rapes, and gross violations of a woman’s integrity account for a fifth of all reported crimes of violence (against women and men combined).

    Violence in partner relationships has significant consequences for physical and mental health; between 12,000 and 14,000 women seek outpatient care each year as a result of violence committed by a partner. Violence can also have serious social repercussions: isolation, financial difficulties, sick leave from work, unemployment, etc., and women subjected to this 

  • 26.
    Moellerberg, Marie-Louise
    et al.
    Skåne University Hospital, Sweden.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council, Sweden.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Benzein, Eva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Family sense of coherence and its associations with hope, anxiety and symptoms of depression in persons with cancer in palliative phase and their family members: A cross-sectional study2019In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030XArticle in journal (Refereed)
    Abstract [en]

    Background: There is evidence indicating that family sense of coherence predicts quality of family life and promotes family well-being. In families living with the palliative phase of cancer, low hope, anxiety and symptoms of depression are common in both persons with cancer and their family members. Aim: To determine whether family sense of coherence was associated with hope, anxiety and symptoms of depression, respectively, in persons with cancer in the palliative phase and their family members. Design: An observational, cross-sectional, multicentre study was conducted. Nested linear regression analyses were performed in two blocks to determine whether family sense of coherence was associated with hope, anxiety and symptoms of depression. Setting/participants: Persons with cancer (n = 179) and their family members (n = 165) were recruited from two oncology clinics and two palliative centres in three regions in Sweden. Results: The main findings showed that family sense of coherence was significantly and independently associated with hope, anxiety and symptoms of depression. Stronger family sense of coherence was associated with higher hope and lower anxiety and symptoms of depression levels in both persons with cancer and their family members. Conclusion: Health care providers should strive to identify families with weak family sense of coherence, because of its associations with hope, anxiety and symptoms of depression, in order to offer them professional support and thereby achieve increased well-being during the palliative phase of cancer. Future studies should expand our knowledge of family sense of coherence and how to identify families at risk of lower levels of well-being.

  • 27.
    Muzrif, Munas M.
    et al.
    Univ Sri Jayawardenapura, Sri Lanka.
    Perera, Dinusha
    Univ Sri Jayawardenapura, Sri Lanka.
    Wijewardena, Kumudu
    Univ Sri Jayawardenapura, Sri Lanka.
    Schei, Berit
    Norwegian Univ Sci & Technol NTNU, Norway;Trondheim Reg & Univ Hosp, Norway.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Domestic violence: a cross-sectional study among pregnant women in different regions of Sri Lanka2018In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 2, article id e017745Article in journal (Refereed)
    Abstract [en]

    Objectives The aims of this study were to assess the regional differences in domestic violence among pregnant women in the capital district and in the tea plantation sector of Sri Lanka, to explore potential contributory factors and to assess whether healthcare workers addressed domestic violence and disclosure among survivors. Design A cross-sectional study was carried out using interviewer-administered Abuse Assessment Screen. Setting Fifty-seven antenatal clinic centres in the capital district and 30 in the tea plantation sector. Participants Pregnant women between 6 and 40 weeks of gestational age. In the capital district, 1375 women were recruited from antenatal clinic centres in the urban (n= 25) and in the rural areas (n= 32), and 800 women from 30 centres in the tea plantation sector. The response rate in the capital district was 95.6% and 96.7% in the tea plantation sector. Results Among the total sample of pregnant women (n= 2088), the prevalence of 'ever abused' was 38.6%, and the prevalence of 'currently abused' was 15.9%. 'Ever abused' (31.5% vs 50.8%) and 'currently abused' (10% vs 25.8%) were significantly higher (P< 0.001) among the women living in the tea plantation sector. 'Ever abused' was associated with living in the tea plantation sector, being employed, living far from gender-based violence care centre and of Muslim ethnicity, after adjusting for age, education and family income. Only 38.8% of all participants had been asked by healthcare workers about abuse. Living in the tea plantation sector and lower level of education were associated with not being asked. Among those who reported 'ever abused', only 8.7% had disclosed the experience to a healthcare worker. Conclusion Domestic violence was prevalent and highest among women in the tea plantation sector compared with the capital district. The capacity of healthcare workers in addressing domestic violence should be increased.

