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Brintow MB, Prinds C, O'Connor M, Möller S, Henriksen TB, Mørk S, Hvidtjørn D. Continuing bonds in parents after a loss in pregnancy, or a death at or shortly after birth: A population-based study. Death Stud 2023:1-13. [PMID: 38145415 DOI: 10.1080/07481187.2023.2297059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Abstract
In this study, we describe continuing bonds and grief reactions and assess their association in 980 parents bereaved in pregnancy, at or shortly after birth. We found that most parents experienced continuing bonds. However, they differed by type of loss. Parents losing their child due to termination of pregnancy or miscarriage experienced bonds less frequently and had the least intense grief reaction. Parents losing their child postpartum experienced bonds most frequently and had the most intense grief reaction. Continuing bonds were associated with intensified grief in parents losing their child after termination or miscarriage, while this relationship was less obvious after stillbirth or postpartum death.
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Affiliation(s)
| | - Christina Prinds
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- University Hospital of Southern Denmark, Aabenraa, Denmark
| | - Maja O'Connor
- Unit for Bereavement Research, Department of Psychology, Aarhus University, Aarhus, Denmark
| | - Sören Möller
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Open Patient Data Exploratory Network, Odense University Hospital, Odense, Denmark
| | - Tine Brink Henriksen
- Child and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Sofie Mørk
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Dorte Hvidtjørn
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
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2
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Timmermann C, Prinds C, Hvidt EA, Hvidt NC, Lau ME, Ammentorp J. Stimulating existential communication - first steps towards enhancing health professionals' reflective skills through blended learning. PEC Innov 2023; 2:100121. [PMID: 37214506 PMCID: PMC10194158 DOI: 10.1016/j.pecinn.2023.100121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 12/20/2022] [Accepted: 01/06/2023] [Indexed: 05/24/2023]
Abstract
Introduction Talking about existential issues with patients is often experienced as challenging for healthcare professionals. This paper describes our first steps towards developing existential communication training with particular attention to reflective learning methods. Blended learning was chosen to support reflection and an easier transition to classroom conversations, and through Participatory Action Research (PAR), patients were involved in developing the curriculum. Method To develop the most valuable and relevant communication training, patients, relatives, healthcare professionals and researchers were involved in a PAR process including 1) three theatre workshops and 2) collaborative meetings to develop the blended learning curriculum and reflection videos. The evaluation of the communication training was based on semi-structured interviews with the healthcare professionals participating in the blended learning communication training. Discussion and innovation The results indicate that a blended learning format involving a high degree of reflection is valuable for developing skills related to existential communication. Engaging patients in the process may be essential to develop a training curriculum for healthcare professionals that accommodates the patient's needs. Conclusion Future communication training on existential communication may benefit from adopting a blended learning format, including reflective learning methods and the involvement of patients in curriculum development.
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Affiliation(s)
- Connie Timmermann
- Centre for Research in Patient Communication, Odense University Hospital, Kløvervænget 12B, 5000 Odense C., Denmark
- Department of Clinical Research, University of Southern Denmark, J.B. Winsløwparken A19, 5000 Odense C., Denmark
| | - Christina Prinds
- Department of Clinical Research, University of Southern Denmark, J.B. Winsløwparken A19, 5000 Odense C., Denmark
- Hospital Sønderjylland, Kresten Philipsens Vej 15, 6200, Aabenraa
| | - Elisabeth Assing Hvidt
- Research Unit for General Practice and Department of Public Health, University of Southern Denmark, J.B. Winsløwparken 19A, 5000 Odense C., Denmark
| | - Niels Christian Hvidt
- Research Unit for General Practice and Department of Public Health, University of Southern Denmark, J.B. Winsløwparken 19A, 5000 Odense C., Denmark
| | | | - Jette Ammentorp
- Centre for Research in Patient Communication, Odense University Hospital, Kløvervænget 12B, 5000 Odense C., Denmark
- Department of Clinical Research, University of Southern Denmark, J.B. Winsløwparken A19, 5000 Odense C., Denmark
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3
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Behboudi-Gandevani S, Bidhendi-Yarandi R, Hossein Panahi M, Mardani A, Prinds C, Vaismoradi M, Glarcher M. Prevalence of preterm birth in Scandinavian countries: a systematic review and meta-analysis. J Int Med Res 2023; 51:3000605231203843. [PMID: 37843530 PMCID: PMC10683576 DOI: 10.1177/03000605231203843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 09/11/2023] [Indexed: 10/17/2023] Open
Abstract
OBJECTIVES As welfare societies, Scandinavian countries share characteristics of equality related to healthcare access, gender, and social services. However, cultural and lifestyle variations create country-specific health differences. This meta-analysis assessed the prevalence of preterm birth (PTB) and its categories in Scandinavian countries. METHODS A systematic search in key databases of literature published between 1990 and 2021 identified studies of the prevalence of PTB and its categories. Following the use of the Freeman-Tukey double arcsine transformation, a meta-analysis of weighted data was performed using the random-effects model and meta-prop method. RESULTS We identified 109 observational studies that involved 86,420,188 live births. The overall pooled prevalence (PP) of PTB was 5.3% (PP = 5.3%, 95% confidence interval [CI] 5.1%, 5.5%). The highest prevalence was in Norway (PP = 6.2%, 95% CI 5.3%, 7.0%), followed by Sweden (PP = 5.3%, 95% CI 5.1%, 5.4%), Denmark (PP = 5.2%, 95% CI 4.9%, 5.3%), and Iceland (PP = 5.0%, 95% CI 4.4%, 5.7%). Finland had the lowest PTB rate (PP = 4.9%, 95% CI 4.7%, 5.1%). CONCLUSIONS The overall PP of PTB was 5.3%, with small variations among countries (4.9%-6.2%). The highest and lowest PPs of PTB were in Norway and Finland, respectively.
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Affiliation(s)
| | - Razieh Bidhendi-Yarandi
- Department of Biostatistics and Epidemiology, School of Social Health, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Hossein Panahi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Mardani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Christina Prinds
- Department of Clinical Research, University South Denmark, Odense, Denmark; Department of Women’s Health, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
- Faculty of Science and Health, Charles Sturt University, Orange, NSW, Australia
| | - Manela Glarcher
- Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
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4
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Hoffmann E, Andersen PT, Mogensen CB, Prinds C, Primdahl J. Relatives' negotiations with healthcare professionals during older people's admission in an emergency department: An ethnographic study. Nurs Open 2023; 10:6381-6389. [PMID: 37312450 PMCID: PMC10416047 DOI: 10.1002/nop2.1886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Relatives are recognised as important for older patients' care and treatment. Variations in relatives' opportunities to negotiate the quality and continuity of older people's care and treatment can potentially lead to inequality in older people's access to care and treatment. AIM This study aimed to examine relatives' opportunities and strategies for negotiation with health care professionals (HCPs) during the admission of older people to emergency departments in Denmark. MATERIALS AND METHODS We planned a qualitative ethnographical study employing a hermeneutic approach. Observations focused on social situations and interactions between relatives and HCPs. The analysis was guided by qualitative content analysis. RESULTS The analysis derived one main theme, attitude to action, containing three subthemes: frustration obtaining access, presenting the case and a powerful relationship. Being active appeared to be essential to achieving possibilities for negotiation with HCPs. DISCUSSION Inspired by Bourdieu, habitus, doxical values and institutional logics of relatives seem to affect their opportunities to negotiate with HCPs during older people's admission to an emergency department. CONCLUSION Active and proactive relatives seem to have better opportunities to negotiate with HCPs during older people's acute hospital admission than reactive, passive and hesitant relatives. The logic of public management and the medical profession seem to dominate and influence doxa in the EDs and put special demands on the relatives. This imbalance constitutes a risk of inequality in older people's access to health.
