| 1. |
- Drott, Jenny, 1976-, et al.
(författare)
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Neurotoxic Side Effects Early in the Oxaliplatin Treatment Period in Patients With Colorectal Cancer
- 2018
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Ingår i: Oncology Nursing Forum. - Pittsburgh, PA, United States : Oncology Nursing Society. - 0190-535X .- 1538-0688. ; 45:6, s. 690-697
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To identify and describe experiences of patients with colorectal cancer (CRC) who have neurotoxic side effects early in the oxaliplatin treatment period, and how neurotoxicity affects their daily lives.PARTICIPANTS & SETTING: 10 patients with stage II-III CRC were included. All were treated with adjuvant oxaliplatin postoperatively and assessed neurotoxicity via a platform-independent mobile phone-based system. Patients were recruited from two hospitals in southern Sweden from November 2013 to August 2014.METHODOLOGIC APPROACH: Qualitative interview study conducted through open-ended, face-to-face, qualitative interviews. Thematic analysis was used.FINDINGS: A main theme was identified.IMPLICATIONS FOR NURSING: Nurses have an obligation to communicate the importance of early detection of neurotoxicity. Mobile phone technology seems to be a valuable tool for monitoring patient-reported neurotoxicity to improve communication and supportive care.
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| 2. |
- Ekwall, Ewa, 1950-, et al.
(författare)
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Important aspects of health care for women with gynecologic cancer
- 2003
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Ingår i: Oncology Nursing Forum. - Pittsburg : Oncology Nursing Society. - 0190-535X .- 1538-0688. ; 30:2, s. 313-319
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Tidskriftsartikel (refereegranskat)abstract
- Purpose/Objectives: To describe what women diagnosed with primary gynecologic cancer reported to be important during their interacion with the healthcare system. Design: Qualitative. Setting: A specialized gynecologic cancer care unit in central Sweden. Sample: 14 women diagnosed with primary gynecologic cancer were recruited. The women had been referred to the specialized care unit for radiation or cytostatic therapy. Methods: Tape-recorded interviews were transcnbed, coded, categoized, and analyzed. Main Research Variables: Primary diagnosed women with cancer and their experience with quality of care during diagnosis and treatment. Findings: Three partly overlapping categories (i.e., optima! care,good communication, and self-image and sexuality) were found to be of central importance in quality of health care. Participants stated that health care should be based on their own perceptions of the need for information and dialogue and how the disease and treatment would affect their health, self-image, and sexuality. Everyday conversations also were very important. Conclusions: Central importance in health care for the women included both rational and human aspects. The primary need of participants was available, competent, and coordinated. Implications for Nursing: Women with gynecologic cancer should be given individualized information and care to satisfy their individual needs and reinforce their self-image. Nurses have an important role in strengthening women´s feelings of hope and supporting them in maintaining as positive a self-image as possible. Information and everyday conversation are of great significance. Sexuality should be an integral part of holistic care; to this end, inclusion of each woman's sexual partner may be helpful when discussions concerning sexuality occur.
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| 3. |
- Henoch, Ingela, 1956, et al.
(författare)
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Symptom dimensions as outcomes in interventions for patients with cancer : A systematic review
- 2018
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Ingår i: Oncology Nursing Forum. - : Oncology Nursing Society. - 0190-535X .- 1538-0688. ; 45:2, s. 237-249
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Tidskriftsartikel (refereegranskat)abstract
- PROBLEM IDENTIFICATION: Symptom experience in patients with cancer consists of several dimensions, often measured descriptively within various populations but seldom used as intervention outcomes. This review aims at describing symptom dimensions as outcomes of interventions designed to alleviate symptoms in patients with cancer and to describe these interventions' effects on at least two symptom dimensions. LITERATURE SEARCH: The PRISMA statement for reporting systematic reviews was used. Searches were undertaken in various indexing sites. DATA EVALUATION: Extracted data included design, participants, intervention and control group treatment, targeted symptom dimension, and summary of results. SYNTHESIS: 2,041 articles were identified and 15 were included. The symptom dimensions were intensity, distress, prevalence, frequency, consequences, and quality. Eleven interventions had significant effect on symptom dimensions, mostly on intensity and distress. IMPLICATIONS FOR PRACTICE: Oncology nurses need clinical skills to be able to understand patients' experiences through their narratives. Various interventions are targeted at symptoms, and these need to be implemented to provide evidence-based symptom management.
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| 4. |
- Karlsson, Katarina, et al.
