Hormonella preventivmedel var initialt en frigörelse för kvinnan. I takt med att kvinnor idag har en tidig samlagsdebut och samtidigt väljer att senare bilda familj krävs det effektiva preventivmedel. Det ses dock en ökad kritisk trend till syntetiska hormoner vilket ställer frågan vad unga kvinnor har för erfarenheter kring hormonella preventivmedel. Syftet med studien var således att belysa unga kvinnors erfarenheter av hormonell antikonception. Tre fokusgruppsintervjuer med totalt tretton unga kvinnor genomfördes under slutet av 2017 och under året 2018. Materialet analyserades med en kvalitativ innehållsanalys som mynnade ut i ett resultat bestående av två kategorier med tre tillhörande subkategorier. Erfarenheter av hormonernas påverkan på kroppen och välbefinnandet med subkategorierna Att inte veta vem man är utan sitt hormonella preventivmedel, Biverkningar av hormonella preventivmedel - en uppoffring för säkert skydd och Negativa erfarenheter var övervägande. Samt kategorin Kunskap om hormonella preventivmedel med subkategorierna Val av metod snarare än val av hormon, Internet och barnmorskan som informationskälla och Erfarenhet av bristande kunskap och intresse hos män. Resultatet visar att negativa erfarenheter av hormonella preventivmedel var övervägande och där kvinnorna i studien uppger att de inte har något annat val än att använda hormonella preventivmedel för ett säkert skydd mot en oönskad graviditet, trots biverkningar. Genom en ökad kunskap kring unga kvinnors erfarenheter av hormonella preventivmedel kan barnmorskan erhålla en större förståelse och således anpassa rådgivningen efter kvinnans individuella behov. Vidare forskning kring kvinnors välbefinnande i relation till hormonella preventivmedel är av intresse för att kunna tillgodose kvinnors sexuella och reproduktiva hälsa.

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<p>The main purpose of this stydy was to evaluate the Aurora clinic (for women afraid of birth/delivery) in the south of Sweden. Questionnaires were sent to 197 women who had contact with the Aurora clinic during 2007 and 2008. The group of participants contained both pregnant women and women who have given birth. A total of 136 women replied. The results showed that both the average age and the level of education of the women were high. Nulli-paras and multi-paras had different reasons for fearing delivery. The study also showed that most women felt that the contact with an Aurora midwife helped them to feel secure and to be better prepared before delivery, that the midwife understood them and took them seriously and that the content of the meetings was satisfactory. Three out of four women, who initially wished for a caesarean section, subsequently accepted a normal delivery. This study supports previous research that shows the importance of the supportive conversation provided at the Aurora clinic for women with fear of delivery.</p>

<p>Bakgrund: Preeklampsi är en allvarlig graviditetskomplikation som drabbar kvinnor över hela världen. Sjukdomen är den största orsaken till gravida kvinnors ohälsa och dödlighet.</p><p>Syftet: Syftet med studien var att kartlägga vilka övervakningsmetoder som används vid preeklampsi samt studera evidensen av metoderna.</p><p>Metod: Författarna har genomfört en litteraturstudie. Detta har genomförts genom granskning och sammanställning av litteratur samt databassökning i PubMed för att finna vetenskapliga artiklar. Till resultatet valdes femton vetenskapliga studier.</p><p>Resultat. Evidens finns för att följa blodtryck- och urinkontroller som påvisar förändringar i sjukdomen. Kontrollerna bör följas av blodprover om kvinnan har konstaterad preeklampsi eftersom dessa visar försämring av sjukdomen. Att mäta flödet i arteria uterina via doppler kan bedöma kvinnans risk att utveckla preeklampsi. Mer forskning behövs för att låta kvinnan själv mäta sitt blodtryck hemma via självövervakning. Stark evidens finns för att fortsätta kontrollera preeklampsitillståndet postpartum.</p><p>Slutsats:  Att mäta flödet i arteria uterina via doppler i graviditetsvecka 22-24  ger möjlighet till riskbedömning speciellt för tidig preeklampsi. Regelbunden kontroll av blodtrycket och proteinuri är effektivt för att upptäcka  preeklampsi både under graviditeten, förlossningen och postpartum och för övervakning av tillståndet. Blodprover kan användas som komplement   för att upptäcka koagulationsrubbningar, försämrad njurfunktion och leverpåverkan.</p>

