| 1. |
- Kohi, Thecla W., et al.
(författare)
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Cancer-related concerns and needs among young adults and children on cancer treatment in Tanzania : A qualitative study
- 2019
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Ingår i: BMC Cancer. - : Springer Science and Business Media LLC. - 1471-2407. ; 19:82
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cancer is one of the leading causes of morbidity and mortality worldwide. Seventy percent of deaths of cancer occur in low or middle-income countries, where the resources to provide cancer treatment and care are minimal. Tanzania currently has very inadequate facilities for cancer treatment as there are only five sites, some with limited services; two are in Dar es Salaam and one each in Mwanza, Kilimanjaro and Mbeya that offer cancer treatment. Despite cancer being a prevalent problem in Tanzania, there is a significant shortage of information on the experiences of young people who receive cancer treatment and care. The aim of this study was to explore cancer-related concerns and needs of care and support among young adults and children who are receiving cancer treatment in Dar es Salaam, Tanzania.Methods: Using an explorative, qualitative design, two focus group discussions (FGDs) with young adults (18 to 25 years) and four FGDs with children (9 to 17 years) were held. Data were transcribed into English and analyzed using content analysis.Results: Identified concerns included physical effects, emotional effects, financial impacts, poor early care, and poor treatment. Identified needs included the need for improved care in hospital by the staff, need for community support, financial needs, needs for improved cancer care and treatment in the hospitals, and the need for increased education about cancer. Resilience was identified, particularly around hope or faith, having hope to be healed, and receiving good care from staff.Conclusion: Young adults and children receiving cancer treatment in Tanzania have many needs and concerns. Improvements with regard to the care provided in hospital by the staff, the cancer care and treatment in the hospital, and population-wide education about cancer are necessary to address the identified needs and concerns. Further studies on specific approaches to address the concerns and needs are also warranted.
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| 2. |
- Reuther, Christina, et al.
(författare)
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E-therapists' views on the acceptability and feasibility of an internet-administered, guided, low-intensity cognitive behavioural therapy intervention for parents of children treated for cancer : A qualitative study
- 2024
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Ingår i: Digital Health. - : Sage Publications. - 2055-2076. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Childhood cancer treatment completion can be a period of vulnerability for parents and is associated with mental health difficulties such as depression and anxiety. We developed an internet-administered, guided, low-intensity cognitive behavioural therapy-based self-help intervention (EJDeR) for parents delivered on the U-CARE-portal (Portal). The acceptability and feasibility of EJDeR and study procedures were examined using a single-arm feasibility trial (ENGAGE). Results indicated that EJDeR and ENGAGE study procedures are acceptable and feasible, however, a need for clinical and technical modifications to EJDeR and refinements to ENGAGE study procedures was identified.Objectives: This study aimed to explore the acceptability and feasibility of EJDeR and ENGAGE study procedures from the perspective of e-therapists to inform clinical and technical modifications to EJDeR and refinements to study procedures prior to progression to a superiority randomised controlled trial.Methods: We conducted semi-structured interviews with 10 e-therapists. Data were analysed using manifest content analysis.Results: We identified three categories relating to the acceptability and feasibility of EJDeR: (a) Support to e-therapists (subcategories: Clinical supervision and Technical difficulties); (b) Guidance to parents (subcategories: Support protocols and Synchronous communication); and (c) Content (subcategories: Relevancy of the intervention and Pacing of the intervention). We identified four categories relating to the acceptability and feasibility of study procedures: (a) Recruitment and training of e-therapists (subcategories: Definition of the role and Training program); (b) Retention of parents (subcategories: Parent suitability and screening and Frequency of weekly Portal assessments); (c) Retention of e-therapists (subcategories: Administrative requirements and Communication with the research team); and (d) The Portal.Conclusions: EJDeR and study procedures were considered acceptable and feasible, however, clinical and technical modifications and refinements to study procedures were suggested to enhance acceptability and feasibility. Results may also inform implementation considerations for both EJDeR and other similar digital psychological interventions.Trial registration number ISRCTN 57233429
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| 3. |
- Wennman-Larsen, Agneta, et al.
