| 1. |
- Ander, Malin, 1983-, et al.
(författare)
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A preliminary open trial of individualised cognitive behavioural therapy for young survivors of cancer during adolescence: initial findings and conceptualisation of distress
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Objective: A subgroup of adolescent and young adult (AYA) survivors of cancer in adolescence report high levels of psychological distress. Empirically-supported treatments tailored to the concerns experienced by this population are lacking. The aims of this study were to (1) conduct a preliminary evaluation of an individualised cognitive behavioural therapy (CBT) intervention for adolescent and young adult (AYA) survivors of cancer during adolescence and (2) identify and conceptualise cancer-related psychological concerns using cognitive-behavioural theory.Methods: A single-arm trial in which ten AYA (17-25 years) survivors of cancer during adolescence were offered up to 15 sessions of individualised CBT guided by behavioural case formulations was undertaken. Clinical outcomes were assessed at baseline, post-treatment, and three months follow-up. Before commencing treatment, two individual qualitative interviews were conducted with each participant. Analysis of cancer-related concerns was guided by qualitative framework analysis and theoretical thematic analysis, and cognitive-behavioural theory was used to inform identification of themes.Results: Ten of 201 potential participants invited to participate were included resulting in an overall participation rate of 5%. Nine participants completed treatment and eight completed the follow-up assessment. The majority of concerns reported were cancer-related and conceptualised as social avoidance, fear and avoidance of emotions and bodily symptoms, low mood and unbalance in activity, and worry and rumination.Conclusions: Given significant difficulties with recruitment, further research is needed to examine barriers and the impact of mental health literacy and stigma on help seeking in the AYA cancer survivor population. Internet-administered CBT self-help tailored towards the main presenting concerns of AYA cancer survivors may be a promising solution.
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| 2. |
- Ander, Malin, 1983-
(författare)
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Cancer during adolescence : Psychological consequences and development of psychological treatment
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of the present thesis was to examine long-term psychological distress following cancer during adolescence and to develop a tailored psychological intervention to reduce cancer-related distress experienced by young survivors of adolescent cancer that was feasible and acceptable.Study I adopted a longitudinal design, assessing health-related quality of life (HRQOL) and symptoms of anxiety and depression among adolescents diagnosed with cancer from shortly after diagnosis (n=61) up to 10 years after diagnosis (n=28). Findings suggest that development of HRQOL and anxiety and depression is not linear and whilst the majority adjust well, a subgroup report long-term elevated distress. In Study II, experiences of cancer-related psychological distress were explored using unstructured interviews. Participants described cancer treatment as a mental challenge, felt marked and hindered by the cancer experience, and struggled with feelings of inadequacy and insecurity, existential issues, and difficulties handling emotions. Study III was a preliminary investigation of individualised cognitive behavioural therapy (CBT), alongside the identification and conceptualisation of cancer-related concerns using cognitive-behavioural theory. Significant difficulties with recruitment were encountered. Participants reported cancer-related concerns conceptualised as social avoidance, fear and avoidance of emotions and bodily symptoms, imbalance in activity, and worry and rumination. In Study IV, the acceptability and feasibility of an internet-administered CBT based self-help intervention (ICBT) for young persons diagnosed with cancer during adolescence was examined using an uncontrolled design and embedded process evaluation. The study protocol for Study IV was included in this thesis along with preliminary findings demonstrating significant difficulties with recruitment.Overall, findings suggest that whilst the majority of survivors of adolescent cancer adjust well over time a subgroup report elevated levels of distress and a range of distressing cancer-related experiences. A number of cancer-related difficulties were identified in Study II and III, which may be used to inform the development of future psychological treatments for the population. Preliminary investigation of the psychological interventions examined within this thesis further highlights the need for future development work to enhance the feasibility and acceptability of psychological support for the population.
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| 3. |
- Ander, Malin, et al.
