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Angelhoff, Charlotte, medicine doktorORCID iD iconorcid.org/0000-0002-0174-8630
Publications (10 of 20) Show all publications
Støre, S. J., Tillfors, M., Wästlund, E., Angelhoff, C., Andersson, G. & Norell, A. (2023). Mind, Body and Machine: Preliminary Study to Explore Predictors of Treatment Response After a Sleep Robot Intervention for Adults with Insomnia.. Nature and Science of Sleep, 15, 567-577
Open this publication in new window or tab >>Mind, Body and Machine: Preliminary Study to Explore Predictors of Treatment Response After a Sleep Robot Intervention for Adults with Insomnia.
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2023 (English)In: Nature and Science of Sleep, ISSN 1179-1608, Vol. 15, p. 567-577Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: The study aimed to explore characteristics of responders to a sleep robot intervention for adults with insomnia, and the likelihood that participants responded to the intervention.

METHODS: Data from the intervention and the control group in a randomized waitlist-controlled trial (n = 44) were pooled together after both had undergone the intervention. A repeated measures ANOVA and Friedman tests were used to explore changes over time. Differences in baseline characteristics between responders (n = 13), defined as a reduction of -5 on the Insomnia Severity Index from pre- to post-intervention, and non-responders (n = 31) were analyzed with t-tests and chi-square tests. Finally, logistic regression models were estimated.

RESULTS: Baseline anxiety was the only statistically significant difference between responders and non-responders (p = 0.03). A logistic regression model with anxiety and sleep quality as predictors was statistically significant, correctly classifying 83.3% of cases.

DISCUSSION: The results imply that people with lower anxiety and higher sleep quality at baseline are more likely to report clinically significant improvements in insomnia from the sleep robot intervention.

Place, publisher, year, edition, pages
DOVE MEDICAL PRESS LTD, 2023
Keywords
anxiety, depression, insomnia, sleep, sleep diary, sleep robot, treatment response
National Category
Applied Psychology
Identifiers
urn:nbn:se:liu:diva-196579 (URN)10.2147/NSS.S408714 (DOI)001031039800001 ()37465662 (PubMedID)
Available from: 2023-08-14 Created: 2023-08-14 Last updated: 2023-12-18
Angelhoff, C. & Grundström, H. (2023). Supporting girls with painful menstruation - A qualitative study with school nurses in Sweden. Journal of Pediatric Nursing: Nursing Care of Children and Families, 68, e109-e115
Open this publication in new window or tab >>Supporting girls with painful menstruation - A qualitative study with school nurses in Sweden
2023 (English)In: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 68, p. e109-e115Article in journal (Refereed) Published
Abstract [en]

Background: Painful menstruation is common among girls. To optimize school nurses' work more knowledgeabout their experiences of supporting these girls is needed. The aim of this study was to describe school nurses'experiences of supporting girls with menstrual pain.Methods: Interviews were conducted with 15 school nurses in Sweden and analyzed using thematic analysis.Results: Three themes emerged: Taking menstrual pain seriously, Being a disseminator of knowledge, andExternal conditions for conducting professional work as a school nurse.Conclusion: School nurses felt competent in supporting girls with menstrual pain. However, they lacked struc-tural, written guidelines and routines for how to treat, support, follow-up and refer girls with menstrual pain.Practice implications: School education about menstruation and sexual health needs to be strengthened. Cooper-ation with other healthcare facilities and networks with other school nurses should be increased. Specific guide-lines on how to support girls with menstrual pain should be implemented.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Adolescent; Dysmenorrhea; Pediatric nursing; School nursing; Women
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-191314 (URN)10.1016/j.pedn.2022.11.022 (DOI)000974888400001 ()36446692 (PubMedID)2-s2.0-85142793865 (Scopus ID)
Available from: 2023-01-26 Created: 2023-01-26 Last updated: 2023-05-23Bibliographically approved
Store, S. J., Tillfors, M., Wästlund, E., Angelhoff, C., Andersson, G. & Norell-Clarke, A. (2023). The effects of a sleep robot intervention on sleep, depression and anxiety in adults with insomnia - A randomized waitlist-controlled trial. Journal of Sleep Research, 32(3), Article ID e13758.
Open this publication in new window or tab >>The effects of a sleep robot intervention on sleep, depression and anxiety in adults with insomnia - A randomized waitlist-controlled trial
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2023 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 32, no 3, article id e13758Article in journal (Refereed) Published
Abstract [en]

