liu.seSearch for publications in DiVA
Change search
Link to record
Permanent link

Direct link
BETA
Alehagen, Siw
Publications (10 of 32) Show all publications
Grundström, H., Gerdle, B., Alehagen, S., Berterö, C., Arendt-Nielsen, L. & Kjölhede, P. (2019). Reduced pain thresholds and signs of sensitization in women with persistent pelvic pain and suspected endometriosis. Acta Obstetricia et Gynecologica Scandinavica, 98(3), 327-336
Open this publication in new window or tab >>Reduced pain thresholds and signs of sensitization in women with persistent pelvic pain and suspected endometriosis
Show others...
2019 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 98, no 3, p. 327-336Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Endometriosis is a gynecological disorder that may cause considerable pelvic pain in women of fertile age. Determining pain mechanisms is necessary in order to optimize the treatment of the disease. The objective of the study was to evaluate pain thresholds in women with persistent pelvic pain with and without confirmed endometriosis, and healthy, unaffected controls, and analyze how pain thresholds in these cohorts related to duration of pelvic pain, quality of life, and symptoms of anxiety and depression.

MATERIAL AND METHODS: Pain thresholds for heat, cold and pressure were assessed with quantitative sensory testing on six locations on a reference group of 55 healthy women and on 37 women with persistent pelvic pain who had been admitted for diagnostic laparoscopy on the suspicion of endometriosis. Validated instruments were applied to assess quality of life and symptoms of anxiety and depression. Data were analyzed by means of uni- and multivariate analysis of variance and Spearman's rank-order correlation.

RESULTS: The women with persistent pelvic pain had significantly lower pain thresholds compared with the reference women. In the women with pain, no differences were observed in pain thresholds between women with (n = 13) and women without (n = 24) biopsy-proven endometriosis. The duration of pelvic pain correlated significantly positively with reduced pain thresholds, ie, the longer the duration, the more sensitization. In the persistent pelvic pain group, pain thresholds for heat correlated significantly with the Short Form Health Survey 36 dimension of bodily pain, and thresholds for cold correlated with Short Form Health Survey 36 bodily pain and with symptoms of depression.

CONCLUSIONS: Our results showed widespread alterations in pain thresholds in women with persistent pelvic pain that are indicative of central sensitization and a time-dependent correlation. Women with pelvic pain and suspicion of endometriosis should probably be treated more thoroughly to prevent or at least minimize the concomitant development of central sensitization.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
chronic pain, endometriosis, health-related quality of life, pain thresholds, persistent pelvic pain, quantitative sensory testing, sensitization
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-154816 (URN)10.1111/aogs.13508 (DOI)000459481000007 ()30472739 (PubMedID)2-s2.0-85059291957 (Scopus ID)
Note

Funding agencies:  Medical Research Council of Southeast Sweden; Region Ostergotland; Linkoping University

Available from: 2019-02-28 Created: 2019-02-28 Last updated: 2019-06-28Bibliographically approved
Grundström, H., Kjølhede, P., Berterö, C. & Alehagen, S. (2016). “A challenge” – healthcare professionals' experiences when meeting women with symptoms that might indicate endometriosis. Sexual & Reproductive HealthCare, 7, 65-69
Open this publication in new window or tab >>“A challenge” – healthcare professionals' experiences when meeting women with symptoms that might indicate endometriosis
2016 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 7, p. 65-69Article in journal (Refereed) Published
Abstract [en]

Objective

The aim of the study was to identify and describe the experiences of healthcare professionals when meeting women with symptoms that might indicate endometriosis.

Methods

Semi-structured interviews were conducted with 10 gynecologists, six general practitioners and nine midwives working at one university hospital, one central hospital, one private gynecology clinic and five healthcare centers in south-east Sweden. The interviews were recorded and transcribed verbatim and analyzed using qualitative conventional content analysis.

Results

Three clusters were identified: the corroborating encounter, the normal variation of menstruation cycles, and the suspicion of endometriosis. The healthcare professionals tried to make a corroborating encounter by acknowledging the woman, taking time to listen, and giving an explanation for the problems. Healthcare professionals had different ways to determine what was normal as regards menstrual pain, ovulation pain and dyspareunia. They also needed to have the competence to act and react when the symptoms indicated endometriosis.

Conclusions

Meeting women with symptoms that might indicate endometriosis is challenging and demands a certain level of competence from healthcare professionals. Sometimes the symptoms are camouflaged as “normal” menstruation pain, making it hard to satisfy the needs of this patient group.

