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Siwe, Karin
Publications (10 of 24) Show all publications
Siwe, K. & Wijma, K. (2015). Validation of the Fear of Pelvic Examination Scale (F-PEXS) - measuring students fear of performing a pelvic examination. Journal of Psychosomatic Obstetrics and Gynaecology, 36(1), 23-28
Open this publication in new window or tab >>Validation of the Fear of Pelvic Examination Scale (F-PEXS) - measuring students fear of performing a pelvic examination
2015 (English)In: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 36, no 1, p. 23-28Article in journal (Refereed) Published
Abstract [en]

Introduction: Medical students of both genders often show signs of fear before they perform their first pelvic examination. This situation puts a novice in a special setting of intimacy never experienced before and where different emotions may emerge. A specially designed questionnaire, the Fear of Pelvic Examination Scale (F-PEXS) has been developed to assess fear in this context. The aim of this paper is to describe the validation of the F-PEXS. Methods: Undergraduate medical students (N = 100) answered the F-PEXS one week before, prior to and after a learning session with professional patients to assess levels of anxiety towards performing the pelvic exam. The validity of the scale was examined using item analysis, reliability assessments and analysis of the construct validity in comparing the F-PEXS with the Spielberger State and Trait Anxiety Inventory and Becks Anxiety Inventory. Results: The F-PEXS has very good reliability (Cronbachs alpha 0.96) and good construct validity. The mean score on the F-PEXS did not differ between gender either before or after the learning session. Conclusions: The F-PEXS can be used to assess students fear of performing the pelvic examination, to evaluate new strategies for learning the pelvic exam and to evaluate the outcome of such interventions.

Place, publisher, year, edition, pages
Informa Healthcare, 2015
Keywords
Fear; measurement; medical student; Pelvic examination; validation
National Category
Basic Medicine Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-117247 (URN)10.3109/0167482X.2014.994500 (DOI)000351351200004 ()25541215 (PubMedID)
Available from: 2015-04-22 Created: 2015-04-21 Last updated: 2018-01-11
Hopwood, N., Abrandt Dahlgren, M. & Siwe, K. (2014). Developing professional responsibility in medicine: A sociomaterial curriculum. In: Tara Fenwick & Monika Nerland (Ed.), Reconceptualising professional learning: sociomaterial knowledges, practices, and responsibilities (pp. 171-183). London and New York: Routledge
Open this publication in new window or tab >>Developing professional responsibility in medicine: A sociomaterial curriculum
2014 (English)In: Reconceptualising professional learning: sociomaterial knowledges, practices, and responsibilities / [ed] Tara Fenwick & Monika Nerland, London and New York: Routledge, 2014, p. 171-183Chapter in book (Other academic)
Abstract [en]

This book presents leading-edge perspectives and methodologies to address emerging issues o concern for professional learning in contemporary society. The conditions for professional practice and learning are changein dramatically in the wake of globalisation, new modes of knowledge production, new regulatory regiemes and increased economic-political pressures. A number of chllenges for professional learning emerge:

  • more practitioners becoming involved in interprofessional collaboration
  • devlopments in new technologies and virtual workworlds
  • emergence of transnational knowedge cultures and interrelated circuits of knowledge.

The space and time relations in which professional practice and learning are mebedded are becoming more complext, as are the epistemic underpinnings om professional work. Together these shifts bring about intersections of professional knowledge and responsibilities that call for new conceptions of professional knowing. Exploring what the authors call sociomaterial perspectives on professional learning, they argue that theories that trace not just the social but also the material aspects of practice - tools, texts, bodies, devices - are useful for coming to terms with the challenges above. Reconceptualising professional learning develops these issues through specific contemporary cases focused on one of the book's three main themes: (1) professionals' knowing in practice, (2) professionals' work arrangements and technologies and (3) professional responsibility. Each chapter draws on innovative theory to highlight the sociomaterial webs through which professional learning may be reconceptualised. Authors are based in Australia, Canada, italy, Norway, Sweden and the USA as well as the UTK and their cases are based in a range of professional settings including medicine, teaching, nursing engineering, social services, the creative industries and more. 