The study objective was to assess if a 3-week intervention with the Somnox sleep robot had effects on symptoms of insomnia, somatic arousal, and/or concurrent symptoms of depression and anxiety in adults with insomnia, compared with a waitlist-control group. The participants (n = 44) were randomized to a 3-week intervention with the sleep robot (n = 22), or to a waitlist-control group (n = 22). The primary outcome measure was the Insomnia Severity Index administered at baseline, mid-intervention, post-intervention and at 1-month follow-up. Secondary outcome measures were the Pre-Sleep Arousal Scale, and the Hospital Anxiety and Depression Scale. Additionally, sleep-onset latency, wake time after sleep onset, total sleep time and sleep efficiency were measured the week prior to and the last week of the intervention, both subjectively with the Consensus Sleep Diary and objectively with wrist actigraphy. Mixed-effects models were used to analyse data. The effect of the sleep robot on the participants insomnia severity was not statistically significant. The differences between the intervention group and the control group on the measures of arousal, anxiety and depression were also not statistically significant, and neither were the sleep diary and actigraphy variables. In conclusion, a 3-week intervention with daily at-home use of the robot was not found to be an effective method to relieve the symptom burden in adults with insomnia.

Place, publisher, year, edition, pages
Wiley, 2023
Keywords
arousal; hyperarousal; robot; sleep
National Category
Otorhinolaryngology
Identifiers
urn:nbn:se:liu:diva-189766 (URN)10.1111/jsr.13758 (DOI)000871837800001 ()36285420 (PubMedID)
Note

Funding Agencies|Region Varmland through DigitalWellResearch project [HNT 2017/279]

Available from: 2022-11-08 Created: 2022-11-08 Last updated: 2023-12-05Bibliographically approved
Store, S. J., Tillfors, M., Wastlund, E., Angelhoff, C. & Clarke, A. N. (2022). Technically sleeping? A clinical single-case study of a commercial sleep robot. Frontiers in Psychology, 13, Article ID 919023.
Open this publication in new window or tab >>Technically sleeping? A clinical single-case study of a commercial sleep robot
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2022 (English)In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 13, article id 919023Article in journal (Refereed) Published
Abstract [en]

The Somnox sleep robot is promoted as sleep enhancing. The current study investigated individual effects, the acceptability and the safety of, and experiences with, a 3-week intervention in adults with insomnia. A repeated ABA single-case design (n = 4) was used to evaluate the effects of the sleep robot compared with baseline, as measured with a sleep diary and actigraphy. Pre-, post-, and 1-month follow-up assessments were conducted, measuring symptoms of insomnia, level of somatic arousal, and symptoms of depression and anxiety. Questions about adherence were included in the sleep diary. Individual interviews were conducted post intervention to explore the participants experiences with the sleep robot. The sleep diary and actigraphy data showed marginal differences, and if something, often a slight deterioration in the intervention phase. Three participants reported improvements regarding their sleep in the interviews compared with baseline, which mirrored the results on the questionnaires (insomnia and arousal) for two of the participants. The same three participants adhered to the intervention. Stable or improved self-assessed symptoms of depression and anxiety, and information from the individual interviews, suggest that the intervention is safe for adults with insomnia. The results regarding the effects of the sleep robot were mixed, and ought to be scrutinized in larger studies before confident recommendations can be made. However, the study supports the acceptability and safety of the intervention in adults with insomnia.

Place, publisher, year, edition, pages
FRONTIERS MEDIA SA, 2022
Keywords
arousal; hyperarousal; insomnia; sleep; wake after sleep onset
National Category
Applied Psychology
Identifiers
urn:nbn:se:liu:diva-191210 (URN)10.3389/fpsyg.2022.919023 (DOI)000905639700001 ()36600701 (PubMedID)
Available from: 2023-01-25 Created: 2023-01-25 Last updated: 2023-05-03
Loyland, B., Angelhoff, C., Kristjansdottir, G. & Sjolie, H. (2020). A systematic integrative review of parents experience and perception of sleep when they stay overnight in the hospital together with their sick children. Journal of Clinical Nursing, 29(5-6), 706-719
Open this publication in new window or tab >>A systematic integrative review of parents experience and perception of sleep when they stay overnight in the hospital together with their sick children
2020 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 29, no 5-6, p. 706-719Article, review/survey (Refereed) Published
Abstract [en]