(författare)
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Exploring Symptom Clusters and Their Measurements in Patients With Lung Cancer: A Scoping Review for Practice and Research.
- 2023
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Ingår i: Oncology nursing forum. - : Oncology Nursing Society. - 1538-0688 .- 0190-535X. ; 50:6, s. 783-815
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Tidskriftsartikel (refereegranskat)abstract
- This scoping review aimed to explore symptom clusters (SCs) in patients with lung cancer and how included symptoms and symptom dimensions are measured.PubMed®, CINAHL®, Scopus®, and Cochrane Library were searched for studies published until December 31, 2021. Fifty-three articles were included.Data extracted included descriptive items and SC constellations. Patient-reported outcome instruments and measured symptom dimensions were described according to the middle-range theory of unpleasant symptoms.13 articles investigated SCs a priori and 40 de novo. Thirty-six instruments were used, mostly measuring intensity alone or in combination with timing. Qualitative articles (n = 6) provided rich descriptions within the distress, timing, and quality dimensions.Fatigue was the symptom found to most frequently co-occur with other symptoms in SCs. Fatigue, psychological symptoms, and nutritional aspects are emphasized as important areas for oncology nursing practice and further research to improve SC management for patients with lung cancer.
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| 5. |
- Langegård, Ulrica, 1969, et al.
(författare)
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Symptom Clusters in Patients With Brain Tumors Undergoing Proton Beam Therapy
- 2019
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Ingår i: Oncology Nursing Forum. - : Oncology Nursing Society. - 0190-535X .- 1538-0688. ; 46:3, s. 349-363
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To explore symptom clusters during proton beam therapy in patients with primary brain tumors and investigate associations among symptom clusters, demographic variables, and comorbidity in this patient population.SAMPLE & SETTING: Data were collected from 187 adult patients with primary brain tumors during their treatment periods in the Skandion Clinic in Uppsala, Sweden. Symptoms were assessed with the Radiotherapy-Related Symptoms Assessment Scale, and comorbidity was evaluated with the Self-Administered Comorbidity Questionnaire.METHODS & VARIABLES: The study used a quantitative and longitudinal design. Exploratory factor analysis was used to determine the underlying structure of symptom clusters.RESULTS: Three clusters were identified: mood, reduced appetite, and reduced energy. The mood cluster had the highest factor loadings (0.71-0.86). In addition, demographic and comorbidity characteristics were associated with symptom clusters in this group of patients.IMPLICATIONS FOR NURSING: Building knowledge about how these symptoms interact and are clustered will support healthcare professionals to more efficiently relieve symptom clusters during proton beam therapy.
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| 6. |
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| 7. |
- Mårtensson, Gunilla, 1957-, et al.
(författare)
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Do oncology nurses provide more care to cancer patients with high levels of emotional distress?
- 2010
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Ingår i: Oncology Nursing Forum. - 0190-535X .- 1538-0688. ; 37:1, s. e34-e42
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE/OBJECTIVES: To investigate nurses' planning and implementation of individualized patient care in relation to patients' emotional distress as assessed by nurses and whether nurses and patients perceived the implemented care in a similar manner. DESIGN: Prospective, comparative. SETTING: Five oncologic-hematologic wards in Sweden. SAMPLE: 90 individual nurse-patient pairs were recruited and 81 were intact after three consecutive days. Each pair consisted of a patient with cancer and a nurse responsible for that patient's care. METHODS: Nurse-patient pairs were followed using questionnaires. Outcome measures were nurses' identification of patients' emotional distress, care planning, and nurse-patient ratings of implemented care. MAIN RESEARCH VARIABLES: Patients' emotional distress and nurses' implemented care. FINDINGS: Nurses identified a variety of emotional issues among patients and planned individual nursing interventions. Nurse and patient perceptions of implemented care demonstrated weak correlations for individually planned interventions and nurses' general caring behavior. With one exception, nurse self-reports did not indicate any differences in nurses' caring behavior directed to more and less distressed patients. Nurses reported providing comfort more frequently to patients with high levels of emotional distress, but this was not substantiated in patients' ratings. CONCLUSIONS: Nurses showed an intention to provide individualized care. However, with one exception, nurses did not report providing more care to patients with cancer with high levels of emotional distress than to less distressed patients. IMPLICATIONS FOR NURSING: To ensure individualized care, nurses in cancer care should closely validate the accuracy of their interpretation of patients' needs and their planning of care in collaboration with the patients.
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| 8. |
- Mårtensson, Gunilla, 1957-, et al.
