{"id":5945,"date":"2026-10-19T09:48:13","date_gmt":"2026-10-19T09:48:13","guid":{"rendered":"https:\/\/phd.hi.is\/doktorsvorn\/doktorsvorn-i-ljosmodurfraedi-valgerdur-lisa-sigurdardottir\/"},"modified":"2026-10-19T09:48:13","modified_gmt":"2026-10-19T09:48:13","slug":"doktorsvorn-i-ljosmodurfraedi-valgerdur-lisa-sigurdardottir","status":"publish","type":"phd_defence","link":"https:\/\/phd.hi.is\/en\/doktorsvorn\/doktorsvorn-i-ljosmodurfraedi-valgerdur-lisa-sigurdardottir\/","title":{"rendered":"Doktorsv\u00f6rn \u00ed lj\u00f3sm\u00f3\u00f0urfr\u00e6\u00f0i – Valger\u00f0ur L\u00edsa Sigur\u00f0ard\u00f3ttir"},"content":{"rendered":"
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F\u00f6studaginn 5. j\u00fan\u00ed ver Valger\u00f0ur L\u00edsa Sigur\u00f0ard\u00f3ttir doktorsritger\u00f0 s\u00edna \u00ed lj\u00f3sm\u00f3\u00f0urfr\u00e6\u00f0i vi\u00f0 Hj\u00fakrunarfr\u00e6\u00f0ideild H\u00e1sk\u00f3la \u00cdslands. V\u00f6rninni ver\u00f0ur streymt h\u00e9r<\/a><\/strong>.<\/p>\n

Ritger\u00f0in ber heiti\u00f0: Neikv\u00e6\u00f0 upplifun f\u00e6\u00f0ingar og lj\u00f3sm\u00f3\u00f0urme\u00f0fer\u00f0: Framt\u00ed\u00f0ars\u00fdn barneignar\u00fej\u00f3nustu. Negative birth experience and midwifery counselling intervention: A vision for maternity care.<\/strong><\/p>\n

Andm\u00e6lendur eru dr. Mirjam Lukasse, pr\u00f3fessor vi\u00f0 Oslo Metropolitan University, Deild hj\u00fakrunar og heilsueflingar, \u00d3sl\u00f3, og dr. Inga D\u00f3ra Sigf\u00fasd\u00f3ttir, pr\u00f3fessor vi\u00f0 S\u00e1lfr\u00e6\u00f0ideild H\u00e1sk\u00f3lans \u00ed Reykjav\u00edk.<\/p>\n

\u00c1grip af ranns\u00f3kn<\/strong><\/p>\n

A\u00f0almarkmi\u00f0 ranns\u00f3knarinnar var a\u00f0 \u00fer\u00f3a lj\u00f3sm\u00f3\u00f0urme\u00f0fer\u00f0 fyrir konur sem hafa \u00fe\u00f6rf fyrir a\u00f0 fara yfir upplifun f\u00e6\u00f0ingar. \u00cd fyrsta hluta voru markmi\u00f0in a\u00f0 l\u00fdsa f\u00e6\u00f0ingarupplifun kvenna fyrstu tv\u00f6 \u00e1rin eftir f\u00e6\u00f0ingu og sko\u00f0a \u00e1hrif stu\u00f0nings \u00e1 upplifun f\u00e6\u00f0ingar. Markmi\u00f0 annars hluta var a\u00f0 sko\u00f0a v\u00e6ntingar og reynslu kvenna af a\u00f0 fara yfir upplifun f\u00e6\u00f0ingar me\u00f0 lj\u00f3sm\u00f3\u00f0ur \u00ed Lj\u00e1\u00f0u m\u00e9r eyra (LME) \u00fej\u00f3nustu \u00e1 Landsp\u00edtala. Markmi\u00f0 \u00feri\u00f0ja hluta var a\u00f0 l\u00fdsa uppbyggingu og forpr\u00f3fa me\u00f0fer\u00f0 sem f\u00f3l \u00ed s\u00e9r a\u00f0 konur \u00ed \u00e1h\u00e6ttume\u00f0g\u00f6ngu skrifu\u00f0u um f\u00e6\u00f0ingarupplifun og komu \u00ed vi\u00f0tal eftir f\u00e6\u00f0ingu til lj\u00f3sm\u00f3\u00f0ur sem sinnti \u00feeim \u00ed me\u00f0g\u00f6nguvernd.<\/p>\n

