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Drott, J., Fomichov, V., Starkhammar, H., Börjeson, S., Kjellgren, K. I. & Berterö, C. (2019). Oxaliplatin-Induced Neurotoxic Side Effects and Their Impact on Daily Activities. Cancer Nursing
Open this publication in new window or tab >>Oxaliplatin-Induced Neurotoxic Side Effects and Their Impact on Daily Activities
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2019 (English)In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background: Oxaliplatin (OXA) is frequently used in the treatment of patients with colorectal cancer, and OXA-induced neurotoxic side effects are common. Reports on real-time patient-reported neurotoxic side effects and impact on the patient's daily activities are sparse in existing studies. Objective: The aim of this study was to identify and assess patient-reported OXA-induced neurotoxic side effects and their impact on the patient's daily activities, during and after chemotherapy. Methods: In a multicenter prospective longitudinal study, 46 chemo-naïve patients with colorectal cancer treated with postoperative adjuvant OXA-based chemotherapy were monitored during treatment and at 3-, 6-, 9-, and 12-month follow-ups. Patients were recruited from September 2013 to June 2016. In total, 370 Oxaliplatin-Associated Neurotoxicity Questionnaire responses were available for analysis. A mobile phone-based system was used to receive real-time assessments. Results: All patients reported neurotoxic side effects and impact on daily activities during treatment. The side effects changed in character and body location over time and had an impact on the daily activities. Conclusions: The high prevalence of OXA-induced neurotoxic side effects significantly interfered with the patients' daily activities. We found significant differences between baseline data and follow-up time points for neurotoxicity, and the patients had not returned to baseline after 1 year. Implications for Practice: The real-time assessment using mobile phone technology seems to be a valuable tool for monitoring patient-reported neurotoxicity and interventions for tailored care. Effectively identifying neurotoxicity and its impact on the patient's daily activities is important in supportive cancer care.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2019
Keywords
Cancer nursing; Chemotherapy; Colorectal cancer; Daily activities, mHealth; Neurotoxicity; Patient-reported outcomes; Symptom control
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-154883 (URN)10.1097/ncc.0000000000000674 (DOI)
Available from: 2019-03-04 Created: 2019-03-04 Last updated: 2019-03-05
Grundström, H., Gerdle, B., Alehagen, S., Berterö, C., Arendt-Nielsen, L. & Kjölhede, P. (2019). Reduced pain thresholds and signs of sensitization in women with persistent pelvic pain and suspected endometriosis. Acta Obstetricia et Gynecologica Scandinavica, 98(3), 327-336
Open this publication in new window or tab >>Reduced pain thresholds and signs of sensitization in women with persistent pelvic pain and suspected endometriosis
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2019 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 98, no 3, p. 327-336Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Endometriosis is a gynecological disorder that may cause considerable pelvic pain in women of fertile age. Determining pain mechanisms is necessary in order to optimize the treatment of the disease. The objective of the study was to evaluate pain thresholds in women with persistent pelvic pain with and without confirmed endometriosis, and healthy, unaffected controls, and analyze how pain thresholds in these cohorts related to duration of pelvic pain, quality of life, and symptoms of anxiety and depression.

MATERIAL AND METHODS: Pain thresholds for heat, cold and pressure were assessed with quantitative sensory testing on six locations on a reference group of 55 healthy women and on 37 women with persistent pelvic pain who had been admitted for diagnostic laparoscopy on the suspicion of endometriosis. Validated instruments were applied to assess quality of life and symptoms of anxiety and depression. Data were analyzed by means of uni- and multivariate analysis of variance and Spearman's rank-order correlation.

RESULTS: The women with persistent pelvic pain had significantly lower pain thresholds compared with the reference women. In the women with pain, no differences were observed in pain thresholds between women with (n = 13) and women without (n = 24) biopsy-proven endometriosis. The duration of pelvic pain correlated significantly positively with reduced pain thresholds, ie, the longer the duration, the more sensitization. In the persistent pelvic pain group, pain thresholds for heat correlated significantly with the Short Form Health Survey 36 dimension of bodily pain, and thresholds for cold correlated with Short Form Health Survey 36 bodily pain and with symptoms of depression.