  • 28.
    Möllerberg, Marie-Louise
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Sandgren, Anna
    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.
    Benzein, Eva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Familial interaction patterns during the palliative phase of a family member living with cancer2017In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 72, p. S162-S162Article in journal (Other academic)
  • 29.
    Möllerberg, Marie-Louise
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Sandgren, Anna
    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.
    Benzein, Eva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Familial Interaction Patterns During the Palliative Phase of a Family Member Living With Cancer2017In: Journal of Hospice and Palliative Nursing, ISSN 1522-2179, E-ISSN 1539-0705, Vol. 19, no 1, p. 67-74Article in journal (Refereed)
    Abstract [en]

    This study aimed to illuminate aspects of familial interactions when 1 member is in the palliative phase of his/her cancer course. An individual cancer diagnosis influences the entire family, often requiring daily life changes for all members. Current research has examined individual family member perspectives; family system nursing studies are warranted. Narrative family interviews were conducted on 13 families living with cancer. The interviews were transcribed and analyzed according to a hermeneutic method. Analyses revealed the following: Family interaction patterns were adjusted in response to changes in family life, which encompassed 3 different, but interrelated, patterns: (1) power dynamics in the family, (2) the "secret game" in the family, and (3) multifaceted closeness and distance in the family. It is crucial to adopt a family perspective during palliative care to meet each unique family's needs. Health care facilitators should be aware of the complex dynamics and challenges that these families encounter. This will help obtain a greater understanding of factors underlying effective palliative care.

  • 30.
    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.

  • 31.
    Pahlm, Jessika
    et al.
    Linköping University, Sweden.
    Svensson, Johan
    Linköping University, Sweden.
    Joshi, Sunil Kumar
    Kathmandu Medical College, Nepal.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Physical activity and diet among adolescents of Kathmandu, Nepal: knowledge and attitudes2013In: Journal of Kathmandu Medical College, ISSN 2091-1785, Vol. 2, no 2, p. 51-58Article in journal (Refereed)
    Abstract [en]

    Background: Non-communicable diseases are becoming more prevalent in Nepal and many risk factors attributing to these diseases are behaviour-related and therefore preventable.

    Objective: The aim of this study was to investigate the attitudes among students of grade eight and nine in Kathmandu toward physical activity and diet and their knowledge about how it affects their health.

    Methods: We conducted four focus groups that included 24 students to explore knowledge and attitudes toward physical activity among them. Focus groups were recorded and transcribed verbatim later. Method described by K. Malterud, inspired by Giorgi’s phenomenological method was used to analyze the transcribed material.

    Results: Participants considered physical activity to be benefi cial for health in many ways. They also believed that healthy food is important to avoid diseases. Several participants mentioned that a balanced lifestyle is essential for a healthy life.

    Conclusion: Though the students saw the importance of physical activity and a healthy diet to avoid diseases and stay healthy, most of them did not connect a lack of physical activity and unhealthy diet to possible noncommunicable diseases in the future.

  • 32.
    Perera, Dinusha
    et al.
    Univ Sri Jayewardenepura, Sri Lanka.
    Lund, Ragnhild
    Norwegian Univ Sci & Technol, Norway.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Schei, Berit
    Norwegian Univ Sci & Technol, Norway.
    Infanti, Jennifer J.
    Norwegian Univ Sci & Technol, Norway.
    'When helpers hurt': women's and midwives' stories of obstetric violence in state health institutions, Colombo district, Sri Lanka2018In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 18, article id 211Article in journal (Refereed)
    Abstract [en]

    Background: The paper explores how age, social position or class, and linguistic and cultural background intersect and place women in varying positions of control and vulnerability to obstetric violence in state health institutions in Colombo district, Sri Lanka. Obstetric violence occurs during pregnancy, childbirth and the immediate postpartum period; hence, it is violence that directly affects women. The authors aim to break the traditional culture of silence around obstetric violence and bring attention to the resulting implications for quality of care and patient trust in obstetric care facilities or providers. Methods: Five focus group discussions were held with 28 public health midwives who had prior experience working in labor rooms. Six focus group discussions were held with 38 pregnant women with previous childbirth experience. Additionally, 10 of the 38 women, whom felt they had experienced excessive pain, fear, humiliation, and/or loss of dignity as patients in labor, participated in individual in-depth interviews. An intersectional framework was used to group the qualitative data into categories and themes for analysis. Results: Obstetric violence appears to intersect with systems of power and oppression linked to structural gender, social, linguistic and cultural inequities in Sri Lanka. In our dataset, younger women, poorer women, and women who did not speak Sinhala seemed to experience more obstetric violence than those with relevant social connections and better economic positions. The women in our study rarely reported obstetric violence to legal or institutional authorities, nor within their informal social support networks. Instead, they sought obstetric care, particularly for childbirth, in other state hospitals in subsequent pregnancies. Conclusions: The quality of obstetric care in Sri Lanka needs improvement. Amongst other initiatives, policies and practices are required to sensitize health providers about the existence of obstetric violence, and repercussions are required for abusive or discriminatory practices. The ethics of care should be further reinforced in the professional training of obstetric health providers.

  • 33.
    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.

