| 1. |
- Carlsson, Eva, 1959, et al.
(författare)
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Development and validation of the preparedness for Colorectal Cancer Surgery Questionnaire: PCSQ-pre 24
- 2016
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Ingår i: European Journal of Oncology Nursing. - : Elsevier BV. - 1462-3889 .- 1532-2122. ; 25, s. 24-32
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The aims of the study were to develop and psychometrically evaluate a patient-reported outcome instrument for the measurement of preoperative preparedness in patients undergoing surgery for colorectal cancer. Methods This study was conducted in two stages: a) instrument development (item generation, construction of items and domains), empirical verification and b) instrument evaluation. A questionnaire with 28 items measuring preparedness for surgery was developed covering four domains and was tested for content validity with an expert panel and with patients. Psychometric testing of the questionnaire was conducted on 240 patients undergoing elective surgery for colorectal cancer. Results The scale content validity index of the preparedness items was 0.97. The final version consisted of 24 items measuring 4 subscales: Searching for and making use of information, Understanding and involvement in the care process, Making sense of the recovery process and Support and access to medical care. Confirmatory factor analysis revealed good model fit with standardized factor loadings ranging from 0.58 to 0.97. A well-fitting second-order factor model provided support for a total preparedness score with second-order factor loadings ranging from 0.75 to 0.93. The ordinal alpha values of the four latent factors ranged from 0.92 to 0.96, indicating good internal consistency. The polyserial correlations with the total score were 0.64 (p<0.01) for the overall preparedness question and 0.37 (p<0.01) for overall well-being. Conclusion The Swedish Preparedness for Colorectal Cancer Surgery Questionnaire for use in the preoperative phase demonstrated good psychometric properties based on a sound conceptualization of preparedness. © 2016 Elsevier Ltd
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| 2. |
- Friberg, Febe, 1950, et al.
(författare)
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Exploration of dynamics in a complex person-centred intervention process based on health professionals' perspectives
- 2018
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The assessment and evaluation of practical and sustainable development of health care has become a major focus of investigation in health services research. A key challenge for researchers as well as decision-makers in health care is to understand mechanisms influencing how complex interventions work and become embedded in practice, which is significant for both evaluation and later implementation. In this study, we explored nurses' and surgeons' perspectives on performing and participating in a complex multi-centre person-centred intervention process that aimed to support patients diagnosed with colorectal cancer to feel prepared for surgery, discharge and recovery. Method: Data consisted of retrospective interviews with 20 professionals after the intervention, supplemented with prospective conversational data and field notes from workshops and follow-up meetings (n = 51). The data were analysed to construct patterns in line with interpretive description. Results: Although the participants highly valued components of the intervention, the results reveal influencing mechanisms underlying the functioning of the intervention, including multiple objectives, unclear mandates and competing professional logics. The results also reveal variations in processing the intervention focused on differences in using and talking about intervention components. Conclusions: The study indicates there are significant areas of ambiguity in understanding how theory-based complex clinical interventions work and in how interventions are socially constructed and co-created by professionals' experiences, assumptions about own professional practice, contextual conditions and the researchers' intentions. This process evaluation reveals insights into reasons for success or failure and contextual aspects associated with variations in outcomes. Thus, there is a need for further interpretive inquiry, and not only descriptive studies, of the multifaceted characters of complex clinical interventions and how the intervention components are actually shaped in constantly shifting contexts.
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| 4. |
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| 5. |
- Kokkinakis, Dimitrios, 1965, et al.
