| 1. |
- Hedayati, Elham, et al.
(författare)
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Cognitive, psychosocial, somatic and treatment factors predicting return to work after breast cancer treatment
- 2013
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 27:2, s. 380-387
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Tidskriftsartikel (refereegranskat)abstract
- Scand J Caring Sci; 2013; 27; 380387 Cognitive, psychosocial, somatic and treatment factors predicting return to work after breast cancer treatment Background: Breast cancer (BC) may affect the ability to work. In this study, we want to identify any associations between cognitive, psychosocial, somatic and treatment factors with time to return to work (RTW) among women treated for BC. Methods and participants: At eight (baseline) and 11(follow-up) months after BC diagnosis, women who had received adjuvant treatment for early BC at Stockholm South General Hospital completed the Headminder neuropsychological tests to obtain the Cognitive Stability Index (CSI), the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire and its Breast Cancer Module. At both time points, we compared the scores from women who had returned to work with those who had not. We also reviewed the medical certificates of women still on sick leave at 8, 11 and 18months after diagnosis to determine why they had not returned to work. Results: At baseline, 29 of 45 enroled women were working and 15 were not (one dropped out after baseline testing). The 14 women still not working 11months after BC diagnosis had more advanced BC (OR=3.64, 95% CI 2.017.31), lymph-node involvement (OR=18.80, 95% CI 5.3290.69) and Her 2-positive tumours (OR=10.42,95% CI 2.1965.32) than did working women. None of the scores for the four cognitive domains changed significantly at follow-up in either group. Comments on the medical certificates generally supported these findings. Independently of any adjuvant cancer therapy, overall quality of life improved and most women did RTW 18months after BC diagnosis. Conclusions: Chemotherapy is associated with longer periods of sick leave. Cognitive functions do not predict RTW. Independently of any adjuvant therapy, most women eventually RTW in a few months. The ability to predict RTW after BC treatment should help prepare higher-risk patients for delayed RTW and allow earlier interventions to restore their social relations and quality of life.
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| 2. |
- Johnsson, Aina, et al.
(författare)
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Improvements in physical and mental health following a rehabilitation programme for breast cancer patients.
- 2011
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Ingår i: European Journal of Oncology Nursing. - : Elsevier BV. - 1462-3889 .- 1532-2122. ; 15:1, s. 12-5
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Tidskriftsartikel (refereegranskat)abstract
- More effective treatments have resulted in an increase in the number of breast cancer survivors and in the demand for rehabilitation. This study shows improvements in health and satisfaction with health, but cannot conclude this result as only an effect of the rehabilitation programme. Since only a few studies have until now shed light on the benefits of in-patient rehabilitation following a breast cancer diagnosis, there is an urgent need for continued research in this area.
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| 3. |
- Johnsson, Aina, et al.
(författare)
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Side effects and its management in adjuvant endocrine therapy for breast cancer : a matter of communication and counseling
- 2023
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Ingår i: Breast Cancer. - : Sage Publications. - 1178-2234. ; 17, s. 1-17
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Women with a newly diagnosed hormone receptor-positive breast cancer are offered adjuvant endocrine therapy (AET). Although the treatment reduces the risk of relapse and death not all women are adherent to it. Many factors, including the therapy’s menopausal side effects, can adversely affect adherence to the treatment. This study explores the extent to which women treated with AET perceived that health care providers addressed their side effects.Methods: Ten focus groups were set up, containing between four to nine women. In total, 58 women participated in the study—45 from the Stockholm metropolitan region and 13 from the scarcely populated Norrbotten region. The interviews were analyzed using qualitative content analysis with an inductive approach.Results: The women were usually satisfied with the care they received from the health care providers. However, their experiences were more complex when it came to their satisfaction with the care in terms of the menopausal side effects of therapy, sexuality in particular. The participants reported that their healthcare providers rarely asked about sex life-related side effects of the treatment.Conclusions: Health care providers need to communicate and consult about issues related to their patients’ sex lives following their breast cancer diagnosis and during their treatment.
