| 1. |
- Carlsson, Eva, 1959, et al.
(författare)
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Concerns and quality of life before surgery and during the recovery period in patients with rectal cancer and an ostomy
- 2010
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Ingår i: Journal of Wound, Ostomy and Continence Nursing (WOCN). - : Lippincott, Williams & Wilkins. - 1071-5754 .- 1528-3976. ; 37:6, s. 654-661
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Rectal cancer is the most common reason for a person to undergo ostomy surgery. The aim of this study was to assess concerns and health-related quality of life (HRQOL) before surgery and during the first 6 months following ostomy surgery in the presence of rectal cancer. SUBJECTS AND SETTINGS: The sample comprised 57 patients at a university hospital in Gothenburg, Sweden. Their median age was 66 years (range, 30-87); 35 men and 22 women participated in the study. METHODS: Participants prospectively answered questionnaires preoperatively, and at 1, 3, and 6 months postoperatively.Concerns were assessed using the rating form of the Inflammatory Bowel Disease Patient Concerns, and HRQOL was evaluated using the 36-Item Short Form Health Survey. Results were compared with population norms. RESULTS: Participants expressed concerns associated with developing cancer, being a burden on others, and related to the uncertain nature of disease. Health-related quality of life scores dropped significantly in 6 of 8 domains when preoperative scores were compared to those obtained 1 month postoperatively, but scores improved at 6 months. There were significant differences between preoperative study group scores and population norms on physical and emotional role function, social function, and for mental health domains. Significant differences persisted when population norms were compared to study group scores 6 months following surgery on all these domains except mental health. Participants identified good relations with significant others, social and leisure activities, psychological issues, and health as important for maintaining QOL. Obstacles to maintaining QOL included fatigue, pain, illness-induced limitations in life, and worries over what their new life would entail. CONCLUSION: Surgical management of rectal cancer raises concerns and profoundly impairs QOL during the first several postoperative months. © 2010 Wound, Ostomy and Continence Nurses Society.
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| 2. |
- Lindholm, Elisabet, 1946, et al.
(författare)
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Ostomy-Related Complications After Emergent Abdominal Surgery : A 2-Year Follow-up Study.
- 2013
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Ingår i: Journal of Wound, Ostomy and Continence Nursing (WOCN). - 1071-5754 .- 1528-3976. ; 40:6, s. 603-610
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of this study was to prospectively evaluate ostomy-related complications and describe ostomy configuration in patients undergoing acute abdominal surgery.SUBJECTS AND SETTING: The study sample comprised 144 patients with a median age of 67 years (IOR: 53.5-78 years) who underwent an intestinal ostomy as part of an acute abdominal surgical procedure. The research setting was the surgical and gynecological clinics at the Sahlgrenska University Hospital in Gothenburg, Sweden.METHODS: Ostomy configuration, diameter, height, and the presence of stomal and peristomal complications were assessed by a WOC nurse 1 to 2 times while in hospital, once at the ostomy outpatient clinic 2 weeks after discharge, and at 3, 6, 12, and 24 months following ostomy creation.RESULTS: The types of ostomies evaluated were end colostomy (58%), end ileostomy (18%), loop ileostomy (17%), and loop colostomy (7%). Most stomal or peristomal complications occurred within 1 year after surgery (31 of 57; 54.4%). Necrosis, separation, and stenosis were most common in patients with an end colostomy. Peristomal skin complications occurred in 45% of subjects during the first 6 months after surgery. The ostomy's diameter decreased significantly during the hospital course and over the first 2 weeks following hospital discharge in patients with end colostomy (P < .0001), end ileostomy (P < .0081), loop ileostomy (P = .008), and loop colostomy (ns). Patients with a low ostomy had peristomal skin problems ranging between 21% and 57% over this time period. The frequency of using a pouching system that incorporated convexity was highest in the case of loop ileostomy, used in 67% at 6 months.CONCLUSION: During the first 2 weeks after discharge, the physical configuration of the ostomy evolves and the pouching system must be frequently adjusted by a WOC nurse. Stomal and peristomal complications are prevalent during the first 2 postoperative years and especially during the first 6 months.
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| 3. |
- Persson, Eva, 1953, et al.
