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  • 201. Adolfsson, Annsofie
    Barnmorskans avancerade kliniska omvårdnad vid gynekologisk öppenvårdsmottagning2011In: Avancerad klinisk sjuksköterska: avancerad klinisk omvårdnad i teori och praxis / [ed] Lisbeth Fagerström, Lund: Studentlitteratur AB, 2011, 1, p. 355-376Chapter in book (Other academic)
  • 202. Adolfsson, Annsofie
    Blödning under tidig graviditet2009In: Lärobok för barnmorskor, Lund: Studentlitteratur, 2009, 3, p. 118-124Chapter in book (Other academic)
  • 203.
    Adolfsson, Annsofie
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Confronting the inevitable: a conceptual model of miscarriage for use in clinical practice and research2010In: , 2010Conference paper (Refereed)
  • 204.
    Adolfsson, Annsofie
    School of Life Sciences, University of Skövde, Skövde, Sweden; Department of Obstetrics and Gynecology, Skaraborg Hospital, Skövde, Sweden.
    Meta-analysis to obtain a scale of psychological reaction after perinatal loss: focus on miscarriage2011In: Psychology Research and Behavior Management, ISSN 1179-1578, E-ISSN 1179-1578, Vol. 4, p. 29-39Article in journal (Refereed)
    Abstract [en]

    Pregnancy has different meanings to different women depending upon their circumstances. A number of qualitative studies have described the experience of miscarriage by women who had desired to carry their pregnancy to full term. The aim of this meta-analysis was to identify a scale of psychological reaction to miscarriage. Meta-analysis is a quantitative approach for reviewing articles from scientific journals through statistical analysis of findings from individual studies. In this review, a meta-analytic method was used to identify and analyze psychological reactions in women who have suffered a miscarriage. Different reactions to stress associated with the period following miscarriage were identified. The depression reaction had the highest average, weighted, unbiased estimate of effect (d(+) = 0.99) and was frequently associated with the experience of perinatal loss. Psychiatric morbidity was found after miscarriage in 27% of cases by a diagnostic interview ten days after miscarriage. The grief reaction had a medium d(+) of 0.56 in the studies included. However, grief after miscarriage differed from other types of grief after perinatal loss because the parents had no focus for their grief. The guilt is greater after miscarriage than after other types of perinatal loss. Measurement of the stress reaction and anxiety reaction seems to be difficult in the included studies, as evidenced by a low d(+) (0.17 and 0.16, respectively). It has been recommended that grief after perinatal loss be measured by an adapted instrument called the Perinatal Grief Scale Short Version.

  • 205. Adolfsson, Annsofie
    Miscarriage: women’s experience and its cumulative incidence2006Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Many women experience miscarriage every year. Every fourth woman who has given birth reports that she has previous experience of miscarriage. In a study of all women in the Swedish Medical Birth Register 1983-2003, we found that the number of cases of self reported miscarriage had increased in Sweden during this 21 year period. This increase can be explained by the introduction of sensitive pregnancy tests around 1990, as well as an increase in the mean age of the mothers, by approximately 3 years, during the observation period. The risk of miscarriage is 13% with the first child. With subsequent pregnancies, the risk of miscarriage is 8%, 6% and 4% with the second, third and fourth child, respectively.

    Thirteen of these women who had suffered a recent miscarriage were interviewed four months later, and their feelings of guilt and emptiness were explored. Their experience was that they wanted their questions to be answered, and that they wanted others to treat them as the mothers to be that they felt themselves to be. They also experienced the need for time to grieve their loss.

    Measurement of grief by means of the Perinatal Grief Scale (PGS) is used in research but has also been proposed for clinical use. We have translated this psychological instrument to Swedish, back-translated and tested it in a small pilot study. In a randomized controlled study, women with early miscarriage were allocated, either to a structured visit (study group) or a regular visit (control group) to a midwife. The structured visit was conducted according to the Swanson caring theory. We could conclude that the structured visit had no significant effect on grief compared to the regular visit, as measured using the PGS. However, women with the sub-diagnosis missed abortion have significantly more grief four months after early miscarriage, regardless of visit type.

    We also performed a content analysis of the tape-recorded structured follow-up visit. The code-key used was Bonanno and Kaltman’s general grief categorization. Women’s expression of grief after miscarriage was found to be very similar to the grief experienced following the death of a relative. Furthermore, the grief was found to be independent of number of children, women’s age, or earlier experience of miscarriage.

    Conclusions: Every fourth woman who gives birth reports that she has also experienced early miscarriage. The experience of these women is that they have suffered a substantial loss and their reaction is grief similar to that experienced following the death of a relative.

    List of papers
    1. Cumulative incidence of previous spontaneous abortion in Sweden in 1983-2003: a register study
    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
    2. Guilt and emptiness: women's experiences of miscarriage
    Open this publication in new window or tab >>Guilt and emptiness: women's experiences of miscarriage
    2004 (English)In: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 25, no 6, p. 543-560Article in journal (Refereed) Published
    Abstract [en]

    Women who lose an early pregnancy are shocked when they are first given the information that they have miscarried. Later they feel guilt and emptiness. Heideggerian interpretive phenomenology has been used with 13 women from southwest Sweden to uncover their lived experience of miscarriage. Women plan their future with a child during early pregnancy. When miscarriage occurs it is not a gore, an embryo, or a fetus they lose, it is their child. They feel that they are the cause of the miscarriage through something they have done, eaten, or thought. They feel abandonment and they grieve for their profound loss; they are actually in bereavement.

    National Category
    Nursing
    Research subject
    Nursing Science
    Identifiers
    urn:nbn:se:oru:diva-25616 (URN)10.1080/07399330490444821 (DOI)15354621 (PubMedID)
    Available from: 2012-08-30 Created: 2012-08-30 Last updated: 2017-12-07Bibliographically approved
    3. Translation of the short version of the Perinatal Grief Scale into Swedish
    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
    4. Effect of a structured follow-up visit to a midwife on women with early miscarriage: a randomized study
    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
    5. 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
    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
  • 206.
    Adolfsson, Annsofie
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Missfall2006In: , 2006Conference paper (Other academic)
  • 207. Adolfsson, Annsofie
    Women's well-being improves after missed miscarriage with more active support and application of Swanson's caring theory2011In: Psychology Research and Behavior Management, ISSN 1179-1578, E-ISSN 1179-1578, Vol. 4, p. 1-9Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The purpose of this study was to provide better organization and more efficient use of resources within the health care system in order to identify women with nonviable pregnancy earlier in their gestation terms and also to identify those women who experience severe grief reaction after the miscarriage. The proposed solution is to offer an appointment with a gynecologist during regular office hours after consultation with the patient's midwife to women experiencing symptoms and who are concerned with the viability of their pregnancy. Unnecessary contact with the emergency room by the patients would be reduced as a result of this improvement in organization. The aim of the study was to give the women experiencing missed miscarriage an increased sense of well-being by applying Swanson's Caring Theory to their recovery, in addition to the better organization and more efficient use of resources.