Keywords
Chronic pelvic pain;Dysmenorrhea;Endometriosis;Healthcare professional;Qualitative study
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-124016 (URN)10.1016/j.srhc.2015.11.003 (DOI)000370089000012 ()
Available from: 2016-01-18 Created: 2016-01-18 Last updated: 2019-06-28
Kilander, H., Alehagen, S., Svedlund, L., Westlund, K., Thor, J. & Brynhildsen, J. (2016). Likelihood of repeat abortion in a Swedish cohort according to the choice of post-abortion contraception: a longitudinal study. Acta Obstetricia et Gynecologica Scandinavica, 95(5), 565-571
Open this publication in new window or tab >>Likelihood of repeat abortion in a Swedish cohort according to the choice of post-abortion contraception: a longitudinal study
Show others...
2016 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 95, no 5, p. 565-571Article in journal (Refereed) Published
Abstract [en]

IntroductionDespite high access to contraceptive services, 42% of the women who seek an abortion in Sweden have a history of previous abortion(s). The reasons for this high repeat abortion rate remain obscure. The objective of this study was to study the choice of contraceptive method after abortion and related odds of repeat abortions within 3-4 years. Material and methodsThis is a retrospective cohort study based on a medical record review at three hospitals in Sweden. We included 987 women who had an abortion during 2009. We reviewed medical records from the date of the index abortion until the end of 2012 to establish the choice of contraception following the index abortion and the occurrence of repeat abortions. We calculated odds ratios (OR) with 95% CI. ResultsWhile 46% of the women chose oral contraceptives, 34% chose long-acting reversible contraceptives (LARC). LARC was chosen more commonly by women with a previous pregnancy, childbirth and/or abortion. During the follow-up period, 24% of the study population requested one or more repeat abortion(s). Choosing LARC at the time of the index abortion was associated with fewer repeat abortions compared with choosing oral contraceptives (13% vs. 26%, OR 0.36; 95% CI 0.24-0.52). Subdermal implant was as effective as intrauterine device in preventing repeat abortions beyond 3 years. ConclusionsChoosing LARC was associated with fewer repeat abortions over more than 3 years of follow up.

Place, publisher, year, edition, pages
WILEY-BLACKWELL, 2016
Keywords
Long-acting reversible contraception; post-abortion contraception; repeat abortion; subdermal implant; termination of pregnancy
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-128136 (URN)10.1111/aogs.12874 (DOI)000374349400012 ()26871269 (PubMedID)
Note

Funding Agencies|Futurum - the academy for healthcare; Jonkoping County Council; Medical Research Council of Southeast Sweden (FORSS)

Available from: 2016-05-19 Created: 2016-05-19 Last updated: 2018-11-26
Skagerström, J., Häggström-Nordin, E. & Alehagen, S. (2015). The voice of non-pregnant women on alcohol consumption during pregnancy: a focus group study among women in Sweden. BMC Public Health, 15, Article ID 1193.
Open this publication in new window or tab >>The voice of non-pregnant women on alcohol consumption during pregnancy: a focus group study among women in Sweden
2015 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, article id 1193Article in journal (Refereed) Published
Abstract [en]

Background: Consensus is that fetal exposure to alcohol is harmful. Abstinence while trying to conceive and throughout pregnancy is recommended. Despite this, there are many women who consume alcohol around conception and until pregnancy recognition. The aim of this study was to explore the voice of non-pregnant women concerning alcohol consumption and its relation to pregnancy.

Methods: Data were collected through seven focus groups interviews with 34 women of fertile age, who were neither pregnant nor mothers. Semi-structured interviews were undertaken, recorded and transcribed verbatim and then analysed using thematic analysis.

Results: Three main themes were identified in the analysis: an issue that cannot be ignored; awareness and uncertainty concerning alcohol and pregnancy; and transition to parenthood. Alcohol was an integral part of the women’s lives. A societal expectation to drink alcohol was prevalent and the women used different strategies to handle this expectation. Most women agreed not to drink alcohol during pregnancy although their knowledge on the specific consequences was scanty and they expressed a need for more information. Most of the participants found drinking alcohol during pregnancy to be irresponsible and saw pregnancy as a start of a new way of life.

