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Sharp, Lena, PhD
Publications (8 of 8) Show all publications
Sharp, L., Fransson, P., Fowler, M. & Ullgren, H. (2024). Aspects of occupational safety: a survey among European cancer nurses. European Journal of Oncology Nursing, 70, Article ID 102595.
Open this publication in new window or tab >>Aspects of occupational safety: a survey among European cancer nurses
2024 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 70, article id 102595Article in journal (Refereed) Published
Abstract [en]

Purpose: Nurses are particularly at risk for occupational exposure to hazardous cancer drugs, risking both acute and chronic health effects. Knowledge on the implemented safety precautions into minimizing these risks is limited.

Methods: The European Cancer Nursing Index (ECNI) was developed by the European Oncology Nursing Society (EONS) to illustrate the development and status of this profession. In this study, anonymous online survey data on occupational safety reported by European cancer nurses as part of the ECNI 2022, was analysed.

Results: A total of 630 cancer nurses from 29 countries responded to the survey. A majority reported that written guidelines (n = 553, 88%) on safe handling and administration of hazardous drugs, personal protection equipment (PPE) and cytotoxic spillage kits (n = 514, 82%) were available at their workplaces. 130 (21%) nurses reported that wipe testing to assess any residual hazardous drugs on workplace surfaces were conducted systematically at their workplaces. 185 (29%) nurses reported that nurses sometimes or always continued with their regular tasks (including handling hazardous cancer drugs) during pregnancy and breast feeding. 185 (29%) also responded that nurses at their workplaces did not receive an introductory education program before handling hazardous drugs. In total, 346 (55%) of the nurses reported that their workplace had a freedom to speak-up guardian or whistle blower policy for members of staff.

Conclusions: Even if most nurses report that there are safety routines in place at their workplaces, the results reveal several serious occupational risks for European nurses handling hazardous cancer drugs. Actions are needed to improve and optimize occupational safety for nursing staff.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Cancer, Hazardous drugs, Nursing, Occupational safety, Safety culture, Working conditions
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-223955 (URN)10.1016/j.ejon.2024.102595 (DOI)2-s2.0-85191164347 (Scopus ID)
Available from: 2024-05-03 Created: 2024-05-03 Last updated: 2024-05-03Bibliographically approved
Karlsson Rosenblad, A., Westman, B., Bergkvist, K., Segersvärd, R., Roos, N., Bergenmar, M. & Sharp, L. (2024). Differences in health-related quality of life between native and foreign-born gynaecological cancer patients in Sweden: a five-year cross-sectional study. Quality of Life Research, 33, 667-678
Open this publication in new window or tab >>Differences in health-related quality of life between native and foreign-born gynaecological cancer patients in Sweden: a five-year cross-sectional study
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2024 (English)In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 33, p. 667-678Article in journal (Refereed) Published
Abstract [en]

Purpose: To examine differences in health-related quality of life (HRQoL) between native and foreign-born gynaecological cancer patients in Sweden, taking into account clinical, demographic, and socioeconomic factors.

Methods: The 30-item European Organisation for Research and Treatment of Cancer quality of life questionnaire (QLQ-C30) and a study-specific questionnaire covering demographic and socioeconomic factors were answered by 684 women aged ≥ 18 years old, diagnosed in 2014, 2016, or 2018 with gynaecological cancer in the Stockholm-Gotland health care region, Sweden. Clinical data were obtained from the Swedish Cancer Register. Data were analysed using the Kruskal–Wallis test and linear regression.

Results: The women had a mean age of 65.4 years, with 555 (81.1%) born in Sweden, 54 (7.9%) in other Nordic countries (ONC), 43 (6.3%) in other European countries (OEC), and 32 (4.7%) in non-European countries (NEC). HRQoL differed significantly between the four groups for 14 of the 15 QLQ-C30 scales/items. On average, Swedish-born women scored 2.0, 15.2, and 16.7 points higher for QoL/functioning scales/items and 2.2, 14.1, and 18.7 points lower for symptom scales/items, compared with ONC-, OEC-, and NEC-born women, respectively. In adjusted analyses, none of the differences between Swedish-born and ONC-born women were significant, while for OEC- and NEC-born women the differences were significant for most QLQ-C30 scales/items.

Conclusion: HRQoL differs between native and foreign-born gynaecological cancer patients in Sweden, with lower HRQoL the further from Sweden the women are born. A more individualised cancer care, with tailored support to optimize HRQoL is needed for this vulnerable group of patients.

