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  • 1.
    Alehagen, Siw
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Molecular and Clinical Medicine, Gender and Medicine. Linköping University, Faculty of Health Sciences.
    Lundberg, Ulf
    Division of Biological Psychology, Department of Psychology, Stockholm University, Stockholm, Sweden.
    Wijma, Klaas
    Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
    Fear, pain and stress hormones during childbirth2005In: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 26, no 3, p. 153-165Article in journal (Refereed)
    Abstract [en]

    Aims. To investigate the course of fear, pain and stress hormones during labor, and the associations between fear, pain, stress hormones and duration of labor in nulliparous women with and without epidural analgesia (EDA).

    Method.  One day during gestation weeks 37–39, urinary and salivary samples were collected to measure catecholamines and cortisol. Hourly during labor, the participants answered the Delivery Fear Scale and a pain intensity scale, and urinary and salivary samples were collected to measure stress hormones.

    Results. The course of fear, pain and stress hormones differed throughout labor in women with and without EDA. Pain and cortisol increased throughout labor in women without EDA. Women who received EDA had more fear, but not more pain, before the administration of the EDA than women who did not receive EDA. Pain, fear and catecholamines decreased when women received EDA, but fear and pain increased again later in labor. Fear and pain correlated, as well as levels of fear in the different phases of labor. During phase one of labor epinephrine and duration of the phase were negatively correlated.

    Conclusion.  The course of fear, pain and concentrations of stress hormones differed, highly influenced by the administration of EDA. Fear and pain correlated more pronounced than stress hormones and fear, pain and duration of labor.

  • 2.
    Alehagen, Siw
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Molecular and Clinical Medicine, Gender and Medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Klaas
    Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
    Fear of childbirth before, during, and after childbirth2006In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 85, no 1, p. 56-62Article in journal (Refereed)
    Abstract [en]

    Background. Only scanty research exists about the relationship between women's expectations during pregnancy and their experiences as reported during the actual process of labor and afterwards. The aims of the present study were: 1. to investigate the associations between fear of childbirth during pregnancy and postpartum and fear and pain during early active labor (phase 1: cervix dilatation 3–5 cm), and 2. to explore possible differences regarding fear of childbirth during pregnancy and postpartum between women who did or did not receive epidural analgesia during labor.

    Methods. Fear of childbirth was measured in 47 nulliparous women during gestation weeks 37–39 by means of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ version A). During early active labor we measured women's fear (Delivery Fear Scale) and their experiences of pain (a pain intensity scale). Finally, fear after childbirth (W-DEQ version B) was measured two hours, two days, and five weeks after delivery.

    Results. A positive correlation appeared between fear of childbirth during pregnancy, postpartum, and early active labor. There were no differences in fear of childbirth during late pregnancy between women who received epidural analgesia and those who did not. Postpartum fear was higher in the women who had received epidural analgesia.

    Conclusions. Pregnant women who fear childbirth are prone to report fear during the actual labor and postpartum. The administration of epidural analgesia is not a sufficient response to women's fear during the process of labor.

  • 3.
    Brohede, Sabina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
    Wingren, Gun
    Linköping University, Department of Clinical and Experimental Medicine, Division of Inflammation Medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Wijma, Klaas
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Validation of the Body Dysmorphic Disorder Questionnaire in a community sample of Swedish women2013In: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 210, no 2, p. 647-652Article in journal (Refereed)
    Abstract [en]

    Body Dysmorphic Disorder (BDD) is characterized by a distressing and impairing preoccupation with a nonexistent or slight defect in appearance. Patients with the disorder present to both psychiatric and non-psychiatric physicians. A few studies have assessed BDD prevalence in the general population and have shown that the disorder is relatively common. To date, no BDD assessment instruments have been validated in the general population. Our aim was to validate a brief self-screening instrument, the Body Dysmorphic Disorder Questionnaire (BDDQ), in a female community sample. The BDDQ was translated into Swedish and filled out by 2891 women from a randomly selected community sample. The questionnaire was validated in a subsample of 88 women, using the Structured Clinical Interview for DSM-IV (SCID) together with clinical assessment as the gold standard. In the validation subsample, the BDDQ showed good concurrent validity, with a sensitivity of 94%, a specificity of 90% and a likelihood ratio of 9.4. The questionnaire can therefore be of value when screening for BDD in female populations.