(författare)
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Experiences of living with increased risk of developing colorectal and gynaecological cancer in individuals with no identified gene mutation
- 2012
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 26:1, s. 20-27
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Tidskriftsartikel (refereegranskat)abstract
- Background: In most families with familial cancers, mutations have not been demonstrated; thus, healthy individuals cannot be tested for mutation status. As a consequence, many persons at risk of familial cancer live with an unknown, but presumably high, risk of developing cancer.Aim: The aim of this study was to describe individuals’ perceptions of living with an increased isk of colorectal and gynaecologic cancer where the gene mutation is unknown.Methods: Interviews were conducted with 30 individuals with familial colorectal cancer. These ersons have no known mutation and therefore should be considered presumptive carriers. In onnection with the interviews, all participants were offered to take part in a surveillance programme consisting of a colonoscopy and gynaecological examinations. The interview ranscriptions were analysed by the use of qualitative content analysis.Results: Two themes emerged from the analyses: first, living under a threat with two ubthemes, threat awareness and distancing oneself from the threat. The second theme, living with uncertainty, was divided into four subthemes: influencing one’s family, being on the safe side, facing emotions evoked by examinations and trust and disappointment to the medical services.Conclusion: These persons live with a lifelong uncertainty with a varying intensity depending on what happens throughout the life trajectory. They have no diagnosis or patient group to elate to; therefore, the entire situation is often perceived as abstract. Thus, providing nformation and counselling needs to be more deeply elucidated, and we need to address both ituational and existential ways of uncertainty. This will, however, require professionals of all disciplines to understand the meaning of uncertainty and help ensure that its adverse effects re decreased with adequate nursing interventions.
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| 4. |
- Bengtsson, Jonas, et al.
(författare)
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Sexual function after failed ileal pouch-anal anastomosis
- 2011
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Ingår i: Journal of Crohn's and Colitis. - : Elsevier. - 1873-9946. ; 5:5, s. 407-414
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Tidskriftsartikel (refereegranskat)abstract
- Background and AimsFailure of ileal pouch-anal anastomosis (IPAA) occurs in around 10% of the patients. Compared to patients with functioning pouches, health related quality of life is deteriorated after failure. Sexual function in patients with pouch failure is however poorly studied.The aim was to study sexual function in patients with pelvic pouch failure; patients with functioning pouches were used as controls. The hypothesis was that patients with pouch failure have worse sexual function.Methods36 patients with pouch failure were compared with 72 age and sex-matched controls with ulcerative colitis and functioning pouches. The patients answered a set of questionnaires concerning sexual function (Female Sexual Function Index [FSFI] and International Index of Erectile Function [IIEF]), body image (BIS-scale) and health-related quality of life (SF-36).ResultsBoth women and men with pouch failure scored lower than controls in the FSFI and IIEF questionnaires. However, none of the observations were statistically significant. The scores in the failure group (for both sexes) were below the cut-off level for sexual dysfunction. Scores for the BIS instrument were significantly lower for both sexes in the failure group. Women and men in the failure group scored lower than the controls in all domains of the SF-36, however statistically significant only for the social function domain in men.ConclusionsThe hypothesis, that a failed IPAA is associated with worse sexual function, was not confirmed. Compared to patients with functioning pouches, patients with pouch failure have inferior body image.
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| 5. |
- Berndtsson, Ina, 1953-
(författare)
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Bukaortascreening in och ut på fem minuter : Hur upplevs undersökningsförfarandet av de screenade och av personalen
- 2010
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Konferensbidrag (refereegranskat)abstract
