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Skagerström, Janna
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Publications (10 of 16) Show all publications
Schildmeijer, K., Nilsen, P., Ericsson, C., Broström, A. & Skagerström, J. (2018). Determinants of patient participation for safer care: A qualitative study of physicians experiences and perceptions. Health science reports, 1(10), Article ID e87.
Open this publication in new window or tab >>Determinants of patient participation for safer care: A qualitative study of physicians experiences and perceptions
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2018 (English)In: Health science reports, ISSN 2398-8835, Vol. 1, no 10, article id e87Article in journal (Refereed) Published
Abstract [en]

Objective

There is a paucity of research on physicians' perspectives on involving patients to achieve safer care. This study aims to explore determinants of patient participation for safer care, according to physicians in Swedish health care.

Methods

We used a deductive descriptive design, applying qualitative content analysis based on the Capability‐Opportunity‐Motivation‐Behaviour framework. Semi‐structured interviews were conducted with 13 physicians in different types of health care units, to achieve a heterogeneous sample. The main outcome measure was barriers and facilitators to patient participation of potential relevance for patient safety.

Results

Analysis of the data yielded 14 determinants (ie, subcategories) functioning as barriers and/or facilitators to patient participation of potential relevance for patient safety. These determinants were mapped to five categories: physicians' capability to involve patients in their care; patients' capability to become involved in their care, as perceived by the physicians; physicians' opportunity to achieve patient participation in their care; physicians' motivation to involve patients in their care; and patients' motivation to become involved in their care, as perceived by the physicians.

Conclusion

There are many barriers to patient participation to achieve safer care. There are also facilitators, but these tend to depend on initiatives of individual physicians and patients, because organizational‐level support may be lacking. Many of the determinants are interdependent, with physicians' perceived time constraints influencing other barriers.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
barriers; determinants; facilitators; patient participation; patient safety; physicians
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-156016 (URN)10.1002/hsr2.87 (DOI)30623042 (PubMedID)
Available from: 2019-04-02 Created: 2019-04-02 Last updated: 2019-05-03Bibliographically approved
Skagerström, J., Ericsson, C. & Nilsen, P. (2017). Patient involvement for improved patient safety: A qualitative study of nurses’ perceptions and experiences. Nursing Open, 4(4), 230-239
Open this publication in new window or tab >>Patient involvement for improved patient safety: A qualitative study of nurses’ perceptions and experiences
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2017 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 4, no 4, p. 230-239Article in journal (Refereed) Published
Abstract [en]

Aim

To explore nurses’ perceptions and experiences of patient involvement relevant to patient safety.

Design

Qualitative design using individual semi-structured interviews.

Methods

Interviews with registered nurses (= 11) and nurse assistants (= 8) were conducted in 2015–2016. Nurses were recruited from five different healthcare units in Sweden. The material was analysed using conventional content analysis.

Results

The analysis resulted in four categories: healthcare professionals’ ways of influencing patient involvement for safer care; patients’ ways of influencing patient involvement for safer care; barriers to patient involvement for safer care; and relevance of patient involvement for safer care. The nurses expressed that patient involvement is a shared responsibility. They also emphasized that healthcare provider has a responsibility to create opportunities for the patient to participate. According to the nurses, involvement can be hindered by factors related to the patient, the healthcare provider and the healthcare system. However, respondents expressed that patient involvement can lead to safer care and benefits for individual patients.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2017
Keywords
barriers, determinants, facilitators, nurses, patient involvement, patient safety
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-145272 (URN)10.1002/nop2.89 (DOI)29085649 (PubMedID)
Available from: 2018-02-20 Created: 2018-02-20 Last updated: 2018-05-04Bibliographically approved
Nilsen, P., Ericsson, C., Skagerström, J. & Schildmeijer, K. (2017). Patientmedverkan från retorik till praktik [Letter to the editor]. Läkartidningen, 114
Open this publication in new window or tab >>Patientmedverkan från retorik till praktik
2017 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 114Article in journal, Letter (Other academic) Published
Place, publisher, year, edition, pages
Stockholm, Sweden: Läkartidningen Förlag AB, 2017
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-146285 (URN)28675407 (PubMedID)
Available from: 2018-04-07 Created: 2018-04-07 Last updated: 2018-04-18Bibliographically approved
Skagerström, J. (2015). Alcohol consumption during pregnancy: Prevalence, predictors and prevention. (Doctoral dissertation). Linköping: Linköping University Electronic Press
Open this publication in new window or tab >>Alcohol consumption during pregnancy: Prevalence, predictors and prevention
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

It is well established that fetal alcohol exposure can disturb the development of the fetus and cause a range of effects for the affected child. However, research on the effects of exposure to lower levels is inconclusive and the subject is debated. Based on the precautionary principle women in many countries, Sweden included, are advised to maintain total abstinence throughout pregnancy. Regardless, studies have shown that a significant proportion of women consume alcohol around conception and throughout pregnancy. The overall aim of this thesis was to generate knowledge about the prevalence, predictors and prevention of alcohol consumption among women before and during pregnancy.