CONCLUSIONS: Our results showed widespread alterations in pain thresholds in women with persistent pelvic pain that are indicative of central sensitization and a time-dependent correlation. Women with pelvic pain and suspicion of endometriosis should probably be treated more thoroughly to prevent or at least minimize the concomitant development of central sensitization.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
chronic pain, endometriosis, health-related quality of life, pain thresholds, persistent pelvic pain, quantitative sensory testing, sensitization
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-154816 (URN)10.1111/aogs.13508 (DOI)000459481000007 ()30472739 (PubMedID)2-s2.0-85059291957 (Scopus ID)
Note

Funding agencies:  Medical Research Council of Southeast Sweden; Region Ostergotland; Linkoping University

Available from: 2019-02-28 Created: 2019-02-28 Last updated: 2019-03-26Bibliographically approved
Drott, J., Starkhammar, H., Kjellgren, K. I. & Berterö, C. (2018). Neurotoxic Side Effects Early in the Oxaliplatin Treatment Period in Patients With Colorectal Cancer. Oncology Nursing Forum, 45(6), 690-697
Open this publication in new window or tab >>Neurotoxic Side Effects Early in the Oxaliplatin Treatment Period in Patients With Colorectal Cancer
2018 (English)In: Oncology Nursing Forum, ISSN 0190-535X, E-ISSN 1538-0688, Vol. 45, no 6, p. 690-697Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Pittsburgh, PA, United States: Oncology Nursing Society, 2018
Keywords
chemotherapy, colorectal cancer, daily life, neurotoxicity, qualitative methodology
National Category
Cancer and Oncology Nursing
Identifiers
urn:nbn:se:liu:diva-154815 (URN)10.1188/18.ONF.690-697 (DOI)000459360700005 ()30339148 (PubMedID)2-s2.0-85055071697 (Scopus ID)
Note

Funding agencies: Swedish Cancer Society; Division of Nursing Science, Department of Medical and Health Sciences at Linkoping University

Available from: 2019-02-28 Created: 2019-02-28 Last updated: 2019-03-08Bibliographically approved
Bergdahl, E., Ternestedt, B.-M., Berterö, C. & Andershed, B. (2018). The theory of a co-creative process in advanced palliative home care nursing encounters: A qualitative deductive approach over time. Paper presented at 2018/11/23. Nursing Open
Open this publication in new window or tab >>The theory of a co-creative process in advanced palliative home care nursing encounters: A qualitative deductive approach over time
2018 (English)In: Nursing Open, E-ISSN 2054-1058Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aims and objectives

The aim of this study was to test the theoretical conceptualization of the co‐creative process in home care nursing encounters over time.

Method and design

This was a multiple case study with a deductive analysis of qualitative data over time, using interviews and observations collected from three cases.

Results

The co‐creative process was complex and contained main, sub‐ and micro‐processes. Time was important and valuable, giving the patient and relatives space to adjust the process to their own pace. Some processes were worked on more intensively in accordance with the patients’ and relatives’ needs, and these are considered the main‐process. The further developed theory of the co‐creative process and its main, sub‐ and microprocesses can be understood as a concretization of how good nursing care can be performed within caring relationships in the context of advanced palliative home care.

Place, publisher, year, edition, pages
John Wiley & Sons, Ltd, 2018
Keywords
caring, case study research, nurse–patient relationship, palliative care
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-152865 (URN)10.1002/nop2.203 (DOI)
Conference
2018/11/23
Available from: 2018-11-23 Created: 2018-11-23 Last updated: 2019-02-27
Berterö, C. & Grundström, H. (2017). The double-edged experience of healthcare encounters among women with endometriosis: a qualitative study. Journal of Clinical Nursing, 27(1-2), 205-211
Open this publication in new window or tab >>The double-edged experience of healthcare encounters among women with endometriosis: a qualitative study
2017 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 1-2, p. 205-211Article in journal (Refereed) Published
Abstract [en]

Aims and objectives

To identify and describe the experience of healthcare encounters among women with endometriosis.

Background

Endometriosis is a “hidden” chronic gynaecological disease appearing in every 10th woman of fertile age. Different manifestations of pain are the main symptoms, often leading to impaired physical and mental health, and lower quality of life. Previous research on healthcare experiences among women with endometriosis has focused on diagnostic delay and experiences of encountering general practitioners.

