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- Bergdahl, Elisabeth, et al.
(author)
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Co-creating possibilities for patients in palliative care to reach vital goals - a multiple case study of home-care nursing encounters
- 2013
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In: Nursing Inquiry. - : Wiley-Blackwell. - 1320-7881 .- 1440-1800. ; 20:4, s. 341-351
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Journal article (peer-reviewed)abstract
- The patients home is a common setting for palliative care. This means that we need to understand current palliative care philosophy and how its goals can be realized in home-care nursing encounters (HCNEs) between the nurse, patient and patients relatives. The existing research on this topic describes both a negative and a positive perspective. There has, however, been a reliance on interview and descriptive methods in this context. The aim of this study was to explore planned HCNEs in palliative care. The design was a multiple case study based on observations. The analysis includes a descriptive and an explanation building phase. The results show that planned palliative HCNEs can be described as a process of co-creating possibilities for the patient to reach vital goals through shared knowledge in a warm and caring atmosphere, based on good caring relations. However, in some HCNEs, co-creation did not occur: Wishes and needs were discouraged or made impossible and vital goals were not reached for the patients or their relatives. Further research is needed to understand why. The co-creative process presented in this article can be seen as a concretization of the palliative care ideal of working with a person-centered approach.
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| 5. |
- Elmberger, Eva, et al.
(author)
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Being a mother with cancer : achieving a sense of balance in the transition process
- 2008
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In: Cancer Nursing. - : Lippincott Williams & Wilkins. - 0162-220X .- 1538-9804. ; 31:1, s. 58-66
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Journal article (peer-reviewed)abstract
- For women with cancer and with children living at home, the demands of being a good mother while undergoing treatments and recovering from illness have been described as a difficult life process. The aim of this study was to further examine the transition process with focus on women's experience of their responsibility toward their children. Interviews from 2 previous studies investigating the transition process of women with cancer were gathered and were subjected to a qualitative secondary analysis, an analytic expansion of the transition process. The 3 phases in the transition process were used in an interpretive description: ending an earlier life situation, in-between, and new beginning. A main theme that integrated these phases was constructed: "the desire to manage ones responsibility as a parent," within the context of mothering. The women expressed moral concern about not being able to function as "good" mothers yet attempted to find a balance between experiences of exhaustion and other experiences that made it difficult to maintain their responsibility as parents. All of the women included in this study expressed the need for professional support to help them endure treatment procedures as well as to sustain their moral responsibility as good mothers.
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| 6. |
- Elmberger, Eva, et al.
(author)
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Experience of dealing with moral responsibility as a mother with cancer
- 2005
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In: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 12:3, s. 253-262
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Journal article (other academic/artistic)abstract
- This study explored how women with a diagnosis of cancer (lymphoma) deal with moral concerns related to their responsibility as parents. Ten women with cancer and who had children living at home were interviewed. The interviews were analysed according to the constant comparative method used in grounded theory. In order to provide a focus for the analysis, the ethics of care and the concept of mothering were used as sensitizing concepts. The core concept ‘experience of dealing with moral responsibility of being a parent with cancer by redefining oneself as a mother’ was identified. The processes involved were: interrupted mothering; facing the life-threatening illness and children’s reactions; striving to be a good mother; attempting to deal with moral responsibility; and coming to terms with being a mother.
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| 7. |
- Elmberger, Eva, et al.
(author)
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Men with cancer : Changes in attempts to master the self-image as a man and as a parent
- 2002
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In: Cancer Nursing. - : Ovid Technologies (Wolters Kluwer Health). - 0162-220X .- 1538-9804. ; 25:6, s. 477-85
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Journal article (peer-reviewed)abstract
- Little is known about men's experience of how cancer affects their role as a father. The aim of this study was to gain an understanding of changes in these men's everyday family lives. The study had an interpretative descriptive design, utilizing the concept of transition as a fore structure. Eight men with different types of blood cancer and with children living at home were recruited for the study. Interviews, guided by the main components of the concept of transition, provided qualitative data for analysis. Through the interpretative process, the central theme--change in self-image as a man and as a parent--was generated. This theme consists of the subthemes gaining control, balancing emotions, subjective well-being, being open or not toward the family, and challenges in family life and to family well-being. The time after diagnosis influenced the process of transition. Self-image changes are more obvious shortly after diagnosis. Further study is needed to identify how nurses and other clinicians can assess the family's needs and support the parental role, especially in consideration of the findings of this study.
