Umeå University's logo

umu.sePublications
Change search
Link to record
Permanent link

Direct link
Publications (10 of 23) Show all publications
Silvennoinen, A.-S., Johansson, E., Finne-Soveri, H., Baxter, R., Bergland, Å., Edvardsson, D. & Fagerström, L. (2025). Cross-sectional study exploring associations between thriving of older persons in Finnish care homes and interRAI scale factors. Nordic journal of nursing research, 45
Open this publication in new window or tab >>Cross-sectional study exploring associations between thriving of older persons in Finnish care homes and interRAI scale factors
Show others...
2025 (English)In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 45Article, review/survey (Other academic) Published
Abstract [en]

Thriving is a scarcely researched topic in nursing sciences. The present study aimed to explore how older persons experience thriving in care homes as assessed by staff and which demographic characteristics and central interRAI scale factors are associated with thriving. The thriving of 145 residents in four public care homes was measured using the short-form Thriving of Older People Assessment Scale (TOPAS). Both enrolled and registered nurses participated in this study. The data were collected in October to November 2022. Descriptive statistics and logistic regression analyses were performed. Resident thriving was assessed by staff as high. The interRAI scale factor of social engagement showed the strongest association with thriving, followed by gender (female). More attention should be focused on social engagement for care home residents and on the male residents’ thriving. The manuscript was guided by the STROBE checklist.

Keywords
aged care, nursing home, older people, quantitative research, wellbeing
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-237805 (URN)10.1177/20571585251326061 (DOI)2-s2.0-105003937793 (Scopus ID)
Available from: 2025-04-17 Created: 2025-04-17 Last updated: 2025-05-27Bibliographically approved
Ortega-Gómez, S., Di Bartolo, L., Velissari, J., Gomes, B., Pusa, S., Thaller, J., . . . Jiménez-Pavón, D. (2025). Exploring the health benefits of outdoor exercise for cancer survivors: a systematic review of more than 700 individuals. Systematic Reviews, 14(1), Article ID 101.
Open this publication in new window or tab >>Exploring the health benefits of outdoor exercise for cancer survivors: a systematic review of more than 700 individuals
Show others...
2025 (English)In: Systematic Reviews, E-ISSN 2046-4053, Vol. 14, no 1, article id 101Article, review/survey (Other academic) Published
Abstract [en]

Background: Cancer’s rising incidence and growing survivor population underscore the need for strategies to enhance health and quality of life. Outdoor physical activity (PA) settings may provide unique benefits, yet evidence in this context is scarce. This systematic review aims to evaluate the impact of outdoor PA and exercise interventions on the health and well-being of cancer survivors.

Methods: A systematic search was conducted in PubMed, Web of Science, and PsycINFO databases from their inception until April 23, 2024. Studies included randomized controlled trials (RCTs) and non-RCTs involving outdoor PA or exercise interventions for cancer survivors. The search strategy adhered to PRISMA guidelines, and the quality of studies was assessed using the PEDro scale.

Results: Twelve studies involving 712 cancer survivors were included, comprising 7 RCTs and 5 non-RCTs. Four studies compared outdoor exercise to indoor exercise instead of a usual care control group, and one used a crossover design. The interventions varied in frequency, intensity, time, and type, with Nordic walking and walking being the most common. Key findings indicated significant improvements in mental health, PA levels, muscular fitness, body composition, and exercise motivation. However, the impact on vital signs and sleep quality was inconclusive due to the limited number of studies and variability in interventions.

Conclusions: Outdoor PA, including structured exercise interventions, substantially benefits cancer survivors, particularly in enhancing mental health and physical fitness. Despite the promising findings, further research is needed to explore long-term effects, the benefits for different cancer types and age groups, and the underlying mechanisms of these interventions. Health practitioners should consider incorporating outdoor activities into cancer rehabilitation programs.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2025
Keywords
Exercise therapy, Quality of life, Survivorship, Mental health
National Category
Health Sciences Clinical Medicine
Identifiers
urn:nbn:se:umu:diva-238549 (URN)10.1186/s13643-025-02834-y (DOI)001485770900001 ()40336008 (PubMedID)2-s2.0-105004785710 (Scopus ID)
Available from: 2025-05-08 Created: 2025-05-08 Last updated: 2025-05-28Bibliographically approved
Baxter, R., Corneliusson, L., Björk, S. & Edvardsson, D. (2025). Promoting resident thriving in nursing homes: a qualitative study. Journal of Advanced Nursing, 81(1), 399-408
Open this publication in new window or tab >>Promoting resident thriving in nursing homes: a qualitative study
2025 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 81, no 1, p. 399-408Article in journal (Refereed) Published
Abstract [en]

Aim: To explore how staff promote resident thriving in an Australian nursing home.