<p>Objectives: This descriptive epidemiological dissertation aims to identify conditions of Swedish women’s sexual well-being. The focus is on the relationship between their idiosyncratically reported levels, during the last 12 months, of 5 sexual functions/dysfunctions per se and distressing and their socio-psychological situation, including aspects of their sexual history. Levels of sexual functions/dysfunctions are also related to levels of sexual satisfaction and to other aspects of life satisfaction.</p><p>Methods: Data on a randomized cross-sectional national sample of 1335 women aged 18-74 (59% of target sample) were gathered in 1996 using a combination of structured interviews and questionnaires/checklists. Analyses were performed for the total sample or for sub-samples aged 18-65 years. In 3 of the 4 dissertational articles, trichotomies of a 6-grade scale characterizing level of sexual dysfunctions into No/Mild/Manifest dysfunction were used.</p><p>Main results: Mild sexual dysfunctions were, generally, much more common than were manifest, and dysfunctional distress was considerably less common than were dysfunctions per se. All dysfunctions, and in particular orgasmic dysfunction, were closely associated with level of sexual well-being. Four factors independently pair-wise linking levels of dysfunctions per se with levels of distressful dysfunction were identified. These were Sexual interest/Desire, Genital function (lubrication and dyspareunia), Orgasm, Vaginismus. Three of these (not vaginismus) were powerful classificators of gross level of sexual well-being. Many of socio-demographic and socio-psychological contextual life-conditions were significantly associated with the different sexual functions/dysfunctions. However, the most prominent contextual variables were satisfaction with partner relationship and partner’s levels of sexual functions.</p><p>In conclusion, many different socio-psychological aspects must be taken into account to optimize treatment modalities and resources when dealing with women’s sexual dysfunction in order to secure a good level of sexual well-being.</p>

Objectives: This descriptive epidemiological dissertation aims to identify conditions of Swedish women’s sexual well-being. The focus is on the relationship between their idiosyncratically reported levels, during the last 12 months, of 5 sexual functions/dysfunctions per se and distressing and their socio-psychological situation, including aspects of their sexual history. Levels of sexual functions/dysfunctions are also related to levels of sexual satisfaction and to other aspects of life satisfaction. Methods: Data on a randomized cross-sectional national sample of 1335 women aged 18-74 (59% of target sample) were gathered in 1996 using a combination of structured interviews and questionnaires/checklists. Analyses were performed for the total sample or for sub-samples aged 18-65 years. In 3 of the 4 dissertational articles, trichotomies of a 6-grade scale characterizing level of sexual dysfunctions into No/Mild/Manifest dysfunction were used. Main results: Mild sexual dysfunctions were, generally, much more common than were manifest, and dysfunctional distress was considerably less common than were dysfunctions per se. All dysfunctions, and in particular orgasmic dysfunction, were closely associated with level of sexual well-being. Four factors independently pair-wise linking levels of dysfunctions per se with levels of distressful dysfunction were identified. These were Sexual interest/Desire, Genital function (lubrication and dyspareunia), Orgasm, Vaginismus. Three of these (not vaginismus) were powerful classificators of gross level of sexual well-being. Many of socio-demographic and socio-psychological contextual life-conditions were significantly associated with the different sexual functions/dysfunctions. However, the most prominent contextual variables were satisfaction with partner relationship and partner’s levels of sexual functions. In conclusion, many different socio-psychological aspects must be taken into account to optimize treatment modalities and resources when dealing with women’s sexual dysfunction in order to secure a good level of sexual well-being.

Bakgrund: Preeklampsi är en allvarlig graviditetskomplikation som drabbar kvinnor över hela världen. Sjukdomen är den största orsaken till gravida kvinnors ohälsa och dödlighet. Syftet: Syftet med studien var att kartlägga vilka övervakningsmetoder som används vid preeklampsi samt studera evidensen av metoderna. Metod: Författarna har genomfört en litteraturstudie. Detta har genomförts genom granskning och sammanställning av litteratur samt databassökning i PubMed för att finna vetenskapliga artiklar. Till resultatet valdes femton vetenskapliga studier. Resultat. Evidens finns för att följa blodtryck- och urinkontroller som påvisar förändringar i sjukdomen. Kontrollerna bör följas av blodprover om kvinnan har konstaterad preeklampsi eftersom dessa visar försämring av sjukdomen. Att mäta flödet i arteria uterina via doppler kan bedöma kvinnans risk att utveckla preeklampsi. Mer forskning behövs för att låta kvinnan själv mäta sitt blodtryck hemma via självövervakning. Stark evidens finns för att fortsätta kontrollera preeklampsitillståndet postpartum. Slutsats:  Att mäta flödet i arteria uterina via doppler i graviditetsvecka 22-24  ger möjlighet till riskbedömning speciellt för tidig preeklampsi. Regelbunden kontroll av blodtrycket och proteinuri är effektivt för att upptäcka  preeklampsi både under graviditeten, förlossningen och postpartum och för övervakning av tillståndet. Blodprover kan användas som komplement   för att upptäcka koagulationsrubbningar, försämrad njurfunktion och leverpåverkan.