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Affiliation(s)
- Eva Hoffmann
- University College South DenmarkAabenraaDenmark
- Department of Regional Health ResearchUniversity of Southern DenmarkOdenseDenmark
- OPEN, Open Patient data ExplorativeRegion of Southern DenmarkOdenseDenmark
| | | | - Christian Backer Mogensen
- Department of Regional Health ResearchUniversity of Southern DenmarkOdenseDenmark
- Hospital SønderjyllandUniversity Hospital of Southern DenmarkAabenraaDenmark
| | - Christina Prinds
- Hospital SønderjyllandUniversity Hospital of Southern DenmarkAabenraaDenmark
- Research Unit of Obstetrics and GynaecologyUniversity of Southern DenmarkOdenseDenmark
| | - Jette Primdahl
- Department of Regional Health ResearchUniversity of Southern DenmarkOdenseDenmark
- Hospital SønderjyllandUniversity Hospital of Southern DenmarkAabenraaDenmark
- Danish Hospital for Rheumatic DiseasesUniversity Hospital of Southern DenmarkSønderborgDenmark
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Prinds C, Timmerman C, Hvidtjørn D, Ammentorp J, Christian Hvidt N, Larsen H, Toudal Viftrup D. Existential aspects of parenthood transition seen from the health professionals' perspective - an interview and theatre workshop study. Sex Reprod Healthc 2023; 37:100884. [PMID: 37454585 DOI: 10.1016/j.srhc.2023.100884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 05/15/2023] [Accepted: 07/01/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES A sense of existential vulnerability is embedded in parenthood transition. It is linked to meaning in life, relationship changes, awareness of death, and sometimes a transcendent belief. Nevertheless, in most maternity service guidelines, the existential aspects of life are not an explicit focus. Therefore, this study aimed to explore how health professionals in maternity services experience and understand existential aspects of parenthood transition among new parents. STUDY DESIGN Data were generated through a user-involving two-phase process inspired by action research consisting of three focus group interviews with health professionals (n = 10) and, subsequently, a theatre workshop for parents, health professionals, and researchers (n = 40). Between the two phases, case narratives were constructed using information from the interviews and, in collaboration with a dramatist, dramatized and then played out at a workshop by professional actors. We used thematic analysis for all data. RESULTS We identified five themes in the data material: 1. Death and fragility in maternity care, 2. Existential aspects in camouflage, 3. Existential and spiritual aspects of being professional in maternity care, 4. Talking about existential aspects of care, 5. Equipped for providing existential care? CONCLUSIONS Existential aspects were often recognized during birth, specially in traumatic situations or discerned in the physical and non-verbal relational energy between the birthing woman and midwife or partner. Less often, existential aspects were recognized during pregnancy and the post-partum period.
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Affiliation(s)
- Christina Prinds
- Hospital Sønderjylland, University Hospital of Southern Denmark, Kresten Philipsens Vej 15, 6200 Aabenraa, Denmark; Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 5000 Odense, Denmark; University College South Denmark, Degnevej 16, 6705 Esbjerg Ø, Denmark.
| | - Connie Timmerman
- Centre for Research in Patient Communication, Odense University Hospital, Kløvervænget 12B, 5000 Odense C, Denmark
| | - Dorte Hvidtjørn
- Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 5000 Odense, Denmark; Department of Clinical Medicine, Aarhus University, Nordre Ringgade 1, 8000 Aarhus, Denmark
| | - Jette Ammentorp
- Centre for Research in Patient Communication, Odense University Hospital, Kløvervænget 12B, 5000 Odense C, Denmark
| | - Niels Christian Hvidt
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9A, 5000 Odense, Denmark
| | - Henry Larsen
- Institute of Entrepreneurship and Relationship Management, University of Southern Denmark, Universitetsparken 1, 6000 Kolding, Denmark
| | - Dorte Toudal Viftrup
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9A, 5000 Odense, Denmark
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6
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Damm MF, Jørgensen ML, Eklund MV, Hvidtjørn D, Prinds C. Carrying Death: A Qualitative Study of Women's Bodily Perceptions After Their Baby Died in Utero. Omega (Westport) 2023:302228231190544. [PMID: 37493011 DOI: 10.1177/00302228231190544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
When a child dies in utero death becomes an integrated part of the mothers living body and this complex experience places a heavy existential and bodily burden on a woman experiencing stillbirth. This study uses a phenomenological approach with focus groups and individual interviews and data is discussed within a theoretical existential framework. Interviews of six women who experienced stillbirth within a range of 5 years were performed in Denmark. The participants experienced the dissonance of carrying death in their living body, expressed heightened existential considerations, a sense of transgression and of feeling trapped in an unbearable situation, and an experience of both dislocation from their body and an extreme bodily awareness. The study generates new knowledge and understanding of the how stillbirth is experienced as incomprehensible and as a violent bodily invasion of death with deep existential impact.
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Affiliation(s)
- Maiken F Damm
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Sygehus Sønderjylland, University Hospital South Denmark, Aabenraa, Denmark
| | | | | | - Dorte Hvidtjørn
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Unit for Perinatal Loss, Aarhus University Hospital, Aarhus, Denmark
| | - Christina Prinds
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Sygehus Sønderjylland, University Hospital South Denmark, Aabenraa, Denmark
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7
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Prinds C, Hvidt NC, Schrøder K, Stokholm L, Rubin KH, Nohr EA, Petersen LK, Jørgensen JS, Bliddal M. Prayer and meditation practices in the early COVID-19 pandemic: A nationwide survey among Danish pregnant women. The COVIDPregDK study. Midwifery 2023; 123:103716. [PMID: 37209582 DOI: 10.1016/j.midw.2023.103716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/17/2023] [Accepted: 05/06/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND The emergence of the COVID-19 pandemic and the derived changes in maternity care have created stress and anxiety among pregnant women in different parts of the world. In times of stress and crisis, spirituality, including spiritual and religious practices, may increase. OBJECTIVE To describe if the COVID-19 pandemic influenced pregnant women's considerations and practises of existential meaning-making and to investigate such considerations and practices during the early pandemic in a large nationwide sample. METHODS We used survey data from a nationwide cross-sectional study sent to all registered pregnant women in Denmark during April and May 2020. We used questions from four core items on prayer and meditation practices. RESULTS A total of 30,995 women were invited, of whom 16,380 participated (53%). Among respondents, we found that 44% considered themselves believers, 29% confirmed a specific form of prayer, and 18% confirmed a specific form of meditation. In addition, most respondents (88%) reported that the COVID-19 pandemic had not influenced their responses. CONCLUSION In a nationwide Danish cohort of pregnant women, existential meaning-making considerations and practices were not changed due to the COVID-19 pandemic. Nearly one in two study participants described themselves as believers, and many practised prayer and/or meditation.
