Papers by Kyllike Christensson
African journal of midwifery and women's health, 2011
Purpose: To evaluate the use of the partograph as a critical tool in the management of labour in ... more Purpose: To evaluate the use of the partograph as a critical tool in the management of labour in two hospitals in Kenya. Method: Midwives were observed administering partographs to a total of 234 women. This process was evaluated using a structured observation checklist. Results: Every one of the partographs evaluated was incomplete or incorrect in some respect. There was also minimal consideration of the recorded data in determining whether to intervene in the pregnancy. The alert line was crossed for 40 partographs (17.1%) with no intervention being instituted. In 6 cases (2.6%) there was a waiting time of 3–16 hours after crossing of the action line before interventions were carried out. Conclusion: Proper monitoring, recording, and interpretation are important in minimizing unnecessary interventions.
Breastfeeding Medicine, Mar 1, 2014
Health Care for Women International, Mar 1, 2004
Acta Paediatrica, Apr 1, 1996
Musculoskeletal Care, May 7, 2009
Objective: Lack of referral guidelines can cause delayed or even non‐existent rehabilitation for ... more Objective: Lack of referral guidelines can cause delayed or even non‐existent rehabilitation for chronic pain patients. Indicators signalling the need for interventions could counteract this delay for pain rehabilitation and thereby prevent deteriorating patient health. This study aimed to explore the indicators of need for pain rehabilitation using a multidisciplinary expert panel working with pain rehabilitation.Methods: A three‐round Delphi study was conducted with a multidisciplinary expert panel (n = 23), each representing one pain rehabilitation unit in Sweden. The expert panel produced indicators, which were then ranked using a four‐point Likert scale.Results: Twenty multi‐faceted indicators for pain rehabilitation were identified. A major part concerned patient problems with activity level, catastrophizing, coping, existential problems, fear avoidance, high pain rating, medication, mental health, motivation, no pain relief, pain spread/increase, psychosocial problems combined with activity problems, psychosocial problems, recovery, and reduced physical function. Furthermore, indicators concerned demographic factors, sick leave, situation in primary health care and work. Finally, tacit knowledge was pointed out as an indicator. The results support previous research but also bring out less quantifiable indicators, such as relying on tacit knowledge while assessing a patient's need for rehabilitation.Conclusion: The indicators for pain rehabilitation were comprehensive, pointing out that needs assessment is complex. Despite reaching consensus on 19 out of 20 indicators, further research is needed to deepen knowledge in this area and to secure a fair assessment of a patient's need for pain rehabilitation. Copyright © 2009 John Wiley & Sons, Ltd.
Early Human Development, Apr 1, 1998
Newborn young of several mammalian species are attracted to the odor of amniotic fluid (AF); thes... more Newborn young of several mammalian species are attracted to the odor of amniotic fluid (AF); these chemical cues also appear to calm neonates and help them adapt to their novel postnatal environment. AF odor likewise elicits positive (head orientation) responses by human infants. The present study systematically examined whether the odors of AF and mother's breasts influence the crying of the newborn infant, when separated from its mother. The total crying time from 31-90 min postnatal was registered on tapes in 47 healthy fullterm newborns, allocated to one of three conditions: exposure to either AF or breast odor or no exposure (controls). Babies exposed to AF smell cried significantly less (median 29 s) than babies in the two other groups (breast odor-301 s, controls-135 s). The data are consistent with the hypothesis that the fetus may become familiar with chemical cues present in the intrauterine environment. Our data provide new evidence of the human baby's fine olfactory discrimination capacity, and add to the growing body of evidence indicating that naturally occurring odors play an important role in the mediation of infants' early behavior.