The aim was addressed in five studies using several datasets and methods. A systematic review of the international literature was undertaken to identify predictors of alcohol consumption during pregnancy (Study I). Questionnaires to midwives were used to investigate the alcohol-preventive work in antenatal care in Sweden (Study II). Questionnaires were also used to gather data on alcohol consumption before and during pregnancy from pregnant women across Sweden and from women who had given birth to a child in one area of Sweden (Study III and IV). Focus group interviews were used to assess non-pregnant women’s voices on alcohol consumption and pregnancy in Sweden (Study V).

The results from the studies showed that alcohol consumption was common among women of childbearing age in Sweden (Study III-V) and that there were social expectations for women to drink (Study V). During pregnancy, the expectation was the opposite, as pregnant women were expected to abstain from all alcohol consumption (Study V), which is in line with the total abstinence recommendation from antenatal care. The national “Risk Drinking” project led to revised alcohol-preventive routines in Swedish antenatal care, including screening of all pregnant women for hazardous alcohol use in the year preceding pregnancy, an important predictor of drinking during pregnancy (Study II). A great majority of pregnant women and new mothers reported abstinence from alcohol after pregnancy recognition (Study III and IV), yet the level of reported alcohol consumption during pregnancy appeared to be affected by formulation of the question (Study IV). Factors associated with more drinking during pregnancy in Sweden were: living in a major city, older maternal age, tobacco use, low social support, stronger pre-pregnancy drinking habits and stronger social drinking motives (Study III). In the international research, pre-pregnancy drinking habits, exposure to abuse or violence, high income or social class and positive screen for dependence were the factors most consistently reported to be associated with more drinking during pregnancy (Study I). Women of childbearing age were uncertain about the potential effects of drinking in the period around conception and the social expectations to abstain did not seem to be as strong in this period as after pregnancy  recognition (Study V). A majority of women reported having reduced their alcohol consumption only after they became aware that they are pregnant, meaning that they could have been dinking for several weeks in early pregnancy (Study III).

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2015. p. 127
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1470
National Category
Obstetrics, Gynecology and Reproductive Medicine Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-122375 (URN)10.3384/diss.diva-122375 (DOI)978-91-7519-024-2 (ISBN)
Public defence
2015-11-20, Belladonna, Hus 511-001, Campus US, Linköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2015-10-30 Created: 2015-10-30 Last updated: 2015-11-12Bibliographically approved
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
Gardner, B., Broström, A., Nilsen, P., Hrubos Strom, H., Ulander, M., Fridlund, B., . . . Johansson, P. (2014). Editorial Material: From does it work? to what makes it work?: The importance of making assumptions explicit when designing and evaluating behavioural interventions in EUROPEAN JOURNAL OF CARDIOVASCULAR NURSING, vol 13, issue 4, pp 292-294. European Journal of Cardiovascular Nursing, 13(4), 292-294
Open this publication in new window or tab >>Editorial Material: From does it work? to what makes it work?: The importance of making assumptions explicit when designing and evaluating behavioural interventions in EUROPEAN JOURNAL OF CARDIOVASCULAR NURSING, vol 13, issue 4, pp 292-294
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2014 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 13, no 4, p. 292-294Article in journal, Editorial material (Other academic) Published
Abstract [en]

n/a

Place, publisher, year, edition, pages
Elsevier / SAGE Publications (UK and US): 12 month Embargo, 2014
National Category
Clinical Medicine Basic Medicine
Identifiers
urn:nbn:se:liu:diva-111759 (URN)10.1177/1474515114531688 (DOI)000342579700001 ()24715537 (PubMedID)
Available from: 2014-10-31 Created: 2014-10-31 Last updated: 2018-01-11
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
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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
Nilsen, P., Skagerström, J., Rahmqvist, M., Hultgren, E. & Blomberg, M. (2012). Alcohol prevention in Swedish antenatal care: effectiveness and perceptions of the Risk Drinking project counseling model. Acta Obstetricia et Gynecologica Scandinavica, 91(6), 736-743
Open this publication in new window or tab >>Alcohol prevention in Swedish antenatal care: effectiveness and perceptions of the Risk Drinking project counseling model
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2012 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 91, no 6, p. 736-743Article in journal (Refereed) Published
Abstract [en]