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Affiliation(s)
- Christina Prinds
- Research Unit of Gynecology and Obstetrics, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Hospital Sønderjylland, University Hospital of Southern Denmark, Kresten Philipsens Vej 15, 6200 Aabenraa, Denmark.
| | - Niels Christian Hvidt
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
| | - Katja Schrøder
- Research Unit of Gynecology and Obstetrics, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; User Perspectives and Community-based Interventions, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
| | - Lonny Stokholm
- OPEN - Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark; Research unit OPEN, department of clinical research, University of Southern Denmark, Odense, Denmark.
| | - Katrine Hass Rubin
- OPEN - Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark; Research unit OPEN, department of clinical research, University of Southern Denmark, Odense, Denmark.
| | - Ellen A Nohr
- Research Unit of Gynecology and Obstetrics, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Lone K Petersen
- Research Unit of Gynecology and Obstetrics, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; OPEN - Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark; Research unit OPEN, department of clinical research, University of Southern Denmark, Odense, Denmark.
| | - Jan Stener Jørgensen
- Research Unit of Gynecology and Obstetrics, Odense University Hospital, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Mette Bliddal
- OPEN - Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark; Research unit OPEN, department of clinical research, University of Southern Denmark, Odense, Denmark.
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Behboudi-Gandevani S, Bidhendi-Yarandi R, Panahi MH, Mardani A, Prinds C, Vaismoradi M. Perinatal and Neonatal Outcomes in Immigrants From Conflict-Zone Countries: A Systematic Review and Meta-Analysis of Observational Studies. Front Public Health 2022; 10:766943. [PMID: 35359776 PMCID: PMC8962623 DOI: 10.3389/fpubh.2022.766943] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 02/03/2022] [Indexed: 12/16/2022] Open
Abstract
Objectives There are controversies regarding the risk of adverse pregnancy outcomes among immigrants from conflict-zone countries. This systematic review and meta-analysis aimed to investigate the risk of perinatal and neonatal outcomes among immigrants from conflict-zone countries compared to native-origin women in host countries. Methods A systematic search on the databases of PubMed/MEDLINE, Scopus, and Web of Science was carried out to retrieve studies on perinatal and neonatal outcomes among immigrants from Somalia, Iraq, Afghanistan, Yemen, Syria, Nigeria, Sudan, Ethiopia, Eritrea, Kosovo, Ukraine, and Pakistan. Only peer-reviewed articles published in the English language were included in the data analysis and research synthesis. The odds ratio and forest plots were constructed for assessing the outcomes of interests using the DerSimonian and Laird, and the inverse variance methods. The random-effects model and the Harbord test were used to account for heterogeneity between studies and assess publication bias, respectively. Further sensitivity analysis helped with the verification of the reliability and stability of our review results. Results The search process led to the identification of 40 eligible studies involving 215,718 pregnant women, with an immigration background from the conflict zone, and 12,806,469 women of native origin. The adverse neonatal outcomes of the risk of small for gestational age (Pooled OR = 1.8, 95% CI = 1.6, 2.1), a 5-min Apgar score <7 (Pooled OR = 1.4, 95% CI = 1.0, 2.1), stillbirth (Pooled OR = 1.9, 95% CI = 1.2, 3.0), and perinatal mortality (Pooled OR = 2, 95% CI = 1.6, 2.5) were significantly higher in the immigrant women compared to the women of native-origin. The risk of maternal outcomes, including the cesarean section (C-S) and emergency C-S, instrumental delivery, preeclampsia, and gestational diabetes was similar in both groups. Conclusion Although the risk of some adverse maternal outcomes was comparable in the groups, the immigrant women from conflict-zone countries had a higher risk of neonatal mortality and morbidity, including SGA, a 5-min Apgar score <7, stillbirth, and perinatal mortality compared to the native-origin population. Our review results show the need for the optimization of health care and further investigation of long-term adverse pregnancy outcomes among immigrant women.
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Affiliation(s)
- Samira Behboudi-Gandevani
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
- *Correspondence: Samira Behboudi-Gandevani
| | - Razieh Bidhendi-Yarandi
- Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Hossein Panahi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Mardani
- Nursing Care Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Christina Prinds
- Department of Clinical Research, University South Denmark, Odense, Denmark
- Department of Midwifery Education, University College South Denmark, Esbjerg, Denmark
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9
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Viftrup DT, Prinds C, Nissen RD, Steenfeldt VØ, Søndergaard J, Hvidt NC. Older Adults' Experience of Meaning at the End of Life in Two Danish Hospices: A Qualitative Interview Study. Front Psychol 2021; 12:700285. [PMID: 34603128 PMCID: PMC8484531 DOI: 10.3389/fpsyg.2021.700285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 08/23/2021] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to explore how older adults (aged > 65) confronted with imminent death express their thoughts and feelings about death and dying and verbalize meaning. Furthermore, the aim was to investigate how health professionals could better address the needs of this patient group to experience meaning at the end of life. The study applied a qualitative method, involving semi-structured interviews with 10 participants at two hospices. The method of analysis was interpretative phenomenological analysis. We found three chronological time-based themes: (1) Approaching Death, (2) The time before dying, and (3) The afterlife. The participants displayed scarce existential vernacular for pursuing meaning with approaching death. They primarily applied understanding and vocabulary from a medical paradigm. The participants' descriptions of how they experienced and pursued meaning in the time before dying were also predominantly characterized by medical vernacular, but these descriptions did include a few existential words and understandings. When expressing thoughts and meaning about the afterlife, participants initiated a two-way dialogue with the interviewer and primarily used existential vernacular. This indicates that the participants' scarce existential vernacular to talk about meaning might be because people are not used to talking with healthcare professionals about meaning or their thoughts and feelings about death. They are mostly "trained" in medical vernacular. We found that participants' use of, respectively, medical or existential vernacular affected how they experienced meaning and hope at the end of life. We encourage healthcare professionals to enter into existential dialogues with people to support and strengthen their experiences of meaning and hope at the end of life.