    METHOD: Both the original study from 2002 to 2003 and the later study from 2004 to 2005 applied Swanson's Caring Theory in the follow-up care management of the women, but only the later study was influenced by the changes made in the health care system. In the past, diagnosis of missed miscarriage was delayed because women experiencing minor symptoms were not highly prioritized in the health care system. More active support was introduced in order to get the proper information to the patient throughout the health care system. The size of the original study database was n = 43, compared with the later study database, which was n = 56. All of the women answered the Perinatal Grief Scale (PGS) questions twice, 1 month and 4 months after their diagnosis. Some additional questions about their circumstances unrelated to the PGS were also mailed to the women 4 months after their diagnosis.

    RESULTS: As a result of the more active support, women felt that they received professional care when they needed it most. The patients were satisfied that they were treated as if they were suffering from normal grief. The group score above the limits for deep grief 4 months after diagnosis was significantly lowered. The chances of receiving their diagnosis at an appointment during office hours increased (odds ratio 3.38). Sick leave time of more than a week was reduced from 44% in the original study to 22% in the later study.

  • 208.
    Adolfsson, Annsofie
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. The Centre for Women’s, Family and Child Health, Faculty of Health Sciences, Buskerud & Vestfold University, Kongsberg, Norway.
    Arbhede, Emelie
    Department Obstetrics and Gynecology, Ryhov County Hospital, Jönköping, Sweden.
    Marklund, Elisabeth
    Women’s Clinic, Highland Distric County Hospital, Eksjö, Sweden.
    Larsson, Per-Göran
    Department of Obstetrics and Gynaecology, University of Linköping, Linköping, Sweden.
    Berg, Marie
    Institutes of Health and Care Science, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.
    Miscarriage: Evidence Based Information for the Web and Its Development Procedure2015In: Advances in Sexual Medicine, ISSN 2164-5191, Vol. 5, no 4, p. 89-110Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this paper is to describe the process of developing web information on miscarriage based on scientific evidence, for women and couples in Sweden experiencing miscarriage. Method: A participatory design was used which included researchers, professional  xperts and users. A participatory design was used involving researchers, professional experts and users. The information was developed in six stages: 1) identifying the needs of information; 2) identifying and constructing the main areas of information and its paths; 3) identifying and inviting experts for revision; 4) developing the text; 5) reviewing the text; 6) design and structuring for adaption to website. Results: The text of information developed gradually based on the seven steps. The final text comprised three parts: 1) what is miscarriage; 2) experiences of miscarriage; 3) processing and lanning for new pregnancy. Conclusion: Using participatory design was time and resource consuming, however it was functional for producing appropriate information for the target group. The developed evidence based facts text is assumed to be a complement to the information that is provided by the health care system.

  • 209.
    Adolfsson, Annsofie
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Berterö, Carina
    Hälsohögskolan i Jönköping, Sweden.
    Heidegger’s interpretive phenomenology given the understanding that experience from the past affecting the present and the future in women who had miscarried2005In: , 2005Conference paper (Refereed)
  • 210.
    Adolfsson, Annsofie
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Berterö, Carina
    Hälsohögskolan i Jönköping, Jönköping, Sweden.
    Sorgen vid missfall, kvalitativ innehållsanalys av strukturerat samtal med barnmorska2005Conference paper (Refereed)
  • 211.
    Adolfsson, Annsofie
    et al.
    Department of Obstetrics and Gynecology, Central Hospital, Skövde, Sweden; Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Berterö, Carina
    Division of Nursing Science, Department of Medicine and Care, Faculty of Health Science, Linköping University, Linköping, Sweden.
    Larsson, Per-Göran
    Department of Obstetrics and Gynecology, Central Hospital, Skövde, Sweden; Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Effect of a structured follow-up visit to a midwife on women with early miscarriage: a randomized study2006In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 85, no 3, p. 330-335Article in journal (Refereed)
    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.

  • 212.
    Adolfsson, Annsofie
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Berterö, Carina
    Hälsohögskolan i Jönköping, Sweden.
    Larsson, Per-Göran
    Skaraborgssjukhus Skövde, Sweden.
    Effekten av strukturerat återbesök till barnmorska för kvinnor med tidiga missfall: en randomiserad studie2004In: , 2004Conference paper (Refereed)
  • 213.
    Adolfsson, Annsofie
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Berterö, Carina
    Hälsohögskolan i Jönköping, Sweden.
    Larsson, Per-Göran
    Skaraborgssjukhus Skövde, Sweden.
    Missfall, cumulativ incidence och kvinnors upplevelser2005Conference paper (Refereed)
  • 214.
    Adolfsson, Annsofie
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Berterö, Carina
    Hälsohögskolan i Jönköping, Jönköping, Sweden.
    Larsson, Per-Göran
    Skaraborgs sjukhus, Skövde, Sweden.
    The effect of structured second visit to midwifes in women with early miscarriage: a randomized study2004Conference paper (Refereed)
  • 215.
    Adolfsson, Annsofie
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Berterö, Carina
    Hälsohögskolan i Jönköping, Sweden.
    Larsson, Per-Göran
    Skaraborgs sjukhus Skövde, Sweden.
    The effect of structured second visit to midwifes in women with early miscarriage: a randomized study2005Conference paper (Refereed)
  • 216.
    Adolfsson, Annsofie
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Finnerup Andresen, Janne
    Örebro Läns Landsting, Örebro, Sweden.
    Brattström Edgren, Kristin
    Örebro Läns Landsting, Örebro, Sweden.
    Why obese women feel better about their "big" condition when they are pregnant: a qualitative study performed in Sweden2013In: Open Journal of Obstetrics and Gynecology, ISSN 2160-8792, E-ISSN 2160-8806, Vol. 3, p. 544-552Article in journal (Refereed)
    Abstract [en]

