Health in Early Life and Parenthood
Our research aims to promote health and welfare in the early stages of life. We are interested in families expecting a child, prenatal period, birth, parent-infant closeness and breastfeeding as well as toddlers, school-aged children and parenthood. The concept of family-centered care is an underlying framework in our research. We use different methodological approaches and aim for multidisciplinary research. For example, with the support of information technology we have developed modern data collection methods suitable for both health care professionals and parents of newborn infants.
Welcome to join in our HELPful group!
Separation and Closeness Experiences in the Neonatal Environment
SCENE is a multi-disciplinary group of international professionals that aims to improve parents’ and infants’ experiences and outcomes of neonatal care. The focus of the SCENE collaboration is to undertake research into how and why parent-infant physical and emotional closeness varies in neonatal units, within and between countries; the short- and long-term effects of closeness and separation on infants, parents and the infant-parent dyad; as well as how to optimise parental and infant health and wellbeing.
A key goal of the SCENE collaboration is to identify, construct, implement and evaluate best practice to support physical and emotional parent-infant closeness during neonatal care
Family Centered Care and Monitoring in Maternity Care
The aim of this project is to develop future solutions for assessing and monitoring family centered care related concepts and outcomes in research and knowledge translation. This work will involve systematic reviews of the currently used research measures, IT solutions and monitoring systems. These reviews and empirical evidence will provide the basis for the development of new innovative IT tools.
Breastfeeding and Baby-friendly Hospital Initiative
The overall aim of this project is to promote breastfeeding among both full-term and preterm infants and their mothers.
The Impact of Baby-friendly Hospital Initiative to Breastfeeding, Breastfeeding Counseling and Breastfeeding Attitudes
The impact of Baby-friendly Hospital Initiative (BFHI) to breastfeeding, breastfeeding counselling and breastfeeding attitudes was examined in Satasairaala, Pori. The baseline measurements were conducted before the implementation of BFHI practices in 2017. The hospital was successfully certified as Baby-friendly in February 2019, and the post-measurements were conducted in April-June 2019. Both staff members and breastfeeding mothers were recruited in the study. The main outcomes were the duration of breastfeeding and breastfeeding attitudes. The results will be reported in 2021-2022.
Maternal Perceptions of Breastfeeding Counseling and Support after Hospital Discharge
To be able to develop the quality of breastfeeding counseling after hospital discharge, the mothers’ perceptions and views on desired as well as received breastfeeding counseling will be investigated shortly after going home from the birth hospital and again at three months after the birth. This project will be conducted in Southwestern Finland starting at 2021.
- Äitien näkemyksiä imetysohjauksesta ja -tuesta synnytyssairaalasta kotiutumisen jälkeen – Tietosuojaseloste (pdf)
Pain in Early Life (PEARL)
Pain in Early Life (PEARL) is a group of researchers dedicated to better pain management for infants and children. More information from the websites
The Close Collaboration with Parents Training Program
The goal of the Close Collaboration with Parents Training Program is to develop family centered care culture on the unit level by training all of the nurses, doctors, and other staff of a neonatal intensive care unit. The research evaluates both immediate and long-term effect of the Close Collaboration with Parents Training Program from the perspectives of child, parents, and staff.
Global Maternal and Child Health
Research projects focusing on global health aim to find effective ways to implement evidence based practice in low- and middle income settings to improve the care of families. The main research areas are peripartum care, neonatal care, children’s pain management and adolescent’s mental health. Implmentation science is the methodological framework for the conducted studies. The research is done in collaboration with:
Mirka Toivonen, RN, MNSc: Implementing family-centered care in NICU – examining unit design and caring culture.
Anneli Saarikoski, RN, MNSc: Voiding School as a treatment of children’s functional incontinence – Development, evaluation and implementation of the intervention.
Jennifer Auxier, MNSc, Supporting patient engagement through IoT Technology in maternity care.
Johanna Saarikko, RM, MNSc, The Implementation of a Weight-Management Intervention with the Help of Wearable IoT Technology for Obese Women during Pregnancy and the Postpartum Period
Ani Heinonen, MD, The association of late miscarriage or preterm birth to stress during subsequent pregnancy.