Ritger\u00f0in byggir \u00e1 \u00feremur ranns\u00f3knum. Ranns\u00f3kn I var langt\u00edma \u00feversni\u00f0sranns\u00f3kn \u00fear sem g\u00f6gnum var safna\u00f0 \u00e1 landsv\u00edsu me\u00f0 \u00feremur spurningalistum \u00e1 me\u00f0g\u00f6ngu og eftir f\u00e6\u00f0ingu (n = 657). A\u00f0hvarfsgreining var notu\u00f0 til a\u00f0 sko\u00f0a forsp\u00e1rgildi stu\u00f0nings lj\u00f3sm\u00e6\u00f0ra \u00ed upplifun f\u00e6\u00f0ingar. Ranns\u00f3kn II var eigindleg innihaldsgreining \u00e1 sv\u00f6rum kvenna sem h\u00f6f\u00f0u leita\u00f0 \u00ed LME (n = 125). \u00cd ranns\u00f3kn III var notu\u00f0 bl\u00f6ndu\u00f0 a\u00f0fer\u00f0 til a\u00f0 sko\u00f0a innlei\u00f0ingu tv\u00ed\u00fe\u00e6ttrar lj\u00f3sm\u00f3\u00f0urme\u00f0fer\u00f0ar fyrir konur me\u00f0 \u00e1h\u00e6ttu\u00fe\u00e6tti \u00e1 me\u00f0g\u00f6ngu (n = 30). Konur sv\u00f6ru\u00f0u spurningalistum fyrir og eftir me\u00f0fer\u00f0ina. Lj\u00f3sm\u00e6\u00f0urnar (n = 8) t\u00f3ku \u00fe\u00e1tt \u00ed r\u00fdnih\u00f3pavi\u00f0tali. Notu\u00f0 var l\u00fdsandi greining og innihaldsgreining.<\/p>\n

\u00cd ranns\u00f3kn I kom \u00ed lj\u00f3s a\u00f0 5-5,7% kvenna h\u00f6f\u00f0u neikv\u00e6\u00f0a f\u00e6\u00f0ingarupplifun. \u00d3\u00e1n\u00e6gja me\u00f0 stu\u00f0ning lj\u00f3sm\u00f3\u00f0ur \u00e1 me\u00f0g\u00f6ngu e\u00f0a \u00ed f\u00e6\u00f0ingu, inngrip \u00ed f\u00e6\u00f0ingarferli\u00f0, langdregin f\u00e6\u00f0ing og a\u00f0 vera nemandi sp\u00e1\u00f0i fyrir um neikv\u00e6\u00f0a upplifun f\u00e6\u00f0ingar. Tv\u00f6 megin\u00feemu og \u00ferj\u00fa undir\u00feemu voru greind \u00ed ranns\u00f3kn II: \u00e1 m\u00ednum forsendum, frumkv\u00e6\u00f0i fagf\u00f3lks, a\u00f0 hlusta er lykilatri\u00f0i\u201a a\u00f0 fylla \u00ed ey\u00f0ur og a\u00f0 horfa fram \u00e1 vi\u00f0. \u00cd ranns\u00f3kn III t\u00f6ldu konur og lj\u00f3sm\u00e6\u00f0ur vi\u00f0talsme\u00f0fer\u00f0 vera gagnlegan og \u00e1kj\u00f3sanlegan kost. Konur m\u00e1tu upplifun s\u00edna af f\u00e6\u00f0ingu markt\u00e6kt j\u00e1kv\u00e6\u00f0ar eftir me\u00f0fer\u00f0ina. Flestar konur kj\u00f3sa a\u00f0 lj\u00f3sm\u00f3\u00f0ir sem \u00fe\u00e6r \u00feekkja veiti me\u00f0fer\u00f0ina.<\/p>\n

Ni\u00f0urst\u00f6\u00f0ur ranns\u00f3knanna benda til a\u00f0 upplifun kvenna breytist l\u00edti\u00f0 me\u00f0 t\u00edmanum og stu\u00f0ningur lj\u00f3sm\u00e6\u00f0ra \u00e1 me\u00f0g\u00f6ngu og \u00ed f\u00e6\u00f0ingu hafi \u00e1hrif \u00e1 upplifun \u00feeirra. Konur vilja a\u00f0 fagf\u00f3lk hafi frumkv\u00e6\u00f0i a\u00f0 samtali um upplifun f\u00e6\u00f0ingar og bj\u00f3\u00f0i \u00feeim a\u00f0 fara yfir hana \u00e1 \u00feeirra eigin forsendum. Ef v\u00e6ntingar eru uppfylltar vir\u00f0ast konur geta n\u00e1\u00f0 stj\u00f3rn og styrk til a\u00f0 horfa fram \u00e1 vi\u00f0. Samtal um upplifun f\u00e6\u00f0ingar \u00e6tti a\u00f0 vera hluti af barneignar\u00fej\u00f3nustu. Konur \u00ed \u00e1h\u00e6ttume\u00f0g\u00f6ngu eru vi\u00f0kv\u00e6mur h\u00f3pur sem \u00fearf a\u00f0 huga s\u00e9rstaklega a\u00f0. \u00deeim fannst gagnlegt a\u00f0 fara yfir f\u00e6\u00f0inguna me\u00f0 lj\u00f3sm\u00f3\u00f0ur sem \u00fe\u00e6r \u00feekkja. B\u00e6\u00f0i konur og lj\u00f3sm\u00e6\u00f0ur telja sl\u00edka me\u00f0fer\u00f0 vera \u00e1kj\u00f3sanlegan kost innan barneignar\u00fej\u00f3nustunnar.<\/p>\n