An efficient referral system is essential in providing access to emergency obstetric care at higher levels of care by supporting antenatal and delivery services in the primary level of care facilities (PLCF). The aim of this thesis was to assess community and health service factors affecting the quality of maternal referrals in rural Tanzania. Ten focus group discussions (FGDs) with health workers and community members were conducted to describe their perceptions on maternal referrals. Women (n=1118) were interviewed to determine awareness of obstetric danger signs and associated factors. Compliance with referral advice was analysed for 1538 women referred from PLCF. Counselling on danger signs and adherence to referral criteria was observed in 438 antenatal consultations. FGDs indicated that women had limited influence, especially on emergency referrals. The process of deciding to seek referral care considered the perception of seriousness and past experience of referral, access to transport, and the cost involved. Women had low awareness of danger signs of obstetric complications: higher years of schooling increased the likelihood of being aware of danger signs. Demographic risks accounted for 70% of referred women but less than half complied with the advice. Compliance was higher for historical obstetric risks, prenatal, natal, and postnatal complications groups. Few women were counselled on pregnancy danger signs and a significant number with ≥5 pregnancies and primigravidae &lt;20 years were not informed of the risk factors. This thesis demonstrated a need for reviewing referral guidelines and an increase in supportive supervision for health workers counselling on obstetric danger signs to enhance acceptance of referrals advices. Women’s education should be given priority for increasing participation in decisions and becoming more aware of danger signs. Costs involved in maternal referrals can be relieved by improving family income, infrastructure, and alleviating the cost of referral through mobilising community transport and financial schemes.

This thesis assessed responses toward rape against women as experienced by the victims and victim supporters in the context of the interaction between victims, supporters, and formal agencies in Tanzania. The overall research design was based on triangulation with a combination of qualitative and quantitative methods. A semi-qualitative study, in which free listings and semi-structured questionnaires were used, explored social reactions from 44 community nurses and 50 rape victims (Paper I). A tool developed from this first study was utilized for collecting data on people’s attitudes and their behavior toward rape and rape victims from a representative community sample of 1505 men and women aged 18-65 years (Paper II). Both studies helped to access suitable rape victims and supporters who participated in the third study to share experiences on the process of rape disclosure to formal and informal social networks (Papers III and IV). The results highlighted the salient social reactions and how rape victims perceived the impact of these reactions. Half of the participants interpreted rape situations based on social relationships, circumstances, and social status of the woman, rather than the legal definition. Two-thirds of the adults explained they would express negative social reactions toward a victim in some rape scenarios, and this correlated with their attitudes towards rape and rape victims. A variety of barriers in the informal and formal networks with potentially negative impacts on rape reporting, service utilization and, health outcomes were identified. In conclusion, successful interventions aimed at improving people’s response to rape, rape disclosure and, health outcomes in Tanzania should assume a holistic approach to address the negative factors identified at the individual, family and, community levels without forgetting the normative context that appears to underlie most decisions and practice.

Ett missfall är en stor och omtumlande händelse i en kvinnas liv. Under denna tid har vårdgivaren stor betydelse i hur kvinnan klara sin situation och för att kunna gå vidare. Syftet med denna litteraturstudie var att beskriva kvinnors upplevelser av stöd vid missfall. Detta kan hjälpa sjuksköterskor att förstå kvinnan bättre i hennes situation vid missfall.  Metoden var en litteraturöversikt enligt Friberg (2006). Materialet som använts för att få fram översikten är nio stycken vetenskapliga artiklar. I resultatet framkom två huvudområden: känslomässigt stöd och praktiskt stöd med fem olika underområden: socialt stöd, professionellt stöd, bemötande och attityd, uppföljning och information. För kvinnor spelade bemötandet en stor roll i hur de upplevde sin situation. En negativ aspekt var att personalen i vissa fall inte behandlade kvinnorna individuellt. Det stöd och den vård som ges vid ett missfall ska göras så bra som möjligt med tanken att varje fall är individuellt och unikt. Detta genom att lyssna till vad kvinnan behöver och forma vården efter henne. / A miscarriage is a big and chaotic event in a woman's life. During this time caregiver has an important role in how women cope with their situation and how they move forward. The purpose of this literature review was to highlight women’s experiences of support at miscarriage. This can help nurses to better understand the woman in her situation in a miscarriage. The method was a literature review according to Friberg (2006). Nine scientific articles formed the base of the review. The results revealed two main areas: emotional support and practical assistance with five different sub-areas: social assistance, professional support, treatment and attitude, follow up and information. It appeared both positive and negative experiences of the provided care. The support and care provided by nurses at an miscarriage should be as good as possible with the idea that each case is individual and unique. This by listening to what the women need and shaping health care for her.