Joonas Korhonen, RN, MNSc, Mental Health Literacy among Primary Health Workers in SADC countries.
Tiina Putkuri, RN, MNSc, Healthy mind – Intervention improving competence of school nurses in mental health work
Heli Mäkelä, RM, MNSc, The significance of care practices supporting closeness and breastfeeding in neonatal care
Malin von Koskull, RN, MNSc, Breastfeeding and early parenthood: predictors, trajectories and supporting factors in Finnish settings
Iina Ryhtä, physiotherapist, MNSc, Online therapeutic training program for postpartum mothers –Feasibility and effectiveness of the intervention
Abigail Kusi Amponsah, RN, PhD, Development of a pediatric pain educational program for nurses in a resource-limited setting, 2020
Simo Raiskila, MD, PhD, Parent-infant closeness and family centered care in neonatal intensive care, 2018
Niina Ekström, Fetal heart rate monitoring, Uppsala university, 2020-
Mikaela Rönnbäck, Neonatal resuscitation, Uppsala university, 2020-
Hanna Koivikko, Fetal heart rate monitoring, 2019-
Marjo Mäkelä, Äitien näkemykset imetysohjauksesta synnytyssairaalasta kotiutumisen jälkeen, 2020-
Karla Uusitalo, Hedelmällisyystietous-sivuston käytettävyys: nuorten aikuisten näkökulma, 2020-
Marika Koivuluoma, Imetys Nepalin vastasyntyneiden teho-osastoilla, 2019-
Kaisu Savolainen, Odottajien ohjaaminen älysormuksen tuella, 2019-
Sini Poropudas, Significant others in NICUs, 2019-
Nita Björklöf, Äitien imetysasenteen muutos, 2019-
Jaana Lojander, Äitien imetysohjauskokemukset ennen ja jälkeen Vauvamyönteisyyssertifikaatin, 2019-
Anna Zadkova, Fideliteetti vanhemmille suunnatuissa digitaalisissa interventioissa, 2018-
Senja Rautajuuri, Sydänsairaiden lasten vanhempien tukeminen raskauden aikana, 2018-
Päivi Oinonen, Vauvamyönteisyysohjelman vaikutukset imetykseen, imetysohjaukseen ja imetysasenteisiin (The impact of Baby-friendly Hospital Initiative to breastfeeding, breastfeeding counselling and breastfeeding attitudes), 2016-
Elisa Lankinen, Sleep and stress during risk pregnancy, 2020
Henrika Merenlehto, Stress and sleep in middle and late pregnancy in risk group expectants, 2020
Maiju Riikonen, Nurses’ level of knowledge and need for education on paediatric delirium in paediatric intensive care units in Finland, 2020
Emma Kainiemi: The unit architecture and the quality of family-centered care from the perspective of NICU parents, 2020
Nazma Hamid, The Effect of Implementation of Skin Care Guidelines on Nurses Knowledge regarding Skin Care and Incidence of Skin Injuries among Neonates at a Private Tertiary Care Hospital, Shifa Tameer-e-Millat University, Islamabad, Pakistan, 2019
Kirsi Grym, Feasibility of smart wristbands for continuous monitoring during pregnancy and puerperium, 2019
Nina Heinikoski, The views of public health nurses about strengthened collaboration with midwives, 2018
Johanna Saarikko, The physical activity in pregnant women measured by a smart band, 2018
Emilia Peltonen: Developing infants pain assessment – translation and cultural adaptation of the The Premature Infant Pain Profile-Revised (PIPP-R) to Finnish care culture, 2017
Johanna Nieminen, Parents’ experiences on single family rooms, 2017
Heli Mäkelä: “LOVE AND YEARNING…” Parents’ perspectives on closeness and separation experiences with their baby in the NICU environment, 2016
Niina Alho: Experience of being a father of a preterm infant and received support, 2016
Jenni Nurmisto: When milk supply is insufficient – perceptions of breastfeeding education in child health centre, 2016
Anu Piispanen: The communication between mother and public health nurse about smoking cessation during prenatal health check, 2016
Sari Huttunen:The quality of life of children and adolescents in mental heath care outpatient clinic, 2016
Anneli Saarikoski: The efficacy and children’s experiences on voiding school intervention, 2016
Liisa Hämäläinen: Changing childrensä surgical caring process – childrens’. adolescents’ and staffs’ perspectives, 2015
Mirka Toivonen: The effect of single family rooms on the amount and content of time that nurses spend with families, 2015
Marianne Takatalo: Preschool children’s perceptions of oral health and associated factots, 2015
Noora Järvinen: Parental stress in the neonatal intensive care unit, 2012
Original Scientific Publications in International Peer-Reviewed Journals
Asgari Mehrabadi M, Azimi I, Sarhaddi F, Axelin A, Niela-Vilen H, Myllyntausta S, Stenholm S, Dutt N, Liljeberg P & Rahmani A. Sleep Validation of Commercially Available Smart Ring and Watch Against Medical-Grade Actigraphy in Everyday Settings. JMIR Mhealth Uhealth. 2020 Sep 23.