  • 4.
    Engman, Maria
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Klaas
    Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Itch and burning pain in women with partial vaginismus with or without vulvar vestibulitis2007In: Journal of Sex and Marital Therapy, ISSN 0092-623X, Vol. 33, no 2, p. 171-186Article in journal (Refereed)
    Abstract [en]

    Fifty-three women with partial vaginismus with or without vulvar vestibulitis and 27 asymptomatic women estimated sensations of burning pain and itch at 20 standardized moments during a standardized penetration situation, including vaginal muscle contractions. Forty-three women with partial vaginismus (81.1%) reported burning pain, 23 (43.4%) itch, and 22 (41.5%) both complaints, compared to 0% of the asymptomatic women. In 17 of 22 cases, burning pain preceded the appearance of itch and in four cases the two complaints coincided. The median time from the moment when burning pain started until itch appeared was 150 seconds.

  • 5.
    Engman, Maria
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Klaas
    Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Long-term coital behaviour in women treated with cognitive behaviour therapy for superficial coital pain and vaginismus2010In: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 39, no 3, p. 193-202Article in journal (Refereed)
    Abstract [en]

    The purpose of the present study was to investigate long-term coital behaviour in women treated with cognitive behaviour therapy (CBT) for superficial coital pain and vaginismus. Data were taken from a questionnaire concerning long-term coital behaviour sent to 59 women who presented to Linköping University Hospital because of superficial coital pain, had been diagnosed with vaginismus, and had been treated with CBT. Data were also traced from therapy records: mean follow-up time was 39 months, the women had suffered for an average of almost 4 years, and required a mean of 14 treatment sessions. Forty-four of the 59 women returned the questionnaire, for a response rate of 74.6%. At follow-up, 81% of the treated women had had intercourse. A majority (61%) rated their ability to have intercourse without pain as 6 or higher (on a scale from 0-10), and 61% rated their ability to enjoy intercourse as 6 or higher (on a scale from 0-10). The proportion of women with positive treatment outcome at follow-up ranged from 81% (able to have intercourse) to 6% (able to have pain-free intercourse). An ability to have intercourse at end of therapy was maintained at follow-up. Two-thirds of the women reported high fulfillment of individual treatment goals. At follow-up, the women estimated a significantly higher self-worth as sex partners, and as women and human beings, than before treatment. Twelve per cent of the original sample had healed after a few assessment sessions and without treatment.

  • 6.
    Engman, Maria
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Klaas
    Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Postcoital burning pain and pain at micturition: early symptoms in women with partial vaginismus with or without vulvar vestibulitis?2008In: Journal of Sex and Marital Therapy, ISSN 0092-623X, Vol. 34, no 5, p. 413-428Article in journal (Refereed)
    Abstract [en]

    Twenty-four women with partial vaginismus with or without vulvar vestibulitis participated in a semi-structured telephone interview concerning early signs and development of their pain symptoms during/after intercourse. At the onset of the problem, pain after intercourse was more common than pain during penetration. Pain intensity during penetration increased from the onset of the problem to when the women ceased having intercourse. Pain during penetration lasted for 1 minute, and was most often described as sharp/incisive/bursting, while pain after intercourse had a duration of 2 hours and was described as burning and/or smarting. Post-coital pain during micturition was described by 70% of the women.