  • 34. Pikarinen, Ulla
    et al.
    Saisto, Terhi
    Schei, Berit
    Swahnberg, Katarina
    Linköpings universitet.
    Halmesmäki, Erja
    Experiences of physical and sexual abuse and their implications for current health2007In: Obstetrics and Gynecology, ISSN 0029-7844, E-ISSN 1873-233X, Vol. 109, no 5, p. 1116-1122Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To estimate the prevalence of a history of physical and sexual abuse in adulthood among gynecological patients and the association with general and reproductive health.

    METHODS: A cross-sectional questionnaire study on abusive experiences of gynecologic outpatients in a tertiary hospital. The total sample size was 691.

    RESULTS: Of all women, 42.4% had experienced moderate or severe physical or sexual abuse as an adult. One hundred forty-seven (21.6%) women reported physical abuse, 84 (12.3%) sexual abuse, and 58 (8.5%) both. The abused and nonabused women did not differ in mean age, education, or parity. Sexually abused women and those who were both sexually and physically abused reported poor general health significantly more often (P=.005 andP=.001, respectively) than the nonabused. They also rated their sex life as significantly worse than the nonabused women (P=.002 and P=.012, respectively). Over half of abused women had experienced common physical complaints during the previous 12 months compared with one third of the nonabused (P<.001). Two thirds of both the abused and the nonabused women preferred that their gynecologist not ask directly about abuse.

    CONCLUSION: Abusive experiences were common in gynecologic outpatients. Women with abusive experiences had ill health and poor sexual life more often than the controls. In contrast to the results of previous studies, most of the women did not want to be asked about abuse by their gynecologist.

    LEVEL OF EVIDENCE: II

  • 35.
    Pun, Kunta Devi
    et al.
    Norwegian Univ Sci & Technol, Norway;Kathmandu Univ, Nepal.
    Rishal, Poonam
    Norwegian Univ Sci & Technol, Norway;Kathmandu Med Coll & Teaching Hosp, Nepal.
    Darj, Elisabeth
    Norwegian Univ Sci & Technol, Norway;St Olays Univ Hosp, Norway;Uppsala University, Sweden.
    Infanti, Jennifer Jean
    Norwegian Univ Sci & Technol, Norway.
    Shrestha, Shrinkhala
    Kathmandu Univ, Nepal.
    Lukasse, Mirjam
    Oslo Metropolitan Univ, Norway;Univ Southeast Norway, Norway.
    Schei, Berit
    Norwegian Univ Sci & Technol, Norway;St Olays Univ Hosp, Norway.
    Lund, Ragnhild
    Norwegian University of Science and Technology, Norway.
    Koju, Rajendra
    Kathmandu Univ, Nepal.
    Joshi, Sunil Kumar
    Kathmandu Univ, Nepal.
    Wijewardene, Kumudu
    Univ Sri Jayewardenepura, Sri Lanka.
    Perera, Dinusha Chamanie
    Univ Sri Jayewardenepura, Sri Lanka.
    Muzrif, Munas M.
    Univ Sri Jayewardenepura, Sri Lanka.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Campbell, Jacquelyn C.
    Johns Hopkins Univ, USA.
    Domestic violence and perinatal outcomes - a prospective cohort study from Nepal2019In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, article id 671Article in journal (Refereed)
    Abstract [en]

    Background: Domestic violence is one of the most common forms of violence against women. Domestic violence during pregnancy is associated with adverse perinatal and maternal outcomes. We aimed to assess whether domestic violence was associated with mode of delivery, low birthweight and preterm birth in two sites in Nepal. Methods: In this prospective cohort study we consecutively recruited 2004 pregnant women during antenatal care at two hospitals between June 2015 and September 2016. The Abuse Assessment Screen (modified) was used to assess fear and violence. Having ever experienced either fear or violence was defined as any domestic violence. Obstetric outcomes were obtained from hospital records for 1381 (69%) women, selecting singleton pregnancies only. Mode of delivery was assessed as birth by cesarean section or not. A birthweight of less than 2500g was defined as low birthweight and preterm birth as birth before completion of 37weeks gestation. Descriptive and multiple logistic regression analyses were performed to assess associations. Results: Twenty percent of the women reported any domestic violence. Among all 1381 women, 37.6% gave birth by cesarean section. Of those women who delivered by cesarean section, 84.7% had an emergency cesarean section. Less than 10% of the babies were born prematurely and 13.5% were born with low birthweight. We found no significant association between exposure to any domestic violence during pregnancy and risk of a low birthweight baby or birth by cesarean section. However, having experienced both violence and fear was significantly associated with giving birth to a preterm infant [aOR 2.33 (95% CI;1.10-4.73)]. Conclusions: Domestic violence is common in Nepal. This is a potential risk factor for severe morbidity and mortality in newborns. We found that the risk of having a preterm baby was higher for pregnant women who experienced both fear and violence. This should be recognized by the health sector. In this study, no significant differences were found in the rate of cesarean section nor low birthweight for women who had experienced any domestic violence compared to those who did not.

