Anna Axelin

University of Turku | UTU · Department of Nursing Science

Background Smart wristbands enable the continuous monitoring of health parameters, for example, in maternity care. Understanding the feasibility and acceptability of these devices in an authentic context is essential. The aim of this study was to evaluate the feasibility of using a smart wristband to collect continuous activity, sleep and heart rat...

Infants born to opioid-dependent women are typically admitted to neonatal intensive-care units for management of neonatal abstinence syndrome (NAS), and their treatment requires medical decision making. It is not only the infants’ vulnerability, in terms of their incompetence and medical condition, that is present in those circumstances, but also t...

Aim We explored the dynamics of neonatologist‐parent communication and decision‐making during medical rounds in a level three neonatal intensive care unit. Methods This was a qualitative study, with an ethnographic approach, that was conducted at Turku University Hospital, Finland, from 2013‐2014. We recruited eight mothers and seven couples, thei...

Background Improving the healthcare providers (HCP) basic resuscitation skills can reduce intrapartum related mortality in low- and middle-income countries. However, the resuscitation intervention’s successful implementation is largely dependent on proper facilitation and context. This study aims to identify the facilitators and barriers for the im...

Introduction The communication skills of healthcare professionals play a crucial role in successful shared decision-making with parents in neonatal intensive care. Improving communication skills can be achieved through practice and reflection on personal experiences after authentic interaction events with parents. The process of reflection typicall...

Aim: To describe parents' experiences with interprofessional collaboration (IPC) in neonatal pain management. Background: Neonatal care should be based on IPC, and non-pharmacological pain-relieving methods are recommended to be used primarily that enables parental participation. However, there is a lack of knowledge about pain management on IPC...

Aim: We aimed to describe clinical practices and criteria for discharge of very preterm infants in Nordic neonatal units. Methods: Medical directors of all 89 level-2 and level-3 units in Denmark, Finland, Iceland, Norway, and Sweden were invited by e-mail to complete a web-based multiple-choice survey with the option to make additional free-tex...

Aim: Little is known about the specific restriction measures used in neonatal intensive care units (NICUs) during the COVID-19 pandemic and their impact on parental well-being. Hence, this study aimed to assess the association between restriction measures and mothers' postpartum depressive symptoms. Methods: This comparative cohort study include...

Background: There is a gap in knowledge about how perinatal eHealth programs function to support autonomy for new and expectant parents from pursuing wellness goals. Objectives: To examine patient engagement (access, personalization, commitment and therapeutic alliance) within the practice of perinatal eHealth. Design: Scoping review. Methods...

Background: The development and quality assurance of perinatal eHealth self-monitoring systems is an upcoming area of inquiry in health science. Building patient engagement into eHealth development as a core component has potential to guide process evaluation. Access, 1 attribute of patient engagement, is the focus of study here. Access to eHealth...

(1) Background. The birth of an infant at 23 to 24 weeks poses a significant challenge to healthy parent–infant bonding because of the high risk of infant loss and the prolonged separation. The aim of this study was to retrospectively explore the narratives of parents with children born at 23–24 weeks about their bonding formation and relational ex...

BACKGROUND Maternal loneliness is associated with adverse physical and mental health outcomes for both the mother and her child. Detecting maternal loneliness non-invasively through wearable devices and passive sensing provides opportunities to prevent or reduce the impact of loneliness on the health and well-being of the mother and her child. OBJ...

Background Maternal loneliness is associated with adverse physical and mental health outcomes for both the mother and her child. Detecting maternal loneliness noninvasively through wearable devices and passive sensing provides opportunities to prevent or reduce the impact of loneliness on the health and well-being of the mother and her child. Objec...

There is strong evidence that family-centered care (FCC) improves the health and safety of infants and families in neonatal settings. In this review, we highlight the importance of common, evidence-based quality improvement (QI) methodology applied to FCC and the imperative to engage in partnership with neonatal intensive care unit (NICU) families....