(författare)
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Do oncology nurses provide more care to patients with high levels of emotional distress?
- 2010
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Ingår i: Oncology Nursing Forum. - 0190-535X .- 1538-0688. ; 37:1, s. E34-E42
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE/OBJECTIVES: To investigate nurses' planning and implementation of individualized patient care in relation to patients' emotional distress as assessed by nurses and whether nurses and patients perceived the implemented care in a similar manner.DESIGN: Prospective, comparative.SETTING: Five oncologic-hematologic wards in Sweden.SAMPLE: 90 individual nurse-patient pairs were recruited and 81 were intact after three consecutive days. Each pair consisted of a patient with cancer and a nurse responsible for that patient's care.METHODS: Nurse-patient pairs were followed using questionnaires. Outcome measures were nurses' identification of patients' emotional distress, care planning, and nurse-patient ratings of implemented care.MAIN RESEARCH VARIABLES: Patients' emotional distress and nurses' implemented care.FINDINGS: Nurses identified a variety of emotional issues among patients and planned individual nursing interventions. Nurse and patient perceptions of implemented care demonstrated weak correlations for individually planned interventions and nurses' general caring behavior. With one exception, nurse self-reports did not indicate any differences in nurses' caring behavior directed to more and less distressed patients. Nurses reported providing comfort more frequently to patients with high levels of emotional distress, but this was not substantiated in patients' ratings.CONCLUSIONS: Nurses showed an intention to provide individualized care. However, with one exception, nurses did not report providing more care to patients with cancer with high levels of emotional distress than to less distressed patients.IMPLICATIONS FOR NURSING: To ensure individualized care, nurses in cancer care should closely validate the accuracy of their interpretation of patients' needs and their planning of care in collaboration with the patients.
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| 9. |
- Wennman-Larsen, Agneta, et al.
(författare)
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Consistency of breast and arm symptoms during the first two years after breast cancer surgery
- 2015
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Ingår i: Oncology Nursing Forum. - 0190-535X .- 1538-0688. ; 42:2, s. 145-155
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE/OBJECTIVES:To examine the severity and development of breast and arm symptoms separately during the two years following breast cancer surgery, and to examine whether previously defined predictors of arm symptoms are associated with breast symptoms.
.DESIGN:Prospective cohort study with two-year follow-up.
.SETTING:Three institutions in the Stockholm, Sweden, region.
.SAMPLE:645 women, aged 20-63 years, enrolled within 12 weeks of surgery for primary breast cancer.
.METHODS:Baseline register and questionnaire data with five follow-ups were submitted to descriptive, inferential, and logistic regression analysis.
.MAIN RESEARCH VARIABLES:Severity of breast and arm symptoms measured by the European Organisation for Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire.
.FINDINGS:Most participants had undergone breast-conserving
surgery and sentinel lymph node dissection, and were scheduled for postoperative radiation therapy. Overall mean levels of breast and arm symptoms were low, but with large individual variations. At all six time points, the mean levels of breast symptoms were significantly higher than those of arm symptoms. Overall, the mean level of both types of symptoms decreased during follow-up. A body mass index (BMI) of 25 or greater and breast symptoms at eight months were associated with having breast symptoms at two years. Arm symptoms at baseline and at eight months, and radiation therapy and a BMI of 25 or greater were associated with having arm symptoms at two years.
.CONCLUSIONS:Breast symptoms show different patterns of change and are not associated with the same factors as arm symptoms.
.IMPLICATIONS FOR NURSING:For nurses monitoring women treated for breast cancer, the results of this study provide knowledge regarding the importance of early symptom identification and long-term symptoms after treatment.
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| 10. |
- Ahlberg, Karin, 1965, et al.
(författare)
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Fatigue, psychological distress, coping resources, and functional status during radiotherapy for uterine cancer.