  • 36.
    Rask, Marie
    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.
    Lindell, G.
    Karolinska Institutet;Kalmar County Hospital.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Women with abnormal Pap smear result: a qualitative study of Swedish healthcare professionals' experiences2016In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 25, no 6, p. 980-991Article in journal (Refereed)
    Abstract [en]

    A Papanicolaou (Pap) smear can be used to detect pre-cancerous cellular changes, so that they can be treated before they develop into cervical cancer. When the results of a Pap smear test are abnormal, women need further investigation, treatment and follow-up. Healthcare professionals (HCPs) are in a position to care for these women with abnormalities. The aim of this study was to explore the experiences of HCPs in caring for women with abnormal Pap smear results. In total, 20 HCPs from two counties in south-eastern Sweden participated in individual interviews, based on two open-ended questions. Interviews were recorded, transcribed verbatim and analysed using content analysis. The results showed that HCPs experienced that abnormal Pap smear results created anxiety in women, who often sought information from the Internet as a way to cope. Furthermore, the HCPs thought that it was a problem that women chose not to attend investigation, treatment and follow-ups. However, information about the seriousness of abnormal Pap smear results causes women to participate. It is a challenge for HCPs to inform in a reassuring manner. Finally, HCPs should collaborate with women to meet their information needs and to also provide support regarding finding and filtering reliable information on the Internet.

  • 37.
    Rask, Marie
    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.
    Ludwig, Neil
    FACITtrans, USA.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    The Swedish translation and cross-cultural adaptation of the Functional Assessment of Chronic Illness Therapy – Cervical Dysplasia (FACIT-CD): linguistic validity and reliability of the Swedish version2017In: BMC Women's Health, ISSN 1472-6874, E-ISSN 1472-6874, Vol. 17, no 1, p. 1-10, article id 24Article in journal (Refereed)
    Abstract [en]

    Background

    Cervical dysplasia is a precancerous condition, which has been shown to create anxiety in women. To be able to investigate these women’s health-related quality of life, a disease-specific instrument is required. There does not seem to be a Swedish version of an instrument to screen for this specific disease. Therefore, this study aims to translate and cross-culturally adapt the Functional Assessment of Chronic Illness Therapy – Cervical Dysplasia (FACIT-CD) into a Swedish context and evaluate its linguistic validity and reliability.

    Methods

    The Functional Assessment of Chronic Illness Therapy (FACIT) translation methodology was used, which consists of several steps including pilot testing of the FACIT-CD instrument through cognitive debriefing interviews. Ten women diagnosed with cervical dysplasia participated in the cognitive debriefing interviews. The internal consistency reliability of the Swedish FACIT-CD was estimated by Cronbach’s alpha coefficient. Homogeneity of the items was evaluated by corrected item-total correlations. The sample consists of 34 women who were diagnosed with cervical dysplasia.

    Results

    The translation and cross-cultural adaptation went smoothly without any problems for the majority of the items. The cognitive debriefing interviews indicated that the Swedish FACIT-CD consists of relevant items, is easy to understand and complete, and has unambiguous and comprehensive response categories. The translation and cross-cultural adaptation resulted in a Swedish FACIT-CD, which is conceptually and semantically equivalent to the English version and linguistically valid. The total scale of the Swedish FACIT-CD exhibited good internal consistency reliability with a Cronbach’s alpha coefficient of 0.84, and all of the subscales exhibited acceptable value between 0.71 and 0.81 except the Relationships subscale, which had a value of 0.67. Finally, all but four items exceeded the acceptable level for the corrected item-total correlations of ≥ 0.20.

    Conclusions

    The Swedish FACIT-CD is conceptually and semantically equivalent to the English version and linguistically valid; further, it exhibits good internal consistency reliability.

  • 38.
    Rask, Marie
    et al.
    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.
    Lindell, Gunnel
    Karolinska Institutet ; Kalmar County Hospital.
    Oscarsson, Marie
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Women's experiences of abnormal Pap smear results: a qualitative study2017In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 12, p. 3-8Article in journal (Refereed)
    Abstract [en]

    Objectives

    To describe women’s experiences of abnormal Pap smear result.

    Methods

    Ten women were recruited from a women’s health clinic. Qualitative interviews based on six open-ended questions were conducted, transcribed verbatim, and analyzed by content analysis.

    Results

    The women believed that their abnormal Pap smear result was indicative of having cancer. This created anxiety in the women, which resulted in the need for emotional support and information. Testing positive with human papillomavirus (HPV) also meant consequences for the relatives as well as concerns about the sexually transmitted nature of the virus. Finally, the women had a need to be treated with respect by the healthcare professionals in order to reduce feelings of being abused.