By presenting detailed accounts of these themes from a sociomaterial perspective, the book raises new questions and opens new methodological approaches. These can help make more visible what is often invisible in today's messy dynamics of professional learning, and pont to new ways of configuring educational support and policy for professionals.

Place, publisher, year, edition, pages
London and New York: Routledge, 2014
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-105994 (URN)978-0-415-81577-2 (ISBN)978-0-415-81578-9 (ISBN)978-1-315-81371-4 (ISBN)
Available from: 2014-04-16 Created: 2014-04-16 Last updated: 2018-02-02
Siwe, K., Berterö, C. & Wijma, B. (2013). Gynecological patients learning to perform the pelvic examination: A win-win concept. Sexual & Reproductive HealthCare, 4(2), 73-77
Open this publication in new window or tab >>Gynecological patients learning to perform the pelvic examination: A win-win concept
2013 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 4, no 2, p. 73-77Article in journal (Refereed) Published
Abstract [en]

Objective: This study explored gynecological patient perceptions of previous pelvic examinations (PE), a learning session about PE prior to a scheduled PE consultation, and the impact of the learning session on the PE during the consultation. Study design: Twelve informants were purposefully sampled from women with scheduled gynecologist appointments at a Swedish University Hospital. The learning session preceded the consultation and provided information on female genital anatomy and the PE, and the informant performed a PE on a mannequin. Individual qualitative interviews followed the consultation. The interviews were transcribed verbatim and analyzed using a constant comparative analysis to acquire a deeper understanding of the womens experiences of the learning session and the subsequent PE. Results: Three categories were identified in the analysis: Harmonizing the bad with the good category, which primarily concerned the informants previous experiences of the PE. Gaining self-confidence through knowledge, which depicted the informants experiences of the learning session. Mental preparation enables bodily recapture, which was the summarizing category of informant experiences of the scheduled PE. The core category, active involvement triggers empowerment, was created from the categories, and constitutes the core of the empirical material. Conclusion: The informants active participation during the learning session increased their knowledge, generated self-confidence, triggered an empowering process, and promoted interaction with the examiner during their subsequent PE.

Place, publisher, year, edition, pages
Elsevier, 2013
Keywords
Gynecological patients; Learning session; Pelvic/gynecological examination; Empowerment; Adult learning
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-96129 (URN)10.1016/j.srhc.2013.01.001 (DOI)000319717600005 ()
Available from: 2013-08-14 Created: 2013-08-14 Last updated: 2018-11-15
Siwe, K. & Wijma, B. (2013). The first pelvic examination for an adolescent: is this rite of passage used to its full potential?. Current Opinion in Obstetrics and Gynecology, 25(5), 357-63
Open this publication in new window or tab >>The first pelvic examination for an adolescent: is this rite of passage used to its full potential?
2013 (English)In: Current Opinion in Obstetrics and Gynecology, ISSN 1040-872X, E-ISSN 1473-656X, Vol. 25, no 5, p. 357-63Article, review/survey (Refereed) Published
Abstract [en]

Purpose of review: Adolescents' experiences of their first pelvic examination (external inspection, speculum examination and bimanual palpation) may have a marked influence on future experiences; why examination techniques and strategies for creating a positive experience of this situation need to be developed. This review addresses to what extent that ambition is reflected in recent literature.Recent findings: The majority of articles on 'pelvic examination during adolescence' come from the United States, which skews the review's perspective. Several researchers recommend using investigations based on new technology rather than a pelvic examination when medical indications for a full examination are present. The profession's attitudes toward annual check-ups and pelvic examinations (in the United States) are currently debated, for teens as well as for adults.How to perform a first pelvic examination on an adolescent is not often discussed, nor are strategies for creating a positive experience of this event.The contexts in which a first pelvic examination is performed probably differ among societies. The Swedish and the US contexts are compared as an illustration; for example preventive healthcare and sex education is in Sweden the responsibility of schools, open for anybody and without admission fees.Summary: Recent literature does not mirror a need for developing examination techniques and strategies for creating a positive experience of the first pelvic examination, nor for exploiting its maximal potential as a positive rite of passage.The ongoing US debate on indications for pelvic examinations and annual check-ups is even more relevant for adolescents, in whom contraindications need to be considered.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2013
Keywords
adolescents, experience, first pelvic/gynecologic examination, indications/contraindications, screening
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-100805 (URN)10.1097/GCO.0b013e3283642b8a (DOI)000326586300003 ()
Available from: 2013-11-12 Created: 2013-11-12 Last updated: 2018-11-15Bibliographically approved
Möller, A., Öfverstedt, S. & Siwe, K. (2012). Proud, not yet satisfied: the experiences of abortion service providers in the Kathmandu Valley, Nepal. Sexual & Reproductive HealthCare, 3(4), 135-140
Open this publication in new window or tab >>Proud, not yet satisfied: the experiences of abortion service providers in the Kathmandu Valley, Nepal
2012 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 3, no 4, p. 135-140Article in journal (Refereed) Published
Abstract [en]