Objective: The aim of this study was to compare subjectively and objectively measured stress during pregnancy and the three months postpartum in women with previous adverse pregnancy outcomes and women with normal obstetric histories. Methods: We recruited two cohorts in southwestern Finland for this longitudinal study: (1) pregnant women (n = 3...

Background: Shared responsibility is an essential part of family-centred care and it characterizes the relationship between parents and healthcare professionals. Despite this, little is known about their shared responsibility for decision-making in neonatal intensive care units. Aim: The aim of this scoping review was to identify previous studie...

Objectives To assess, in terms of self-efficacy in weight management, the effectiveness of the SLIM lifestyle intervention among overweight or obese women during pregnancy and after delivery, and further to exploit machine learning and event mining approaches to build personalized models. Additionally, the aim is to evaluate the implementation of t...

Background: Specificities regarding the quality and quantity of sleep of preterm infants and their parents following discharge of the preterm infant from the hospital are not well known. Given this lack of knowledge, the links between the sleep characteristics of these parents, family functioning, and their psychological well-being are also unclea...

Objective Activity trackers appear cost-effective and acceptable intervention tools for promoting physical activity among older adults, particularly in the short-term. However, long-term studies focused on participants’ experiences continue to be scarce. This study evaluated participants’ experiences of a 12-month activity tracker-driven physical a...

Protokollan laatiminen satunnaistetusta kontrolloidusta tutkimuksesta (RCT) on tärkeää, koska se lisää tutkimuksen luotettavuutta. Aiheeseen liittyvä menetelmäkirjallisuus on kuitenkin vähäistä ja tieto protokollan toteuttamisesta on hajanaista. Tämän artikkelin tarkoituksena on kuvata RCT-tutkimuksen protokollan vaiheita hoitotieteellisessä tutkim...

Background Photoplethysmography (PPG) is a low-cost and easy-to-implement method to measure vital signs, including heart rate (HR) and pulse rate variability (PRV) which widely used as a substitute of heart rate variability (HRV). The method is used in various wearable devices. For example, Samsung smartwatches are PPG-based open-source wristbands...

Objective: Inadequate adherence to resuscitation for non-crying infants will have poor outcome and thus rationalise a need for real-time guidance and quality improvement technology. This study assessed the usability, feasibility and acceptability of a novel technology of real-time visual guidance, with sound and video recording during resuscitatio...

Background Breastfeeding practices remain globally suboptimal despite many known maternal and neonatal health benefits and the Baby-Friendly Hospital Initiative as a global effort to support breastfeeding. Objective We aimed to evaluate the effects of the implementation of the Baby-Friendly Hospital Initiative for a proportion of mothers who exclu...

Background: The autonomic nervous system (ANS) is known as a critical regulatory system for pregnancy-induced adaptations. If it fails to function, life-threatening pregnancy complications could occur. Hence, understanding and monitoring the underlying mechanism of action for these complications are necessary. Objective: We aimed to systematical...

BACKGROUND The autonomic nervous system (ANS) is known as a critical regulatory system for pregnancy-induced adaptations. If it fails to function, life-threatening pregnancy complications could occur. Hence, understanding and monitoring the underlying mechanism of action for these complications are necessary. OBJECTIVE We aimed to systematically r...

BACKGROUND Access to eHealth self-monitoring has the potential to influence receival of appropriate health resources during pregnancy. Little is known about influences of the process of accessing eHealth systems on use patterns. OBJECTIVE Here, we examined processes occurring during the adaption of eHealth self-monitoring use from a socio-material...

Background In developing countries, mental health literacy (MHL) still needs to be improved due to the high prevalence of mental disorders. It is widely recognized that MHL can improve health outcomes for both individuals and populations. Healthcare professionals’ development in MHL is crucial to the prevention of mental disorders. The aim of this...

