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  • 51.
    Salander, Pär
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Scientific rigour is far more than a matter of sample size2015Ingår i: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 23, nr 4, s. 901-902Artikel i tidskrift (Refereegranskat)
  • 52.
    Salander, Pär
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Skilled statistics cannot ove rcome the absence of a meaningful design2017Ingår i: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 26, nr 2, s. 286-286Artikel i tidskrift (Refereegranskat)
  • 53.
    Salander, Pär
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    "Spirituality" hardly facilitates our understanding of existential distress - but "everyday life" might2018Ingår i: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 27, nr 11, s. 2654-2656Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The existential predicament of being human might come to the fore when we are stricken by cancer, perhaps primarily because we are removed from the shelter inherent in our routines of everyday life. These routines might help us to deal with the ultimate concerns of life, ie, isolation, freedom, meaninglessness, and death.1 We recognise these conceptualisations from European existential philosophy. However, instead of discussing the existential challenge in these terms, it has become far more popular in the scientific literature to instead make use of “spirituality” as a frame of reference. Broadly speaking, there has been a roughly 26‐fold increase in the number of papers focused on “spirituality” from the 1980s to the 2000s,2 and nearly all studies on “spiritual care” have emanated from the United States and the United Kingdom.3

    In this paper, I will briefly scrutinise the concept of “spirituality” first by critically reflecting on how the concept is constructed, defined, and made use of; in other words, what are “spirituality” researchers talking about? Second, I will question its validity, and third I will question the legitimacy of the cherished research concluding that “spirituality” alleviates distress and promotes well‐being. Finally, I will briefly, as roughly outlined above, suggest that “everyday life,” a bottom‐up perspective grounded in the patients' way of living their lives, might be a more fruitful conceptualisation that we should pay attention to in order to widen our scope when it comes to understanding how patients deal with distress.

  • 54.
    Salander, Pär
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Statistical efficiency cannot save a study without a meaningful hypothesis2013Ingår i: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 22, nr 9, s. 2156-2156Artikel i tidskrift (Refereegranskat)
  • 55.
    Salander, Pär
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    The Emperor's new clothes: Spirituality: a concept based on questionable ontology and circular findings2012Ingår i: Archive for the Psychology of Religion/ Archiv für Religionspsychologie, ISSN 0084-6724, E-ISSN 1573-6121, Vol. 34, nr 1, s. 17-32Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    ‘Spirituality’ is an old word which throughout history has been given different meanings. Overthe last two decades, it has successively become an increasingly frequent concept in scientificstudies, none the least in psychosocial oncology. Advocates of ‘spirituality’ regard it as a humandimension and state that since all humans have ‘spiritual needs’ it is urgent to develop ‘spiritualcare’. With the focus on recent publications, this article critically scrutinizes aspects of scientificsoundness in this growing research tradition, foremost problems of the lack of conceptual clarityand reliance on interconnected instruments that imply circular findings. It is concluded that theconcept adds more confusion than clarity if it is not put into a meaningful theoretical and culturalcontext, and subsequently it is important to guard against preconceptions and vague meaningsin this research field.

