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Larsson, Per-Göran
Publications (10 of 11) Show all publications
Adolfsson, A., Lindén, K., Sparud Lundin, C., Larsson, P.-G. & Berg, M. (2014). A web-based support for pregnant women and new mothers with type 1 diabetes mellitus in Sweden (MODIAB-Web): study protocol for arandomized controlled trial. Trials, 15, 513
Open this publication in new window or tab >>A web-based support for pregnant women and new mothers with type 1 diabetes mellitus in Sweden (MODIAB-Web): study protocol for arandomized controlled trial
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2014 (English)In: Trials, ISSN 1745-6215, E-ISSN 1745-6215, Vol. 15, p. 513-Article in journal (Other academic) Published
Abstract [en]

Background: Women with type 1 diabetes face particular demands in their lives in relation to childbearing. During pregnancy, in order to optimize the probability of giving birth to a healthy child, their blood glucose levels need to be as normal as possible. After childbirth, they experience a 'double stress': in addition to the ordinary challenges they face as new mothers, they also need to focus on getting their blood glucose levels normal. To improve self-management of diabetes and overall well-being in women with type 1 diabetes, a person-centered web-based support was designed to be tested in a randomized controlled trial (RCT) to be used during pregnancy and early motherhood. This protocol outlines the design of this RCT, which will evaluate the effectiveness of the specially designed web-based support for mothers with type 1 diabetes in Sweden.

Methods: The study is designed as an RCT. The web support consists of three parts: 1) evidence-based information, 2) a self-care diary, and 3) communication with peers. The primary outcome is general well-being evaluated with the Well-Being Questionnaire short version (W-BQ12) and diabetes management evaluated with the Diabetes Empowerment Scale, short version (SWE-DES). Women attending six hospital-based antenatal care centers in Sweden are invited to participate. The inclusion period is November 2011 to late 2014. The allocation of participants to web support (intervention group) and to usual care (control group) is equal (1:1). In total, 68 participants in each group will be needed to reach a statistical power of 80% with significance level 0.05.

Discussion: The web support is expected to strengthen the women's personal capacity and autonomy during pregnancy, breastfeeding, and early motherhood, leading to optimal well-being and diabetes management.

Keywords
Diabetes Mellitus, Type 1, Pregnancy, Support, Social Media, Access Information, Parenting, Motherhood, Randomized Controlled Trial
National Category
Nursing
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-36254 (URN)000349125300001 ()25543854 (PubMedID)
Projects
MODIAB-Web
Note

Funding Agencies:

Center for Person-Centered Care at the University of Gothenburg (GPCC), Sweden

Swedish Diabetes Association

Health & Medical Care Committee of the Regional Executive Board, Region Västra Götaland

Institute of Health and Care Sciences

Sahlgrenska Academy at the University of Gothenburg, Sweden

Available from: 2014-09-01 Created: 2014-09-01 Last updated: 2018-06-09Bibliographically approved
Ekström, L., Adolfsson, A., Ericson, H., Poutakidis, G., Charonis, G. & Larsson, P.-G. (2013). Vaginal flora and urinary and vaginal group B streptococci in early pregnancy. Gynecology, 1
Open this publication in new window or tab >>Vaginal flora and urinary and vaginal group B streptococci in early pregnancy
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2013 (English)In: Gynecology, ISSN 2052-6210, Vol. 1Article in journal (Refereed) Published
Abstract [en]

Background: Bacterial vaginosis (BV) is a risk factor for premature birth and group B streptococci (GBS) colonizing the vagina are etiological agents of neonatal infections. Significant growth of GBS in the vagina has been assumed to be detectable through urinary culture. The aim was to investigate the correlation between BV and the presence of GBS in qualitative vaginal or quantitative urinary culture, since this could predict a higher risk for perinatal morbidity.

Design and setting: A consecutive prospective study of women in early pregnancy included 3101 women between 2007 and 2010, in a region of south-western Sweden.

Methods: Vaginal and urine samples were obtained from women in early pregnancy at maternity health care clinics. BV was diagnosed according to the Ison/Hay classification. GBS in urine were detected in amounts as low as 100 CFU/ml. Vaginal culturing for GBS was obtained from a selected group of 481 women.

Results: There was no difference in the prevalence of GBS in the urine among women with BV compared with women with lactobacilli flora (OR 0.7; 95% CI 0.4-1.1). Vaginal presence of GBS was found among 17.3% of women with BV and among 23.5% of women with lactobacilli flora (OR 0.7; 95% CI 0.3-1.4). Among the 105 women who had vaginal GBS, the urine culture of GBS was positive in only 21.9% of cases.

Conclusions: Even though women with BV. have much higher concentration of bacteria in the vagina, they do not necessarily have more GBS in the vagina or urine. The modest correlation between positive vaginal culture and positive urine culture of GBS question the value of urinary culture for detection of vaginal GBS.