Korean Journal of Pediatrics, Dec 15, 1995
Journal of children's and young people's nursing, 2008
Cesarean birth is a mode of delivery that often minimizes the mothers’ possibility to handle her ... more Cesarean birth is a mode of delivery that often minimizes the mothers’ possibility to handle her term baby skin-to-skin while the father takes care of the baby for part, or all, of the first hours. No attention has, as far as we know, been given to different caregiving models and their eventual effects on the adaptation of breathing for the term infant born by elective cesarean. Previous publications on breathing patterns in newborn infants have mostly been conducted on premature infants in kangaroo care. The aim of this pilot study was to compare the effects of two caregiving models on the adaptation of breathing and infant crying after elective cesarean section, in term infants during the first hours after birth. Term infants born by elective cesarean were held skin-to-skin on their father’s chest or cared-for in a cot during the mother’s post operative observation stay. Thirteen father-infant pairs participated in a pilot sub-study with a randomized control trial design. Data were collected both by respiratory inductance plethysmography (RIP) and by tape-recorded crying time. The data raises important questions about the effects on breathing adaptation in relation to caregiving models. The infants in the skin-to-skin group showed significantly higher inspiratory and expiratory air flows, larger breath volume (all p < 0.001) and minute ventilation as compared with the cot group. The infants in the skin-to-skin group cried less than the infants in the cot group (p < 0.001). A caregiving model where fathers hold their infants skin-to-skin in an upright position on their chest has a positive impact on the infants’ respiratory adaptation and reduced infant crying. Larger studies of caregiving models after elective cesarean birth on the adaptation of breathing need to be conducted.
Human Reproduction, Nov 15, 2015
study question: Can paracervical block (PCB) administered before the onset of pain decrease women... more study question: Can paracervical block (PCB) administered before the onset of pain decrease women's pain experience during secondtrimester medical termination of pregnancy (MToP)? summary answer: There were no clinically significant differences between groups receiving PCB with bupivacaine or saline with regard to the highest and lowest pain intensity, morphine consumption or induction-to abortion interval. what is known already: The most common side effect of misoprostol is pain; nevertheless, there are sparse studies in pain and pain treatment during MToP, especially in second-trimester abortion. Pain reported in second-trimester medical abortion is often intense, and peaks when the fetal expulsion occurs. study design, size, duration: A double-blinded RCT was carried out from May 2012 until April 2015. A power calculation was based on a previous pilot study showing that the proportion of women with severe pain [visual analogue scale (VAS) ≥7] was 63%. A clinically significant reduction was considered to yield 35% with severe pain, and with a power of 80% and significance level of 5% (two-sided) 112 women were needed. Accounting for a 20% drop-out rate, a total of 140 women were needed. The primary outcome, pain intensity measured as any VAS ≥7, was analysed using a generalized estimating equations model. The level of significance was set to P , 0.05 two-sided. A computer generated randomization list with block size of 10 was used. The treatment allocation was placed in a sealed, opaque, envelope and picked consecutively. participants/materials, setting, methods: A total of 589 women attending a gynaecological clinic had a second-trimester abortion during the study period and 276 were invited to participate. A total of 113 women undergoing abortion from 13 weeks of gestation and above were recruited, of which 55 were randomly allocated to receive a PCB with bupivacaine and 58 a PCB with sodium chloride 1 h after the first dose of misoprostol. The full analysis set (FAS) population was defined as all randomized women that had at least one value for any of the outcomes (n ¼ 102). The per-protocol (PP) population was defined as a subset of the FAS excluding patients with major protocol deviations or without a value for the primary outcome (n ¼ 99). Pain was measured by VAS at misoprostol initiation (baseline) and repeated every 30 min until fetal expulsion. The primary outcome was the highest VAS pain intensity at any time point. main results and the role of chance: The highest pain intensity, did not show any differences at a cutoff of VAS ≥7 [risk ratio (RR): 1.1; 95% confidence interval (CI): 0.9-1.5; P ¼ 0.0.292]. In the PP analyses, there were 75% women in the bupivacaine group and 64% in the sodium chloride group with VAS ≥7 (RR: 1.2; 95% CI: 0.9-1.5; P ¼ 0.235). Most women did not experience pain at the misoprostol start, 19 women scored a VAS of .0, ranging from 1 to 4 with a mean of 1.8 and median of 2 (P ¼ 1.000). Immediately prior to PCB, 61 women scored a VAS of .0, from 1 to 10 with a mean of 2.0 and median of 1 (P ¼ 0.771). There was a 48% loss of VAS scores at the time of expulsion and the remaining scores did not differ between groups (RR: 1.5; 95% CI: 0.9-2.5). A subgroup analysis of primipara did not show any difference in highest pain intensity VAS ≥7 (RR: 1.2; 95% CI: 0.9-1.6; P ¼ 0.283). No statistically significant differences were observed between groups with regard to the highest and lowest (P ¼ 553 and 0.182) pain intensity and morphine consumption (P ¼ 0.772). Side effects were reported by 28
