| 61. |
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| 62. |
- CARLSSON, STEFAN, 1987, et al.
(författare)
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Orgasm-Associated Urinary Incontinence and Sexual Life after Radical Prostatectomy.
- 2011
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Ingår i: The journal of sexual medicine. - : Oxford University Press (OUP). - 1743-6109 .- 1743-6095.
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Tidskriftsartikel (refereegranskat)abstract
- Introduction. Involuntary release of urine during sexual climax, orgasm-associated urinary incontinence, occurs frequently after radical prostatectomy. We know little about its prevalence and its effect on sexual satisfaction. Aim. To determine the prevalence of orgasm-associated incontinence after radical prostatectomy and its effect on sexual satisfaction. Methods. Consecutive series, follow-up at one point in calendar time of men having undergone radical prostatectomy (open surgery or robot-assisted laparoscopic surgery) at Karolinska University Hospital, Stockholm, Sweden, 2002-2006. Of the 1,411 eligible men, 1,288 (91%) men completed a study-specific questionnaire. Main Outcome Measure. Prevalence rate of orgasm-associated incontinence. Results. Of the 1,288 men providing information, 691 were sexually active. Altogether, 268 men reported orgasm-associated urinary incontinence, of whom 230 (86%) were otherwise continent. When comparing them with the 422 not reporting the symptom but being sexually active, we found a prevalence ratio (with 95% confidence interval) of 1.5 (1.2-1.8) for not being able to satisfy the partner, 2.1 (1.1-3.5) for avoiding sexual activity because of fear of failing, 1.5 (1.1-2.1) for low orgasmic satisfaction, and 1.4 (1.2-1.7) for having sexual intercourse infrequently. Prevalence ratios increase in prostate-cancer survivors with a higher frequency of orgasm-associated urinary incontinence. Conclusion. We found orgasm-associated urinary incontinence to occur among a fifth of prostate cancer survivors having undergone radical prostatectomy, most of whom are continent when not engaged in sexual activity. The symptom was associated with several aspects of sexual life. Nilsson AE, Carlsson S, Johansson E, Jonsson MN, Adding C, Nyberg T, Steineck G, and Wiklund NP. Orgasm-associated urinary incontinence and sexual life after radical prostatectomy. J Sex Med **;**:**-**.
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| 63. |
- Carlsson, Stefan, et al.
(författare)
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Salvage radiotherapy after radical prostatectomy: functional outcomes in the LAPPRO trial after 8-year follow-up.
- 2023
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Ingår i: Scandinavian journal of urology. - 2168-1813. ; 58, s. 11-19
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Tidskriftsartikel (refereegranskat)abstract
- Radical prostatectomy reduces mortality among patients with localized prostate cancer, however up to 35% of patients will experience biochemical recurrence, often treated with salvage radiotherapy. The objective of the study was to investigate long-term effects of salvage radiotherapy.A prospective, controlled, non-randomized trial at 14 Swedish center's including 4,003 patients scheduled for radical prostatectomy 2008-2011. A target trial emulation approach was used to identify eligible patients that was treated with salvage radiotherapy. The control group received no salvage radiotherapy. Outcomes were assessed by patient questionnaires on ordinal scales and statistical group comparisons were made using ordered logit regression with adjustment for baseline outcome and confounding factors. The primary endpoints were bowel, urinary and sexual function and bothering due to dysfunction at 8 years.Eleven percent (330/3,139) of the analyzed study population received salvage radiotherapy. Fecal leakage, leakage of mucus and hematochezia were more common after receiving salvage radiotherapy compared with the control group; 4.5% versus 2.6% odds ratio (95% confidence interval [CI]): (1.90 [1.38; 2.62]), 6.8% versus 1.5% 4.14 (2.98; 5.76) and 8.6% versus 1.2% 4.14 (2.98; 5.76), respectively. Urinary incontinence, erectile dysfunction and hematuria were more common after receiving salvage radiotherapy, 34% versus 23% 2.23 (2.65; 3.00), 65% versus 57% 1.65 (1.18; 2.29) and 16% versus 1.6% 11.17 (5.68; 21.99), respectively.Salvage radiotherapy was associated with increased risk for fecal leakage, hematochezia, urinary incontinence and hematuria. Our results emphasize the importance of selecting patients for salvage radiotherapy to avoid overtreatment and to give high quality pre-treatment information to ensure patients' preparedness for late side-effects.