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Affiliation(s)
- Dorte Toudal Viftrup
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Christina Prinds
- Research Unit of Gynecology and Obstetrics, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department for Research and Development, University College South Denmark, Haderslev, Denmark
| | - Ricko Damberg Nissen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | | | - Jens Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Niels Christian Hvidt
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, Denmark
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10
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Hoffmann E, Andersen PT, Mogensen CB, Prinds C, Primdahl J. Relatives' negotiation power in relation to older people's acute hospital admission: A qualitative interview study. Scand J Caring Sci 2021; 36:1016-1026. [PMID: 34156115 DOI: 10.1111/scs.13012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 05/30/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Acutely admitted older people are potentially vulnerable and dependent on relatives to negotiate and navigate on their behalf. AIM This study aimed to explore relatives' experiences of their interactions with healthcare professionals during acute hospital admission of older people to derive themes of importance for relatives' negotiations with these professionals. METHOD A qualitative design was applied. Relatives of acutely admitted older people at two emergency departments in Denmark were interviewed (n = 17). The qualitative content analysis was guided by Graneheim and Lundman's concepts. RESULTS The analysis derived four themes: (a) Mandate, (b) Incentive, (c) Capability and (d) Attitude to taking action. These four sources of relatives' negotiation power can be illustrated in the MICA model. CONCLUSION Four themes were identified as important sources of relatives' negotiation power. Since the four sources of power potentially change according to the situation, relatives' negotiation power seems to be context dependent.
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Affiliation(s)
- Eva Hoffmann
- University College South Denmark, Aabenraa, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,OPEN, Open Patient data Explorative, Region of Southern Denmark, Odense, Denmark
| | | | - Christian Backer Mogensen
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Hospital Sønderjylland, University Hospital of Southern Denmark, Aabenraa, Denmark
| | - Christina Prinds
- University College South Denmark, Aabenraa, Denmark.,Research Unit of Obstetrics and Gynecology, University of Southern Denmark, Odense, Denmark
| | - Jette Primdahl
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Hospital Sønderjylland, University Hospital of Southern Denmark, Aabenraa, Denmark.,Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sønderborg, Denmark
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11
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Prinds C, Timmerman C, Hvidtjørn D, Ammentorp J, Christian Hvidt N, Larsen H, Toudal Viftrup D. Existential aspects in the transition to parenthood based on interviews and a theatre workshop. Sex Reprod Healthc 2021; 28:100612. [PMID: 33744508 DOI: 10.1016/j.srhc.2021.100612] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 02/22/2021] [Accepted: 03/04/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES There are multitudes of existential feelings and considerations around childbirth, with both positive and negative sources of existential meaning; often they are mixed up, but they impact parents' ideas of meaning and purpose in life. The aim of this study was to explore existential aspects of parenthood transition among new fathers and mothers in view of a potential training programme for professionals in maternity services. STUDY DESIGN Data were generated through a user-involving two-phase process inspired by action research consisting of first, four focus group-interviews (n = 10); and second, a theatre workshop for parents, health professionals, and researchers (n = 40). Between the two phases, case-narratives were constructed based on the interviews and, in collaboration with a dramatist, dramatized and then played at the workshop by professional actors. Data from interviews and the workshop were thematised for further analysis. RESULTS We identified five themes: 1. A turning point of what to hold sacred; 2. Changed relationships - guilt and overwhelming love; 3. Awareness of death; 4. Religiousness embodied; 5. What we talk about. CONCLUSIONS Existential aspects of parenthood transition were closely related to meaning in life, changes in relationships, awareness of death and relation to a transcendent belief. Existential aspects were explicated and discussed in nuanced ways expressing existential vulnerability. It is therefore important to both acknowledge and address existential aspects in maternity care, for the simple reason (among others) that they matter to parents. Moreover, this might enhance a coherent and authentic parenthood transition embedding the paradoxicalities.
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Affiliation(s)
- Christina Prinds
- University College South Denmark, Lembckesvej 7, 6100 Haderslev, Denmark; Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 5000 Odense, Denmark.
| | - Connie Timmerman
- Health Services Research Unit, Lillebaelt Hospital, University of Southern Denmark, Beriderbakken 4, 7100 Vejle, Denmark
| | - Dorte Hvidtjørn
- Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 5000 Odense, Denmark
| | - Jette Ammentorp
- Health Services Research Unit, Lillebaelt Hospital, University of Southern Denmark, Beriderbakken 4, 7100 Vejle, Denmark
| | - Niels Christian Hvidt
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9A, 5000 Odense, Denmark
| | - Henry Larsen
- Institute of Entrepreneurship and Relationship Management, University of Southern Denmark, Universitetsparken 1, 6000 Kolding, Denmark
| | - Dorte Toudal Viftrup
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9A, 5000 Odense, Denmark
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Prinds C, Paal P, Hansen LB. Characteristics of existing healthcare workforce education in spiritual care related to childbirth: A systematic review identifying only two studies. Midwifery 2021; 97:102974. [PMID: 33714917 DOI: 10.1016/j.midw.2021.102974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 02/03/2021] [Accepted: 02/28/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND It has been argued that the beginning of life is one of the most significant, universally-shared life events, impacting parental health biologically, sociologically, psychologically and spiritually. In maternity care settings, only a few educational initiatives exist focusing on increasing competencies in spiritual care. OBJECTIVE To explore the characteristics of content in existing under- and post-graduate education of healthcare professionals in spiritual care in the field of maternity care. METHODS We conducted an integrative review, searching seven databases for studies describing the content of existing education in spiritual care in maternity care settings. RESULTS From 235 studies assessed eligible and full text screened, only two were included, originating from the same project. The majority of existing studies about spiritual care focus on the perspective of women related to loss, sickness or bereavement, whereas research related to the field of maternity care is sparser. Furthermore, the perspective of the professional seems overlooked. CONCLUSION There is a lack of research exploring the content and structure of educational initiatives related to spiritual care in maternity care. In order to strengthen spiritual care competencies in maternity care, for both women/partners and professionals, future research should investigate how education is planned and evaluated.
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Affiliation(s)
- Christina Prinds
- University College South Denmark, Degnevej 16, DK-6705 Esbjerg, Ø, Denmark; University of Southern Denmark, Faculty of Health Sciences, Department of Clinical Institute, Kløvervænget 10, DK-5000 Odense, C, Denmark.
| | - Piret Paal
- WHO Collaborating Centre for Nursing Research and Education, Institute of Nursing Science and Practice, Paracelsus Medical Private University, Strubergasse 21, 5020 Salzburg Austria.
