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Publications (10 of 190) Show all publications
Tjust, A. E., Hellman, U., Giannopoulos, A., Winsnes, A., Strigård, K. & Gunnarsson, U. (2024). Evaluation of extracellular matrix remodeling in full-thickness skin grafts in mice. Journal of Histochemistry and Cytochemistry, 72(2), 79-94
Open this publication in new window or tab >>Evaluation of extracellular matrix remodeling in full-thickness skin grafts in mice
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2024 (English)In: Journal of Histochemistry and Cytochemistry, ISSN 0022-1554, E-ISSN 1551-5044, Vol. 72, no 2, p. 79-94Article in journal (Refereed) Published
Abstract [en]

Abdominal hernia is a protruding weakness in the abdominal wall. It affects abdominal strength and life quality and can lead to complications due to intestinal entrapment. Autologous full-thickness skin graft (FTSG) has recently become an alternative material for reinforcement in the surgical repair of large abdominal hernias instead of synthetic mesh. FTSG eventually integrates with the abdominal wall, but the long-term fate of the graft itself is not fully understood. This has implications as to how these grafts should be optimally used and handled intraoperatively. This study investigates the remodeling of FTSG in either the onlay or the intraperitoneal position 8 weeks after FTSG transplantation in an experimental mouse model. There was a significant presence of fibroblasts, indicated by vimentin and S100A4 staining, but there were significant variations among animals as to how much of the graft had been remodeled into dense connective tissue. This correlated significantly with the proportion of vimentin-positive cells in the dense connective tissue. We also found that collagen hybridizing peptide staining intensity, a marker of active remodeling, was significantly associated with the proportion of S100A4-positive cells in the dense connective tissue of the FTSG.

Place, publisher, year, edition, pages
Sage Publications, 2024
Keywords
collagen, extracellular matrix, fibroblasts, hernia, hyaluronan, mouse model, S100A4, vimentin
National Category
Surgery
Identifiers
urn:nbn:se:umu:diva-221051 (URN)10.1369/00221554231225995 (DOI)001147995400001 ()38264898 (PubMedID)2-s2.0-85184511984 (Scopus ID)
Funder
Swedish Research Council, 2021-00972Region Västerbotten, RV-927121Region Västerbotten, RV-965797
Available from: 2024-02-21 Created: 2024-02-21 Last updated: 2024-02-21Bibliographically approved
Odensten, C., Gunnarsson, U., Johansson, J. & Näsvall, P. (2024). Impact of parastomal hernia on colostomy costs at 1 year: secondary analysis of a randomized clinical trial (STOMAMESH). Scandinavian Journal of Surgery, 113(1), 33-39
Open this publication in new window or tab >>Impact of parastomal hernia on colostomy costs at 1 year: secondary analysis of a randomized clinical trial (STOMAMESH)
2024 (English)In: Scandinavian Journal of Surgery, ISSN 1457-4969, E-ISSN 1799-7267, Vol. 113, no 1, p. 33-39Article in journal (Refereed) Published
Abstract [en]

Background and aims: Parastomal hernia (PSH) is a common complication after the creation of a colostomy, with a prevalence of approximately 50%. Despite the high frequency, little is known how PSH affects the cost of colostomy care. The hypothesis in this study was that PSH increases the cost of colostomy care compared with not having a PSH.

Methods: Two groups with (N = 61) and without (n = 147) PSH were compared regarding costs of stoma appliances and visits. The population from a large randomized trial comparing construction of colostomy with or without prophylactic mesh (STOMAMESH) was used and cross-matched with health economic data from the National Pharmaceutical Register, 1 year after initial surgery.

Results: Patients with and without a PSH were similar in basic demographic data. No difference in cost of stoma appliances (with PSH 2668.3 EUR versus no PSH 2724.5 EUR, p = 0.938) or number of visits to a stoma therapist (p = 0.987) was seen, regardless of the presence or not of a PSH.

Conclusions: PSH appears not to affect costs due to colostomy appliances or the need to visit a stoma therapist, in the first year. The lesson to be learnt is that PSHs are not a driver for costs. Other factors may be determinants of the cost of a colostomy, including manufacturers' price and persuasion, means of procurement, and presence of guidelines.