  • 56.
    Salander, Pär
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete. Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    The question remains: what is a 'spiritual' world view in relation to a secular or a religious world view? A reply to comments made about my letter questioning the 'spirituality' concept [1].2007Ingår i: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 16, nr 3, s. 260-1Artikel i tidskrift (Övrigt vetenskapligt)
  • 57.
    Salander, Pär
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete. Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    The question remains: What is a spiritual world view in relation to a secular or a religious view?2007Ingår i: Psycho-Oncology, Vol. 16, s. 260-261Artikel i tidskrift (Refereegranskat)
  • 58.
    Salander, Pär
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete. Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Utsatthet och bemötande2005Ingår i: Rosa boken om bröstcancer: fysiska, psykiska, social och existentiella aspekter, Cancerfonden, Stockholm , 2005, s. 15-24Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 59.
    Salander, Pär
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete. Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    We should avoid vague conceptualisations and circular outcomes:  (Letters to the editor)2010Ingår i: Lung Cancer, ISSN 0169-5002, E-ISSN 1872-8332, Vol. 70, nr 2, s. 226-Artikel i tidskrift (Refereegranskat)
  • 60.
    Salander, Pär
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    We should be more attentive and critically scrutinize the philosophical assumptions included in study designs2013Ingår i: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 92, nr 2, s. 281-282Artikel i tidskrift (Refereegranskat)
  • 61.
    Salander, Pär
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Whether 'spirituality' can be a meaningful concept is still open to question2015Ingår i: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 13, nr 01, s. 101-102Artikel i tidskrift (Refereegranskat)
  • 62.
    Salander, Pär
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete. Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Who needs the concept of spirituality?2006Ingår i: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 15, nr 7, s. 647-9Artikel i tidskrift (Övrigt vetenskapligt)
  • 63.
    Salander, Pär
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Why doesn't mind matter when we are to find out what is helpful?2011Ingår i: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 20, nr 4, s. 441-442Artikel i tidskrift (Refereegranskat)
  • 64.
    Salander, Pär
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Why promote 'spirituality' uncritically?2014Ingår i: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 23, nr 6, s. 819-820Artikel i tidskrift (Refereegranskat)
  • 65.
    Salander, Pär
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Bergknut, Mirjam
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper.
    Henriksson, Roger
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    The creation of hope in patients with lung cancer2014Ingår i: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 23, nr S3, s. 373-374Artikel i tidskrift (Övrigt vetenskapligt)
  • 66.
    Salander, Pär
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Bergknut, Mirjam
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper.
    Henriksson, Roger
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi. Regional Cancer Center, Stockholm/Gotland , Sweden.
    The creation of hope in patients with lung cancer2014Ingår i: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 53, nr 9, s. 1205-1211Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Lung cancer is associated with biomedical and psychological symptoms as well as a generally poor prognosis. When healthcare staff communicate with lung cancer patients it is essential that they consider the patients' own views of the situation to avoid putting unnecessary strain upon the patients' shoulders. The purpose of the present study is to better understand how a group of patients with lung cancer reflects upon their new life situation after diagnosis and primary treatment. METHOD: Fifteen patients with non-small cell lung cancer were consecutively included and, where possible, repeatedly interviewed during the course of the disease process. The 29 interviews were conducted in a thematically structured narrative form that facilitated a dialog between the interviewer and the patient. The interviews covered experiences with health care, living an everyday life, and thoughts about the future. FINDINGS AND REFLECTIONS: By focusing on how the patients more or less preconsciously elaborated mentally with their vulnerable situation, it was possible to detect different mental manoeuvres that they used as a way of creating hope. The patients distanced themselves from their disease, relied on a feeling of a sound body, idealised treatment possibilities, relied on healthy behaviour, focused on a concrete project, found that they were better off than others, and took solace in the fact that there were patients who had successfully managed the disease. DISCUSSION: The patients were not passive victims in the face of their diagnosis, but were actively trying to find ways of looking at their despairing situation in a positive light. A creative process for psychological survival had thus been initiated by the patients. We suggest that acknowledging this process should be the starting point from which physicians can engage in hope work with their patients.

  • 67.
    Salander, Pär
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Hamberg, Katarina
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Gender differences in patient´s written narratives when being diagnosed with cancer2005Ingår i: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 14, nr 8, s. 685-695Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The medical field has shown a growing interest in gender and gender differences. In psychosocial oncology, for example, some studies suggest that men and women cope differently with cancer; e.g. women express their emotions more readily than men do, and men rely more on their healthy spouse.

    Using a qualitative perspective, this study examines 83 narratives written by male and female cancer patients who were asked to write down how they experienced receiving their cancer diagnosis. The narratives were analyzed both as to structure and content.

    The women wrote longer, more personally, and more emotionally than the men, and to a greater extent they included family members and other relatives in their stories. When the men mentioned relatives, they mainly referred to their spouse. Men and women commented differently as to their experiences of ‘reception’; i.e. how their psychological needs were addressed and ‘connection’; i.e. whether they felt in sufficient contact with medical staff. Although the women described good reception, they complained a lot about bad connection. Among the men, it was just as common to report about positive as negative experiences in both categories.

    There are reasons to be cautious when evaluating these findings. The found differences may be due to different ways of reacting to similar situations or different willingness and ways of commenting on similar situations, but also to different reception and connection for men and women. Further research should focus on the basic question: Are men and women without medical reasons being treated differently during their oncological treatment?

  • 68.
    Salander, Pär
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Hamberg, Katarina
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Why "spirituality" instead of "the humanistic side of medicine"?2014Ingår i: Academic Medicine, ISSN 1040-2446, E-ISSN 1938-808X, Vol. 89, nr 11, s. 1430-1430Artikel i tidskrift (Övrigt vetenskapligt)
  • 69.
    Salander, Pär
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Hamberg, Katarina
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Why 'spirituality' instead of 'the humanistic side of medicine'?2014Ingår i: Academic Medicine, ISSN 1040-2446, E-ISSN 1938-808X, Vol. 89, nr 11, s. 1430-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    To the Editor: In a recent commentary, Puchalski et al1 describe the developing field of "spirituality” and its expansion into health professions education. However, we question whether this promotion really reflects an improvement.

    1 Puchalski CM, Blatt B, Kogan M, Butler A. Spirituality and health: The development of a field. Acad Med. 2014;89:10–16.

  • 70.
    Salander, Pär
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Hamberg, Katarina
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Why 'spirituality' instead of 'the humanistic side of medicine'?2014Ingår i: Academic Medicine, ISSN 1040-2446, E-ISSN 1938-808X, Vol. 89, nr 11, s. 1430-Artikel i tidskrift (Refereegranskat)
  • 71.
    Salander, Pär
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Henriksson, Roger
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper.
    Severely diseased lung cancer patients narrate the importance of being included in a helping relationship2005Ingår i: Lung Cancer, ISSN 0169-5002, E-ISSN 1872-8332, Vol. 50, nr 2, s. 155-162Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Because patients with advanced lung cancer have a poor prognosis, healthcare staff should treat and support them with sensitivity without placing them under necessary strain. A common way of revealing patients’ psychological needs is to rely on questionnaires where predefined potential problem areas are examined. Another and less common way of detecting their needs is to focus on the patients’ concrete everyday-experiences in their contacts with health care. In this study, 23 consecutive patients with advanced non-small cell lung cancer were asked to describe their experiences in dealing with their healthcare providers. Data were analysed qualitatively by categorising the incidents according to content. It emerged that ‘being connected to health care’ and being ‘acknowledged as a person’ were by far the most prominent dimensions. Very few incidents were directly related to ‘information’. The results suggest that in oncology it is important to call attention to the fact that the patient-physician relationship cannot be reduced to the communication of information. Other dimensions are worth considering.

     

  • 72.
    Salander, Pär
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Isaksson, Joakim
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Granström, Brith
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Öron- näs- och halssjukdomar.
    Laurell, Göran
    Institutionen för kirurgiska vetenskaper, Öron- näs- och halssjukdomar.
    How patients make use of a specialist nurse function in head and neck cancer: an empirical study2014Ingår i: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 23, nr Special issue S3, s. 159-Artikel i tidskrift (Övrigt vetenskapligt)
  • 73.
    Salander, Pär
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Isaksson, Joakim
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Granström, Brith
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Öron- näs- och halssjukdomar.
    Laurell, Göran
    Uppsala Universitet, Department of Surgical Sciences - Otolaryngology and Head & Neck Surgery.
    Motives that head and neck cancer patients have for contacting a specialist nurse: an empirical study2016Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, nr 21-22, s. 3160-3166Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims and objectives: The purpose of this study is to systematically explore the motives for patients with head and neck cancer to contact a speciaist nurse during two years postdiagnosis.

    Background: Research focusing on the role of specialist nurses in cancer care almost exclusively concern cancers other than head and neck cancer

    Design: Qualitative, descriptive study based on the contacts between patients with head and neck cancer and a specialist nurse.

    Methods: Patients were invited to contact a specialist nurse by telephone. The specialist nurse took systematic field notes, that is, she registered who contacted her, the nature of the call and the outcome. Sixty patients were included.