Aims and objectives To elucidate knowledge available on parents experience and perception of sleep when they stay overnight in hospital together with their sick children. Background In Nordic countries, children are entitled to have at least one parent with them during hospitalisation. Parents sleep, when accommodated at the hospital during the childs admission, may be a challenge. Design A systematic literature search was conducted in EMBASE, MEDLINE and PsycINFO; period is restricted from 1 January 2007 to 1 April 2019. Studies included were those in which parents were accommodated in hospital with their child, 0-18 years of age, for at least one night. Original peer-reviewed scientific research papers conducting qualitative, quantitative or mixed designs were included. Systematic reviews were not included. This systematic integrative review was registered in PROSPERO and performed according to the PRISMA guidelines. All authors participated in study selection, data extraction and quality assessment of the literature. Results Fifteen studies were included, and they varied in terms of origin, aims, design, methods used and sample size. Three overall main themes appeared: sleep quality, factors affecting sleep and consequences of sleep loss. Combined psychological factors were found to affect parents sleep, as well as isolated psychological factors, for example, stress, anxiety, worries and difficult thoughts. Environmental and social factors were also identified, for example, privacy and caring for family. Conclusion Study of this subject is still in its exploratory phase. There is a need for the development of theory of substance in the clarification of the meaning of sleep among parents during difficult times such as childrens hospitalisation. Relevance to clinical practice Understanding risk factors associated with sleep and sleep deprivation in parents staying overnight in the hospital with their sick child is important, since lack of sleep may lead to serious stress-related outcomes for the parents.

Place, publisher, year, edition, pages
WILEY, 2020
Keywords
hospitalised child; parents; sleep quality; stress; systematic Integrative review
National Category
Other Health Sciences
Identifiers
urn:nbn:se:liu:diva-163025 (URN)10.1111/jocn.15134 (DOI)000504738900001 ()31821674 (PubMedID)
Available from: 2020-01-09 Created: 2020-01-09 Last updated: 2021-04-25
Lundgren, J., Norell Clarke, A., Hellström, I. & Angelhoff, C. (2020). Adolescents’ experiences of staying overnight at family-centered pediatric wards. Sage Open Nursing, 6
Open this publication in new window or tab >>Adolescents’ experiences of staying overnight at family-centered pediatric wards
2020 (English)In: Sage Open Nursing, E-ISSN 2377-9608, Vol. 6Article in journal (Refereed) Published
Abstract [en]

Background

Sleep is essential for health and recovery. Hospital stays may affect adolescents’ sleep quality negatively as routines in the ward are not adapted for adolescents’ developmental status or sleep habits. The aims with this study were to (a) explore and describe how adolescents experience sleep in the family-centered pediatric ward, (b) explore and describe how adolescents experience the presence or absence of a parent during the hospital stay, and (c) identify circumstances that the adolescents describe as influential of their sleep in the pediatric wards.

Methods

This is a qualitative interview study employing thematic analysis with an inductive and exploratory approach. Sixteen adolescents aged between 13 and 17 years participated in the study.

Results

Three themes were found: the importance of good sleep, safety as a prerequisite for sleep in hospital, and circumstances influencing adolescents’ sleep in hospital.

Conclusion

The adolescents described their sleep at the pediatric ward positively, but mentioned disturbing factors associated with pain, nightly check-ups, noises, and inactivity. Parental presence was perceived as very positive both during the night and the day.

Place, publisher, year, edition, pages
Sage Publications, 2020
Keywords
adolescents, family-centered care, pediatrics, qualitative, sleep
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-165043 (URN)10.1177/2377960819900690 (DOI)000508566300001 ()2-s2.0-85078074583 (Scopus ID)
Available from: 2020-04-09 Created: 2020-04-09 Last updated: 2022-12-12Bibliographically approved
Angelhoff, C., Sjolie, H., Mörelius, E. & Loyland, B. (2020). Like Walking in a Fog: Parents' perceptions of sleep and consequences of sleep loss when staying overnight with their child in hospital. Journal of Sleep Research, 29(2), Article ID e12945.
Open this publication in new window or tab >>Like Walking in a Fog: Parents' perceptions of sleep and consequences of sleep loss when staying overnight with their child in hospital
2020 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 29, no 2, article id e12945Article in journal (Refereed) Published
Abstract [en]