- Etiska aspekter vid screening av bukaortaaneurysm - en delutvärdering vid införandet i Västra Götaland Regionstyrelsen har beslutat om införande av screening av 65-åriga män för buk-aortaaneurysm (fortsättningsvis benämnt AAA) i Västra Götalandsregionen. Syftet är, i likhet med andra screeningundersökningar, att ställa diagnos i ett tidigt skede, redan innan sjukdomen har börjat ge symtom. Utvärderarna, liksom den helt övervägande delen av de kallade och intervjuade medarbetarna, anser att detta är en riktig satsning. Utvärderingsgruppen ställer sig således bakom införandet och huvuddragen i genomförandet av AAA screening i Västra Götalandsregionen. De kunskaper vi har om screening i allmänhet och AAA i synnerhet indikerar helt enkelt att det vore oetiskt att inte screena denna grupp personer. Det finns dock en risk för oro och ångest i samband med förfarandet. Det är därför viktigt att minimera negativa upplevelser hos de kallade. Utvärderingen är gjord med detta som utgångspunkt och har således ansatsen att finna förbättringsmöjligheter i det framväxande förfarandet. Under 2009 kallades 10 361 män och av dessa avstod 14,5 % . Till SU/Östra och SU/Mölndal avstod ca 20 % att komma medan de som kallades till SÄS, SKAS och NU avstod i mindre utsträckning (ca 11 %). Förbättringsförslagen i rapporten bygger på enkätsvar, telefonintervjuer från såväl de som kom som de som uteblev. Det genomfördes också fokusgruppsintervjuer med den personalen som undersökte de kallade (ST-läkare, sjuksköterskor och biomedicinska analytiker) på de kliniskt fysiologiska mottagningarna vid Sahlgrenska universitetssjukhuset Mölndal och Östra, Kungälvs sjukhus (röntgen), Södra Älvsborgs sjukhus (SÄS), Norra Älvsborgs sjukhus (NÄL) och Skaraborgs sjukhus (SkaS).Kort om resultatenDe kallade och personalen var i allmänhet positiva till att sjukvården gjorde screeningundersökning av 65-åriga män. Kallelse och informationsbrev upplevdes av de flesta som bra. Avståndet till screeningorten påverkade inte deltagandet i screeningen negativt trots kommentarer om lång resväg. De som hade längst resväg undersöktes på NÄL och SkaS. Att få ett påminnelsebrev gjorde att flera som glömt eller var bortresta kunde undersökas. Egenavgiften (100 kr) hade inte betydelse för deltagandet. Undersökningen medförde inga obehag och gick snabbt (5 min). Undersökningens korta tid kunde dock vara ett besvär för den som behövde mer omfattande information eller omhändertagande. Informationen om undersökningen var bra men besked om hur vanligt tillståndet var och normalgränserna saknades av de undersökta. Av dem som avstod från undersökning förekom fysisk psykisk sjukdom eller handikapp som orsak till att det var svårt eller omöjligt att undersökas. Flera hade negativa attityder till massundersökningar och som exempel angavs svininfluensa-vaccinationen för inställningen. Andra orsaker till att man avstod var inställningen ”det drabbar inte mig”. Några hade dålig erfarenhet av sjukvård eller läkarskräck. Det förekom också transportproblem, som att man inte hade egen bil. Den största andel som avstod bodde i Göteborgsregionen (22 %). Screeningpersonalen upplevde att de flesta var positiva och nöjda med informationen i kallelsen, förutom att man trodde att hela bukaortaavsnittet skulle undersökas. Personalen fick påpekanden från män att egenavgiften (100 kr) utgjorde ett problem för dem som inte hade internet då en betalningsavgift tillkommer. Speciell tid var avsatt för undersökningarna, på två ställen på kvällstid för att det skulle vara lättare med parkering. Ofta räckte undersökningstiden till (5 min) men ibland, om undersökningen var mer komplicerad eller om någon hade svårt att röra sig eller behövde prata, upplevdes tiden för kort. Principen var att det skulle ges besked om bukaorta var normal eller förstorad, men beskedet gavs på olika sätt, en del fick muntligt besked, andra också skriftligt. Några fick reda på måttet när det var normalt men inte om det var förstorat. Vid upptäckt av vidgad aorta skulle personalen faxa uppgifter till kärlkirurgen i Göteborg. Personalen upplevde att de inte hade klara besked på hur informationen till patienten skulle ges om vidgad aorta upptäcktes. Det var även osäkert om och när patienten skulle bli omhändertagen både beroende på tillgång till mottagningstid till kärlkirurg och beroende på hur stor vidgning aorta hade. Utvärderingsgruppen har reflekterat över de etiska aspekterna av screeningen. Gruppen anser att tillvägagångssättet visat sig vara hållbart och föreslår endast förbättringar av förfarandet och rekommendationer om alternativa förhållningssätt.Sammanfattning av etiska reflektioner vid bukaortascreeningen i Västra GötalandInformation och undersökning byggde på ett rationalistiskt perspektiv där 65-åriga män ansågs vara friska, svensktalande och utan hjälpbehov.Vid komplicerad undersökning eller vidgad aorta var det brist på tidsmarginal vilket innebar att kravet på ett fullgott omhändertagande riskerade att inte kunna uppfyllas.Förfarandet vid beskedet av mätresultat, både skriftligt och muntligt, var inte samstämmiga mellan screeningorterna.Yrkeskategori som inte var utbildad för eller hade erfarenhet av omhändertagande vid besked kunde skapa oro och ångest.Beskeden till männen om och när läkarkontakt skulle fås varierade.Osäkerhet och frustration över att inte ha tillgång till läkare/psykolog fanns bland screeningpersonalen.