    Overweight and obesity as measured by the body mass index (BMI) is an increasing problem worldwide according to the World Health Organization (WHO) [1]. Women having a body mass index greater than or equal to30 kg/m2 are considered to be obese and they run a greater risk of complications when they are pregnant. Complications such as high blood pressure, gestational diabetes, risk of intrauterine fetal death and slower delivery when giving birth to the baby are risks that can affect the well being of the woman and the child. According to the study on the women, the midwife’s most important role when meeting with the pregnant obese woman is to inform them about potential risks during pregnancy. The midwife must withhold judgment. For many women living with obesity means that they are not seen as the person they actually are. Obese women feel that they do not conform to the societal ideal of an attractive woman because of their size and because of other people’s prejudices regarding their obesity. When an obese woman becomes pregnant they may feel more comfortable with their standing in society because there is a happy explanation for the size of their abdomen. They experience that they are happy and proud about their stomach and this gives them a sense of relief and belonging.

  • 217.
    Adolfsson, Annsofie
    et al.
    Örebro University, School of Health Sciences. University College of Southeast Norway, Tonsberg, Norway.
    Hagander, Anna
    University College, Skövde, Sweden.
    Mahjoubipour, Farzane
    University College, Skövde, Sweden.
    Larsson, Per-Göran
    Department of Obstetrics and Gynaecology, Skaraborg Hospital, Skövde, Sweden; University of Linköping, Linköping, Sweden.
    How Vaginal Infections Impact Women's Everyday Life: Women's Lived Experiences of Bacterial Vaginosis and Recurrent Vulvovaginal Candidiasis2017In: Advances in Sexual Medicine, ISSN 2164-5205, Vol. 7, no 1, p. 1-19Article in journal (Refereed)
    Abstract [en]

    Reoccurring symptoms and persistent problems that continue post treatment can becharacteristic of the vaginal infections Bacterial Vaginosis (BV) and recurrent vulvovaginalcandidiasis (RVVC). The purpose of this study was to describe women’s lifeexperiences in managing the symptoms of bacterial vaginosis and Candida. Sixteenwomen were recruited and participated in an interview study when they contacted aSwedish gynecology clinic with vaginal complaints that ranged from and includedabnormal discharge, irritation itching along with serious malodor. An interpretivephenomenological approach was used with an individual interview to get a more intimateunderstanding of the women experiencing these problems. The finding of thisstudy shows that managing the recurrent symptoms of the infections remains to be achallenge for women as it has a clearly negative impact on the quality of their lives.Four themes developed: frustration and mood disorders, intimacy changes in the relationship,exposure, hope and relief. The women had high hopes of eliminating thesymptoms within the six-month study period. The treatment program, with itswell-developed guidelines and continuity of care within the context of the studygreatly improved the quality of life of these women. Women had feelings of frustrationand anxiety when nothing could cure their problem while they had also a greathope to get rid of the symptoms with a long striking treatment. Well-developedguidelines and continuity of care can help these women to have an improved qualityof life.

  • 218.
    Adolfsson, Annsofie
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Hogström, Lars
    Department of Obstetrics and Gynecology, Central Hospital, Skövde, Sweden.
    Johansson, Marianne
    Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Janson, Per Olof
    Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Berg, Marie
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Francis, Jynfiaf
    Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Sogn, Jan
    Department of Obstetrics and Gynecology, Central Hospital, Uddevalla, Sweden.
    Hellström, Anna-Lena
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Livskvalitet bland par i Sverige efter adoption, efter IVF och efter spontan befruktning och förlossning2011In: Svenska barnmorskeförbundet 300 år. Stockholm Abstrakt bok, 2011Conference paper (Refereed)
  • 219.
    Adolfsson, Annsofie
    et al.
    School of Life Sciences, University of Skövde, Skövde, Sweden; Department of Obstetrics and Gynaecology, Skaraborg Hospital, Skövde, Sweden.
    Jansson, Malin
    School of Life Sciences, University of Skövde, Skövde, Sweden.
    Prototype for Internet support of pregnant women and mothers with type 1 diabetes: focus group testing2012In: Psychology Research and Behavior Management, ISSN 1179-1578, E-ISSN 1179-1578, Vol. 5, p. 97-103Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The aim of this study was to pilot test a prototype website called MODIAB-web designed to support pregnant women and mothers with type 1 diabetes.

    METHOD: A focus group was undertaken and the results were analyzed using qualitative content analysis.

    RESULTS: Eight subthemes were identified, comprising "blood glucose versus insulin," "application for smart phones," "the time aspect," "interface and technology," "forum," "direct link to the diabetes midwife," "ask the expert," and "lack of contact information." These subthemes were condensed into two main themes. The first theme was "easily understood interface, but in need of a more blood-glucose focused orientation" and the second theme was "forum for interaction with both equals and experts."

    CONCLUSION: The women in this study had positive impressions of several of the MODIAB-web functions, including a forum for pregnant mothers with type 1 diabetes and the possibility of being able to put their blood glucose levels into a diagram which could be sent directly to the diabetes midwife. Access to articles and information via the "fact" tab and the ability to ask questions of experts were also significantly helpful to women in the focus group. Pregnant women and mothers with type 1 diabetes can gain support from such a Web-based self-help system.

  • 220.
    Adolfsson, Annsofie
    et al.
    Örebro University, School of Health Sciences.
    Jordmorfag, Innen
    Fakultet for helsevitenskap, Institutt for sykepleievitenskap – Vestfold, University College of Southeast, Kongsberg, Norway.
    The EKC-Model Provides Empathy, Knowledge and Care for Women that Encounter Health issues During the Reproductive Life2016In: International Journal of Gynecology & Clinical Practices, ISSN 2394-4986, Vol. 3, article id 121Article in journal (Refereed)
    Abstract [en]

    The EKC model (Empathy, Knowledge and Care) provides the necessary empathy, knowledge andcare for the women who encounter health issues during their reproductive life. This approach to caring requires that healthcare workers are knowledgeable in order to confirm that a patient has suffered a miscarriage or a IUFD (Intra-uterine fetus death). Through understanding and training in the EKC model the healthcare professional increases their ability to be sympathetic and empathetic to a patient’s needs. The workers get training in sexual and reproductive health in order to intimately understand how they affect the lives of individuals and their families.                                                                            l

    Sexual and reproductive health is a cross-sectional science that includes medicine, psychology, sociology and the caring sciences. Some of the more commonly experienced issues are in the areas of spontaneous abortion, miscarriages, invitrofertilization and adoption. Issues such as sexual abuse and violence towards women is another issue that is treatable with the EKC model. Pregnant women with diabetes type 1 fall under “maternity and diabetes” issues.