(författare)
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Development of health-related quality of life and symptoms of anxiety and depression among persons diagnosed with cancer during adolescence : a 10-year follow-up study
- 2016
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Ingår i: Psycho-Oncology. - : Wiley. - 1057-9249 .- 1099-1611. ; 25:5, s. 582-589
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The main aim was to investigate the development of health-related quality of life (HRQOL) and symptoms of anxiety and depression in a cohort diagnosed with cancer during adolescence from shortly after up to 10 years after diagnosis.Methods: Participants (n = 61) completed the SF-36 and the HADS shortly; six, 12, and 18 months; and two, three, four, and 10 years (n = 28) after diagnosis. Polynomial change trajectories were used to model development.Results: Polynomial change trajectories showed an initial increase which abated over time into a decrease which abated over time for the SF-36 subscales Mental Health and Vitality; an initial decline which abated over time into an increase for HADS anxiety; and an initial decline which abated over time into an increase which abated over time for HADS depression. The SF-36 mental component summary showed no change from two to 10 years after diagnosis whereas the SF-36 physical component summary showed an increase from two years after diagnosis which declined over time. Ten years after diagnosis 29% reported possible anxiety.Conclusions: Development of HRQOL and symptoms of anxiety and depression appears to be nonlinear among persons diagnosed with cancer during adolescence. Well into permanent survivorship an increase in symptoms of anxiety is shown and approximately a third of the participants report possible anxiety. The findings indicate the need for: studies designed to pinpoint the times of highest psychological risk, clinical follow-up focusing on psychological problems, and development of effective psychological interventions for survivors of adolescent cancer
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| 4. |
- Ander, Magnus, et al.
(författare)
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Elchockvapen som hjälpmedel vid polisiära ingripanden : En vetenskaplig utvärdering av Polismyndighetens försöksverksamhet med elchockvapen 2018-2019
- 2020
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- BAKGRUND: Ur ett internationellt perspektiv har det, inom polisen, under de senaste åren skett en ökning i användandet av mindre dödliga vapen. Dessa vapen används för att ta kontroll över potentiellt farliga och icke samarbetsvilliga personer. Ett vanligt förekommande mindre dödligt vapen är elchockvapen (ECV). Elchockvapen har fram till 2018 inte använts i Sverige, men Polismyndigheten har under åren 2018–2019 genomfört en försöksverksamhet med ECV.SYFTE: Syftet med undersökningen var att utvärdera Polismyndighetens försöksverksamhet med ECV, samt att undersöka vilken legitimitet polisens användning av ECV har bland allmänheten.METOD: Både kvantitativa och kvalitativa data samlades in för att utvärdera försöket med ECV. Mätningar före, under, och i slutet av försöksverksamheten genomfördes med hjälp av en enkät. Enkäten besvarades av två grupper av poliser; en grupp som ingick i försöksverksamheten med ECV samt en kontrollgrupp poliser som inte ingick i försöksverksamheten. För att fördjupa förståelsen för enkätresultaten genomfördes djupintervjuer och fokusgruppsintervjuer med poliser som hade erfarenhet av ECV under försöksverksamheten. För att undersöka legitimitetsaspekter utifrån ett medborgarperspektiv genomfördes fokusgrupper med deltagare från allmänheten. Data från Polisens arbetsskadesystem LISA inhämtades för att undersöka ECV:s inverkan på skador hos poliserna.RESULTAT: Enkätresultaten visade inga skillnader mellan delaktiga och kontrollgrupp när det gäller upplevelse av stressfulla situationer. Upplevelsen av trygghet vid ingripanden med hög grad av motstånd eller när polisen blir fysisk angripen har dock ökat för de poliser som deltagit i ECVförsöket, jämfört med kontrollgruppen. Intervjuresultaten åskådliggör också att tillgången till ECV bidrar till att minska upplevelsen av stress i våldsamma situationer genom att ECV ökar tryggheten i sådana situationer. Intervjuresultaten påvisar även att tillgången till ECV gör att man slipper använda andra potentiellt skadligare våldshjälpmedel såsom fysiska metoder och skjutvapen. Enkätresultatet visar ingen skillnad mellan de som ingick i försöksverksamheten och kontrollgruppen när det gäller att utsättas för hot, våld eller motstånd, eller att polis eller motpart blir skadade. Resultaten från intervjuer och fokusgrupper synliggör att poliserna upplever att ECV fyller en viktig funktion. Poliserna ser enbart fördelar med ECV och vissa menar att det är det bästa verktyg som de har fått. ECV upplevs kunna rädda liv, minska skador på polis och motpart, samt förbättra arbetsmiljön för poliser. Intervjuer och fokusgrupper pekar på att deltagarna upplever att ECV har en deeskalerande inverkan, vilket både kan minska våldsanvändningen, och förebygga våld mot polisen. Enkät och intervjuresultaten indikerar att ECV bidrar till en minskad användning av andra hjälpmedel såsom batong och pepparspray, vilka ofta ger mer skador på både motpart och polis. Deltagarna från allmänheten har uppfattningen att ECV är ett effektivt och bra verktyg för polisen, men lyfter vikten av att det finns en lyhördhet gällande vilka situationer som den används i och mot vem.SLUTSATSER: Utifrån våra enkätresultat är det svårt att dra några säkra slutsatser kring hur användandet av ECV inverkar på skador hos poliser och motpart. Erfarenheterna bland de delaktiga är dock att risken för våld och skador minskar markant, vilket är en viktig indikator. Tillgången till ECV kan öka trygghet och minska stress i ingripandesituationer där kraftigt motstånd och våld förekommer. ECV kan även minska användandet av pepparspray och batong, och det finns indikationer på att ECV har använts istället för skjutvapen. ECV kan underlätta val av hjälpmedel vid ingripanden med hög grad av hot och våld och kan ha en deeskalerande inverkan. Polisens användande av våldshjälpmedel, inklusive ECV, upplevs berättigat av informanterna från allmänheten.
