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  • 1.
    Eisemann, Martin
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Lalos, Ann
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Psychosocial determinants of well-being in gynecologic cancer patients1999In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 22, no 4, p. 303-306Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to investigate the well-being of women with endometrial versus cervical cancer before treatment, and its determinants at 12 to 15 months follow-up. The subjects were interviewed before treatment, then 6 and 12 to 15 months after initiation of treatment. Simultaneously, they completed questionnaires on psychological symptoms and social support. It appeared that well-being at baseline and at the follow-ups were highly correlated. Furthermore, cervical cancer patients reported significantly more symptoms on all occasions. After discriminant function analysis, the following three variables remained in the analysis: (a) well-being before treatment, (b) diagnosis, and (c) children at home. This allowed 81% of the patients to be classified as having a favorable versus an unfavorable outcome. The results of this study highlight the importance of well-being before treatment as a predictor of well-being after treatment. The necessity of individualized intervention measures is warranted.

  • 2.
    Fallbjörk, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Salander, Pär
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Rasmussen, Birgit H
    Umeå University, Faculty of Medicine, Department of Nursing.
    From "no big deal" to "losing oneself": different meanings of mastectomy2012In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 35, no 5, p. E41-E48Article in journal (Refereed)
    Abstract [en]

    Background: Because of early detection and advanced treatment options, more women with breast cancer survive after mastectomy and thus have to face the choice of living with or without a reconstructed breast for many years to come. O

    bjective: This article investigates these women’s narratives about the impact of mastectomy on their lives, as well as their reflections on breast reconstruction.

    Methods: Fifteen women were strategically chosen from a previous population-based study on mastectomy. They were contacted for further exploration in thematic narrative-inspired interviews 4.5 years after mastectomy.

    Results: Three types of storylines were identified. In the first storyline, the mastectomy was described as ‘‘no big deal’’; losing a breast did not disturb the women’s view of themselves as women, and breast reconstruction was not even worth consideration. In the second storyline, the women described the mastectomy as shattering their identity. Losing a breast implied losing oneself as a sexual being, a woman, and a person. The third storyline fell in between the other two; the sense of femininity was wounded, but not to the extent that they felt lost as women.

    Conclusion: Our findings suggest that the experience of mastectomy due to breast cancer is very much individual and contextual. Losing a breast may be of minor or major importance.

    Implications for Practice: Healthcare practitioners should be attentive to how the women themselves experience the personal meaning of losing a breast and guard against vague preconceptions based on the breast-sexuality-femininity discourse and its connection to what the patient needs.

  • 3.
    Fransson, Per
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology. Umeå University, Faculty of Medicine, Department of Nursing.
    Quality of life for members of Swedish Prostate Cancer Patient Associations2008In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 31, no 1, p. 23-31Article in journal (Refereed)
    Abstract [en]

    Prostate Cancer Patient Associations (PCPAs) have become common. The aim of this study was to evaluate the quality of life of patients belonging to PCPAs. Members of 10 PCPAs in Sweden with prostate cancer completed 2 quality of life questionnaires (Quality-of-Life Questionnaire [QLQ-C30] and Prostate Cancer Symptom Scale). Of 2,028 members, 1,301 (64%) responded to the survey. Sixty percent of the members felt "healthy," and 38% were "free from the cancer." Ninety-five percent scored >80 on the physical function scale compared with 44% on the overall quality of life/health scale. The most severe symptom was sleeping disturbances (mean = 29). Seventeen percent scored "Quite a bit/Much" tiredness. More than 50% did not report any bladder or bowel problems. Fifty percent had "Much" sexual problems, and almost 80% did not have sufficient erection. Those reported as being "disease free" scored higher on the functioning scales than those with "metastatic disease." Those with an experience of a "metastatic disease" had more symptoms than those with less advanced disease. This is the first descriptive study of quality of life in members of Swedish PCPAs with prostate cancer. These findings show that it is possible to gain valid data to further study the situation of patients living with prostate cancer by collecting data from PCPAs.