(författare)
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Consistency of breast and arm symptoms during the first two years after breast cancer surgery
- 2015
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Ingår i: Oncology Nursing Forum. - 0190-535X .- 1538-0688. ; 42:2, s. 145-155
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE/OBJECTIVES:To examine the severity and development of breast and arm symptoms separately during the two years following breast cancer surgery, and to examine whether previously defined predictors of arm symptoms are associated with breast symptoms.
.DESIGN:Prospective cohort study with two-year follow-up.
.SETTING:Three institutions in the Stockholm, Sweden, region.
.SAMPLE:645 women, aged 20-63 years, enrolled within 12 weeks of surgery for primary breast cancer.
.METHODS:Baseline register and questionnaire data with five follow-ups were submitted to descriptive, inferential, and logistic regression analysis.
.MAIN RESEARCH VARIABLES:Severity of breast and arm symptoms measured by the European Organisation for Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire.
.FINDINGS:Most participants had undergone breast-conserving
surgery and sentinel lymph node dissection, and were scheduled for postoperative radiation therapy. Overall mean levels of breast and arm symptoms were low, but with large individual variations. At all six time points, the mean levels of breast symptoms were significantly higher than those of arm symptoms. Overall, the mean level of both types of symptoms decreased during follow-up. A body mass index (BMI) of 25 or greater and breast symptoms at eight months were associated with having breast symptoms at two years. Arm symptoms at baseline and at eight months, and radiation therapy and a BMI of 25 or greater were associated with having arm symptoms at two years.
.CONCLUSIONS:Breast symptoms show different patterns of change and are not associated with the same factors as arm symptoms.
.IMPLICATIONS FOR NURSING:For nurses monitoring women treated for breast cancer, the results of this study provide knowledge regarding the importance of early symptom identification and long-term symptoms after treatment.
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| 4. |
- Gottvall, Maria, 1980-, et al.
(författare)
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Including a discussion forum in a web-based intervention on fertility and sexuality following cancer - Usage and content
- 2022
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Ingår i: Internet interventions. - : Elsevier. - 2214-7829. ; 29
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of the study was to investigate how young adult survivors of childhood cancer used an online discussion forum as part of a web-based psycho-educational intervention. Specifically, we aimed to characterize users of the discussion forum, investigate how they used the discussion forum (type of usage) and content of the posted messages.Methods: This study is a part of a randomized controlled trial, Fex-Can Childhood RCT. Participants with self-reported sexual dysfunction or fertility-related distress were drawn from a population-based national cohort. Sociodemographic and clinical characteristics of the intervention group (n = 322) and data on usage of the discussion forum were analysed with descriptive statistics and compared between subgroups. Messages posted in the online discussion forum were analysed with qualitative thematic analysis.Results: Approximately half (48 %) of participants in the intervention group accessed the discussion forum and most of them (76 %) without writing own posts. Users of the discussion forum did not statistically differ in sociodemographic or clinical characteristics from the rest of the intervention group. The 97 written posts, written by 38 individuals, were mainly descriptions of own experiences and thoughts and concerned three themes: A changed body, Concerns around family building and Longing for support. Peer-support and interaction between participants were seen in some forum threads and the 'like'-function was frequently used, demonstrating engagement and activity. Participants expressed that they felt affinity with and appreciated sharing own experiences and to recognize themselves in others' stories.Conclusions: A discussion forum as part of a web-based intervention appears to be a valuable component by giving participants an opportunity to share intimate experiences and concerns related to surviving cancer.
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| 5. |
- Saboonchi, Fredrik, et al.
(författare)
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Changes in caseness of anxiety and depression in breast cancer patients during the first year following surgery : patterns of transiency and severity of the distress response
- 2014
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Ingår i: European Journal of Oncology Nursing. - : Elsevier BV. - 1462-3889 .- 1532-2122. ; 18:6, s. 598-604
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Psychological distress is prevalent in patients with breast cancer and is viewed as a non-pathological occurrence. Severe distress and mental disorder display a substantial overlap in both conceptual contexts and studies in oncological settings. A domain that may contribute to distinguishing non-pathological distress from signs of potential disorder is the transiency of distress.AIM: To examine the transiency of distress response in breast cancer patients by investigating the changes in clinical caseness of depression and anxiety during one year following surgery.METHODS: Data on the Hospital Anxiety and Depression Scale from a cohort of 715 women with breast cancer on three assessments within one year following breast surgery were subjected to Generalized Estimation Equation Analysis, McNemar's test, and logistic regression.RESULTS: There was a significant decrease in the proportions of anxiety cases from baseline (37.7%) to 4 months (26.7%) but no significant change from 4 to 12 months. Caseness in depression significantly increased from baseline (18.5%) to 4 months (21.5%) but decreased to 15.3% at 12 months. Only experience of major adverse life events contributed to 12 months caseness of anxiety and depression beyond baseline caseness.DISCUSSION: The average decrease in caseness of anxiety and depression a year following surgery lends support to the view of distress as a transient non-pathological response. A subgroup of patients, however, displayed enduring or recurrent severe distress indicating the presence of potential disorder. The findings emphasize the importance of screening and follow up monitoring of distress.