Place, publisher, year, edition, pages
Springer Nature, 2024
Keywords
Demography, Foreign-born, Gynaecological cancer, Health-related quality of life, Socioeconomic factors, Women
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-216902 (URN)10.1007/s11136-023-03548-1 (DOI)001096968700002 ()37930556 (PubMedID)2-s2.0-85176232473 (Scopus ID)
Available from: 2023-12-04 Created: 2023-12-04 Last updated: 2024-04-26Bibliographically approved
Sharp, L., Dodlek, N., Willis, D., Leppänen, A. & Ullgren, H. (2023). Cancer prevention literacy among different population subgroups: challenges and enabling factors for adopting and complying with cancer prevention recommendations. International Journal of Environmental Research and Public Health, 20(10), Article ID 5888.
Open this publication in new window or tab >>Cancer prevention literacy among different population subgroups: challenges and enabling factors for adopting and complying with cancer prevention recommendations
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2023 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 20, no 10, article id 5888Article in journal (Refereed) Published
Abstract [en]

It is estimated that 40% of the cancer cases in Europe could be prevented if people had better information and tools to make healthier choices and thereby reduce some of the most important cancer risk factors. The aim of this study is to gain knowledge and understanding about cancer prevention literacy among people with intellectual disabilities, immigrants, young people and young cancer survivors. In this qualitative study, we conducted six online focus-group interviews, including forty participants, to explore the cancer prevention literacy of four population subgroups and determine how cancer prevention recommendations according to the European Code Against Cancer (ECAC) were perceived. The analysis resulted in the following main categories: current health beliefs and their impacts on how the ECAC recommendations were perceived, communication strategies and sources benefiting or hindering cancer prevention information from reaching out, and how vulnerabilities in these subgroups impact cancer prevention literacy. To improve cancer prevention literacy in Europe, more attention is needed this topic to overcome barriers among different population subgroups. Recommendations include improved and adapted cancer prevention information, support to individuals, as well as societal support, such as easy-access screening and vaccination programmes and regulations related to tobacco, alcohol, and diet.

Place, publisher, year, edition, pages
MDPI, 2023
Keywords
cancer prevention, cancer prevention literacy, communication, health inequalities, health literacy, public health
National Category
Public Health, Global Health, Social Medicine and Epidemiology Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-209196 (URN)10.3390/ijerph20105888 (DOI)37239613 (PubMedID)2-s2.0-85160333293 (Scopus ID)
Available from: 2023-06-09 Created: 2023-06-09 Last updated: 2023-06-09Bibliographically approved
Wode, K., Sharp, L., Fransson, P. & Hök Nordberg, J. (2023). Communication about complementary and alternative medicine when patients decline  conventional cancer treatment: patients' and physicians' experiences. The Oncologist, 28(9), e774-e783
Open this publication in new window or tab >>Communication about complementary and alternative medicine when patients decline  conventional cancer treatment: patients' and physicians' experiences
2023 (English)In: The Oncologist, ISSN 1083-7159, E-ISSN 1549-490X, Vol. 28, no 9, p. e774-e783Article in journal (Refereed) Published
Abstract [en]

Background: Complementary and alternative medicine (CAM) is a broad set of nonconventional practices used alongside or instead of conventional treatment: The latter poses obvious risks related to cancer prognosis. Patient-physician dialogue about CAM is crucial for patient safety and mutual trust. Little is known about communication in the rare situations when patients decline recommended cancer treatment and consider using CAM. The objective of this study was to explore patients' and physicians' experiences from situations when patients decline recommended cancer treatment and consider using CAM.

Materials and methods: Semi-structured interviews were carried out with 7 CAM-using cancer patients who had declined some or all conventional treatment as well as 10 physicians from oncology and palliative care. Framework analysis was used.

Results: Regarding treatment choices, there was a dissonance between physicians' focus on medical reasoning and patients' expression of complex values. Physicians' difficulty in understanding patients' treatment decline was exacerbated when patients considered using CAM, impairing communication even further. Inequalities in roles resulting in power struggles risked pushing both parties toward extreme and inflexible standpoints. Despite these challenges regarding treatment choices and hierarchical roles, both parties considered open and respectful communication as crucial.

Conclusions: This study highlights the difficulty of shared decision-making in practice when patients' and physicians' views on treatment decisions deviate in clinically challenging situations. Our results point to a need to address the complexity of these situations, pay attention to patients' values, and improve knowledge among physicians about CAM.

Place, publisher, year, edition, pages
Oxford University Press, 2023
Keywords
neoplasms, complementary therapies, treatment refusal, communication, physician-patient relations, qualitative research
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-194750 (URN)10.1093/oncolo/oyad084 (DOI)000974142300001 ()37071805 (PubMedID)2-s2.0-85170294322 (Scopus ID)
Note

Originally included in thesis in manuscript form. 