- 2005
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Ingår i: Oncology nursing forum. - 1538-0688. ; 32:3, s. 633-40
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE/OBJECTIVES: To evaluate how patients diagnosed with uterine cancer experience fatigue, psychological distress, coping resources, and functional status before, during, and after treatment with radiation therapy and to study whether significant correlations exist among these variables. DESIGN: Longitudinal, descriptive, and correlational. SETTING: The Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden. SAMPLE: 60 women diagnosed with uterine cancer who were receiving curative external radiation therapy. Typical participants were 64 years old, married, and on sick leave or retired from work. METHODS: Data were collected through self-report instruments. Demographic and clinical data were extracted from the patients' records. Main Research Variables: Cancer-related fatigue, psychological distress, coping resources, and functional status. FINDINGS: Patients' fatigue scores increased significantly during and after completion of radiotherapy. The participants reported normal levels of anxiety and depression, and their coping resources changed over time. After completing therapy, all dimensions of function had decreased; for social function, the decrease was significant. The correlation over time was significant among fatigue and physical function, role function, and cognitive function. The variation of the change in fatigue after therapy was completed was explained only by the level of fatigue experienced at baseline. CONCLUSIONS: Fatigue is a symptom that increases in connection with radiotherapy. Functional status is influenced by the variation in fatigue levels. Fatigue level before treatment may be an important variable when trying to find a risk factor for the development of fatigue over the course of treatment. IMPLICATIONS FOR NURSING: Nurses must inform patients receiving radiotherapy about the expected changes in fatigue and functional status. Pretreatment screening for fatigue is needed to identify patients at risk for developing fatigue.
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| 11. |
- Ahlberg, Karin, 1965, et al.
(författare)
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The importance of participation in support groups for women with ovarian cancer.
- 2006
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Ingår i: Oncology nursing forum. - 1538-0688. ; 33:4
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE/OBJECTIVES: To explore the experience of participation in support groups for women recently diagnosed with ovarian cancer. RESEARCH APPROACH: Exploratory, qualitative. SETTING: Oncology department in a hospital in western Sweden. PARTICIPANTS: 10 Swedish women, aged 42-76, who recently had been diagnosed with ovarian cancer and had participated in support groups. METHODOLOGIC APPROACH: Data were collected by semistructured interviews and analyzed using grounded theory. MAIN RESEARCH VARIABLES: Ovarian cancer, support group experience. FINDINGS: Three categories emerged from the data analysis: sharing experiences and emotions, exchanging informational support, and exchanging emotional support. The core category was the experience of being in the same boat. Trust, openness, and willingness to create space for each other were experienced. CONCLUSIONS: Support groups offer an opportunity to share experiences and emotions as well as exchange information. They are also a possible source of emotional support and therefore can contribute to quality of life of patients with ovarian cancer. INTERPRETATION: Knowing that others had similar symptoms and reactions, and that those experiences are normal, was very important for support group participants. Nurses can reduce patients' fears and uncertainties by confirming normality. Oncology nurses need to be aware that cancer support groups offer a unique opportunity to interact with others in a similar situation. Participation in support groups can be an important source of emotional and informational support for patients. The support program in this study may be used as a model when planning for extended emotional and informational support.
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| 12. |
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| 13. |
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| 14. |
- Edwinson Månsson, Marie, et al.
(författare)
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The effect of preparation for lumbar puncture on children undergoing chemotherapy
- 1993
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Ingår i: Oncology Nursing Forum. - 0190-535X. ; 20:1, s. 39-45
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Tidskriftsartikel (refereegranskat)abstract
- At the University Hospital in Lund, Sweden, a preparation program was developed for children undergoing lumbar punctures (LPs) during chemotherapy for leukemia or lymphoma. Subsequently, a study was initiated to determine whether a preparation program for children prior to treatment would reduce their anxiety and improve their cooperation. This study also was undertaken to examine whether reinforcing the preparation information prior to each LP would be beneficial. The 30 children who participated in the study were divided into three groups: a control group whose members did not receive preparation and two other groups whose members were exposed to different numbers of preparation programs. The parents and the nurse in charge evaluated the children's reactions during treatment using two 6-point rating scales: an anxiety scale and a noncooperation behavior scale. Two unbiased, trained observers later viewed video recordings of the children's reactions and evaluated them using the same tools. In addition, each child rated his or her experience of pain on a 10 cm visual analogue scale. Based on these ratings, the groups were analyzed to determine if within-group differences existed from one treatment to the next and to determine if between-group differences existed at the various times of treatment. Few statistically significant differences were found, but the results indicate that the children in the most informed group exhibited sustained reductions in their perceptions of pain. This may signify that reinforcing the preparation information before each of the LPs enabled these children to cope with the pain more effectively.
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| 15. |
- Ekfors, Helene, et al.
(författare)
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A qualitative study of the experiences during radiotherapy of Swedish patients suffering from lung cancer.