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| 64. |
- Carlsson, S, et al.
(författare)
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Self-perceived penile shortening after radical prostatectomy.
- 2012
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Ingår i: International journal of impotence research. - : Springer Science and Business Media LLC. - 1476-5489 .- 0955-9930. ; 24:5, s. 179-84
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Tidskriftsartikel (refereegranskat)abstract
- The postoperative effect on penile length after radical prostatectomy has been the subject of studies with conflicting results. We analyzed self-perceived penile shortening, quality of life and self-esteem after radical prostatectomy. In this cross-sectional study of a cohort of 1411 men who underwent a radical prostatectomy at Karolinska University Hospital between 2002 and 2006, we used a study-specific questionnaire. Patients and controls were asked about their perceived penile shortening by comparing present penile length now and at age 30 years. All subjects were also asked about their present quality of life and self-esteem. Patients were compared with 442 age-matched population-based controls. Among 1288 who underwent radical prostatectomy and answered the questionnaire (response rate 91%), 663 patients reported self-perceived penile shortening (55%), as compared with 85 (26%) of 350 men in the control group, corresponding to a relative risk (RR) of 2.1 (95% confidence interval (CI) 1.8-2.6) of self-perceived penile shortening compared with the age-matched control group. Age, grade of erectile dysfunction and angina were correlated with self-perceived penile shortening in both the operated and the control group. After adjustments for all of these mentioned potential confounders, we obtained a RR of 1.7 (95% CI 1.4-2.1) of self-perceived penile shortening compared with the controls. We also found that self-assessed penile shortening was associated with a RR of 1.2 (95% CI 1.1-1.3) for a low-to-moderate self-assessed quality of life and a RR of 1.2 (95% CI 1.1-1.4) for a low-to-moderate self estimation of self-esteem. Extensive nerve-sparing technique seems to be associated with less self-perceived penile shortening compared with radical prostatectomy with lower degree of nerve-sparing approach. These data indicate that radical prostatectomy is associated with self-perceived penile shortening and suggests that erectile function is a key factor in penile shortening.
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| 65. |
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| 66. |
- Cerna, K., et al.
(författare)
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Changing Categorical Work in Healthcare: the Use of Patient-Generated Health Data in Cancer Rehabilitation
- 2020
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Ingår i: Computer Supported Cooperative Work-the Journal of Collaborative Computing and Work Practices. - : Springer Science and Business Media LLC. - 0925-9724. ; 29, s. 563-586
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Tidskriftsartikel (refereegranskat)abstract
- Categorical work in chronic care is increasingly dependent on digital technologies for remote patient care. However, remote care takes many forms and while various types of digital technologies are currently being used, we lack a nuanced understanding of how to design such technologies for specific novel usages. In this paper, we focus on digital technologies for patient-generated health data and how their use changes categorical work in chronic care. Our aim is to understand how categorical work changes, which novel forms of categorical work emerge and what the implications are for the care relation. This paper is based on an ethnographic study of healthcare professionals' work at a pelvic cancer rehabilitation clinic and their interactions with patients. In this setting, supportive talks between patients and nurses are central. To understand the complexities of categorical work in chronic care when patient-generated health data are introduced, we contrast the traditional supportive talks with supportive talks where the nurses had access to the patients' patient-generated health data. We identify and analyze challenges connected to novel forms of categorical work. Specifically, we focus on categorical work and how it can undergo changes. Our empirical findings show how changes occur in the way patients' lived experience of the chronic disease aligns with the categories from chronic care, as well as in the way the nurse works with clinical categories during the talk. These insights help us further understand the implications of patient generated-data use in supportive talks. We contribute to an improved understanding of the use of patient-generated health data in clinical practice and based on this, we identify design implications for how to make categorical work more collaborative.
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| 67. |
- Cerna, Katerina, 1986, et al.
(författare)
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Decision-support System for Cancer Rehabilitation : Designing for Incorporating of Quantified Data into an Existing Practice
- 2018
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Ingår i: Proceedings of the 10th Nordic Conference on Human-Computer Interaction. - New York, NY, USA : ACM Publications. - 9781450364379 ; , s. 747-753
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Recent development in self-monitoring devices indicates that using quantified data in clinical practicesupporting chronic diseases management holds a big potential. However, exploration of this design space also suggests that some unattended challenges still exist, such as a low adoption rate of self-monitoring tools in existing clinical practice. In this text, wetherefore focus on the ways healthcare professionalsuse quantified data in their practice. We draw onempirical data from an ethnographic study of a cancer rehabilitation center. Our preliminary findings suggestthat the self-monitoring tool supported the nurses'work because it became a functional complement totheir work by allowing them to appropriate the deviceto their and the patients' needs.