  • 7.
    Salomonsson, Birgitta
    Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
    Fear is in the air: Midwives´ perspectives of fear of childbirth and childbirth self-efficacy and fear of childbirth in nulliparous pregnant women2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Introduction: In Western countries, about one pregnant woman in five experiences a considerable fear of childbirth (FOC). Consequently FOC is an important topic for midwives, being pregnant women’s main care givers. Also, although many aspects of FOC have been studied, almost no studies have into detail applied a theoretical frame of reference for studying pregnant women’s expectations for their upcoming labour and delivery. Therefore, the theory of self-efficacy, here regarding pregnant women’s belief in own capability to cope with labour and delivery, has been applied with the aim to better understand the phenomenon of FOC.

    Aim: The overall aims of the thesis were to describe midwives´ perceptions and views on FOC and to expand the current knowledge about expectations for the forthcoming birth in nulliparous women in the context of FOC.

    Method: Study I had a descriptive design. In total 21 midwives, distributed over four focus-groups, participated. Data were analysed by the phenomenographic approach. Studies II and III had cross sectional designs. Study II comprised 726 midwives, randomly selected from a national sample that completed a questionnaire that addressed the findings from Study I. Study III included 423 pregnant nulliparous women. FOC was measured using the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), self-efficacy by the Childbirth Self-Efficacy Inventory (CBSEI). Study IV had a descriptive interpretative design. Seventeen women with severe FOC were conveniently selected from the sample of Study III and individually interviewed. Content analyses, both deductive and inductive, were performed.

    Method: Study I had a descriptive design. In total 21 midwives, distributed over four focus-groups, participated. Data were analysed by the phenomenographic approach. Studies II and III had cross sectional designs. Study II comprised 726 midwives, randomly selected from a national sample that completed a questionnaire that addressed the findings from Study I. Study III included 423 pregnant nulliparous women. FOC was measured using the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), self-efficacy by the Childbirth Self-Efficacy Inventory (CBSEI). Study IV had a descriptive interpretative design. Seventeen women with severe FOC were conveniently selected from the sample of Study III and individually interviewed. Content analyses, both deductive and inductive, were performed.

    Conclusions: Swedish midwives regard severe FOC as a serious problem that influences pregnant women’s view on the forthcoming labour and delivery. Midwives at antenatal care clinics, compared to colleagues working at labour wards, experience a greater need for training in care of pregnant women with severe FOC. Self-efficacy is a useful construct and the self-efficacy theory an applicable way of thinking in analysing fear of childbirth. The self-efficacy concept might be appropriate in midwives’ care for women with severe FOC.

    List of papers
    1. Swedish midwives' perceptions of fear of childbirth
    Open this publication in new window or tab >>Swedish midwives' perceptions of fear of childbirth
    2010 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 26, no 3, p. 327-337Article in journal (Refereed) Published
    Abstract [en]

    OBJECTIVES: to describe midwives' experiences with, and perceptions of, women with fear of childbirth. DESIGN: a qualitative study with a phenomenographic approach. Data were collected by means of interviews in focus groups. SETTING: four focus groups at four types of hospital in Southern Sweden over a period of 18 months, 2004-2006. PARTICIPANTS: 21 experienced midwives. FINDINGS: four description categories emerged, i.e. appearance of fear of childbirth, origins of fear of childbirth, consequences of fear of childbirth, and fear of childbirth and midwifery care. KEY CONCLUSION: fear of childbirth is seen as a continuum from normal to irrational, severe fear. It has various origins which are more or less difficult to operationalise. Fear of childbirth influences the experience of pregnancy, the labour process and the transition to parenthood. Midwifery care of women with fear of childbirth is emotionally demanding and time consuming. Aspects of care required early identification of women with fear of childbirth, individual care, preparation for giving birth, support of a companion during labour, and postpartum follow-up.  