- 2004
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Ingår i: Oncology Nursing Forum. - 0190-535X. ; 31:2, s. 329-334
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Tidskriftsartikel (refereegranskat)abstract
- Purpose/Objectives: To describe experiences during radiotherapy of patients suffering from lung cancer. Design: Inductive, qualitative. Setting: A radiotherapy department in the south of Sweden. Sample: 15 patients with lung cancer undergoing their second week of radiotherapy. Methodologic Approach: Interviews were conducted in a hospital setting, transcribed, and content analyzed. Main Research Variables: Experiences during radiotherapy. Findings: The patients' experiences fall into four categories: fatigue, physical distress, managing disease- and treatment-related issues, and obstacles to managing. Fatigue was a major experience expressed in terms of low energy levels and low fitness, sometimes leading to social isolation. Conclusions: Nurses need to implement interventions to minimize side effects of radiotherapy and maximize patients' abilities to manage the disease and the treatment. Interpretation: Informing and educating patients about pretreatment and assessing fatigue as well as implementing interventions (e.g., nurse-patient interaction, support, information, encouragement, focus on the patients' own resources) may lead to improved comprehensive care during radiation therapy.
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| 16. |
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| 17. |
- Jakobsson, Sofie, 1968, et al.
(författare)
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Components that influence assessment and management of cancer-related symptoms: an interdisciplinary perspective.
- 2008
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Ingår i: Oncology nursing forum. - 1538-0688. ; 35:4, s. 691-8
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE/OBJECTIVES: To describe, from an interdisciplinary perspective, how cancer-related symptoms are assessed and managed in a cancer care setting and to describe the components that influence symptom management. DESIGN: Descriptive, qualitative, and cross-sectional. SETTING: An oncology and hematology department in a university hospital in western Sweden. SAMPLE: 31 nurses, physicians, physical therapists, dietitians, occupational therapists, and a medical social worker who all cared for patients with cancer-related symptoms. METHODS: Data were collected in focus groups and analyzed using content analysis. MAIN RESEARCH VARIABLES: Cancer-related symptoms and symptom management. FINDINGS: Symptom management, from a clinician's perspective, is a process involving different components. Four themes emerged from the data analysis: creating a relationship with the patient, understanding the patient, assessing the symptoms, and cooperating as a team. CONCLUSIONS: This study highlights several components that should be discussed in an effort to enhance symptom management. Discussion will help ensure that barriers to effective symptom management are acknowledged and addressed when implementing clinical routines designed to enhance management of different symptoms. In addition, these components should be acknowledged in the interest of facilitating adherence to symptom management strategies. Whether these components are important factors from patients' perspectives remains unknown. IMPLICATIONS FOR NURSING: Enhancing symptom management is not only a matter of implementing clinical guidelines; it must be preceded by teamwork, assessment, and evaluation method discussions and the ability to create a relationship with the patient. Nurses should be aware that their understanding of a patient affects their assessment of that patient's symptom experience.
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| 18. |
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| 19. |
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| 20. |
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| 21. |
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| 22. |
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| 23. |
- Langegård, Ulrica, 1969, et al.
(författare)
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Consolation in conjunction with incurable cancer.
- 2009
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Ingår i: Oncology Nursing Forum. - 0190-535X. ; 36:2
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE/OBJECTIVES: To increase knowledge of what patients with incurable cancer have found consoling during the course of the disease. DESIGN: Descriptive, cross-sectional analysis. SETTING: Hospice in western Sweden. SAMPLE: 10 patients (8 women, 2 men) aged 30-90 years. METHODS: Data were collected through semistructured interviews and analyzed with the constant comparative method of analysis. FINDINGS: Four categories emerged from the interview data: connection, self-control, affirmation, and acceptance. The core variable of the study was developed and defined as "being seen." To be seen and, therefore, consoled results from experiencing a sense of connection, self-control, affirmation, and acceptance. To be consoled is a step toward increased well-being. When patients feel their suffering is seen and understood by another person, they are filled with relief. CONCLUSIONS: Raising the issue of consolation and what consolation means to the patient is essential. Physical contact is not as important as mental presence. The act of listening is the most important factor when it comes to being seen, and what the nurse communicates is what defines the patient/nurse relationship. Nurses should be clear that they have the time and interest to deal with the patient. In addition, a nurse who is concerned with patients and has the courage to stay with them during difficult situations develops an attitude marked by presence, understanding, and commitment. Creativity, knowledge, and, most of all, courage are needed from the nurse as a caregiver to recognize the patient's need for consolation. Creativity and knowledge are needed to determine what point the patient has reached, and courage is needed to be present with the patient during difficult times. Results show that the caregiver, without having an established long-term relationship with the patient, can still bring consolation to the patient. IMPLICATIONS FOR NURSING: Creativity, knowledge, and courage are needed to comprehend and accept a patient's need for consolation. By using simple interventions, the nurse can console the patient with little effort. Words become less important when consolation is done through body language.