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| 6. |
- Berndtsson, Ina, 1953-
(författare)
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Livskvalitet och sexualitet efter stomioperation
- 2010
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Konferensbidrag (refereegranskat)abstract
- Fysiska och psykiska besvär kan påverka hälsan och i förlängningen sexualiteten. Ett exempel är patienten som har diarréer, ont i magen och förlorar vikt och energi orsakat av en inflammatorisk tarmsjukdom. Medan att ha en cancer i colon eller rektum ger oftast inga besvärliga symtom, inte i början. Men för patienten med cancer påverkar behandlingen i form av strålning, kirurgi och cytostatika bla. sexualiteten.Det är viktigt att sjuksköterskan är medveten om patienten påverkas även sexuellt. Sjuksköterskan kan vanligtvis prata med patienten om privata saker som tex. avföringsvanor och om döden. Sjuksköterskan skall även ges information om sexualiteten, och frågor skall kunna ställas av patienten och eventuell partner. Sexualiteten betyder olika mycket för olika personer och vid olika tidpunkter i livet. Att negligera patientens behov om att prata om detta eller resonera som att de får någon annan ta upp om (läkaren) är inte rätt. Människan är en sexuell varelse.
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| 7. |
- Berndtsson, Ina, 1953-, et al.
(författare)
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Long-term adjustment to living with an ileal pouch-anal anastomosis.
- 2011
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Ingår i: Diseases of the colon and rectum. - : Lippincott Williams & Wilkins. - 1530-0358 .- 0012-3706. ; 54:2, s. 193-9
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe long-term adjustment to life with an ileal pouch-anal anastomosis after surgery for ulcerative colitis, to investigate the relationship of pouch function to adjustment, and to explore factors affecting quality of life.
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| 8. |
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| 9. |
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| 10. |
- Emilsson, Maria, 1966-, et al.
(författare)
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The Influence of personality traits and beliefs about medicines on adherence to asthma treatment
- 2011
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Ingår i: Primary Care Respiratory Journal. - : Strategic Medical Pub. - 1471-4418 .- 1475-1534. ; 20:2, s. 141-147
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Forskningsöversikt (refereegranskat)abstract
- Aim:To explore the influence of personality traits and beliefs about medicines on adherence to treatment with asthma medication.Methods:Respondents were 35 asthmatic adults prescribed controller medication. They answered questionnaires about medication adherence, personality traits, and beliefs about medicines.Results:In gender comparisons, the personality traits “Neuroticism” in men and “adherence to medication” were associated with lower adherent behaviour. Associations between personality traits and beliefs in the necessity of medication for controlling the illness were identified. Beliefs about the necessity of medication were positively associated with adherent behaviour in women. In the total sample, a positive “necessity-concern” differential predicted adherent behaviour.Conclusion:The results imply that personality and beliefs about medicines may influence how well adults with asthma adhere to treatment with asthma medication.
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| 11. |
- Johansson, Ann-Caroline, et al.
(författare)
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Illness perceptions in relation to experiences of contemporary cancer care settings among colorectal cancer survivors and their partners
- 2014
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Ingår i: International Journal of Qualitative Studies on Health and Well-Being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Illness is constituted by subjective experiences of symptoms and their psychosocial consequences. Illness perceptions concern people's lay beliefs about understandings and interpretation of a disease and expectations as to disease outcome. Our knowledge about illness perceptions and coping in relation to the cancer care context among persons with colorectal cancer (CRC) and their partners is incomplete. The aim of the present study was to explore illness perceptions in relation to contemporary cancer care settings among CRC survivors and partners. The present research focused on illness rather than disease, implying that personal experiences are central to the methodology. The grounded theory method used is that presented by Kathy Charmaz. The present results explore illness perceptions in the early recovery phase after being diagnosed and treated for cancer in a contemporary cancer care setting. The core category outlook on the cancer diagnosis when quickly informed, treated, and discharged illustrates the illness perceptions of survivors and partners as well as the environment in which they were found. The cancer care environment is presented in the conceptual category experiencing contemporary cancer care settings. Receiving treatment quickly and without waiting was a positive experience for both partners and survivors; however partners experienced the information as massive and as causing concern. The period after discharge was being marked by uncertainty and loneliness, and partners tended to experience non-continuity in care as more problematic than the survivor did. The results showed different illness perceptions and a mismatch between illness perceptions among survivors and partners, presented in the conceptual category outlook on the cancer diagnosis. One illness perception, here presented among partners, focused on seeing the cancer diagnosis as a permanent life-changing event. The other illness perception, here presented among survivors, concentrated on leaving the cancer diagnosis behind and moving forward. The importance of illness perceptions among survivors, and the differences in illness perceptions between survivors and partners, should be recognized by healthcare professionals to achieve the goals of person-centered contemporary cancer care.
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| 12. |
- Jonsson, Åsa, et al.