Design: Qualitative research design using content analysis.

Methods: Interviews were held with 14 nursing staff working in an Australian nursing home in March/April 2018. Data were analysed using qualitative content analysis.

Results: Four themes were revealed: promoting personalized care; promoting opportunities for autonomy; promoting connection and meaning; and promoting a curated environment.

Conclusions: Staff promoted resident thriving in relation to everyday care, activities, capabilities, relationships and the lived environment. Interventions that were perceived to promote thriving were described relative to the nurse, the resident, the care team and the wider nursing home context.

Place, publisher, year, edition, pages
John Wiley & Sons, 2025
National Category
Nursing
Research subject
Geriatrics; Caring Sciences
Identifiers
urn:nbn:se:umu:diva-224147 (URN)10.1111/jan.16206 (DOI)001207795500001 ()38661264 (PubMedID)2-s2.0-85191332993 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-4016Swedish Research Council, 521-2014-2715
Available from: 2024-05-08 Created: 2024-05-08 Last updated: 2025-01-13Bibliographically approved
Pusa, S., Baxter, R., Andersson, S., Fromme, E. K., Paladino, J. & Sandgren, A. (2024). Core competencies for serious illness conversations: an integrative systematic review. Journal of Palliative Care, 39(4), 340-351
Open this publication in new window or tab >>Core competencies for serious illness conversations: an integrative systematic review
Show others...
2024 (English)In: Journal of Palliative Care, ISSN 0825-8597, Vol. 39, no 4, p. 340-351Article, review/survey (Refereed) Published
Abstract [en]

Objective: The Serious Illness Care Program was developed to support goals and values discussions between seriously ill patients and their clinicians. The core competencies, that is, the essential clinical conversation skills that are described as requisite for effective serious illness conversations (SICs) in practice, have not yet been explicated. This integrative systematic review aimed to identify core competencies for SICs in the context of the Serious Illness Care Program. 

Methods: Articles published between January 2014 and March 2023 were identified in MEDLINE, PsycINFO, CINAHL, and PubMed databases. In total, 313 records underwent title and abstract screening, and 96 full-text articles were assessed for eligibility. The articles were critically appraised using the Joanna Briggs Institute Critical Appraisal Guidelines, and data were analyzed using thematic synthesis.

Results: In total, 53 articles were included. Clinicians' core competencies for SICs were described in 3 themes: conversation resources, intrapersonal capabilities, and interpersonal capabilities. Conversation resources included using the conversation guide as a tool, together with applying appropriate communication skills to support better communication. Intrapersonal capabilities included calibrating one's own attitudes and mindset as well as confidence and self-assurance to engage in SICs. Interpersonal capabilities focused on the clinician's ability to interact with patients and family members to foster a mutually trusting relationship, including empathetic communication with attention and adherence to patient and family members views, goals, needs, and preferences.

Conclusions: Clinicians need to efficiently combine conversation resources with intrapersonal and interpersonal skills to successfully conduct and interact in SICs.

Place, publisher, year, edition, pages
Sage Publications, 2024
Keywords
clinical competence, health communication, palliative care, serious illness care program, serious illness conversations, systematic review
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-223027 (URN)10.1177/08258597241245022 (DOI)001194529500001 ()38557369 (PubMedID)2-s2.0-85189149661 (Scopus ID)
Funder
The Kamprad Family Foundation, 20210163
Available from: 2024-04-08 Created: 2024-04-08 Last updated: 2024-12-11Bibliographically approved
Maric, D., Ficarra, S., Di Bartolo, L., Rossi, C., Asimakopoulou, Z., Vantarakis, A., . . . Bianco, A. (2024). Effects of resistance training on sleep quality and disorders among individuals diagnosed with cancer: a systematic review and meta‐analysis of randomized controlled trials. Cancer Medicine, 13(8), Article ID e7179.
Open this publication in new window or tab >>Effects of resistance training on sleep quality and disorders among individuals diagnosed with cancer: a systematic review and meta‐analysis of randomized controlled trials
Show others...
2024 (English)In: Cancer Medicine, E-ISSN 2045-7634, Vol. 13, no 8, article id e7179Article in journal (Refereed) Published
Abstract [en]