    Keywords
    Fear of childbirth; Midwives; Focus group interview; Care
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-43572 (URN)10.1016/j.midw.2008.07.003 (DOI)000278029000009 ()18774630 (PubMedID)74247 (Local ID)74247 (Archive number)74247 (OAI)
    Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
    2. Swedish midwives’ views on severe fear of childbirth
    Open this publication in new window or tab >>Swedish midwives’ views on severe fear of childbirth
    2011 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 2, no 4, p. 153-159Article in journal (Refereed) Published
    Abstract [en]

    Objective

    To describe the views of Swedish midwives on severe fear of childbirth (SFOC).

    Study design

    In this cross sectional study, a random sample of 1000 midwives, selected from the database of the Swedish Association of Midwives, received a questionnaire. The response rate was 84% (n = 834), with 726 questionnaires included in the final analysis.

    Main outcome measures

    The views of midwives on SFOC in different contexts of work: antenatal care clinic (ACC), labour ward (LW) either ACC/LW or Neither-Nor ACC/LW.

    Results

    The majority of respondents thought that the frequency of SFOC has increased during the last 10 years (67%), and that pregnant women today are more likely to discuss their fears (70%). Midwives at ACCs thought that special education in SFOC is needed (p < 0.001) and that they have more responsibility to identify women with SFOC (p < 0.001) than midwives at LWs. The majority of respondents, both at ACCs (60%) and LWs (65%), intuitively sensed when they were meeting a woman with SFOC. Opinions among midwives who alternate between working in ACCs and LWs reflected the views of the midwives working either in an ACC or an LW.

    Conclusions

    The views of midwives on SFOC are partly in concordance and partly contradictory in relation to the different workplaces as well as research data. Knowledge of the views of midwives on SFOC is a necessary pre-requisite to improve care for pregnant women.

    Keywords
    Anxiety, Fear of childbirth, Midwives, Views
    National Category
    Nursing
    Identifiers
    urn:nbn:se:liu:diva-73549 (URN)10.1016/j.srhc.2011.07.002 (DOI)
    Available from: 2012-01-09 Created: 2012-01-09 Last updated: 2017-12-08Bibliographically approved
    3. Self-efficacy beliefs and fear of childbirth in nulliparous women
    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
    4. Self-efficacy in pregnant women with severe fear of childbirth
    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
  • 8.
    Salomonsson, Birgitta
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
    Alehagen, Siw
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Wijma, Klaas
    Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
    Swedish midwives’ views on severe fear of childbirth2011In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 2, no 4, p. 153-159Article in journal (Refereed)
    Abstract [en]

    Objective

    To describe the views of Swedish midwives on severe fear of childbirth (SFOC).

    Study design

    In this cross sectional study, a random sample of 1000 midwives, selected from the database of the Swedish Association of Midwives, received a questionnaire. The response rate was 84% (n = 834), with 726 questionnaires included in the final analysis.

    Main outcome measures

    The views of midwives on SFOC in different contexts of work: antenatal care clinic (ACC), labour ward (LW) either ACC/LW or Neither-Nor ACC/LW.

    Results

    The majority of respondents thought that the frequency of SFOC has increased during the last 10 years (67%), and that pregnant women today are more likely to discuss their fears (70%). Midwives at ACCs thought that special education in SFOC is needed (p < 0.001) and that they have more responsibility to identify women with SFOC (p < 0.001) than midwives at LWs. The majority of respondents, both at ACCs (60%) and LWs (65%), intuitively sensed when they were meeting a woman with SFOC. Opinions among midwives who alternate between working in ACCs and LWs reflected the views of the midwives working either in an ACC or an LW.

    Conclusions

    The views of midwives on SFOC are partly in concordance and partly contradictory in relation to the different workplaces as well as research data. Knowledge of the views of midwives on SFOC is a necessary pre-requisite to improve care for pregnant women.

  • 9.
    Salomonsson, Birgitta
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
    Berterö, Carina
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Alehagen, Siw
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Self-efficacy in pregnant women with severe fear of childbirth2013In: 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)
    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.