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| 24. |
- Olofsson, Anne, et al.
(författare)
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Perspectives on music therapy in adult cancer care : a hermeneutic study
- 2009
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Ingår i: Oncology Nursing Forum. - 1538-0688. ; 36:4, s. E223-31
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE/OBJECTIVES: To explore perspectives on music therapy as a nursing intervention in adult cancer care and to expand and integrate knowledge and understanding about music therapy as an adjunctive intervention in adult cancer nursing care. DATA SOURCES: Published nursing articles. DATA SYNTHESIS: Medical and nursing journals have reported on research related to music and its effect as a nursing intervention. However, this research often lacks a musical context (i.e., knowledge and understanding from a musical perspective). CONCLUSIONS: Music therapy is not a consistent concept. Perspectives on the meanings of music therapy vary according to knowledge and scientific orientation. The perspective may influence the character and methodology of the music therapy intervention as well as the understanding of its results. IMPLICATIONS FOR NURSING: To fully develop music therapy as an adjunct intervention in adult cancer care, interdisciplinary cooperation between nurses and music therapists should be supported on clinical and educational levels.
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| 25. |
- Wengström, Yvonne, 1959-, et al.
(författare)
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Justifying radiation oncology nursing practice : a literature review
- 1999
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Ingår i: Oncology nursing forum. - 0190-535X. ; 26:4, s. 741-750
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Forskningsöversikt (refereegranskat)abstract
- PURPOSE/OBJECTIVES: To determine the scientific basis for the nursing care given to individuals undergoing radiation therapy, identify patient needs, and develop recommendations for care delivery based on these findings. DATA SOURCES: Scientific literature dating from 1993 to June 1997. Articles of recognized importance and those cited repeatedly were included, dating back to 1977. DATA SYNTHESIS: Articles included in this review investigated patient-information needs, psychosocial reactions, self-care, side effects, and sexual dysfunction. The weight of the scientific evidence varies in the included studies. CONCLUSIONS: The findings provide a foundation on which future studies can build. Additional conceptual work and resolution of methodologic issues are needed for research in this area to guide future practice. IMPLICATIONS FOR NURSING PRACTICE: Patients receiving radiation therapy often experience side effects and complications as a result of treatment. The scientific literature suggests that patients need information about their treatment, general emotional support, and practical help with side effects. A need exists to substantiate radiation nursing care practice using the literature and to create contemporary studies to enhance practice.
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| 26. |
- Charvat, Hadrien, et al.
(författare)
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Excess body fatness during early to mid-adulthood and survival from colorectal and breast cancer : a pooled analysis of five international cohort studies
- 2022
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Ingår i: Cancer Epidemiology, Biomarkers and Prevention. - : American Association for Cancer Research. - 1055-9965 .- 1538-7755. ; 31:2, s. 325-333
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Tidskriftsartikel (refereegranskat)abstract
- Background: Here, we explore the association between excess weight during early to mid-adulthood and survival in patients diagnosed with breast and colorectal cancer, using a pooled analysis of five cohort studies and study participants from 11 countries.Methods: Participant-level body mass index (BMI) trajectories were estimated by fitting a growth curve model using over 2 million repeated BMI measurements from close to 600,000 cohort participants. Cumulative measures of excess weight were derived. Data from over 23,000 patients with breast and colorectal cancer were subsequently analyzed using time-to-event models for death with the date of diagnosis as start of follow-up. Study-specific results were combined through a random effect meta-analysis.Results: We found a significant dose–response relationship (P trend ¼ 0.013) between the average BMI during early and mid-adulthood and death from breast cancer, with a pooled HR of 1.31 (1.07–1.60) and the time to death shortened by 16% for average BMI above 25 kg/m2 compared with average BMI less than or equal to 22.5 kg/m2, respectively. Similar results were found for categories of cumulative time spent with excess weight. There was no association between excess body fatness during early to mid-adulthood and death in patients with colorectal cancer.Conclusions: Excess body fatness during early to mid-adulthood is associated not only with an increased risk of developing cancer, but also with a lower survival in patients with breast cancer.Impact: Our results emphasize the importance of public health policies aimed at reducing overweight during adulthood and inform future studies on the relationship between excess weight and cancer outcomes.
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| 27. |
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