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| 68. |
- Cerna, Katarina, et al.
(författare)
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Nurses' work practices in design : managing the complexity of pain
- 2020
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Ingår i: Journal of Workplace Learning. - : Emerald Group Publishing Limited. - 1366-5626 .- 1758-7859. ; 32:2, s. 135-146
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose of this study is to understand the activities in nurses' work practices in relation to the design process of a self-monitoring application. Design/methodology/approach: A design ethnographic approach was applied in this study. Findings: To solve the problem of translating highly qualitative phenomena, such as pain, into the particular abstract features of a self-monitoring application, design participants had to balance these two aspects by managing complexity. In turn, the nurses'€™ work practices have changed because it now involves a new activity based on a different logic than the nurses’ traditional work practices. Originality/value: This study describes a new activity included in nurses’ work practices when the nurses became part of a design process. This study introduces a novel way on how to gain a deeper understanding of existing professional practice through a detailed study of activities taking place in a design process. This study explores the possible implications for nurses’ professional practices when they participate in a self-monitoring application design process. Â2020, Emerald Publishing Limited.
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| 69. |
- Cerna, Katerina, 1986, et al.
(författare)
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Nurses' work practices in design: managing the complexity of pain
- 2020
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Ingår i: Journal of Workplace Learning. - : Emerald. - 1366-5626. ; 2:2, s. 135-146
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose The purpose of this study is to understand the activities in nurses' work practices in relation to the design process of a self-monitoring application. Design/methodology/approach A design ethnographic approach was applied in this study. Findings To solve the problem of translating highly qualitative phenomena, such as pain, into the particular abstract features of a self-monitoring application, design participants had to balance these two aspects by managing complexity. In turn, the nurses' work practices have changed because it now involves a new activity based on a different logic than the nurses' traditional work practices. Originality/value This study describes a new activity included in nurses' work practices when the nurses became part of a design process. This study introduces a novel way on how to gain a deeper understanding of existing professional practice through a detailed study of activities taking place in a design process. This study explores the possible implications for nurses' professional practices when they participate in a self-monitoring application design process.
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| 70. |
- Cerna, Katerina, 1986, et al.
(författare)
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Supporting self-management of radiation-induced bowel and bladder dysfunction in pelvic-cancer rehabilitation: An ethnographic study
- 2019
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 28:13-14, s. 2624-2634
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Tidskriftsartikel (refereegranskat)abstract
- © 2019 John Wiley & Sons Ltd Aims and objectives: To describe and understand strategies that oncological nurses use to support self-management of radiation-induced bowel and bladder issues in pelvic-cancer rehabilitation patients. Background: Nurse-led self-management of radiation-induced bowel and bladder issues holds the potential to support cancer survivors. Design: An ethnographic approach was applied in this study, which adhered to Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Methods: Data collection was conducted in Sweden between October 2015–April 2018, involving observations of nurses’ daily work, formal and informal interviews, individual and group interviews, and reviews of relevant documents used in the studied practice. Furthermore, 15 supportive nurse–patient talks were observed, and an ethnographic analysis was performed. Results: The analysis identified the following three categories of nursing strategies that support self-management of radiation-induced bowel and bladder issues in pelvic-cancer rehabilitation patients: encouraging self-reflection, tailoring solutions together and keeping patients motivated. Nurses and patients jointly make sense of patients’ symptoms using data that patients collect about themselves. Based on their shared understanding, they can co-create solutions to meet each individual patient's needs and develop routines to keep the patient motivated in performing the devised solutions. Conclusions: The results indicate that the strategies nurses use to support patients in self-management of radiation-induced bowel and bladder issues entail intertwining patients’ experiences with their nurses’ medical knowledge and specific clinical practice. Nurses’ strategies build on their ability to connect patients’ experiences and the elements of their own work practice. Relevance to clinical practice: A deeper understanding of nurses’ strategies to support self-management of radiation-induced bowel and bladder issues in pelvic-cancer rehabilitation patients can improve other self-management programmes, inform nurses’ education and aid in the design of tools for pelvic-cancer rehabilitation support.
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