(författare)
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Jag vet inte riktigt vad jag ska göra med svaret… : En intervjustudie om distriktssköterskors erfarenheter av att samtala med patienter om alkohol
- 2013
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Ingår i: Vård i Norden. - 0107-4083 .- 1890-4238. ; 33:3, s. 4-8
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Tidskriftsartikel (refereegranskat)abstract
- Background: Nurses should work from health perspective and have profound knowledge of what affects public health. Through dialogue with patients, nurses have an essential role to illustrate patients drinking behavior and illuminate the effects of alcohol on health.Aim: The aim of this study was to illuminate the district nurses experiences of dialogue with patients concerning alcohol.Method: Eight district nurses were interviewed at experiences of dialogue with patients concerning alcohol.Findings: Three themes were interpreted, as feeling of security in reassuring to know that there had time, have sufficient knowledge and to find a good opportunity to talk about alcohol. Personal values attitude affected the dialogue Patient’s responsibility for the dialogue when the patient herself not asked at alcohol was it no conversation or if the patient signaled that they did not want to talk about alcohol ended the dialogue.Conclusion: The experience of safety in the work situation, personal attitudes towards alcohol affected the district nurse´s attitudes and abilities to accomplish dialogue with patients concerning alcohol. It was remarkable that the responsibility for the content of the dialogue in several occasions was submitted to patients. The district nurses want guidelines and procedures for working with alcohol issues.
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| 13. |
- Persson, Eva, et al.
(författare)
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Stoma-related complications and stoma size – a 2-year follow up
- 2010
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Ingår i: Colorectal Disease. - : Blackwell Publishing Ltd. - 1462-8910 .- 1463-1318. ; 12:10, s. 971-976
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Aim The purpose of the study was to prospectively describe stoma configuration and evaluate stoma-related complications and their association with possible risk factors. Method All elective patients (n = 180) operated on with a formation of colostomy, ileostomy or loop-ileostomy between 2003 and 2005 were included in the study. Follow up took place on the ward postoperatively and five times during 2 years after discharge. On these occasions the diameter and height of the stoma were recorded. Complications such as peristomal skin problems, necrosis, leakage caused by a low stoma, stenosis, granuloma formation, prolapse and peristomal hernia formation were evaluated. Results Most complications occurred 2 weeks after discharge; 53% of patients with colostomies, 79% with loop-ileostomies and 70% of patients with end-ileostomy had one or more complications. The most common complication was skin problems and it was most common in patients with end-ileostomies (60%) and loop-ileostomies (73%). Postoperatively at ward review, the most common complication was necrosis, which occurred in 20% of patients with a colostomy. Granuloma formation was most frequent in colostomies. Almost all patients with an end-ileostomy and loop-ileostomy with a height lower than 20 mm had leakage and skin problems as had half of the patients with a colostomy height lower than 5 mm. Conclusion To prevent stoma-related complications, it is important to produce an adequate height of the stoma, with early and regular follow ups and adjustment of the appliance. To work closely in collaboration with the colorectal surgeons is of utmost important to provide feedback and in turn, to improve stoma outcome.
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| 14. |
- Pettersson, Monica, 1963, et al.
(författare)
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Experiences of Screening for Abdominal Aortic Aneurysm : In and Out on Five Minutes
- 2014
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Ingår i: Health. - : Scientific Research Publishing, Inc.. - 1949-4998 .- 1949-5005. ; 6, s. 1385-1395
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Tidskriftsartikel (refereegranskat)abstract
- Background: The purpose of AAA screening is to prevent rupture and mortality. Screening for life-threatening diseases is a double-edged sword. The aim of this study is to describe 65-year-old men's experiences of health related quality of life and anxiety after screening for Abdominal Aortic Aneurysm, and experiences of information and reasons for not participating. Methods: 368 men answered Short Form 36 (SF-36), and anxiety and depression scale (HAD). 72 telephone interviews were conducted with the participants and 77 with those who declined to take part in the screening programme. Results: The SF-36 domains of Physical Function and Role limitations due to emotional health problems were significantly better for men who had undergone screening compared to a matched population. Compared to non-smokers, smokers had lower values in the SF-36 domains of general health perceptions, social functioning, role limitations due to emotional health problems and mental health. 80% of patients did not experience any form of anxiety/panic in connection with the screening invitation. Of the men who did not participate, 56% stated that they would like to be screened or had already undergone the examination. Conclusion: The men who underwent the investigation were healthier in some of the SF-36 domains than the general population. The participants did not experience any great anxiety before the screening and despite the short duration of the examination.
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