Background Maternal loneliness is associated with adverse physical and mental health outcomes for both the mother and her child. Detecting maternal loneliness non-invasively through wearable devices and passive sensing provides opportunities to prevent or reduce the impact of loneliness on the health and well-being of the mother and her child. Obj...

Background: The 5-visual analogue scale Richards-Campbell Sleep Questionnaire subjective sleep measure is widely used in intensive care. A cut-off score indicative of good quality sleep has not been established and is required to guide the categorisation of individual patient and unit wide sleep quality. Design and methods: The aim was to determin...

Background: There is a dearth of knowledge regarding the specific factors associated with emotional closeness in parents with an infant in the NICU. Aim: To determine if parental presence, involvement in infant care, holding, skin-to-skin contact (SSC), perceived family-centered care, depression symptoms, and sociodemographic characteristics are as...

Introduction In 2018 to 2020, a multicentre cohort study was conducted in 23 NICUs across 15 countries. The aim of this study was to examine the potential association of family-centred care as perceived by parents during a NICU stay with parents’ depressive symptoms at discharge and at 4 months corrected for infant age. Methods Parents (n = 635 mo...

Descriptive Comparative Pilot study: Self-monitoring in pregnancy 1 1 2 Abstract 3 Pregnancy is a challenging time for maintaining quality sleep and managing stress. 4 Digital self-monitoring technologies are popular due to assumed increased patient 5 engagement leading to an impact on health outcomes. However, the actual association 6 between wear...

Background: Preterm birth increases the risk for postpartum depression in both mothers and fathers, calling for strategies to alleviate and prevent depressive symptoms in parents of preterm infants. The aim of this study was to assess the association between early parent-infant closeness and later depressive symptoms among parents of preterm infan...

Aims and objectives: First, to describe the variation in stakeholders' perceptions related to the desirable mental health services in school environments. Second, to construct alternative future visions based on these perceptions. Finally, to describe stakeholders' perceptions about the actions needed to reach such an ideal state. Background: Th...

Background Patient recruitment for clinical trials is challenging—only approximately one third of all trials recruit their participants as planned. The pharmaceutical industry’s views on recruitment success have not been comprehensively investigated, although the industry globally conducts almost one third of all clinical drug trials. This study ex...

Background Photoplethysmography (PPG) is a low-cost and easy-to-implement method to measure vital signs, including heart rate (HR) and heart rate variability (HRV). The method is widely used in various wearable devices. For example, Samsung smartwatches are PPG-based open-source wristbands used in remote well-being monitoring and fitness applicatio...

Background: The 5-visual analogue scale Richards-Campbell Sleep Questionnaire subjective sleep measure is widely used in intensive care. A cut-off score indicative of good quality sleep has not been established and is required to guide the categorisation of individual patient and unit wide sleep quality. Design and methods: The aim was to determ...

Objective To examine the psychometric properties of the Digi Family-Centered Care–Parent Version (DigiFCC-P), which was developed to measure parents’ perceptions of family-centered care (FCC) in NICUs. Design Cross-sectional psychometric study. Setting Twenty-three NICUs in 15 countries in Europe, Canada, and Australia. Participants Mothers (n =...

Introduction Trust of women and families toward health institutions has led to increased use of their services for childbirth. Whilst unpleasant experience of care during childbirth will halt this achievement and have adverse consequences. We examined the experience of women regarding the care received during childbirth in health institutions in Ne...

Objective : The purpose of this study was to examine maternal perceptions of postnatal breastfeeding support in the hospital before and after designation to the Baby-Friendly Hospital Initiative (BFHI). Further maternal and infant characteristics associated with the maternal perception of breastfeeding support were investigated. Our hypothesis was...

Smart rings, such as the Oura ring, might have potential in health monitoring. To be able to identify optimal devices for healthcare settings, validity studies are needed. The aim of this study was to compare the Oura smart ring estimates of steps and sedentary time with data from the ActiGraph accelerometer in a free-living context. A cross-sectio...

