| 1. |
- Ax, Anna-Karin, et al.
(författare)
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Short- and long-term effect of high versus low-to-moderate intensity exercise to optimise health-related quality of life after oncological treatment-results from the Phys-Can project
- 2022
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Ingår i: Supportive Care in Cancer. - Heidelberg, Germany : Springer Nature. - 0941-4355 .- 1433-7339. ; 30:7, s. 5949-5963
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: This study aimed to evaluate the effect of high intensity (HI) vs low-to-moderate intensity (LMI) exercise on health-related quality of life (HRQoL) up to 18 months after commencement of oncological treatment in patients with breast, colorectal or prostate cancer. In addition, we conducted a comparison with usual care (UC).METHODS: Patients scheduled for (neo)adjuvant oncological treatment (n = 577) were randomly assigned to 6 months of combined resistance and endurance training of HI or LMI. A longitudinal descriptive study (UC) included participants (n = 89) immediately before the RCT started. HRQoL was assessed by EORTC QLQ-C30 at baseline, 3, 6 and 18 months (1 year after completed exercise intervention) follow-up. Linear mixed models were used to study the groups over time.RESULTS: Directly after the intervention, HI scored significant (P = 0.02), but not clinically relevant, higher pain compared with LMI. No other significant difference in HRQoL was found between the exercise intensities over time. Clinically meaningful improvements in HRQoL over time were detected within both exercise intensities. We found favourable significant differences in HRQoL in both exercise intensities compared with UC over time.CONCLUSION: This study adds to the strong evidence of positive effect of exercise and shows that exercise, regardless of intensity, can have beneficial effects on HRQoL during oncological treatment and also for a substantial time after completion of an exercise intervention. In this study, for one year after.IMPLICATIONS FOR CANCER SURVIVORS: Patients can be advised to exercise at either intensity level according to their personal preferences, and still benefit from both short-term and long-term improvements in HRQoL.
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| 2. |
- Cronfalk, Berit, et al.
(författare)
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The existential experiences of receiving soft tissue massage in palliative home care-an intervention
- 2009
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Ingår i: Supportive Care in Cancer. - : Springer Science and Business Media LLC. - 0941-4355 .- 1433-7339. ; 17:9, s. 1203-1211
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Tidskriftsartikel (refereegranskat)abstract
- Background Soft tissue massage is currently used in palliative care for the relief of anxiety and pain. Only few studies have focused on patients' deeper experience of receiving the massage. Aim The purpose of this study was to explore how patients with cancer in palliative home care experienced soft tissue massage. Materials and methods Twenty-two patients received soft tissue massage (hand or foot) nine times over a period of 2 weeks. Each session lasted for 25 min. Following the last massage session, a qualitative interview was conducted. The analysis was performed using a hermeneutic approach. Findings Soft tissue massage generated feelings of existential respite with perceptions of being released from illness for a while. Two categories constituted the basis of the experiences: (1) "an experience of thoughtful attention" and (2) "a sensation of complete tranquility" resulting in the overarching theme "A time of existential respite." Conclusion The patients experienced the massage to give meaning and to be important as it generated feelings of an inner respite. Relevance to clinical practice Soft tissue massage appears to be an appreciated source of support to dying patients in palliative home care. The method is easy to comprehend and relatively short (25 min) which may imply that it is a suitable complement in nursing care for this patient group.
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| 3. |
- Dielenseger, Pascale, et al.