    Intimate knowledge about how the grieving process works is essential to be able to provide the necessary support to the patient. It is possible that the support will give them the courage and motivation to try and conceive again. One key aspect of the EKC model is to provide open and clear communication between the healthcare personnel and the patient, whether that communication is done face-to-face or otherwise. The structured EKC conversation provides a viable tool to help healthcare professionals assist their patients in coming to terms and resolving their loss.

  • 221.
    Adolfsson, Annsofie
    et al.
    School of Life Sciences, University of Skövde, Skövde, Sweden.
    Larsson, Per-Göran
    School of Life Sciences, University of Skövde, Skövde, Sweden.
    Applicability of general grief theory to Swedish women's experience after early miscarriage, with factor analysis of Bonanno's taxonomy, using the Perinatal Grief Scale2010In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 115, no 3, p. 201-209Article in journal (Refereed)
    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.

  • 222. Adolfsson, Annsofie
    et al.
    Larsson, Per-Göran
    Cumulative incidence of previous spontaneous abortion in Sweden in 1983-2003: a register study2006In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 85, no 6, p. 741-747Article in journal (Refereed)
    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.

  • 223.
    Adolfsson, Annsofie
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Larsson, Per-Göran
    Skaraborgs sjukhus, Skövde, Sweden.
    Kvinnors sorg efter missfall kan minska med ändrade vårdrutiner2006Conference paper (Refereed)
  • 224. Adolfsson, Annsofie
    et al.
    Larsson, Per-Göran
    Translation of the short version of the Perinatal Grief Scale into Swedish2006In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 20, no 3, p. 269-273Article in journal (Refereed)
    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.

  • 225.
    Adolfsson, Annsofie
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Larsson, Per-Göran
    Skaraborgssjukhus Skövde, Sweden.
    Berterö, Carina
    Hälsohögskolan i Jönköping, Sweden.
    Missfall: kvinnans upplevelser2004In: , 2004Conference paper (Refereed)
  • 226.
    Adolfsson, Annsofie
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Larsson, Per-Göran
    Skaraborgs Sjukhus Skövde.
    Berterö, Carina
    Hälsohögskolan i Jönköping, Sverige.
    Swansons omvårdnadsteori tillämpad vid samtal med barnmorska efter tidiga missfall2005In: Konferens Reproduktiv Hälsa, Svenska Barnmorskeförbundet, 2005Conference paper (Refereed)
  • 227.
    Adolfsson, Annsofie
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Larsson, Per-Göran
    Örebro University, School of Medicine, Örebro University, Sweden.
    Wijma, Barbro
    Institutionen för klinisk och experimentell medicin, Linköpings universitet.
    Berterö, Carina
    Department of Medical and Health Sciences, Linköpings universitet.
    Guilt and emptiness: women's experiences of miscarriage2004In: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 25, no 6, p. 543-560Article in journal (Refereed)
    Abstract [en]

    Women who lose an early pregnancy are shocked when they are first given the information that they have miscarried. Later they feel guilt and emptiness. Heideggerian interpretive phenomenology has been used with 13 women from southwest Sweden to uncover their lived experience of miscarriage. Women plan their future with a child during early pregnancy. When miscarriage occurs it is not a gore, an embryo, or a fetus they lose, it is their child. They feel that they are the cause of the miscarriage through something they have done, eaten, or thought. They feel abandonment and they grieve for their profound loss; they are actually in bereavement.

  • 228.
    Adolfsson, Annsofie
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Lindén, Karolina
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.
    Sparud Lundin, Carina
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.
    Larsson, Per-Göran
    Department of Obstetrics and Gynecology, Skaraborg Hospital, Skövde, Sweden.
    Berg, Marie
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.
    A web-based support for pregnant women and new mothers with type 1 diabetes mellitus in Sweden (MODIAB-Web): study protocol for arandomized controlled trial2014In: Trials, ISSN 1745-6215, E-ISSN 1745-6215, Vol. 15, p. 513-Article in journal (Other academic)
    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.

  • 229.
    Adolfsson, Annsofie
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Renström, Ragna
    Skaraborgssjukhus Skövde, sweden.
    Kvalitetshandbok, gynmottagningen, KSS1998Conference paper (Other academic)
  • 230.
    Adolfsson, Annsofie
    et al.
    Department of Obstetrics and Gynecology, Central Hospital Skövde, Skövde, Sweden; School of Life Sciences, University of Skövde, Skövde, Sweden.
    Tullander-Tjörnstrand, Karin
    Department of Obstetrics and Gynecology, Central Hospital Skövde, Skövde, Sweden.
    Larsson, Per-Göran
    Department of Obstetrics and Gynecology, Central Hospital Skövde, Skövde, Sweden; School of Life Sciences, University of Skövde, Skövde, Sweden.
    Decreased need for emergency services after changing management for suspected miscarriage2011In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 90, no 8, p. 921-923Article in journal (Refereed)
    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.

  • 231.
    Adolfsson, Camilla
    et al.
    Örebro University, School of Hospitality, Culinary Arts & Meal Science.
    Kenne, John
    Örebro University, School of Hospitality, Culinary Arts & Meal Science.
    Barns åsikter om måltidsmiljön i skolrestauranger2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 232.
    Adolfsson, Chandra
    Örebro University, Department of Business, Economics, Statistics and Informatics.
    Utvärdering av granskningssystem för SCB:s undersökningar Kortperiodisk Sysselsättningsstatistik och Konjunkturstatistik över Vakanser2007Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    I denna studie har undersökningarna Kortperiodisk Sysselsättningsstatistiks (KS) och Konjunkturstatistik över Vakansers (KV) befintliga granskningssystem utvärderats med avseende på hur effektivt det är. Processdata har framställts och analyserats. Resultaten tyder på att många av de inkomna blanketterna med misstänkt felaktiga uppgifter inte rättas upp, utan tvingas igenom trots att granskningssystemet ej accepterade uppgifterna. Det befintliga granskningssystemet har en högre träffsäkerhet avseende KS-undersökningen, men både KS och KV skulle kunnas granskas mer effektivt.