    Conclusions

    In general, women have a low level of awareness of HPV and its relation to abnormal Pap smear results. Women who receive abnormal Pap smear results need oral information, based on the individual women’s situation, and delivered at the time the women receive the test result. It is also essential that a good emotional contact be established between the women and the healthcare professionals.

  • 39.
    Rask, Marie
    et al.
    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.
    Lindell, Gunnel
    Karolinska Institutet.
    Oscarsson, Marie
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Women's experiences of an abnormal Pap smear result: a qualitative study2016Conference paper (Refereed)
  • 40.
    Rask, Marie
    et al.
    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.
    Notification of an abnormal Pap smear: an intervention study2019In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 28, no 2, p. 1-7, article id e12969Article in journal (Refereed)
    Abstract [en]

    This study aims to assess whether notification of an abnormal Pap smear result via a phone call, delivered by a trained healthcare provider, has an effect on women's HRQoL, coping and awareness of HPV. For this intervention study, women were consecutively recruited from a women's health clinic in Sweden. Women in the intervention group (n = 113) were notified of their Pap smear result via a phone call by a trained healthcare provider, while those in the comparison group (n = 122) were notified via a standard letter. A questionnaire was used to collect data. The results found no significant differences between the groups for HRQoL. However, 42.5% ofwomen in the intervention group versus 48.3% in the comparison group reported anxiety. Women in the intervention group were more satisfied with the manner in which they were notified of their abnormal result than those in the comparison group (92.0% vs. 67.2%; p < 0.001), more aware of HPV (71% vs. 50%; p = 0.001), and called healthcare services less often (10.6% vs. 18.0%; p = 0.113), no significance. In conclusion, notification of an abnormal Pap smear result via a phone call does not increase women's HRQoL or reduce their anxiety.

  • 41.
    Rask, Marie
    et al.
    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.
    Swedish women's awareness of human papillomavirus, and health-related quality of life, anxiety and depression after a notification of an abnormal Pap smear result : a cross-sectional study2019In: European Journal of Cancer Prevention, ISSN 0959-8278, E-ISSN 1473-5709, Vol. 28, no 2, p. 96-101Article in journal (Refereed)
    Abstract [en]

    This study aims to assess (a) women's awareness of the human papillomavirus (HPV), (b) women's health-related quality of life (HRQoL) and levels of anxiety and depression symptoms, and (c) to compare the outcomes between women who are aware of the sexually transmitted nature of the HPV infection and women who are not. Swedish women who have been notified of an abnormal Pap smear result completed a questionnaire. This questionnaire consisted of sociodemographic characteristics, items on awareness of HPV, and how to cope with the Pap smear result and the instruments: the Functional Assessment of Chronic Illness Therapy - Cervical Dysplasia and the Hospital Anxiety and Depression Scale (HADS). Data were analyzed using descriptive statistics, Student's t-test, χ-tests, Fisher's exact test, the Mann-Whitney U-test, and Fisher-Freeman-Halton exact test. In total, 122 women participated. The women reported a median (quartile 1-quartile 3) score of 87.6 on the Functional Assessment of Chronic Illness Therapy - Cervical Dysplasia (81.8-107.0), compatible with a good HRQoL. The median (quartile 1-quartile 3) scores on HADS-anxiety and HADS-depression were 7.0 (4.0-10.0) and 3.0 (1.0-5.3), respectively; however, 48.4% of the women reported anxiety (compared with 20% in a normal population). There were no statistically significant differences in the median scores in any of the scales, including the prevalence of distress between the subgroups. Women with abnormal Pap smear results have a good HRQoL; they can become anxious, but not depressed. Awareness of HPV as a sexually transmitted infection is low, but being aware does not impact on women's HRQoL or on anxiety and depression.

  • 42.
    Rishal, Poonam
    et al.
    Norwegian University of Science and Technology (NTNU), Norway;Kathmandu Medical College Teaching Hospital, Nepal.
    Devi Pun, Kunta
    Norwegian University of Science and Technology (NTNU), Norway;Kathmandu University, Nepal.
    Darj, Elisabeth
    Norwegian University of Science and Technology (NTNU), Norway;St. Olav's University Hospital;Uppsala University.
    Joshi, Sunil Kumar
    Kathmandu Medical College Teaching Hospital, Nepal.
    Bjorngaard, Johan Håkon
    Norwegian University of Science and Technology (NTNU), Norway;St. Olav's University Hospital.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Schei, Berit
    Norwegian University of Science and Technology (NTNU), Norway;St. Olav's University Hospital.
    Lukasse, Mirjam
    Oslo and Akershus University College, Norway;University College of Southeast Norway, Norway.
    Prevalence and associated factors of domestic violence among pregnant women attending routine antenatal care in Nepal.2018In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 46, no 8, p. 785-793Article in journal (Refereed)
    Abstract [en]