Saarikko J, Ekholm E, Niela-Vilen H, Hamari L, Azimi I, Liljeberg P, Rahmani AM, Löyttyniemi E & Axelin A. Continuous 7-month Internet of Things -based monitoring of Health Parameters of Pregnant and Postpartum Women: A Prospective Observational Feasibility Study, JMIR Form Res. 2020 Jul 24;4(7):e12417.
Niela-Vilén H, Axelin A & Flacking R. The golden hour in Finnish birthing units – an ethnographic study, Midwifery, 2020, vol 89, October
Niela-Vilén H, Rahmani A, Liljeberg P & Axelin A. Being ‘A Google Mom’ or Securely Monitored at Home – Perceptions of Remote Monitoring in Maternity Care, Journal of Advanced Nursing. 2020 Jan;76(1):243-252
Azimi I, Liljeberg P, Niela-Vilén H, Axelin A, Rahmani A. Personalized Maternal Sleep Quality Assessment: An Objective IoT-based Longitudinal Study (Accepted, IEEE Access)
Azimi I, Pahikkala T, Rahmani AM, Niela-Vilén H, Axelin A & Liljeberg P. Missing Data Resilient Decision-making for Healthcare IoT through Personalization: A Case Study on Maternal Health. February 2019, Future Generation Computer Systems 96, July, 297-308
Grym K, Niela-Vilen H, Ekholm E, Hamari L, Azimi I, Rahmani AM, Liljeberg P, Löyttyniemi E & Axelin A. Feasibility of smart wristbands for continuous monitoring during pregnancy and one month after birth. BMC Pregnancy Childbirth. 2019 Jan 17;19(1):34.
Maastrup R, Haiek LN; Neo-BFHI Survey Group. Compliance with the “Baby-friendly Hospital Initiative for Neonatal Wards” in 36 countries. Matern Child Nutr. 2019 Apr;15(2):e12690.
Niela-Vilén H, Axelin A, Salanterä S & Melender H-L. A Typology of Breastfeeding Mothers of Preterm Infants: A Qualitative Analysis. Adv Neonatal Care. 2019 Feb;19(1):42-50.
Niela-Vilen H, Axelin A, Melender H-L, Löyttyniemi E & Salanterä S. Breastfeeding preterm infants – the effectiveness of an internet-based peer-support group. Journal of Advanced Nursing, 2016;72(10):2495-507.
Niela-Vilen H, Melender H-L, Axelin A, Löyttyniemi E & Salanterä S. Predictors of Breastfeeding Initiation and Frequency of Infants in the NICU. Journal of Obstetric, Gynecologic & Neonatal Nursing, 2016;45(3):346-58.
Niela-Vilen H, Axelin A, Melender H-L & Salanterä S. Aiming to be a breastfeeding mother in a NICU and at home – a thematic analysis of peer- support group discussion in social media, Maternal & Child Nutrition 2015;11(4):712-26.
Niela-Vilén H, Axelin A, Salanterä S, Lehtonen L, Tammela O, Salmelin R & Latva R. Early physical contact between a mother and her preterm or sick infant. Midwifery 2013;29:1321-30.
