| 1. |
- Blomberg, Karin, 1970-, et al.
(författare)
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Symptoms and self-care strategies during and six months after radiotherapy for prostate cancer : Scoping the perspectives of patients, professionals and literature
- 2016
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Ingår i: European Journal of Oncology Nursing. - : Elsevier. - 1462-3889 .- 1532-2122. ; 21, s. 139-145
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Under-diagnosed and uncontrolled symptoms in patients with prostate cancer during radiotherapy can have a negative impact on the individual's quality of life. An opportunity for patients to report their symptoms systematically, communicate these symptoms to cancer nurses and to receive self-care advice via an application in an Information and Communication Technology-platform could overcome this risk. The content in the application must precisely capture symptoms that are significant to both patients and health care professionals. Therefore, the aim of the study was to map and describe symptoms and self-care strategies identified by patients with prostate cancer undergoing radiotherapy, by health care professionals caring for these patients, and in the literature.Methods: The study combines data from interviews with patients (n ¼ 8) and health care professionals (n ¼ 10) and a scoping review of the literature (n ¼ 26) focusing on the period during and up to 6 months after radiotherapy.Results: There was a concordance between the patients, health care professionals, and the literature on symptoms during and after radiotherapy. Urinary symptoms, bowel problems, pain, sexual problems, fatigue, anxiety, depression, cognitive impairment and irregular symptoms were commonly described during the initial treatment period. Self-care strategies were rarely described in all three of the sources.Conclusions: The results show which symptoms to regularly assess using an Information and Communication Technology-platform for patients with newly-diagnosed prostate cancer during radiotherapy. The next step is to evaluate the efficacy of using the platform and the accuracy of the selected symptoms and self-care advice included in a smartphone application.
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| 2. |
- Browall, Maria, et al.
(författare)
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Information needs of women with recently diagnosed ovarian cancer - A longitudinal study
- 2004
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Ingår i: European Journal of Oncology Nursing. - : Elsevier. - 1462-3889 .- 1532-2122. ; 8:3, s. 200-207
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate the information needs among patients with ovarian cancer and whether these information needs change over time. The information needs were evaluated three times, through structured interviews, and were based on the paired comparison approach developed by Degner and colleagues. A consecutive sample of patients (n=82) with recently diagnosed ovarian cancer was asked to participate.Sixty-four patients (78%) chose to participate. The three different measurements of participants' information needs revealed only small changes in these needs. The three most important information needs, in all measurements, were information about the likelihood of cure, information about the stage and spreading of the disease, and information about different treatment options. Information regarding sexual attractiveness was the lowest ranked item in all measurements. Regarding subgroups (age, education) the only significant difference throughout all measurements was that younger patients rated issues of sexual attractiveness higher than older patients (p=0.005).In this longitudinal study patients with ovarian cancer ranked information about the disease and its treatment (i.e. likelihood of cure, stage of disease, and treatment options) highest, and information about psychosocial aspects and self-care lowest. These findings are in accordance with the results from studies of women diagnosed with other types of cancer, which used the same methodology. © 2004 Elsevier Ltd. All rights reserved.
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| 3. |
- Henoch, Ingela, 1956, et al.
(författare)
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The Swedish Version of the Frommelt Attitude Toward Care of the Dying Scale : Aspects of Validity and Factors Influencing Nurses' and Nursing Students' Attitudes.
- 2014
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Ingår i: Cancer Nursing. - : Lippincott Williams & Wilkins. - 0162-220X .- 1538-9804. ; 37:1, s. E1-E11
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:: Nurses' attitudes toward caring for dying persons need to be explored. The Frommelt Attitude Toward Care of the Dying (FATCOD) scale has not previously been used in Swedish language. OBJECTIVES:: The objectives of this study were to compare FATCOD scores among Swedish nurses and nursing students with those from other languages, to explore the existence of 2 subscales, and to evaluate influences of experiences on attitudes toward care of dying patients. METHODS:: A descriptive, cross-sectional, and predictive design was used. The FATCOD scores of Swedish nurses from hospice, oncology, surgery clinics, and palliative home care and nursing students were compared with published scores from the United States, Israel, and Japan. Descriptive statistics, t tests, and factor and regression analyses were used. RESULTS:: The sample consisted of 213 persons: 71 registered nurses, 42 enrolled nurses, and 100 nursing students. Swedish FATCOD mean scores did not differ from published means from the United States and Israel, but were significantly more positive than Japanese means. In line with Japanese studies, factor analyses yielded a 2-factor solution. Total FATCOD and subscales had low Cronbach α's. Hospice and palliative team nurses were more positive than oncology and surgery nurses to care for dying patients. CONCLUSIONS:: Although our results suggest that the Swedish FATCOD may comprise 2 distinct scales, the total scale may be the most adequate and applicable for use in Sweden. Professional experience was associated with nurses' attitudes toward caring for dying patients. IMPLICATION FOR PRACTICE:: Care culture might influence nurses' attitudes toward caring for dying patients; the benefits of education need to be explored.
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| 4. |
- Henoch, Ingela, et al.