    Aims: The primary aim of this study was to assess the prevalence of domestic violence (DV) and its associated factors among pregnant women in Nepal. The secondary aims were to investigate disclosure of DV by women to health-care personnel and to assess whether health-care personnel had asked women about their experience of DV. Methods: This cross-sectional study included 2004 pregnant women between 12 and 28 weeks of gestation attending routine antenatal care at two hospitals in Nepal from August 2014 to November 2015. In this study, DV was defined as fear of a family member and/or an experience of physical, emotional or sexual violence. Associated risk factors were analysed using logistic regression analyses. Results: Twenty-one per cent of the women had experienced DV; 12.5% experienced fear only, 3.6% violence only and 4.9% experienced both violence and fear. Less than 2% per cent reported physical violence during pregnancy. This study found that just 17.7% had ever been asked by health-care personnel about DV, and of the women who had reported DV, only 9.5% had disclosed their experience to health-care personnel. Women of young age and low socio-economic status were more likely to have experienced DV. Women who reported having their own income and the autonomy to use it were at significantly lower risk of DV compared to women with no income. Conclusions: A substantial proportion of women reported having experienced DV. Victims had rarely disclosed their experience of DV to health-care personnel. This study underlines the importance of integrating systematic assessment of DV in antenatal care.

  • 43.
    Rishal, Poonam
    et al.
    Norwegian Univ Sci & Technol, Norway.
    Joshi, Sunil Kumar
    Kathmandu Med Coll, Nepal.
    Lukasse, Mirjam
    Oslo & Akershus Univ, Norway.
    Schei, Berit
    Norwegian Univ Sci & Technol, Norway ; Univ Trondheim Hosp, St Olavs Hosp, Norway.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    'They just walk away' - women's perception of being silenced by antenatal health workers: a qualitative study on women survivors of domestic violence in Nepal2016In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 9, p. 1-10, article id 31838Article in journal (Refereed)
    Abstract [en]

    Background: Domestic violence during pregnancy has detrimental effects on the health of the mother and the newborn. Antenatal care provides a 'window of opportunity' to identify and assist victims of domestic violence during pregnancy. Little is known about the experience, needs, and expectations from the women's perspective in relation to domestic violence in Nepal. Objective: Our study aims to explore how women who have experienced domestic violence evaluate their antenatal care and their expectations and needs from health centers. Design: Twelve in-depth interviewswere conducted among women who had experienced domestic violence during pregnancy and utilized antenatal care. The women were recruited from two different organizations in Nepal. Results: Women in our study concealed their experience of domestic violence due to fear of being insulted, discriminated, and negative attitudes of the health care providers. The women wished that the health care providers were compassionate and asked them about their experience, ensured confidentiality and privacy, and referred them to services that is free of cost. Conclusions: Findings from our study may help the health care providers to change their attitudes toward women survivors of domestic violence. Identifying and assisting these women through antenatal care could result in improved services for them and their newborns.

  • 44. Shrestha, S.
    et al.
    Wijma, Barbro
    Swahnberg, Katarina
    Linköpings universitet.
    Siwe, Karin
    Learning pelvic examination with professional patients2010In: Journal of Nepal Medical Association, ISSN 0028-2715, E-ISSN 1815-672X, Vol. 49, no 1, p. 68-75Article in journal (Refereed)
    Abstract [en]

    Performing pelvic examination is a vital skill to learn during gynecological and obstetrical training. It's a difficult maneuver to master as there is very little to see and more to feel and interpret. In addition, learning PE in usual clinical set-up has been found to induce lot of stress and anxiety among both the patients and the students. Students fear of hurting the patients and being judged inept, whereas patients feel embarrassed having to expose their most intimate body parts for learning purpose. This hampers effective learning. Learning PE on sedated women before surgery or on mannequins has been practiced as alternative learning models. But, they have been found to miss out on teaching the communication skills, which are as important as the palpation skills. However, there exists another model of learning PE--the professional patients, who are specially trained to act as patients and also guide the students on how to make a proper PE. They provide stress-free environment for the students to learn PE and at the same time, provide immediate feedback on each of their maneuvers. They form a complete learning model and help students to see patients as partner and not just a person seeking help.

  • 45.
    Simmons, Johanna
    et al.
    Linköping University.
    Brüggemann, Adrianus Jelmer
    Linköping University.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Disclosing victimisation to healthcare professionals in Sweden: A constructivist grounded theory study of experiences among men exposed to interpersonal violence2016In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, no 6, article id e010847Article in journal (Refereed)
    Abstract [en]

    Objective: To develop a theoretical model concerning male victims' processes of disclosing experiences of victimisation to healthcare professionals in Sweden.