(författare)
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Evaluation of antiemetic practices for prevention of chemotherapy-induced nausea and vomiting (CINV): results of a European oncology nurse survey
- 2019
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Ingår i: Supportive Care in Cancer. - : SPRINGER. - 0941-4355 .- 1433-7339. ; 27:11, s. 4099-4106
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Preventing CINV is possible when guideline-recommended antiemetics are used. Because oncology nurses play a critical role in risk assessment and management of CINV, a survey of European nurses was conducted to evaluate antiemetic practices, assess awareness of and adherence to current guideline recommendations, and explore barriers to adherence. Methods From March 2016 to Feb 2017, 212 oncology nurses in 16 European countries completed a 20-question online survey. Results Respondents had 15-year (median) oncology nursing experience, and most (75%) were able to suggest or prescribe antiemetics. Most (80%) worked in the public not-for-profit hospital setting. Guideline awareness was generally low with nurses most familiar with ASCO (46%) and MASCC/ESMO (40%) guidelines; individual institution guidelines were most commonly used (47%). Key discrepancies between reported antiemetic use and guideline recommendations in the highly emetogenic chemotherapy (HEC) setting were underutilization of the recommended NK(1)RA + 5-HT(3)RA + steroid combination on day 1 (55%) and high use of 5-HT3RAs (50%) on days 2-5 when a steroid (63% use) should be used. Metoclopramide use was high in both HEC and moderately emetogenic settings, with 30% and 50% reporting use on day 1 and days 2-5, respectively. The most common reported barrier to use of guideline-recommended agents was physician preference (40%). The most common challenges in managing CINV were "controlling nausea/vomiting in the delayed phase" (64%) and "reducing the impact of CINV on patients quality-of-life" (61%). Conclusions This survey highlights opportunities to improve utilization of guideline-recommended antiemetics, thereby optimizing prevention of CINV and QoL for patients receiving emetogenic chemotherapy.
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| 4. |
- Drott, Jenny, et al.
(författare)
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The trajectory of neurotoxic side effects' impact on daily life: a qualitative study
- 2016
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Ingår i: Supportive Care in Cancer. - : Springer Science and Business Media LLC. - 0941-4355 .- 1433-7339. ; 24:8, s. 3455-3461
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE:The purpose of this study was to explore the experiences of oxaliplatin-induced neurotoxic side effects among patients with colorectal cancer (CRC) and how these side effects influenced their daily lives over time.METHODS:To assess neurotoxic side effects, ten patients were repeatedly interviewed. The patients were recruited from two hospitals in south of Sweden, had stage II-III CRC, and had been treated with adjuvant oxaliplatin postoperatively, from November 2013 to October 2015. They had received FOLFOX and XELOX, with a mean total dose of 791 mg oxaliplatin. After completed chemotherapy, at 3, 6, and 12 months into the post-treatment phase, 25 interviews were conducted and thematic analysis was used according to Braun and Clarke.RESULTS:Oxaliplatin-induced neurotoxicity affects patients in several ways in the long term. Four themes were identified: Expectation of cure, Dubiety, Normalization, and Learn to live with neurotoxicity. The findings of this study describe the trajectory of neurotoxicity and its impact on these patients' life situation. The findings confirmed that neurotoxicity is multi-faceted and that the experience of it changes over time.CONCLUSION:The desire to survive stimulates adaptations and strategies to manage daily life, and patients learn to live with the neurotoxic side effects. This study provides evidence that these patients need individual attention and support during the trajectory of neurotoxic side effects. Current care provision is inadequate due to a lack of knowledge of the ways in which neurotoxicity impacts the patient's daily life. This study provides insights that could be used to develop a more person-centered care.
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| 5. |
- Dunberger, Gail, et al.
(författare)
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Lower limb lymphedema in gynecological cancer survivors-effect on daily life functioning.
- 2013
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Ingår i: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. - : Springer Science and Business Media LLC. - 1433-7339 .- 0941-4355. ; 21:11, s. 3063-70
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Tidskriftsartikel (refereegranskat)abstract
- Lower limb lymphedema (LLL) is a common condition after pelvic cancer treatment but few studies have evaluated its effect on the quality of life and its consequences on daily life activities among gynecological cancer survivors.
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| 6. |
- Enblom, Anna, et al.
