| 1. |
- Browall, Maria, 1963, et al.
(författare)
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The impact of age on Health-Related Quality of Life (HRQoL) and symptoms among postmenopausal women with breast cancer receiving adjuvant chemotherapy.
- 2008
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Ingår i: Acta oncologica (Stockholm, Sweden). - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 47:2, s. 207-15
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Elderly women with breast cancer are often not given adjuvant chemotherapy (CT). One reason for this is that older women are believed to have more problems in tolerating side-effects of CT. The purpose of this study was to analyze the impact of age on health related quality of life (HRQoL) and symptoms in postmenopausal women with breast cancer undergoing adjuvant CT. PATIENTS AND METHODS: Eighty consecutive postmenopausal patients planned for CT were invited. Seventy-five agreed to participate (age 55-77 years). The patients completed two cancer-specific HRQoL questionnaires, The European Organisation for Research and Treatment of cancer (EORTC) EORTC-QLQ-C30, the EORTC-QLQ-BR23, and the Hospital Anxiety and Depression Scale (HADS) before, during, and 4 months after completion of treatment. The design was descriptional and longitudinal. Correlations were examined between age and change in HRQoL variables. RESULTS: No significant correlations were found between age and any of the assessed HRQoL domains or symptom scales, except for dyspnoea and sexual functioning. Age was inversely correlated to change in dyspnoea from baseline through follow-up, whereas older women perceived their sexual functioning significantly lower at baseline. CONCLUSION: The results indicate that among postmenopausal patients in the age range 55-77 years consecutively selected for adjuvant CT age was not a predictor of decreased HRQoL. This supports the argument that age should not be used in isolation in decisions about adjuvant CT for breast cancer in elderly women.
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| 2. |
- Snögren, Maria, et al.
(författare)
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Psychometric evaluation of a short-form version of the Swedish "Attitudes to and Knowledge of Oral Health" questionnaire
- 2022
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Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Healthcare professionals' attitudes to and knowledge of oral health are fundamental to providing good oral health care to older adults. One instrument that assesses healthcare professionals' attitudes to and knowledge of oral health in a Swedish context is the "Attitudes to and Knowledge of Oral health" (AKO) questionnaire. Two of the three item-groups of the AKO have previously been validated in a Swedish context. However, it is crucial that all three item-groups are validated, and beneficial to design a shorter, easy-to-use questionnaire for healthcare professionals while maintaining adequate integrity of its reliability and validity. Therefore, the present study aims to develop a short-form version of AKO and to secure its psychometric properties. Methods Psychometric evaluation with Classical Test Theory and Item Response Theory to validate and shorten AKO with 611 healthcare professionals from a population of 1159 working in a municipality in an urban area in western Sweden. Results Of the original 16 items in the AKO, 13 were shown to warrant retention in the abbreviated/shortened form. These showed acceptable validity and reliability for assessing healthcare professionals' attitudes to and knowledge of oral health. Conclusion This validated short-form version of AKO shows acceptable validity and reliability after being reduced to 13 items, structured in a 3-part scale. The items are consistent with the total scale, indicating that the internal consistency is acceptable. Future studies should be performed to evaluate AKO in other groups of healthcare professionals, across cultures, languages, and so on, to investigate its use and strengthen its validity and reliability.
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| 3. |
- Zhou, Lihua, et al.
(författare)
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Post-traumatic growth and its influencing factors among Chinese women diagnosed with gynecological cancer: A cross-sectional study.
- 2021
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Ingår i: European Journal of Oncology Nursing. - : Elsevier BV. - 1462-3889 .- 1532-2122. ; 51
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The experience of cancer could lead to positive psychological changes following the struggle with diagnosis and treatment. Understanding post-traumatic growth and its influencing factors in women affected by gynecological cancer is essential to enhance their possibility of achieving positive changes. The purpose of this study was to describe the post-traumatic growth level and explore the influencing factors of post-traumatic growth in Chinese women diagnosed with gynecological cancer. Method: A cross-sectional survey with a convenience sampling method was employed to collect data using the Post-traumatic Growth Inventory (PTGI), Distress Disclosure Index (DDI), Medical Coping Modes Questionnaire (MCMQ), and Multidimensional Scale of Perceived Social Support (MSPSS). The questionnaires were administered to 344 participants recruited from two hospitals in Hefei City, the capital of Anhui Province in China, between March 2018 and March 2019. All statistical analyses were performed using nonparametric tests. The Mann-Whitney U Test was used to distinguish the intergroup differences. Correlations were evaluated with Spearman rank correlation coefficients. Results: Total score for PTGI was 56.5 (range 48.0-68.0). The subscale with the highest centesimal score in the PTGI was appreciation of life and the lowest was spiritual change. The top five items with the highest scores of PTGI belonged to appreciating life, personal strength, and relating to others. Self-disclosure, confrontation, avoidance, acceptance-resignation, perceived social support, education level, cancer type and the place they lived had significant influence on post-traumatic growth. Conclusions: The findings indicate that women who have high levels of perceived social support, confrontation, avoidance, self-disclosure and education level tend to experience more post-traumatic growth, while, conversely, high levels of acceptance-resignation have a negative influence on promoting post-traumatic growth. These meaningful findings propose new perspectives for promoting post-traumatic growth in Chinese women diagnosed with gynecological cancer.