  • 4.
    Hedestig, Oliver
    et al.
    Umeå University, Faculty of Medicine, Radiation Sciences, Oncology.
    Sandman, Per-Olof
    Umeå University, Faculty of Medicine, Nursing.
    Tomic, Radisa
    Umeå University, Faculty of Medicine, Surgical and Perioperative Sciences, Urology and Andrology.
    Widmark, Anders
    Umeå University, Faculty of Medicine, Radiation Sciences, Oncology.
    Living after external beam radiotherapy of localized prostate cancer: A qualitative analysis of patient narratives.2005In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 28, no 4, p. 310-317Article in journal (Refereed)
  • 5.
    Hedestig, Oliver
    et al.
    Umeå University, Faculty of Medicine, Radiation Sciences.
    Sandman, Per-Olof
    Widmark, Anders
    Living with untreated localized prostate cancer: a qualitative analysis of patient narratives2003In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 26, no 1, p. 55-60Article in journal (Refereed)
  • 6. Langegård, Ulrica
    et al.
    Ahlberg, Karin
    Björk-Eriksson, Thomas
    Fransson, Per
    Umeå University, Faculty of Medicine, Department of Nursing. Department of Cancercentrum, Norrlands University Hospital, Umeå.
    Johansson, Birgitta
    Ohlsson-Nevo, Emma
    Witt-Nyström, Petra
    Sjövall, Katarina
    The art of living with symptoms: a qualitative study among patients with primary brain tumors receiving proton beam therapy2019In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804Article in journal (Refereed)
    Abstract [en]

    Background: Symptom management in conjunction with proton beam therapy (PBT) from patient's perspective has not been explored. Such knowledge is essential to optimize the care in this relatively new treatment modality.

    Objective: The aim of this study was to explore the process of symptom management in patients with brain tumor receiving PBT.

    Methods: Participants were 22 patients with primary brain tumor who received PBT, recruited in collaboration with a national center for proton therapy and 2 oncology clinics at 2 university hospitals in Sweden. Interviews using open-ended questions were conducted before, during, and/or after treatment. Verbatim interview transcripts were analyzed using classic Grounded Theory.

    Results: The art of living with symptoms” emerged as the core concept. This encompassed 3 interconnected symptom management concepts: “Adapting to limited ability,” “Learning about oneself,” and “Creating new routines.” These concepts were summarized in a substantive theoretical model of symptom management. Despite the struggle to manage symptoms, participants lived a satisfactory life.

    Conclusions: Symptom management in conjunction with PBT comprises a process of action, thoughts, and emotions. The concepts that emerged indicated patients' symptom management strategies were based on their own resources.

    Implications for Practice: It is important that PBT facilities develop an approach that facilitates the symptom management process based on patients' experiences of symptoms, as well as their actions and available resources.

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  • 7.
    Lindqvist, Olav
    et al.
    Umeå University, Faculty of Medicine, Radiation Sciences, Oncology. Onkologi.
    Widmark, Anders
    Umeå University, Faculty of Medicine, Radiation Sciences, Oncology. Onkologi.
    Rasmussen, Birgit H
    Umeå University, Faculty of Medicine, Omvårdnad.
    Meanings of the phenomenon of fatigue as narrated by 4 patients with cancer in palliative care2004In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 27, no 3, p. 237-243Article in journal (Refereed)
  • 8.
    Lindqvist, Olav
    et al.
    Umeå University, Faculty of Medicine, Radiation Sciences, Oncology. Onkologi.
    Widmark, Anders
    Umeå University, Faculty of Medicine, Radiation Sciences, Oncology. Onkologi.
    Rasmussen, Birgit H
    Umeå University, Faculty of Medicine, Omvårdnad.
    Reclaiming wellness - living with bodily problems, as narrated by men with advanced prostate cancer2006In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 29, no 4, p. 327-337Article in journal (Refereed)
  • 9. Lövgren, Malin
    et al.
    Hamberg, Katarina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Tishelman, Carol
    Clock time and embodied time experienced by patients with inoperable lung cancer2010In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 33, no 1, p. 55-63Article in journal (Refereed)
    Abstract [en]