| | - Line Bruun Hansen
- University College South Denmark, Degnevej 16, DK-6705 Esbjerg, Ø, Denmark
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Jørgensen ML, Prinds C, Mørk S, Hvidtjørn D. Stillbirth - transitions and rituals when birth brings death: Data from a danish national cohort seen through an anthropological lens. Scand J Caring Sci 2021; 36:100-108. [PMID: 33576029 DOI: 10.1111/scs.12967] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/12/2021] [Accepted: 01/22/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Many parents bereaved of a stillborn baby spend time with the child. In this time frame, different acts with the child in focus may occur. Some parents invite others to see the child too. Parents who suffer the loss of a newborn are vulnerable, and understanding acts and practices surrounding the dead newborn is important knowledge for caretakers. AIMS This article aims to enlighten the amount of time Danish parents spend with their stillborn in hospital settings that encourage this practice. Furthermore, it aims to transcend the mere quantitative numbers through a theoretical approach that frames the analysis and discussion of possible layers of meaning imbedded in time spent with a dead newborn. STUDY DESIGN Data from a Danish cohort of bereaved parents were collected using web-based questionnaires. These numbers were successively interpreted through an anthropological lens within the perspective of transition and ritualisation. Knowledge from existing empirical literature was also fused. RESULTS FROM THE COHORT Danish parents spend hours or days with their stillborn child. They feel supported in this by healthcare professionals. Mainly close relatives join the parents while admitted to the hospital to see the stillborn child, followed by other family members and friends. CONCLUSION Danish parents engage to a very high degree in contact with their dead baby. The analysis points out that 'Time' and 'Others' are needed to create a socially comprehensible status for parents and child when birth brings death. In liminal space during the transition, healthcare professionals act as ritual experts, supporting parents and their relatives to ascribe social status to the dead body of the child through ritualised acts. Instead of only thinking of this period as 'memory-making', we suggest regarding it as a time of ontological clarification as well.
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Affiliation(s)
| | | | - Sofie Mørk
- University of Southern Denmark, Odense, Denmark
| | - Dorte Hvidtjørn
- Unit for Perinatal Loss: Aarhus University Hospital, Aarhus N, Denmark.,University of Southern Denmark, Odense, Denmark
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Hansen LB, Hvidt NC, Mortensen KE, Wu C, Prinds C. How Giving Birth Makes Sense: A Questionnaire Study on Existential Meaning-Making Among Mothers Giving Birth Preterm or at Term. J Relig Health 2021; 60:335-353. [PMID: 33123971 DOI: 10.1007/s10943-020-01106-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/06/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Women's reflections on existential meaning-making in relation to giving birth may seem indistinct in maternity services and have not been thoroughly explored in secular contexts. However, research suggests that childbirth accentuates spiritual and existential considerations and needs even in secular contexts highlighting the importance of care for such needs in maternity care practices. The objectives of this study were two-fold: Firstly, to explore how first-time mothers, living in a secular context, experience their first birth in relation to existential meaning-making. Secondly, to describe the relationship between existential meaning-making reflections and gestational week at birth. METHODS A nationwide cross-sectional study in Denmark based on the questionnaire "Faith, existence and motherhood" was conducted in 2011. Eight core items related to birth experience informed this study. The cohort was sampled from the Danish Medical Birth Registry and consisted of 913 mothers having given birth 6-18 months previously. Twenty-eight per cent had given birth preterm (PT) and 72% had given birth at full-term (FT). A total of 517 mothers responded. RESULTS In relation to the birth of their first child, both FT and PT mothers answered, that they had existential meaning-making reflections. The consent to the 8 items ranged from 17 to 73% among FT mothers and from 19 to 58% among PT mothers. Mothers who gave birth preterm mainly identified the negative aspects of birth, whereas mothers, who gave birth at full-term, to a higher degree identified positive aspects. CONCLUSIONS Findings suggest that not only traumatic birth events accentuate existential reflections, but that even normal childbirth to most mothers is an existential event. However, the quality of existential reflections differs when comparing normal and traumatic birth. The study points towards change in education and organization of maternity care to better care for existential needs and reflections specific to every new mother and birthing woman.
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Affiliation(s)
- Line Bruun Hansen
- University College South Denmark, Degnevej 16, 6705, Esbjerg Ø, Denmark.
- University Library of Southern Denmark, Niels Bohrs Vej 9-10, 6700, Esbjerg Ø, Denmark.
| | - Niels Christian Hvidt
- Institute of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9, 5000, Odense C, Denmark
| | - Katrine Ernst Mortensen
- Department of Gynaecology and Obstetrics, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark
| | - Chunsen Wu
- Department of Gynaecology and Obstetrics, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark
- Department of Clinical Institute, Faculty of Health Sciences, University of Southern Denmark, Kløvervænget 10, 5000, Odense C, Denmark
| | - Christina Prinds
- University College South Denmark, Degnevej 16, 6705, Esbjerg Ø, Denmark
- Department of Clinical Institute, Faculty of Health Sciences, University of Southern Denmark, Kløvervænget 10, 5000, Odense C, Denmark
- OPEN - Odense Patient Data Explorative Network, Odense University Hospital, J.B. Winsløws Vej 9, 5000, Odense C, Denmark
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Hvidt NC, Nielsen KT, Kørup AK, Prinds C, Hansen DG, Viftrup DT, Assing Hvidt E, Hammer ER, Falkø E, Locher F, Boelsbjerg HB, Wallin JA, Thomsen KF, Schrøder K, Moestrup L, Nissen RD, Stewart-Ferrer S, Stripp TK, Steenfeldt VØ, Søndergaard J, Wæhrens EE. What is spiritual care? Professional perspectives on the concept of spiritual care identified through group concept mapping. BMJ Open 2020; 10:e042142. [PMID: 33372078 PMCID: PMC7772306 DOI: 10.1136/bmjopen-2020-042142] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES The overall study aim was to synthesise understandings and experiences regarding the concept of spiritual care (SC). More specifically, to identify, organise and prioritise experiences with the way SC is conceived and practised by professionals in research and the clinic. DESIGN Group concept mapping (GCM). SETTING The study was conducted within a university setting in Denmark. PARTICIPANTS Researchers, students and clinicians working with SC on a daily basis in the clinic and/or through research participated in brainstorming (n=15), sorting (n=15), rating and validation (n=13). RESULTS Applying GCM, ideas were identified, organised and prioritised online. A total of 192 unique ideas of SC were identified and organised into six clusters. The results were discussed and interpreted at a validation meeting. Based on input from the validation meeting a conceptual model was developed. The model highlights three overall themes: (1) 'SC as an integral but overlooked aspect of healthcare' containing the two clusters SC as a part of healthcare and perceived significance; (2) 'delivering SC' containing the three clusters quality in attitude and action, relationship and help and support, and finally (3) 'the role of spirituality' containing a single cluster. CONCLUSION Because spirituality is predominantly seen as a fundamental aspect of each individual human being, particularly important during suffering, SC should be an integral aspect of healthcare, although it is challenging to handle. SC involves paying attention to patients' values and beliefs, requires adequate skills and is realised in a relationship between healthcare professional and patient founded on trust and confidence.