Design

A qualitative, interpretive, phenomenological approach was used.

Methods

We interviewed nine women aged 23–55, with a laparoscopy-confirmed diagnosis of endometriosis. The interviews were recorded and transcribed verbatim. The data were analysed following the steps of the interpretive phenomenological approach.

Results

Two themes were identified in the interview transcripts: being treated with ignorance and being acknowledged. The essence: “the double-edged experience of healthcare encounters” emerged from the themes. The women's experience was double-edged as it involved contradictory feelings: the encounters were experienced as both destructive or constructive. On the one hand, the destructive side was characterised by ignorance, exposure and disbelief. On the other hand, the constructive side made the women feel acknowledged and confirmed, boosting their self-esteem.

Conclusions

The new and important aspects of the findings are that the experience of healthcare encounters is for the first time expressed as double-edged: both destructive and constructive. The experience was of specific importance as it affected the women's perceptions of themselves and of their bodies.

Relevance to clinical practice

The information about the constructive side of the experience is of clinical valuable for all healthcare professionals (nurses, midwives and doctors) encountering these women, as it provides a new level of understanding of the experiences. The findings demonstrate both psychological and practical aspects that can help professionals to improve the encounters.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2017
Keywords
dysmenorrhoea, endometriosis, experience, healthcare encounter, healthcare professionals, phenomenology, qualitative study
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-141005 (URN)10.1111/jocn.13872 (DOI)000418871000042 ()28493635 (PubMedID)
Note

Funding agencies: County Council of Ostergotland; Linkoping University; Medical Research Council of Southeast Sweden

Available from: 2017-09-20 Created: 2017-09-20 Last updated: 2018-09-10Bibliographically approved
Grundström, H., Kjølhede, P., Berterö, C. & Alehagen, S. (2016). “A challenge” – healthcare professionals' experiences when meeting women with symptoms that might indicate endometriosis. Sexual & Reproductive HealthCare, 7, 65-69
Open this publication in new window or tab >>“A challenge” – healthcare professionals' experiences when meeting women with symptoms that might indicate endometriosis
2016 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 7, p. 65-69Article in journal (Refereed) Published
Abstract [en]

Objective

The aim of the study was to identify and describe the experiences of healthcare professionals when meeting women with symptoms that might indicate endometriosis.

Methods

Semi-structured interviews were conducted with 10 gynecologists, six general practitioners and nine midwives working at one university hospital, one central hospital, one private gynecology clinic and five healthcare centers in south-east Sweden. The interviews were recorded and transcribed verbatim and analyzed using qualitative conventional content analysis.

Results

Three clusters were identified: the corroborating encounter, the normal variation of menstruation cycles, and the suspicion of endometriosis. The healthcare professionals tried to make a corroborating encounter by acknowledging the woman, taking time to listen, and giving an explanation for the problems. Healthcare professionals had different ways to determine what was normal as regards menstrual pain, ovulation pain and dyspareunia. They also needed to have the competence to act and react when the symptoms indicated endometriosis.

Conclusions

Meeting women with symptoms that might indicate endometriosis is challenging and demands a certain level of competence from healthcare professionals. Sometimes the symptoms are camouflaged as “normal” menstruation pain, making it hard to satisfy the needs of this patient group.

Keywords
Chronic pelvic pain;Dysmenorrhea;Endometriosis;Healthcare professional;Qualitative study
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-124016 (URN)10.1016/j.srhc.2015.11.003 (DOI)000370089000012 ()
Available from: 2016-01-18 Created: 2016-01-18 Last updated: 2018-09-10
Bergdahl, E. & Berterö, C. M. (2016). Concept analysis and the building blocks of theory: misconceptions regarding theory development.. Journal of Advanced Nursing, 72(10), 2558-2566
Open this publication in new window or tab >>Concept analysis and the building blocks of theory: misconceptions regarding theory development.
2016 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 10, p. 2558-2566Article in journal (Refereed) Published
Abstract [en]

AIM: The purpose of this article is to discuss the attempts to justify concepts analysis as a way to construct theory - a notion often advocated in nursing.

