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  • 1.
    Berterö, Carina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Nursing Science.
    Affected self-respect and self-value: Breast cancer treatments impact on the QOL2000In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 9, no 5, p. 151-Conference paper (Other academic)
  • 2.
    Berterö, Carina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Nursing Science.
    Affected self-respect and self-value: The impact of breast cancer treatment on self-esteem and QoL2002In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 11, no 4, p. 356-364Article in journal (Refereed)
    Abstract [en]

    There is a need to understand and explain the impact of breast cancer on women's self-esteem and quality of life. The purpose of the present study was to identify and describe, from the perspective of the women's lived experiences, the impact of breast cancer on women's self-esteem and elucidate its impact on their quality of life. Thirteen women diagnosed as having breast cancer were interviewed about these phenomena. The narrated interviews, tape-recorded and transcribed verbatim were analysed and interpreted using a qualitative text analysis, based on the following question: What sense of satisfaction and importance is there with respect to the women's value and preferences? The findings were interpreted as affected self-respect and self-value, which were found to be important aspects affecting the quality of life of these women, within this lies the satisfaction of desire, to be respected and loved as the women they are. Concerns related to their quality of life seemed to be heightened when treatment has been completed, i.e. when the psychological effects of the treatment experience become a reality. Health professional need to be aware of how to recognise these women, in order to provide them with support to maintain a positive self-esteem to enhance quality of life as a caring outcome. Copyright © 2002 John Wiley & Sons, Ltd.

  • 3.
    Christina, Snöbohm
    et al.
    KI, sjukgymnastik.
    Friedrichsen, Maria
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Department of LAH/Linnéa.
    Heiwe, Sussanne
    KI, sjukgymnastik.
    Experiencing one's body after a diagnosis of cancer-a phenomenological study of young adults.2010In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 19, no 8, p. 863-869Article in journal (Refereed)
    Abstract [en]

    Young adults with cancer are still in the process of shaping their lives and are therefore at a vulnerable stage. Altered body image may change how patients cope with the disease and impact rehabilitation capacity.Objective: To describe the essence of how young adults with cancer experience their bodies.Methods: Interviews (12 informants), transcribed verbatim. Analysis: Giorgi's phenomenological method.Results: Identified themes: experience of 'physical body change', 'discomfort', 'the body at the moment without reflecting on the disease and treatment', 'body image' and 'grasping the illness'. Essences: The body as the bearer of life; conflict between age and disease; manifest changes in appearance, physically and mentally; the body no longer a whole; the body as influenceable and able to recover and heal.Conclusions: These patients undergo physical and mental changes that affect their self-image and health-related life quality. Thus, future studies need to explore interventions that may enhance the individualś perception of their body.

  • 4.
    Drott, Jenny
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
    Fomichov Casaballe, Victoria
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Health and Developmental Care, Regional Cancer Center South East Sweden.
    Börjeson, Sussanne
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology.
    Berterö, Carina
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences.
    Sense of coherence and health-related quality of life in patients with neurotoxicity after cancer chemotherapy: Assessment from a real-time mobile phone-based system2020In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 29, no 1, p. 107-113Article in journal (Refereed)
    Abstract [en]

    Objective In the present study, we aimed to assess sense of coherence (SOC) and health-related quality of life (HRQOL) during and after adjuvant chemotherapy by mobile phone-based reporting in patients with colorectal cancer experiencing neurotoxicity. Methods In this prospective descriptive cohort study, a mobile phone-based system was used to receive a series of real-time longitudinal patient-reported assessments of SOC (13-item), HRQOL (Functional Assessment of Cancer Therapy-General (FACT-G) 27-item), and neurotoxicity (OANQ 29-item) from 43 patients with colorectal cancer after being treated with chemotherapy including oxaliplatin. Measurements were conducted during the whole treatment period (mean 5 cycles) and up to 12 months after completing chemotherapy. Results In total, 817 questionnaire responses (226 SOC, 221 FACT-G, 370 OANQ) answered during and after chemotherapy treatment were available for analysis. Even though all patients experienced neurotoxicity during the treatment period, HRQOL was stable over time. Over time, the ratings of physical wellbeing tended to increase, while the subscale of social wellbeing tended to decrease. Overall SOC, including the three components comprehensibility, manageability, and meaningfulness was stable during the entire study period. No internal data was missing due to the mobile phone-based system. Conclusions All patients had neurotoxicity during the treatment period that seemed to affect the social wellbeing component of HRQOL, but SOC seemed unaffected. Real-time patient-reported assessment using mobile phone technology could be valuable in the clinical setting to provide continuous individualised monitoring to help identify patients who need further evaluation to maintain or improve their psychosocial health.