Available from: 2022-05-16 Created: 2022-05-16 Last updated: 2023-09-26Bibliographically approved
Scott Duncan, T., Riggare, S., Bylund, A., Hägglund, M., Stenfors, T., Sharp, L. & Koch, S. (2023). Empowered patients and informal care-givers as partners?: A survey study of healthcare professionals' perceptions. BMC Health Services Research, 23(1), Article ID 404.
Open this publication in new window or tab >>Empowered patients and informal care-givers as partners?: A survey study of healthcare professionals' perceptions
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2023 (English)In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 23, no 1, article id 404Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: More knowledge is needed regarding the perceptions of healthcare professionals when encountering empowered patients and informal caregivers in clinical settings. This study aimed to investigate healthcare professionals' attitudes towards and experiences of working with empowered patients and informal caregivers, and perception of workplace support in these situations. METHODS: A multi-centre web survey was conducted using a non-probability sampling of both primary and specialized healthcare professionals across Sweden. A total of 279 healthcare professionals completed the survey. Data was analysed using descriptive statistics and Thematic analysis. RESULTS: Most respondents perceived empowered patients and informal caregivers as positive and had to some extent experience of learning new knowledge and skills from them. However, few respondents stated that these experiences were regularly followed-up at their workplace. Potentially negative consequences such as increased inequality and additional workload were, however, mentioned. Patients' engagement in the development of clinical workplaces was seen as positive by the respondents, but few had own experience of such engagement and considered it difficult to be achieved. CONCLUSION: Overall positive attitudes of healthcare professionals are a fundamental prerequisite to the transition of the healthcare system recognizing empowered patients and informal caregivers as partners.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Healthcare professionals’ perceptions, Patient empowerment, Patient-centered care, Primary Health Care, Secondary care, Specialized Healthcare, Sweden
National Category
Nursing Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:umu:diva-208217 (URN)10.1186/s12913-023-09386-8 (DOI)000983705600005 ()37101266 (PubMedID)2-s2.0-85153908522 (Scopus ID)
Funder
Karolinska Institute
Available from: 2023-05-12 Created: 2023-05-12 Last updated: 2023-09-05Bibliographically approved
Oliva, D., Andersson, B.-Å., Shamoun, L., Lewin, N., Nilsson, M. P., Schildt, E.-B., . . . Lewin, F. (2023). Single nucleotide polymorphism directed antiemetic treatment in women with breast cancer treated with neo- or adjuvant chemotherapy: a randomised multicentre phase II study. (EudraCT: 2015–000658-39). Anticancer Research, 43(6), 2671-2681
Open this publication in new window or tab >>Single nucleotide polymorphism directed antiemetic treatment in women with breast cancer treated with neo- or adjuvant chemotherapy: a randomised multicentre phase II study. (EudraCT: 2015–000658-39)
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2023 (English)In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 43, no 6, p. 2671-2681Article in journal (Refereed) Published
Abstract [en]

Background/aim: The role of single nucleotide polymorphisms (SNPs) in the frequency and intensity of chemotherapy-induced nausea and vomiting (CINV) in women with breast cancer (BC) is unclear. The primary purpose of this study was to compare/evaluate the effect of SNP-guided antiemetic treatment versus standard CINV treatment.

Patients and methods: A randomised, factorial, phase II multicentre study design was used. Women planned for neoadjuvant or adjuvant chemotherapy with epirubicin, cyclophosphamide and fluorouracil (FEC /EC, with or without fluorouracil) for BC were randomised to SNP-guided antiemetic treatment (based on the results of SNP analyses) versus standard CINV treatment. Blood samples were taken before the treatment was initiated. Patient-reported data on CINV (during 10 days from onset of cancer treatment) and health-related quality of life (HRQoL), were collected before and after the first cancer treatment.

Results: A total of 188 women were included. Overall, nausea was reported by 86% (n=129) of the patients during the ten-day period from the start of cancer treatment. The SNP genotype studied varied. In FAS-CD95, the genotypes AG and GG were overrepresented; in RB1-LPAR6, GG was overrepresented, and in CCL2, both AA and GG were overrepresented. We found no statistically significant difference in CINV between SNP-guided antiemetic treatment versus standard CINV treatment.

Conclusion: SNP-guided antiemetic treatment could be as effective as standard treatment. SNP-guided antiemetic treatment of CINV is possibly useful in detecting patients with a higher or lower risk for CINV and thus may help in avoiding over-treatment with toxic components. CINV negatively affects the HRQL.Keywords: Breast cancer; chemotherapy-induced nausea and vomiting; single nucleotide polymorphism.