BACKGROUND: The notion that concepts are the building blocks or threads from which theory is constructed is often repeated. It can be found in many articles and well-known textbooks. However, this notion is seldom explained or defended. The notion of concepts as building blocks has also been questioned by several authors. However, most of these authors seem to agree to some degree that concepts are essential components from which theory is built.

DESIGN: Discussion paper.

DATA SOURCES: Literature was reviewed to synthesize and debate current knowledge.

IMPLICATIONS FOR NURSING: Our point is that theory is not built by concepts analysis or clarification and we will show that this notion has its basis in some serious misunderstandings. We argue that concept analysis is not a part of sound scientific method and should be abandoned.

CONCLUSION: The current methods of concept analysis in nursing have no foundation in philosophy of science or in language philosophy. The type of concept analysis performed in nursing is not a way to 'construct' theory. Rather, theories are formed by creative endeavour to propose a solution to a scientific and/or practical problem. The bottom line is that the current style and form of concept analysis in nursing should be abandoned in favour of methods in line with modern theory of science.

Place, publisher, year, edition, pages
John Wiley & Sons, 2016
Keywords
young adults, energy end-users, end-use efficiency, employment
National Category
Social Sciences Interdisciplinary
Identifiers
urn:nbn:se:liu:diva-130638 (URN)10.1111/jan.13002 (DOI)000383626900027 ()27218439 (PubMedID)
Available from: 2016-08-19 Created: 2016-08-19 Last updated: 2018-01-10Bibliographically approved
Gustafsson, E., Litström, E., Berterö, C. & Drott, J. (2016). Reliability testing of oxaliplatin-associated neurotoxicity questionnaire (OANQ), a pilot study. Supportive Care in Cancer, 24(2), 747-754
Open this publication in new window or tab >>Reliability testing of oxaliplatin-associated neurotoxicity questionnaire (OANQ), a pilot study
2016 (English)In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 24, no 2, p. 747-754Article in journal (Refereed) Published
Abstract [en]

PURPOSE:

The purpose of this study was to test the reliability of the Swedish version of the Oxaliplatin-Associated Neurotoxicity Questionnaire (OANQ) administrated throughout a self-reported mobile phone-based system, a pilot study.

METHODS:

Twenty-three patients from two university hospitals and two regional hospitals who had been treated with oxaliplatin were included through purposive sampling between autumn 2013 to autumn 2014. A test-retest was performed through a mobile phone-based system, with a recall period of 1 h to determine the reliability of the questionnaire.

RESULTS:

Internal consistency was strong for the three domains of the scale (α > 0.840). The statistical analyses for the test-retest indicated that the OANQ was stable. Intraclass correlation (ICC) for symptom items and effect on daily activities items showed an overall excellent reproducibility at 69 and 83 %, respectively. The weighted kappa for symptom items and daily activities items showed an overall almost perfect agreement at 59 and 52 %, respectively. A paired samples t test did not reveal any significant differences between the two measures.

CONCLUSIONS:

The OANQ was tested and considered a reliable assessment for capturing the oxaliplatin-induced peripheral neurotoxicity (OIPN) in patients receiving oxaliplatin. However, further reliability testing of the OANQ is needed.

Place, publisher, year, edition, pages
Springer, 2016
Keywords
Oxaliplatin-induced peripheral neurotoxicity; Oxaliplatin; Symptom
National Category
Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:liu:diva-121518 (URN)10.1007/s00520-015-2838-y (DOI)000367458200028 ()26137985 (PubMedID)
Note

Funding agencies: Division of Nursing Science at the Department of Medical and Health Sciences

Available from: 2015-09-23 Created: 2015-09-23 Last updated: 2017-12-01Bibliographically approved
Drott, J., Starkhammar, H., Kjellgren, K. & Berterö, C. (2016). The trajectory of neurotoxic side effects' impact on daily life: a qualitative study. Supportive Care in Cancer, 24(8), 3455-3461
Open this publication in new window or tab >>The trajectory of neurotoxic side effects' impact on daily life: a qualitative study
2016 (English)In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 24, no 8, p. 3455-3461Article in journal (Refereed) Published
Abstract [en]

PURPOSE:

The purpose of this study was to explore the experiences of oxaliplatin-induced neurotoxic side effects among patients with colorectal cancer (CRC) and how these side effects influenced their daily lives over time.

