| 1. |
- Arver, Brita, et al.
(författare)
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Bilateral Prophylactic Mastectomy in Swedish Women at High Risk of Breast Cancer: A National Survey.
- 2011
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Ingår i: Annals of surgery. - : Lippincott Williams and Wilkins; 1999. - 1528-1140 .- 0003-4932. ; 253:6, s. 1147-1154
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND/OBJECTIVE:: This study attempted a national inventory of all bilateral prophylactic mastectomies performed in Sweden between 1995 and 2005 in high-risk women without a previous breast malignancy. The primary aim was to investigate the breast cancer incidence after surgery. Secondary aims were to describe the preoperative risk assessment, operation techniques, complications, histopathological findings, and regional differences. METHODS:: Geneticists, oncologists and surgeons performing prophylactic breast surgery were asked to identify all women eligible for inclusion in their region. The medical records were reviewed in each region and the data were analyzed centrally. The BOADICEA risk assessment model was used to calculate the number of expected/prevented breast cancers during the follow-up period. RESULTS:: A total of 223 women operated on in 8 hospitals were identified. During a mean follow-up of 6.6 years, no primary breast cancer was observed compared with 12 expected cases. However, 1 woman succumbed 9 years post mastectomy to widespread adenocarcinoma of uncertain origin. Median age at operation was 40 years. A total of 58% were BRCA1/2 mutation carriers. All but 3 women underwent breast reconstruction, 208 with implants and 12 with autologous tissue. Four small, unifocal, invasive cancers and 4 ductal carcinoma in situ were found in the mastectomy specimens. The incidence of nonbreast related complications was low (3%). Implant loss due to infection/necrosis occurred in 21 women (10%) but a majority received a new implant later. In total, 64% of the women underwent at least 1unanticipated secondary operation. CONCLUSIONS:: Bilateral prophylactic mastectomy is safe and efficacious in reducing future breast cancer in asymptomatic women at high risk. Unanticipated reoperations are common. Given the small number of patients centralization seems justified.
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| 2. |
- 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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| 3. |
- 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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| 4. |
- Silfver, Ann-Louise, et al.
(författare)
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Educating Parents : A critical encounter between Swedish government parent support and parent’s narratives
- 2011
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Ingår i: Changing the Future Educating about Gender. - Exeter : Exeter University.
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Konferensbidrag (refereegranskat)abstract
- The main purpose of this study is to explore constructions of family and parenthood in Swedish contemporary parent support initiatives. We focus on government policy; municipal support initiatives; media representations of parenthood; parents’ narratives, and online activities. A discourse analytical perspective will guide the study. We draw on notions of how discourses form actions and boundaries in government’s parent support initiatives and in narratives of parents. The governmentality concept will be used to analyse processes of governance at state and individual levels (Foucault 1991). For policy analysis a “What’s the problem represented to be” approach (2009) will be used addressing how problems are constructed in policy, and how representations of problems bring about effects. Since issues of parenthood are saturated by ideas of e.g. gender, sexual orientation and dis-/ability, the study will be informed by theories of social categorizations (Butler 1990/1999; Connell 2009; Young 1997) and how these categories intersect (Crenshaw 1994; Yuval-Davies 2006). Research states Swedish parent support mainly addresses women/mothers (Bremberg, 004). There also seems to be a bias where “parents” are mainly represented by ethnic Swedish, well educated, urban, heterosexual nuclear families (Sarkadi 2009). Since parent education primarily has been studied from a medical perspective, there certainly is a need for educational researchers to study these programs and those involved, from a pedagogical and psychological perspective.
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| 5. |
- Stjerna, Marie-Louise, et al.
(författare)
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The management of situated risk : A parental perspective on child food allergy
- 2014
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Ingår i: Health. - : SAGE Publications. - 1363-4593 .- 1461-7196. ; 18:2, s. 130-145
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Tidskriftsartikel (refereegranskat)abstract
- Food allergy is an illness that requires constant risk management in everyday life. To date, there is no cure or preventive treatment, and the only way to manage the condition is therefore careful avoidance of the offending foodstuff and treatment of reactions when they occur. This article draws on a socio-cultural approach to explore parents' understandings and management of child food allergy in the context of everyday life, as situated' risk. A focus group study was carried out with 31 parents of children diagnosed with food allergy at two children's hospitals. The analysis of the focus group material reveals how the management of allergy risk seems to permeate most aspects of everyday life as well as how the parents draw on a dominant norm of risk avoidance as well as a counter-discourse of calculated risk taking. The patterns of risk management found in this study are discussed in terms of how risk avoidance and risk taking are intertwined and balanced in the context of moral parenthood.
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| 6. |
- Tengvall, Oili, et al.
(författare)
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Memories of pain after burn injury : the patient's experience
- 2010
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Ingår i: Journal of Burn Care & Research. - 1559-047X .- 1559-0488. ; 31:2, s. 319-327
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Tidskriftsartikel (refereegranskat)abstract
- Pain after burns is a major clinical problem and researchers continue to report that burn pain remains undertreated. Adequate pain management could contribute to the prevention of post-traumatic stress disorder and can give a growing sense of patients' self-confidence and strength. Freedom from pain might be unrealistic, but the objective should be to reduce pain as much as possible. The purpose of this study was to describe burn patients' experiences and memories of pain during burn care and to acquire a deeper understanding of how patients cope with the experience. The study method was qualitative and interviews were conducted with 12 adult burn patients ( eight men and four women) 6 to 12 months postburn (mean = 7 months). The mean burn size for the group was 10.6% mean of TBSA and the mean stay in hospital was 16 days. The interviews were analyzed using Kvales' method for structuring analysis. The patients' experiences and memories of pain during the trajectory of care were clearly described by the informants during the interviews. Four themes were identified for pain: becoming aware of pain, allowing oneself to feel pain, different pain experiences, and fragile body surface. Four themes were identified for coping: pragmatic coping, allowing someone to care for you, carrying the pain, and perspectives on the trauma. Both good and bad memories were recorded during the care trajectory, and it is evident that the patient has to carry the pain experience by themselves to a large extent. (J Burn Care Res 2010;31:319-327)
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