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| 4. |
- Browall, Maria, et al.
(författare)
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Daily assessment of stressful events and coping among post-menopausal women with breast cancer treated with adjuvant chemotherapy : Original article
- 2009
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Ingår i: European Journal of Cancer Care. - : John Wiley & Sons. - 0961-5423 .- 1365-2354. ; 18:5, s. 507-516
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the study was twofold: to examine what type of daily stressful events post-menopausal woman with breast cancer experience during adjuvant chemotherapy and how bothersome these are and to identify coping strategies used by these women used to manage such stressful events. The patient group comprised 75 consecutively invited women (≥55 years of age) at two university hospitals and one county hospital in Sweden. The Daily Coping Assessment was used to collect data over time. Data were analysed both qualitatively and quantitatively. Six categories of stressful events were identified: 'nausea and vomiting', 'fatigue', 'other symptoms', 'isolation and alienation', 'fear of the unknown' and 'being controlled by the treatment'. The first three categories were subsumed under the domain physical problems and the latter three under psychosocial problems. Almost 30% of the diary entries recorded no stressful event. Physical problems were three times as frequent as psychosocial problems. 'Nausea/vomiting' was the most frequently observed stressful event (21.6%). 'Isolation and alienation' and 'fear of the unknown' were less frequent, but when they occurred they were rated as the most distressing. Several coping strategies were used to manage each stressful event. The most common strategies were acceptance, relaxation and distraction. Religion was rarely used as a coping strategy.
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| 5. |
- Browall, Maria, 1963
(författare)
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Experience of adjuvant treatment among postmenopausal women with breast cancer - Health-Related Quality of Life, symptom experience, stressful events and coping strategies.
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In Sweden, breast cancer is today the most common type of cancer among women. Of the approximately 7,059 women who developed the disease in Sweden during 2006, about 73% were postmenopausal and aged 55 or older at time of diagnosis, and about 33% were aged 70 or older. Survival time for women with breast cancer has been extended due primarily to the development of new adjuvant treatments; however, these treatments may produce a wide variety of troublesome symptoms. There are limited descriptions in the literature of how Health-Related Quality of Life (HRQoL) is affected by adjuvant treatments in elderly populations. Nevertheless, it is common that in clinical practice these women are offered less aggressive treatment due to fears that the side effects may be greater for them.This thesis explores the experience of adjuvant chemotherapy (CT) and/or radiotherapy (RT) among postmenopausal women with breast cancer. More specifically, the thesis aims to examine how HRQoL develops over time, what factors predict overall HRQoL after treatment and if age is associated with HRQoL. A further aim was to describe stressful events experienced by these women and how they manage these stressful events or situations. The participants were recruited from three centres in Sweden (Gothenburg, Stockholm and Skövde). In the first study, 150 women scheduled to receive adjuvant chemotherapy (CT, n=75) or radiotherapy (RT, n=75) were included. In the second study, 20 women with breast cancer were interviewed regarding their experiences during CT. The third and fourth studies included the same 75 women scheduled to receive adjuvant CT from the first study. Both inductive and deductive research methods were used. Data from the qualitative studies (II and IV) were analysed with content analyses (qualitative and quantitative). Data collected with quantitative methods were analysed using mainly non-parametric methods (Paper I and III). No significant relationship was found between age and any of the HRQoL domains, except dyspnoea and sexual functioning. Thirty percent of the diaries recorded no stressful events during adjuvant CT. Stressful events experienced during CT were more related to physical problems than to psychosocial problems. CT and RT affected many aspects of the women?s HRQoL negatively. RT was associated with more localized problems, whereas CT was associated with systemic symptoms. Nausea/vomiting was one of the most stressful events reported by women undergoing CT, increased significantly during and after treatment and was also the most anticipated side effect of CT. Fatigue and depression increased over time and remained high at time of follow-up. Baseline predictors for overall QoL after CT were emotional functioning and pain, whereas overall QoL after RT was predicted by baseline emotional and physical functioning, lower tumour stage and less breast symptoms. Social support from family, friends and health care professionals was important for these women. The women employed many different coping strategies for each stressful event. Acceptance, relaxation and distraction were the most commonly used strategies. In conclusion, CT and RT variously and seriously affect aspects of HRQoL in postmenopausal women. This indicates that the situation of these women cannot be understood as simply a function of chronological age, but as an individual process where the biological age is important. Patient care may be improved by focusing more attention on specific symptoms, notably fatigue, nausea/vomiting, and depression, and also on social and emotional functioning. Interventional studies are needed that specifically target identified pre-treatment predictors of later impaired QoL to determine if it is possible to prevent declines in QoL in these women. The deeper understanding of the coping strategies used by women to handle stressful events is also an important knowledge and a possible way for health care professionals to support in clinical practice.
