| 1. |
- Eilegard, A, et al.
(författare)
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To loose a sister or brother to cancer
- 2007
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Ingår i: PEDIATRIC BLOOD & CANCER. - 1545-5009. ; 49:4, s. 508-508
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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- Surkan, P. J., et al.
(författare)
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Perceptions of inadequate health care and feelings of guilt in parents after the death of a child to a malignancy: a population-based long-term follow-up
- 2006
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Ingår i: J Palliat Med. - : Mary Ann Liebert Inc. - 1096-6218 .- 1557-7740. ; 9:2, s. 317-31
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Parental feelings of guilt can be a serious problem after the death of a child to a malignancy. This study identified predictors of feelings of guilt in parents during the year after a child's death. METHODS: The Swedish Cause of Death Register and Swedish Cancer Register were used to identify all parents in Sweden who had a child who died of a malignancy between 1992-1997. RESULTS: Among parents not reporting recent depression, those who were not confident that their child would immediately receive help from the staff in the hospital while he or she was sick with a malignancy (compared to those who felt partly or entirely sure, relative risk [RR] 4.0; 95% confidence interval [CI] 2.1-7.6), were at increased risk for reporting daily or weekly feelings of guilt in the year after the child's death. Parents who perceived that the staff in the pediatric cancer ward were incompetent were at increased risk (compared to parents reporting partial or total competence, RR 3.7; 95% CI 1.6-8.6). Compared to parents reporting that their children had moderate or much access, those who felt their children had little or no access to pain relief, dietary advice, anxiety relief, and relief of other psychological symptoms beside anxiety were at more than two times greater risk for reporting feelings of guilt. CONCLUSIONS: Bereaved parents' perceptions of inadequate health care were associated with subsequent feelings of guilt during the year following their child's death due to a malignancy.
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| 10. |
- Adami, HO, et al.
(författare)
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Time to abandon early detection cancer screening
- 2019
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Ingår i: European journal of clinical investigation. - : Wiley. - 1365-2362 .- 0014-2972. ; 49:3, s. e13062-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 22. |
- Guðmundsdóttir, R. B., et al.
(författare)
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Medication use in populations exposed to the 2010 Eyjafjallajökull eruption: an interrupted time series analysis
- 2022
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Ingår i: Bmj Open. - : BMJ. - 2044-6055. ; 12:5
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To assess the trends in medication use indicative of physical and psychological morbidity following the 2010 volcanic eruption in Eyjafjallajökull immediately after and during a 3-year period following the eruption. DESIGN: Population-based register study. SETTING: Eyjafjallajökull eruption in Iceland, 2007-2013. PARTICIPANTS: All residents in Iceland who received at least one medication dispensing were identified. Residents of exposed areas were classified into exposure groups (individual-level data) and residents in other parts of Iceland were included as a non-exposed group (aggregated data). INTERVENTION/EXPOSURE: Eyjafjallajökull erupted on 14 April 2010 and continued for 39 days, producing heavy ash fall in South Iceland. MAIN OUTCOME MEASURES: Using interrupted time series analysis, we examined annual and quarterly changes in medicine use, measured as number of dispensed defined daily dose (DDD) per 1000 individuals. We calculated the level shift (immediate change) and change in slope from pre-eruption to post-eruption (long-term change) in medication dispensing. RESULTS: Among exposed residents, there was a 6% decrease (95%CI -7% to -4%) in the annual number of dispensed DDDs 1-year post-eruption in the overall medication class, including analgesics (-5%, 95%CI -6% to -3%), hypnotics and sedatives (-9%, 95%CI -11% to -7%) and respiratory medications (-7%, 95%CI -9% to -5%; -8%, 95%CI -11% to -4%). Simultaneously, there was a 9% decrease (95%CI -14% to -4%) in the overall medication class among non-exposed residents. Moreover, among exposed residents, we observed change in slope of -4% (95%CI -7% to -1%) in the overall medication class, including for analgesics (-6%, 95%CI -8% to -3%) and other respiratory drugs (-10%, 95%CI -16% to -4%). CONCLUSION: Our findings indicate that the eruption did not lead to increases in medication dispensing among residents of exposed areas, rather decreases for some medicine classes. The results should be interpreted with caution since the content of each eruption differs.