Place, publisher, year, edition, pages
Herbert Publications Limited, 2013
Keywords
Bacterial vaginosis, group B streptococci, pregnancy, vagina
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology; Medicine
Identifiers
urn:nbn:se:oru:diva-30306 (URN)10.7243/2052-6210-1-6 (DOI)
Available from: 2013-08-22 Created: 2013-08-22 Last updated: 2018-05-21Bibliographically approved
Adolfsson, A., Tullander-Tjörnstrand, K. & Larsson, P.-G. (2011). Decreased need for emergency services after changing management for suspected miscarriage. Acta Obstetricia et Gynecologica Scandinavica, 90(8), 921-923
Open this publication in new window or tab >>Decreased need for emergency services after changing management for suspected miscarriage
2011 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 90, no 8, p. 921-923Article in journal (Refereed) Published
Abstract [en]

We investigated the effect of a changed routine to identify women with a nonviable pregnancy, in order to utilize health care resources more efficiently during office hours rather than relying on emergency care services. From hospital register data about where and when women with miscarriages were treated, there was a significant trend during a nine-year period for miscarriages to be more rarely diagnosed (p-value<0.001) in the emergency ward after office hours. The proportion of miscarriages that were diagnosed and handled at the emergency ward decreased from 31% in 2001 to 17% in 2009. Furthermore, the number of women showing up with bleeding at the emergency ward, but who also had a normal viable pregnancy, declined during the same period (p-value<0.01). Women with suspected miscarriage benefit from structured information and standardized management and can effectively be scheduled for day-time assessment including ultrasound with a concomitant reduced need for emergency services.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2011
Keywords
Miscarriage; missed abortion; nonviable pregnancy
National Category
Obstetrics, Gynecology and Reproductive Medicine Nursing
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-24678 (URN)10.1111/j.1600-0412.2011.01144.x (DOI)000293151900018 ()21477000 (PubMedID)2-s2.0-79960349503 (Scopus ID)
Available from: 2012-08-23 Created: 2012-08-23 Last updated: 2018-05-03Bibliographically approved
Adolfsson, A. & Larsson, P.-G. (2010). Applicability of general grief theory to Swedish women's experience after early miscarriage, with factor analysis of Bonanno's taxonomy, using the Perinatal Grief Scale. Upsala Journal of Medical Sciences, 115(3), 201-209
Open this publication in new window or tab >>Applicability of general grief theory to Swedish women's experience after early miscarriage, with factor analysis of Bonanno's taxonomy, using the Perinatal Grief Scale
2010 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 115, no 3, p. 201-209Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Grief is a normal phenomenon but showing great variation depending on cultural and personal features. Bonanno and Kaltman have nonetheless proposed five aspects of normal grief. The aim of this study was to investigate if women with miscarriage experience normal grief.

MATERIAL AND METHODS: Content analyses of 25 transcribed conversations with women 4 weeks after their early miscarriages were classified depending on the meaning-bearing units according to Bonanno and Kaltman's categories. In the factor analyses, these categories were compared with the Perinatal Grief Scale and women's age, number of children and number of miscarriages, and gestational weeks.

RESULTS: Women with miscarriage fulfill the criteria for having normal grief according to Bonanno and Kaltman. All of the 25 women had meaning-bearing units that were classified as cognitive disorganization, dysphoria, and health deficits, whereas disrupted social and occupational functioning and positive aspects of bereavement were represented in 22 of 25 women. From the factor analysis, there are no differences in the expression of the intensity of the grief, irrespective of whether or not the women were primiparous, younger, or had suffered a first miscarriage.

CONCLUSION: Women's experience of grief after miscarriage is similar to general grief after death. After her loss, the woman must have the possibility of expressing and working through her grief before she can finish her pregnancy emotionally. The care-giver must facilitate this process and accept that the intensity of the grief is not dependent on the woman's age, or her number of earlier miscarriages.

National Category
Obstetrics, Gynecology and Reproductive Medicine Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-25610 (URN)10.3109/03009731003739851 (DOI)000281013000008 ()20636255 (PubMedID)
Note

Per-Göran Larsson is also affiliated toDepartment of Obstetrics and Gynecology, Skaraborgs sjukhus, Kärnsjukhuset Skövde, Skövde, SwedenandDivision of Women and Child Health, Department of Clinical and Experimental Medicine, Faculty of Health and Sciences, Linköping University, Linköping, Sweden

Available from: 2012-08-30 Created: 2012-08-30 Last updated: 2018-02-23Bibliographically approved
Eriksson, K., Adolfsson, A., Forsum, U. & Larsson, P.-G. (2010). The prevalence of BV in the population on the Åland Islands during a 15-year period. Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), 118(11), 903-908
Open this publication in new window or tab >>The prevalence of BV in the population on the Åland Islands during a 15-year period
2010 (English)In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 118, no 11, p. 903-908Article in journal (Refereed) Published
Abstract [en]