  • 5.
    Fors, Egil A
    et al.
    St Olavs University Hospital.
    Bertheussen, Gro F
    Norwegian University of Science and Technology.
    Thune, Inger
    Oslo University Hospital.
    Juvet, Lene K
    Norwegian Knowledge Centre for Health Service.
    Elvsaas, Ida-Kristin O
    Norwegian Knowledge Centre for Health Service.
    Oldervoll, Line
    Norwegian University of Science and Technology.
    Anker, Gun
    Haukeland Hospital.
    Falkmer, Ursula
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Lundgren, Steinar
    St Olavs University Hospital.
    Leivseth, Gunnar
    Norwegian University of Science and Technology.
    Psychosocial interventions as part of breast cancer rehabilitation programs? Results from a systematic review2011In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 20, no 9, p. 909-918Article, review/survey (Refereed)
    Abstract [en]

    Objective: This systematic review aimed to determine the effectiveness of psychoeducation, cognitive behavioural therapy (CBT) and social support interventions used in the rehabilitation of breast cancer (BC) patients. less thanbrgreater than less thanbrgreater thanMethods: We conducted a systematic literature search to identify randomised controlled trials of female BC patients who underwent different psychosocial interventions during or after primary cancer treatment. The methodological quality of all studies was independently assessed by two reviewers. Studies with low quality, less than 20 participants in each group, patients with metastatic cancer, data not presented separately for BC and studies that included other cancer types were excluded. less thanbrgreater than less thanbrgreater thanResults: Among 9617 identified studies, only 18 RCTs published between 1999 and 2008, including 3272 patients were finally included in this systematic evaluation. Outcome measures were categorised into quality of life (QoL), fatigue, mood, health behaviour and social function. Six trials examined psychoeducation had inconsistent results, both during and after the primary treatment. Seven trials examined the effect of CBT, four of which given after primary treatment (range 6-12 weeks) demonstrated improvements in QoL; the other three CBT studies given during primary treatment (range 9-20 weeks) had inconsistencies. Five studies addressed social support and showed no conclusive impacts of this intervention. less thanbrgreater than less thanbrgreater thanConclusions: Limited documentation exists on the efficacy of psychosocial rehabilitation interventions among BC patients. However, we found that patients might have QoL benefits from CBT given after primary BC treatment. More documentation is needed regarding the effects of CBT during primary treatment and the effects of psychoeducation and social support.

  • 6.
    Forss, A
    et al.
    Karolinska Inst, Dept Nursing, SE-17177 Stockholm, Sweden Karolinska Inst, Dept Publ Hlth Sci, Div Int Hlth, Stockholm, Sweden Linkoping Univ, Dept Commun Studies, Linkoping, Sweden Karolinska Hosp, Canc Screening Unit, Ctr Oncol, S-10401 Stockholm, Sweden.
    Tishelman, C
    Karolinska Inst, Dept Nursing, SE-17177 Stockholm, Sweden Karolinska Inst, Dept Publ Hlth Sci, Div Int Hlth, Stockholm, Sweden Linkoping Univ, Dept Commun Studies, Linkoping, Sweden Karolinska Hosp, Canc Screening Unit, Ctr Oncol, S-10401 Stockholm, Sweden.
    Widmark, C
    Karolinska Inst, Dept Nursing, SE-17177 Stockholm, Sweden Karolinska Inst, Dept Publ Hlth Sci, Div Int Hlth, Stockholm, Sweden Linkoping Univ, Dept Commun Studies, Linkoping, Sweden Karolinska Hosp, Canc Screening Unit, Ctr Oncol, S-10401 Stockholm, Sweden.
    Lundgren, EL
    Karolinska Inst, Dept Nursing, SE-17177 Stockholm, Sweden Karolinska Inst, Dept Publ Hlth Sci, Div Int Hlth, Stockholm, Sweden Linkoping Univ, Dept Commun Studies, Linkoping, Sweden Karolinska Hosp, Canc Screening Unit, Ctr Oncol, S-10401 Stockholm, Sweden.
    Sachs, L
    Tornberg, S
    Karolinska Inst, Dept Nursing, SE-17177 Stockholm, Sweden Karolinska Inst, Dept Publ Hlth Sci, Div Int Hlth, Stockholm, Sweden Linkoping Univ, Dept Commun Studies, Linkoping, Sweden Karolinska Hosp, Canc Screening Unit, Ctr Oncol, S-10401 Stockholm, Sweden.
    'I got a letter ...' a qualitative study of women's reasoning about attendance in a cervical cancer screening programme in urban Sweden2001In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 10, no 1, p. 76-87Article in journal (Refereed)
    Abstract [en]