Aim: To test whether the implementation of the Close Collaboration with Parents intervention at a neonatal intensive care unit (NICU) decreases depression symptoms of mothers up to two years after the delivery of preterm infants. Methods: We used a non-equivalent two-group design, comparing mothers of very low birthweight infants in the same NIC...

Aims The aim of this study was to examine the potential association of family-centred care as perceived by parents during a NICU stay with parents’ depressive symptoms at discharge and at 4 months corrected for infant age. Design A longitudinal, multicentre cohort study was conducted from 2018 to 2020 in 23 NICUs across 15 countries. Methods Pare...

Background: The Baby-Friendly Hospital Initiative represents a global effort to support breastfeeding. Commitment to this program has been associated with the longer duration and exclusivity of breastfeeding and improvements in hospital practices. Further, healthcare professionals’ breastfeeding attitudes have been associated with the ability to pr...

Aim The aim of this study was to evaluate the construct validity and internal consistency of the revised Mental Health Literacy Scale (MHLS) in South Africa (SA) and Zambia. Design This cross-sectional study was conducted between October 2018 and December 2019. Methods The study population comprised PHC workers (n = 454) in five districts in SA a...

Aims and objectives: This study aimed to explore staff attitudes and experiences of parents' friends and families' social presence and involvement in neonatal intensive care units (NICUs). Background: In NICUs, parents need emotional and practical support during infant hospitalisation. Friends and families of parents may constitute the most sign...

Background: Systematic training for the neonatal staff to support parents' active involvement is lacking. There is little information about the effectiveness of educational interventions. Purpose: To evaluate the effects of an educational intervention to neonatal staff on the quality of family-centered care from the perspectives of parents and n...

Background Dysfunctions related to pelvic floor muscles such as urinary incontinence and pelvic pain are common among pregnant and postpartum women. With properly functioning pelvic floor muscles, it is possible to prevent these dysfunctions. Still, shared understanding about effective exercise interventions is missing. The aim of this review of re...

BACKGROUND Heart rate variability (HRV) is a non-invasive method reflecting autonomic nervous system (ANS) regulations. Altered HRV is associated with adverse mental or physical health complications. ANS also has a central role in physiological adaption during pregnancy causing normal changes in HRV. OBJECTIVE Assessing trends in heart rate (HR) a...

Background Heart rate variability (HRV) is a noninvasive method that reflects the regulation of the autonomic nervous system. Altered HRV is associated with adverse mental or physical health complications. The autonomic nervous system also has a central role in physiological adaption during pregnancy, causing normal changes in HRV. Objective The ai...

Objective The aim of this study was to evaluate the effects of a single family room architecture in a neonatal intensive care unit (SFR-NICU) on parents’ presence, parent–infant skin-to-skin contact (SSC) and the quality of family centered care. Study design Two cohorts of parents of preterm infants were compared: those in the unit before and afte...

Introduction: Feasibility evaluations are performed to create the best possible starting point for the set-up and execution of a clinical trial, and to identify any obstacles for successful trial conduct. New digital technologies can provide various types of data for use in feasibility evaluations. There is a need to identify and compare such data...

Purpose: We aimed to understand the relationship between exercise and stress among socioeconomically at-risk women who participated in a home visitation service during pregnancy and postpartum. Methods: A mixed-methods design was used to support and supplement quantitative data using qualitative data. Convenience sampling was used to collect dat...

Background: The unique perspective of fathers with an infant in the neonatal unit on the development of emotional closeness toward their infant is not well understood. The purpose of this study is to explore experiences and instances of emotional closeness from the perspective of fathers as well as factors influencing emotional closeness during an...

Background Active parent participation in neonatal care and collaboration between parents and professionals during infant hospitalization in the neonatal intensive care unit (NICU) is beneficial for infants and their parents. A tool is needed to support parents and to study the effects and implementation of parent-partnered models of neonatal care....