Conclusions: Social expectations concerning women’s alcohol use change with pregnancy when women are suddenly expected to abstain. Although most study participants shared an opinion for zero tolerance during pregnancy, their knowledge regarding consequences of drinking during pregnancy were sparse. In order for prospective mothers to make informed choices, there is a need for public health initiatives providing information on the relationship between alcohol consumption and reproduction.

Place, publisher, year, edition, pages
BioMed Central, 2015
Keywords
Alcohol consumption, Pregnancy, Fertile age, Pregnancy planning, Health education, Focus group
National Category
Public Health, Global Health, Social Medicine and Epidemiology Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-122374 (URN)10.1186/s12889-015-2519-2 (DOI)000365477300002 ()
Note

On the day of the defence day the status of this article was Manuscript.

Funding agencies: Systembolaget Alcohol Research Council (Systembolagets alkoholforskningsrad)

Available from: 2015-10-30 Created: 2015-10-30 Last updated: 2017-12-01Bibliographically approved
Åsenhed, L., Kilstam, J., Alehagen, S. & Baggens, C. (2014). Becoming a father is an emotional roller coaster - an analysis of first-time fathers' blogs. Journal of Clinical Nursing, 23(9-10), 1309-1317
Open this publication in new window or tab >>Becoming a father is an emotional roller coaster - an analysis of first-time fathers' blogs
2014 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, no 9-10, p. 1309-1317Article in journal (Refereed) Published
Abstract [en]

Aims and objectives. To identify and describe the process of fatherhood during the partner’s pregnancy among expectant,first-time fathers.Background. Pregnancy seems to be a demanding period for expectant fathers, and this period is a part of their transition tofatherhood. Blogs can be seen as personal diaries and offer an alternative method of collecting data as they are an arena forsharing experiences and narratives.

Design. An explorative qualitative design.Methods. Blogs from the Internet by eleven first-time fathers living in Sweden were included in the study. Qualitative contentanalysis was used for the analysis of the blogs.

Results. A theme emerged expressing the latent content of the text: ‘Becoming a father for the first time is an emotional rollercoaster where the role of the expectant father is not obvious’ and five different categories describing the manifest content: thepregnancy, a new life, to make the child real, preparations for the delivery and the arrival of the child, and a new role in life.

Conclusions. The metaphor ‘roller coaster’ indicates the tension between different feelings about the men’s future as fathers.They are searching for answers on how to be a good father. They feel excluded when they visit antenatal care centres andhave difficulties finding out how to support their partner. This is an existential period when they understand themselves asadults and also miss relatives who have died. During pregnancy, the men start to communicate with their child, and thisinteraction gives a sense of reality and creates hope and joy about being a father.Relevance to clinical practice. Staff involved in antenatal care can use the knowledge from this study when meeting withexpectant fathers. Perspectives expressed in blogs may enhance the professionals’ understanding that the transition processof fatherhood is complex.

Key words: blogs, first-time fathers, pregnancy, qualitative content analysis, qualitative study, reproductive health, sexuality,transition

Place, publisher, year, edition, pages
Wiley-Blackwell, 2014
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-106915 (URN)10.1111/jocn.12355 (DOI)000334178300016 ()
Available from: 2014-05-26 Created: 2014-05-26 Last updated: 2017-12-05Bibliographically approved
Brantelid, I. E., Nilver, H. & Alehagen, S. (2014). Menstruation during a lifespan: A qualitative study of women's experiences. Health Care for Women International, 35(6), 600-616
Open this publication in new window or tab >>Menstruation during a lifespan: A qualitative study of women's experiences
2014 (English)In: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 35, no 6, p. 600-616Article in journal (Refereed) Published
Abstract [en]

Menstruation is a natural phenomenon for women during their reproductive years. Our aim was to describe womens experiences of menstruation across the lifespan. Qualitative interviews with a narrative approach were conducted with 12 women between 18 and 48 years of age in Sweden. Using thematic analysis, we found menstruation to be a complex phenomenon that binds women together. It is perceived as an intimate and private matter, which makes women want to conceal the occurrence of menstrual bleeding. Over time, menstruation becomes a natural part of womens lives and gender identity. Health professionals play a central role supporting women to deal with menstruation.

