Anna Sarkadi

Fathers' involvement and children's developmental outcomes: a systematic review of longitudinal studies

Objective: This systematic review aims to describe longitudinal evidence on the effects of father involvement on childrens developmental outcomes.

Support needs of expectant mothers and fathers: a qualitative study.

The aim of this study was to describe expectant mothers’ and fathers’ perceived needs of support during pregnancy. Twenty-two women and 10 men were interviewed in four focus groups and 13 individual interviews. Systematic text condensation was performed to analyze the data. Parents described not only a broad spectrum of social support needs but also needs of psychological and physical support. They also requested to share their experiences with others. The foci of care and parents’ needs of support are more harmonized with medical support than with psychological and emotional support. Mothers’ needs were predominately addressed in the health services, but fathers often felt “invisible.” Antenatal services may need to offer more customized individual support and emphasize peer support in groups; the challenge is to involve both parents through communication and encouragement so they can support each other.

Did I really want to know this? Pregnant women's reaction to detection of a soft marker during ultrasound screening.

OBJECTIVE To investigate womens expectations of routine ultrasound and experiences when soft markers were discovered: what the disclosure meant, how it affected them, how they experienced the information given and why they did or did not choose amniocentesis. DESIGN Semi-structured, in-depth interviews were conducted with 11 women 25-30 weeks into the pregnancy, 7-13 weeks after the discovery of a soft marker. FINDINGS Women lacked knowledge about the potential of the scan and detection of soft markers created strong emotional reactions that women thought could have been alleviated by prior information about potential findings. Information in connection with the scan was perceived as insufficient. Decision about amniocentesis was affected by attitudes to disability, anxiety about fetal loss due to the procedure, need for certainty by a diagnostic test, and partners opinion. CONCLUSIONS Women were shocked by the unexpected and sometimes unwanted information on elevated risk for a chromosomal aberration for which they lacked any preparation. Because this event often has long-lasting effects on the pregnancy, models of information that are efficient in promoting informed decisions are imperative. PRACTICE IMPLICATIONS Both women and their partners need relevant information before and in connection with ultrasound scan to be able to make informed choices.

Study Circles at the Pharmacy--A New Model for Diabetes Education in Groups.

During the past years diabetes education has developed greatly. However, a survey of diabetes care in Sweden in 1995 showed that only 40% of the patients examined had acceptable HbAlc values. This underlines the need for an effective and low-cost patient education programme. In this study we tested the feasibility of a 1-year group education model for patients with type 2 diabetes at Swedish pharmacies. In the study circles, led by specially trained pharmacists, participants learned how to self-monitor glucose, to interpret the results and to act upon them. We conclude that study circles held at pharmacies are a feasible way of educating persons with type 2 diabetes. The group setting promoted learning through peer help and gave emotional support to participants. Metabolic control as measured by HbAlc improved significantly after 6 months, but reverted to baseline levels again at 12 months. The reason for this needs further investigation.

SOCIAL NETWORK AND ROLE DEMANDS IN WOMEN'S TYPE 2 DIABETES: A MODEL

Type 2 diabetes is a common chronic disease in middle-aged and older women. The social network, although an important source of support, can place conflicting demands on women who cope with a chronic disorder. Because this paradoxical situation can be a burden for many women a model was constructed to systematically investigate social network demands in womens Type 2 diabetes. In developing the model, network theory provided the framework and an extensive literature review determined which network components should be included. Material from our individual and focus group interviews was used to clarify the model. Traditional gender roles in the home, obligation profiles at the workplace, cultural expectations on womens bodies, and prejudice about the psychological etiology of womens diseases in health care, could all contribute to womens experiencing role conflict in their daily diabetes management. To systematically investigate potential deterrents to womens self-care, questions that address the different components of womens social networks are proposed.

Variation of patients’ views on Type 2 diabetes management over time

Aims  The aim of the study was to examine the relationship between participants’ views about their role in diabetes treatment and their glycaemic control 3–7 years after having entered an educational intervention, and to investigate whether peoples attitudes towards diabetes management change over an extended period of time.

‘Children are exposed to temptation all the time’– parents’ lifestyle‐related discussions in focus groups

Aim:  To explore parents’ perspectives on providing their preschool child with a healthy lifestyle, including obstacles and resources.

Ultrasonographic fetal soft markers in a low‐risk population: prevalence, association with trisomies and invasive tests

To investigate the prevalence of soft markers identified at second trimester ultrasound in a low‐risk population and the association of these markers with trisomies and invasive testing.

The Children and Parents in Focus project: a population-based cluster-randomised controlled trial to prevent behavioural and emotional problems in children

BackgroundThere is large body of knowledge to support the importance of early interventions to improve child health and development. Nonetheless, it is important to identify cost-effective blends of preventive interventions with adequate coverage and feasible delivery modes. The aim of the Children and Parents in Focus trial is to compare two levels of parenting programme intensity and rate of exposure, with a control condition to address impact and cost-effectiveness of a universally offered evidence-based parenting programme in the Swedish context.Methods/DesignThe trial has a cluster randomised controlled design comprising three arms: Universal arm (with access to participation in Triple P - Positive Parenting Program, level 2); Universal Plus arm (with access to participation in Triple P - Positive Parenting Program, level 2 as well as level 3, and level 4 group); and Services as Usual arm. The sampling frame is Uppsala municipality in Sweden. Child health centres consecutively recruit parents of children aged 3 to 5 years before their yearly check-ups (during the years 2013–2017). Outcomes will be measured annually. The primary outcome will be children’s behavioural and emotional problems as rated by three informants: fathers, mothers and preschool teachers. The other outcomes will be parents’ behaviour and parents’ general health. Health economic evaluations will analyse cost-effectiveness of the interventions versus care as usual by comparing the costs and consequences in terms of impact on children’s mental health, parent’s mental health and health-related quality of life.DiscussionThis study addresses the need for comprehensive evaluation of the long-term effects, costs and benefits of early parenting interventions embedded within existing systems. In addition, the study will generate population-based data on the mental health and well-being of preschool aged children in Sweden.Trial registrationISRCTN: ISRCTN16513449.

Using different approaches to conducting postal questionnaires affected response rates and cost-efficiency

OBJECTIVE To compare three different approaches for consent in postal questionnaire in terms of response rate, time consumption, and cost-efficiency, and to collect a demographic questionnaire for dropout analyses. STUDY DESIGN AND SETTING Population survey in Sweden. Mothers and fathers (n=600) of three hundred 3-year olds were divided into three groups. One group was asked to Actively Agree to participate in a cover letter and send consent back to receive the main questionnaire. The second group received the cover letter, the consent, and the main questionnaire in the initial mailings, Direct Delivery. The third group received the cover letter and consent form in which they were asked to Actively Decline participation within 7 days if they did not want to participate. Otherwise, they were sent the main questionnaire. All parents were asked to fill in a demographic questionnaire regardless of whether they wanted to complete the main questionnaire. RESULTS The highest response rate was in the Actively Decline mode. The cost-efficiency for this approach was 1.52 compared with Direct Delivery and 1.29 compared with Actively Agree. CONCLUSION Researchers can improve the response rate, time consumption, and cost-efficiency and obtain a demographic questionnaire for dropout analysis by using the Actively Decline approach for postal questionnaires.