(författare)
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The Swedish version of the Frommelt Attitude Toward Care of the Dying Scale (FATCOD) : Aspects of validity and factors influencing nurses' and nursing students' attitudes
- 2014
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Ingår i: Cancer Nursing. - : Lippincott Williams & Wilkins. - 0162-220X .- 1538-9804. ; 37:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Nurses' attitudes toward caring for dying persons need to be explored. The Frommelt Attitude Toward Care of the Dying (FATCOD) scale has not previously been used in Swedish language.Objectives: The objectives of this study were to compare FATCOD scores among Swedish nurses and nursing students with those from other languages, to explore the existence of 2 subscales, and to evaluate influences of experiences on attitudes toward care of dying patients.Methods: A descriptive, cross-sectional, and predictive design was used. The FATCOD scores of Swedish nurses from hospice, oncology, surgery clinics, and palliative home care and nursing students were compared with published scores from the United States, Israel, and Japan. Descriptive statistics, t tests, and factor and regression analyses were used.Results: The sample consisted of 213 persons: 71 registered nurses, 42 enrolled nurses, and 100 nursing students. Swedish FATCOD mean scores did not differ from published means from the United States and Israel, but were significantly more positive than Japanese means. In line with Japanese studies, factor analyses yielded a 2-factor solution. Total FATCOD and subscales had low Cronbach [alpha]'s. Hospice and palliative team nurses were more positive than oncology and surgery nurses to care for dying patients.Conclusions: Although our results suggest that the Swedish FATCOD may comprise 2 distinct scales, the total scale may be the most adequate and applicable for use in Sweden. Professional experience was associated with nurses' attitudes toward caring for dying patients.Implication for Practice: Care culture might influence nurses' attitudes toward caring for dying patients; the benefits of education need to be explored.
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| 5. |
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| 6. |
- Snögren, Maria, et al.
(författare)
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Impacts on oral health attitude and knowledge after completing a digital training module among Swedish healthcare professionals working with older adults
- 2024
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Ingår i: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Oral health care is essential, and digital training may influence healthcare professionals’ attitudes to and knowledge of oral health. The aim, therefore, was to evaluate the impact on attitudes to and knowledge of oral health after using a digital training module among Swedish healthcare professionals working within a municipality-run healthcare service for older adults. A secondary aim was to explore the healthcare professionals’ experiences of using the digital module. The study comprised a survey of healthcare professionals (registered nurses (RNs), assistant nurses, and care assistants) caring for older adults in a municipality in Sweden. Pre-post-tests were conducted to evaluate the outcomes for attitudes to and knowledge of oral health and of their experiences of completing the digital training module in oral health. These were statistically explored by comparing differences between the pre-post-tests, while the open-ended questions were analysed with qualitative content analysis. The findings of this study indicate that healthcare professionals had similar perceptions of their attitudes to and knowledge of oral health both before and after the digital training module in oral health. The study also indicates that healthcare professionals experienced that it is easier to perform practical oral health care after completing the digital training. The results also show that healthcare professionals value oral health knowledge and that the digital training module was easy to use and to disseminate knowledge throughout the municipality. The findings have implications for developing, implementing, and promoting healthcare professionals’ attitudes to and knowledge of oral health and in using a digital training module in combination with practical exercises in oral health in municipality health care.
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| 7. |
- Snögren, Maria
(författare)
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Munhälsa – Äldre personers upplevelser och vårdpersonals attityder och kunskaper
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund: Det är känt att äldre personer har bättre munhälsa i dag och fler kvarvarande tänder än tidigare generationer. Det är en komplex uppgift att utföra munvård för att förebygga nedsatt munhälsa på någon annan. Nedsatt munhälsa kan påverka allmänhälsan på olika sätt, till exempel genom smärta och nedsatt aptit. Nedsatt munhälsa kan också vara en bidragande orsak till infektioner lokalt i munnen, men även i andra delar av kroppen. Det har dock visat sig att vårdpersonal (sjuksköterskor, undersköterskor och vårdbiträden) inom kommunal äldreomsorg försummar utförandet av munvård hos äldre personer av olika skäl, däribland tidsbrist, okunskap och bristande rutiner. Vårdpersonal värdesätter kunskap om munhälsa och efterfrågar utbildning om munhälsa och munvård. Kompetensutveckling för vårdpersonal tar tid samtidigt som den digitala utvecklingen och tillgången till digitala tjänster ökar. Digital utbildning kan vara en lösning till att sprida kunskap i en hel arbetsgrupp. Studier har visat på stort värde av möjligheten till interaktivitet, repetition och feedback som tydligt förknippas med ett ökat lärande vid användande av digitala utbildningar. Studier visar även att vårdpersonal som kompetensutvecklas genom utbildning om munhälsa tillhandahåller bättre munvård till äldre personer efter utbildning.Syfte: Det övergripande syftet var att studera äldre personers uppfattning om munhälsa och vårdpersonals attityder till och kunskaper om omvårdnad relaterat till munhälsa. Ytterligare ett syfte var att beskriva vårdpersonals attityder och kunskaper före och efter en digital utbildning i munhälsa och användbarheten av denna.Metod: Avhandlingen inkluderar fyra delstudier varav två har en kvalitativ design, delstudie I och IV, en med kvantitativ design, delstudie II och en med mixad metod, delstudie III. Delstudie I inkluderar äldre personer och delstudie II-IV inkluderar vårdpersonal. Data har samlats in med hjälp av frågeformulär, individuella intervjuer och fokusgruppsintervjuer. Kvalitativ analys genomfördes med hjälp av kvalitativ innehållsanalys i delstudie I och IV. Kvantitativa analyser genomfördes med Psykometrisk utvärdering med klassisk testteori (CTT) kompletterad med Item Response Theory (IRT) i delstudie II och beskrivande statistik och Wilcoxon signed-rank test i delstudie III.Resultat: Resultaten visar att det är komplext att utföra munvård på någon annan och kräver att tid ges till att bygga personkännedom mellan vårdpersonalen och den äldre personen som får hjälp med munvård. Personkännedom beskrivs av vårdpersonal främja och ge trygghet i utförandet av munvård. Äldre personer beskriver att de är experter på sina egna upplevelser av munhälsan och att denna kunskap behöver delas med vårdpersonalen. Personkännedom etableras och uppnås genom att vårdpersonalen skapar förtroende, är närvarande, förutser behov, är pålästa och genom att reflektera över vården. Det är ett förtroende att utföra munvård på någon annan, vilket underlättas av personkännedom. Det ger vårdpersonalen information och bättre förutsättningarna att utföra god munvård och att synliggöra hinder som tids-, personal- och kunskapsbrist. Äldre personer värdesätter en god munhälsa och vårdpersonalen värdesätter kunskap relaterad till munhälsa. Ett sätt att sprida kunskap om munhälsa bland vårdpersonalen är genom digitala utbildningsinterventioner. Kombinationen av teoretisk kunskap med hjälp av digital utbildning och praktiska övningar beskrivs av vårdpersonalen som ett sätt att ge både teoretisk och praktisk kunskap. Att arbeta tillsammans över professionsgränser i omvårdnad kring munvården beskrivs ofta brista inom kommunal äldreomsorg. Arbetet tillsammans upplevs dock fungera bra vid palliativ omvårdnad. Äldre personer beskriver en önskan om hjälp med sin munhälsa när behov uppstår.Slutsatser: Äldre personer värdesätter en god munhälsa och vårdpersonalen värdesätter kunskap relaterad till munhälsa. Munvård är komplex och förutsätter att vårdpersonalen erhåller kunskap, rutiner, tid och samarbetar för att utföra den med god personkännedom om den äldre person. Digital utbildning är ett sätt att öka kunskapen om munhälsa bland vårdpersonalen. En kombination av teori med hjälp av digital utbildning och praktiska övningar bidrar till både teoretisk och praktisk kunskap. Samarbetet kring munvård mellan sjuksköterskor, undersköterskor och vårdbiträden fungerade inte alltid optimalt, däremot fungerade samarbetet bra vid palliativ omvårdnad. Samarbete, tid och kunskap samt reflektion anses vara viktiga faktorer för vårdverksamheter att beakta i framtiden för att god munvård ska kunna utföras inom kommunal äldreomsorg.
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| 8. |
- Snögren, Maria, et al.
(författare)
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Older adults’ perceptions of oral health and its influence on general health : A deductive direct content analysis
- 2023
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Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 43:1, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- Oral health is a complex issue associated with social and behavioral factors and general health. Therefore, this study aims to explore Swedish older adults’ perceptions of oral health and its influence on general health, based on the World Dental Federation's (FDI) definition and framework of oral health. The study adopted a descriptive qualitative design. Data were collected from semi-structured individual and focus group interviews with older adults (n = 23) and were analyzed with deductive direct content analysis. The study was evaluated using the COnsolidated criteria for REporting Qualitative research (COREQ) checklist. The older adults described the importance of good oral health in the physical, social, emotional, and mental aspects of their daily lives. The findings also indicate that older adults described oral health as multifaceted and agreed with the FDI's definition and framework of oral health. Therefore, the study findings might provide healthcare professionals with new knowledge and further insight into older adults’ perceptions of oral health and its influence on their well-being and general health.
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| 9. |
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| 10. |
- Snögren, Maria, et al.
(författare)
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Psychometric evaluation of a short-form version of the Swedish "Attitudes to and Knowledge of Oral Health" questionnaire
- 2022
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Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Healthcare professionals' attitudes to and knowledge of oral health are fundamental to providing good oral health care to older adults. One instrument that assesses healthcare professionals' attitudes to and knowledge of oral health in a Swedish context is the "Attitudes to and Knowledge of Oral health" (AKO) questionnaire. Two of the three item-groups of the AKO have previously been validated in a Swedish context. However, it is crucial that all three item-groups are validated, and beneficial to design a shorter, easy-to-use questionnaire for healthcare professionals while maintaining adequate integrity of its reliability and validity. Therefore, the present study aims to develop a short-form version of AKO and to secure its psychometric properties. Methods Psychometric evaluation with Classical Test Theory and Item Response Theory to validate and shorten AKO with 611 healthcare professionals from a population of 1159 working in a municipality in an urban area in western Sweden. Results Of the original 16 items in the AKO, 13 were shown to warrant retention in the abbreviated/shortened form. These showed acceptable validity and reliability for assessing healthcare professionals' attitudes to and knowledge of oral health. Conclusion This validated short-form version of AKO shows acceptable validity and reliability after being reduced to 13 items, structured in a 3-part scale. The items are consistent with the total scale, indicating that the internal consistency is acceptable. Future studies should be performed to evaluate AKO in other groups of healthcare professionals, across cultures, languages, and so on, to investigate its use and strengthen its validity and reliability.
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| 11. |
- Zhou, Lihua, et al.
(författare)
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Factors associated with posttraumatic growth among spouses of women diagnosed with gynaecological cancer: A cross-sectional study
- 2023
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Ingår i: Nursing Open. - : Wiley. - 2054-1058. ; 10:2, s. 630-640
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Tidskriftsartikel (refereegranskat)abstract
- Aim:The aim of this study was to explore the factors that are associated with posttraumatic growth among spouses of women diagnosed with gynaecological cancer. Design:A cross-sectional descriptive study. Methods:A convenience sample of 312 spouses of women diagnosed with gynaecological cancer was recruited from two comprehensive hospitals in China, from March 2018 to March 2020. Demographic characteristics, cancer-related characteristics, posttraumatic growth, perceived social support and coping were assessed using self-reported questionnaires. Descriptive statistics and multiple linear regression analysis were performed. The methods were guided by the STROBE checklist. Results:The mean score of posttraumatic growth was 46.7 (standard deviation = 16.7). The associated factors of posttraumatic growth were spouses' age, perceived social support, problem-focused coping, dysfunctional coping (e.g. denial) and cancer treatment received by partners, which accounted for 34% of total posttraumatic growth score. Patient or public contribution:All participants contributed to the conducting of this study by completing self-reported questionnaires.
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| 12. |
- Zhou, Lihua
(författare)
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Perceived growth following gynecological cancer and its associated factors from the perspectives of Chinese women, spouses, couples and registered nurses
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Gynecological cancer (GC) is the most common cancer diagnosis among women, globally, including China. Women who experience a diagnosis of GC, their spouses, the couples as a unit, as well as registered nurses (RNs) caring for these women, all face different challenges during this cancer trajectory. Prior to this study, few studies have explored the factors associated with perceived growth among women diagnosed with GC, their spouses, and couples, as well as RNs caring for these women, based on a growth-related theory and model. The overall aim of this thesis was therefore to explore perceived growth and its associated factors, based on these persons’ perspectives.Four studies (Study I–IV) ) were conducted, each using a cross-sectional and descriptive study design. In Study I, women’s posttraumatic growth (PTG) and its associated factors were explored. Data were collected through 344 questionnaires and analyzed by using binary stepwise logistic regression. In Study II, spouses’ PTG and its associated factors were explored. Data were collected through 312 questionnaires and analyzed by using multiple regression analysis. Study III explored the actor effects and partner effects of perceived social support on PTG among couples where the woman had been diagnosed with GC. Data were collected with 126 couples using questionnaires and analyzed by using Structural Equation Modeling. Study IV described the perceived professional benefits and explored the association between perceived professional benefits, sense of coherence, and coping strategies in RNs caring for women diagnosed with GC. Data were collected with 250 RNs using questionnaires and analyzed by using multiple regression analysis.The results indicate that women’s self-disclosure was positively associated with their PTG. Confrontation coping strategies, avoidance coping strategies, problem-focused coping strategies (e.g., active coping, instrumental support, and planning), and dysfunctional coping (e.g., denial, behavioral disengagement, self-distraction, and venting) were positively associated with perceived growth. Perceived social support was positively associated with PTG in both women diagnosed with GC and their spouses. Spouses’ perceived social support was positively associated with women’s perceived social support and women’s PTG. In addition, sense of coherence was positively associated with RNs’ perceived professional benefits.Based on the findings from this thesis, it is concluded that RNs need to encourage these women and their spouses to communicate their feelings, concerns, and supportive care needs, with other family members and loved ones. RNs also needs to pay more attention to the spouses’ supportive care needs, so that they are able to better support these women. It was shown that integrating effective coping strategies into existing cancer care practice may help couples to cope with the challenges related to GC. Furthermore, RNs should consider women and their spouses as a whole unit to provide effective care, and to help couples as a unit to re-evaluate their understanding of what really matters in their life. In addition, there is a need to help RNs to promote the nurse–patient relationship and a sense of belonging to the work team in their nursing practice.
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| 13. |
- Zhou, Lihua, et al.
(författare)
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Perceived professional benefits and their associated factors among Chinese registered nurses caring for women diagnosed with gynecological cancer
- 2023
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Ingår i: European Journal of Oncology Nursing. - : Elsevier. - 1462-3889 .- 1532-2122. ; 66
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Tidskriftsartikel (refereegranskat)abstract
- ProposeRegistered nurses (RNs) are considered to be a major source of professional supportive care for women diagnosed with gynecological cancer (GC). This study described the level of perceived professional benefits and explored association between perceived professional benefits, sense of coherence (SOC), and coping strategies in Chinese RNs caring for women diagnosed with GC.MethodA cross-sectional survey was employed to collect data using the Nurses' Perceived Professional Benefits Questionnaire (NPPBQ), Sense of coherence scale (SOC-13), and Brief Coping Orientation to Problems Experienced (Brief COPE). The questionnaires were administered to 250 RNs in China. The correlations between NPPBQ, SOC-13, and Brief COPE were evaluated with Pearson's correlation coefficient. Multiple regression analysis was performed to assess the relative contribution of each possible factor in explaining variance in the increased NPPBQ.ResultsTotal score for NPPBQ was 142.4 (range 33.0–165.0). SOC, dysfunctional coping strategies, and problem-focused coping strategies were recognized as predictors of RNs' perceived professional benefit, while, emotion-focused coping strategies were not significantly associated with RNs’ perceived professional benefits.ConclusionsThe findings indicate that RNs who have high levels of SOC, dysfunctional coping strategies, and problem-focused coping strategies tend to experience more perceived professional benefit. These findings propose new perspectives for nursing managers to promote RNs' perceived professional benefit by helping RNs to find meaningfulness when caring for women diagnosed with GC, increasing RNs’ communication skills to improve their relationship with patients, and training RNs to use coping strategies effectively.
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| 14. |
- Zhou, Lihua, et al.
(författare)
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Post-traumatic growth and its influencing factors among Chinese women diagnosed with gynecological cancer: A cross-sectional study.
- 2021
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Ingår i: European Journal of Oncology Nursing. - : Elsevier BV. - 1462-3889 .- 1532-2122. ; 51
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The experience of cancer could lead to positive psychological changes following the struggle with diagnosis and treatment. Understanding post-traumatic growth and its influencing factors in women affected by gynecological cancer is essential to enhance their possibility of achieving positive changes. The purpose of this study was to describe the post-traumatic growth level and explore the influencing factors of post-traumatic growth in Chinese women diagnosed with gynecological cancer. Method: A cross-sectional survey with a convenience sampling method was employed to collect data using the Post-traumatic Growth Inventory (PTGI), Distress Disclosure Index (DDI), Medical Coping Modes Questionnaire (MCMQ), and Multidimensional Scale of Perceived Social Support (MSPSS). The questionnaires were administered to 344 participants recruited from two hospitals in Hefei City, the capital of Anhui Province in China, between March 2018 and March 2019. All statistical analyses were performed using nonparametric tests. The Mann-Whitney U Test was used to distinguish the intergroup differences. Correlations were evaluated with Spearman rank correlation coefficients. Results: Total score for PTGI was 56.5 (range 48.0-68.0). The subscale with the highest centesimal score in the PTGI was appreciation of life and the lowest was spiritual change. The top five items with the highest scores of PTGI belonged to appreciating life, personal strength, and relating to others. Self-disclosure, confrontation, avoidance, acceptance-resignation, perceived social support, education level, cancer type and the place they lived had significant influence on post-traumatic growth. Conclusions: The findings indicate that women who have high levels of perceived social support, confrontation, avoidance, self-disclosure and education level tend to experience more post-traumatic growth, while, conversely, high levels of acceptance-resignation have a negative influence on promoting post-traumatic growth. These meaningful findings propose new perspectives for promoting post-traumatic growth in Chinese women diagnosed with gynecological cancer.
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| 15. |
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| 16. |
- Backman, Malin, et al.
(författare)
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Experiencing health - Physical activity during adjuvant chemotherapy treatment for women with breast cancer
- 2016
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Ingår i: European Journal of Oncology Nursing. - : Elsevier. - 1462-3889 .- 1532-2122. ; 21, s. 160-167
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of this study was to explore how women with breast cancer experience physical activity (PA) during adjuvant chemotherapy treatment.METHODS: This study included sixteen women diagnosed with breast cancer who had participated in a supervised 16-week PA intervention during adjuvant chemotherapy treatment. The qualitative approach included semi-structured individual and focus group interviews. Data were analyzed inductively with content analysis.RESULT: The content analysis resulted in a description of experiencing health during chemotherapy treatment covered by five categories: Solidarity with others and being good to oneself; Experiencing functional improvement and social support; Empowerment and motivation to focus on health; Barriers to adherence to PA during illness and treatment; and Enabling health and independence. A core category was identified; PA a tool for maintenance and recovery of physical, mental and social health. The women reported that PA had a positive impact on both physical function and mental wellbeing. Participating in the PA intervention also increased their feeling of social support, which was reported to be important to motivate adherence to PA when the side effects became more severe. Symptom burden, time and lack of motivation were reported as barriers to continue PA during treatment.CONCLUSION: The women in this study reported that PA had a positive impact on their perceived health and that it was possible to exercise despite increasing symptom burden from treatment. PA was perceived as a tool that supported health processes and gave the women a feeling of getting respite from the illness.
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| 17. |
- Browall, Maria, et al.