Family centered care
He F, Axelin A, Ahlqvist-Björkroth S, Raiskila S, Löyttyniemi E & Lehtonen L. Effectiveness of the Close Collaboration with Parents intervention on parent-infant closeness in NICU. (Accepted BMC Pediatrics)
Axelin A, Raiskila S & Lehtonen L. The development of data collection tools to measure parent–infant closeness and family-centered care in NICUs. Worldviews Evid Based Nurs. 2020 Nov 19.
Toivonen M, Lehtonen L, Ahlqvist-Björkroth S & Axelin A. Close Collaboration with Parents training improves family centered care in different contexts – a pre-post study. Pediatr Res. 2020 May 7.
Toivonen M, Lehtonen L, Ahlqvist-Björkroth S & Axelin A. Key factors supporting implementation of a training program for neonatal family centered care – a qualitative study, BMC Health Services Research 2019 Jun 19;19(1):394.
Aija A, Toome L, Axelin A, Raiskila S & Lehtonen L. Parents’ presence and participation in medical rounds in 11 European neonatal units. Early Human Development, 2019;130(3):10-16. (IF 2.025)
Ahlqvist-Björkroth S, Axelin A, Korja R & Lehtonen L. An educational intervention for NICU staff decreased maternal postpartum depression. Pediatr Res. 2019 Jan 23.
Liu LX, Mozafarinia SM, Axelin A & Feeley N. Parents’ Experience of Support in the Single-Family Rooms of a Combined Pod and Single-Family Room NICU. Parents’ Experiences of Support in NICU Single-Family Rooms. March 2019, Neonatal network: NN 38(2):88-97
Bujold M, Feeley N, Axelin A & Cinquino C. Expressing Human Milk in the NICU – Coping Mechanisms and Challenges Shape the Complex Experience of Closeness and Separation. Adv Neonatal Care. 2018 Feb;18(1):38-48.
Mäkelä H, Axelin A, Feeley N & Niela-Vilén H. Clinging to closeness: The parental view on developing a close bond with their infant in the NICU, Midwifery. 2018 Jul;62:183-188.
Toivonen M, Lehtonen L, Löyttyniemi E & Axelin A. Effects of Family-Room Neonatal Intensive Care Unit on Nurse-Parent and Nurse-Infant. Early Human Development 2017;(106–107):59–62.
Niela-Vilen H, Feeley N, Axelin A. Hospital routines promote parent-infant closeness and cause separation in the birthing unit in the first two hours after birth – a pilot study. Birth: Issues in Perinatal Care 2017 doi: 10.1111/birt.12279.
Raiskila S, Axelin A, Toome L, Caballero S, Silness Tandberg B, Montirosso R, Normann E, Hallberg B, Ewald U & Lehtonen L. Parents’ Presence and Parent–Infant Closeness in 11 NICUs in 6 European Countries, Acta Paediatrica 2017 Feb 24.
Treherne S, Feeley N, Charbonneau L & Axelin A. Closeness and Separation between Parent and Infant in the Neonatal Intensive Care Unit: Parent Perspectives. J Obstet Gynecol Neonatal Nurs. 2017 Sep – Oct;46(5):737-747.
Uusitalo S & Axelin A. Opioid-dependent mothers in medical decision-making about the treatment of their infants. Who is vulnerable and why?, the Ethics Forum, Les ateliers de l’éthique, Volume 12, Issue 2–3, Automne, 2017, p. 221–242.
Raiskila S, Axelin A, Rapeli S, Vasko I & Lehtonen L. Trends in care practices reflecting parental involvement in neonatal care. Early Human Development 2014;90(12):863-867.
Flacking R, Thomson G & Axelin A. Emotional closeness in neonatal units – a cross-national qualitative study. BMC Pregnancy and Childbirth, 2016;19;16(1):170.
Feeley N, Genest C, Niela-Vilén H, Charbonneau L & Axelin A. Parents and nurses balancing parent-infant closeness and separation – A qualitative study of NICU nurses’ perceptions. BMC Pediatrics, 2016;20;16(1):134.