    Design: Qualitative interview study.

    Setting: Informants were recruited from the general population and a primary healthcare centre in Sweden.

    Participants: Informants were recruited by means of theoretical sampling among respondents in a previous quantitative study. Eligible for this study were men reporting sexual, physical and/or emotional violence victimisation by any perpetrator and reporting that they either had talked to a healthcare provider about their victimisation or had wanted to do so.

    Method: Constructivist grounded theory. 12 interviews were performed and saturation was reached after 9.

    Results: Several factors influencing the process of disclosing victimisation can be recognised from previous studies concerning female victims, including shame, fear of negative consequences of disclosing, specifics of the patient-provider relationship and time constraints within the healthcare system. However, this study extends previous knowledge by identifying strong negative effects of adherence to masculinity norms for victimised men and healthcare professionals on the process of disclosing. It is also emphasised that the process of disclosing cannot be separated from other, even seemingly unrelated, circumstances in the men's lives.

    Conclusions: The process of disclosing victimisation to healthcare professionals was a complex process involving the men's experiences of victimisation, adherence to gender norms, their life circumstances and the dynamics of the actual healthcare encounter.

  • 46.
    Simmons, Johanna
    et al.
    Linköping Uniersity, Sweden.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Can nonresponse bias and known methodological differences explain the large discrepancies in the reported prevalence rate of violence found in Swedish studies?2019In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 5, article id e0216451Article in journal (Refereed)
    Abstract [en]

    Introduction The reported prevalence rate of violence varies considerably between studies, even when conducted in similar populations. The reasons for this are largely unknown. This article considers the effects of nonresponse bias on the reported prevalence rate of interpersonal violence. We also single out violence perpetrated in intimate relationships and compare our results to previous Swedish studies. The aim was to explore the reasons for the large discrepancies in the prevalence rates found between studies. Material and method This is a cross sectional study of a random population sample. The NorVold Abuse Questionnaire (NorAQ), covering emotional, physical, and sexual violence, was answered by 754 men (response rate 35%) and 749 women (response rate 38%). Nonresponse bias was investigated in six ways, e. g., findings were replicated in two samples and we explored nonresponders' reasons for declining participation. Also, the prevalence rate of intimate partner violence was compared to four previous studies conducted in Sweden, considering the methodological differences. Results and discussion The only evidence of nonresponse bias found was for differences between the sample and the background population concerning the sociodemographic characteristics. However, the magnitude of that effect is bleak in comparison with the large discrepancies found in the prevalence rates between studies concerning intimate partner violence, e. g., emotional violence women: 11-41% and men: 4-37%; sexual and/or physical violence women: 12-27% and men: 2-21%. Some of the reasons behind these differences were obvious and pertained to differences in the definition and operationalization of violence. However, a considerable proportion of the difference could not easily be accounted for. Conclusion It is not reasonable that so little is known about the large discrepancies in the prevalence rate for what is supposedly the same concept, i.e., intimate partner violence. This study is a call for more empirical research on methods to investigate violence.

  • 47.
    Simmons, Johanna
    et al.
    Linköping University.
    Wijma, Barbro
    Linköping University.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Associations and Experiences Observed for Family and Nonfamily Forms of Violent Behavior in Different Relational Contexts Among Swedish Men and Women2014In: Violence and Victims, ISSN 0886-6708, E-ISSN 1945-7073, Vol. 29, no 1, p. 152-170Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to examine how lifetime experiences of different types of violent behavior as well as violence by different kinds of perpetrators overlap, and to investigate the co-occurrence of experiences of violent behavior by kind of perpetrator. This was done among both sexes in both a random sample from a county population (women n = 1,168, men n = 2,924) and a clinical sample (women n = 2,439, men, n = 1,767) in Sweden. More than 1 kind of perpetrator was reported by 33%-37% of female and 22%-23% of male victims of some kind of violence, whereas 47%-48% of female and 29%-31% of male victims reported more than 1 kind of violence. The reporting of 2 or 3 kinds of perpetrators was associated with the reporting of experiences of more than 1 kind of violent behavior. Health care providers must be trained to recognize the overlap of violent victimization and help prevent further victimization of those who already have such experiences.