Place, publisher, year, edition, pages
Sage Publications, 2024
Keywords
Colostomy, health economy, parastomal hernia
National Category
Surgery
Identifiers
urn:nbn:se:umu:diva-213413 (URN)10.1177/14574969231188021 (DOI)001046532600001 ()37563916 (PubMedID)2-s2.0-85167775479 (Scopus ID)
Funder
Swedish Research Council, 214-7196Norrbotten County CouncilRegion Västerbotten, RV-927121
Available from: 2023-08-25 Created: 2023-08-25 Last updated: 2024-05-02Bibliographically approved
Silfvenius, A. U. .., Lindmark, M., Tall, J. V., Österberg, J. K., Strigård, K. K., Thorell, A. & Gunnarsson, U. (2024). Laparoscopic ventral hernia repair: early follow-up of a randomized controlled study of primary fascial closure before mesh placement. British Journal of Surgery, 111(1), Article ID znad434.
Open this publication in new window or tab >>Laparoscopic ventral hernia repair: early follow-up of a randomized controlled study of primary fascial closure before mesh placement
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2024 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 111, no 1, article id znad434Article in journal (Refereed) Published
Abstract [en]

Background: Suturing of the hernia aperture in laparoscopic ventral hernia repair has increased during the past decade. The primary aim of this is to restore the anatomy of the abdominal wall. Closure of the aperture, however, may cause additional tension in the abdominal wall which could increase postoperative pain. The aim of this study was to investigate whether suturing of the hernia aperture affects postoperative pain and hernia-site complications, including seroma, infection, pseudohernia, and mesh migration, 3 months after repair.

Methods: Some 192 patients with a midline hernia between 2 and 8 cm in transverse diameter were included in a randomized controlled double-blinded multicentre study. Patients were randomized to mesh repair with (intervention) or without (control) suturing of the hernia aperture before mesh placement. Patients completed the Ventral Hernia Pain Questionnaire before and 3 months after surgery. Abdominal wall pain and hernia-site complications were assessed 3 months after surgery.

Results: Ninety-seven patients were randomized to the intervention group and 95 to the control group. Among all patients, median age and BMI was 56 years and 31 kg/m2 respectively. Overall pain experienced decreased by 3 months after operation (P < 0.001). There was no difference between groups regarding hernia-site complications or pain experienced during the past week (13 versus 23 patients; P = 0.111). Seroma and pseudohernia occurred in 13 and 11 patients in the intervention and control groups respectively (P = 0.975 and P = 0.977).

Conclusion: Restoration of the abdominal wall anatomy by suturing the hernia aperture before mesh placement does not increase the risk of hernia-site complication or pain 3 months after surgery. This implies that fascial suturing of the aperture can be justified if there are potential long-term benefits such as lower recurrence and/or complication rates.

Registration number: ISRCTN51495042 (http://www.controlled-trials.com).

Place, publisher, year, edition, pages
Oxford University Press, 2024
National Category
Surgery
Identifiers
urn:nbn:se:umu:diva-219817 (URN)10.1093/bjs/znad434 (DOI)001134437500001 ()38159027 (PubMedID)2-s2.0-85181781906 (Scopus ID)
Funder
Umeå UniversityRegion Västerbotten, RV-979794Region Västerbotten, RV-978927Region Västerbotten, RV-965797Visare Norr, 929704Familjen Erling-Perssons Stiftelse, 20190200
Available from: 2024-01-22 Created: 2024-01-22 Last updated: 2024-01-22Bibliographically approved
Gkekas, I., Novotny, J., Kaprio, T., Beilmann-Lehtonen, I., Fabian, P., Tavelin, B., . . . Gunnarsson, U. (2024). Sporadic deficient mismatch repair in colorectal cancer increases the risk for non-colorectal malignancy: a European multicenter cohort study. Journal of Surgical Oncology
Open this publication in new window or tab >>Sporadic deficient mismatch repair in colorectal cancer increases the risk for non-colorectal malignancy: a European multicenter cohort study
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2024 (English)In: Journal of Surgical Oncology, ISSN 0022-4790, E-ISSN 1096-9098Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background and Objectives: Disparities between tumors arising via different sporadic carcinogenetic pathways have not been studied systematically. This retrospective multicenter cohort study evaluated the differences in the risk for non-colorectal malignancy between sporadic colorectal cancer (CRC) patients from different DNA mismatch repair status.

