| 11. |
- Bood, Sven Åke, 1950-
(författare)
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Bending and Mending the Neurosignature : Frameworks of influence by flotation-REST (Restricted Environmental Stimulation Technique) upon well-being in patients with stress related ailments
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overarching purpose of the current thesis was to assess the long term effects of a treatment program involving flotation-REST for the experience of pain, from the point of view of variables connected with Melzack´s neuromatrix theory, and to examine the extent of a potential attention-placebo effect in connection with flotation-REST.The first study (Paper I) aimed to investigate long-term effects of flotation-REST four months after treatment. Seventy patients participated, diagnosed as having stress-related pain. Participants were randomly assigned to either a control group or a flotation-REST group and participated in a total of twelve flotation REST or control sessions. Results indicated that pain areas, stress, anxiety and depression decreased, while sleep quality, optimism, and prolactin increased. Positive effects generally maintained four months after treatment. The second (Paper II) examined the potential effects of attention-placebo. Thirty-two patients who were diagnosed as having stress-related muscular pain were treated for a period of six weeks. Half of the patients were also given attention for a period of 12 weeks, while the remainder received attention for 6 weeks. Participants in both groups exhibited lowered blood pressure, reduced pain, anxiety, depression, stress, and negative affectivity, as well as increased optimism, energy, and positive affectivity. The third (Paper III) investigated whether or not 33 flotation sessions were more effective for stress related ailments as compared to 12 sessions. Participants were 37 patients with stress related ailments. Analyzes for subjective pain and psychological variables typically indicated that 12 sessions were enough to get considerably improvements and no further improvements were noticed after 33 sessions. Finally, the fourth study (Paper IV) aimed to examine whether and how the combination of therapy and flotation tank could be used to treat patients with severe stress problems. Two women on long-term sick-leave participated in the study, which was carried out over a period of one year. Four overarching themes were generated: the therapeutic work model, transformation of feelings, self-insight and meaning. These together constituted a “therapeutic circle” which after a while transformed in to a “therapeutic spiral” of increased meaning and enhanced wellbeing.It was therefore concluded that flotation tank therapy is an effective method for the treatment of stress-related pain.
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| 12. |
- Koinberg, Ingalill, 1955-
(författare)
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Traditional or individualised follow-up in women after breast cancer surgery
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The general aim was to compare different follow-up approaches after breast cancer surgery, i.e. traditional follow-up to a physician and individualised approaches, with specific emphasis on satisfaction, well-being and self-care. Both quantitative and qualitative research methods have been employed. This thesis is based on two study cohorts; in studies 1-III, 264 women who had undergone surgery for breast cancer between 1991-2001 at two hospitals in Sweden were consecutively randomised to two parallel groups (study I). From this study cohort 20 women were interviewed about their experience of traditional follow-up to a physician (study II) and 19 women were interviewed about their experience from the nurse-led follow-up on demand (study III). Study I compared and evaluated the two systems; traditional physician follow-up and nurse led follow-up on demand. Studies II and III explored the needs of women after breast cancer surgery. Study IV contains a new study cohort of 96 women who had undergone surgery for breast cancer and who were consecutively selected and divided into two parallel groups between 2001-2003 at two hospitals in Sweden. Study IV compared traditional physician follow-up with a multi-disciplinary educational programme. Instruments such as The Hospitality Anxiety and Depression-scale, the Functional Assessment of Cancer Therapy-General scale and the Sense of Coherence scale as well as semi-structured interviews were used for the data collection. Analysis of the data was mainly performed by inferential statistical mainly non-parametric methods and by a phenomenographic approach. The result showed that women with breast cancer in stages I to II could be followed up by a specialist nurse leading to high patient satisfaction and good medical safety (study I). Women tend to vary in their appreciation of different aspects of the follow-up; some need routine while others require accessibility, continuity, confidence and security were demanded as self-care education and individualised information (studies II, III). A multidisciplinary education programme based on patients' needs led to a similar level of well-being, self-care and coping ability as that resulting from traditional physician follow-up and thus, can be considered as a viable alternative (study IV).The women value the nurses professional knowledge and skills. Accessibility and early assessment by healthcare professionals or an oncology nurse are essential in a system without routine follow-up. There are good reasons for reviewing and changing the design of the traditional follow-up system in order to ensure the most effective and well-functioning system possible, to better meet the needs of women with breast cancer and to involve them in decision making concerning follow-up.
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