    In this study, we explore how patients with inoperable lung cancer (LC) discuss their experiences of time, based on content analysis of open interviews with 35 patients 1 year after diagnosis, using Davies' distinction between "clock time" and "embodied time" as sensitizing concepts. Two interrelated themes were derived: (1) aspects related to the healthcare system, with 3 subthemes: waiting times in the healthcare system, limited time for patient-professional contact, and limited time for coordination of services, and (2) existential aspects, with subthemes: the future with LC and managing an uncertain and finite life with LC. Time could be experienced as problematic for these patients, when limited or lacking or through long periods of waiting, especially when these periods occurred without adequate preparation or information. This contributed to exacerbation of these patients' existing sense of uncertainty, their perception of care as impersonal and insecure, and their need to remain alert and act on their own behalf. Awareness of the seriousness of their disease and the prospect of a limited lifetime was described as increasing uncertainty about dying and fear of certain death. People also described efforts to constructively deal with their situation by reprioritizing their remaining time, having increased appreciation of some aspects of daily life, and living consciously in the present. This analysis suggests a collision between clock time, which steers the healthcare system, and embodied time, as experienced by individuals. Greater attention to psychosocial needs is suggested as one means of positively affecting patients' experiences of time and uncertainty.

  • 10. Pascoe, Elizabeth C.
    et al.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia.
    Psychological Characteristics and Traits for Finding Benefit From Prostate Cancer Correlates and Predictors2016In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 39, no 6, p. 446-454Article in journal (Refereed)
    Abstract [en]

    Background: Although beginning evidence suggests that the capacity to derive benefit from cancer-associated experiences may be influenced by some individual psychological characteristics and traits, little is known about predictors for finding benefit from prostate cancer.

    Objective: The aim of this study was to explore the correlates and predictors for finding benefit from prostate cancer among a sample of men undergoing androgen deprivation.

    Methods: Pearson correlation and multiple linear regression modeling were performed on data collected in an acute tertiary hospital outpatient setting (N = 209) between July 2011 and December 2013 to determine correlates and predictors for finding benefit from prostate cancer.

    Results: Multiple linear regression modeling showed that while the 6 predictors of self-reported coping, depression, anxiety, distress, resilience, and hope explained 38% of the variance in finding benefit, coping provided the strongest and statistically significant predictive contribution.

    Conclusions: Self-reported coping was strongly predictive of finding benefit from prostate cancer, but questions remain about if subtypes of coping strategies can be more or less predictive of finding benefit. Self-reported levels of depression, anxiety, distress, resilience, and hope had a less predictive and nonsignificant role in finding benefit from prostate cancer and raise questions about their function in this subpopulation.

    Implications for Practice: The findings suggest that coping strategies can maximize finding benefit from prostate cancer. Knowledge of influential coping strategies for finding benefit from prostate cancer can be immensely valuable to support men in rebuilding positive meaning amid a changed illness reality. Developing practice initiatives that foster positive meaning-making coping strategies seems valuable.

  • 11. Persson, Carina
    et al.
    Sundin, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Being in the situation of a significant other to a person with inoperable lung cancer2008In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 31, no 5, p. 380-8Article in journal (Refereed)
    Abstract [en]

    Little is known about how significant others experience their own situation when a family member becomes seriously ill. To illuminate the meanings of significant others’ experiences of their situation after a family member had been diagnosed with inoperable lung cancer, we analyzed narratives from 12 significant others, using a phenomenological hermeneutic approach. Findings revealed 4 themes: feeling dislocated in life, being in an altered relationship, being in a struggle, and feeling secure. When reflecting on these findings, we considered the transition theories and works of Ricoeur and Lo¨gstrup. The significant others’ experiences indicated a transition process because of the changes brought about by the diagnosis of lung cancer and a struggle to endure and overcome difficulties and distress on the way to regaining a smooth functioning life. Furthermore, the diagnosis of lung cancer had altered the relationship toward the next of kin and meant not only feelings of increased closeness but also loss of intimacy and reciprocity. The significant others suffered in this process of transition, and healthcare professionals, who recognize the World Health Organization’s definition of palliative care, may consider the findings of this study useful when reflecting on their care of families.