    För att utvärdera det befintliga granskningssystemet ytterligare användes en poängfunktion. Till studien fanns tillgång till både helt ogranskat material och helt granskat material och dessa material användes i poängfunktionen. Det uppräknade ogranskade värdet för varje objekt jämfördes med det uppräknade granskade värdet och ställdes i relation till respektive skattade branschtotal. De poängsatta blanketterna rangordnades sedan. Därefter analyserades materialet för att försöka finna var det skulle vara lämpligt att sätta det tröskelvärde som skulle skilja det material som ”egentligen” skulle ha behövts granskas från det som kunde ha lämnats orört. Att sätta tröskelvärdet är svårt. Här gjordes det godtyckligt utifrån kriterierna att det fel som införs i skattningarna för att allt material inte granskas skulle hållas så lågt som möjligt samt att antalet blanketter som skulle behöva granskas manuellt av produktionsgruppen också skulle hållas så lågt som möjligt. Även här visade det sig att det befintliga granskningssystemet inte är så effektivt som önskas. När resultaten från denna del av utvärderingen analyserades upptäcktes problem som beror på blankettutformningen. Skulle blanketterna ses över och åtgärdas skulle det fel som införs för att allt material inte granskas kunna minskas avsevärt. Genom att minska det införda felet kan tröskelvärdet förmodligen sättas på en ny nivå vilket medför att omfattningen av granskningen skulle minska ytterligare.

    Hur skulle då ett mer effektivt granskningssystem kunna se ut? I den här studien har valet fallit på att testa ”significance editing” på KS-undersökningen, det som på svenska kallas för effektgranskning. En poängfunktion användes även här, denna tilldelar de inkomna blanketterna varsin poäng och dessa poäng rangordnas därefter. Efter att poängen rangordnats bestäms en gräns, ett tröskelvärde, och de blanketter med en poäng som överstiger tröskelvärdet granskas och rättas upp av produktionsgruppen. De blanketter med en poäng som understiger det satta tröskelvärdet rättas inte upp, utan behåller sina originalvärden. Poängfunktionen jämför det inkomna ogranskade, uppräknade, värdet med ett uppräknat ”förväntat” värde och ställer denna differens i relation till den skattade branschtotalen. Svårigheten ligger ofta i att hitta ett bra förväntat värde och detta problem uppstår ideligen i urvalsundersökningar. Tanken med effektgranskning är att omfattningen av granskningen ska minska och den granskning som utförs ska ha effekt på slutresultatet.

    Det var inte lätt att hitta ett bra förväntat värde på den tid som stod till förfogande. Två problem som snabbt upptäcktes var dels att i KS-undersökningen finns inte uträknade säsongs- eller trendfaktorer per variabel. Dessutom byttes en mycket stor del av urvalet ut till kvartal 2 (som denna studie har avgränsats till att behandla). Detta har fått till följd att cirka hälften av objekten i urvalet inte går att följa bakåt i tiden eftersom de inte ingått i urvalet tidigare. I studien har respektive stratums medelvärde använts som förväntat värde. Resultaten visar att det valda förväntade värdet inte skulle ha använts i praktiken, men det fungerar bra i syfte att illustrera hur det i praktiken skulle kunna gå till att införa en mer effektiv granskning.

  • 233.
    Adolfsson, Chandra
    et al.
    Örebro University, Swedish Business School at Örebro University.
    Håkansson, Alexandra
    Örebro University, Swedish Business School at Örebro University.
    En studie av sambandet mellan kvarstående bias och kostnad vid selektiv granskning i undersökningen Kortperiodisk Sysselsättningsstatistik: Analys av parameterval i verktyget Selekt2009Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Det har pågått ett intensivt utvecklingsarbete på Statistiska Centralbyrån (SCB) under de senaste åren i syfte att standardisera och effektivisera statistikproduktionsprocessen. I detta utvecklingsarbete har fokus främst riktats mot processerna insamling och granskning. Ett flertal studier har visat att det finns potential att reducera granskningens omfattning samtidigt som den övergripande kvaliteten i undersökningarna bibehålls. För att uppnå detta krävs att nya arbetssätt, metoder och verktyg utvecklas och implementeras.

    Den traditionella ansatsen på SCB har varit att i granskningsprocessen försöka hitta och rätta alla databearbetnings- och mätfel. Ingen skillnad har gjorts mellan stora och små fel eller om felen har någon effekt på statistiken eller inte. Detta är en ineffektiv ansats där stora resurser åtgår till att rätta fel som inte påverkar den statistiska redovisningen nämnvärt. I mer moderna ansatser betonas vikten av att hitta betydelsefulla fel som har stor påverkan på parameterskattningarna och att fel som inte ger någon påverkan bör lämnas som de är eller åtgärdas via imputering. Detta, att inte granska allt, kallas för selektiv granskning.

    SCB har beslutat att införa metoden selektiv granskning med poängfunktioner. Metoden fordrar att poängberäkningar görs, dessa utförs i verktyget Selekt. Verktyget ingår i den framtida verktygslådan för granskning som är under utveckling vid SCB och är uppbyggt av ett stort antal parametrar. För att uppnå så effektiv granskning som möjligt måste de mest lämpliga parametervärdena sökas för att sedan implementeras i Selekt.

    I denna studie har ett datamaterial från undersökningen Kortperiodisk Sysselsättningsstatistik, privat sektor (KSP) använts för att studera sambanden mellan statistikens kvalitet och valet av parametrar i Selekt.  Valet av datamaterial motiveras främst av att Selekt ska implementeras i KSP under år 2010. De parametrar som har behandlats i studien kallas för KAPPA, TAU och LAMBDA samt variablerna RPB_20 och Kostnad.

