| 1. |
- Browall, Maria, et al.
(författare)
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The course of health related quality of life in postmenopausal women with breast cancer from breast surgery and up to five years post-treatment
- 2013
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Ingår i: Breast. - : Elsevier. - 0960-9776 .- 1532-3080. ; 49, s. S344-S345
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Tidskriftsartikel (refereegranskat)abstract
- Background: Previous studies include too few patients over 70 years to be able to assess treatment effects on Health Related Quality Of Life (HRQOL) in the older age group. We aimed to follow HRQOL in postmenopausal women (55-80 years) with breast cancer receiving adjuvant treatment, until five years post-treatment, and compare with a general population.Patients and methods: The patient sample included 150 women (adjuvant CT n=75 and RT n=75) and two reference samples from the Swedish SF-36 norm database.Results: Data from baseline showed significantly higher levels of physical functioning and general health among the patients compared to the reference sample, and significantly lower levels of bodily pain, emotional role functioning and mental health. Longitudinal analyses showed significant changes in all scales, and three different patterns (a decrease-stable, a decrease-increase, and a stable- increase pattern) were identified.Conclusion: Postmenopausal women seem to successfully manage the effects of adjuvant treatment on HRQOL.
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| 2. |
- Browall, Maria, et al.
(författare)
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The course of health related quality of life in postmenopausal women with breast cancer from breast surgery and up to five years post-treatment
- 2013
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Ingår i: European Journal of Cancer. - Oxon, United Kingdom : Elsevier. - 0959-8049 .- 1879-0852. ; 49, s. S344-S345
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cancer treatment of the elderly patients is an increasingly important concern since the risk for developing breast cancer increases with age. The effects of adjuvant chemotherapy on the breast cancer disease seem to be as good for pre and postmenopausal patients, at least for hormone receptor negative patients. However, very few patients older than 65 years are included in randomised studies. In clinical practice, it is common that elderly women are offered less chemotherapy, because of the unsubstantiated belief that they will experience a larger number and more severe adverse effects as well as poor functional outcomes and significant decrements in health related quality of life (HRQOL). The aim of this study was to follow HRQOL in postmenopausal women (55−80 years) with breast cancer receiving adjuvant treatment after surgery, until five years post-treatment, and compare with a general population.Patients and Methods: The patient sample included 150 women (adjuvant CT n = 75 and RT n = 75) and two reference samples from the Swedish SF- 36 norm database.Results: The results showed that at baseline the women in the patient sample experienced significantly higher levels of physical functioning and general health compared to the general population. They also experienced significantly less bodily pain, lower emotional role functioning and mental health. Five years after completion of treatment, the patient sample experienced better HRQOL than the reference sample in all domains, supporting our hypothesis that the impact on HRQOL would have been resolved over time for these patients. Conclusion: Postmenopausal women (55−80 years) seem to successfully manage the effects of adjuvant treatment on HRQOL.
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| 3. |
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| 4. |
- Bäckman, Malin, et al.
(författare)
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A randomized pilot study with daily walking during adjuvant chemotherapy for patients with breast and colorectal cancer
- 2014
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Ingår i: Acta Oncologica. - 0284-186X .- 1651-226X. ; 53:4, s. 510-520
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Tidskriftsartikel (refereegranskat)abstract
- Background. Physical activity during chemotherapy has been shown in several studies to reduce fatigue, improve symptoms and impact positively on health-related quality of life (HRQoL). Challenges associated with intervention studies on physical activity during cancer treatment relate to consistent adherence. The primary objective was to study feasibility and adherence of physical activity intervention among patients with cancer during adjuvant chemotherapy treatment. The secondary objective was to investigate the effects of physical activity on health aspects, including HRQoL, symptoms and surrogate markers for cardiovascular disease. Material and methods. This randomized controlled trial included patients with breast cancer (BRCA) and colorectal cancer (CRC) during adjuvant chemotherapy. The intervention continued for 10 weeks and included daily walks of 10 000 steps and a weekly supervised group walk. Adherence was assessed by a pedometer and the number of participants who reported step counts every week and percentage of participants who achieved the target steps every week. Results. Adherence average reached 91% during the intervention period; in total 74% completed the exercise intervention. The majority of the participants achieved an average of 83% of the target of 10 000 steps per day for 10 weeks. There was a significant increase in daily physical activity (p = 0.016) in the intervention group. Significant differences were also found for some breast cancer-specific symptoms [swelling, mobility and pain (p = 0.045)]. The study showed a relatively small weight gain an average of 0.9 kg in the intervention group and 1.3 kg in the control group. Conclusion. Physical activity in the form of walking is feasible during adjuvant chemotherapy treatment despite increasing symptoms. The physical activity increased in the intervention group during the study time and had a positive impact on breast symptoms and the weight gain was lower in comparison to previous studies.