Disruption of parental sleep in hospital, with frequent awakenings and poor sleep quality, limits the parents resources to meet the childs needs and maintain parental wellbeing. The aim of the study was to explore and describe how parents perceive their sleep when staying overnight with their sick child in hospital. A further aim was to explore and describe parents perception of what circumstances influence their sleep in the hospital. Twenty-two parents who were accommodated with their sick child (0-17 years) in paediatric wards in Norway and Sweden participated. Interviews were conducted during the hospital stay to elicit their perspectives. Phenomenography was used to analyse data. Two descriptive categories were found: (a) "Perceptions of sleep", with two sub-categories: "Sleep in the paediatric ward" and "Consequences of sleep loss"; and (b) "Circumstances influencing sleep in the paediatric ward" with three sub-categories: "The importance of the family", "Information and routines at the paediatric ward", and "Accommodation facilities". Parents sleep and needs must be acknowledged in paediatric wards. An individual plan of care for the upcoming night could be a valuable tool for both the parents and nurses. The childs medical needs must be met with respect to the parents willingness to take part in the childs care during the night, and the need for rest and sleep for both parent and child.

Place, publisher, year, edition, pages
WILEY, 2020
Keywords
children; family-centred care; hospitalized; paediatric nursing; paediatrics
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-162524 (URN)10.1111/jsr.12945 (DOI)000496160900001 ()31724227 (PubMedID)
Note

Funding Agencies|Crown Princess Victoria Childrens Hospital; Perth Childrens Hospital Foundation; Oslo Metropolitan University

Available from: 2019-12-13 Created: 2019-12-13 Last updated: 2023-01-27
Angelhoff, C., Edéll-Gustafsson, U. & Morelius, E. (2019). The cortisol response in parents staying with a sick child at hospital. Nursing Open, 6(2), 620-625
Open this publication in new window or tab >>The cortisol response in parents staying with a sick child at hospital
2019 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 6, no 2, p. 620-625Article in journal (Refereed) Published
Abstract [en]

Aim

To study the cortisol response in parents staying with their child in paediatric wards, to compare the parents’ cortisol levels between the paediatric ward and at home 4 weeks after discharge and to compare the parents’ cortisol levels with data of an adult reference population, reported by Wust et al., as there are few studies investigating parental cortisol.

Design

This study has a descriptive and prospective comparative design.

Method

Thirty‐one parents participated. Saliva samples were collected in the paediatric ward and 4 weeks later at home.

Results

The parents had lower morning awakening cortisol levels in the paediatric ward than at home after discharge. There were no statistically significant differences in postawakening cortisol or cortisol awakening response (CAR). The child's age, diagnosis or previously diagnosed chronic condition did not affect the parents’ cortisol levels. The morning and postawakening cortisol levels were lower than those of the reference population.

Conclusion

The hospital stay with a sick child affects parents’ cortisol levels. Parental stress needs more attention to find interventions to prevent the risk of stress‐related complications that subsequently can affect the care of the child.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2019
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-155717 (URN)10.1002/nop2.245 (DOI)000461835600041 ()30918712 (PubMedID)2-s2.0-85062974527 (Scopus ID)
Projects
What about the parents?: Sleep quality, mood, saliva cortisol response and sense of coherence in parents with a child admitted to pediatric care
Funder
Medical Research Council of Southeast Sweden (FORSS), FORSS‐159681
Available from: 2019-03-25 Created: 2019-03-25 Last updated: 2020-04-27Bibliographically approved
Angelhoff, C., Thernström Blomqvist, Y., Sahlén Helmer, C., Olsson, E., Shorey, S., Frostell, A. & Mörelius, E. (2018). Effect of skin-to-skin contact on parents sleep quality, mood, parent-infant interaction and cortisol concentrations in neonatal care units: study protocol of a randomised controlled trial. BMJ Open, 8(7), Article ID e021606.
Open this publication in new window or tab >>Effect of skin-to-skin contact on parents sleep quality, mood, parent-infant interaction and cortisol concentrations in neonatal care units: study protocol of a randomised controlled trial
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2018 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 8, no 7, article id e021606Article in journal (Refereed) Published
Abstract [en]

Introduction Separation after preterm birth is a major stressor for infants and parents. Skin-to-skin contact (SSC) is a method of care suitable to use in the neonatal intensive care unit (NICU) to minimise separation between parents and infants. Less separation leads to increased possibilities for parent-infant interaction, provided that the parents’ sleep quality is satisfactory. We aimed to evaluate the effect of continuous SSC on sleep quality and mood in parents of preterm infants born <33 weeks of gestation as well as the quality of parent-infant interaction and salivary cortisol concentrations at the time of discharge.