  • 10.
    Salomonsson, Birgitta
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
    Gullberg, Mats T
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Alehagen, Siw
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Wijma, Klaas
    Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
    Self-efficacy beliefs and fear of childbirth in nulliparous women2013In: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 34, no 3, p. 116-121Article in journal (Refereed)
    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.

  • 11.
    Samelius, Charlotta
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Wingren, Gun
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Klaas
    Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
    Lifetime history of abuse, suffering, and psychological health2010In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 64, no 4, p. 227-232Article in journal (Refereed)
    Abstract [en]

    Background: In a representative Swedish sample, we investigated lifetime prevalence of physical, sexual and psychological abuse of women and their current suffering. The relationship between current suffering from abuse and psychological health problems was also studied. Method: The study was cross-sectional and population-based. The Abuse Screening Inventory (ASI), measuring experiences of physical, sexual and psychological abuse and including questions on health and social situation, was sent by mail to 6000 women, randomly selected from the population register. The questionnaire was completed and returned by 4150 (70%) of 5896 eligible women. Results: 27.5% of the women reported abuse of any kind. Of those, 69.5% reported current suffering from abuse. Abused suffering women reported more anxiety, depression and sleep disturbances, and a less advantageous social situation than both non-abused and abused non-suffering women. Also, abused non-suffering women reported more depression than non-abused women. Somatization was reported more often by both abused suffering and non-suffering women than by non-abused women, with no difference between suffering and non-suffering women when adjusted for possible confounders. Conclusion: A majority of abused women, when investigating lifetime history of abuse, report current suffering thereof, which warrants considering abuse an important societal problem. Suffering could be a valuable construct, possibly useful to assess psychological health problems normally not captured by existing diagnostic instruments, although further investigations of the concept are needed.

  • 12.
    Samelius, Charlotta
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Wingren, Gun
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Klaas
    Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
    Post-traumatic stress and somatization in abused women2009In: Traumatology, ISSN 1534-7656, E-ISSN 1085-9373, Vol. 15, no 1, p. 103-112Article in journal (Refereed)
    Abstract [en]

    This study examines the relationship between posttraumatic stressdisorder (PTSD) and somatization in abused women; 213 abusedwomen were assessed for PTSD, somatization, health care contacts,and abuse-related variables. The main analyses in this exploratorystudy are based on the 91 respondents reporting either PTSDor somatization. We found no association between the occurrenceof PTSD and somatization in abused women. Women with PTSD reportedhigher total magnitude of abuse and a larger number of perpetratorsthan women with somatization. Sexually abused women with PTSDmore often described their experience as an act of abuse comparedwith sexually abused women with somatization. Results suggestthat PTSD might not be a necessary mediator between abuse andsomatization and that variables other than abuse magnitude aredecisive for the development of somatization in abused women.

  • 13.
    Samelius, Charlotta
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Wingren, Gun
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Wimja, Klaas
    Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
    Somatization in abused women2007In: Journal of Women's Health, ISSN 1059-7115, E-ISSN 2168-7668, Vol. 16, no 6, p. 909-918Article in journal (Refereed)
    Abstract [en]

    Background: The association between abuse and somatization has been less systematically investigated than other abuse-related outcomes. Moreover, such studies have given inconsistent results. Therefore, the aim of the present study was to investigate the relation between somatization and lifetime exposure to physical, sexual, and psychological abuse.

    Methods: A total of 800 women, 400 reporting abuse and 400 reporting no abuse in a previous randomized, population-based study, were sent two questionnaires: SOMAT, a questionnaire on somatization, and the Abuse Inventory (AI). Of 781 eligible women, 547 participated (70% response rate).