  • 48.
    Simmons, Johanna
    et al.
    Linköping Univ.
    Wijma, Barbro
    Linköping Univ.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping Univ.
    Lifetime co-occurrence of violence victimisation and symptoms of psychological ill health: a cross-sectional study of Swedish male and female clinical and population samples2015In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, article id 979Article in journal (Refereed)
    Abstract [en]

    Background: Lifetime co-occurrence of violence victimisation is common. A large proportion of victims report being exposed to multiple forms of violence (physical, sexual, emotional violence) and/or violence by multiple kinds of perpetrators (family members, intimate partners, acquaintances/strangers). Yet much research focuses on only one kind of victimisation. The aim of this study was to investigate the association between symptoms of psychological ill health, and A) exposure to multiple forms of violence, and B) violence by multiple perpetrators. Method: Secondary analysis of cross-sectional data previously collected for prevalence studies on interpersonal violence in Sweden was used. Respondents were recruited at hospital clinics (women n = 2439, men n = 1767) and at random from the general population (women n = 1168, men n = 2924). Multinomial regression analysis was used to estimate associations between exposure to violence and symptoms of psychological ill health. Results: Among both men and women and in both clinical and population samples, exposure to multiple forms of violence as well as violence by multiple perpetrators were more strongly associated with symptoms of psychological ill health than reporting one form of violence or violence by one perpetrator. For example, in the female population sample, victims reporting all three forms of violence were four times more likely to report many symptoms of psychological ill health compared to those reporting only one form of violence (adj OR: 3.8, 95 % CI 1.6-8.8). In the male clinical sample, victims reporting two or three kind of perpetrators were three times more likely to report many symptoms of psychological ill health than those reporting violence by one perpetrator (adj OR 3.3 95 % CI 1.9-5.9). Discussion: The strong association found between lifetime co-occurrence of violence victimisation and symptoms of psychological ill-health is important to consider in both research and clinic work. If only the effect of one form of violence or violence by one kind of perpetrator is considered this may lead to a misinterpretation of the association between violence and psychological ill health. When the effect of unmeasured traumata is ignored, the full burden of violence experienced by victims may be underestimated. Conclusion: Different kinds of victimisation can work interactively, making exposure to multiple forms of violence as well as violence by multiple perpetrators more strongly associated with symptoms of psychological ill health than any one kind of victimisation alone.

  • 49.
    Smirthwaite, Goldina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Lundström, Mats
    Lund University.
    Albrecht, Susanne
    EyeNet Sweden, Karlskrona.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Indication criteria for cataract extraction and gender differences in waiting time2014In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 92, no 5, p. 432-438Article in journal (Refereed)
    Abstract [en]

    Purpose:  The purpose of this study was to investigate national indication criteria tool for cataract extraction (NIKE), a clinical tool for establishing levels of indications for cataract surgery, in relation to gender differences in waiting times for cataract extraction (CE).

    Methods:  Data were collected by The Swedish National Cataract Register (NCR). Eye clinics report to NCR voluntarily and on regular basis (98% coverage). Comparisons regarding gender difference in waiting times were performed between NIKE-categorized and non-NIKE-categorized patients, as well as between different indication groups within the NIKE-system. All calculations were performed in spssversion 20. Multivariate analyses were carried out using logistic regression, and single variable analyses were carried out by Student’s t-test or chi square as appropriate.

    Results:  Gender, age, visual acuity and NIKE-categorization were associated with waiting time. Female patients had a longer waiting time to CE than male, both within and outside the NIKE-system. Gender difference in waiting time was somewhat larger among patients who had not been categorized by NIKE. In the non-NIKE-categorized group, women waited 0.20 months longer than men. In the group which was NIKE-categorized, women waited 0.18 months longer than men.

    Conclusions:  It is reasonable to assume that prioritizing patients by means of NIKE helps to reduce the gender differences in waiting time. Gender differences in waiting time have decreased as NIKE was introduced and there may be a variety of explanations for this. However, with the chosen study design, we could not distinguish between effects related to NIKE and those due to other factors which occurred during the study period.

  • 50.
    Smirthwaite, Goldina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Lundström, Mats
    Lund University.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Doctors Doing Gender at Eye Clinics: Gender Constructions in Relation to Waiting Times for Cataract Extractions in Sweden2017In: NORA: Nordic Journal of Feminist and Gender Research, ISSN 0803-8740, E-ISSN 1502-394X, Vol. 25, no 2, p. 107-125Article in journal (Refereed)
    Abstract [en]

    Why do eye clinics differ in their waiting times for women's and men's access to cataract extraction (CE)/gra starroperation? Taking a doing-gender perspective as the starting point, this study explores how gender constructions embedded in Swedish eye clinics contribute to longer waiting times for women than for men. Focus group interviews were conducted with doctors at two Swedish eye clinics: one with a larger and another with a smaller than average gender difference in waiting times for CE. Several differences were found between the clinics regarding how gender was constructed: Women and men were constructed as different with respect to ascribed traits such as assertiveness and care-seeking behaviour. Their need for visual acuity in working life was perceived as different by the doctors, and the study indicates differences between the clinics regarding their interest and awareness concerning issues related to inequity, reflected in the dissimilar prevalence of jokes with racist and misogynist connotations at the two clinics.

12 1 - 50 of 95
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf