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  • 1.
    Kero, Anneli
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynecology. Umeå University, Faculty of Social Sciences, Department of Social Work.
    Abort - en tabubelagd rättighet: kvinnors mångbottnade upplevelser rymmer både lättnad och smärta2005In: Läkartidningen, Vol. 48, no 102, p. 3677-3680Article in journal (Refereed)
    Abstract [sv]

    Abort förekommer i alla samhällsgrupper, och abortmotiven avspeglar kvinnors (och mäns) behov av ett planerat föräldraskap. Abort är inte bara accepterad som en principiell rättighet utan också integrerad bland kvinnor som ett möjligt alternativ vid en oönskad graviditet. Kvinnors upplevelser av abort är mångbottnade. Att göra abort ses som ett ansvarstagande och upplevs som en lättnad. Detta behöver inte utesluta etiska reflektioner eller parallella smärtsamma känslor. Så länge abort främst uppmärksammas som en nödlösning bland vissa riskgrupper och inte som ett fenomen som avspeglar reproduktiva förväntningar, upprätthålls bilden av abort som något tabubelagt. Osynliggörandet av kvinnors komplexa överväganden och upplevelser i samband med abort bidrar till att myter om abort lever vidare.

  • 2.
    Kero, Anneli
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Paradoxes in legal abortion: a longitudinal study of motives, attitudes and experiences in women and men2002Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: About one in four pregnancies in Sweden are terminated by legal abortion. However, women seeking abortion constitute a relatively invisible group. This is even more accentuated when it comes to the men involved in induced abortion.

    Aim: The general aim of the present thesis was to investigate psychosocial background, current living conditions, motives, attitudes and experiences of legal abortion in women and men.

    Methods: The five papers included in the thesis are based on a questionnaire study and a longitudinal interview study. Women seeking abortion were asked consecutively as they come to the hospital for the first time if they were willing to participate in the questionnaire study, which ultimately included 211 women and 75 men. The interview study comprised 58 women and 26 men and was conducted just after abortion and four and twelve months later.

    Results: Most women and men had stable partner relationships and adequate finances. More than half were married or cohabiting and already had children. About half the women gave motives for abortion related to family planning. They wanted either to postpone childbirth or limit the number of children so they would be able to combine good parenting with professional employment. Motives for abortion in men were strikingly in accordance with the women's motives. Most men were in favour of abortion, 20 stressed they supported the decision and two wanted the woman to continue the pregnancy. Contradictory feelings in relation to both pregnancy and the coming abortion were common in women as well as men, but were very seldom associated with doupts about the actual decision to have an abortion. Social perspectives, connected with responsibility for all concerned (the foetus included) were found to legitimise the decision to have an abortion, whilst positive feelings in relation to the pregnancy and ethical perspectives concerning the rights of the foetus made in more difficult. In addition, the complexity increased in cases when the abortion could be simultaneously experienced as both a relief and a loss. However, at the follow-ups, the majority of the women did not report any emotional distress, either directly after the abortion or four or 12 months later, and the predominant reactions were relief and mental growth. As concerns contraceptives, about half the respondents had not used any contraceptive method at the time of conception. Common explanations for not preventing pregnancy were: thought it was a safe-period or let sexual feelings take over or took a chance. Furthermore, in 12 % of cases, the woman had felt pressure or threat from the man in connection with the conception.

    Conclusions: Women resort to legal abortion in all kinds of psychosocial contexts. The motives reveal that women and men want to have children with the right partner at the right time and to limit the number of children. Despite painful and contradictory feelings almost no one regretted the abortion, either directly after the abortion or one year later. It is essential that both clinical work and research are open to contradictory feelings and paradoxical thinking in relation to abortion. In addition, it is necessary also to focus on the involvement and role of the males in order to obtain a proper picture of the phenomenon of abortion.

  • 3.
    Kero, Anneli
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Högberg, Ulf
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Lalos, Ann
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Legal abortion: a painful necessity2001In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 53, no 11, p. 1481-1490Article in journal (Refereed)
    Abstract [en]

    This study was conducted to increase knowledge about the psychosocial background and current living conditions of Swedish women seeking abortion, along with their motives for abortion and their feelings towards pregnancy and abortion. Two hundred and eleven women answered a questionnaire when they consulted the gynaecologist for the first time. The study indicates that legal abortion may be sought by women in many circumstances and is not confined to those in special risk groups. For example, most women in the sample were living in stable relationships with adequate finances. The motives behind a decision to postpone or limit the number of children revealed a wish to have children with the right partner and at the right time in order to combine good parenting with professional career. The study shows that prevailing expectations about lifestyle render abortion a necessity in family planning. One-third of the women had had a previous abortion(s) and 12% had become pregnant in a situation where they had felt pressured or threatened by the man. Two-thirds of the women characterised their initial feelings towards the pregnancy solely in painful words while nearly all the others reported contradictory feelings. Concerning feelings towards the coming abortion, more than half expressed both positive and painful feelings such as anxiety, relief, grief, guilt, anguish, emptiness and responsibility, while one-third expressed only painful feelings. However, almost 70% stated that nothing could change their decision to have an abortion. Thus, this study highlights that contradictory feelings in relation to both pregnancy and the coming abortion are common but are very seldom associated with doubts about the decision to have an abortion.

  • 4.
    Kero, Anneli
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Högberg, Ulf
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Lalos, Ann
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Contraceptive risk-taking in women and men facing legal abortion2001In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 6, no 4, p. 205-218Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of the study was to gain knowledge about contraceptive use, reproductive risk-taking and sexuality in Swedish women seeking abortion and their partners.

    Methods: Two hundred and eleven women and 75 men answered a questionnaire before the abortion. The data have been divided into six subgroups: women with and without previous experience of abortion, single women and women with a partner relationship, and women whose partner participated in the study and the male partners.

    Results: The main findings showed that there are more similarities than differences between the subgroups. Overall, there were no differences regarding use of contraceptives, sexual life and psychosocial characteristics. However, women with previous abortion experience were found to be older, had longer partner relationships and more often had children. Some gender differences were also found, i.e. women favored coitus-dependent contraceptives to a larger extent and took more responsibility for preventing unwanted pregnancies. At the time of conception, half the participants had not used any contraceptive methods and one-fifth had relied on 'natural family planning'. The most common reasons for not using contraceptives were related to risk-taking and/or to strong sexual desire. Twelve per cent of the women had felt pressure/threat from their partner in connection with the conception.

    Conclusion: In efforts to prevent undesired pregnancies, this study highlights the need to incorporate a gender perspective both in communication about risk-taking and in counselling about contraceptives.

  • 5.
    Kero, Anneli
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Högberg, Ulf
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Lalos, Ann
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Wellbeing and mental growth: long-term effects of legal abortion2004In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 58, no 12, p. 2559-2569Article in journal (Refereed)
    Abstract [en]

    The present study aims to increase knowledge about coping with legal abortion by studying women's reasoning, reactions and emotions over a period of 1 year. The study comprises interviews focusing on the experiences and effects of abortion in 58 women, 4 and 12 months after the abortion. The women also answered a questionnaire before the abortion concerning their living conditions, decision-making process and feelings about the pregnancy and the abortion. Majority of the women did not experience any emotional distress post-abortion and almost all the woman reported that they had coped well at the 1-year follow-up, although 12 had had severe emotional distress directly post-abortion. Furthermore, almost all described the abortion as a relief or a form of taking responsibility and more than half reported only positive experiences such as mental growth and maturity of the abortion process. Those without any emotional distress post-abortion stated clearly before the abortion that they did not want to give birth since they prioritised work, studies and/or existing children. The study shows that women generally are able to make the complex decision to have an abortion without suffering any subsequent regret or negative effects, as ascertained at the 1-year follow-up.

  • 6.
    Kero, Anneli
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Lalos, Ann
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Ambivalence - a logical response to legal abortion: a prospective study among women and  men2000In: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 21, no 2, p. 81-91Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to elucidate ambivalence in relation to legal abortion by studying emotions, attitudes, motives for abortion and ethical reasoning in a-strategic sample of women and men who, 1 year after abortion, expressed both positive and painful feelings in relation to the abortion. The study shows that social perspectives legitimate the decision to have an abortion whilst ethical perspectives complicate the decision. Nearly all women and men described having the abortion as an expression of responsibility. Almost one-half also had parallel feelings of guilt, as they regarded the abortion as a violation of their ethical values. The majority of the sample expressed relief while simultaneously experiencing the termination of the pregnancy as a loss coupled with feelings of grief/emptiness, in spite of the ambivalence, only one woman regretted the abortion. For the vast majority, the impact of the abortion had led to increased maturity and deepened self-knowledge. Thus, ambivalence might be regarded not only as problematic but also as indicating openness to the complexity of the abortion issue. Since incompatible values clash in connection with abortion, experiences of ambivalence become both logical and understandable.

    Read More: http://informahealthcare.com/doi/abs/10.3109/01674820009075613

  • 7.
    Kero, Anneli
    et al.
    Umeå University, Faculty of Medicine, Clinical Sciences, Obstetrics and Gynaecology.
    Lalos, Ann
    Umeå University, Faculty of Medicine, Clinical Sciences, Obstetrics and Gynaecology.
    Förhindra och avbryta graviditet: kvinnors och mäns villkor och val2004In: Kropp och genus i medicinen, Studentlitteratur, Lund , 2004, p. 333-341Chapter in book (Other academic)
  • 8.
    Kero, Anneli
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Lalos, Ann
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Increased contraceptive use one year post-abortion2005In: Human Reproduction, ISSN 0268-1161, E-ISSN 1460-2350, Vol. 20, no 11, p. 3085-3090Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The aim of the study was to investigate the impact of abortion on contraceptive use, partner relationship and sexual satisfaction. METHODS: In a longitudinal study, 58 women answered a pre-abortion questionnaire and participated in two interviews, one in connection with the abortion and a second 1 year later. RESULTS: Most women (40/58) had retained the same partner 1 year after the abortion. More than half of these (22/40) experienced no change in the quality of the partner relationship, while the rest (18/40) had deepened their relationship. Furthermore, the majority of the women (45/58) had not experienced any negative influence on their sexual satisfaction. Most women who were sexually active 1 year post-abortion (42/47) used some contraceptive method; the number who used hormonal methods or intrauterine devices had, for example, increased from four to 35, although one-third of them had been doubtful about these methods before abortion. Conversely, 15 women had tried these methods during the follow-up year but had not continued because of negative effects. Overall, contraceptive use 1 year post-abortion had increased. CONCLUSIONS: To achieve well-founded decisions about contraceptives, counsellors should be aware of women’s ambivalence about the use of modern, effective contraceptive methods. In order to prevent abortion it is important to discuss gender differences in sexual behaviour and encourage communication with both sexes about the pros and cons of coitus-dependent and coitus-independent methods.

  • 9. Kero, Anneli
    et al.
    Lalos, Ann
    Kvinnors och mäns upplevelser av abort2018In: Inducerad abort, Stockholm: Svensk förening för obstetrik och gynekologi , 2018, p. 44-46Chapter in book (Other academic)
  • 10.
    Kero, Anneli
    et al.
    Umeå University, Faculty of Social Sciences, Social Welfare.
    Lalos, Ann
    Mäns upplevelser och reaktioner före och efter abort2006In: Inducerad abort, Svensk förening för obstetrik och gynekologi arbets och referensgrupp för familjeplanering, Stockholm , 2006Chapter in book (Other academic)
  • 11.
    Kero, Anneli
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Lalos, Ann
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Reactions and reflections in men, 4 and 12 months post-abortion2004In: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 25, no 2, p. 135-143Article in journal (Refereed)
    Abstract [en]

    Background: In general, men involved in legal abortion constitute an invisiblegroup and there is scarcely any knowledge about their experiences and opinions.Therefore, the aim of the present study was to increase knowledge about reactionsand reflections by means of a prospective study of men’s attitudes and feelingstowards abortion.

    Methods: Twenty-six men answered a questionnaire before abortion, andparticipated in interviews at the time of abortion and 4 and 12 months postabortion.

    Results: Nearly all of the men were happy with the women’s decision to havean abortion at both follow-ups. They experienced the abortion as a relief and aresponsible act. Simultaneously, abortion could also be experienced as a painfuland ethically problematic act. Overall, most men had only positive experiencespost- abortion, such as a feeling of maturity. More than half of those whoaccompanied their partners to the hospital felt that the staff did not have awelcoming attitude. It was also found that 1-year post-abortion, more than a thirdconsistently did not use a reliable contraceptive method.

    Conclusions: There is a need for further studies concerning men’s experiencesand reactions in the context of abortion and it is of fundamental importance that agender perspective is incorporated into this specific field of reproductive healthresearch.

  • 12.
    Kero, Anneli
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Lalos, Ann
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Högberg, Ulf
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    The male partner involved in legal abortion1999In: Human Reproduction, ISSN 0268-1161, E-ISSN 1460-2350, Vol. 14, no 10, p. 2669-2675Article in journal (Refereed)
    Abstract [en]

    This study comprises 75 men who have been involved in legal abortion. The men answered a questionnaire concerning living conditions and attitudes about pregnancy and abortion. Most men were found to be in stable relationships with good finances. More than half clearly stated that they wanted the woman to have an abortion while 20 stressed that they submitted themselves to their partner's decision. Only one man wanted the woman to complete the pregnancy. Apart from wanting children within functioning family units, the motivation for abortion revealed that the desire to have children depended on the ability to provide qualitatively good parenting. More than half the men had discussed with their partner what to do in event of pregnancy and half had decided to have an abortion if a pregnancy occurred. More than half expressed ambivalent feelings about the coming abortion, using words such as anxiety, responsibility, guilt, relief and grief. In spite of these contradictory feelings, prevailing expectations concerning lifestyle make abortion an acceptable form of birth control. A deeper understanding of the complexity of legal abortion makes it necessary to accept the role of paradox, which the ambivalence reflects. Obviously, men must constitute a target group in efforts to prevent abortions.

  • 13.
    Kero, Anneli
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology. Umeå University, Faculty of Social Sciences, Department of Social Work.
    Lalos, Ann
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Wulff, Marianne
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Home abortion - experiences of male involvement2010In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 15, no 4, p. 264-270Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To gain knowledge about the male partner's experience of being present during an induced home abortion. METHODS: Twenty-three couples, whose male partner had been present when the woman aborted at home, were interviewed one to two weeks post-abortion. RESULTS: Each of the men supported his partner in her decision to have a home abortion, as this gave him the possibility of being near and of caring for her needs on the expulsion day. All the men were present and all their partners confirmed that they had been supportive. Half the men had been anxious prior to the expulsion, but most considered that their experiences during the expulsion had been 'easier than expected' and their dominant feeling was one of relief. CONCLUSIONS: Abortion is an important life event. When taking place at home, it increases the possibility for the couple to share the experience. Sharing an abortion may have a positive impact on those men who lack a sense of responsibility regarding reproductive issues, such as contraceptive use. This could facilitate society's efforts to involve men as a target group in this field. Designing an abortion policy that caters for the needs of both partners is a challenge.

  • 14.
    Kero, Anneli
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Lalos, Ann
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Wulff, Marianne
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Home abortion implies radical changes for women2009In: The European journal of contraception and reproductive health care, ISSN 1362-5187, Vol. 14, no 5, p. 324-333Article in journal (Refereed)
  • 15.
    Kero, Anneli
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Lalos, Ann
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Wulff, Marianne
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Why shouldn't one report on women's positive feelings with regard to abortion?2010In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 15, no 2, p. 150-151Article in journal (Other academic)
  • 16.
    Lilliehorn, Sara
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    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).
    Kero, Anneli
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Salander, Pär
    Umeå University, Faculty of Social Sciences, Department of Social Work. Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Admission into a helping plan: a watershed between positive and negative experiences in breast cancer2010In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 19, no 8, p. 806-813Article in journal (Refereed)
    Abstract [en]

    Cancer patients are in an exposed situation that raises certain psychosocial needs in contact with health care. Previous studies have mainly investigated these needs by assessments on predefined categories.Objective: The purpose of the present study is, from the patients' perspective, to identify breast cancer patients' psychosocial needs, and to synthesise them in a model reflecting the core of these needs.Methods: Seventy-one patients treated with radition therapy were consecutively included and repeatedly interviewed about their experiences of health care. 'Critical incidents' where identified from the interviews and analysed due to the similarities-differences technique in grounded theory.Results: Four categories of needs where detected: 'access', 'information', 'treatment', and 'how approached'. These categories and their properties merged into a core category - 'admission into a helping plan'. These findings are well understood in terms of attachment theory. In times of immanent danger and stress people strive to fina a 'safe haven' to attach to. Cancer patients' 'safe haven' can be described as 'a helping plan'. It is not the result of a separate patient-caregiver relationship but is created by a pattern of individual experiences from all kind of contacts with the health-care system as a whole.Conclusions: The presented model of patients needs as converging into 'admission into a helping plan' may serve as an easily comprehendible model for caregivers, guiding them to contribute to the patient's feeling of security and trust, and thus to the patient's own 'hoope work'.

  • 17.
    Lilliehorn, Sara
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Hamberg, Katarina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Kero, Anneli
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Salander, Pär
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Breast cancer experience through the body: A consecutive, six-year longitudinal study of 24 womenManuscript (preprint) (Other academic)
  • 18.
    Lilliehorn, Sara
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    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).
    Kero, Anneli
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Salander, Pär
    Umeå University, Faculty of Social Sciences, Department of Social Work. Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Critical incidents in contact with healthcare reflecting the needs of women with breast cancer2008In: Psycho-Oncology, 2008, p. S10-Conference paper (Other academic)
  • 19.
    Lilliehorn, Sara
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    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).
    Kero, Anneli
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Salander, Pär
    Umeå University, Faculty of Social Sciences, Department of Social Work. Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Meaning of work and the returning process after breast cancer: a longitudinal study of 56 women2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 2, p. 267-274Article in journal (Refereed)
    Abstract [en]

    Background: An increasing number of women survive breast cancer and a majority return to work. However, findings based on mean values may conceal individual processes that need to be better understood to discuss meaningful rehabilitation.

    Aim: The purpose of this paper is to describe the sick-leave pattern of a group of Swedish women with primary breast cancer but foremost to explore their ideas about what motivates and discourages their return to work.

    Method: Fifty-six women were repeatedly interviewed over a period of 18 to 24 months. Interview sections that clearly illustrated the women’s experiences and ideas about work were categorized using the comparative similarities-differences technique.

    Findings: The average length of sick leave was 410 days (range 0-942). Six months after the first day of sick leave, 29% worked at least their previous service grade. At 12 months, 55%, and at 18 months 57% did so. Those treated with chemotherapy had in average more than twice as large sick leave as those who did not. Three categories emerged. ‘Motives for not returning to work’ consists of four sub-categories: ‘I’m still too fragile to return to work’; ‘My workplace is a discouraging place’; ‘I took an opportunity to pause’ and ‘I’ve lost the taste for work’. ‘Motives for returning’ consists of two sub-categories: ‘Work generates and structures my everyday life’ and ‘I miss my workplace’. Finally, ‘Transition in work approach’ reflects a changed approach to work.

    Conclusion: The meaning of work varies over time, but first and foremost work was regarded as an important part of the healing process as it restores the disruption of everyday life. Guidelines cannot be reduced to a linear relationship with biomedical variables but the individual context of everyday life must be considered.

  • 20.
    Lilliehorn, Sara
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Kero, Anneli
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Hamberg, Katarina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Salander, Pär
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Breast Cancer Experience Through the Body: A Consecutive, Six-Year Longitudinal Study of 24 Women2013In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 22, p. 334-334Article in journal (Other academic)
    Abstract [en]

    BACKGROUND: Breast cancer is a disruptive s bodies in body experiences in a life context are not sufficiently acknowledged in breast cancer research. Due to the increasing number of breast cancer survivors, longitudinal studies that pay attention to long-term experiences of the body are of vital importance in order to gain knowledge valuable for rehabilitation initiatives. This study is a contribution.

    four women were consecutively included in a prospective project and repeatedly interviewed during 6 years from ending hospitalised treatment. The qualitative analysis was made by means of thematic narrative analysis. Out of the interviews individual narratives were constructed s body experience over time. The narratives were repeatedly read to identify possible common thematic elements across participants of how the body appeared to the women and to discern processes of how this developed over time. Three main processes were found in the analysis.

    RESULTS: Common to all women was to initially experience the body as surviving. Survival was key target and bodily complaints were thus measured and valued in favour of that. When back to a new everyday life after treatment five women quickly experienced their bodies as comprehensible. They had undergone a minimum of treatments. 19 women reported more complaints and experienced the body as broken, fragile and as incomprehensible. With time and regained function most came to experience their bodies as comprehensible. Three women, however, met with more bodily decline than they could reconcile, they eventually disassociated from their bodies.

    CONCLUSIONS: This study makes a unique contribution by mapping out how breast cancer patients experience and value their bodies over 6 years from ending hospitalised treatment. The findings are considered from a phenomenological perspective and reflect how the women “discovered” and handled their bodies as something they had, the bodies were seen as separated from themselves while altering and changing due to side effects. The processes of establishing liveable body relations differed depending on treatment impact and ability to incorporate body changes as part of themselves. The findings are discussed in relation to theories of bodynormativity and biographical continuity.

    RESEARCH IMPLICATIONS: The study clarifies that experiences and valuations of body alterations and side effects shifts over time. It indicates the importance of further studies to carefully consider this transition over time and interpret selfassessments of body experience in relation to treatment (on-going/completed) and overall life context (on sick-leave/working).

    CLINICAL IMPLICATIONS: This study highlights the impact of side effects, especially from endocrine treatment, on breast cancer patients’ everyday life. We find it reasonable to suggest that physicians take a quite humble stand when discussing the treatment options. In cases of massive side effects, it must be possible to end treatment without this causing excessive worries for disease progression.

  • 21.
    Salander, Pär
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work. Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Lilliehorn, Sara
    Umeå University, Faculty of Social Sciences, Department of Social Work. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Hamberg, Katarina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Kero, Anneli
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    The impact of breast cancer on living an everyday life 4.5-5 years post-diagnosis: a qualitative prospective study of 39 women2011In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 50, no 3, p. 399-407Article in journal (Refereed)
    Abstract [en]

    Background. The survival of women with breast cancer has improved. There are many studies available describing different aspects of how the illness and its treatment affect the women. Usually these studies are cross-sectional and focus on assessments of a sample of women at a single point in time during post-treatment. These studies are important but of limited value if we are interested in understanding more about breast cancer in a life context. The present study is a contribution.

    Methods. A consecutive sample of 39 women was followed up by means of repeated thematic interviews about how they lived their lives, from the end of radiation therapy to a point four years later, i.e. 4.5–5 years post diagnosis.

    Results. Four different groups of women emerged. Largely, the first group evaluated the cancer initiated transformation of their lives in a positive way. The breast cancer helped them depart from a career treadmill or to positive interpersonal experiences. In the second group the cancer and its treatment seemed to pass without marked traces. The cancer made a difference for the third group, but both in positive and negative ways. A different life perspective or improved relationships were weighted against troublesome side effects from treatment. Finally, in the fourth group a bodily decline due to side effects and other health problems was predominant and this obstructed their chances of living a good life.

    Discussion. The narratives showed that being diseased by breast cancer has different impacts depending on how the woman lives her life – it is very much a matter of transition in a life context. The results are furthermore discussed in relation to adaptation and coping theory.

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