METHODS:

To assess neurotoxic side effects, ten patients were repeatedly interviewed. The patients were recruited from two hospitals in south of Sweden, had stage II-III CRC, and had been treated with adjuvant oxaliplatin postoperatively, from November 2013 to October 2015. They had received FOLFOX and XELOX, with a mean total dose of 791 mg oxaliplatin. After completed chemotherapy, at 3, 6, and 12 months into the post-treatment phase, 25 interviews were conducted and thematic analysis was used according to Braun and Clarke.

RESULTS:

Oxaliplatin-induced neurotoxicity affects patients in several ways in the long term. Four themes were identified: Expectation of cure, Dubiety, Normalization, and Learn to live with neurotoxicity. The findings of this study describe the trajectory of neurotoxicity and its impact on these patients' life situation. The findings confirmed that neurotoxicity is multi-faceted and that the experience of it changes over time.

CONCLUSION:

The desire to survive stimulates adaptations and strategies to manage daily life, and patients learn to live with the neurotoxic side effects. This study provides evidence that these patients need individual attention and support during the trajectory of neurotoxic side effects. Current care provision is inadequate due to a lack of knowledge of the ways in which neurotoxicity impacts the patient's daily life. This study provides insights that could be used to develop a more person-centered care.

Keywords
Adjuvant chemotherapy; Colorectal cancer; Neurotoxicity; Oxaliplatin; Qualitative interviews; Thematic analysis
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-126626 (URN)10.1007/s00520-016-3179-1 (DOI)000378884400030 ()26992409 (PubMedID)
Note

Funding agencies:We thank all patients for their participation in this study. We also thank the Swedish Cancer Society, the Department of Oncology and Surgery, Linkoping University Hospital, and the Division of Nursing Science at the Department of Medical and Health Sciences for the financial support. Further thanks go to all the health professionals in the oncology clinics who were involved in the study in different ways.

Available from: 2016-03-31 Created: 2016-03-31 Last updated: 2018-05-15
Mylen, J., Nilsson, M. & Berterö, C. (2016). To feel strong in an unfamiliar situation; Patients lived experiences of neurosurgical intensive care. A qualitative study. Intensive & Critical Care Nursing, 32, 42-48
Open this publication in new window or tab >>To feel strong in an unfamiliar situation; Patients lived experiences of neurosurgical intensive care. A qualitative study
2016 (English)In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 32, p. 42-48Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of this study was to explore the lived experiences of conscious patients in neurosurgical intensive care. Method: Data collection was performed by qualitative interviews using an interview guide. Eleven former patients, seven women and four men, were interviewed two to 14 months after discharge. The interviews were recorded and transcribed verbatim and analysed using an interpretive phenomenological approach. Findings: The analysis revealed three themes: To feel safe in an unfamiliar situation, to experience strains and limitations, and to be confirmed as a human being. These three themes culminated in the essence: To feel strong in an unfamiliar situation. Patients experienced a soothing environment where, despite strains, they felt safe being cared for in a ward with specialised medical treatment. When mental and physical strains decreased during the period of care, they experienced the ability to cope with the simplest tasks as a sign of regained identity. Conclusion: Patients main experience during intensive care was security. Security along with human contact and interaction with staff and next of kin made the patients feel strengthened as human beings in an unfamiliar situation. The fact that the patients were conscious enabled them to understand their situation and to experience security. (C) 2015 Elsevier Ltd. All rights reserved.

Place, publisher, year, edition, pages
ELSEVIER SCI LTD, 2016
Keywords
Interaction; Interpretive phenomenology; Neurosurgical intensive care; Nursing; Security
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-124079 (URN)10.1016/j.iccn.2015.08.001 (DOI)000366954700006 ()26552575 (PubMedID)
Note

Funding Agencies|Department of Neuro Surgery and Neurosurgical Intensive Care, Linkoping University Hospital; Division of Nursing Science, Department of Medical and Health Sciences Linkoping University, Linkoping, Sweden

Available from: 2016-01-25 Created: 2016-01-19 Last updated: 2018-03-23
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-1588-135X

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