The aim of the study was to describe the prevalence and age distribution of bacterial vaginosis (BV) during an observation period of 15 years in a population study with cross-sectional samples of adult women living on the Åland Islands. The Åland Islands form an archipelago in the Baltic Sea and are a province of Finland. Every fifth year, specific age groups in the adult female population are invited to participate in a screening program for early diagnosis of cervical cancer using a papanicolaou (PAP)-stained vaginal smear. Women in the age groups of 20, 25, 30, 35, 40, 45, 50, 55, and 60 years are called each year. BV diagnosis of the PAP-stained smears uses the classification according to Nugent. The PAP-stained smears from the screening program of cervical cancer 1993, 1998, 2003, and 2008 were used in this study. A total of 3456 slides were investigated and 271 women could be followed for the 15-year observation period. The prevalence of BV declined from 15.6% in 1993 to 8.6% in 2008. The highest prevalence occurred among the age groups of 35 and 50 years. Among the 271 women who could be followed for the 15-year observation period, two-third showed normal/intermediate flora and one-third were infected with BV at least once. As this is a cross-sectional population study spanning 15 years, the prevalence of BV in the female adult population of the Åland Islands can be estimated. The prevalence has declined between 1993 and 2008 from 15.6% to 8.6%.

Place, publisher, year, edition, pages
Malden, USA: John Wiley & Sons, 2010
Keywords
BV, prevalence, population study, diagnostics, PAP smear
National Category
Cell and Molecular Biology
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-24682 (URN)10.1111/j.1600-0463.2010.02678.x (DOI)000283161100012 ()20955464 (PubMedID)2-s2.0-78149241961 (Scopus ID)
Available from: 2012-08-23 Created: 2012-08-23 Last updated: 2018-08-29Bibliographically approved
Eriksson, K., Adolfsson, A., Larsson, P.-G. & Forserum, U. (2008). BV är ett tillstånd som för vissa individer är konstant under lång tid. In: : . Paper presented at SFOG-veckan, 25-29 augusti 2008, Skövde, Sweden.
Open this publication in new window or tab >>BV är ett tillstånd som för vissa individer är konstant under lång tid
2008 (Swedish)Conference paper, Poster (with or without abstract) (Refereed)
Keywords
BV
National Category
Nursing Obstetrics, Gynecology and Reproductive Medicine
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-36230 (URN)
Conference
SFOG-veckan, 25-29 augusti 2008, Skövde, Sweden
Available from: 2014-08-31 Created: 2014-08-31 Last updated: 2017-10-17Bibliographically approved
Eriksson, K., Adolfsson, A., Forsum, U. & Larsson, P.-G. (2008). Prevalens och incidens av BV hos Ålands befolkning under fem år. In: : . Paper presented at SFOG-veckan, 25-29 augusti 2008, Skövde, Sweden.
Open this publication in new window or tab >>Prevalens och incidens av BV hos Ålands befolkning under fem år
2008 (Swedish)Conference paper, Poster (with or without abstract) (Refereed)
Keywords
PAP-Smear
National Category
Nursing Obstetrics, Gynecology and Reproductive Medicine
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-36229 (URN)
Conference
SFOG-veckan, 25-29 augusti 2008, Skövde, Sweden
Available from: 2014-08-31 Created: 2014-08-31 Last updated: 2017-10-17Bibliographically approved
Adolfsson, A. & Larsson, P.-G. (2006). Cumulative incidence of previous spontaneous abortion in Sweden in 1983-2003: a register study. Acta Obstetricia et Gynecologica Scandinavica, 85(6), 741-747
Open this publication in new window or tab >>Cumulative incidence of previous spontaneous abortion in Sweden in 1983-2003: a register study
2006 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 85, no 6, p. 741-747Article in journal (Refereed) Published
Abstract [en]

AIM: The aim of this study is to find out how common miscarriages are among women who have delivered a child. METHODS: The numbers of deliveries and miscarriages were extracted from the Swedish Medical Birth Register between 1983 and 2003. Linear regression was performed in order to investigate whether the increasing mean age of mothers or differences in pregnancy identification methods could explain the increased frequency of miscarriage. RESULTS: The reported number of miscarriages increased each year during the 21-year period, with a marked increase between 1991 and 1993 and only a slight increase during the final 10 years. For primiparous women, the frequency of reported miscarriages per delivery increased from 8.6% in 1983 to 13.9% in 2003. The corresponding figures for 2-parous women showed an increase from 14.5% to 21.3% respectively. Women aged 30-34 years had an odds ratio of 1.43 (95% CI 1.40-1.45) to suffer spontaneous abortion compared to the age group 25-29 years. Linear regression showed that an increase in mean age at delivery could only partly explain the increase in the frequency of reported miscarriages. A possible explanation could be differences in methods of identifying early pregnancy. CONCLUSION: Of all women who deliver a child, nearly 20% have experienced previous miscarriage. The increased mean age of women could only explain a small portion of the seen increase in miscarriage. The marked increase from 1991 to 1993 is interesting. Possible reasons for the increase are discussed.