Place, publisher, year, edition, pages
International Institute of Anticancer Research, 2023
Keywords
Breast cancer, chemotherapy-induced nausea and vomiting, single nucleotide polymorphism
National Category
Cancer and Oncology Nursing
Identifiers
urn:nbn:se:umu:diva-209177 (URN)10.21873/anticanres.16433 (DOI)001006164400006 ()37247895 (PubMedID)2-s2.0-85160499222 (Scopus ID)
Funder
Medical Research Council of Southeast Sweden (FORSS)Region Jönköping County
Available from: 2023-06-26 Created: 2023-06-26 Last updated: 2023-09-05Bibliographically approved
Drury, A., Sulosaari, V., Sharp, L., Ullgren, H., de Munter, J. & Oldenmenger, W. (2023). The future of cancer nursing in Europe: Addressing professional issues in education, research, policy and practice. European Journal of Oncology Nursing, 63, Article ID 102271.
Open this publication in new window or tab >>The future of cancer nursing in Europe: Addressing professional issues in education, research, policy and practice
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2023 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 63, article id 102271Article, review/survey (Refereed) Published
Abstract [en]

Cancer nursing has evolved to meet the demands of rising cancer incidence, newer and more complex treatment options, and the emergence of specialist roles supporting patients from pre-diagnosis, through treatment, survivorship and end of life care. Nurses are involved in direct and in-direct care of people at risk of, and living with and after cancer in diverse contexts. As a result, nurses are positioned to have a significant influence on the processes and outcomes of cancer care, through education, research, policy, practice and leadership. However, nursing and cancer care face challenges, arising from workforce shortages, under-investment in services and under-representation in decision-making. This paper discusses the evolution of cancer nursing across education, policy, research, profession and practice, and sets an agenda for innovation and disruption across these domains to ensure sustainability of cancer care services and care for people living with and after cancer. We argue for the continued advancement of cancer nursing with critical focus on identifying and addressing inequities in role recognition and access to specialist cancer nursing education throughout Europe. Partnership, exchange of learning, and co-design will be central to progressing education, evidence and policy to support future growth in the cancer nursing workforce and embed cancer nurses in research and policy setting at local, national and international levels.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Cancer, Disruption, Education, Innovation, Leadership, Nursing, Policy, Practice, Research, Workforce
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-205487 (URN)10.1016/j.ejon.2023.102271 (DOI)000991859900001 ()2-s2.0-85148760712 (Scopus ID)
Available from: 2023-03-15 Created: 2023-03-15 Last updated: 2023-09-05Bibliographically approved
Ullgren, H., Sharp, L., Fransson, P. & Bergkvist, K. (2022). Exploring health care professionals’ perceptions regarding shared clinical decision-making in both acute and palliative cancer care. International Journal of Environmental Research and Public Health, 19(23), Article ID 16134.
Open this publication in new window or tab >>Exploring health care professionals’ perceptions regarding shared clinical decision-making in both acute and palliative cancer care
2022 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 23, article id 16134Article in journal (Refereed) Published
Abstract [en]

Developments in cancer care have resulted in improved survival and quality of life. Integration of acute and palliative cancer care is desirable, but not always achieved. Fragmented care is associated with sub-optimal communication and collaboration, resulting in unnecessary care transitions. The aim of this study was to explore how health care professionals, from both acute and palliative care, perceive clinical decision-making when caring for patients undergoing active cancer treatment in parallel with specialized palliative care at home. Methods: Qualitative explorative design, using online focus-group interviews, based on patient-cases, among health care professionals (physicians and nurses) and Framework Analysis. Results: Six online focus-group interviews were performed. Few signs of systematic integration were found, risking fragmented care, and putting the patients in a vulnerable situation. Different aspects of uncertainty related to mandates and goals-of-care impacted clinical decision-making. Organizational factors appeared to hinder mutual clinical decision-making as well as the uncertainty related to responsibilities. These uncertainties seemed to be a barrier to timely end-of-life conversations and clinical decisions on optimal care, for example, the appropriateness of transfer to acute care. Conclusions: Lack of integration between acute and palliative care have negative consequences for patients (fragmented care), health care professionals (ethical stress), and the health care system (inadequate use of resources).

Place, publisher, year, edition, pages
MDPI, 2022
Keywords
cancer care, clinical decision-making, clinical research home care, focus groups, palliative care
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-203331 (URN)10.3390/ijerph192316134 (DOI)000896061800001 ()36498204 (PubMedID)2-s2.0-85143725411 (Scopus ID)
Funder
Cancerforskningsfonden i Norrland, AMP 18-928
Available from: 2023-01-18 Created: 2023-01-18 Last updated: 2023-01-18Bibliographically approved
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