(författare)
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One third of patients with radiotherapy-induced nausea consider their antiemetic treatment insufficient
- 2009
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Ingår i: Supportive Care in Cancer. - : Springer. - 0941-4355 .- 1433-7339. ; 17:1, s. 23-32
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe the prevalence of nausea and vomiting during radiotherapy and to compare quality of life, psychological and functional status in patients experiencing or not experiencing nausea.Materials and methods: A cross-sectional selection of 368 cancer patients treated with radiotherapy answered a questionnaire (=93% answering rate) regarding nausea, vomiting, actual use of and interest in antiemetic treatment, quality of life and psychological and functional status during the preceding week of radiotherapy. Mean age was 60 years and 66% were women.Main results: Nausea was experienced by 39% ( 145) and vomiting by 7% ( 28) of patients in general, by 63% in abdominal or pelvic fields and by 48% in head/neck/brain fields. Abdominal/pelvic field (Relative risk (RR) 2.0), age <= 40 years (RR 1.9) and previous nausea in other situations (RR 1.8) implied an increased risk for nausea. Antiemetics were used by 17% and 78% were interested in or wanted more information about acupuncture treatment against nausea. Of the 145 nauseous patients only 25% felt that antiemetics had helped them and 34% would have liked additional treatment, although the nausea intensity was mild in 72%. The nauseous patients reported lower well-being and quality of life, lower satisfaction with aspects of daily living and more frequent anxiety and depressed mood than the patients without nausea.Conclusions: Of all patients undergoing radiotherapy, 39% experienced nausea and one third of them would have liked more treatment against the nausea. This study stresses the importance to identify and adequately treat patients with increased risk for nausea related to radiotherapy.
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| 7. |
- Erichsén, Eva, 1959-, et al.
(författare)
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Constipation in specialized palliative care : factors related to constipation when applying different definitions
- 2016
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Ingår i: Supportive Care in Cancer. - : Springer Berlin/Heidelberg. - 0941-4355 .- 1433-7339. ; 24:2, s. 691-698
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Tidskriftsartikel (refereegranskat)abstract
- CONTEXT:For patients in palliative care, constipation is primarily a result of opioid treatment. Impacts from other factors related to constipation in palliative care are rarely studied.OBJECTIVES:The aim was to identify factors related to constipation in patients in palliative care, and then to compare these factors between patients with different types of constipation and patients without constipation.METHODS:Cross-sectional data on constipation was collected with a 26-item questionnaire from 485 patients in 38 specialist palliative care units in Sweden. Three different constipation groups were used; MC ONLY, PC ONLY, and MC & PC. Logistic regression analyses were used to calculate odds ratios.RESULTS:Patients with <3 defecations/week, MC ONLY, (n = 36) had higher odds of being hospitalized, bed-restricted, in need of personal assistance for toilet visits, and of having a poor fluid intake. Patients with the perception of being constipated, PC ONLY, (n = 93) had higher odds of having poor appetite, hemorrhoids, hard stool, more opioid treatment, less laxative treatment and of being more dissatisfied with constipation information. Patients with both <3 defecations/week and a perception of being constipated, MC & PC, (n = 78) had higher odds of having cancer- disease.CONCLUSION:There were several significant factors related to constipation with higher odds than opioid- treatment, for patients in palliative care, such as; hard stool, cancer diagnosis, dissatisfaction with information, low fluid intake, hemorrhoids, bed restriction, hospitalization, and need of personal assistance for toilet visits.
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| 8. |
- Friedrichsen, Maria, et al.
(författare)
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Breaking bad news in the transition from curative to palliative cancer care : patient's view of the doctor giving the information.
- 2000
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Ingår i: Supportive Care in Cancer. - 0941-4355 .- 1433-7339. ; 8:6, s. 472-478
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Tidskriftsartikel (refereegranskat)abstract
- In the transition from curative to palliative cancer care, communication is of special importance. The aim of this study was to explore how patients with a disseminated cancer disease experienced the information about their incurable state, focusing on the physician. The persons taking part were 30 patients admitted to a hospital-based home care unit in Sweden. Semi-structured interviews were conducted and analysed using a qualitative method. All patients described their doctors as experts, despite different qualities. Sire subcategories were identified: (1) the inexperienced messenger, (2) the emotionally burdened, (3) the rough and ready expert (4) the benevolent but tactless expert, (5) the "distanced" doctor and (6), the empathic professional. The relationship was described as very important to the patients' capacity to handle the information and was felt to have been built up during earlier meetings. The relationship was described in four subcategories: personal between well-acquainted individuals, impersonal between unacquainted individuals, personal between unacquainted individuals and impersonal between well-acquainted individuals. Both the character of the physician and his or her ability to create personal relationships influence patients' capacity to cope with this specific situation. Education and guidance are needed both in clinical practice and in medical schools.