    Logistisk regression har använts för att undersöka vilken påverkan parametrarna har på den bias (kallad RPB) som införs i skattningarna vid selektiv granskning. En ansats valdes där sambandet mellan responsvariabeln RPB_20 och förklaringsvariablerna KAPPA, TAU och Kostnad studerades separat för olika värden på LAMBDA.

    Vid resultatframställningen indikerades tidigt att valet av värde på LAMBDA inte verkade ha någon nämnvärd betydelse för modellen och i de fortsatta analyserna stärktes denna misstanke och kom att omfatta även KAPPA och TAU. Det var redan från början känt att Kostnad är en viktig variabel att ta hänsyn till och för att undersöka detta närmare konstruerades en modell bestående av ett fjärdegradspolynom med enbart variabeln Kostnad. Modellen lyckades fånga upp huvuddragen av variationen i RPB_20.

    Det går inte att dra generella slutsatser från den studie som här har genomförts. Resultaten visar dock att en modell utan KAPPA, TAU och LAMBDA fungerar för att beskriva variationen i RPB_20.  Valet av värden på KAPPA, TAU och LAMBDA i Selekt är av mindre betydelse. I implementeringsarbetet av Selekt i KSP rekommenderas därför att, förutom RPB, fokusera på variabeln Kostnad för att hitta den mest lämpliga kombinationen av parameterinställningar.

  • 234.
    Adolfsson, Daniel
    et al.
    Örebro University, School of Science and Technology.
    Lowry, Stephanie
    Örebro University, School of Science and Technology.
    Andreasson, Henrik
    Örebro University, School of Science and Technology.
    Improving Localisation Accuracy using Submaps in warehouses2018Conference paper (Other academic)
    Abstract [en]

    This paper presents a method for localisation in hybrid metric-topological maps built using only local information that is, only measurements that were captured by the robot when it was in a nearby location. The motivation is that observations are typically range and viewpoint dependent and that a map a discrete map representation might not be able to explain the full structure within a voxel. The localisation system uses a method to select submap based on how frequently and where from each submap was updated. This allow the system to select the most descriptive submap, thereby improving the localisation and increasing performance by up to 40%.

  • 235.
    Adolfsson, Elin
    et al.
    Örebro University, School of Humanities, Education and Social Sciences.
    Öster, Emma
    Örebro University, School of Humanities, Education and Social Sciences.
    Samspelet mellan numeracypraktiker: - i skola och hem2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 236.
    Adolfsson, Emelie
    et al.
    Örebro University, Örebro University School of Business.
    Bergkvist, Sofia
    Örebro University, Örebro University School of Business.
    Bjärkstedt, Anna
    Örebro University, Örebro University School of Business.
    Kvinnliga revisorers avancemang inom revisionsbranschen: En studie om jämställdhet och struktur 2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 237.
    Adolfsson, Emma
    Örebro University, School of Humanities, Education and Social Sciences.
    Fler män än kvinnor?: En studie av könsobalans bland unga vuxna i Sveriges kommuner2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Denna uppsats handlar om den skeva könsfördelningen bland ungdomar i åldern 20-24 år i Sverige.

    Fokus som kommer framförallt att ligga på ett kommunalt perspektiv men också efter SKL:s kommungruppsindelning. Syftet är dels att undersöka hur själva könsfördelningen ser ut runt om i landet, men också genom att undersöka vad konsekvenserna kan bli för Sverige på en kommunal såväl som en nationell nivå. Nedslag kommer att göras i två kommuner i olika delar av landet. Båda kommunerna har en väldigt stor snedfördelning mellan könen i ålderskategorin 20-24 år. Frågeställningarna som uppsatsen utgår från är: – I vilka typer av kommuner finns det en obalans mellan män och kvinnor i åldern 20-24 år? – Vilka konsekvenser skapar en skev könsfördelning för Sverige på såväl nationell som kommunal nivå? – Hur arbetas det förebyggande för att minska den skeva könsfördelningen på kommunal nivå? – Hur kommer det sig att vissa kommuner har en större könsobalans är andras? Hur kan detta motverkas? I uppsatsen kommer både kvalitativ och kvantitativ metod att användas. Den kvalitativa delen utgörs av två intervjuer och den kvantitativa delen utgörs av offentlig statistik som presenteras med hjälp av kartor och tabeller.

    De huvudsakliga slutsatserna som arbetet kommer fram till att anledningen till att vi på ett nationellt perspektiv gått från ett kvinnoöverskott till ett mansöverskott framförallt har orsakas av att dagens män lever allt längre i kombination med att det föds fler män än kvinnor. Den kommunala snedfördelningen är framförallt orsakad av flyttningar där kvinnor i lite högre utsträckning än männen väljer att lämna hemkommunen för storstäder respektive studentstäder. Orsaken grundas bland annat i att kvinnor i högre utsträckning påbörjar högskolestudier än vad män gör. De kommungrupperna med skevast könsfördelning, från högst till lägst är "varuproducerande kommuner, "glesbygdskommuner" och slutligen "pendlingskommuner". De kommungrupper med jämnast könsfördelning är "större städer" följt av "storstäder". De konsekvenser som kan uppkomma ur ett nationellt perspektiv är bland annat samhällsklimatet blir hårdare. En större andel bittra män som upplever sig som ratade av både samhället och av kvinnor löper ökad risk för att utveckla kriminellt beteende och extremism. Svårigheterna med att hitta en partner leder till att vi får barn allt senare. Ur ett kommunalt perspektiv är den minskande andelen ung och arbetsför befolkning de största problemen. Många mindre kommuner har en högre andel äldre vars vårdbehov ökar. Kommuner med en hög andel män utvecklar lätt ett väldigt patriarkal samhällsklimat vilket både skrämmer bort unga kvinnor men också har en negativ effekt på männens hälsa. För att undvika ovanstående problem behövs det bland annat att det arbetas mer aktivt med jämställdhetsfrågor ute bland mindre orter. Det måste även bli mer attraktivt att stanna kvar i småkommunerna och arbetsgivare måste visa att det finns andra yrken än bara inom industrin och vården. Ur ett nationellt perspektiv måste det satsas på att höja mäns betyg i skolan.