Place, publisher, year, edition, pages
Routledge, 2014
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-109161 (URN)10.1080/07399332.2013.868465 (DOI)000337633200002 ()24313552 (PubMedID)
Available from: 2014-08-13 Created: 2014-08-11 Last updated: 2017-12-05Bibliographically approved
Johansson, A., Carlsson, N., Almfors, H., Rosén, M. & Alehagen, S. (2014). Parents' experiences of participating in an intervention on tobacco prevention in Child Health Care. BMC Pediatrics, 14(69)
Open this publication in new window or tab >>Parents' experiences of participating in an intervention on tobacco prevention in Child Health Care
Show others...
2014 (English)In: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 14, no 69Article in journal (Refereed) Published
Abstract [en]

Background

Child health care is an important arena for tobacco prevention in Sweden. The aim of this study was to describe parents’ experiences from participating in a nursebased tobacco prevention intervention.     

Methods

Eleven parents were interviewed using semi-structured interviews. The material was analysed in a qualitative content analysis process.     

Results

The analysis emerged four categories; Receiving support, Respectful treatment, Influence on smoking habits and Receiving information. The parents described how the CHC nurses treated them with support and respect. They described the importance of being treated with respect for their autonomy in their decisions about smoking. They also claimed that they had received little or no information about health consequences for children exposed to environmental tobacco smoke (ETS). The findings also indicate that both the questionnaire used and the urine-cotinine test had influenced parents’ smoking.     

Conclusion

The clinical implication is that CHC is an important arena for preventive work aiming to minimize children’s tobacco smoke exposure. CHC nurses can play an important role in tobacco prevention but should be more explicit in their communication with parents about tobacco issues. The SiCET was referred to as an eye-opener and can be useful in the MI dialogues nurses perform in order to support parents in their efforts to protect their children from ETS.

Place, publisher, year, edition, pages
BioMed Central, 2014
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-105308 (URN)10.1186/1471-2431-14-69 (DOI)000335411500002 ()
Available from: 2014-03-17 Created: 2014-03-17 Last updated: 2017-12-05Bibliographically approved
Skagerström (Malmsten), J., Alehagen, S., Haggstrom-Nordin, E., Franzén Årestedt, K. & Nilsen, P. (2013). Prevalence of alcohol use before and during pregnancy and predictors of drinking during pregnancy: a cross sectional study in Sweden. BMC Public Health, 13(780)
Open this publication in new window or tab >>Prevalence of alcohol use before and during pregnancy and predictors of drinking during pregnancy: a cross sectional study in Sweden
Show others...
2013 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13, no 780Article in journal (Refereed) Published
Abstract [en]

Background

There is a paucity of research on predictors for drinking during pregnancy among women in Sweden and reported prevalence rates differ considerably between studies conducted at different antenatal care centres. Since this knowledge is relevant for preventive work the aim of this study was to investigate these issues using a multicenter approach.

Methods

The study was conducted at 30 antenatal care centers across Sweden from November 2009 to December 2010. All women in pregnancy week 18 or more with a scheduled visit were asked to participate in the study. The questionnaire included questions on sociodemographic data, alcohol consumption prior to and during the pregnancy, tobacco use before and during pregnancy, and social support.

Results

Questionnaires from 1594 women were included in the study. A majority, 84%, of the women reported alcohol consumption the year prior to pregnancy; about 14% were categorized as having hazardous consumption, here defined as a weekly consumption of > 9 standard drinks containing 12 grams of pure alcohol or drinking more than 4 standard drinks at the same occasion. Approximately 6% of the women consumed alcohol at least once after pregnancy recognition, of which 92% never drank more than 1 standard drink at a time. Of the women who were hazardous drinkers before pregnancy, 19% reduced their alcohol consumption when planning their pregnancy compared with 33% of the women with moderate alcohol consumption prior to pregnancy. Factors predicting alcohol consumption during pregnancy were older age, living in a large city, using tobacco during pregnancy, lower score for social support, stronger alcohol habit before pregnancy and higher score for social drinking motives.

Conclusions

The prevalence of drinking during pregnancy is relatively low in Sweden. However, 84% of the women report drinking in the year preceding pregnancy and most of these women continue to drink until pregnancy recognition, which means that they might have consumed alcohol in early pregnancy. Six factors were found to predict alcohol consumption during pregnancy. These factors should be addressed in the work to prevent alcohol-exposed pregnancies.