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| 9. |
- Friedrichsen, Maria, et al.
(författare)
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Palliative care consultation team on acute wards-an intervention study with pre-post comparisons
- 2017
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Ingår i: Supportive Care in Cancer. - : SPRINGER. - 0941-4355 .- 1433-7339. ; 25:2, s. 371-380
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Tidskriftsartikel (refereegranskat)abstract
- There is little evidence regarding primary healthcare team members perceptions concerning palliative care consultation team (PCCT) and palliative care (PC) issues on their own wards. This study aimed to study whether a PCCT can influence and change primary healthcare team members perceptions regarding the palliative care at the end of life they are providing to patients in their own acute wards. The intervention was a PCCT visiting surgical and internal medicine wards in 1 year. We used a quasi-experimental design with pre-post-testing, measuring at baseline, and after 1 years intervention. A questionnaire was answered by all primary healthcare team members in three acute wards. A total of 252 team members (pre-post-intervention n = 132/n = 120) participated in the study. Overall, 11 of the 12 statements scored significantly higher after the intervention than before. Responses varied significantly between different professions and depending on the number of dying patients cared for during the last month. The five with the highest Wald values were as follows: the presence of a break point dialogue with a patient, where the changed aim and focus of care was discussed; early detection of impending death; adequate symptom relief and psychological and existential issues. It is possible to change perceptions about end-of-life care in primary healthcare team members on acute wards. Palliative care consultation teams should be a natural part wherever dying patients are cared for.
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| 10. |
- Frisk, Jessica, et al.
(författare)
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Acupuncture improves health-related quality-of-life (HRQoL) and sleep in women with breast cancer and hot flushes
- 2012
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Ingår i: Supportive Care in Cancer. - : Springer. - 0941-4355 .- 1433-7339. ; 20:4, s. 715-724
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Evaluate effects of electro-acupuncture (EA) and hormone therapy (HT) on health-related quality-of-life (HRQoL) and sleep in breast cancer survivors with vasomotor symptoms. METHODS: Forty-five women, randomized to EA (n = 27) for 12 weeks or HT (n = 18) for 24 months, were followed for up to 2 years. Distress caused by, and numbers of, hot flushes, hours slept and times woken up/night, Psychological and General Well-being Index (PGWB) and Women's Health Questionnaire (WHQ) were registered before and during treatment and at 6, 9, 12, 18 and 24 months after start of treatment. RESULTS: After 12 weeks of EA (n = 19), WHQ improved from 0.32 (IQR 0.23-0.53) at baseline to 0.24 (IQR 0.12-0.39; p < 0.001) and PGWB from 78 (IQR 53-89) to 79 (IQR 68-93; p = 0.002). All sleep parameters improved and Hot Flush Score (HFS) decreased by 80%. At 12 months, WHQ, PGWB and all sleep parameters remained significantly improved (n = 14) and HFS decreased by 65%. After 12 weeks of HT (n = 18), WHQ improved from 0.29 (IQR 0.15-0.44) at baseline to 0.15 (IQR 0.05-0.22; p = 0.001), PGWB from 75 (IQR 59-88) to 90 (62-97; p = 0.102) and three of five sleep parameters improved. CONCLUSION: Both EA and HT increased HRQoL and sleep, probably through decreasing numbers of and distress by hot flushes. Although flushes decreased less in the EA group than in the HT group, HRQoL improved at least to the same extent maybe due to other effects of EA, not induced by HT, e.g. on anxiety, vitality and sleep, supported by subscale analyses. EA should be further evaluated as treatment for women with breast cancer and climacteric complaints, since HT no longer can be recommended for these women.
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