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| 5. |
- Dahl, Oili, et al.
(författare)
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Adapting to life after burn injury : reflections on care
- 2012
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Ingår i: Journal of Burn Care & Research. - 1559-047X .- 1559-0488. ; 33:5, s. 595-605
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Tidskriftsartikel (refereegranskat)abstract
- A burn injury is an unforeseen event that means physical and psychological trauma for the person afflicted. The trauma experienced by different individuals varies greatly, as do perceived problems during care, rehabilitation, and throughout the remainder of life. The purpose of this study was to explore burn patients' experiences of adapting to life after burn injury to acquire a deeper understanding of the most important issues for patients when providing care during and after a burn injury. A qualitative approach was applied, and interviews were conducted with 12 adult burn patients (8 men and 4 women) 6 to 12 months postburn. The interviews were analyzed using Kvales' method for structuring analysis and comprised a close reading and interpretation of the texts. Analysis focused on the personal experiences of burn patients living after burn injury and treatment. Struggling with the consequences of burn injury and how patients perceived life today after treatment are important issues for adapting to life after burn injury. New experiences of a fragile body, coping with daily life, and reflections of burn care were also prominent themes. Patients with burn injuries need adequate repeated information about the plan for their care, about the physiological changes, and more support to handle the trauma event. The patients would also like to be more involved in their care. A program of support and preparatory work to help the patient to cope with the new bodily sensations and new body image is necessary and should begin during hospital care. A multidisciplinary team approach for pain treatment needs to be prioritized. In addition, multidisciplinary follow-up after burns need to include patients with minor burns. (J Burn Care Res 2012;33:595-605)
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| 6. |
- Dahl, Oili, et al.
(författare)
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The cultural adaptation and validation of a Swedish version of the Satisfaction With Appearance Scale (SWAP-Swe)
- 2014
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Ingår i: Burns. - : Elsevier BV. - 0305-4179 .- 1879-1409. ; 40:4, s. 598-605
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Tidskriftsartikel (refereegranskat)abstract
- Background: Body image dissatisfaction is a source of stress after burns and it is important to attempt to objectively measure this aspect. Unfortunately, there are no Swedish questionnaires to assess satisfaction of appearance after burns,. Aim: The aim of this study was to translate, culturally adapt and validate the Satisfaction With Appearance Scale (SWAP) into Swedish from American English to be used in the context of burn care. Method: The SWAP was translated and cross-cultural adapted inspired by the guidelines by Guillemin. Pre-testing with 13 burn patients was conducted and 90 patients tested the questionnaire in order to determine its psychometric properties. Results: Cronbach's alpha was 0.89 indicating a high level of internal consistency of Swedish SWAP. Test for construct validity showed that length of hospital stay, more severe burns and female gender generated significantly higher scores in SWAP-Swe. The principal-components analysis found similar subscales according to the original SWAP that together accounted for 68% of the total variance. Conclusions: SWAP-Swe is a reliable and valid instrument for use in a Swedish speaking population. The questionnaire was perceived to be relevant for usage in the context of burn care and is well understood by the patients. (C) 2013 Elsevier Ltd and ISBI. All rights reserved.