Background Sleep is vital to our wellbeing. Critically ill patients are vulnerable with effects of sleep deprivation including weakened immune function, decreased glucose tolerance, and increased sympathetic activity. Intensive care unit (ICU) patients' sleep evaluation is difficult and often not reliable. The most commonly used instrument for asse...

Pregnancy is a unique time when many mothers gain awareness of their lifestyle and its impacts on the fetus. High-quality care during pregnancy is needed to identify possible complications early and ensure the mother’s and her unborn baby’s health and well-being. Different studies have thus far proposed maternal health monitoring systems. However,...

Background Maternal overweight is increasing, and it is associated with several risk factors for both the mother and child. Healthy lifestyle behaviors adopted during pregnancy are likely to impact women’s health positively after pregnancy. The study’s aim was to identify and describe weight management behaviors in terms of the Capability, Opportun...

Background Technology enables the continuous monitoring of personal health parameter data during pregnancy regardless of the disruption of normal daily life patterns. Our research group has established a project investigating the usefulness of an Internet of Things–based system and smartwatch technology for monitoring women during pregnancy to expl...

BACKGROUND Photoplethysmography (PPG) is a non-invasive and low-cost method to remotely and continuously track vital signs. The Oura ring is a compact PPG-based smart ring, which has recently drawn attention to be used in remote health monitoring and wellness applications. The ring is employed to acquire nocturnal heart rate (HR) and heart rate var...

Background Photoplethysmography is a noninvasive and low-cost method to remotely and continuously track vital signs. The Oura Ring is a compact photoplethysmography-based smart ring, which has recently drawn attention to remote health monitoring and wellness applications. The ring is used to acquire nocturnal heart rate (HR) and HR variability (HRV...

Background Surviving children born at 23 gestational weeks are a growing population. As many of these children face developmental challenges during childhood and adolescence, more knowledge is needed about the everyday life of this group. The parental perspective is important, as developmental problems often pose a challenge for the parents. The ai...

Background Parent-infant closeness during hospital care of newborns has many benefits for both infants and parents. We developed an educational intervention for neonatal staff, Close Collaboration with Parents, to increase parent-infant closeness during hospital care. The aim of this study was to evaluate the effectiveness of the intervention on pa...

Background Mental health problems among children and adolescents are a worldwide issue of concern. Health professionals who have sufficient competency in mental health issues are crucial for responding to this situation. Aim The aim of the study was to describe the competency in mental health issues required by the work of public health nurses in...

Background: Preterm and sick infants benefit from parent-infant closeness and family-centered care (FCC) in neonatal intensive care units (NICUs). Prospective and feasible tools are needed to measure these care practices to facilitate their implementation. Aims: To describe the development process of three prospective data collection tools that...

Background: Maternal overweight is increasing, and it is associated with several risks for both the mother and child. Healthy lifestyle behaviors adopted during pregnancy are likely impact women’s health positively after pregnancy. The study’s aim was to identify and describe weight management behaviors in terms of the Capability, Opportunity and M...

Background As part of efforts to develop and implement a short course educational program on pediatric pain management, the current study sought to understand the culture and contextual factors that influence children’s pain management in order to improve the practice in pediatric care settings. Methods Guided by Bourdieu’s theory of practice, a f...

In this article, we compared the content validity of two instruments used in measuring pediat-ric pain knowledge and attitudes. This was considered necessary due to the universal differences in culture, semantics and healthcare resources in different parts of the globe. Thirteen (13) pediatric experts in Ghana assessed the content validity of two i...

Background Assessment of sleep quality is essential to address poor sleep quality and understand changes. Owing to the advances in the Internet of Things and wearable technologies, sleep monitoring under free-living conditions has become feasible and practicable. Smart rings and smartwatches can be employed to perform mid- or long-term home-based s...