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| 4. |
- Johnsson, Aina
(författare)
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The rehabilitation process after breast cancer diagnosis : factors of importance for return to work
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The most common female cancer in Western countries is breast cancer and women diagnosed with this disease are often under 65 years old. With increasing prevalence of survivors it is important to shed light on problems facing these women after diagnosis and treatment. The overall aim of this thesis was to study the rehabilitation process following a breast cancer diagnosis for women at working age by examining factors related to type of treatment, tumour stage, socio-demographic status, health status, working condition, life satisfaction, and coping skills, and their association with return to work. In this thesis both quantitative and qualitative approaches are represented in three longitudinal cohort studies and a narrative interview study (16 enrolled women). The quantitative studies are based on two different sets of material of women treated for breast cancer (270 respective 102 enrolled women). Study I investigated whether factors such as type of treatment, tumour stage, educational level, matrimonial status, and presence of under-age children were associated with long-term problems in returning to work in women with breast cancer treated with endocrine therapy. The use of adjuvant endocrine therapy was associated with a twofold increase in the odds ratio of not having returned to work, although the confidence interval of this ratio was wide and included unity. Tumour stage (pN1-4+) was negatively associated with work status, possibly because of its association with adjuvant chemotherapy and radiotherapy to the regional nodes. Socio-demographic factors were not significantly associated with return to work. The aim of Study II was to identify factors contributing to a successful return to the labour market using the narratives of women treated for breast cancer. All the women strove to belong to the labour market, but the study also revealed how women´s perceptions of the value of employment changed. The quality of social support received from employers and co-workers differed between women who returned to work and those still sick-listed one year after breast cancer treatment. Study III investigated if treatment type, socio-demographic factors, health status, and work-related factors could predict return to work 10 months after surgery for early-stage breast cancer in women. Axillary node dissection, treatment with chemotherapy, and high demands at work were shown to play an important role in return to work for women with early-stage breast cancer. Socio-demographic factors were not significantly associated with return to work. The aims of Study IV were to generate new knowledge about life satisfaction, coping and rehabilitative measures taken after early-stage breast cancer treatment and the association of these concepts with return to work. Global life satisfaction was higher among the working women at both assessments. The working women used more positive coping resources compared with the sick-listed women, especially if treated with chemotherapy. Few of the sick-listed women received rehabilitation. The principal finding was that most of the studied women successfully returned to work after their active cancer treatments were completed. Type of treatment as well as work-related factors, life satisfaction and coping skills were associated with return to work.
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| 5. |
- Klernäs, Pia, et al.
(författare)
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Health-related quality of life in patients with lymphoedema - a cross-sectional study
- 2018
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 32:2, s. 634-644
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Lymphoedema may cause complex problems that can strongly influence patients' health-related quality of life (HRQoL). The main purpose of this study was to investigate the impact of lymphoedema on HRQoL in patients with varying forms of lymphoedema. Methods: The Lymphoedema Quality of Life Inventory (LyQLI), measuring three domains, physical, psychosocial and practical, and the Short Form 36 Health Survey Questionnaire (SF-36), measuring eight health domains, were sent to 200 lymphoedema patients. Out of those who answered both questionnaires, 88 patients had lymphoedema secondary to cancer treatment and they additionally received the Functional Assessment of Cancer Therapy Scale-General (FACT-G). The relation between continuous variables and the three domains were analysed by Spearman's correlation coefficients, and Kruskal-Wallis test was used to analyse categorical variables. Results: Altogether 129 patients completed the LyQLI and SF-36 and 79 of them also completed FACT-G. Twenty per cent had a high mean score (≥2.0) in at least one domain of the LyQLI, thus having a low HRQoL. Lower HRQoL was found in the practical domain of LyQLI in patients with lower limb lymphoedema compared to patient with lymphoedema in upper limb or head/neck (p = 0.002) and in patients working part-time compared to patients working full-time (p = 0.005). The impact on HRQoL tended to decrease with age, with a significant correlation in the psychosocial domain (rs = 0.194, p = 0.028). Compared with the general Swedish population, patients with lymphoedema scored significantly lower in general health (p = 0.006), vitality (p = 0.002) and social functioning (p = 0.025) assessed by the SF-36. From a cancer-specific view, HRQoL was similar to other Swedish studies using the FACT-G. Conclusions: This study indicates that about 20% of the patients with lymphoedema had major impact on their HRQoL. More effort and research is needed to identify, understand and support groups of patients with severe lymphoedema-related problems.
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| 6. |
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| 7. |
- Klernäs, Pia, et al.
(författare)
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Quality of Life Improvements in Patients with Lymphedema After Surgical or Nonsurgical Interventions with 1-Year Follow-Up
- 2020
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Ingår i: Lymphatic Research and Biology. - : Mary Ann Liebert Inc. - 1539-6851 .- 1557-8585. ; 18:4, s. 340-350
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Tidskriftsartikel (refereegranskat)abstract
- Background: Lymphedema may impact patients' health-related quality of life (HRQoL). The purpose of this study was to evaluate HRQoL after two different treatments to the 12-month follow-up point. Methods and Results: Study participants were patients with moderate lymphedema in the upper or lower limb who attended a Swedish rehabilitation program (RP) undergoing conservative treatment, or those with severe, chronic lymphedema dominated by excess adipose tissue, who underwent liposuction (LS) combined with controlled compression therapy (CCT) in Australia, Scotland, or Sweden. The patients completed the Lymphedema Quality of Life Inventory (LyQLI) before intervention and after 1, 3, 6, and 12 months. Mean values and standard deviations were calculated for total limb volume and excess limb volume. Mean values were also calculated for the three LyQLI domains (physical, psychosocial, and practical). To detect and analyze differences in LyQLI responses in the three domains, the Wilcoxon signed rank test was performed. In the RP, 18 eligible patients completed the LyQLI. The results show improvements in HRQoL in physical (p = 0.003) and psychosocial domains (p = 0.002) at 1 month after the RP, with results remaining steady for 12 months for the physical domain (p = 0.024). Fifty-seven eligible LS patients completed the LyQLI. The results show improvements in HRQoL in all three domains (p < 0.001), with results remaining steady up to the 12-month follow-up (p < 0.001). The total volume in affected limb and the excess volume decreased significantly in both patient groups 1 month after intervention (p < 0.001). Conclusions: Treatment with a conservative RP in moderate lymphedema or with LS combined with CCT in severe lymphedema improves HRQoL.