Objectives: In Nepal, the change of the abortion law in 2002 extended the staff duties at family planning clinics to include performing induced abortions. This study investigated the experiences, opinions and attitudes of the staff about their work at safe abortion service centres in the Kathmandu Valley and identified areas in which the health care staff stated the need for improvement.

Study design: Fifteen qualitative semi-structured interviews were conducted with doctors and nurses working with induced abortion at one hospital and five clinics in the Kathmandu Valley. The interviews were transcribed verbatim and analysed using the constant comparative method.

Results: The core category ‘Proud, not yet satisfied’ comprised a strong perception of providing an important service that is beneficial for women’s health and a feeling of pride in providing quality service. Four related categories were identified: ‘Beneficial legal framework’, ‘A will to reach out to all women’, ‘Frustration about misuse’ and ‘Dilemma of sex-selective abortion’. The respondents emphasised that improvements are necessary to (1) ensure that all women have access to safe abortion services; (2) prevent abortions from being used instead of contraceptives; (3) stop illegal medical abortions; and (4) deal with the dilemma of sex-selective abortions.

Conclusions: Respondents were proud of and had psitive experiences from their work. They stated they have the opportunity to secure women’s rights and health; however, changes are needed to bring the quality of abortion care to a satisfactory level.

Keywords
Abortion, Nepal, Attitude of health personnel, Legislation
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-86399 (URN)10.1016/j.srhc.2012.10.003 (DOI)000312359000002 ()23182445 (PubMedID)
Available from: 2012-12-14 Created: 2012-12-14 Last updated: 2017-12-06Bibliographically approved
Siwe, K., Berterö, C. & Wijma, B. (2012). Unexpected enlightening of a "female world". Male medical students experiences of learning and performing the first pelvic examination. Sexual & Reproductive HealthCare, 3(3), 123-127
Open this publication in new window or tab >>Unexpected enlightening of a "female world". Male medical students experiences of learning and performing the first pelvic examination
2012 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 3, no 3, p. 123-127Article in journal (Refereed) Published
Abstract [en]

Objective: To gain a deeper understanding of how undergraduate male medical students experience a pelvic examination learning concept and performing the first pelvic examination (PE) on a professional patient. less thanbrgreater than less thanbrgreater thanStudy design: A qualitative study. In-depth interviews with 12 male medical students after their involvement in a learning session about the PE, with professional patients and a supervising gynecologist as instructors. The interviews were analyzed according to the constant comparative method, a variety of content analysis, to acquire a deeper understanding of the students experiences and the ongoing social processes. less thanbrgreater than less thanbrgreater thanResults: The essence of the entire analysis was "Unexpected enlightening of a female world" and was identified from the three categories; "Not just any exam", "Professional supportive interaction" and "Humble awareness". The male students most prominent concern was how to establish a professional rapport with the patient in the PE situation. Beneficial active support from the professional patient and the gynecologist assisted the students to overcome inherent barriers and facilitated the examination procedure. The informants gained "inside information" from the patients perspective of being examined leading to a new awareness about an earlier unknown "female world" that is what women might go through before and during a PE and an humble understanding of how vulnerable it is to be placed in the examination position. less thanbrgreater than less thanbrgreater thanConclusion: The beneficial PE learning concept promoted an unexpected insight in what a woman might experience during a PE, creating a humble awareness of this vulnerable intimate situation and ideas for how to establish professional rapport.