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| 23. |
- Gudmundsdottir, R, et al.
(författare)
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Evacuation of Swedish survivors after the 2004 Southeast Asian tsunami: The survivors' perspective and symptoms of post-traumatic stress
- 2019
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 47:2, s. 260-268
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Following the 2004 Southeast Asian tsunami, Swedish authorities received public criticism for slow implementation of rescue work. Meanwhile, data are scarce on survivors’ perspectives and potential mental health symptoms associated with timing of evacuation. Therefore, the aim of this study was to investigate survivors’ contentment with evacuation time and whether duration at disaster site following the 2004 tsunami was associated with post-traumatic stress symptoms (PTSS) and psychological morbidity. Methods: Of 10,116 Swedish tsunami survivors who returned to Sweden in the first 3 weeks post tsunami, 4910 (49%) answered a questionnaire 14 months later including questions on evacuation time, contentment with evacuation time and PTSS (Impact of Event Scale). We used logistic regression to calculate odds ratios (OR) and 95% confidence intervals (95% CI) of PTSS by timing of evacuation adjusting for gender, age, education, various indicators of trauma exposure and pre-tsunami psychiatric diagnoses. Results: More than half of the survivors (53%) were content with evacuation time while 33% wanted later evacuation and 13% earlier evacuation. Compared with those evacuated 14–21 days post tsunami, individuals evacuated at day 1–4 presented with increased odds of PTSS (crude OR 3.0, 95% CI 2.0–4.5; and multivariable adjusted OR 2.0, 95% CI 1.3–3.0) and impaired mental health (crude OR 1.7, 95% CI 1.2–2.4; and multivariable adjusted OR 1.4 95% CI 1.0–2.0). Conclusions: One-third of Swedish tsunami survivors preferred a later evacuation from disaster sites. These findings call for further studies, with prospective designs, to disentangle the causal direction of the association between evacuation time and PTSS.
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| 25. |
- Hauksdottir, A., et al.
(författare)
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Towards better measurements in bereavement research: order of questions and assessed psychological morbidity
- 2006
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Ingår i: Palliat Med. - : SAGE Publications. - 0269-2163 .- 1477-030X. ; 20:1, s. 11-6
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to determine if the order of questions in a study on men who have lost a wife in cancer affects self-assessed measures of psychological morbidity. Data were collected from 76 men who had lost a wife owing to cancer in the breast, ovary or colon in 1999. They were randomly allocated to one of two questionnaires with identical content but varying design. One version began with questions about the wife's disease and ended with the respondent's current wellbeing (morbidity-last group). The other version had a reversed order (morbidity-first group). Results showed that the design of the questionnaire affected self-assessed psychological morbidity; all relative risks for these measures were above 1.0 in the morbidity-last group. The highest relative risk was obtained for anxiety (as measured by HADS), 3.4 (0.8-15.0), and depression (as measured by a visual-digital scale), 3.1 (1.2-8.5). Psychological morbidity is assessed as higher when questions appear in the end, rather than the beginning, of a bereavement-related questionnaire. In order to avoid a detrimental bias in a study on bereavement, psychological morbidity is probably best measured first in such a questionnaire.
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| 29. |
- Hunt, H., et al.