Raiskila S, Lehtonen L, Silnes Tandberg B, Nordmann E, Ewald U, Caballero S, Varendi H, Toome L, Nordhov M, Hallberg B, Montirosso R, Westrup B & Axelin A. Parent and Nurse Perceptions on the Quality of Family-Centered Care in 11 European NICUs. Australian Critical Care, 2016;29(4):201-209.
Ahlqvist-Björkroth S, Boukydis Z, Axelin A & Lehtonen L. “Close Collaboration with ParentsTM Intervention to Improve Parents’ Psychological Well-being and Child Development: Description of the Intervention and Study Protocol. Behavioural Brain Research, 2016;S0166-4328(16)30810-5.
Olsson E, Dovland Andersen R, Axelin A, Jonsdottir RB, Maastrup R & Eriksson M. Skin-to-skin care in the Nordic countries – A survey of attitudes and practices among NICU-staff. Acta Paediatrica 2012;101:1140-46.
Inberg E, Axelin A & Salanterä S. Keskosvauvan ja vanhempien varhaisen vuorovaikutuksen tukeminen hoitotyön menetelmin. (Supporting early interaction between premature baby and parents with the help of nursing methods) Hoitotiede 2008;20:192-202.
Infant pain management
Olsson E, Anderzén-Carlsson A, Atladóttir SM, Axelin A, Campbell-Yeo M, Eriksson M, Peltonen E, Vederhus B, Dovland Andersen R. Cultural adaptation and harmonization of four Nordic translations of the revised Premature Infant Pain Profile (PIPP-R). BMC Pediatr. 2018 Nov 8;18(1):349.
Pölkki T, Korhonen A, Axelin A, Saarela T, Laukkala H, Palomaa A-K, Heikkinen U & Miettinen S. NIAPAS-kipumittari tehohoidossa oleville vastasyntyneille: mittarin kehittäminen ja luotettavuuden arviointi. Hoitotiede 2016.
Marfurt-Russenberger K, Axelin A, Kesselring A, Franck LS & Cignacco E. Talking about pain or keeping it silent – Professionals experiences involving parents in neonatal pain management Journal of Obstetric, Gynecologic, & Neonatal Nursing 2016;45(5):671-83.
Axelin A, Anderzén-Carlsson A, Eriksson M, Pölkki T, Korhonen A & Franck LS. Neonatal Intensive Care Nurses’ Perceptions of Parental Participation in Infant Pain Management – a comparative focus group study. Journal of Perinatal and Neonatal Nursing 2015;29(4):363-74.
Pölkki T, Korhonen A, Axelin A, Saarela T & Laukkala H. Development and preliminary validation of the Neonatal Infant Acute Pain Assessment Scale (NIAPAS). International Journal of Nursing Studies 2014;51(12):1585-94.
Axelin A, Cilio MR, Asunis M, Peloquin S & Franck LS. Sleep-Wake Cycling in a Neonate Admitted to the NICU. Journal of Perinatal & Neonatal Nursing 2013;27:263-73.
Axelin A, Lehtonen L, Pelander T & Salanterä S. Äidit keskoslasten kivunlievittäjinä. (Mothers alleviating preterm infant pain) Tutkiva Hoitotyö 2012;10:32-9.
Axelin A, Lehtonen L, Pelander T & Salanterä S. Mothers’ different styles of involvement in preterm infants’ pain care. Journal of Obstetric, Gynecologic and Neonatal Nursing, 2010;39:415-24.
Axelin A, Kirjavainen J, Salanterä S, & Lehtonen L. Effects of Pain Management on Sleep in Preterm Infants. European Journal of Pain 2010;14:752-58.
Axelin A, Ojajärvi U, Viitanen J & Lehtonen L. Promoting Shorter Duration of Ventilator Treatment Decreases the Number of Painful Procedures in Preterm Infants. Acta Paediatrica, 2009;98:1751-55.
Axelin A, Salanterä S, Kirjavainen J & Lehtonen L. Oral glucose and parental holding preferable to opioid in pain management in preterm infants. The Clinical Journal of Pain, 2009;25:138–45.
Axelin A, Salanterä S, Lehtonen L. “Facilitated tucking by parents” in pain management of preterm infant – a randomized crossover trial. Early Human Development, 2006;82:241–47.