    Objective: This explorative study aims at investigating how 'healthy' women describe and reason about participation in a cervical cancer screening programme in Sweden. The study is part of a multidisciplinary research project studying a population-based cervical cancer-screening programme from the perspective of different actors. Setting and methods: Data collection took place at three ante-natal health centres (ANHCs) in demographically diverse areas in the Stockholm region in spring 1995. Interviews were conducted and audiotaped with 66 'healthp' women at the ANHCs immediately before taking a Papanicolau test. Open questions such as 'Why have you come here today?' and 'What kind of test will you take?' were used to initiate the interview. Verbatim transcripts were analysed with a modified phenomenographical method to identify and describe qualitatively different ways of understanding cervical cancer screening. Results: Four different ways of reasoning about cervical cancer screening are described, with only one similar to the biomedical rationale for screening with focus on attending for the test/results. Two types of reasoning refer to the invitation letter as a catalyst, with one emphasizing benefits in attendance and the second emphasizing hinders to attendance. A final way of reasoning focuses on the individual's own proactive role in prevention. Common themes are also identified. Implications: This study complements the research literature by providing a better knowledge base of the variations in reasoning among women attending screening, often seen as a homogenous group. It can contribute to better adapting the screening situation to the varied needs and expectations of the women who attend. Copyright (C) 2001 John Wiley & Sons, Ltd.

  • 7.
    Krevers, Barbro
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
    Milberg, Anna
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Department of Advanced Home Care in Norrköping. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Center of Palliative Care.
    The instrument Sense of Security in Care - Patients Evaluation: its development and presentation2014In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 23, no 8, p. 914-920Article in journal (Refereed)
    Abstract [en]

    ObjectiveThe aim of this paper is to report the development, construction, and psychometric properties of the new instrument Sense of Security in Care - Patients Evaluation (SEC-P) in palliative home care. MethodsThe preliminary instrument was based on a review of the literature and an analysis of qualitative interviews with patients about their sense of security. To test the instrument, 161 patients (58% women) in palliative home care were recruited and participated in a structured interview based on a comprehensive questionnaire (response rate 73%). We used principal component analysis to identify subscales and tested the construction in correlation with other scales and questions representing concepts that we expected to be related to sense of security in care. ResultsThe principal component analysis resulted in three subscales: Care Interaction, Identity, and Mastery, built on a total of 15 items. The component solution had an explained variance of 55%. Internal consistency of the subscales ranged from 0.84 to 0.69. Inter-scale correlations varied between 0.40 and 0.59. The scales were associated to varying degrees with the quality of the care process, perceived health, quality of life, stress, and general sense of security. ConclusionsThe developed SEC-P provides a three-component assessment of palliative home care settings using valid and reliable scales. The scales were associated with other concepts in ways that were expected. The SEC-P is a manageable means of assessment that can be used to improve quality of care and in research focusing on patients sense of security in care.

  • 8.
    Milberg, Anna
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Geriatrics. Linköping University, Faculty of Health Sciences.
    Strang, Peter
    Karolinska Institutet, FoUU, Stockholms Sjukhem, Stockholm, Sweden.
    Exploring comprehensibility and manageability in palliative home care: an interview study of dying cancer patients' informal carers2004In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 13, no 9, p. 605-618Article in journal (Refereed)
    Abstract [en]

    The presence of an informal carer is often a prerequisite for successful palliative home care, and the staff's ability to support informal carers' coping in such situations is important. Recent research has revealed that it is possible to achieve positive psychological states in palliative care despite the burdening situation. As there is a lack of theory-based coping studies, the aim of this study was to describe, within the context of palliative home care, two concepts in Antonovsky's theory of Sense of Coherence: comprehensibility (a perception that the challenge is understood) and manageability (a perception that the resources to cope are available). Tape-recorded semi-structured interviews with 19 informal carers during ongoing palliative home care were transcribed and analysed with a qualitative hermeneutic approach. Elements that facilitated comprehensibility included open information, symbolic information, basic life assumptions and previous knowledge. These were important for creating a congruent inner reality (as opposed to chaos). Resources contributing to manageability dealt with power, support, competence and accessibility, which on a more abstract level resulted in a feeling of togetherness (as opposed to isolation). The findings are discussed in relation to the complexity of communication between staff and carers within palliative care.