(författare)
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When death appears best for the child with severe malignancy: a nationwide parental follow-up
- 2006
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Ingår i: Palliative Medicine. - : SAGE Publications. - 0269-2163 .- 1477-030X. ; 20:6, s. 567-77
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Loss of a child to malignancy is associated with long-term morbidity among surviving parents. This study aims to identify particular sources of stress among parents of children with severe malignancy. METHODS: We attempted to contact all parents in Sweden who lost a child to cancer between 1992 and 1997. Some 449 parents answered an anonymous questionnaire, including a question regarding whether they ever thought that death would be best for the child with severe malignancy. RESULTS: Mothers whose children were unable to communicate during their last week of life were more likely to think that death would be best for the child (relative risk (RR): 1.6; 95% confidence interval (CI): 1.2-2.1). Fathers whose children faced six years or more with malignancy were more likely to think that death would be best for their child (RR: 2.1; 95% CI: 1.3-3.5). CONCLUSIONS: The inability of the child with severe malignancy to communicate increases the likelihood of mothers thinking that death would be best for the child, while longer duration of the child's illness increases the occurrence of this thought among fathers.
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| 34. |
- Kreicbergs, Ulrika, et al.
(författare)
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Anxiety and depression in parents 4-9 years after the loss of a child owing to a malignancy: a population-based follow-up
- 2004
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Ingår i: Psychol Med. - : Cambridge University Press (CUP). - 0033-2917 .- 1469-8978. ; 34:8, s. 1431-41
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Some consider the loss of a child as the most stressful life event. When the death is caused by a malignancy, the parents are commonly exposed not only to their own loss, but also to the protracted physical and emotional suffering of the child. We investigated parental risk of anxiety and depression 4-9 years after the loss of a child owing to a malignancy. METHOD: In 2001, we attempted to contact all parents in Sweden who had lost a child due to a malignancy during 1992--1997. We used an anonymous postal questionnaire and utilized a control group of non-bereaved parents with a living child. RESULTS: Participation among bereaved parents was 449/561 (80 %); among non-bereaved 457/659 (69%). We found an increased risk of anxiety (relative risk 1.5, 95 % confidence interval 1.1-1.9) and depression (relative risk 1.4, 95 % confidence interval 1.1-1.7) among bereaved parents compared with non-bereaved. The risk of anxiety and depression was higher in the period 4-6 years after bereavement than in the 7-9 years period, during which the average excess risks approached zero. Psychological distress was overall higher among bereaved mothers and loss of a child aged 9 years or older implied an increased risk, particularly for fathers. CONCLUSIONS: Psychological morbidity in bereaved parents decreases to levels similar to those among non-bereaved parents 7-9 years after the loss. Bereaved mothers and parents who lose a child 9 years or older have on average an excess risk for long-term psychological distress.
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| 35. |
- Kreicbergs, Ulrika, et al.
(författare)
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Care-related distress: a nationwide study of parents who lost their child to cancer
- 2005
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Ingår i: J Clin Oncol. - 0732-183X .- 1527-7755. ; 23:36, s. 9162-71
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Palliative care is an important part of cancer treatment. However, little is known about how care-related factors affect bereaved intimates in a long-term perspective. We conducted a population-based, nationwide study addressing this issue, focusing on potential care-related stressors in parents losing a child to cancer. METHODS: In 2001, we attempted to contact all parents in Sweden who had lost a child to cancer in 1992 to 1997. The parents were asked, through an anonymous postal questionnaire, about their experience of the care given and to what extent these experiences still affect them today. RESULTS: Information was supplied by 449 (80%) of 561 eligible parents. Among 196 parents of children whose pain could not be relieved, 111 (57%) were still affected by it 4 to 9 years after bereavement. Among 138 parents reporting that the child had a difficult moment of death, 78 (57%) were still affected by it at follow-up. The probability of parents reporting that their child had a difficult moment of death was increased (relative risk = 1.4; 95% CI, 1.0 to 1.8) if staff were not present at the moment of death. Ten percent of the parents (25 of 251 parents) were not satisfied with the care given during the last month at a pediatric hematology/oncology center; the corresponding figure for care at other hospitals was 20% (33 of 168 parents; P = .0163). CONCLUSION: Physical pain and the moment of death are two important issues to address in end-of-life care of children with cancer in trying to reduce long-term distress in bereaved parents.