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| 6. |
- Browall, Maria, 1963, et al.
(författare)
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Health care staff's opinions about existential issues among patients with cancer.
- 2010
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Ingår i: Palliative & supportive care. - : Cambridge University Press. - 1478-9523 .- 1478-9515. ; 8:1, s. 59-68
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The objective of this study was to explore health care staff's opinions about what existential issues are important to patients with cancer and staff's responsibility when existential issues are raised by patients. METHOD: Four focus group interviews were conducted with health care staff (N = 23) at an in-patient hospice, on an oncology ward, on a surgical ward, and with a palliative home health care team. The focus group interviews focused on two questions, first, about health care staff's opinions about patients' important existential questions and, second, about health care staff's responsibility when existential issues are raised by the patient. The interviews were tape-recorded, transcribed verbatim, and analyzed by qualitative content analysis into subcategories and categories. RESULTS: Four categories and 11 subcategories emerged from the first question. The first category, "life and death," was based on joy of living and thoughts of dying. The second category "meaning," consisted of acceptance, reevaluation, hope, and faith. The third category, "freedom of choice," consisted of responsibility and integrity, and the fourth and last category, "relationships and solitude," consisted of alleviation, dependency, and loss. One category emerged from the second question about the health care staff's responsibility, "to achieve an encounter," which was based on the subcategories time and space, attitudes, and invitation and confirmation. SIGNIFICANCE OF RESULTS: The strength of this study was that the findings were fairly congruent in different settings and in different geographical areas. Health care staff were aware of the importance of existential issues to patients. The existential issues, mentioned by health care staff, are similar to findings from studies conducted among patients, which is another strength of the present study. Health care staff are also confident about how to act when these issues are raised by the patients. The challenge for the future is to implement the findings from this study among health care staff in different settings.
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| 7. |
- Browall, Maria, et al.
(författare)
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Health-related quality of life during adjuvant treatment for breast cancer among postmenopausal women
- 2008
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Ingår i: European Journal of Oncology Nursing. - : Elsevier. - 1462-3889 .- 1532-2122. ; 12:3, s. 180-189
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the present study was twofold: first, to describe changes of Health-Related Quality of Life (HRQoL) during the adjuvant treatment among postmenopausal women with breast cancer; second, in the same population to identify the best predictors of Overall Quality of Life (QoL) after treatment, from perceived functioning, symptoms, emotional distress and clinical/demographic variables measured at baseline. The study group was 150 women (>= 55 years of age) scheduled for adjuvant chemotherapy (CT, n=75) or radiotherapy (RT, n=75). They were examined before (baseline), during and after completing the treatment. Data about QoL, perceived functioning, symptoms and emotional distress were collected with the European Organisation for Research and Treatment of Cancer (EORTC)-QLQ-C30, BR23 and Hospital Anxiety and Depression Scale (HADS) questionnaires. The general finding was that the adjuvant treatments were associated with decrease in overall QoL, physical and role functioning, anxiety and body image, as well as with increase in fatigue, dyspnoea, pain, nausea/vomiting, constipation and systemic therapy side effects measured over time. For women receiving CT, better emotional functioning and less pain at baseline predicted better overall QoL at the end of the treatment. For women receiving RT, better physical and emotional functioning, less breast symptoms and lower tumour stage at baseline predicted better overall QoL at the end of the treatment.
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| 8. |
- Craftman, Åsa, et al.