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| 5. |
- Ander, Malin, et al.
(författare)
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Exploration of psychological distress experienced by survivors of adolescent cancer reporting a need for psychological support
- 2018
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 13:4
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Tidskriftsartikel (refereegranskat)abstract
- Objective In this qualitative study, we aimed to provide an in-depth exploration of cancer-related psychological distress experienced by young survivors of cancer during adolescence reporting a need for psychological support.MethodsTwo individual interviews were held with ten young survivors of cancer diagnosed in adolescence. The interviews were audio-recorded and transcribed verbatim. Analysis followed the guidelines for inductive qualitative manifest content analysis.ResultsThe survivors described distress experienced during and after the end of treatment. Five categories comprising 14 subcategories were generated. The categories included: A tough treatment, Marked and hindered, Not feeling good enough, Struggling with the fragility of life, and finally, An ongoing battle with emotions.Conclusion Young survivors of adolescent cancer reporting a need for psychological support described feeling physically, socially, and mentally marked by the cancer experience. They struggled with powerlessness, insecurity, social disconnection, loneliness, and feelings of being unimportant and a failure, and had difficulties understanding and managing their experiences. These concerns should be addressed in psychological treatments for the population irrespective of which approach or model is used to understand survivors’ difficulties. A transdiagnostic approach targeting processes that underpin different manifestations of distress may be effective.
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| 6. |
- Ander, Malin, et al.
(författare)
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Guided Internet-Administered Self-Help to Reduce Symptoms Of Anxiety and Depression Among Adolescents and Young Adults Diagnosed With Cancer During Adolescence (U-CARE: YoungCan) : study protocol for a feasibility trial
- 2017
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- Introduction A subgroup of adolescents and young adults diagnosed with cancer during adolescence reports elevated levels of anxiety and depressive symptoms and unmet needs for psychological support. Evidence-based psychological treatments tailored for this population are lacking. This protocol describes a feasibility study of a guided-internet-administered self-help programme (YoungCan) primarily targeting symptoms of anxiety and depression among young persons diagnosed with cancer during adolescence and of the planned study procedures for a future controlled trial. Methods/analysis The study is an uncontrolled feasibility trial with a pre-post and 3-month follow-up design. Potential participants aged 15-25years, diagnosed with cancer during adolescence, will be identified via the Swedish Childhood Cancer Registry. 30 participants will be included. Participants will receive YoungCan, a 12-week therapist-guided, internet-administered self-help programme consisting primarily of cognitive-behavioural therapy organised into individually assigned modules targeting depressive symptoms, worry and anxiety, body dissatisfaction and post-traumatic stress. Interactive peer support and psychoeducative functions are also available. Feasibility outcomes include: recruitment and eligibility criteria; data collection; attrition; resources needed to complete the study and programme; safety procedures; participants' and therapists' adherence to the programme; and participants' acceptability of the programme and study methodology. Additionally, mechanisms of impact will be explored and data regarding symptoms of anxiety, depression, post-traumatic stress, body dissatisfaction, reactions to social interactions, quality of life, axis I diagnoses according to the Mini International Neuropsychiatric Interview and healthcare service use will be collected. Exploratory analyses of changes in targeted outcomes will be conducted. Ethics/dissemination This feasibility protocol was approved by the Regional Ethical Review Board in Uppsala, Sweden (ref: 2016/210). Findings will be disseminated to relevant research, clinical, health service and patient communities through publications in peer-reviewed and popular science journals and presentations at scientific and clinical conferences.