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| 37. |
- Lu, Donghao, et al.
(författare)
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Suicide and suicide attempt after a cancer diagnosis among young individuals
- 2013
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Ingår i: Annals of Oncology. - : Elsevier BV. - 0923-7534 .- 1569-8041. ; 24:12, s. 3112-3117
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Tidskriftsartikel (refereegranskat)abstract
- Background: Data are scarce on the potential change in suicidal behavior among adolescents and young adults after receiving a cancer diagnosis.Patients and methods: We conducted a population-based cohort study including 7 860 629 Swedes at the age of >= 15 during 1987-2009. Among the cohort participants, 12 669 received a first diagnosis of primary cancer between the age of 15 and 30. We measured the relative risks (RRs) of suicidal behavior (defined as completed suicides or suicide attempts) after cancer diagnosis. We also carried out a case-crossover study nested within the cohort to adjust for unmeasured confounders.Results: Twenty-two completed suicides (versus 14 expected) and 136 suicide attempts (versus 80 expected) were identified among the cancer patients. The RR of suicidal behavior was 1.6 [ 95% confidence interval (CI), 1.4-1.9] after a cancer diagnosis, compared with cancer-free individuals. Risk increase was greatest immediately after diagnosis; the RR was 2.5 (95% CI 1.7-3.5) during the first year after diagnosis and was 1.5 (95% CI 1.2-1.8) thereafter. This pattern was similar for completed suicide and suicide attempts. The elevated risks were evident for majority of the main cancer types, except for cancer in thyroid, testis and melanoma. The case-crossover analysis of suicidal behavior during the first year after cancer diagnosis revealed similar results.Conclusions: Adolescents and young adults receiving a cancer diagnosis are at substantially increased risk of suicidal behavior, particularly during the first year after diagnosis. Although the absolute excess risk is modest, these findings emphasize the need to support and carefully monitor this vulnerable population.
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| 39. |
- Lynch, R, et al.
(författare)
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Perceived stress and hair cortisol concentration in a study of Mexican and Icelandic women
- 2022
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Ingår i: PLOS global public health. - : Public Library of Science (PLoS). - 2767-3375. ; 2:8, s. e0000571-
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Tidskriftsartikel (refereegranskat)abstract
- Hair cortisol concentration (HCC) represent a potential biomarker of chronic psychological stress. Previous studies exploring the association between perceived stress and HCC have been limited to relatively small and selected populations. We collected hair samples from 881 women from the Mexican Teachers’ Cohort (MTC) and 398 women from the Icelandic SAGA pilot-cohort following identical protocols. HCC was quantified using liquid chromatography coupled with tandem mass spectrometry. The self-reported Perceived Stress Scale (PSS, 10 and 4 item, range 0–40 and 0–16) was used to assess psychological stress. We conducted multivariable linear regression analyses to assess the association between perceived stress and log-transformed HCC in the combined sample and in each cohort separately. MTC participants had slightly higher HCC and PSS scores than SAGA participants (median HCC 6.0pg/mg vs. 4.7pg/mg and mean PSS-10 score 12.4 vs. 11.7, respectively). After adjusting for sociodemographic factors and health behaviors, we observed a 1.4% (95% CI 0.6, 2.1) increase in HCC for each unit increase in the PSS-10 score in the combined sample. Furthermore, PSS-10 quintiles were associated with a 24.3% (95% CI 8.4, 42.6, mean logHCC 1.8 vs 1.6) increase in HCC when comparing the highest to the lowest quintile, after multivariable adjustment. Similar results were obtained when we analyzed each cohort separately and when using the PSS-4. Despite relatively small absolute differences, an association between perceived stress and HCC was found in a sample of women from two diverse geographical and cultural backgrounds supporting the hypothesis that HCC is a viable biomarker in studies of chronic psychological stress.