(författare)
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Literacy Demands and Information to Cancer Patients
- 2012
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Ingår i: Proceedings of the 15th International Conference on Text, Speech and Dialogue. - Berlin, Heidelberg : Springer Berlin Heidelberg. - 0302-9743. - 9783642327896
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Konferensbidrag (refereegranskat)abstract
- This study examines language complexity of written health information materials for patients undergoing colorectal cancer surgery. Written and printed patient information from 28 Swedish clinics are automatically analyzed by means of language technology. The analysis reveals different problematic issues that might have impact on readability. The study is a first step, and part of a larger project about patients’ health information seeking behavior in relation to written information material. Our study aims to provide support for producing more individualized, person centered information materials according to preferences for complex and detailed or legible texts and thus enhance a movement from receiving information and instructions to participating in knowing. In the near future the study will continue by integrating focus groups with patients that may provide valuable feedback and enhance our knowledge about patients’ use and preferences of different information material.
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| 6. |
- Sawatzky, Richard, et al.
(författare)
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Predictors of preparedness for recovery following colorectal cancer surgery: a latent class trajectory analysis.
- 2023
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Ingår i: Acta Oncologica. - 0284-186X .- 1651-226X. ; 62:12, s. 1625-1634
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Tidskriftsartikel (refereegranskat)abstract
- With an interest in providing knowledge for person-centred care, our overall goal is to contribute a greater understanding of diversity among patients in terms of their preparedness before and up to six months after colorectal cancer surgery. Our aim was to describe and provide a tentative explanation for differences in preparedness trajectory profiles.The study was explorative and used prospective longitudinal data from a previously published intervention study evaluating person-centred information and communication. The project was conducted at three hospitals in Sweden. Patient-reported outcomes measures, including the Longitudinal Preparedness for Colorectal Cancer Surgery Questionnaire, were collected before surgery, at discharge, and four to six weeks, three months, and six months after surgery. Clinical data were retrospectively obtained from patients' medical records. We used latent class growth models (LCGMs) to identify latent classes that distinguish subgroups of patients who represent different preparedness trajectory profiles. To determine the most plausible number of latent classes, we considered statistical information about model fit and clinical practice relevance. We used multivariable regression models to identify variables that explain the latent classes.The sample (N=488) comprised people with a mean age of 68years (SD = 11) of which 44% were women. Regarding diagnoses, 60% had colon cancer and 40% rectal cancer. The LCGMs identified six latent classes with different preparedness for surgery and recovery trajectories. The latent classes were predominantly explained by differences in age, sex, physical classification based on comorbidities, treatment hospital, global health status, distress, and sense of coherence (comprehensibility and meaningfulness).Contrary to the received view that emphasizes standardized care practices, our results point to the need for adding person-centred and tailored approaches that consider individual differences in how patients are prepared before and during the recovery period related to colorectal cancer surgery.
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| 7. |
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| 8. |
- Smith, Frida, et al.
(författare)
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Developing a toolkit for written information materials for patients with colorectal cancer undergoing elective surgery
- 2011
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Ingår i: Svenska Läkaresällskapets Riksstämman.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- This study examines language complexity, readability and suitability, of written health information materials given to patients undergoing colorectal cancer (CRC) surgery. The overall aim is to investigate whether the implementation of adapted, person-centred information and communication for patients with CRC undergoing elective surgery, can enhance the patients’ self-care beliefs and well-being during recovery in the phase following diagnosis and initial treatment. Several explorative, qualitative studies are planned and will function both as a basis for the proposed interventions and provide explanations for the actual processes leading to the desired outcomes. Patients’ knowledge enablement will be reached by several interrelated intervention strategies and specific activities. One of these strategies deals with means to facilitate patients’ information seeking patterns and the goal is to provide patients with written information materials according to preferences for complex and detailed or legible texts. Thus, the interventions planed aim to enhance a movement from receiving information and instructions to participating in knowing. Written and printed patient information material from 28 Swedish clinics for patients diagnosed with CRC undergoing elective surgery were selected for analysis by means of standard metrics and more elaborate language technology techniques. Various text parameters such as lexical variation, frequency bands and the use of terminology were examined. The material was also analysed using a Suitability Assessment Instrument in order to examine content, literacy demand, graphic illustrations, layout and typography, learning stimulation and finally cultural appropriateness. In addition, five focusgroups were conducted where patients were asked to give their experiences of using written information. Results from the language technology analysis showed a variety in materials, where it could be divided in to easy, medium and difficult to read and comprehend. Patients in focusgroups told they would like written materials to be levelled in order to gain information stepwise, but also stressed the importance of information given both orally and in writing, and that they must correspond. Using the SAM-instrument was a good complement for deeper understanding, and taking all three analyses in account, we aim to design a balanced toolkit for how to best design written information materials where a person tailored approach can be offered.