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| 6. |
- Saboonchi, Fredrik, et al.
(författare)
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Examination of the construct validity of the Swedish version of Hospital Anxiety and Depression Scale in breast cancer patients
- 2013
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Ingår i: Quality of Life Research. - : Springer Science and Business Media LLC. - 0962-9343 .- 1573-2649. ; 22:10, s. 2849-2856
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To examine the construct validity of the Swedish version of Hospital Anxiety and Depression Scale (HAD) in women with breast cancer. METHOD: Acquired data on HAD from 727 women who recently had breast cancer surgery, were aged 20-63 years and worked before diagnosis, and had no previous breast cancer (n = 725) were subjected to confirmatory factor analysis examining the viability of three hypothesized measurement models. RESULTS: The analysis showed adequate fit to the data for both bi-dimensional and three-factorial models of HAD. The single-factorial model, however, was shown to have inferior fit to the data. Substantive correlations were found between anxiety and depression in the bi-dimensional model, and negative affectivity and anxiety in the three-factorial model of HAD. CONCLUSIONS: The findings support the utility of scoring procedure based on the original bi-dimensional model, but add indication of co-occurrence of anxiety and depression in this patient population. The discriminant validity of a third factor of negative affectivity in a three-factorial model, however, remains unclear.
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| 7. |
- Bränström, Richard, et al.
(författare)
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Physical activity following a breast cancer diagnosis : Implications for self-rated health and cancer-related symptoms
- 2015
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Ingår i: European Journal of Oncology Nursing. - : Elsevier BV. - 1462-3889 .- 1532-2122. ; 19:6, s. 680-5
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Studies have consistently shown an association between physical activity and increased health and well-being after a cancer diagnosis. Nevertheless, large proportions of breast cancer survivors do not meet recommended levels of physical activity. The aim of this study was to describe physical activity levels during the first two years after being diagnosed with breast cancer, and to explore the predictive ability of physical inactivity on longer-term self-rated health, physical symptoms, and psychological distress.METHOD: Study participants were women recently having had a first breast cancer surgery at one of the three main hospitals in Stockholm between 2007 and 2009. A total of 726 women were included and responded to six questionnaire assessments during the 24 months following diagnosis.RESULTS: Less than one third of the participants were sufficiently physically active at baseline. Physical activity decreased after surgery, increased at 8 month follow-up, and subsequently decreased slightly during the subsequent follow-up period. Physical inactivity was related to reduced health, increased symptoms such as pain, depression, and anxiety.CONCLUSION: This study provides additional support for the beneficial consequences of being physically active after a breast cancer diagnosis and highlights a potential target for intervention. This study provides additional support showing that being physically active even at a very low level seems to result in health benefits. Physical activity should be encouraged among patients treated for breast cancer.
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| 8. |
- Gabrielsson, Hanna, 1977-, et al.