Children's nursing care
Hamari L, Lähteenmäki PM, Pukkila H, Arola M, Axelin A, Salanterä S & Järvelä L. Motor performance in children diagnosed with cancer: a longitudinal observational study, Children (Basel). 2020 Aug 15;7(8):98.
Hamari L, Järvelä LS, Lähteenmäki PM, Arola M, Axelin A, Lilius J, Vahlberg T & Salanterä S. The effect of an active video game intervention on physical activity, motor performance, and fatigue in children with cancer: A randomized controlled trial, BMC Res Notes. 2019 Nov 29;12(1):784
Saarikoski A, Koppeli R, Taskinen S & Axelin A. Voiding school as a treatment of functional incontinence: Assessing the effectiveness of intervention by measuring changes in wetting episodes, J Pediatr Urol. 2018 Jun;14(3):256.e1-256.e7.
Saarikoski A, Koppeli R, Salanterä S, Taskinen S & Axelin A. Voiding school as a treatment of functional incontinence: Children’s experiences of the intervention, J Pediatr Urol. 2018 Feb;14(1):56.e1-56.e7.
Takatalo M, Axelin A & Niela-Vilén H. Esikouluikäisten lasten käsityksiä suun terveydestä. Tutkiva Hoitotyö 2016;14:4:12-20.
Global Maternal and Child Health
Kusi Amponsah A, Oduro E, Bam V, Kyei-Dompim J, Kwadwo Ahoto C & Axelin A. “Dynamics on the field: A focused study on the culture and context of pediatric pain management at four Ghanaian hospitals.” (Accepted, BMC Pediatrics)
Kusi Amponsah A, Bam V, Stolt M, Korhonen J & Axelin A. Evaluating the content validity of two versions of an instrument used in measuring pediatric pain knowledge and attitudes in the Ghanaian context. PLoS One. 2020 Nov 6;15(11):e0241983.
Kusi Amponsah A, Kyei-Dompim J, Bam V, Kyei E, Oduro E, Kwadwo Ahoto C & Axelin A. Exploring the educational needs of nurses on children’s pain management: a descriptive qualitative study. Nurs Open. 2020 Feb 18;7(3):841-849.
Kc A, Axelin A, Litorp H, Singh Tinkari B, K Sunny A, Gurung R. Coverage, associated factors, and impact of companionship during labour: A large-scale observational study in six hospitals in Nepal. Birth. 2020 Mar;47(1):80-88.
Gurung R, Kumar Jha A, Nath Pyakurel S, Gurung A, Litorp H,, Wrammert J, Jha B, Paudel P, Rahman SM, Malla H, Sharma S, Gautam M, Erland Linde J, Moinuddin M, Ewald U, Malqvist M, Axelin A & KC A. Scaling Up Safer Birth Bundle Through Quality Improvement in Nepal (SUSTAIN) – A stepped wedge cluster randomized controlled trial in public hospitals. Implementation Science, 2019 Jun 19;14(1):65.
Kusi Amponsah A, Oduro E, Bam V, Kyei-Dompim J, Kwadwo Ahoto C & Axelin A. Nursing Students and Nurses’ Knowledge and Attitudes regarding Children’s Pain: A Comparative Cross-sectional study, PLoS One. 2019 Oct 10;14(10):e0223730.
Korhonen J, Axelin A, Grobler G & Lahti M. Content Validation of Mental Health Literacy Scale (MHLS) for Primary Health Care Workers in South Africa and Zambia ─ A Heterogeneous Expert Panel Method. Global Health Action, Accepted
Reviews in Scientific International Peer-Reviewed Journals
Kusi Amponsah A, Björn A, Bam V & Axelin A. The Effect of Educational Strategies targeted for Nurses on Pain Assessment and Management in Children: An Integrative Systematic Review, Pain Management Nursing 2019 May 15.
Niela-Vilen H, Axelin A, Salantera S & Melender H-L. Internet-based peer support for parents: a systematic integrative review. International Journal of Nursing Studies 2014;51:1524-1537.
Axelin A & Salanterä S. Ethics in neonatal pain research. Nursing Ethics, 2008;15:492-99.