Methods: A retrospective European multicenter cohort study including in total of 1706 CRC patients treated between 1996 and 2019 in three different countries. The proficiency (pMMR) or deficiency (dMMR) of mismatch repair was determined by immunohistochemistry. Cases were analyzed for tumor BRAFV600E mutation, and BRAF mutated tumors were further analyzed for hypermethylation status in the promoter region of MLH1 to distinguish between sporadic and hereditary cases. Swedish and Finish patients were matched with their respective National Cancer Registries. For the Czech cohort, thorough scrutiny of medical files was performed to identify any non-colorectal malignancy within 20 years before or after the diagnosis of CRC. Poisson regression analysis was performed to identify the incidence rates of non-colorectal malignancies. For validation purposes, standardized incidence ratios were calculated for the Swedish cases adjusted for age, year, and sex.

Results: Of the 1706 CRC patients included in the analysis, 819 were female [48%], median age at surgery was 67 years [interquartile range: 60–75], and sporadic dMMR was found in 188 patients (11%). Patients with sporadic dMMR CRC had a higher incidence rate ratio (IRR) for non-colorectal malignancy before and after diagnosis compared to patients with a pMMR tumor, in both uni- (IRR = 2.49, 95% confidence interval [CI] = 1.89–3.31, p = 0.003) and multivariable analysis (IRR = 2.24, 95% CI = 1.67–3.01, p = 0.004). This association applied whether or not the non-colorectal tumor developed before or after the diagnosis of CRC in both uni- (IRR = 1.91, 95% CI = 1.28–2.98, p = 0.004), (IRR = 2.45, 95% CI = 1.72–3.49, p = 0.004) and multivariable analysis (IRR = 1.67,95% CI = 1.05–2.65, p = 0.029), (IRR = 2.35, 95% CI = 1.63–3.42, p = 0.005), respectively.

Conclusion: In this retrospective European multicenter cohort study, patients with sporadic dMMR CRC had a higher risk for non-colorectal malignancy than those with pMMR CRC. These findings indicate the need for further studies to establish the need for and design of surveillance strategies for patients with dMMR CRC.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
colorectal cancer, non-colorectal malignancy, sporadic deficient mismatch repair
National Category
Cancer and Oncology Surgery
Identifiers
urn:nbn:se:umu:diva-223081 (URN)10.1002/jso.27619 (DOI)001182569800001 ()38470492 (PubMedID)2-s2.0-85187434806 (Scopus ID)
Funder
Cancerforskningsfonden i Norrland, LP16‐2131Visare Norr
Available from: 2024-04-15 Created: 2024-04-15 Last updated: 2024-04-15
Renman, D., van Guelpen, B., Anderson, F., Axelsson, J., Riklund, K., Strigård, K., . . . Gylling, B. (2023). Association of pre-diagnostic physical exercise and peri-diagnostic body composition with mortality in non-metastatic colorectal cancer. International Journal of Colorectal Disease, 38(1), Article ID 239.
Open this publication in new window or tab >>Association of pre-diagnostic physical exercise and peri-diagnostic body composition with mortality in non-metastatic colorectal cancer
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2023 (English)In: International Journal of Colorectal Disease, ISSN 0179-1958, E-ISSN 1432-1262, Vol. 38, no 1, article id 239Article in journal (Refereed) Published
Abstract [en]

Purpose: Sarcopenia and myosteatosis, quantified via computed tomography (CT), are associated with poor colorectal cancer outcomes. These body composition estimates can be influenced by physical exercise. We explored the correlation between pre-diagnostic physical exercise, body composition close to diagnosis, and the combined prognosis impact of these factors.

Methods: We studied 519 stage I–III colorectal cancer (CRC) cases diagnosed 2000–2016 with pre-diagnostic self-reported recreational physical exercise data collected in the prospective, population-based Northern Sweden Health and Disease Study, and CT-estimated skeletal muscle index (SMI) or skeletal muscle density (SMD). Risk estimates were calculated by multivariable logistic regression and Cox proportional hazards models.

Results: No association was seen between low pre-diagnostic physical exercise and sarcopenia/myosteatosis in the multivariable model adjusted for age, sex, educational level, tumor stage, and tumor location. In multivariable Cox regression models, the combination of low pre-diagnostic physical exercise and either sarcopenia or myosteatosis at the time of diagnosis was associated with cancer-specific mortality compared to the reference group of high physical exercise combined with no sarcopenia/myosteatosis (adjusted HR 1.94 95% CI 1.00–3.76 for sarcopenia and adjusted HR 2.39 95% CI 1.16–4.94 for myosteatosis).

Conclusions: The combined presence of low pre-diagnostic physical exercise and sarcopenia or myosteatosis was associated with increased CRC-specific mortality. Despite the positive effect on prognosis, physical exercise did not alter body composition estimates at diagnosis, which could indicate attenuation from other factors.