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Affiliation(s)
- Niels Christian Hvidt
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
- Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, Denmark
| | - Kristina Tomra Nielsen
- Department of Occupational Therapy, University College of Northern Denmark (UCN), Aalborg, Denmark
- The ADL Unit, The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark
| | - Alex K Kørup
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
- Department of Mental Health Service Kolding-Vejle, Region of Southern Denmark, Vejle, Denmark
| | - Christina Prinds
- Clinical Institute, Syddansk Universitet Det Sundhedsvidenskabelige Fakultet, Odense, Denmark
- Research, University College South - Campus Haderslev, Haderslev, Denmark
| | - Dorte Gilså Hansen
- IRS, Center for Shared Decision Making, Lillebaelt Hospital, University of Southern Denmark, Vejle, Denmark
| | - Dorte Toudal Viftrup
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Elisabeth Assing Hvidt
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | | | - Erik Falkø
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Flemming Locher
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, JELLING, Denmark
| | - Hanne Bess Boelsbjerg
- Interacting Minds Centre, Department of Clinical Medicine, Aarhus Universitet, Aarhus, Denmark
- Elective Surgery Center, Silkeborg Regional Hospital, Silkeborg, Midtjylland, Denmark
| | - Johan Albert Wallin
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Karsten Flemming Thomsen
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Katja Schrøder
- Department of Public Health, Syddansk Universitet, Odense, Denmark
| | - Lene Moestrup
- Health Science Research Center, University College Lillebaelt - Campus Odense, Odense, Denmark
| | - Ricko Damberg Nissen
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Sif Stewart-Ferrer
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Tobias Kvist Stripp
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | | | - Jens Søndergaard
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Eva Ejlersen Wæhrens
- The Research Initiative for Activity studies and Occupational Therapy, Research Unit of User Perspectives, Institute of Public Health, University of Southern Denmark, Odense, Denmark
- The ADL unit, Frederiksberg Hospital Parker Institute, Frederiksberg, Hovedstaden, Denmark
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Eklund MV, Prinds C, Mørk S, Damm M, Möller S, Hvidtjørn D. Parents' religious/spiritual beliefs, practices, changes and needs after pregnancy or neonatal loss-A Danish cross-sectional study. Death Stud 2020; 46:1529-1539. [PMID: 32960749 DOI: 10.1080/07481187.2020.1821260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study describes religious/spiritual beliefs, practices, changes, and needs among parents bereaved by pregnancy or neonatal loss, and assess gender differences in religiosity/spirituality, in this population. A cross-sectional study using data from the Danish cohort Life After the Loss was conducted. Data were gathered from a questionnaire survey collected between January 2016 and December 2019. Among 713 respondents, several answered in the affirmative to items related to religious/spiritual beliefs and practices. Some experienced changes in religious/spiritual beliefs and practices, and some wished to talk to someone about these questions. Women reported higher levels of religiosity/spirituality than men.
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Affiliation(s)
| | - Christina Prinds
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Development and Research, University College South Denmark, Haderslev, Denmark
| | - Sofie Mørk
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Maiken Damm
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Sören Möller
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Open Patient Data Exploratory Network, Odense University Hospital, Odense, Denmark
| | - Dorte Hvidtjørn
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Prinds C, der Wal JGV, Crombag N, Martin L. Counselling for prenatal anomaly screening-A plea for integration of existential life questions. Patient Educ Couns 2020; 103:1657-1661. [PMID: 32268986 DOI: 10.1016/j.pec.2020.03.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 03/04/2020] [Accepted: 03/27/2020] [Indexed: 05/09/2023]
Abstract
The availability in many countries of new prenatal anomaly screening methods, such as the non-invasive prenatal test (NIPT), and the potential broadening of testing for genetic conditions, creates an ongoing debate about the accompanying existential dilemmas at both societal level and for individual new parents. In many countries, the main goal of counselling for prenatal anomaly screening is to facilitate the reproductive decision-making process of future parents. Therefore, counsellors share information to enable a woman and her partner to think about the pros and cons of participating in screening, try to clarify possible moral dilemmas, and dwell on existential life questions. In line with the CanMEDS framework, healthcare professionals must combine the role of communicator (providing health education) with that of professional (by recognising and responding to existential life questions while facilitating decision-making). This is not easy but it is essential for providing balanced counselling. At present, counselling tends to be sufficient regarding health education, whereas guidance in decision-making, including attention for existential life questions and philosophy of life, offers room for improvement. In this paper, we suggest slowing down and turning the traditional prenatal counselling encounter upside down by starting as a counselling professional instead of a healthcare information sharing communicator and thus making the story of the woman and her partner, within their societal context, the starting point and the basis of the counselling encounter.
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Affiliation(s)
- Christina Prinds
- University of Southern Denmark, Institute of Clinical Research, Odense C, Denmark; University College South Denmark, Haderslev, Denmark.
| | | | - Neeltje Crombag
- University of Leuven, Department of Development and Regeneration, Biomedical Sciences, Belgium
| | - Linda Martin
- Amsterdam UMC, Vrije Universiteit Amsterdam, Midwifery Science, AVAG, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, The Netherlands
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Eri TS, Berg M, Dahl B, Gottfreðsdóttir H, Sommerseth E, Prinds C. Models for midwifery care: A mapping review. Eur J Midwifery 2020; 4:30. [PMID: 33537631 PMCID: PMC7839165 DOI: 10.18332/ejm/124110] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/04/2020] [Accepted: 06/16/2020] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION According to WHO, midwives are found competent to provide evidencebased and normalcy-facilitating maternity care. Models for midwifery care exist, but seem to be lacking explicit epistemological status, mainly focusing on the practical and organizational level of care delivery. To make the values and attitudes of care visible, it is important to implement care models with explicit epistemological status. The aim of this paper is to identify and gain an overview of publications of theoretical models for midwifery care. METHODS A mapping review was conducted with systematic searches in nine databases for studies describing a theoretical model or theory for midwifery care that either did or was intended to impact clinical practice. Eligibility criteria were refined during the selection process. RESULTS Six models from six papers originating from different parts of the world were included in the study. The included models were developed using different methodologies and had different philosophical underpinnings and complexity gradients. Some characteristics were common, the most distinctive being the emphasis of the midwife-woman relationship, secondly the focus on woman-centeredness, and thirdly the salutogenic focus in care. CONCLUSIONS Overall, scarcity exists regarding theoretical models for midwifery care with explicit epistemological status. Further research is needed in order to develop generic theoretical models with an epistemological status to serve as a knowledge base for midwifery healthcare.