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| 9. |
- Smith, Frida, et al.
(författare)
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Hur kan vi förbättra skriftligt informations- och utbildningsmaterial för patienter som opereras elektivt för kolorektal cancer?
- 2012
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Ingår i: Nationella konferensen i Cancervård, 24-25 maj 2012, Stockholm.
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Konferensbidrag (refereegranskat)abstract
- Kolorektal cancer (KRC) är den tredje största cancerdiagnosen i Sverige med drygt 5500 drabbade årligen. Primär behandling är kirurgi kompletterad av pre- och postoperativ onkologisk behandling. Standardiserade koncept för accelererat vårdförlopp med kortare vårdtider lägger mycket fokus på fysisk rehabilitering, men mindre på den psykiska påfrestning det innebär att bli opererad för en cancerdiagnos. Patienter förväntas ta stort ansvar för sin rehabilitering, både på sjukhuset och hemma. För att vara förberedd behövs både skriftlig och muntlig information. Syftet med studien var att kartlägga och karaktärisera det skriftliga informations- och utbildningsmaterial (IOU) som används till patienter som opereras elektivt för KRC. Vidare var syftet att beskriva patienters uppfattning om struktur och innehåll på IOU. IOU från 28 kliniker som opererar patienter med KRC samlades in (totalt 220 st). För att kunna ge ett mått på texternas svårighetsgrad gjordes språkteknologisk analys på samtliga IOU, där bl.a. ordlängd, meningsbyggnad och jämförelse med annan typ av litteratur mättes På 117 st gjordes en suitabilityanalys med instrumentet SAM+CAM där domän som innehåll, läsbarhet, bilder, layout samt stimulans och motivation för lärande bedömdes. Fem fokusgrupper med patienter genomfördes där patienterna uppmanades att berätta om vad de tycker utmärker ett bra respektive dåligt IOU, vad de saknar i innehåll och när och på vilket sätt de vill ha materialet utlämnat. Resultatet av språkteknologiska- och suitabilityanalysen visar att de flesta IOU bedömdes som ”adequate”, men spridningen var stor. Patienterna hade önskemål om mer nivåuppdelat/nivåriktat material, där man själv kan välja hur mycket information man vill ha vid ett visst tillfälle. Flera ämnen saknades, eller var för otydligt beskrivna för att patienterna skulle känna sig trygga vid hemgång. Resultatet av de tre analysmetoderna bör kunna användas för att utveckla en ”verktygslåda” för att i framtiden kunna utforma bättre riktat IOU för patientgruppen.
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| 10. |
- Smith, Frida, et al.
(författare)
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Ny studie visar hur information till patienter med kolorektal cancer kan förbättras
- 2012
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Ingår i: Cancervården. - 1401-6583. ; :5, s. 18-21
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Skriftligt informationsmaterial är ofta skrivet på för hög nivå och ställer höga krav på den tänkta läsaren (patienten). Förutom läsbarhet finns det fler faktorer att utvärdera för att se om materialet är lämpligt. Innehåll, struktur, layout och typsnitt, illustrationer och lärande och motivation är sådant som bör tas hänsyn till. Ett lämpligare, bättre anpassat material kan hjälpa personer med sjukdom att ställa bättre frågor när de har samtal med vårdpersonal och det kan göra personen mindre osäker och orolig för det okända som väntar. En ny studie som ingår i forskningsprojektet PINCORE (personcentred information and communication in colorectal cancer care) syftar till att förbättra information och kommunikation vid kolorektal cancer.
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