| 1. |
- Johansson, Karl-Axel, et al.
(author)
-
The quality assurance process for the ARTSCAN head and neck study - a practical interactive approach for QA in 3DCRT and IMRT.
- 2008
-
In: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. - : Elsevier BV. - 0167-8140 .- 1879-0887. ; 87:2, s. 290-9
-
Journal article (peer-reviewed)abstract
- AIM: This paper describes the quality assurance (QA) work performed in the Swedish multicenter ARTSCAN (Accelerated RadioTherapy of Squamous cell CArcinomas in the head and Neck) trial to guarantee high quality in a multicenter study which involved modern radiotherapy such as 3DCRT or IMRT. MATERIALS AND METHODS: The study was closed in June 2006 with 750 randomised patients. Radiation therapy-related data for every patient were sent by each participating centre to the QA office where all trial data were reviewed, analysed and stored. In case of any deviation from the protocol, an interactive process was started between the QA office and the local responsible clinician and/or physicist to increase the compliance to the protocol for future randomised patients. Meetings and workshops were held on a regular basis for discussions on various trial-related issues and for the QA office to report on updated results. RESULTS AND DISCUSSION: This review covers the 734 patients out of a total of 750 who had entered the study. Deviations early in the study were corrected so that the overall compliance to the protocol was very high. There were only negligible variations in doses and dose distributions to target volumes for each specific site and stage. The quality of the treatments was high. Furthermore, an extensive database of treatment parameters was accumulated for future dose-volume vs. endpoint evaluations. CONCLUSIONS: This comprehensive QA programme increased the probability to draw firm conclusions from our study and may serve as a concept for QA work in future radiotherapy trials where comparatively small effects are searched for in a heterogeneous tumour population.
|
|
| 2. |
|
|
| 3. |
- Wiklund Gustin, Lena, 1960-, et al.
(author)
-
The drama of suffering as narrated by patients who have undergone coronary bypass surgery
- 2009
-
In: International Journal for Human Caring. - Harrisburg, USA : IAHC. - 1091-5710. ; 13:4, s. 17-25
-
Journal article (peer-reviewed)abstract
- The struggle with suffering can be said to be at the centre of what can metaphorically be described as a drama. The study aims to establish whether the drama of suffering is conducted on different levels of health and suffering, and if so, to describe this suffering. Data was analysed using a narrative hermeneutic approach. The analysis revealed four different kinds of drama of suffering. They are described in terms of tragic, romantic, satiric or comic drama – the differences between them relating to different levels of health and suffering and to what the sufferer has to sacrifice to relieve suffering.
|
|
| 4. |
|
|
| 5. |
- Wiklund, Lena, 1960-
(author)
-
"New" knowledge for "old" nursing leaders
- 2008
-
In: 4th International Nursing Management Conference. - Belek, Turkiet.
-
Conference paper (peer-reviewed)abstract
- During the last decades nurse-education has become more oriented towards scientific knowledge. Nursing-theories are taught at school and new nurses are prepared to use them in their clinical practice. However, when graduated and entering the clinical reality the nurses describe that this kind of knowledge are not always appreciated while experienced nursing leaders describes that the new nurses have a kind of knowledge that doesn’t always fit into the existing system. Thus, it is a problem when to different paradigms – one that is more practical and skill-oriented and one where actions are theory-driven – meets. What usually happens is that the new nurses either quit their work or adapt to the old system, thus preserving old knowledge and old routines instead of contributing to the development of nursing care in their units.In order to deal with this the county hospital and the university arranged an education for nursing leaders. The education, “Leadership on Good Caring” took place on advanced level during a five-month period. The nursing leaders was simultaneously working and given 8 credits when passing the examination seminars. In the course the leaders was given an introduction to the content in today’s nurse-education. The main parts of the course consisted in three integrated parts; caring science and nursing theories, building good teams, and approaches to care-development. During the first part focus was on the Finish nurse-theorist Eriksson’s theory of caritative caring, focusing issues relating to the importance of a basic value-system for the development of a caring culture. In their exams the leaders presented plans for how to implement nursing theory at their units in order not only to improve care but also to engage their teams in this process. This paper will not only describe the education but also what kind of projects it resulted in.
|
|
| 6. |
|
|
| 7. |
- Wiklund, Lena, 1960-
(author)
-
Perspektiv på lidande
- 2009
-
In: Omvårdnadens grunder. - Lund : Studentlitteratur. - 9789144049069 ; , s. 295-325
-
Book chapter (other academic/artistic)
|
|
| 8. |
- Wiklund, Lena, 1960-
(author)
-
Resolving spiritual challenges in recovery from addiction
- 2008
-
Conference paper (peer-reviewed)abstract
- Aim: This paper aims to explore the existential aspects of living with addiction.Background: The study focuses on research into addiction conducted within nursing science and takes as its point of departure the patient’s perspective. Addiction is described as being related to traumatic experience and to loss of control, shame, guilt and low self-esteem, but also to spirituality. This causes profound suffering, and drugs are used as a means of handling this suffering.Method: The study constitutes a secondary analysis of data derived from a study in 2000. It is based on interviews with people with rich, personal experience of addiction. Analysis was conducted using a hermeneutic approach.Findings: On an existential level the experiences of living with addiction can be understood as a striving to resolve the spiritual challenges caused by a person’s suffering and, paradoxically, also by his/her efforts to relieve that suffering through the use of drugs. These challenges are presented as existential themes focusing on the conflict that must be resolved; meaning – meaninglessness, connectedness – loneliness, life – death, freedom – adjustment, responsibility – guilt, control – chaos.Conclusion: Living with addiction appears as being in the midst of a struggle with existential challenges. Further more the use of drugs is paradoxical as it momentarily relieves suffering but at the same time increases it. To understand an addicted person’s health and suffering nurses must be aware of the existential aspects of being addicted and the spiritual challenges that must be addressed.
|
|
| 9. |
|
|