Background: Sleep disorders are often complained by cancer patients and can last years after the end of therapies, leading to different negative consequences. Non-pharmacological strategies such as exercise interventions may be considered to counteract this phenomenon. The literature supports the beneficial effects of aerobic training (AT), while evidence on resistance training (RT) is scarce. Accordingly, our systematic review aims to investigate the potential novel effect of RT on sleep outcomes in cancer survivors.

Methods: The literature search was conducted on MEDLINE (Pubmed), Web of Science, Scopus, and Cochrane Central Register of Controlled Trials databases, including only randomized controlled trials (RCTs). The screening procedure was conducted using the web-based software COVIDENCE. Sleep outcomes assessed through self-reported questionnaires or objective sleep measurements were extracted from RCTs recruiting cancer survivors of any age and gender, on or off treatment. The risk of bias (RoB) for each study was assessed using the Cochrane RoB 2 tool for RCTs. Meta-analytic syntheses were performed on sleep quality and insomnia.

Results: A total of 21 studies were included in the review. Considering the mean percentage differences of all studies combined, promising positive results were found after combined aerobic and resistance exercise program (COMB) for sleep quality (−19%) and sleep disturbance (−17.3%). The meta-analysis results showed significant improvement for both sleep quality and insomnia (d = 0.28, SE: 0.11, Z = 2.51, p < 0.01, 95% CI: 0.07–0.49 and d = 0.43, SE: 0.20, Z = 2.18, p = 0.029, 95% CI: 0.07–0.49, respectively).

Conclusion: RT interventions of 60 minutes per session, performed 2–3 times a week for 12 weeks, with exercise intensity ranging from 60% to 80% of one-repetition maximum can be administered to cancer survivors, aiming to improve sleep outcomes.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
exercise oncology, insomnia, physical activity, quality of life, tumor
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-223737 (URN)10.1002/cam4.7179 (DOI)001206198000001 ()38650577 (PubMedID)2-s2.0-85191073352 (Scopus ID)
Available from: 2024-04-24 Created: 2024-04-24 Last updated: 2024-05-03Bibliographically approved
Thomas, E., Di Bartolo, L., Galioto, M., Seminara, D., Pusa, S., Baxter, R., . . . Bianco, A. (2024). Experiences, behaviours, and perspectives of young cancer survivors on physical activity. Heliyon, 10(15), Article ID e35732.
Open this publication in new window or tab >>Experiences, behaviours, and perspectives of young cancer survivors on physical activity
Show others...
2024 (English)In: Heliyon, E-ISSN 2405-8440, Vol. 10, no 15, article id e35732Article, review/survey (Refereed) Published
Abstract [en]

This narrative review aimed to identify young cancer survivors’ behaviours, experiences, and perspectives concerning physical activity, and identify useful strategies for promoting a healthy lifestyle. A manual search on the following databases was conducted: PubMed, Scopus, and Web of Science. The search was conducted between June 1, 2023, and April 12, 2024. Articles published from database inception up to April 12, 2024, were retrieved. Articles published in any language were considered. Perspectives including ideas, perceived barriers, and facilitators have been identified. Young cancer survivors seem to engage in physical activity as a useful coping strategy to regain normality and keep healthy after the cancer diagnosis. Although emotional and social support seems fundamental to increase participation, several other factors, including physical limitations, fatigue, sex, cancer type, and socio-economic status can influence physical activity participation. For those engaged in physical activity, the preferred activities are walking, biking, going to the gym, and exercising at home, while the least preferred are exercising at the hospital or boot camp-based exercises. Yoga is more frequently chosen by those still under treatment. Young cancer survivors appear to have unique needs different from those of adult cancer survivors. Mode of treatment delivery, increased awareness concerning the effects of physical activity, including families and friends, connecting survivors, and providing social support together with increasing motivation are key strategies for the promotion of physical activity in young cancer survivors. Fitness and healthcare professionals should consider these aspects to increase young cancer survivors' involvement in physical activities.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Exercise, Family nursing, Healthy lifestyle, Social support
National Category
Cancer and Oncology Nursing
Identifiers
urn:nbn:se:umu:diva-228427 (URN)10.1016/j.heliyon.2024.e35732 (DOI)001290978300001 ()2-s2.0-85200419211 (Scopus ID)
Available from: 2024-08-14 Created: 2024-08-14 Last updated: 2025-04-24Bibliographically approved
Baxter, R., Pusa, S., Andersson, S. & Sandgren, A. (2024). Perils and payoffs for patients in serious illness conversations as described by physicians: a qualitative study. BMJ Open Quality, 13(2), Article ID e002734.
Open this publication in new window or tab >>Perils and payoffs for patients in serious illness conversations as described by physicians: a qualitative study
2024 (English)In: BMJ Open Quality, E-ISSN 2399-6641, Vol. 13, no 2, article id e002734Article in journal (Refereed) Published
Abstract [en]