  • 9.
    Milberg, Anna
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies, Äldre - vård - civilsamhälle (ÄVC) . Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Geriatric and Hospital Based Homecare UHL.
    Strang, Peter
    Karolinska institutet.
    What to do when 'there is nothing more to do'? A study within a salutogenic framework of family members' experience of palliative home care staff2007In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 16, no 8, p. 741-51Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to develop a theoretical framework of family members' experience of palliative home care staff based on a secondary analysis of four previous studies. A salutogenic framework was used, i.e. with the origin of health in focus. Data had been collected (semi-structured tape-recorded interviews and postal questionnaires with open-ended questions) from 469 family members of mainly cancer patients referred to advanced palliative home care. Walker and Avant's strategies for theory construction were used. The secondary analysis generated three theoretical blocks: (1) general components of staff input (including five generalized resistance resources (GRRs): competence, support, spectrum of services, continuity, and accessibility); (2) specific interactions with staff (including two GRRs: being in the centre and sharing caring); (3) emotional and existential consequences of staff support (including six health-disease continuums: security-insecurity, hope-hopelessness, congruent inner reality-chaos, togetherness-isolation, self-transcendence-feelings of insufficiency and retained everyday life-disrupted everyday life). It seems important that all three aspects of family members' experience of palliative care staff are to be considered in evaluations of palliative care, in goal-setting and in teaching role models. The study is specific to the Swedish model of palliative home care and replication of the work in other countries is recommended.

  • 10.
    Milberg, Anna
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Advanced Home Care in Linköping. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Center of Palliative Care.
    Wåhlberg, Rakel
    Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Department of LAH/Linnéa.
    Jakobsson, Maria
    Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Center of Palliative Care.
    Olsson, Eva-Carin
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Olsson, Maria
    PRIVO/Palliative Consulting Team, Northern County of Kalmar, Oskarshamn.
    Friedrichsen, Maria
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Center of Palliative Care.
    What is a “secure base” when death is approaching? A study applying attachment theory to adult patients’ and family members’ experiences of palliative home care2012In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 21, no 8, p. 886-895Article in journal (Refereed)
    Abstract [en]

    Objective

    Attachment theory has received much interest lately in relation to how adults cope with stress and severe illness. The aim of this study was using the experiences of patients and family members to explore palliative home care as a ‘secure base’ (a central concept within the theory).

    Methods

    Twelve patients and 14 family members were interviewed during ongoing palliative home care. The interviews were analysed with deductive qualitative content analysis.

    Results

    Informants expressed the relevance of sensing security during palliative home care because death and dying were threats that contributed to vulnerability. Palliative home care could foster a feeling of security and provide a secure base. This was facilitated when informants had trust in staff (e.g. due to availability and competence in providing symptom relief), felt recognised as individuals and welcomed to contact the team in times of needs. Being comfortable, informed and having an everyday life also contributed to a perception of palliative home care as a secure base. Family members stressed the importance of being relieved from responsibilities that were too heavy. The underlying meanings of experiencing palliative home care as a secure base involved gaining a sense of control and of inner peace, perceiving that despite a demanding and changed life situation, one could continue partially being oneself and having something to hope for, even if this no longer concerned cure for the ill person.

    Conclusions

    Important aspects of palliative home care as providing a secure base were identified and these have implications for clinical practice. Copyright © 2011 John Wiley & Sons, Ltd.

  • 11.
    Milberg, Anna
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Center of Palliative Care. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Department of Advanced Home Care in Norrköping.
    Wåhlberg, Rakel
    Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Department of Advanced Home Care in Norrköping.
    Krevers, Barbro
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
    Patients' sense of support within the family in the palliative care context: what are the influencing factors?2014In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 23, no 12, p. 1340-1349Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Mutual support within the family is of great importance to maintain its proper functioning. The study aim, which was based on a family system approach, was to evaluate which variables are associated with patients' sense of support within the family in the palliative care context.

    METHODS: We recruited 174 adult patients (65% of those eligible) from six palliative home care units, who had non-curable disease with an expected short-term survival, such as disseminated cancer or non-malignant diagnosis. The relationship between the endpoint and individual factors were evaluated in a stepwise model-building procedure using generalised linear model (ordinal multinomial distribution and logit link).

    RESULTS: The respondents' ratings of their sense of support within the family ranged from 1 (never) to 6 (always), with a mean value of 5.2 (standard deviation 1.06). Patients who less frequently sensed family support experienced more often stress, worry about their private economy, lower self-efficacy, lower sense of security with palliative care provided (lower ratings on subscales of care interaction, mastery and prevailed own identity), more often anxiety, less often perceived general well-being for closest ones and less often sense of support from more distant family members. In the model building, three variables were selected to predict the patients' sense of support within the family.

    CONCLUSIONS: The dying patients' sense of support within the family related to several factors, and these may help the palliative care teams to identify patients at risk and to alleviate suffering, for example, through supporting the closest family members.

  • 12. Salander, P.
    et al.
    Karlsson, Thomas
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Cognition, Development and Disability.
    Bergenheim, A.T.
    Henriksson, R.
    Comment on Weitzner and Meyers1998In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 7, p. 141-142Article in journal (Refereed)
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