Place, publisher, year, edition, pages
Springer Nature, 2023
Keywords
Colorectal cancer, Exercise, Myosteatosis, Physical activity, Sarcopenia
National Category
Cancer and Oncology Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-215081 (URN)10.1007/s00384-023-04536-0 (DOI)37755537 (PubMedID)2-s2.0-85172659066 (Scopus ID)
Funder
Cancerforskningsfonden i Norrland, AMP 20-999Visare Norr, 967732Region Västerbotten, ALF RV-968855Region Västerbotten, ALF RV-982739
Available from: 2023-10-13 Created: 2023-10-13 Last updated: 2024-02-08Bibliographically approved
Dahlstrand, U., Gustafsson, P., Näsvall, P., Johansson, J., Gunnarsson, U. & Lindforss, U. (2023). Costs related to diverting ileostomy after rectal cancer surgery: a population-based healthcare cost analysis based on nationwide registers. Inquiry, 60, 1-8
Open this publication in new window or tab >>Costs related to diverting ileostomy after rectal cancer surgery: a population-based healthcare cost analysis based on nationwide registers
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2023 (English)In: Inquiry, ISSN 0046-9580, E-ISSN 1945-7243, Vol. 60, p. 1-8Article in journal (Refereed) Published
Abstract [en]

Low anterior resection for rectal cancer often includes a diverting loop-ileostomy to avoid the severe consequences of anastomotic leakage. Reversal of the stoma is often delayed, which can incur health-care costs on different levels. The aim is to, on population basis, determine stoma-related costs, and to investigate habitual and socioeconomic factors associated to the level of cost. Multi-register design with data from the Swedish Rectal Cancer Registry, the National Prescribed Drug Register, Statistics Sweden and cost-administrative data from the National Board of Health and Welfare. Data was gathered for 3564 patients with rectal cancer surgery 2007 to 2013, for 3 years following the surgery. Factors influencing the cost of inpatient care and stoma-related consumables were assessed with linear regression analyses. All monthly costs were higher for females (consumables P <.001 and in-patient care P =.031). Post-secondary education (P =.003) and younger age (P =.020) was associated with a higher cost for consumables while suffering a surgical complication was associated with increased cost for inpatient care (P <.001). Patients who had their stoma longer had lower monthly costs (consumables P <.001 and in-patient care P <.001). Female gender, longer duration of stoma, young age, and higher education are associated with higher costs for the care of a diverting stoma after rectal cancer surgery. This study does not allow for analyses of causality but the results together with deepened analyses of underlying reasons form a proper basis for decisions in health care planning and allocation of resources. These findings may have implications on the debate of equal care for all.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
cost analysis, defunctioning stoma, healthcare costs, ileostomy, inpatients, low anterior resection, rectal neoplasms, resource allocation, socioeconomic factors, stoma reversal
National Category
Surgery Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:umu:diva-218886 (URN)10.1177/00469580231212126 (DOI)38105185 (PubMedID)2-s2.0-85180186050 (Scopus ID)
Funder
Region Västerbotten, RV-979794Region Västerbotten, RV-978927Swedish Research Council, 2021-00972Visare Norr, 930645
Available from: 2024-01-04 Created: 2024-01-04 Last updated: 2024-02-08Bibliographically approved
Olsson, A., Sandblom, G., Franneby, U., Sondén, A., Gunnarsson, U. & Dahlstrand, U. (2023). Do postoperative complications correlate to chronic pain following inguinal hernia repair?: a prospective cohort study from the Swedish hernia register. Hernia, 27(1), 21-29
Open this publication in new window or tab >>Do postoperative complications correlate to chronic pain following inguinal hernia repair?: a prospective cohort study from the Swedish hernia register
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2023 (English)In: Hernia, ISSN 1265-4906, E-ISSN 1248-9204, Vol. 27, no 1, p. 21-29Article in journal (Refereed) Published
Abstract [en]

Purpose: To analyse if postoperative complications constitute a predictor for the risk of developing long-term groin pain.

Methods: Population-based prospective cohort study of 30,659 patients operated for inguinal hernia 2015–2017 included in the Swedish Hernia Register. Registered post-operative complications were categorised into hematomas, surgical site infections, seromas, urinary tract complications, and acute post-operative pain. A questionnaire enquiring about groin pain was distributed to all patients 1 year after surgery. Multivariable logistic regression analysis was used to find any association between postoperative complications and reported level of pain 1 year after surgery.