Background: The Serious Illness Care Programme was developed to promote more, better and earlier serious illness conversations. Conversations about goals and values are associated with improved experiences and outcomes for seriously ill patients. Clinicians’ attitudes and beliefs are thought to influence the uptake and performance of serious illness conversations, yet little is known about how clinicians perceive the impact of these conversations on patients. This study aimed to explore physicians’ perceptions regarding the impact of serious illness conversations for patients.

Methods: The Serious Illness Care Programme was implemented as a quality improvement project in two hospitals in Southern Sweden. Focus group evaluation discussions were conducted with 14 physicians and inductive thematic analysis was undertaken.

Results: The results revealed that physicians considered potential perils and optimised potential payoffs for patients when engaging in serious illness conversations. Potential perils encompassed inappropriate timing, damaging emotions and shattering hopes. Potential payoffs included reflection time, secure space, and united understandings.

Conclusions: Physicians depicted a balance in evaluating the perils and payoffs of serious illness conversations for patients and recognised the interrelation of these possibilities through continual assessment and adjustment.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2024
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-225091 (URN)10.1136/bmjoq-2023-002734 (DOI)001231853300002 ()2-s2.0-85194129877 (Scopus ID)
Funder
The Kamprad Family Foundation, 20172014
Available from: 2024-05-27 Created: 2024-05-27 Last updated: 2025-04-24Bibliographically approved
Andersson, S., Granat, L., Baxter, R., Reimertz, H., Modéus, C., Pusa, S. & Sandgren, A. (2024). Translation, adaptation, and validation of the swedish serious illness conversation guide. Journal of Palliative Care, 39(1), 21-28
Open this publication in new window or tab >>Translation, adaptation, and validation of the swedish serious illness conversation guide
Show others...
2024 (English)In: Journal of Palliative Care, ISSN 0825-8597, Vol. 39, no 1, p. 21-28Article in journal (Refereed) Published
Abstract [en]

Objective: To translate and adapt the Serious Illness Conversation Guide for use within the Swedish healthcare setting and examine the validity and acceptability of the Swedish Serious Illness Conversation Guide.

Methods: Three rounds of cognitive interviews were conducted (T1-3); patients (T1 n = 11; T2 n = 10; T3 n = 8), family members (T1 n = 5; T2 n = 2; T3 n = 2), and healthcare professionals (T1 n = 6; T2 n = 6; T3 n = 5). The guide was iteratively adapted based on interview feedback, clinical experience, and the literature. The guide was tested on training days with physicians and nurses.

Results: The Swedish Serious Illness Conversation Guide was found to be useful in supporting serious illness conversations. Clinicians reported that some questions were emotionally challenging. Explicit questions about prognosis and timing were excluded. Instead, the dual approach of “hoping for the best and preparing for the worst” was used to explore patients’ thoughts about the future.

Conclusions: Patients, family members, and healthcare professionals found the Swedish Serious Illness Conversation Guide to be appropriate, sensitive, and responsive to their needs. The Swedish Serious Illness Conversation Guide may facilitate a more health-promoting approach to serious illness conversations. Further research is needed to understand the impact of these conversations on person-centered and goal-concordant care.