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Affiliation(s)
- Tine S. Eri
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Marie Berg
- Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
- The Obstretic Unit, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Bente Dahl
- Centre for Women’s, Family and Child Health, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Helga Gottfreðsdóttir
- Department of Midwifery, Faculty of Nursing, University of Iceland, Reykjavík, Iceland
- Women´s Clinic, Landspitali University Hospital, Reykjavík, Iceland
| | - Eva Sommerseth
- Centre for Women’s, Family and Child Health, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Christina Prinds
- Institute of Clinical Research, University of Southern Denmark, Odense C, Denmark
- Department of Research, University College South Denmark, Haderslev, Denmark
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Viftrup DT, Hvidt NC, Prinds C. Dignity in end-of-life care at hospice: An Action Research Study. Scand J Caring Sci 2020; 35:420-429. [PMID: 32419195 DOI: 10.1111/scs.12872] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 03/31/2020] [Accepted: 04/20/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Safeguarding the dignity of patients at the end of life is a key objective in palliative care practice in Denmark. The concept of dignity and how it influences a dying persons' quality of life is thus influential in end-of-life care at hospices. However, what is meant by dignity, how dignity is understood and practiced by healthcare professionals in Danish hospices, and whether this relates to the patients' understandings and needs concerning dignity remains unanswered. AIM The aim of this study was to explore and improve dignity in care through an action research study with patients and hospice staff at two different hospices in Denmark. This was done by exploring how patients and healthcare professionals expressed their understandings and needs concerning dignity and involving participants in the research process with the goal of improving dignity in care. METHODS An action research method with reflection-of-praxis and action-in-praxis was applied. It was combined with methods of semi-structured individual interviews with twelve patients, five staff and nine focus-group interviews with staff. RESULTS Three themes emerged from the analysis of data. The themes were as follows: (1) being understood, (2) contributing and (3) holistic care. Deeper analysis indicated that staff understandings of dignity mostly focused on preserving patients' autonomy, whereas patients expressed needs for relational and spiritual aspects of dignity. Staff were mostly concerned about preserving patients' autonomy when providing dignity in care, however, through the action-in-praxis they increased their awareness on their own praxis and patients' needs and understanding concerning dignity. The theoretical model on dignity presented in the study also worked as a map to guide staffs' reflections on dignity in praxis and facilitated a broader focus on supporting and caring for patients' dignity in care. We believe this study has improved dignity in care at the two hospices involved in the study.
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Affiliation(s)
- Dorte Toudal Viftrup
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Niels Christian Hvidt
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Christina Prinds
- Institute of Clinical Research, Research Unit for Gynecology and Obstetrics, University of Southern Denmark, Odense C, Denmark.,University College South Denmark, Haderslev, Denmark
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Prinds C, Nikolajsen H, Folmann B. Yummy Mummy - The ideal of not looking like a mother. Women Birth 2019; 33:e266-e273. [PMID: 31176586 DOI: 10.1016/j.wombi.2019.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 05/23/2019] [Accepted: 05/23/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Pregnancy and childbirth are important life experiences that entail major changes, both physically, psychologically, socially and existentially for women. Motherhood transition and the accompanying bodily changes involve expectations of body image that are simultaneously naturally and socially produced and culturally informed by public, private and professional discourses about motherhood transition. PROBLEM Much focus is levelled at the antepartum body in maternity services whereas the postpartum body seems left alone, although bodily dissatisfaction is of concern for many mothers, whose expectations of bodily appearance postpartum are sharp and explicit. AIM To explore Danish first-time mothers' experiences of their body postpartum, focusing on body image. METHODS Eleven first-time mothers participated in semi-structured interviews related to the postpartum body image. Data was analysed thematically. FINDINGS Four themes: (1) Reverting the body: on bouncing back and losing weight; (2) Picturing me: on standards of beauty and ideal bodies; (3) Redefining earlier self-images: on meta-reproachment of the body; (4) Idealisation of not looking like a mother: on societal pressure to think positively. Findings were discussed through the theoretical concepts by Scheper-Hughes and Lock: the body as both individual, social and political. CONCLUSION Despite nuanced reflections over the body as subject and object, women identified beauty as a personal trait dependent on visual appearance. Bodily beauty was identified as something individual, yet standardised. Women felt strengthened through motherhood but looking like a mother was not considered worth pursuing. To allow for women's contradictory perspectives, caregivers are advised to communicate reflexively about the postpartum body.
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Affiliation(s)
- Christina Prinds
- University College South Denmark, Applied Research and Development, Lembckesvej, Haderslev, 6100, Denmark; University of Southern Denmark, Institute of Clinical Research, Research Unit of Gynaecology and Obstetrics, Kløvervænget 10, Odense C., 5000, Denmark.
| | - Helene Nikolajsen
- University College South Denmark, Department of Physiotherapy, Degnevej, Esbjerg Ø, 6705, Denmark.
| | - Birgitte Folmann
- University College South Denmark, Applied Research and Development, Lembckesvej, Haderslev, 6100, Denmark.
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Hvidtjørn D, Prinds C, Bliddal M, Henriksen TB, Cacciatore J, O'Connor M. Life after the loss: protocol for a Danish longitudinal follow-up study unfolding life and grief after the death of a child during pregnancy from gestational week 14, during birth or in the first 4 weeks of life. BMJ Open 2018; 8:e024278. [PMID: 30580272 PMCID: PMC6318761 DOI: 10.1136/bmjopen-2018-024278] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION After the death of a child during pregnancy, birth or in the neonatal period, parents often experience feelings of guilt, disenfranchisement, feelings of betrayal by one's own body and envy of others. Such bereavement results in high rates of distress: psychologically, emotionally, physiologically and existentially. These data are collected using a national, longitudinal cohort to assess grief in mothers and their partners after the death of a child during pregnancy, birth or in the neonatal period. Our aim is to achieve a general description of grief, emotional health, and existential values after pregnancy or perinatal death in a Danish population. METHODS AND ANALYSIS The cohort comprises mothers and their partners in Denmark who lost a child during pregnancy from gestational week 14, during birth or in the neonatal period (4 weeks post partum). We began data collection in 2015 and plan to continue until 2024. The aim is to include 5000 participants by 2024, generating the largest cohort in the field to date. Parents are invited to participate at the time of hospital discharge or via the Patient Associations homepage. Data are collected using web-based questionnaires distributed at 1-2, 7 and 13 months after the loss. Sociodemographic and obstetric variables are collected. Validated psychometric measures covering attachment, continuing bonds, post-traumatic stress, prolonged grief, perinatal grief and existential values were chosen to reach our aim. ETHICS AND DISSEMINATION The study was approved by The Danish National Data Protection Agency (no. 18/15684, 7 October 2014). The results will be disseminated in peer-reviewed and professional journals as well as in layman magazines, lectures and radio broadcasts.