  • 238.
    Adolfsson, Hanna
    Örebro University, Department of Behavioural, Social and Legal Sciences.
    Kollegiegranskning, en metod för att utvärdera och lära av varandra2006Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 239.
    Adolfsson Hultgren, Camilla
    et al.
    Örebro University, School of Health and Medical Sciences.
    Wedin, Madeleine
    Örebro University, School of Health and Medical Sciences.
    Evidens för användandet av hund vid arbete med klienter i olika situationer: En systematisk litteraturstudie2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med denna studie var att undersöka vilken evidens det fanns för att användandet av hund vid arbete med klienter i olika situationer har någon fysiologisk effekt. Frågor vi ställde oss var i vilka situationer hunden används som medel, vilka mätmetoder som har använts, vilka fysiologiska effekter som uppmätts, vilka ytterligare effekter som uppmätts samt hur hunden kan användas som medel i en arbetsterapeutisk kontext. En systematisk sökning efter vetenskapliga artiklar utfördes i databaserna Cinahl, PubMed och PsycInfo. Efter att studierna granskats utifrån kvalitet, samt inklusions- och exklusionskriterier, återstod 11 artiklar av kvantitativ karaktär som analyserades utifrån syfte och frågeställningar. Genom kritisk granskning och sammanställning av litteraturen skapades en syntes från tidigare genomförda empiriska studier. På detta sätta hittades vad som fungerar, vad som är effektivt och vilket vetenskapligt stöd för användningen av hund som finns. Resultatet visar viss evidens för några av de fysiologiska variablerna som sänkt hjärtfrekvens samt att rörelserelaterade aktiviteter i form av promenaders längd och hastighet samt personers gångmönster förbättrades. De övriga fysiologiska samt de ytterligare variabler författarna undersökte visade flera på statistisk signifikans. Dock nådde evidensstyrkan endast otillräckligt vetenskapligt underlag vilket gör att det inte går att dra några säkra slutsatser om evidens. Samtidigt såg författarna att orsaken till det otillräckliga vetenskapliga underlaget i flera fall berodde på att endast en studie undersökt en specifik variabel som i sig gav högt bevisvärde, och detta gör att författarna trots det begränsade vetenskapliga underlaget menar att det finns belägg för att uttrycka att hunden kan vara användbar i en arbetsterapeutisk kontext på flera plan. Detta då arbetsterapeutens arbetsområde ofta täcker in en stor del av en människas liv och att hunden där kan vara ett bra redskap i att nå flera av klientens behovsområden.

  • 240. Adolfsson, Jan
    et al.
    Garmo, Hans
    Varenhorst, Eberhard
    Ahlgren, Göran
    Ahlstrand, Christer
    Andren, Ove
    Örebro University, School of Health and Medical Sciences.
    Bill-Axelson, Anna
    Bratt, Ola
    Damber, Jan-Erik
    Hellström, Karin
    Hellström, Magnus
    Holmberg, Erik
    Holmberg, Lars
    Hugosson, Jonas
    Johansson, Jan-Erik
    Örebro University, School of Health and Medical Sciences.
    Petterson, Bill
    Törnblom, Magnus
    Widmark, Anders
    Stattin, Pär
    Clinical characteristics and primary treatment of prostate cancer in Sweden between 1996 and 2005: Data from the national prostate cancer register in Sweden2007In: Scandinavian Journal of Urology and Nephrology, ISSN 0036-5599, E-ISSN 1651-2065, Vol. 41, no 6, p. 456-477Article in journal (Refereed)
    Abstract [en]

    Objective. The incidence of prostate cancer is rising rapidly in Sweden and there is a need to better understand the pattern of diagnosis, tumor characteristics and treatment. Material and methods. Between 1996 and 2005, all new cases of adenocarcinoma of the prostate gland were intended to be registered in the National Prostate Cancer Register (NPCR). This register contains information on diagnosing unit, date of diagnosis, cause of diagnosis, tumor grade, tumor stage according to the TNM classification in force, serum prostate-specific antigen (PSA) levels at diagnosis and primary treatment given within the first 6 months after diagnosis. Results. In total, 72 028 patients were registered, comprising >97% of all pertinent incident cases of prostate cancer in the Swedish Cancer Register (SCR). During the study period there was a considerable decrease in median age at the time of diagnosis, a stage migration towards smaller tumors, a decrease in median serum PSA values at diagnosis, a decrease in the age-standardized incidence rate of men diagnosed with distant metastases or with a PSA level of >100 ng/ml at diagnosis and an increase in the proportion of tumors with Gleason score ≤6. Relatively large geographical differences in the median age at diagnosis and the age-standardized incidence of cases with category T1c tumors were observed. Treatment with curative intent increased dramatically and treatment patterns varied according to geographical region. In men with localized tumors and a PSA level of <20 ng/ml at diagnosis, expectant treatment was more commonly used in those aged ≥75 years than in those aged <75 years. Also, the pattern of endocrine treatment varied in different parts of Sweden. Conclusions. All changes in the register seen over time are consistent with increased diagnostic activity, especially PSA testing, resulting in an increased number of cases with early disease, predominantly tumors in category T1c. The patterns of diagnosis and treatment of prostate cancer vary considerably in different parts of Sweden. The NPCR continues to be an important source for research, epidemiological surveillance of the incidence, diagnosis and treatment of prostate cancer

  • 241.
    Adolfsson, Jessica
    et al.
    Örebro University, School of Humanities, Education and Social Sciences.
    Lindevall, Vilhelm
    Örebro University, School of Humanities, Education and Social Sciences.
    Politiskt kvitter : En kvantitativ innehållsanalys av politisk kommunikation på Twitter 2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 242.
    Adolfsson, Kristin
    Örebro University, School of Law, Psychology and Social Work.
    Att växa upp med fostersyskon - hur upplevs det?2009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 243.
    Adolfsson, Lina
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Eriksson, Maria
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Fysisk aktivitet som hälsofrämjande omvårdnadsåtgärd vid depression: 2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 244.
    Adolfsson, Margareta
    et al.
    HILD, School of Education and Communication, Jönköping University, Jönköping, Sweden; The Swedish Institute for Disability Research, Jönköping University, Jönköping, Sweden.
    Westerberg, Christina
    Department of Special Education, Faculty of Social Sciences, Stockholm University, Stockholm, Sweden .
    Möller, Kerstin
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Audiological Research, The University Hospital, Örebro, Sweden.
    Everyday life situations of school-aged children with severe disabilities: what are the goals for the future? an exploratory study2014In: Journal of Intellectual Disability - Diagnosis and Treatment, E-ISSN 2292-2598, no 2, p. 21-32Article in journal (Refereed)
    Abstract [en]

    This study investigated present and future everyday life situations (ELS) in home, school, work, and leisureenvironments for a group of school-aged children with severe disabilities, including complex disorders and a combinationof disabilities.