    Results: In descending order, the motives for contact were questions about practical and uncomplicated matters, consultations about medical troubles/worries, presenting a report of the patient's situation, requests for additional information about the treatment plan and requests for medical information. The pattern of the patients' motivations for calling was not related to medical or social factors, suggesting that the initiative to make a contact is very much a question of the complexity of individual life circumstances. Very few referrals were sent from the specialist nurse to other professionals.

    Conclusions: The specialist nurse turned out to be more than just a coordinator of health-care resources. The findings bring up questions about the potential of the nurse's function as a coordinator, but also as a potential attachment figure, and questions about the nurse's relationships to other professionals.

    Relevance to clinical practice: When implementing a specialist nurse function, it is important to decide whether the function should be inspired by a broader relational perspectice. In addition to the indispensible competence and experience in the clinical field of head and neck cancer, training in counselling and acquaintance with object-relational psychology will then be desirable.

  • 74.
    Salander, Pär
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Isaksson, Joakim
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Lilliehorn, Sara
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete. Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    A nationwide study of the function of the social worker in cancer care and rehabilitation: the present status and prospects for the future2016Ingår i: Psycho-Oncology: Abstracts of the 2016 World Congress of Psycho-Oncology, 17-21 October 2016, Dublin, Ireland, John Wiley & Sons, 2016, Vol. 25, s. 94-Konferensbidrag (Refereegranskat)
  • 75.
    Salander, Pär
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Isaksson, Joakim
    Institutionen för socialt arbete, Stockholms universitet.
    Lilliehorn, Sara
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Kuratorsfunktionen i svensk cancersjukvård: en nationell genomlysning2018Ingår i: Omsorg: Nordisk tidsskrift for Palliativ Medisin, ISSN 0800-7489, nr 3, s. 62-65Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [sv]

    Socialarbetaren (kuratorn) är den profession som i svensk cancersjukvård specifikt står för det psykosociala perspektivet. Föreliggande studie analyserar kuratorns verksamhet med utgångspunkt i patienters motiv till att söka upp kurator. Utfallet ger vid handen att motiven inte i första hand är socioekonomiska eller juridiska, utan i stället psykologiska, och förtrogenhet med det councelling-orienterade samtalet är därför efterfrågat och centralt. Detta bör beaktas när man planerar för legitimation av kuratorer i hälso- och sjukvård.

  • 76.
    Salander, Pär
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Lilliehorn, Sara
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete. Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    To carry on as before: a meta-synthesis of qualitative studies in lung cancer2016Ingår i: Lung Cancer, ISSN 0169-5002, E-ISSN 1872-8332, Vol. 99, s. 88-93Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    As a complement to quantitative studies, qualitative studies give us a better understanding of how persons affected by lung cancer live their everyday lives and how they deal with the obvious strain of having lung cancer. Because qualitative studies are based on only a few participants in specific contexts, the purpose of the present study is to synthesize knowledge from these qualitative studies to get a more general picture of the everyday lives of patients with lung cancer. A search on PubMed, CINAHL, Medline and PsychInfo yielded 383 hits. After exclusion we found 16 studies that focused on how these patients lived, reflected, and dealt with their new life situation. These studies comprised 393 interviews with 283 patients with primary lung cancer, and the findings from these studies were synthesized into a core process with subcategories. The overarching process was that the patients were eager "to carry on as before". They wanted to resume their former everyday life, and their views on their relationships with their bodies and side effects of treatments, their families, the health care staff, and with dying and death were very much related to how these could assist the core process. The synthesis presented here suggests that health care in consultations with patients with lung cancer should defer to the importance of the patient's core idea that life carries on despite the fact that it will probably soon come to an end.

  • 77.
    Salander, Pär
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Lilliehorn, Sara
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete. Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    To carry on as before: A meta-synthesis of qualitative studies in lung cancer2017Ingår i: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 26, s. 81-82, artikel-id P-002Artikel i tidskrift (Övrigt vetenskapligt)
  • 78.
    Salander, Pär
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete. Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Lilliehorn, Sara
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete. Umeå universitet, Samhällsvetenskapliga fakulteten, Umeå centrum för genusstudier (UCGS).
    Hamberg, Katarina
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Kero, Anneli
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    The impact of breast cancer on living an everyday life 4.5-5 years post-diagnosis: a qualitative prospective study of 39 women2011Ingår i: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 50, nr 3, s. 399-407Artikel i tidskrift (Refereegranskat)
    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.