Place, publisher, year, edition, pages
BioMed Central, 2013
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-97660 (URN)10.1186/1471-2458-13-780 (DOI)000323754500003 ()
Note

Funding Agencies|Swedish National Institute of Public Health||

Available from: 2013-09-19 Created: 2013-09-19 Last updated: 2017-12-06
Salomonsson, B., Gullberg, M. T., Alehagen, S. & Wijma, K. (2013). Self-efficacy beliefs and fear of childbirth in nulliparous women. Journal of Psychosomatic Obstetrics and Gynaecology, 34(3), 116-121
Open this publication in new window or tab >>Self-efficacy beliefs and fear of childbirth in nulliparous women
2013 (English)In: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 34, no 3, p. 116-121Article in journal (Refereed) Published
Abstract [en]

Objective: To explore how childbirth self-efficacy, i.e. outcome expectancy and efficacy expectancy, was associated with fear of childbirth (FOC) and how efficacy expectancy and FOC, respectively were related to socio-demographic characteristics, mental problems and preference for a caesarean section.

Methods: In this cross-sectional study, a consecutive sample of 1000 pregnant nulliparous women was sent the Wijma Delivery Expectancy Questionnaire and Childbirth Self-Efficacy Inventory. Statistical analyses were performed on data from 423 women.

Results: Outcome expectancy and efficacy expectancy correlated significantly and positively, FOC correlated significantly and negatively with both outcome expectancy and efficacy expectancy. Women with severe FOC (20.8%) had a significantly lower level of education (p = 0.001), and had more often sought help because of mental problems (p = 0.004). They were more likely to have low-efficacy expectancy (p < 0.001) and to prefer a caesarean section instead of a vaginal birth (p < 0.001).

Conclusions: Lower efficacy expectancy was associated with higher FOC while preference for a caesarean section was not. Improvement of self-efficacy could be a part of care for women with FOC during pregnancy; however, it would not be enough for fearful women who wish to have a caesarean section.

Place, publisher, year, edition, pages
Informa Healthcare, 2013
Keywords
Caesarean section, CBSEI, Fear of childbirth, Self-Efficacy, W-DEQ
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-85647 (URN)10.3109/0167482X.2013.824418 (DOI)000323332400004 ()
Available from: 2012-11-27 Created: 2012-11-27 Last updated: 2017-12-07Bibliographically approved
Salomonsson, B., Berterö, C. & Alehagen, S. (2013). Self-efficacy in pregnant women with severe fear of childbirth. Journal of Obstetric, Gynecologic and Neonatal Nursing, 42(2), 191-202
Open this publication in new window or tab >>Self-efficacy in pregnant women with severe fear of childbirth
2013 (English)In: Journal of Obstetric, Gynecologic and Neonatal Nursing, ISSN 0884-2175, E-ISSN 1552-6909, Vol. 42, no 2, p. 191-202Article in journal (Other academic) Published
Abstract [en]

Objective: To apply and test the concept of childbirth self-efficacy to expectations of the upcoming birth in the context of severe fear of childbirth (SFOC).

Design: Qualitative study using semi-structured interviews.

Setting: A region in the southeast of Sweden

Participants: Nulliparous pregnant women (n=17) with SFOC.

Method: The interviews were analysed according to content analysis, using deductive and inductive approaches. The seven domains of the childbirth self-efficacy inventory (CBSEI) made up the matrix for the deductive analysis.

Results: Behaviours for coping with labour and childbirth were related to six domains of childbirth self-efficacy; “concentration”, “support”, “control”, “ motor/relaxation”, “selfencouragement” and “breathing”. Most of these behaviours referred to capabilities to carry out (self-efficacy expectancy) rather than to beliefs in effectiveness (outcome expectancy). Five additional sub-domains representing defined childbirth self-efficacy were identified; “guidance”, “the body controls”, “the professionals´ control”, “reliance” and ‘fatalism’.

Conclusion: The domains of childbirth self-efficacy have been deepened and expanded in relation to SFOC. It is imperative to identify pregnant women with SFOC and their efficacy beliefs in order to help them find appropriate coping behaviours prior to the onset of labour, and furthermore these behaviours must be supported by healthcare professionals during labour and childbirth. Support in the form of verbal persuasion emanating from the subdomains of childbirth self-efficacy ought to be added.

Place, publisher, year, edition, pages
John Wiley & Sons, 2013
Keywords
CBSEI, content analysis, fear of childbirth, qualitative study, self-efficacy
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-85649 (URN)10.1111/1552-6909.12024 (DOI)000316279500010 ()
Available from: 2013-04-12 Created: 2012-11-27 Last updated: 2017-12-07Bibliographically approved
Organisations

Search in DiVA

Show all publications