Place, publisher, year, edition, pages
Elsevier, 2012
Keywords
Pelvic/gynecological examination, Professional patients, Learning session, Medical students, Male medical students
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-87254 (URN)10.1016/j.srhc.2012.07.001 (DOI)000312282100006 ()
Available from: 2013-01-14 Created: 2013-01-14 Last updated: 2018-11-15
Swahnberg, K., Wijma, B. & Siwe, K. (2011). Strong discomfort during vaginal examination: why consider a history of abuse?. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 157(2), 200-205
Open this publication in new window or tab >>Strong discomfort during vaginal examination: why consider a history of abuse?
2011 (English)In: European Journal of Obstetrics, Gynecology, and Reproductive Biology, ISSN 0301-2115, Vol. 157, no 2, p. 200-205Article in journal (Refereed) Published
Abstract [en]

Objective

To study factors associated with strong discomfort during vaginal examinations (SD/VE) by means of four hypotheses.

Study design

A cross sectional postal questionnaire study, conducted at three Swedish departments of obstetrics and gynaecology and with a random population sample (n = 4453).

Main outcome measures

The associations between a self-reported history of emotional, physical and sexual abuse and abuse in health care, flashbacks during the previous year, emotional contact with the examiner, and SD/VE during the index visit (discomfort estimated on a ten-point scale; six-ten = SD). Statistical analyses used were Chi-square, Binary logistic regression, and Pearson Correlation.

Results

Eighteen percent of the women reported SD/VE. There was an association between SD/VE and a lifetime history of abuse. Having experienced combinations of abuse, especially combinations including emotional abuse and abuse in health care, was strongly associated with SD/VE. SD/VE was furthermore associated with flashbacks during the previous year, and negative emotional contact with the examiner during the index visit.

Conclusions

We conclude that women who unexpectedly react with SD/VE are more likely to have a background of abuse, and may even run a risk of feeling re-traumatised during the VE. A clinical implication is to consider a history of abuse in patients who react with SD/VE or experience negative emotional contact during the consultation.

Place, publisher, year, edition, pages
Elsevier, 2011
Keywords
NorAQ, Sexual abuse, Emotional abuse, Vaginal examination, Discomfort, Abuse in health care
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-67861 (URN)10.1016/j.ejogrb.2011.02.025 (DOI)000293727800016 ()
Available from: 2011-04-29 Created: 2011-04-29 Last updated: 2018-11-15
Siwe, K. (2010). Att växa i gynstolen- en möjlighet genom empowerment? (1:1ed.). In: Barbro Wijma, Goldina Smirthwaite, Katarina Swahnberg (Ed.), Genus och kön inom medicin och vårdutbildningar (pp. 135-149). Lund: Studentlitteratur
Open this publication in new window or tab >>Att växa i gynstolen- en möjlighet genom empowerment?
2010 (Swedish)In: Genus och kön inom medicin och vårdutbildningar / [ed] Barbro Wijma, Goldina Smirthwaite, Katarina Swahnberg, Lund: Studentlitteratur , 2010, 1:1, p. 135-149Chapter in book (Other academic)
Abstract [sv]

Kvinnor och män är delvis lika, delvis olika. Det innebär att kvinnor och män både har behov av likadan behandling och av behandling som är anpassad till det egna könets förutsättningar. Denna antologi belyser kvinnors och mäns förutsättningar och behov inom en rad olika medicinska områden och tar upp både biologiska och sociala faktorer som påverkar hälsa och behandling. Den behandlar även den roll som kön spelar inom vårdens arbetsliv samt hur köns- och genusperspektiv kan integreras inom olika typer av medicin- och vårdutbildningar. Ett av bokens teman är våld, kränkningar och diskriminering, och inom ramen för detta behandlas några av de olika maktordningar som kommer till uttryck vid behandlingar inom hälso- och sjukvården. Antologin har en stor spännvidd när det gäller ämnen och författare. Förhoppningsvis ska den bredd som antologin uppvisar, leda fram till frågeställningar där läsaren utmanar sina förgivettaganden inom både genusvetenskap och mer traditionell medicin samt väcka nya frågor: Om könet snarare ses som en konstruktion än en fysisk realitet - kan då kvinnor lika gärna äta mediciner som är utprovade på män och opereras med metoder och verktyg anpassade till mäns fysiologi? Å andra sidan - hur objektiv är den naturvetenskapligt inriktade medicinska forskningen egentligen om man börjar granska den utifrån frågeställningar om perspektivval och genus? Antologin vänder sig till lärare på utbildningar inom medicin, hälsa och vård. Andra målgrupper är studenter på sådana utbildningar, vårdpersonal och en intresserad allmänhet.