  • 79.
    Salander, Pär
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Sandström, Maria
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    A Balint-inspired reflective forum in oncology for medical residents: Main themes during seven years2014Ingår i: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 97, nr 1, s. 47-51Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Reflection groups for clinicians, often called Balint groups, are a way of refining professional competence in health care. This study presents a model for reflective practice in a group setting and describes the kinds of troublesome cases that medical residents are concerned about.

    Methods: From 2005 to 2012 a Balint-inspired reflective forum has been a part of the academic seminar program for physicians in training in a Department of Oncology at a Swedish university. The present study is focused on all 63 cases presented in the forum.

    Results: The cases were categorized into three kinds of challenges: Communication challenges in the patient-physician relationship, Communication challenges in organizational matters, and Communication challenges with close relatives of the patient.

    Conclusion: The study tells us something about the vulnerability of being a medical resident and the identified challenges have bearings on medical education curricula as well as on how the training of junior physicians is organized. Practice implications: The cases are contextual and multifaceted, and a forum of this kind might therefore be regarded as a potential way to develop professional competence and to refine communication in clinical practice. A structured evaluation of the forum would be valuable.

  • 80.
    Spetz, Agneta
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Henriksson, Roger
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Bergenheim, A Tommy
    Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap, Neurokirurgi.
    Salander, Pär
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete. Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    A specialist nurse-function in neurooncology: a qualitative study of possibilities, limitations, and pitfalls2005Ingår i: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 3, nr 2, s. 121-130Artikel i tidskrift (Refereegranskat)
  • 81.
    Spetz, Agneta
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Henriksson, Roger
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Salander, Pär
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete. Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    A specialist nurse as a resource for family members to patients with brain tumors: an action research study2008Ingår i: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 31, nr 4, s. E18-26Artikel i tidskrift (Refereegranskat)
    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.

  • 82.
    Vargo, Mary
    et al.
    Department of Physicial Medicine and Rehabilitation, Case Western Reserve University, Metroheaalth Medical Center, Cleveland, OH, USA.
    Henriksson, Roger
    Regional Cancer Centre, Stockholm, Gotland, Stockholm, sweden.
    Salander, Pär
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Rehabilitation of patients with glioma2016Ingår i: The handbook of clinical neurology: vol. 134, Gliomas / [ed] Mitchel S. Berger and Michael Weller, Elsevier, 2016, s. 287-304Kapitel i bok, del av antologi (Övrigt vetenskapligt)
    Abstract [en]

    Disabling sequelae occur in a majority of patients diagnosed with brain tumor, including glioma, such as cognitive deficits, weakness, and visual perceptual changes. Often, multiple impairments are present concurrently.

    Healthcare staff must be aware of the "biographic disruption" the patient with glioma has experienced. While prognostic considerations factor into rehabilitation goals and expectations, regardless of prognosis the treatment team must offer cohesive support, facilitating hope, function, and quality of life. Awareness of family and caregiver concerns plays an important role in the overall care.

    Inpatient rehabilitation, especially after surgical resection, has been shown to result in functional improvement and homegoing rates on a par with individuals with other neurologic conditions, such as stroke or traumatic brain injury.

    Community integration comprises a significant element of life satisfaction, as has been shown in childhood glioma survivors. Employment is often affected by the glioma diagnosis, but may be ameliorated, when appropriate, by addressing modifiable factors such as depression, fatigue, or sleep disturbance, or by workplace accommodations.

    Further research is needed into many facets of rehabilitation in the setting of glioma, including establishing better care models for consistently identifying and addressing functional limitations in this population, measuring outcomes of various levels of rehabilitation care, identifying optimal physical activity strategies, delineating the long-term effects of rehabilitation interventions, and exploring impact of rehabilitation interventions on caregiver burden. The effective elements of cognitive rehabilitation, including transition of cognitive strategies to everyday living, need to be better defined.

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