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| 43. |
- Saevarsdottir, KS, et al.
(författare)
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Illness severity and risk of mental morbidities among patients recovering from COVID-19: a cross-sectional study in the Icelandic population
- 2021
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 11:7, s. e049967-
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Tidskriftsartikel (refereegranskat)abstract
- To test if patients recovering from COVID-19 are at increased risk of mental morbidities and to what extent such risk is exacerbated by illness severity.DesignPopulation-based cross-sectional study.SettingIceland.ParticipantsA total of 22 861 individuals were recruited through invitations to existing nationwide cohorts and a social media campaign from 24 April to 22 July 2020, of which 373 were patients recovering from COVID-19.Main outcome measuresSymptoms of depression (Patient Health Questionnaire), anxiety (General Anxiety Disorder Scale) and posttraumatic stress disorder (PTSD; modified Primary Care PTSD Screen for DSM-5) above screening thresholds. Adjusting for multiple covariates and comorbidities, multivariable Poisson regression was used to assess the association between COVID-19 severity and mental morbidities.ResultsCompared with individuals without a diagnosis of COVID-19, patients recovering from COVID-19 had increased risk of depression (22.1% vs 16.2%; adjusted relative risk (aRR) 1.48, 95% CI 1.20 to 1.82) and PTSD (19.5% vs 15.6%; aRR 1.38, 95% CI 1.09 to 1.75) but not anxiety (13.1% vs 11.3%; aRR 1.24, 95% CI 0.93 to 1.64). Elevated relative risks were limited to patients recovering from COVID-19 that were 40 years or older and were particularly high among individuals with university education. Among patients recovering from COVID-19, symptoms of depression were particularly common among those in the highest, compared with the lowest tertile of influenza-like symptom burden (47.1% vs 5.8%; aRR 6.42, 95% CI 2.77 to 14.87), among patients confined to bed for 7 days or longer compared with those never confined to bed (33.3% vs 10.9%; aRR 3.67, 95% CI 1.97 to 6.86) and among patients hospitalised for COVID-19 compared with those never admitted to hospital (48.1% vs 19.9%; aRR 2.72, 95% CI 1.67 to 4.44).ConclusionsSevere disease course is associated with increased risk of depression and PTSD among patients recovering from COVID-19.
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| 50. |
- Valdimarsdottir, U., et al.
(författare)
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Awareness of husband's impending death from cancer and long-term anxiety in widowhood: a nationwide follow-up
- 2004
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Ingår i: Palliat Med. - : SAGE Publications. - 0269-2163 .- 1477-030X. ; 18:5, s. 432-43
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: We investigated the predictors and long-term consequences of awareness time - the length of time a woman is aware of her husband's impending death from cancer. METHODS: All women (n = 506) living in Sweden under 80 years of age who lost their husband/partner owing to cancer of the prostate in 1996 or of the urinary bladder in 1995 or 1996 were followed with an anonymous postal questionnaire, 2-4 years after their loss. RESULTS: We received completed questionnaires from 379 of the widows. Of these, 55 (15%) reported an awareness time of 24 hours or less, 56 (15%) of 3-6 months and 95 (26%) of one year or more. The associations between the awareness time and morbidity were of a reverted 'J-shape,' with awareness time of 24 hours or less carrying the highest risk and 3-6/6-12 months the lowest. On comparing the awareness time of 24 hours or less with 3-6 months (preformed response category), the relative risks for anxiety were found to be 1.9. (1.0-3.6) (visual digital scale) and 4.5 (1.0-20.0) for intake of tranquillising drugs. Those not informed of their husband's fatal condition or not provided with psychological support by caregivers during their husband's last months of life had an increased risk of a short awareness time. CONCLUSIONS: During a man's terminal cancer illness, the wife's awareness time varies considerably and is influenced by information and psychological support from caregivers. A short awareness time may result in an additional and avoidable psychological trauma.
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