    Results: Psychological abuse of both limited (6 months–2 years) and prolonged duration (>2 years) was associated with somatization (OR = 2.45, 95% CI 1.37-4.40 and OR = 3.09, 95% CI 1.52-6.30, respectively). Sexual abuse without penetration was associated with somatization (OR = 2.47, 95% CI 1.17-5.20), but sexual abuse with penetration was not. Physical abuse was not associated with somatization when adjustments for other kinds of abuse were made. Being abused in adulthood and in both adulthood and childhood was associated with somatization (OR = 4.20, 95% CI 2.45-7.20 and OR = 2.90, 95% CI 1.69-4.90, respectively), whereas being abused in childhood only was not.

    Conclusions: Abuse of women is associated with somatization. Other factors than severity of abuse, such as whether the abused woman herself perceives her experience as abuse, seem to be more decisive for developing somatization in abused women. Abuse should be taken into account when meeting women with somatization symptoms as patients.

  • 14.
    Söderquist, Johan
    et al.
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Molecular and Clinical Medicine, Gender and Medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Klaas
    Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
    The longitudinal course of post-traumatic stress after childbirth2006In: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 27, no 2, p. 113-119Article in journal (Refereed)
    Abstract [en]

    Post-traumatic stress was assessed in early and late pregnancy, and 1, 4, 7, and 11 months postpartum by means of questionnaires among 1224 women. Thirty-seven women (3%) had post-traumatic stress (meeting criteria B, C, and D for PTSD) at least once within 1–11 months postpartum. In pregnancy, depression, severe fear of childbirth, ‘pre’-traumatic stress, previous counseling related to pregnancy/childbirth, and self-reported previous psychological problems were associated with an increased risk of having post-traumatic stress within 1–11 months postpartum. Sum-scores of post-traumatic stress did not decrease over time among women who at least once had post-traumatic stress (criteria B, C, and D) within 1–11 months postpartum. Women with post-traumatic stress also showed a decrease in perceived social support over time postpartum.

  • 15.
    Wijma, Barbro
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Wijma, Klaas
    Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
    Kronisk bäckensmärta2004In: Öppenvårdsgynekologi / [ed] Claes Gottlieb och Bo von Schoultz, Stockholm: Liber, 2004, p. 268-280Chapter in book (Refereed)
    Abstract [sv]

    Öppenvårdsgynekologi är en lärobok som riktar sig främst till läkarstuderande och allmänmedicinare. Vanliga åkommor och problem belyses och boken försöker att ge aktuella behandlingsråd och riktlinjer som går att tillämpa i det dagliga sjukvårdsarbetet. Den är därför en värdefull kunskapskälla även för gynekologer, distriktssjuksköterskor och barnmorskor. I denna andra upplaga har ett helt nyskrivet kapitel tillkommit som behandlar ultraljud inom gynekologin. Boken har försetts med en ny layout, delvis nya illustrationer och med mjuka pärmar för att göra boken mer lättillgänglig och användarvänlig i det dagliga arbetet.

  • 16.
    Wijma, Klaas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
    Samelius, Charlotta
    Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
    Wingren, Gun
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    The association between ill-health and abuse: a cross-sectional population-based study2007In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 48, no 6, p. 567-575Article in journal (Refereed)
    Abstract [en]

    The lifetime prevalence of physical, sexual and psychological abuse was studied cross-sectionally in a representative sample of Swedish women. The association between the three kinds of abuse and ill-health, and the relation between magnitude of abuse and various health problems were also investigated. The Abuse Screening Inventory (ASI), measuring experiences of physical, sexual and psychological abuse and including questions on health and social situation, was sent by mail to 6,000 women, randomly selected from the population register. The questionnaire was completed and returned by 4,150 (70%) of 5,896 eligible women. Various kinds of abuse were reported by 1,142 women (27.5%). The prevalence rates were 19.4% for physical abuse, 9.2% for sexual abuse and 18.2% for psychological abuse. Abused women reported more ill-health and a less advantageous social situation than non-abused women. There was an association between magnitude of abuse and health problems. Also a low magnitude of abuse was substantially associated with ill-health.

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