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| 8. |
- Elmberger, Eva
(author)
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Parents with cancer : the experiences of family responsibility
- 2004
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Doctoral thesis (other academic/artistic)abstract
- Then main aim of this study was to gain an understanding of how women and men with cancer illnesses, looking after children at home, experience and manage their life situation, with focus on the responsibility as parent. An additional aim was to identify the parents’ need for support, in order to develop support activities for them from a family nursing perspective. The perspective of symbolic interactionism influenced the qualitative studies in the thesis. Concepts used in the thesis were transition, identified as a core concept in nursing, and mothering and ethics of care as sensitizing concepts. The emphasis was on a conceptual framework in nursing, encompassing the main components of the theory of transition. The analysis methods used were grounded theory (study I and III), interpretive description (study II) and secondary analysis (study IV). Data was collected from open interviews with women and men with cancer who had children living at home. The participants in study I were nine women with breast cancer, in study II, eight men with cancer in the blood producing organs and in study III, ten women with cancer in blood systems and a focus group interview. Study IV involved the same participants as study I and III. The results of study I illustrate the main theme of how the lives of these women had changed: transforming the exhausting-to-energising process of being a good parent in the face of cancer. All of the women expressed the desire to be a good mother. In study II, a central theme was generated – change in self-image as a man and as a parent. The men’s self-image changed as well as their function as parents. In study III the core concept identified was the experience of dealing with the moral responsibility of being a mother with cancer. The findings were presented as a life story where the women’s experiences were weaved together. In Study IV, the three phases in the transition process were used and a main theme was constructed that integrated these phases: “the desire to manage one’s responsibility as a parent” within the context of mothering. All of the women included in this study expressed the need for professional support to help them to endure treatment procedures as well as to sustain their moral responsibility as good mothers. A model for professional moral support is suggested, based on these findings. The research implications are that the concept of moral support has been identified and can be incorporated into a theoretical model in order to further generate a hypothesis with the aim of creating a useful clinical intervention model. The clinical implications of this are to use and evaluate the tentative model for moral support in clinical practice in patient encounters with the family and in training health care staff.
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| 9. |
- Elmberger, Eva, et al.
(author)
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Transforming the Exhausting to Energizing Process of Being A Good Parent in the Face of Cancer
- 2000
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In: Health Care for Women International. - 0739-9332 .- 1096-4665. ; 21:6, s. 485-499
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Journal article (peer-reviewed)abstract
- The aim in this study was to gain a deeper understanding of the interaction between women who have been treated for breast cancer and their children. The focus was on how they deal with being a mother at the same time attending to their own needs. The main strategies of the grounded theory method were used to conceptualize the interactive process involved. Nine women, with children aged 4 to 23, living at home at the time of diagnosis, were interviewed. By the process of constant comparative analysis, the main theme that seemed to capture how the lives of these women had changed was transforming the exhausting-to-energizing process in being a good parent in the face of cancer. This theme is related to Meleis's concept of health–illness transition. The findings here indicate the need for family counseling, with special attention paid to the single parent with cancer.
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| 10. |
- Mellin Dahlstrand, Hanna, et al.
(author)
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P16(INK4a) correlates to human papillomavirus presence, response to radiotherapy and clinical outcome in tonsillar carcinoma.
- 2005
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In: Anticancer Research. - 0250-7005 .- 1791-7530. ; 25:6C, s. 4375-83
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Journal article (peer-reviewed)abstract
- BACKGROUND: Human papillomavirus (HPV) in tonsillar carcinoma is correlated with favourable clinical outcome. Here, p16(INK4A), in situ HPV DNA hybridisation (ISH) and HPVL1 capsid detection were evaluated in tonsillar carcinoma to predict the response to radiotherapy (RT) and prognosis. MATERIALS AND METHODS: Fifty-one pre-treatment paraffin-embedded tonsillar cancer biopsies were analysed. Immunohistochemistry (IHC) was used for p16(INK4A) and HPVL1 capsid analysis and PCR and ISH for HPV detection. RESULTS: High-risk HPV DNA was detected by PCR in 49% of the tumours. P16(INK4a) staining was correlated to HPV In the high-grade p16(INK4a) staining group, 94% had a complete RT response. High p16(INK4a) staining as well as the HPV PCR-positive cases had a favourable prognosis. HPV DNA ISH and L1 IHC could not predict RT response or clinical outcome. CONCLUSION: P16(INK4a) overexpression was correlated to HPV in tonsillar carcinoma and is useful for predicting RT response and prognosis in tonsillar carcinoma patients.
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