Keywords
Abortion, Spontaneous/*epidemiology
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-27333 (URN)10.1080/00016340600627022 (DOI)16752269 (PubMedID)
Available from: 2013-02-05 Created: 2013-02-05 Last updated: 2017-12-06Bibliographically approved
Adolfsson, A., Berterö, C. & Larsson, P.-G. (2006). Effect of a structured follow-up visit to a midwife on women with early miscarriage: a randomized study. Acta Obstetricia et Gynecologica Scandinavica, 85(3), 330-335
Open this publication in new window or tab >>Effect of a structured follow-up visit to a midwife on women with early miscarriage: a randomized study
2006 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 85, no 3, p. 330-335Article in journal (Refereed) Published
Abstract [en]

Background: Women's grief after miscarriage is substantial and important. Women who experience early miscarriage do not constitute a homogenous group. The aim of this study is to measure whether a structured follow-up visit to a midwife (group 1) at 21-28 days after early miscarriage could reduce the women's grief, measured using the perinatal grief scale Swedish short version (PGS) after a further 3 months (i.e. 4 months after the miscarriage), compared to a regular follow-up visit to a midwife (group 2).

Methods: We performed an open randomized study of women who experienced early miscarriage (n = 88). The midwife's attitude in group 1 came from Swanson science theory of midwifery. In group 2, the women were offered only the ordinary type of consultation at a regular visit. A questionnaire with the PGS was used in both groups. Four months after the miscarriage, a second questionnaire with the same perinatal grief scale was sent by post.

Results: There was a 30% greater reduction in grief in group 1 than that in group 2, when comparing the first and second measurements (not significant). The biggest differences were in the subscales active grief and difficulty in coping. Women with the subdiagnosis missed abortions had, as a group, significantly higher PGS scores at both visits, especially in active grief and difficulty in coping, regardless of the type of follow-up visit.

Conclusions: A structured follow-up visit did not, in comparison with a regular follow-up visit, imply any significant reduction in grief as measured using the PGS scale. However, the subgroup missed abortion had more extensive grief than the other women with miscarriage. Structured follow-up visits are not imperative for all women with early miscarriage.

Place, publisher, year, edition, pages
Oslo, Norway: Taylor & Francis, 2006
Keywords
Early miscarriage, grief, midwife, support, treatment
National Category
Obstetrics, Gynecology and Reproductive Medicine Nursing
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-25614 (URN)000236110500012 ()16553182 (PubMedID)
Available from: 2012-08-30 Created: 2012-08-30 Last updated: 2017-12-07Bibliographically approved
Adolfsson, A. & Larsson, P.-G. (2006). Translation of the short version of the Perinatal Grief Scale into Swedish. Scandinavian Journal of Caring Sciences, 20(3), 269-273
Open this publication in new window or tab >>Translation of the short version of the Perinatal Grief Scale into Swedish
2006 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 20, no 3, p. 269-273Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Women's emotions and grief after miscarriage are influenced not only by the context in which the miscarriage occurred but also by their past experience, the circumstances around the miscarriage and their future prospects. Their emotions therefore express a specific form of grief. Normally the time needed to work through the loss varies. A number of different scales, measuring women's emotions and grief after miscarriage have been published. One instrument that measures the specific grief, such as the grief after miscarriage is the Perinatal Grief Scale (PGS) that was designed to measure grief after perinatal loss and has good reliability and validity.

AIMS: The purpose of this study was to translate the PGS into Swedish and to use the translation in a small pilot study.

MATERIAL AND METHOD: The original short version of the PGS was first translated from English into Swedish and then back-translated into English, using different translators. During translation and back-translation, not only the linguistic and grammatical aspects were considered but also cultural differences. The Likert 5-point and a 10-point scale were tested in a pilot study where 12 volunteers anonymously answered the PGS twice. The intra-personal correlations were compared and analysed with weighted kappa-coefficient.

FINDINGS: In all, five different versions were tested before the final Swedish version was established. The weighted kappa-coefficient for the volunteers was 0.58, which is regarded as representing good reproducibility.

CONCLUSION: The PGS was translated successfully into Swedish and could be used in a Swedish population. As this work is rather time-consuming we therefore wish to publish the Swedish version so that it may be used by other researchers.

National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-25613 (URN)10.1111/j.1471-6712.2006.00404.x (DOI)16922980 (PubMedID)
Available from: 2012-08-30 Created: 2012-08-30 Last updated: 2017-12-07Bibliographically approved

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