Results: The response rate was 64.5%. In total 19,773 eligible participants responded to the questionnaire, whereof 73.4% had undergone open anterior mesh repair and 26.6% had undergone endo-laparoscopic mesh repair. Registered postoperative complications were: 750 hematomas (2.3%), 516 surgical site infections (1.6%), 395 seromas (1.2%), 1216 urinary tract complications (3.7%), and 520 hernia repairs with acute post-operative pain (1.6%). Among patients who had undergone open anterior mesh repair, an association between persistent pain and hematomas (OR 2.03, CI 1.30–3.18), surgical site infections (OR 2.18, CI 1.27–3.73) and acute post-operative pain (OR 7.46, CI 4.02–13.87) was seen. Analysis of patients with endo-laparoscopic repair showed an association between persistent pain and acute post-operative pain (OR 9.35, CI 3.18–27.48).

Conclusion: Acute postoperative pain was a strong predictor for persistent pain following both open anterior and endo-laparoscopic hernia repair. Surgical site infection and hematoma were predictors for persistent pain following open anterior hernia repair, although the rate of reported postoperative complications was low.

Place, publisher, year, edition, pages
Springer, 2023
Keywords
Chronic pain, Groin hernia, Inguinal hernia, Postoperative complications
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:umu:diva-190582 (URN)10.1007/s10029-021-02545-y (DOI)000729215200001 ()34894341 (PubMedID)2-s2.0-85120887769 (Scopus ID)
Note

Errata: Olsson, A., Sandblom, G., Franneby, U. et al. Correction to: Do postoperative complications correlate to chronic pain following inguinal hernia repair? A prospective cohort study from the Swedish Hernia Register. Hernia. 2023;27:481. DOI: 10.1007/s10029-023-02743-w

Available from: 2021-12-20 Created: 2021-12-20 Last updated: 2024-02-08Bibliographically approved
Almkvist, L., Gunnarsson, U. & Strigård, K. (2023). Improved assessment of fecal incontinence in women with previous obstetric injury combining Low Anterior Resection Syndrome and Wexner scores. International Journal of Gynecology & Obstetrics, 161(3), 839-846
Open this publication in new window or tab >>Improved assessment of fecal incontinence in women with previous obstetric injury combining Low Anterior Resection Syndrome and Wexner scores
2023 (English)In: International Journal of Gynecology & Obstetrics, ISSN 0020-7292, E-ISSN 1879-3479, Vol. 161, no 3, p. 839-846Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of the current study was to assess whether Low Anterior Resection Syndrome (LARS) score could provide additional unique information to the Wexner score when assessing fecal incontinence (FI) in women with previous obstetric injury, thus providing a better foundation for treatment decisions.

Methods: This was a retrospective cohort study with intraindividual comparison of two scoring systems. Women with previous obstetric injury and diagnosed with FI between January 1, 2015, and December 31, 2018, with valid LARS and Wexner scores were included. Statistical methods used were Spearman rank correlation, Kendall τ, scatterplot, and ratios.

Results: Seventy women were included. Correlation coefficients varied from 0.42 to 0.66 (Spearman rank correlation) and 0.44 to 0.51 (Kendall τ). Cohen κ values varied from 0.33 to 0.67. No strong association was seen in the correlation analyses or the scatterplot.

Conclusion: LARS score was shown to provide extra relevant information when assessing FI in women with previous obstetric injury. All symptoms should be considered relevant when assessing FI since it is a complex condition and should be approached accordingly. The authors suggest a combination of LARS and Wexner scores when assessing FI among women with previous obstetric injury.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
colorectal surgery, fecal incontinence, gynecology, obstetrics, questionnaires, scoring methods, surgery
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:umu:diva-204750 (URN)10.1002/ijgo.14673 (DOI)000923561500001 ()36637255 (PubMedID)2-s2.0-85147520630 (Scopus ID)
Available from: 2023-02-21 Created: 2023-02-21 Last updated: 2024-02-08Bibliographically approved
Ringblom, C., Odensten, C., Strigård, K., Gunnarsson, U. & Näsvall, P. (2023). No reduction in parastomal hernia rate 3 years after stoma construction with prophylactic mesh: Three-year follow-up results from stomamesh-a multicenter double-blind randomized controlled trial. Annals of Surgery, 277(1), 38-42
Open this publication in new window or tab >>No reduction in parastomal hernia rate 3 years after stoma construction with prophylactic mesh: Three-year follow-up results from stomamesh-a multicenter double-blind randomized controlled trial
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2023 (English)In: Annals of Surgery, ISSN 0003-4932, E-ISSN 1528-1140, Vol. 277, no 1, p. 38-42Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The primary objective was to compare rates of parastomal hernia (PSH) 3 years after stoma construction with prophylactic mesh or no mesh. A secondary objective was to compare complications requiring reintervention within 3 years.