Place, publisher, year, edition, pages
Sage Publications, 2024
Keywords
health communication, palliative care, patients, serious illness conversation, translation, validation
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-216215 (URN)10.1177/08258597231210136 (DOI)001088228000001 ()37886797 (PubMedID)2-s2.0-85175310374 (Scopus ID)
Funder
The Kamprad Family Foundation, 20210163
Available from: 2023-11-06 Created: 2023-11-06 Last updated: 2025-04-24Bibliographically approved
Baxter, R., Pusa, S., Andersson, S., Fromme, E. K., Paladino, J. & Sandgren, A. (2023). Core elements of serious illness conversations: an integrative systematic review. BMJ Supportive & Palliative Care
Open this publication in new window or tab >>Core elements of serious illness conversations: an integrative systematic review
Show others...
2023 (English)In: BMJ Supportive & Palliative Care, ISSN 2045-435X, E-ISSN 2045-4368Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background: Ariadne Labs' Serious Illness Care Program (SICP), inclusive of the Serious Illness Conversation Guide (SICG), has been adapted for use in a variety of settings and among diverse population groups. Explicating the core elements of serious illness conversations could support the inclusion or exclusion of certain components in future iterations of the programme and the guide.

Aim: This integrative systematic review aimed to identify and describe core elements of serious illness conversations in relation to the SICP and/or SICG.

Design: Literature published between 1 January 2014 and 20 March 2023 was searched in MEDLINE, PsycINFO, CINAHL and PubMed. All articles were evaluated using the Joanna Briggs Institute Critical Appraisal Guidelines. Data were analysed with thematic synthesis.

Results: A total of 64 articles met the inclusion criteria. Three themes were revealed: (1) serious illness conversations serve different functions that are reflected in how they are conveyed; (2) serious illness conversations endeavour to discover what matters to patients and (3) serious illness conversations seek to align what patients want in their life and care.

Conclusions: Core elements of serious illness conversations included explicating the intention, framing, expectations and directions for the conversation. This encompassed discussing current and possible trajectories with a view towards uncovering matters of importance to the patient as a person. Preferences and priorities could be used to inform future preparation and recommendations. Serious illness conversation elements could be adapted and altered depending on the intended purpose of the conversation.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2023
Keywords
Communication, End of life care, Hospital care, Quality of life, Psychological care, Supportive care
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:umu:diva-214330 (URN)10.1136/spcare-2023-004163 (DOI)001023721700001 ()37369576 (PubMedID)2-s2.0-85164331520 (Scopus ID)
Available from: 2023-09-11 Created: 2023-09-11 Last updated: 2024-03-14
Pusa, S., Baxter, R. & Sandgren, A. (2023). Physicians' perceptions of the implementation of the serious illness care program: a qualitative study. BMC Health Services Research, 23(1), Article ID 1401.
Open this publication in new window or tab >>Physicians' perceptions of the implementation of the serious illness care program: a qualitative study
2023 (English)In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 23, no 1, article id 1401Article in journal (Refereed) Published
Abstract [en]

Background: Conversations about goals, values and priorities with patients that are seriously ill are associated with improved palliative healthcare. The Serious Illness Care Program is a multi-component program that can facilitate more, better, and earlier conversations between clinicians and seriously ill patients. For successful and sustainable implementation of the Serious Illness Care Program, it is important to consider how stakeholders perceive it. The aim of our study was to explore physicians’ perceptions and experiences of implementing the Serious Illness Care Program.

Methods: Data were collected through four focus group discussions with physicians (n = 14) working at a hospital where the Serious Illness Care program was in the process of being implemented. Data were analyzed with inductive thematic analysis.

Results: Physicians’ perceptions of the implementation encompassed three thematic areas: hovering between preparedness and unpreparedness, being impacted and being impactful, and picking pieces or embracing it at all.

Conclusions: This study identified key aspects related to the individual physician, the care team, the impact on the patient, and the organizational support that were perceived to influence the implementation and sustainable integration of the Serious Illness Care Program. Describing these aspects provides insight into how the Serious Illness Care Program is implemented in practice and indicates areas for future training and development.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Advance care planning, Health communication, Implementation science, Palliative care, Physicians, Serious Illness care program, Serious Illness conversations
National Category
Nursing Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:umu:diva-218556 (URN)10.1186/s12913-023-10419-5 (DOI)38087357 (PubMedID)2-s2.0-85179644265 (Scopus ID)
Funder
The Kamprad Family Foundation, 20172014
Available from: 2023-12-21 Created: 2023-12-21 Last updated: 2024-01-19Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-6595-6298

Search in DiVA

Show all publications