  • 12.
    Spetz, Agneta
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Henriksson, Roger
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Salander, Pär
    Umeå University, Faculty of Social Sciences, Department of Social Work. Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    A specialist nurse as a resource for family members to patients with brain tumors: an action research study2008In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 31, no 4, p. E18-26Article in journal (Refereed)
    Abstract [en]

    There are few scientific publications available with a focus on the value of supportive care services for patients with brain tumors and their families. The present study is part of a project where a specialist nurse (SN) function was implemented for patients with malignant glioma and their next-of-kin. The purpose of the present study was to identify how next-of-kin made use of the SN function. To identify what they asked for when they contacted the nurse is a way of understanding the vulnerability of family members and thus to learn how to provide better support to the benefit of the family. In accordance to a design inspired by action research, the SN approached patients and next-of-kin during diagnosis at the Departments of Oncology/Neurosurgery and informed them that they could use her as a resource when they wanted. The SN documented all contacts with the next-of-kin of 16 consecutive patients in field notes during the course of the disease: telephone calls and personal meetings-who contacted whom, about what, and with what outcome. In addition, summarizing interviews were conducted. The study is based on the field notes and complemented with the interview data. Different needs were expressed throughout the relationship between the next-of-kin and the SN: initially, conversation about the sick family member was paramount, but as time passed, talk about oneself came to the forefront, and thereafter, they also commented on the relationship to the SN in a more personal tone. The relationship to the SN per se is important-the SN function can be far more than a provider of information. Altogether, the platform provided by the SN easily lends itself to the conceptualization of "a secure base" in attachment theory.

  • 13.
    Ångström-Brännström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindh, Viveca
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Lindh, Jack
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Engvall, Gunn
    Staff's Experiences of Preparing and Caring for Children With Cancer and Their Families During the Child's Radiotherapy2019In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 42, no 5, p. E10-E18Article in journal (Refereed)
    Abstract [en]

    Background: Approximately one-third of children diagnosed with cancer are treated with radiotherapy (RT). Staff experiences of preparing and distracting the children and their families during a child’s RT are sparsely described.

    Objective: The aim of this study was to describe staff experiences of preparing and caring for children with cancer and their families during the child’s RT.

    Intervention/Methods: Semistructured interviews with staff were performed at 3 Swedish RT centers. The interviews were analyzed using inductive qualitative content analysis.

    Results: The analysis revealed 5 categories summarizing the staff members’ experiences. These include the following: experiences of various emotions; care for the child and the child’s family; commitments before, during, and after RT; organizational issues; and experiences of the intervention and suggestions for improvement.

    Conclusions: The preparatory intervention facilitated the ability of staff members to conduct their work, although the intervention should be specifically tailored to each child. Meeting children and their families and providing care to both during RT were challenging. The staff strived to provide optimal care for each child and family. Interdisciplinary teamwork and organizational acceptance for the importance of preparation and distraction were essential.

    Implications for Practice: A future challenge will be to provide opportunities for all staff involved in the treatment of children with cancer to develop their skills continuously in order to provide high-quality preparation and distraction to all children undergoing RT, regardless of the geographical location of the RT center.

  • 14.
    Ödling, Gunvor
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Danielson, E
    Christensen, SB
    Norberg, A
    Living with breast cancer: care givers’ perceptions in a surgical ward1998In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 21, no 3, p. 187-195Article in journal (Refereed)
  • 15.
    Ödling, Gunvor
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Danielson, E
    Jansson, L
    Caregivers’ descriptions of patients with advanced breast cancer in connection with supervision sessions in a surgical ward2001In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 24, no 1, p. 28-34Article in journal (Refereed)
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