BACKGROUND: Recent studies have shown that a prophylactic mesh does not reduce the rate of PSH contrary to older studies. Long-term data on efficacy and safety is however scarce.

METHODS: A randomized controlled double-blind multicenter trial. Patients planned for permanent end colostomy were randomized to either prophylactic mesh in the retromuscular position around the stoma site or no mesh. They were evaluated for PSH clinically and with computed tomography (CT) 3 years after stoma construction. Medical records of all patients included were also reviewed at 3 years to detect any abdominal or abdominal wall surgery during that period.

RESULTS: A total of 232 patients were randomized. At 3 years, 154 patients were available for clinical evaluation and 137 underwent a CT scan. No significant difference in PSH rates was seen between the treatment allocation arms (clinical: P=0.829 and CT: P=0.761, respectively), nor was there a significant difference in the number of reinterventions, but 2 patients had their mesh removed at emergency surgery.

CONCLUSIONS: Prophylactic mesh does not reduce the rate of PSH and cannot be recommended for routine use.

Place, publisher, year, edition, pages
Wolters Kluwer, 2023
Keywords
parastomal hernia, mesh, prevention, prophylaxis
National Category
Surgery
Identifiers
urn:nbn:se:umu:diva-202661 (URN)10.1097/SLA.0000000000005537 (DOI)000905219700014 ()35837972 (PubMedID)2-s2.0-85145304565 (Scopus ID)
Funder
Swedish Research Council, 214-7196Region Västerbotten, VLL-545001Norrbotten County Council
Available from: 2023-01-12 Created: 2023-01-12 Last updated: 2024-02-08Bibliographically approved
Näverlo, S., Strigård, K., Gunnarsson, U. & Edin-Liljegren, A. (2023). Patients’ experiences of living with a stoma in rural areas in Northern Sweden. International Journal of Circumpolar Health, 82(1), Article ID 2221767.
Open this publication in new window or tab >>Patients’ experiences of living with a stoma in rural areas in Northern Sweden
2023 (English)In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 82, no 1, article id 2221767Article in journal (Refereed) Published
Abstract [en]

Introduction: Stoma complications are common and interfere with many aspects of everyday life. Stoma problems are usually managed by a specialised stoma nurse, a service not present in the rural areas of South Lapland in Sweden. The aim of this study was to describe how stoma patients in rural areas experience living with a stoma.

Methods: A qualitative descriptive study with semi-structured interviews were conducted with 17 stoma patients living in rural municipalities and who received a part of their care at the local cottage hospital. Qualitative content analysis was employed.

Results: Initially, the stoma was experienced as very depressing. Participants had difficulties in properly managing the dressing. Over time they learned how to properly care for their stoma, making their life easier. Both satisfaction and dissatisfaction with the healthcare were experienced. Those who were dissatisfied expressed a lack of competence in dealing with stoma-related problems.

Conclusions: Living with a stoma in a rural area in northern Sweden is experienced as a learning process and acceptance of the stoma’s existence is important. This study emphasises the need for increased knowledge of stoma-related problems in rural primary healthcare in order to help patients cope with everyday life.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2023
Keywords
Chronic illness, Quality of life, Rural health service, Rural nursing, Stoma care
National Category
Surgery
Identifiers
urn:nbn:se:umu:diva-211997 (URN)10.1080/22423982.2023.2221767 (DOI)001003462100001 ()37300840 (PubMedID)2-s2.0-85163149340 (Scopus ID)
Funder
Umeå University, VLL-545001Region Västerbotten, VLL-545001Visare Norr, 732841Cancerforskningsfonden i Norrland, AMP-18-956
Available from: 2023-07-12 Created: 2023-07-12 Last updated: 2024-02-08Bibliographically approved
Projects
Stoma complaints ? a public health problem. Can this be solved by surgical intervention? [2014-07196_VR]; Umeå UniversityAbdominal Wall Defects ? surgical innovations based on understanding of biological interactions [2017-00824_VR]; Umeå University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-3806-2114

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