Objective. To compare an earlier Swedish antenatal care counseling routine concerning alcohol consumption with an expanded model in terms of effectiveness in achieving abstinence in pregnancy. A further objective was to assess the womens perceptions of the alcohol counseling. Design. Cohort study. Setting. Antenatal care center in a provincial Swedish university town. Population. Women who received alcohol counseling; 1533 in cohort 1 (routine counseling) and 1476 in cohort 2 (expanded model). Approximately 93% of all pregnant women in Linkoping are registered at this center. Methods. Data were collected by means of an anonymous questionnaire. Thirteen questions in the questionnaire were analysed for this study. Main outcome measures. Replies from three questions concerning pre-pregnancy drinking and three questions on drinking during pregnancy. Results. The response rate was 60% for cohort 1 and 64% for cohort 2. Perceptions of the advice from the antenatal care center were generally favorable. Similar proportions of women, approximately 6%, in both cohorts drank at least once during the pregnancy (after pregnancy recognition). There were four predictors for drinking during pregnancy: older age; having previously given birth to a child; frequency of pre-pregnancy drinking; and perceiving the message from antenatal care as small amounts of alcohol during pregnancy dont matter.Conclusions. An expanded counseling model implemented in Swedish antenatal care did not reduce the proportion of women who continued drinking during pregnancy in comparison with a previous counseling model, although the advice provided in the new model was perceived more favorably.

Place, publisher, year, edition, pages
Informa Healthcare / Wiley-Blackwell, 2012
Keywords
Antenatal care, pregnancy, alcohol consumption, advice, counseling, implementation
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-78266 (URN)10.1111/j.1600-0412.2012.01402.x (DOI)000304087500014 ()
Available from: 2012-06-08 Created: 2012-06-08 Last updated: 2017-12-07Bibliographically approved
Skagerstrom, J. & Nilsen, P. (2012). DRINKING DURING PREGNANCY IN SWEDEN - PREVALENCE AND PREDICTORS in ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH, vol 36, issue SI, pp 105A-105A. In: ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH: (pp. 105A-105A). Wiley-Blackwell, 36(SI)
Open this publication in new window or tab >>DRINKING DURING PREGNANCY IN SWEDEN - PREVALENCE AND PREDICTORS in ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH, vol 36, issue SI, pp 105A-105A
2012 (English)In: ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH, Wiley-Blackwell , 2012, Vol. 36, no SI, p. 105A-105AConference paper, Published paper (Refereed)
Abstract [en]

n/a

Place, publisher, year, edition, pages
Wiley-Blackwell, 2012
Series
ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH, ISSN 0145-6008
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-82048 (URN)000308396700361 ()
Available from: 2012-10-01 Created: 2012-09-28 Last updated: 2013-08-19
Skagerström, J., Johansson, A. L., Holmqvist, M., Envall, E.-K. & Nilsen, P. (2012). Towards improved alcohol prevention in Swedish antenatal care?. Midwifery, 28(3), 314-320
Open this publication in new window or tab >>Towards improved alcohol prevention in Swedish antenatal care?
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2012 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 28, no 3, p. 314-320Article in journal (Refereed) Published
Abstract [en]

Objective: to evaluate an education effort and revised alcohol-preventive routine in Swedish antenatal care; to generate more knowledge for further development of alcohol issues in antenatal care. less thanbrgreater than less thanbrgreater thanDesign: two national cross-sectional surveys of Swedish midwives were conducted. Baseline data were collected in 2006 and follow-up data in 2009. less thanbrgreater than less thanbrgreater thanSetting: antenatal care centres in Sweden. less thanbrgreater than less thanbrgreater thanParticipants: 974 midwives in 2006 and 1108 midwives in 2009. less thanbrgreater than less thanbrgreater thanMeasurement: amount and content of continuing professional education, work with alcohol-related issues, identification of women with risky consumption of alcohol, and action after identifying women with risky consumption. less thanbrgreater than less thanbrgreater thanFindings: the amount of continuing professional education undertaken by midwives on handling risky drinking increased significantly between 2006 and 2009. The routine to detect risky drinking changed between the baseline and follow-up data collection, as nearly all midwives reported the use of an alcohol screening questionnaire in 2009. The most confident midwives in 2009 had taken part in more days of education, more often stated it was their own initiative to participate, and had more often taken part in education regarding MI, provision of advice and information on the health risks associated with alcohol and, screening. less thanbrgreater than less thanbrgreater thanKey conclusions: our results indicate that a broad, national education effort can be successful in enhancing knowledge and changing antenatal care practice. However, generalisation to other countries or cultures may be limited because the usage of new routines is affected by many organisational and contextual factors.

Place, publisher, year, edition, pages
Elsevier, 2012
Keywords
Antenatal care, Alcohol, Education
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-78573 (URN)10.1016/j.midw.2011.04.008 (DOI)000304441400006 ()
Note

Funding Agencies|Swedish National Institute of Public health||

Available from: 2012-06-15 Created: 2012-06-15 Last updated: 2017-12-07
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