    The purpose was to explore universal ELS; clarify how the children can be supported in their developmentof autonomy; and to gather information on potential overall goals for interventions. To make data comparable, allreported ELS were linked to the International Classification of Functioning, Disability and Health, Child and Youth version(ICF-CY) and listed along with information on the setting. Both today, and in the future, recreational activities andparticipation in school or work were of highest importance, but few reported ELS involved directly interacting with otherchildren. More ELS were predicted to occur outside the home and with a higher degree of autonomy. Therefore,interventions would be focused on the overall goal that children with severe disabilities take initiatives to becomeindependent and to form relationships with others.

  • 245.
    Adolfsson, Moa
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Widmark, Nina
    Örebro University, School of Law, Psychology and Social Work.
    The impact of pain information on pain intensity An experimental study on violation of expectations and conflicting information2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Previous research has shown that there are several components involved in how we perceive pain, e.g. social and psychological factors such as expectations of pain. A cold pressor experiment was conducted to investigate the impact of negative/positive information on pain perception. We also investigated if a cognitive conflict created by disconfirming information of a pain expectation influences the pain experience. 106 participants (49 men and 57 women) got to hold their hand in 5°C water for 1 minute. The main outcome variable was self-reported pain during the cold pressor test. The results show that participants receiving negative information perceived more pain than the group receiving positive information. There was no significant difference in pain perception between those who were confirmed or disconfirmed in an expectation, nor was there a difference in cognitive conflict between the two groups. This is a first attempt to explore pain and cognitive conflict and can work as an inspiration for further investigation.

  • 246.
    Adolfsson, Monica
    et al.
    Örebro University, Department of Health Sciences.
    Unosen, Berit
    Örebro University, Department of Health Sciences.
    Icke farmakologiska metoder för att lindra postoperativ smärta hos vuxna 2007Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Postoperativ smärta är relaterad till vävnadsskadan som uppstår i samband med operation. Denna smärta kan många gånger vara svår att lindra optimalt med olika farmaka och underbehandlas i stor utsträckning. Syftet med denna litteraturstudie var att beskriva olika icke farmakologiska metoder som kan lindra postoperativ smärta hos vuxna. Metoden som användes bestod av en litteraturstudie där data samlades in genom systematiska databassökningar samt manuella sökningar. De icke farmakologiska metoder som framkom var specifik preoperativ information, avslappning, vägledd visualisering, akupunktur, massage, musik och vibrationsterapi. Metoderna kunde utföras av både sjuksköterskor och annan sjukvårdspersonal. Det framkom i flera artiklar att patienterna även kunde använda några av dessa metoder i egenvårdande syfte. De icke farmakologiska metoderna som framkom i litteraturstudien visade sig kunna lindra postoperativ smärta.

  • 247.
    Adolfsson, Per
    Örebro University, Swedish Business School at Örebro University.
    Stockholms trängselskatter och hur de påverkat räddningstjänstens körtider i Stockholms kommun2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 248.
    Adolfsson, Per
    et al.
    Örebro University, Örebro University School of Business.
    Ivic, Marijo
    Örebro University, Örebro University School of Business.
    Ett försök till att statistiskt modellera matchutfall för fotbollens division 1 för herrar i Sverige2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 249.
    Adolfsson, Per
    et al.
    Örebro University, Swedish Business School at Örebro University.
    Karlsson, Anna
    Örebro University, Swedish Business School at Örebro University.
    Aktieindexobligationer: Värdering med hjälp av Monte Carlo-simulering2011Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 250.
    Adolfsson, Peter
    et al.
    Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Endocrine and Diabetes Center, The hospital of Halland Kungsbacka, Kungsbacka, Sweden.
    Mattsson, Stig
    Faculty of Health Sciences and Medicine, Örebro University Hospital, Örebro, Sweden; Endocrine and Diabetes Center, Falun Hospital, Falun, Sweden.
    Jendle, Johan
    Faculty of Health Sciences and Medicine, Örebro University Hospital, Örebro, Sweden; Endocrine and Diabetes Center, Karlstad Hospital, Karlstad, Sweden.
    Evaluation of glucose control when a new strategy of increased carbohydrate supply is implemented during prolonged physical exercise in type 1 diabetes2015In: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 115, no 12, p. 2599-2607Article in journal (Refereed)
    Abstract [en]

    Purpose: In healthy individuals, high carbohydrate intake is recommended during prolonged exercise for maximum performance. In type 1 diabetes (T1D), this would alter the insulin requirements. The aim of the study was to evaluate the safety of high glucose supplementation during prolonged exercise and the glucose control when a novel strategy of increased carbohydrate supply was implemented during prolonged exercise in T1D.

    Methods: Eight subjects with T1D participated in a sports camp including sessions of prolonged exercise and individualized feedback during three consecutive days. This was later followed by a 90 km cross-country skiing race. Large amounts of carbohydrates, 75 g/h, were supplied during exercise and the insulin requirements were registered. Glucose was measured before, during and after exercise aiming at euglycaemia, 4-8 mmol/L (72-144 mg/dL). During the race, continuous glucose monitoring (CGM) was used as an aspect of safety and to allow direct and individual adjustments.

    Results: Compared to ordinary carbohydrate supply during exercise, the high carbohydrate supplementation resulted in significantly increased insulin doses to maintain euglycaemia. During the cross-country skiing race, the participants succeeded to reach mean target glucose levels; 6.5 ± 1.9 mmol/L (117 ± 34 mg/dL) and 5.7 ± 1.5 mmol/L (103 ± 27 mg/dL) at the start and finish of the race, respectively. Episodes of documented hypoglycemia (<4 mmol/L/72 mg/dL) were rare. CGM was used for adjustments.

    Conclusion: In this study, large carbohydrate supplementation in T1D individuals during prolonged aerobic exercise is safe and allows the subjects to maintain glycaemic control and indicates the feasibility of CGM under these conditions.

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