(författare)
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A prospective exploration of symptom burden clusters in women with breast cancer during chemotherapy treatment
- 2017
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Ingår i: Supportive Care in Cancer. - : Springer. - 0941-4355 .- 1433-7339. ; 25:5, s. 1423-1429
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Tidskriftsartikel (refereegranskat)abstract
- PurposeThe aim was to prospectively map symptom clusters in patients with stage I–IIIa breast cancer during standard chemotherapy treatment in a randomised study.MethodsParticipants completed the Memorial Symptom Assessment Scale (MSAS) at baseline, day 12 after the first and third cycle of FEC 75 or FEC 100, and day 12 after the last cycle of Taxotere. Cut-off values for symptom scores, a mean value based on each individual reporting a symptom including occurrence, frequency, severity and distress for inclusion in analysis, were determined.ResultsThe symptom burden cluster analysis was conducted in two steps and included symptoms with high frequency and high levels of distress. The factor analysis revealed three symptom clusters; physical, gastro (phys/gastro) and emotional, with core symptoms that remained stable over time. The most prevalent symptoms for the total sample during all cycles were as follows: lack of energy (range between 48 and 90%), feeling sad (48–79%), difficulty sleeping (54–78%), difficulty concentrating (53–74%), worrying (54–74%) and pain (29–67%).ConclusionIn summary, we have prospectively established that symptom clusters remain stable over time with a basis of core symptoms. This knowledge will aid in the development of effective core symptom-focused interventions to minimise symptom burden for patients treated with chemotherapy for breast cancer.
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| 18. |
- Browall, Maria, et al.
(författare)
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Assessing patient outcomes and cost effectiveness of nurse-led follow-up for women with breast cancer : have relevant and sensitive evaluation measures been used?
- 2017
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Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell Publishing Inc.. - 0962-1067 .- 1365-2702. ; 26:13-14, s. 1770-1786
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Forskningsöversikt (refereegranskat)abstract
- AimTo explore how interventions using nurse-led follow-up in breast cancer care have been evaluated with a focus on patient outcomes and cost effectiveness.BackgroundAs part of the advancement of breast care, nurse-led follow-up is increasingly used as an alternative to routine hospital follow-up in outpatient clinics. There is evidence suggesting that patients appear to be satisfied with the nurse-led follow-up, but there is a lack of evidence of whether this perception equates to patients’ satisfaction with the model of physician-led follow-up.DesignSystematic review.MethodThree databases were searched, and 29 RCT were initially screened. Finally, 13 articles were critically appraised. Searches included articles between 2005 and 2013. The quality of appraisal assessment was inspired by the GRADE system.ResultsThe results show that there are many different instruments used when evaluating nurse-led follow up which makes it difficult to compare the studies. Several of the studies used QoL as an outcome measure; this is a broad concept that includes several aspects ranging from social role and psychosocial issues to symptoms and therefore difficult to use as an outcome measure. Only two of the studies made any cost-effective analyses and the results are hard to interpret.ConclusionsNurse-led follow-up can potentially result in better continuity of care and the availability of more time to provide psychosocial support and address patients’ information needs. However, more well-conducted research is needed before equivalence to physician-led follow-up can be assessed in terms of survival, recurrence, patient well-being and cost-effectiveness.
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| 19. |
- Browall, Maria, et al.
(författare)
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Daily assessment of stressful events and coping among post-menopausal women with breast cancer treated with adjuvant chemotherapy : Original article
- 2009
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Ingår i: European Journal of Cancer Care. - : John Wiley & Sons. - 0961-5423 .- 1365-2354. ; 18:5, s. 507-516
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the study was twofold: to examine what type of daily stressful events post-menopausal woman with breast cancer experience during adjuvant chemotherapy and how bothersome these are and to identify coping strategies used by these women used to manage such stressful events. The patient group comprised 75 consecutively invited women (≥55 years of age) at two university hospitals and one county hospital in Sweden. The Daily Coping Assessment was used to collect data over time. Data were analysed both qualitatively and quantitatively. Six categories of stressful events were identified: 'nausea and vomiting', 'fatigue', 'other symptoms', 'isolation and alienation', 'fear of the unknown' and 'being controlled by the treatment'. The first three categories were subsumed under the domain physical problems and the latter three under psychosocial problems. Almost 30% of the diary entries recorded no stressful event. Physical problems were three times as frequent as psychosocial problems. 'Nausea/vomiting' was the most frequently observed stressful event (21.6%). 'Isolation and alienation' and 'fear of the unknown' were less frequent, but when they occurred they were rated as the most distressing. Several coping strategies were used to manage each stressful event. The most common strategies were acceptance, relaxation and distraction. Religion was rarely used as a coping strategy.
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| 20. |
- Browall, Maria, et al.