Journal of Pediatric Surgery, Jul 1, 2006
Midwifery, Jun 1, 2008
Objective: to explore and understand how midwives perceive and experience decision-making about a... more Objective: to explore and understand how midwives perceive and experience decision-making about augmentation of labour. Design: focus-group discussions. Setting: Stockholm, Sweden. Participants: 20 midwives experienced in working in labour wards. Findings: five categories were identified that illustrate the factors considered by the midwives to influence decisionmaking during augmentation of labour: 'regulations and guidelines'; 'shortage of delivery rooms'; 'influence of obstetricians'; 'women in labour'; and 'midwives' professional selves'. The theme identified was how midwives managed to 'navigate' these factors, which provided midwives with a decisive influence during the decision-making process. Key conclusions and implications: midwife job satisfaction can result from a sense of professional power over the possibility of navigating factors that influence decision-making during augmentation of labour. This sense of power can subsequently influence cooperation with both obstetricians and women during labour.
Midwifery, Mar 1, 2004
Objective: to describe women's experiences of participating in decision-making related to augment... more Objective: to describe women's experiences of participating in decision-making related to augmentation of labour. Design: a qualitative approach using modified grounded theory technique. Openended interviews were conducted 1-3 days after childbirth. Setting: the interviews were performed in the postnatal wards in five hospitals (tertiary level) in Stockholm, Sweden. Participants: 20 newly delivered women who had received oxytocin infusion for augmentation of labour during childbirth. Findings and key conclusions: support and guidance from midwives in combination with knowledge and expectations about the intervention seemed to be important for women's satisfaction with decision-making concerning augmentation of labour. Four patterns of decision-making were found. One group of women participated in the decision-making regarding augmentation of labour while a second group was invited, but refrained from participation. These women were satisfied with the decisions made. A third group of women did not participate, but wanted to and they were dissatisfied with the decisions made. The fourth group did not participate in the decision-makingFand did not want to. These women accepted the decisions made. The desire for information exceeded the desire for involvement in decision-making and the majority of women had confidence in the midwives' assessment.
The Lancet, Oct 1, 1998
Randomised study of skin-to-skin versus incubator care for rewarming low-risk hypothermic neonate... more Randomised study of skin-to-skin versus incubator care for rewarming low-risk hypothermic neonates. By - Kyllike Christensson, Ganapati J Bhat, Beatrice C Amadi, Bo Eriksson, Bengt Höjer.
Acta Paediatrica, Jul 1, 1987
ABSTRACT. Gastric emptying of newborn infants is a procedure performed to prevent aspiration of g... more ABSTRACT. Gastric emptying of newborn infants is a procedure performed to prevent aspiration of gastric contents. The present investigation was conducted to study the effects of gastric suction on circulatory and behavioural parameters in 21 healthy newborn children (11 cases, 10 controls). A small elevation in mean arterial blood pressure was observed during gastric suction. The incidence of retching was also increased. In all children spontaneous sucking and rooting movements, as well as state of sleep and wakefulness were recorded. In the control group spontaneous sucking and rooting movements started to occur 15 min after birth and reached a maximum at 45 and 60 min, respectively. The first hand to mouth movement was observed after a mean of 34 min and the infants found the nipple and started to suckle at about 55 min. This sequence of prefeeding behaviour was disrupted in children who had undergone gastric suction. The physiological side‐effects induced by gastric suction are minor, but it seemed to be unpleasant for the child and no clear advantages are gained by the procedure.
PsycTESTS Dataset, 2009
This is an Open Access article distributed under the terms of the Creative Commons Attribution Li... more This is an Open Access article distributed under the terms of the Creative Commons Attribution License
International Journal of Environmental Research and Public Health, Aug 5, 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
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Papers by Kyllike Christensson