Place, publisher, year, edition, pages
Lund: Studentlitteratur, 2010 Edition: 1:1
National Category
Gender Studies
Identifiers
urn:nbn:se:liu:diva-63444 (URN)978-91-44-05950-1 (ISBN)9144059507 (ISBN)
Available from: 2010-12-19 Created: 2010-12-19 Last updated: 2013-04-24Bibliographically approved
Wijma, B. & Siwe, K. (2010). Den gynekologiska undersökningen (1:1ed.). In: Per-Olof Janson, Britt-Marie Landgren (Ed.), Gynekologi: (Lärobok i gynekologi) (pp. 33-44). Lund: Studentlitteratur
Open this publication in new window or tab >>Den gynekologiska undersökningen
2010 (Swedish)In: Gynekologi: (Lärobok i gynekologi) / [ed] Per-Olof Janson, Britt-Marie Landgren, Lund: Studentlitteratur , 2010, 1:1, p. 33-44Chapter in book (Other academic)
Abstract [sv]

Kvinnosjukvården genomgår för närvarande stora förändringar, där gynekologer och övrig vårdpersonal tar ett allt större ansvar för kvinnors hälsa. Den gynekologiska öppenvården ökar och samtidigt koncentreras de traditionella kärnverksamheterna förlossningsvård och tung gynekologisk kirurgi i den slutna vården.Inom gynekologin kommer specialiteten att engageras av förebyggande och behandling av åkommor som kan drabba kvinnor i högre åldrar, av nya principer för antikonception, av utvecklingen inom urogynekologin och den genetiska diagnostiken, och av nya teknologier inom reproduktionsmedicinen.Denna lärobok i gynekologi tar bland annat fasta på vikten av kritisk granskning av medicinska och kirurgiska åtgärder så att medicinska prioriteringar kan göras på bästa möjliga evidens. Läroboken innehåller utförliga kapitel om lagstiftning, gynekologisk ultraljudsdiagnostik, våld mot kvinnor, sexologi och diagnostik och behandling av akut och kronisk bäckensmärta.Läroboken är resultatet av ett unikt samarbete mellan ett stort antal specialister inom gynekologi. Boken vänder sig till läkarstuderande på grundutbildningen samt till läkare, barnmorskor och sjuksköterskor inom såväl öppen som sluten vård. Den kan även användas som fördjupnings- och referensbok.

Place, publisher, year, edition, pages
Lund: Studentlitteratur, 2010 Edition: 1:1
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-63789 (URN)978-91-44-04793-5 (ISBN)914-4-04793-2 (ISBN)
Available from: 2011-01-03 Created: 2011-01-03 Last updated: 2018-11-15Bibliographically approved
Siwe, K. (2010). Gynekologisk undersökning: Instruktionsbroschyr om gýnekologisk undersökningsteknik..
Open this publication in new window or tab >>Gynekologisk undersökning: Instruktionsbroschyr om gýnekologisk undersökningsteknik.
2010 (Swedish)Other (Other academic)
Abstract [sv]

Instruktionsbroschyr i färgtryck om gynekologisk undersöknigsteknik  för läkar- och  barnmorskestudenter liksom läkare under allmäntjänstgöring och specialistutbildning. Broschyren visar stegvis och i detalj hur en fullständig gynekologisk undersökning går till med instrument och palpation med händerna. Därutöver visas bilder på kvinnlig anatomi, anvisningar för cellprovstagning och provtagning för infektionssjukdomar i de kvinnliga könsorganen.

Keywords
Gynekologisk undersökning, student, undervisning
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-64021 (URN)
Available from: 2011-01-11 Created: 2011-01-11 Last updated: 2011-02-04
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