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| 9. |
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| 10. |
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| 11. |
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| 12. |
- Hagström, Josefin, et al.
(författare)
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Heeding the psychological concerns of young cancer survivors : A single-arm feasibility trial of CBT and a cognitive behavioral conceptualization of distress
- 2020
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Ingår i: PeerJ. - : PeerJ. - 2167-8359. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundA subgroup of adolescent and young adult (AYA) survivors of cancer during adolescence report high levels of psychological distress. To date, evidence-based psychological interventions tailored to the cancer-related concerns experienced by this population are lacking. The present study aimed to (1) examine the feasibility and preliminary efficacy of an individualized cognitive behavioral therapy (CBT) intervention for AYA survivors of cancer during adolescence; and (2) identify and conceptualize cancer-related concerns as well as maintaining factors using cognitive-behavioral theory.MethodsA single-arm trial, whereby AYA survivors of cancer during adolescence (aged 17–25 years) were provided individualized face-to-face CBT at a maximum of 15 sessions. Clinical outcomes were assessed at baseline, post-intervention, and three-month follow-up. Intervention uptake, retention, intervention delivery, and reliable change index scores were examined. An embedded qualitative study consisted of two unstructured interviews with each participant pre-intervention. Along with individual behavioral case formulations developed to guide the intervention, interview data was analyzed to identify and conceptualize cancer-related concerns and potential maintaining factors.ResultsTen out of 213 potential participants invited into the study were included, resulting in an overall participation rate of 4.7%. Nine participants completed the intervention, with respectively seven and eight participants completing the post-intervention and three month follow-up assessment. The majority of reported cancer-related concerns and maintaining factors were conceptualized into four themes: social avoidance, fear of emotions and bodily symptoms, imbalance in activity, and worry and rumination.ConclusionsGiven significant recruitment difficulties, further research is required to examine barriers to help-seeking in the AYA cancer survivor population. However, the conceptualization of cancer-related concerns and maintaining factors experienced by the population may represent an important first step in the development of psychological support tailored toward AYA cancer survivors’ unique needs.
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| 13. |
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| 14. |
- Lehmann, Vicky, et al.
(författare)
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Negative and positive consequences of adolescent cancer 10 years after diagnosis : An interview-based longitudinal study in Sweden
- 2014
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Ingår i: Psycho-Oncology. - : Wiley-Blackwell. - 1057-9249 .- 1099-1611. ; 23:11, s. 1229-1235
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to provide insight into survivor-reported negative and positive consequences of cancer during adolescence 10 years after diagnosis and compare these with consequences reported 3 and 4 years after diagnosis. METHODS: Three, 4, and 10 years after diagnosis, survivors of adolescent cancer were interviewed about negative and positive consequences due to their cancer experience. Manifest content analysis was used to identify categories of reported consequences. Categories of consequences 10 years after diagnosis were compared with consequences reported 3 and 4 years after diagnosis. RESULTS: Seven categories of negative consequences were identified: bodily concerns, existential thoughts about loss and life (new at 10 years), psychological problems, difficulties interacting with others, health worries (new), fertility concerns (new), and frustrations about health care (new); and six categories of positive consequences: positive view of life, positive view of self, compassion for others (new), close relationships, gained knowledge about disease and health care, and financial gains. Consistent with previous time points, bodily concerns were reported most often. The majority of survivors (n = 22) reported both negative and positive consequences of their former disease. Few reported only negative (n = 2) or only positive consequences (n = 4). CONCLUSIONS: Ten years after diagnosis, most survivors reported both negative and positive consequences. New themes, relevant to young adulthood and long-term survival, were identified. Health care professionals treating young adult survivors may anticipate and address problems regarding physical health, fertility, and health care but may also reinforce positive affect by addressing survivors’ positive views of life, sense of self, and close relationships.
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| 15. |
- Ljungman, Lisa, et al.