Methods and analysis A randomised intervention study with two arms—intervention versus standard care. Data will be collected from 50 families. Eligible families will be randomly allocated to intervention or standard care when transferred from the intensive care room to the family-room in the NICU. The intervention consists of continuous SSC for four consecutive days and nights in the family-room. Data will be collected every day during the intervention and again at the time of discharge from the hospital. Outcome measures comprise activity tracker (Actigraph); validated self-rated questionnaires concerning sleep, mood and bonding; observed scorings of parental sensitivity and emotional availability and salivary cortisol. Data will be analysed with pairwise, repeated measures, Mann Whitney U-test will be used to compare groups and analysis of variance will be used to adjust for different hospitals and parents’ gender.

Ethics and dissemination The study is approved by the Regional Research Ethics Board at an appropriate university (2016/89–31). The results will be published in scientific journals. We will also use conferences and social media to disseminate our findings.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018
Keywords
attachment; bonding; kangaroo mother care; neonata care; sleep; Stress
National Category
Pediatrics
Identifiers
urn:nbn:se:liu:diva-152093 (URN)10.1136/bmjopen-2018-021606 (DOI)000446181900144 ()30068615 (PubMedID)2-s2.0-85053045224 (Scopus ID)
Note

Funding Agencies|County Council of Ostergotland [LIO-720151, LIO-663781]; Medical Research of Southeast Sweden [FORSS-661721]

Available from: 2018-10-17 Created: 2018-10-17 Last updated: 2023-12-28Bibliographically approved
Angelhoff, C., Edéll-Gustafsson, U. & Mörelius, E. (2018). Sleep quality and mood in mothers and fathers accommodated in the family-centred paediatric ward. Journal of Clinical Nursing, 27(3-4), e544-e550
Open this publication in new window or tab >>Sleep quality and mood in mothers and fathers accommodated in the family-centred paediatric ward
2018 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 3-4, p. e544-e550Article in journal (Refereed) Published
Abstract [en]

Aims and objectives

To describe sleep quality and mood in parents accommodated with their sick child in a family‐centred paediatric ward. Secondary aims were to compare mothers’ and fathers’ sleep quality and mood in the paediatric ward and to compare the parents’ sleep quality and mood between the paediatric ward and in a daily‐life home setting after discharge.

Background

Frequent interruptions, ward noise and anxiety affect parents’ sleep quality and mood negatively when accommodated with their sick child in paediatric wards. Poor sleep quality and negative mood decrease the parents’ ability to sustain attention and focus, and to care for their sick child.

Methods

This was a prospective and descriptive study. Eighty‐two parents (61 mothers and 21 fathers) with children (median age 6.25 years) admitted to six paediatric wards participated in the study. Uppsala Sleep Inventory, a sleep diary and the Mood Adjective Checklist were used to measure sleep quality and mood.

Results

The parents had a good sleep quality in the paediatric ward even though they had more nocturnal awakenings compared to home. Moreover, they were less alert, less interested and had reduced concentration, and were more tired, dull and passive in the hospital than at home after discharge. Vital sign checks, noises made by the staff and medical treatment were given reasons influencing sleep. Poor sleep quality correlated with negative mood.

Conclusion

Parents’ sleep quality in family‐centred paediatric care is good. However, the habitual sleep efficacy before admittance to the hospital is lower than expected and needs to be further investigated.

Relevance to Clinical Practice

The healthcare professionals should acknowledge parents’ sleep and mood when they are accommodated with their sick child. Further should care at night be scheduled and sleep promoted for the parents to maintain health and well‐being in the family.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
adolescents, child, child nursing, children’s nurses, family nursing, family-centred care, hospitalised child, paediatrics, parent, sleep
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-143585 (URN)10.1111/jocn.14092 (DOI)000425733600018 ()28960555 (PubMedID)2-s2.0-85037348121 (Scopus ID)
Note

Funding agencies: Medical Research Council of Southeast Sweden [FORSS-159681]; Region of Ostergotland, Sweden

Available from: 2017-12-11 Created: 2017-12-11 Last updated: 2019-05-01Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-0174-8630

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