(författare)
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Development and Psychometric Evaluation of a New Short Version of the Swedish Frommelt Attitudes Toward Care of the Dying Scale
- 2021
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Ingår i: Cancer Nursing. - : Ovid Technologies (Wolters Kluwer Health). - 0162-220X .- 1538-9804. ; 44:4, s. 305-313
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Frommelt Attitudes Toward Care of the Dying (FATCOD) is widely used as a measure of attitudes toward care of dying patients. However, poor factor structure and item redundancy have been reported across the literature.OBJECTIVE: A short version of the questionnaire is needed, to facilitate effective assessments of the attitudes of those caring for dying patients. The purpose of this study was to develop a FATCOD-Short Form and to secure its psychometric properties.INTERVENTIONS/METHODS: Data gathered from 1000 nurses in previous studies were pooled and reanalyzed. Principal components analysis and confirmatory factor analysis were utilized to assess the factor structure of the FATCOD-30. A Rasch model was used to evaluate the measurement functioning of the scale.RESULTS: Of the original 30 items, 9 items of FATCOD were chosen for retention in the short form based on the principal components analysis, floor or ceiling effects, interitem correlations, and item-total correlation. All 9 items had good internal reliability. Both confirmatory factor analysis and Rasch analysis supported the unidimensionality of the FATCOD-Short Form.CONCLUSIONS: The 9-item FATCOD-Short Form demonstrates evidence of acceptable validity and reliability to identify nurses' attitudes toward caring for dying persons because of its brevity and comprehensive content.IMPLICATIONS FOR PRACTICE: When changing curricula in nursing education or implementing new procedures in nursing practice, it is important to have valid instruments to evaluate the results of the change. Such instruments should not be too lengthy or complicated. FATCOD-Short Form is a brief and valid instrument that can be easily used.
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| 21. |
- Browall, Maria, et al.
(författare)
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Digi-Do : A digital information tool to support patients with breast cancer before, during, and after start of radiotherapy treatment
- 2020
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Ingår i: Annals of Oncology. - : Elsevier. - 0923-7534 .- 1569-8041. ; 31:Supplement 4, s. S1126-S1126
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Tidskriftsartikel (refereegranskat)abstract
- Radiation Therapy (RT) is a common treatment after breast cancer surgery. The high-tech environment and unfamiliar nature of RT can affect the patient’s experience of the treatment. Misconceptions or a lack of knowledge about RT processes can increase levels of anxiety and enhance feelings of being unprepared at the beginning of treatment. Moreover, the waiting time can be long and experienced as meaningless or even life threatening. For successful radiotherapy, the person often needs to be immobilized. A calm, well informed patient might enhance quality of treatment, both from patient and provider perspective. Waiting times can become meaningful instead of meaningless if used wisely for information and preparation for patients and loved ones.
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| 22. |
- Browall, Maria, et al.
(författare)
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Existential encounters: Nurses' descriptions of critical incidents in end-of-life cancer care
- 2014
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Ingår i: European Journal of Oncology Nursing. - : Elsevier BV. - 1462-3889 .- 1532-2122. ; 18:6, s. 636-644
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Tidskriftsartikel (refereegranskat)abstract
- Nurses working with cancer patients in end of life care need to be prepared to encounter patients' psychosocial and spiritual distress. Aim: The aim of this study was to describe nurses' experiences of existential situations when caring for patients severely affected by cancer. Methods and sample: Nurses (registered and enrolled) from three urban in-patient hospices, an oncology clinic and a surgery clinic and a palliative homecare team were, prior to the start of a training program, invited to write down their experiences of a critical incident (CI), in which existential issues were featured. Results: Eighty-eight CIs were written by 83 nurses. The CIs were analyzed with qualitative content analysis. Two main themes were found: Encounters with existential pain experiences, which concerned facing death and facing losses; and Encountering experiences of hope, which concerned balancing honesty, and desire to live. Conclusions: This study points out that health care professionals need to be aware of patients' feelings of abandonment in exposed situations such as patients' feelings of existential loneliness. That there are some patients that express a desire to die and this makes the nurses feel uncomfortable and difficult to confront these occurrences and its therefore important to listen to patients' stories, regardless of care organization, in order to gain access to patients' inner existential needs.
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| 23. |
- Browall, Maria, 1963
(författare)
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Experience of adjuvant treatment among postmenopausal women with breast cancer - Health-Related Quality of Life, symptom experience, stressful events and coping strategies.