Abstract<\/strong><\/p>\n

The overall aim of the study was to develop a midwifery intervention for women to review their birth experience. The aims of study I were to describe women\u2019s birth experience up to two years after birth and explore the predictive role of support in the birth experience. The aim of study II was to explore women\u2019s experience and preferences of reviewing birth experience at a special counselling clinic Lend me an ear (LME) at Landspitali. The aim of study III was to describe the construction of and explore the feasibility of a postpartum midwifery counselling intervention for women following high-risk pregnancies.<\/p>\n

Study I was a longitudinal cohort study, conducted with a sample of pregnant women from primary health care centres in Iceland. Data were gathered via three questionnaires during pregnancy and postpartum (n = 657). Logistic regression analyses were performed to examine the predictive role of midwifery support in the birth experience. Study II was a qualitative content analysis of text from women attending the LME clinic (n = 125). Study III was a mixed-method pilot feasibility study. Thirty women were invited to write about and review their birth experience by a known midwife. Eight midwives provided the intervention. Data were collected from women before and after the intervention. Midwives providing the intervention participated in a focus group interview. Descriptive and content analysis were used.<\/p>\n

The prevalence of women perceiving their birth as negative was 5-5.7%. Not being satisfied with support from midwife during pregnancy or birth, operative birth, prolonged birth and being a student predicted negative birth experience. Two themes and three subthemes were revealed in study II: on my terms, being recognised, listening is paramount, mapping the unknown and moving on. In study III, women and midwives perceived the counselling intervention as helpful and feasible. Women had significantly more positive appraisals of birth after the intervention. Most women preferred to review their birth experience with a midwife they knew.<\/p>\n

Women\u00b4s experience of birth is relatively consistent over time. Support from midwives during pregnancy and birth has a significant impact on women\u2019s perception of birth experience. Women prefer to be recognised and invited to review their birth experience in a tailored counselling provided on their terms. When expectations of reviewing their birth experience are fulfilled, they may regain control and strength to move on. Offering a discussion of the birth experience should be a routine part of maternity services. Women experiencing high-risk pregnancies are a vulnerable group and require further attention. They value a follow up by a midwife they know and both women and midwives perceive the counselling intervention as a feasible option in maternity care.<\/p>\n

Um doktorsefni\u00f0<\/strong><\/p>\n

Valger\u00f0ur L\u00edsa Sigur\u00f0ard\u00f3ttir lauk st\u00fadentspr\u00f3fi fr\u00e1 Fj\u00f6lbrautask\u00f3lanum \u00ed Brei\u00f0holti \u00e1ri\u00f0 1982, BS-pr\u00f3fi \u00ed hj\u00fakrunarfr\u00e6\u00f0i fr\u00e1 H\u00e1sk\u00f3la \u00cdslands \u00e1ri\u00f0 1988, emb\u00e6ttispr\u00f3fi \u00ed lj\u00f3sm\u00f3\u00f0urfr\u00e6\u00f0i fr\u00e1 H\u00e1sk\u00f3la \u00cdslands 1998 og MS-pr\u00f3fi \u00ed lj\u00f3sm\u00f3\u00f0urfr\u00e6\u00f0i fr\u00e1 H\u00e1sk\u00f3la \u00cdslands \u00e1ri\u00f0 2008. Valger\u00f0ur hlaut s\u00e9rfr\u00e6\u00f0ileyfi \u00ed lj\u00f3sm\u00f3\u00f0urfr\u00e6\u00f0um \u00e1ri\u00f0 2013 og er starfandi s\u00e9rfr\u00e6\u00f0ilj\u00f3sm\u00f3\u00f0ir \u00e1 kvennadeild Landsp\u00edtala. S\u00e9rsvi\u00f0 hennar er me\u00f0g\u00f6nguvernd me\u00f0 \u00e1herslu \u00e1 ge\u00f0heilsu. Einnig sinnir Valger\u00f0ur stundakennslu vi\u00f0 n\u00e1msbraut \u00ed lj\u00f3sm\u00f3\u00f0urfr\u00e6\u00f0i, Hj\u00fakrunarfr\u00e6\u00f0ideild H\u00e1sk\u00f3la \u00cdslands. Foreldrar Valger\u00f0ar eru Sigur\u00f0ur Vigg\u00f3sson (l\u00e1tinn) og Anna Sigur\u00f0ard\u00f3ttir. Valger\u00f0ur er gift J\u00f3ni Steingr\u00edmssyni vi\u00f0skiptafr\u00e6\u00f0ingi og eiga \u00feau b\u00f6rnin \u00d6rnu Hrund, Erlu Bj\u00f6rk og Birki Val.<\/p>\n

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