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| 8. |
- Klernäs, Pia, et al.
(författare)
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Test of Responsiveness and Sensitivity of the Questionnaire "lymphedema Quality of Life Inventory"
- 2018
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Ingår i: Lymphatic Research and Biology. - : Mary Ann Liebert Inc. - 1539-6851 .- 1557-8585. ; 16:3, s. 300-308
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Tidskriftsartikel (refereegranskat)abstract
- Background: Lymphedema may affect patients' health-related quality of life (HRQoL) and thus a disease-specific questionnaire is needed. The Lymphedema Quality of life Inventory (LyQLI) has been tested for reliability and validity. The purpose of this study was to test the LyQLI for responsiveness and sensitivity. Methods and Results: The study participants were patients with lymphedema in the upper or lower limb, attending a Swedish rehabilitation program (RP) and undergoing conservative treatment without surgery (RP-sample), or undergoing liposuction (LS) in Australia, Scotland, and Sweden (LS-sample). Mean values for the three LyQLI domains (physical, psychosocial, and practical) were calculated before and 1 month after intervention, and the paired t-Test was used to detect group differences. Responsiveness was calculated using standardized response mean (SRM), and sensitivity was analyzed with box plots and an independent t-Test to detect group differences. Eighteen patients in the RP-sample and 50 in the LS-sample were studied, and both samples demonstrated increased HRQoL after intervention. The changes were significant in all domains, except for the practical domain in the RP-sample. The SRM for the three LyQLI domains (physical, psychosocial, and practical) were 0.8, 0.8, and 0.4, respectively, in the RP-sample and 0.7, 1.2, and 0.9 in the LS-sample. Statistical testing indicated that the LyQLI was sensitive enough to reveal differences between patient groups. Conclusions: LyQLI responsiveness and sensitivity indicated that the tool can be used to evaluate patients undergoing conservative or surgical lymphedema treatments.
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| 9. |
- Stenmarker, Margaretha, et al.
(författare)
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Morbidity and mortality among children, adolescents, and young adults with cancer over six decades : a Swedish population-based cohort study (the Rebuc study)
- 2024
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Ingår i: The Lancet Regional Health. - : Elsevier. - 2666-7762. ; 42
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Tidskriftsartikel (refereegranskat)abstract
- Background Despite progress in managing cancer in children, adolescents, and young adults (CAYAs), persistent complications may impact their quality of life. This study covers the morbidity and mortality, among CAYAs, with the aim to investigate the influence of socioeconomic factors on outcomes. Methods This retrospective matched cohort study included the entire Swedish population of individuals under 25 with cancer 1958 - 2021. The population was identified from the Cancer Register, and controls were paired 1:5 based on age, sex, and residence. Multiple registers provided data on morbidity, mortality, and demographics. Findings This survey covering 63 years, identified 65,173 CAYAs and matched controls, a total of 378,108 individuals (74% females). CAYAs exhibited a 3.04 -times higher risk for subsequent cancer (Odds ratio (OR) 95% confidence interval (CI) 2.92 - 3.17, p < 0.0001), a 1.23 -times higher risk for cardiovascular disease (OR 95% CI 1.20 - 1.26, p < 0.0001), and a 1.41 -times higher risk for external affliction (OR 95% CI 1.34 - 1.49, p < 0.0001). CAYAs had a higher mortality hazard, and after adjusting for socioeconomic factors, males, individuals born outside Europe, and those with greater sick -leave had a higher association with mortality, while education and marriage showed a beneficial association. Interpretation The Rebuc study, showed an increased risk for serious complications among young cancer patients in Sweden. Patient -specific variables, demographics, and socioeconomic factors influenced mortality. These results underscore the impact of cancer on the health and lifespan of young individuals and the necessity for further research to address socioeconomic disparities in cancer care.
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| 10. |
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