(författare)
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Övergången från att vara patient med cancer till person med erfarenhet av cancer : Civilsamhällets roll i rehabilitering
- 2023
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Ingår i: Socialmedicinsk Tidskrift. - : Socialmedicinsk tidskrift. - 0037-833X .- 2000-4192. ; 100:1, s. 165-178
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Forskningsöversikt (refereegranskat)abstract
- En avslutad cancerbehandling innebär inte automatiskt ett avslut på de utmaningar som följer med cancer. Behovet av cancerrehabilitering ökar i takt med fler som överlever cancer. Det råder viss otydlighet kring vilka rehabiliteringsinsatser som efterfrågas och vilka aktörer som erbjuder dessa. Denna studie har genom en litteraturöversikt satt ljuset på deltagares erfarenheter av cancerrehabilitering samt civilsamhällets roll i rehabilitering efter genomgången cancer i de nordiska länderna. Resultatet av litteraturöversikten visar att få studier finns publicerade om civilsamhällets roll i cancerrehabilitering. Personer som har genomgått en cancersjukdom har ofta behov av stöd under sin rehabilitering, där stöd från personer i liknande situation uppskattas av många. Resultatet visar även att organisationer i civilsamhället spelar en betydande roll. Studien har genomförts vid Centrum för civilsamhällesforskning, Marie Cederschiöld Högskola.
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| 9. |
- Kidayi, Paulo L, et al.
(författare)
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Cross-Cultural Adaptation and Psychometric Properties of the Swahili Version of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-BR45 among Breast Cancer Patients in Tanzania
- 2023
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Ingår i: Healthcare. - : MDPI. - 2227-9032. ; 11:18
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Tidskriftsartikel (refereegranskat)abstract
- Breast cancer is the most frequent cancer in women in Africa and contributes to premature death and poor quality of life. This study aimed to determine the validity, reliability, and psychometric properties of the Swahili version of EORTC QLQ-BR45 among women with breast cancer in Tanzania. A cross-sectional study design with non-probability convenience sampling was employed. Data were collected in two tertiary hospitals and one national cancer institute; 414 participants completed the EORTC-QLQ-C-30 and EORTC-QLQ-BR45. The reliability of QLQ-BR45 was measured using Cronbach's alpha and McDonald's Omega coefficients. The factor structure of EORTC QLQ-BR45 was assessed using confirmatory factor analysis. The internal consistencies for the five dimensions were all above 0.7 indicating satisfaction, except for systemic therapy side effects with a marginal value of 0.594 and significant correlations between the dimensions of QLQ-C30 and BR45. The final model fit well to the data, with the comparative fit index = 0.953, Tucker-Lewis index = 0.947, root mean square error of approximation = 0.041 (90% CI: 0.035, 0.046), and standardized root mean square residual = 0.072. In conclusion, the QLQ BR45 Swahili version displayed good reliability, validity, and psychometric properties and can be used in Swahili-speaking Sub-Saharan countries.
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| 10. |
- Nilsson, Marie I, et al.
(författare)
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Changes in importance of work and vocational satisfaction during the 2 years after breast cancer surgery and factors associated with this
- 2016
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Ingår i: Journal of cancer survivorship. - : Springer Science and Business Media LLC. - 1932-2259 .- 1932-2267. ; 10:3, s. 564-572
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of this study is to investigate how women, during the 2 years following breast cancer surgery, rate importance of work and vocational satisfaction, and baseline factors associated with rating over time.METHODS: A prospective cohort study of 692 women aged 20-63 included about 4 weeks after a first breast cancer surgery. Register data on treatment and data from six repeated questionnaires during a 2-year follow-up (at baseline, 4, 8, 12, 18, 24 months) were used in two-way mixed repeated analysis of variance and mixed repeated measures analysis of covariance.RESULTS: The women rated importance of work (m = 3.74; sd 0.88) (maximum 5) and vocational satisfaction (m = 4.30; sd 1.38) (maximum 6) high during the 2 years. Women with planned chemotherapy rated lower vocational satisfaction and especially so at 4 months after inclusion (F 1, 498 = 8.20; p = 0.004). Higher age, better physical, and mental/social work ability at baseline influenced rating of vocational satisfaction. Supportive colleagues was an important covariate that significantly affected ratings of importance of work as well as vocational satisfaction, i.e., women with better support rated on average higher on these outcomes. The effect of chemotherapy disappeared after including the abovementioned baseline covariates.CONCLUSIONS: Women diagnosed with breast cancer in the following 2 years rate importance of work and vocational satisfaction high, which are associated to lower work ability and social support.IMPLICATIONS FOR CANCER SURVIVORS: Work is a very important aspect in life also after a cancer diagnosis, which has to be acknowledged when discussing treatment and rehabilitation plans with women with breast cancer. Furthermore, workplace support needs to be assessed as this is an influential factor.
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