(författare)
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Home care assistants' attitudes and perceptions of caring for people at the end of life in their homes in Sweden
- 2022
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Ingår i: Health & Social Care in the Community. - : Hindawi Limited. - 0966-0410 .- 1365-2524. ; 30:5
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Tidskriftsartikel (refereegranskat)abstract
- The ageing population is increasing worldwide, with older people often having multimorbidity and a need for help with activities and personal care. Home Care Assistants (HCAs) are central to the provision of care in the home. They meet older people approaching the end of life and their relatives. Little is known about HCAs attitudes towards caring for a dying person and how aspects such as education, age, earlier care experiences, care education and experience of caring for dying older people affect their attitudes. The aim was to describe HCAs' attitudes towards the care of dying persons living in their ordinary homes. This cross-sectional study used the Frommelt Attitude Toward Care of the Dying Scale (FATCOD) for data collection during December 2017 and January 2018, and descriptive statistics and regression analysis for data analysis. The participants were HCAs (n = 127, 96% of those eligible) in a municipality in central Sweden. An overall positive attitude was reported. About 32% lacked formal HCA education although 93% had experience of interacting with a dying person. Age, HCA education, internal palliative care education, number of years' experience and previous experience of caring for a dying person were independently associated with HCAs' attitudes. In the multivariate regression analysis, age and years of experience were the only significant predictors of HCAs' attitudes towards caring for dying care recipients. Young employees without HCA education and experience of a dying person might be vulnerable in situations involving caring for a dying person. Communicating about death and dying, forming a relationship with the care recipient and the family, and providing care when a person is dying can be challenging. Implications: Young employees without HCA education and experience of interacting with a dying person needs to be prepared for the situation. This needs to be considered by stakeholders and social and healthcare organisations.
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| 9. |
- Fristedt, Sofi, 1969-, et al.
(författare)
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Digi-Do: a digital information tool to support patients with breast cancer before, during, and after start of radiotherapy treatment: an RCT study protocol
- 2021
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Ingår i: BMC Medical Informatics and Decision Making. - : Springer Science and Business Media LLC. - 1472-6947. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Radiation Therapy (RT) is a common treatment after breast cancer surgery and a complex process using high energy X-rays to eradicate cancer cells, important in reducing the risk of local recurrence. The high-tech environment and unfamiliar nature of RT can affect the patient's experience of the treatment. Misconceptions or lack of knowledge about RT processes can increase levels of anxiety and enhance feelings of being unprepared at the beginning of treatment. Moreover, the waiting time is often quite long. The primary aim of this study will be to evaluate whether a digital information tool with VR-technology and preparatory information can decrease distress as well as enhance the self-efficacy and health literacy of patients affected by breast cancer before, during, and after RT. A secondary aim will be to explore whether the digital information tool increase patient flow while maintaining or increasing the quality of care. Method: The study is a prospective and longitudinal RCT study with an Action Research participatory design approach including mixed-methods data collection, i.e., standardised instruments, qualitative interviews (face-to-face and telephone) with a phenomenological hermeneutical approach, diaries, observations, and time measurements, and scheduled to take place from autumn 2020 to spring 2022. The intervention group (n=80), will receive standard care and information (oral and written) and the digital information tool; and the control group (n=80), will receive standard care and information (oral and written). Study recruitment and randomisation will be completed at two centres in the west of Sweden. Discussion: Research in this area is scarce and, to our knowledge, only few previous studies examine VR as a tool for increasing preparedness for patients with breast cancer about to undergo RT that also includes follow-ups six months after completed treatment. The participatory approach and design will safeguard the possibilities to capture the patient perspective throughout the development process, and the RCT design supports high research quality. Digitalisation brings new possibilities to provide safe, person-centred information that also displays a realistic picture of RT treatment and its contexts. The planned study will generate generalisable knowledge of relevance in similar health care contexts.Trial registration: ClinicalTrials.gov Identifier: NCT04394325. Registered May 19, 2020. Prospectively registered.
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| 10. |
- Grynne, A., et al.
(författare)
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Integrating perspectives of patients, healthcare professionals, system developers and academics in the co-design of a digital information tool
- 2021
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Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 16:7
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Tidskriftsartikel (refereegranskat)abstract
- Background Patients diagnosed with cancer who are due to commence radiotherapy, often, despite the provision of a considerable amount of information, report a range of unmet information needs about the treatment process. Factors such as inadequate provision of information, or the stressful situation of having to deal with information about unfamiliar things, may influence the patient's ability to comprehend the information. There is a need to further advance the format in which such information is presented. The composition of information should be tailored according to the patient's individual needs and style of learning. Method and findings The PD methodology is frequently used when a technology designed artefact is the desired result of the process. This research is descriptive of its kind and provides a transparent description of the co-design process used to develop an innovative digital information tool employing PD methodology where several stakeholders participated as co-designers. Involving different stakeholders in the process in line with recommended PD activities enabled us to develop a digital information tool that has the potential to be relevant and user-friendly for the ultimate consumer. Conclusions Facilitating collaboration, structured PD activities can help researchers, healthcare professionals and patients to co-design patient information that meets the end users' needs. Furthermore, it can enhance the rigor of the process, ensure the relevance of the information, and finally have a potential to employ a positive effect on the reach of the related digital information tool.
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