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In Sweden, breast cancer is today the most common type of cancer among women. Of the approximately 7,059 women who developed the disease in Sweden during 2006, about 73% were postmenopausal and aged 55 or older at time of diagnosis, and about 33% were aged 70 or older. Survival time for women with breast cancer has been extended due primarily to the development of new adjuvant treatments; however, these treatments may produce a wide variety of troublesome symptoms. There are limited descriptions in the literature of how Health-Related Quality of Life (HRQoL) is affected by adjuvant treatments in elderly populations. Nevertheless, it is common that in clinical practice these women are offered less aggressive treatment due to fears that the side effects may be greater for them.This thesis explores the experience of adjuvant chemotherapy (CT) and/or radiotherapy (RT) among postmenopausal women with breast cancer. More specifically, the thesis aims to examine how HRQoL develops over time, what factors predict overall HRQoL after treatment and if age is associated with HRQoL. A further aim was to describe stressful events experienced by these women and how they manage these stressful events or situations. The participants were recruited from three centres in Sweden (Gothenburg, Stockholm and Skövde). In the first study, 150 women scheduled to receive adjuvant chemotherapy (CT, n=75) or radiotherapy (RT, n=75) were included. In the second study, 20 women with breast cancer were interviewed regarding their experiences during CT. The third and fourth studies included the same 75 women scheduled to receive adjuvant CT from the first study. Both inductive and deductive research methods were used. Data from the qualitative studies (II and IV) were analysed with content analyses (qualitative and quantitative). Data collected with quantitative methods were analysed using mainly non-parametric methods (Paper I and III). No significant relationship was found between age and any of the HRQoL domains, except dyspnoea and sexual functioning. Thirty percent of the diaries recorded no stressful events during adjuvant CT. Stressful events experienced during CT were more related to physical problems than to psychosocial problems. CT and RT affected many aspects of the women?s HRQoL negatively. RT was associated with more localized problems, whereas CT was associated with systemic symptoms. Nausea/vomiting was one of the most stressful events reported by women undergoing CT, increased significantly during and after treatment and was also the most anticipated side effect of CT. Fatigue and depression increased over time and remained high at time of follow-up. Baseline predictors for overall QoL after CT were emotional functioning and pain, whereas overall QoL after RT was predicted by baseline emotional and physical functioning, lower tumour stage and less breast symptoms. Social support from family, friends and health care professionals was important for these women. The women employed many different coping strategies for each stressful event. Acceptance, relaxation and distraction were the most commonly used strategies. In conclusion, CT and RT variously and seriously affect aspects of HRQoL in postmenopausal women. This indicates that the situation of these women cannot be understood as simply a function of chronological age, but as an individual process where the biological age is important. Patient care may be improved by focusing more attention on specific symptoms, notably fatigue, nausea/vomiting, and depression, and also on social and emotional functioning. Interventional studies are needed that specifically target identified pre-treatment predictors of later impaired QoL to determine if it is possible to prevent declines in QoL in these women. The deeper understanding of the coping strategies used by women to handle stressful events is also an important knowledge and a possible way for health care professionals to support in clinical practice.
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| 24. |
- Browall, Maria, 1963, et al.
(författare)
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Health care staff's opinions about existential issues among patients with cancer.
- 2010
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Ingår i: Palliative & supportive care. - : Cambridge University Press. - 1478-9523 .- 1478-9515. ; 8:1, s. 59-68
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The objective of this study was to explore health care staff's opinions about what existential issues are important to patients with cancer and staff's responsibility when existential issues are raised by patients. METHOD: Four focus group interviews were conducted with health care staff (N = 23) at an in-patient hospice, on an oncology ward, on a surgical ward, and with a palliative home health care team. The focus group interviews focused on two questions, first, about health care staff's opinions about patients' important existential questions and, second, about health care staff's responsibility when existential issues are raised by the patient. The interviews were tape-recorded, transcribed verbatim, and analyzed by qualitative content analysis into subcategories and categories. RESULTS: Four categories and 11 subcategories emerged from the first question. The first category, "life and death," was based on joy of living and thoughts of dying. The second category "meaning," consisted of acceptance, reevaluation, hope, and faith. The third category, "freedom of choice," consisted of responsibility and integrity, and the fourth and last category, "relationships and solitude," consisted of alleviation, dependency, and loss. One category emerged from the second question about the health care staff's responsibility, "to achieve an encounter," which was based on the subcategories time and space, attitudes, and invitation and confirmation. SIGNIFICANCE OF RESULTS: The strength of this study was that the findings were fairly congruent in different settings and in different geographical areas. Health care staff were aware of the importance of existential issues to patients. The existential issues, mentioned by health care staff, are similar to findings from studies conducted among patients, which is another strength of the present study. Health care staff are also confident about how to act when these issues are raised by the patients. The challenge for the future is to implement the findings from this study among health care staff in different settings.
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| 25. |
- Browall, Maria, et al.
(författare)
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Health-related quality of life during adjuvant treatment for breast cancer among postmenopausal women
- 2008
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Ingår i: European Journal of Oncology Nursing. - : Elsevier. - 1462-3889 .- 1532-2122. ; 12:3, s. 180-189
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the present study was twofold: first, to describe changes of Health-Related Quality of Life (HRQoL) during the adjuvant treatment among postmenopausal women with breast cancer; second, in the same population to identify the best predictors of Overall Quality of Life (QoL) after treatment, from perceived functioning, symptoms, emotional distress and clinical/demographic variables measured at baseline. The study group was 150 women (>= 55 years of age) scheduled for adjuvant chemotherapy (CT, n=75) or radiotherapy (RT, n=75). They were examined before (baseline), during and after completing the treatment. Data about QoL, perceived functioning, symptoms and emotional distress were collected with the European Organisation for Research and Treatment of Cancer (EORTC)-QLQ-C30, BR23 and Hospital Anxiety and Depression Scale (HADS) questionnaires. The general finding was that the adjuvant treatments were associated with decrease in overall QoL, physical and role functioning, anxiety and body image, as well as with increase in fatigue, dyspnoea, pain, nausea/vomiting, constipation and systemic therapy side effects measured over time. For women receiving CT, better emotional functioning and less pain at baseline predicted better overall QoL at the end of the treatment. For women receiving RT, better physical and emotional functioning, less breast symptoms and lower tumour stage at baseline predicted better overall QoL at the end of the treatment.
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