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Affiliation(s)
- Dorte Hvidtjørn
- University of Southern Denmark and Odense University Hospital, Research Unit for Gynecology and Obstetrics, Institute of Clinical Research, Odense, Denmark
- Unit for Perinatal Loss, Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
| | - Christina Prinds
- University of Southern Denmark and Odense University Hospital, Research Unit for Gynecology and Obstetrics, Institute of Clinical Research, Odense, Denmark
- Midwifery College, University College South Denmark, Esbjerg, Denmark
| | - Mette Bliddal
- OPEN Odense Patient Data Explorative Network, University of Southern Denmark and Odense University Hospital, Odense, Denmark
| | - Tine Brink Henriksen
- Perinatal Epidemiology Research Unit, Aarhus University Hospital, Aarhus, Denmark
- Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Joanne Cacciatore
- School of Social Work, Arizona State University, Tempe, Arizona, USA
| | - Maja O'Connor
- Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
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Prinds C, Mogensen O, Hvidt NC, Bliddal M. First child's impact on parental relationship: an existential perspective. BMC Pregnancy Childbirth 2018; 18:157. [PMID: 29747602 PMCID: PMC5946442 DOI: 10.1186/s12884-018-1802-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 04/30/2018] [Indexed: 01/13/2023] Open
Abstract
Background The first child’s birth is for most mothers a profound experience carrying the potential to change life orientations and values. However, little is known of how becoming a mother influences the existential dimensions of life within the parental relationship for example how motherhood may change how we view our partner and what we find important. The aim of this study was to explore how becoming a mother might change the parental relationship seen from the mother’s perspective with a specific focus on dimensions related to existential meaning-making. Methods In 2011, 499 Danish first time mothers answered a questionnaire, from which five core items related to changes in the partner relationship from the perspective of the mother, informed this study. The cohort consisted of mothers who gave birth before the 32nd week of gestation (n = 127) and mothers who gave birth at full term (n = 372). Item 1 focused on thoughts and conversations with her partner about the life change. Item 2 referred to the potential feeling of stronger ties to the partner. Item 3 related to the feeling of being connected to ‘something bigger than one self’ together with the partner. Item 4 focused on potential conflicts due to having a child, and item 5 referred to the experience of dreams. Possible answers ranged from ‘To a high degree’ to ‘Not at all’. Results Most respondents found birth of the first child to have forged stronger ties to their partner and have led to both thoughts and conversations about how life together as a couple changed. At the same time, some experienced more conflicts with their partner than before giving birth, however, the majority did actually not. More than half felt their relationship linked to ‘something bigger than themselves’ or had had dreams on being a family. Conclusion Findings suggest motherhood transition to be a significant transformer of partnership relation influencing also existential meaning-making. Having the potential to be of importance for the health and vitality of the mother, partner and child, it seems essential to scientifically and clinically address concerns related to existential meaning-making in partner relationship.
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Affiliation(s)
- Christina Prinds
- Department of Clinical Institute, University of Southern Denmark, Kløvervænget 10, 5000, Odense C, Denmark. .,University College South Denmark, Degnevej 16, 6705, Esbjerg Ø, Denmark.
| | - Ole Mogensen
- Departmen of Gynaecology and Karolinska Institute, Karolinska University Hospital, 17176, Stockholm, Sweden
| | - Niels Christian Hvidt
- University of Southern Denmark, Institute of Public Health, J.B. Winsløws Vej 9, DK-5000, Odense, C, Denmark
| | - Mette Bliddal
- University of Southern Denmark, Institute of Public Health, J.B. Winsløws Vej 9, DK-5000, Odense, C, Denmark.,OPEN - Odense Patient data Explorative Network, Odense University Hospital, J.B Winsløws Vej 9, DK-5000, Odense C, Denmark
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Prinds C, Hvidtjørn D, Skytthe A, Mogensen O, Hvidt NC. Prayer and meditation among Danish first time mothers-a questionnaire study. BMC Pregnancy Childbirth 2016; 16:8. [PMID: 26786049 PMCID: PMC4719672 DOI: 10.1186/s12884-016-0802-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 01/08/2016] [Indexed: 11/21/2022] Open
Abstract
Background Mothers’ existential dimensions in the transition to motherhood have not been described thoroughly. They might experience disruption and new perspectives in existential ways and this may especially be the case in preterm birth. The aim of this study was twofold. First we investigated the existential dimension of motherhood transition in a secularized context, through practices of prayer and meditation. Second we described the relationship between time of birth (term/preterm) and the prayer/meditation practices of the mothers. Methods Data were gathered from a nationwide questionnaire survey among first time mothers conducted during the summer 2011. All Danish women who gave birth before the 32nd pregnancy week (n = 255), and double the number of mothers who gave birth at full term (n = 658) in 2010 were included (total n = 913). The questionnaire consisted of 46 overall items categorized in seven sections, which independently cover important aspects of existential meaning-making related to becoming a mother. The respondent rate was 57 % (n = 517). Results Moments of praying or meditation 6–18 months post partum were reported by 65 %, and mothers who responded affirmatively, practiced prayer (n = 286) more than meditation (n = 89), p < 0,001. We did not observe differences in affirmative responses to prayer or meditation between mothers of full term or preterm born children, not even after controlling for perinatal or post partum loss, mode of birth, age, status of cohabiting or education. Conclusions In this explorative study we found specific practices of existential meaning-making through prayer and/or meditation among first time mothers, living in a very secularized context. Yet we know only little about character or importance of these practices among mothers, and hardly anything about existential meaning-making among new fathers. Hence the implications of meaning-making practices related to other dimensions of health are difficult to address in a qualified way in care for new mothers and families.
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Affiliation(s)
- Christina Prinds
- Department of Clinical Institute, University of Southern Denmark, J.B. Winsløws Vej 19, DK-5000, Odense, C, Denmark. .,University College South Denmark, Degnevej 16, 6705, Esbjerg Ø, Denmark.
| | - Dorte Hvidtjørn
- Department of Clinical Institute, University of Southern Denmark, J.B. Winsløws Vej 19, DK-5000, Odense, C, Denmark.
| | - Axel Skytthe
- Institute of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9, DK-5000, Odense C, Denmark.
| | - Ole Mogensen
- Department of Gynaecology and Obstetrics, Odense University Hospital, Sdr. Boulevard 29, DK-5000, Odense C, Denmark.
| | - Niels Christian Hvidt
- Institute of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9, DK-5000, Odense C, Denmark.
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Abstract
Research indicates that childbirth is a time when a woman might experience existential disruptions and gain new perspectives on life. The 2-fold aim of this study was to investigate whether attitudes related to existential meaning among first-time mothers intensify and whether they differ between mothers who gave birth at full term and those who gave birth preterm. All first-time mothers who gave birth in Denmark in 2010 before the 32nd week of pregnancy and twice that number of full-term mothers (randomly sampled) were invited to participate in a national cross-sectional survey. Five core items concerning meaning in life, vulnerability of life, responsibility, thoughts about life and death, and "something bigger than oneself" were analyzed to compare mothers' attitudes on existential meaning. The overall response rate was 57% (517/913). Contrary to the hypothesis, attitudes related to existential meaning intensified to the same degree among mothers of full-term and preterm infants, with no statistically significant differences in terms of age, marital status, educational level, or birth method. Danish first-time mothers' attitudes related to existential meaning measured in 5 core items were intensified and almost similar, regardless of whether they gave birth full-term or preterm.
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Affiliation(s)
- Christina Prinds
- Institute of Public Health (Ms Prinds and Drs Skytthe and Hvidt) and Institute of Clinical Research (Dr Hvidtjørn), University of Southern Denmark, Odense C, Denmark; and Department of Gynaechology and Obstetrics, Odense University Hospital, Odense C, Denmark (Dr Mogensen)
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