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| 7. |
- Drott, Jenny, 1976-
(författare)
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Neurotoxic side effects and impact on daily life in patients with colorectal cancer with adjuvant oxaliplatin-based chemotherapy
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Colorectal cancer (CRC) is one of the most common cancers globally. Chemotherapeutic drugs are frequently used in postoperative treatment. The platinum compound oxaliplatin (OXA) is an option for adjuvant treatment of patients with resected CRC, and has been shown to improve survival. OXA-induced neurotoxic side effects are common (e.g. sensitivity to cold, numbness). Neurotoxicity can interfere with the patient’s daily living and affect ability to carry out activities. Because there is no evidence for effective treatment in terms of eliminating neurotoxic side effects, the most successful approaches include early identification, reduction of dose and interruption of treatment. Current research has identified a need for patient-oriented evidence in terms of long-term follow-up of neurotoxicity.Aim: The overall aim of this thesis was to explore OXA-induced neurotoxic side effects in patients with colorectal cancer, and the influence on patients’ daily lives during and post OXA treatment.Methods: The thesis is based on four studies, and includes an analysis of medical records, as well as prospective quantitative and qualitative approaches with longitudinal data collection through a mobile phone-based system. The studies were performed at oncology departments in four hospitals in Sweden. Inclusion criteria were that patients should be at least 18 years of age, and should have been treated with chemotherapy, including OXA (FOLFOX, XELOX), in an adjuvant setting for CRC stages II-III. Study I had a retrospective design, and data involved (n=61) medical records. A structured protocol was used to evaluate the documentation of patients’ neurotoxic side effects. In studies II and III, ten patients were recruited using a strategy of purposeful and consecutive selection according to the inclusion criteria, where OXA-related neurotoxic side effects were assessed. A total of 10 interviews were carried out when neurotoxic side effects appeared (II), and after completed OXA treatment (3, 6 and 12 month’s follow-up) 25 repeated interviews were conducted (III). The prospective longitudinal study IV aimed to identify and assess patient-reported outcomes in terms of neurotoxic side effects, and their impact on patients’ daily activities (n=46). An Oxaliplatin-associated Neurotoxicity Questionnaire (OANQ) was administered in real time to indicate patientreported outcomes. In total, 370 questionnaire responses were available for analysis.Results: The results from the retrospective study (I) showed that a free description of the degree of neurotoxic side effects was given in the patients’ medical records. No formal assessment had been used in the documentation. The findings of the two qualitative studies contribute knowledge about how patients endure neurotoxic side effects early in the treatment phase, and how they learn to live with neurotoxicity in the long-term perspective. Patients coped with their side effects by developing different self-care strategies to restore normality in their daily lives (II-III). Neurotoxic side effects interferes with the patient’s daily activities in a variety of ways. These side effects change in terms of their character and their location in the body over time. The most frequent side effects during treatment were cold-precipitated tingling in the upper extremities and in the mouth/throat. At the end of treatment, neurotoxicity in the lower extremities was considered high and interfered with the patients’ daily activities. The results show significant differences between baseline data, and nine of the patients had not returned to baseline after one year (IV).Conclusion: Neurotoxic side effects affect patients’ daily activities in different ways, with an impact on their physical, psychological, emotional and social life. Patients endured and coped with their side effects in different ways involving self-care strategies to restore normality. The patients’ daily lives were affected by numbness and tingling in the legs and tingling in upper extremity, and they had learned to live with these side effects. The neurotoxic side effects changed character and localisation over time. These results should be taken into account when patients are informed about treatment, and in the dialogue about the benefits and risks.
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| 8. |
- Eicher, Manuela, et al.
(författare)
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Training breast care nurses throughout Europe : the EONS post basic curriculum for breast cancer nursing
- 2012
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Ingår i: European Journal of Cancer. - : Elsevier BV. - 0959-8049 .- 1879-0852. ; 48:9, s. 1257-1262
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Tidskriftsartikel (refereegranskat)abstract
- Background: The European Parliamentary Group on Breast Cancer and the European Society of Breast Cancer Specialists state that there is a need for EU agreed guidelines on breast care nursing and training. Therefore the European Oncology Nursing Society (EONS) commissioned the development of a post-basic curriculum for breast cancer nursing. Purpose: The goal was to define a European curriculum for the training of breast care nurses. Methods: The curriculum was developed using a variety of sources, including guidelines from a number of European and other countries world wide, relevant literature and input from an expert panel of senior European nurses with expertise in breast care nursing. Results: An English language, European curriculum of breast care nursing was developed at a postbasic level to provide guidance for the training of breast care nurses throughout Europe. Definitions for breast care nurse roles and activities and levels of practice, as well as indicative content are provided. Conclusions: The training of nurses in breast cancer care should be mandatory and common practice for European countries. To enhance comparability and standard development, the indicative content should be applied in all future post-basic education. (C) 2011 Elsevier Ltd. All rights reserved.
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