(författare)
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Impressions that last : Particularly negative and positive experiences reported by parents five years after the end of a child's successful cancer treatment or death
- 2016
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:6
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe the experience of parenting a child diagnosed with cancer by examining particularly negative and positive experiences reported by parents of childhood cancer survivors and parents of children lost to cancer.METHODS: 168 parents (88 mothers, 80 fathers) participated. Data were collected five years after the end of successful treatment or the child's death. The parents' experiences were identified by open-ended semi-structured questions about particularly negative and positive experiences of the child's cancer. An inductive approach was used in which the manifest verbal content of the answers was analysed using content analysis.RESULTS: The analysis revealed eight categories of negative experience (child late effects; distressing events; healthcare; impaired relationships; long-term psychological consequences; own reactions; surrounding institutions; the fact that the child got cancer) and seven categories of positive experience (healthcare; improved relationships; long-term consequences for the child; personal development; support systems; treatment outcome; unexpected joy). The categories were related to past events or to the present situation. The findings indicate variations in experiences between parents of survivors and bereaved parents, and between fathers and mothers, as some experiences were only reported by parents of survivors and some experiences were only reported by mothers.CONCLUSIONS: The results highlight the importance of past and present events to parents, and accordingly the long-lasting impact of paediatric cancer on parents. The results also point to the wide range of negative as well as positive experiences involved in parenting a child diagnosed with cancer, and provide a comprehensive understanding of the overall experience for parents of children with cancer. Specifically, the findings give guidance to healthcare providers by illustrating the need to provide healthcare personnel with continuous training in communication skills, offering parents opportunities to meet other parents in the same situation and increasing the access to psychosocial supportive services and psychological care.
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| 16. |
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| 17. |
- Olsson, Erik, et al.
(författare)
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U-CARE : a research program on psychosocial care via the internet
- 2012
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Konferensbidrag (refereegranskat)abstract
- U-CARE is one of the Swedish government’s strategic research programs atUppsala University. The overarching goal is to promote psychosocial healthamong patients suffering from somatic disease and their significant others by means of self-help programs delivered via an internet platform. Another goal is to reduce costs for individuals and the society caused by emotional distress in response to somatic disease. Professionals within clinical psychology, health economics, and information systems collaborate to reach this goal.Approximately 20% of patients suffering from somatic disease as well as theirsignificant others experience a clinically relevant level of emotional distress in response to disease and treatment. This is in itself alerting, but becomes even moreproblematic since physicians and nurses show low sensitivity and specificityin detecting patients and significant others experiencing a clinically relevant level of distress. This can result in persistent distress causing human suffering as well as costs for individuals and the society.During 2010-2011 an internet platform: www.u-care.se to provide interactive support and cognitive behavioral therapy has been constructed within the U-CARE program. The platform supports, among other things, rule-based unfolding of self-help material for participants, interaction between participants and therapists, interaction within a participant community, and research including a detailed log of participants’ behaviors on the platform. In addition self-help programs of interactive support and cognitive behavioural therapy for adolescents with cancer: U-CARE: TeenCan, adults with cancer: U-CARE: AdultsCan, and adults having had a myocardial infarct: U-CARE: Heart to be provided via www.u-care.se have been constructed.Through a multi-disciplinary and design-oriented approach, the U-CARE program aims at developing new evidence-based knowledge in basic and applied psychosocial health care,and actively promoting its implementation in health care practice as well as in undergraduate and advanced education.
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| 18. |
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| 19. |
- Wallander, Linda, et al.
(författare)
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Textile Informed Structures - How to Braid a Roof, Translating the logic of textile structure into the scale of architecture
- 2019
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Ingår i: IASS Symposium 2019 - 60th Anniversary Symposium of the International Association for Shell and Spatial Structures; Structural Membranes 2019 - 9th International Conference on Textile Composites and Inflatable Structures, FORM and FORCE. - 9788412110104 ; , s. 2756-2763
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Konferensbidrag (refereegranskat)abstract
- There is a great variety of textiles materials, both in terms of the behaviour of the fibres they comprise and the assembly methods used to construct them. Hence, the definition of textile is expanded nowadays from including only conventional fabrics to encompassing surfaces with structures that follows the logic of textiles.[1] One can then refer to textile as a repetition of bindings, or joints, forming a non-hierarchical surface. Analogies between classical textile assembly methods of interlacing threads (triaxial weave and bobbin lace) and architectural structural systems are explored in this research. Similar to the work of Snelson the internal structural logic is identified by the joints used, and these typologies are mapped onto structures.[2] The resulting modules aim to be used for the assembly of structures in the scale of architecture. Like the assembly logic of the textiles, these structures have the potential to grow in all directions depending on spatial requirements while still retaining some kinetic properties. Subsequently, the result proposes two concepts: firstly a tensegrity weave structural system- combining triaxial woven textiles and tensegrity; secondly a reciprocal lace system where a basic pattern of bobbin lace is mapped onto reciprocal structures. The final concepts propose intriguing load bearing systems that illustrate the possibility to design and construct temporary structures able to seamlessly span irregular spaces.
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