Bakgrund: Bröstcancer är idag den vanligaste cancersjukdomen bland kvinnor globalt. När en kvinna drabbas av bröstcancer tar ofta anhöriga ett stort ansvar för kvinnans omsorg i hemmet. Problematiken med anhörigomsorg är att anhörigas förutsättningar för att ge omsorg ser olika ut och att deras egen hälsa riskerar att påverkas. Syfte: Syftet var att belysa anhörigas upplevelser av att ge omsorg till en kvinnlig familjemedlem med bröstcancer. Metod: Metoden var en allmän kvalitativ litteraturöversikt med 11 artiklar som analyserades genom en kvalitativ innehållsanalys. Resultat: Två kategorier identifierades; Omsorgens utmaningar och Stöd i omsorgen. Under Omsorgens utmaningar identifierades två sub-kategorier; Svårigheter att ge omsorg och Känsla av att vardagen prövades. Under Stöd i omsorgen identifierades två sub-kategorier; Känsla av att stärka kvinnan och Behov av att vägledas. Slutsats: Anhöriga upplevde flera svårigheter med att ge omsorg. Den ökade belastningen på dagens hälso- och sjukvård gör att ansvaret för patientens omsorg ökar för anhöriga, vilket var svårt att ta sig an. Anhöriga upplever likväl att deras insatser gör skillnad. Trots att forskning understryker vikten av att se till alla familjemedlemmars behov och öka utrymmet för familjefokuserad omvårdnad, finns ett fortsatt behov av ytterligare forskning kring anhörigas upplevelser av familjefokuserad omvårdnad i dagens vård och omsorg. / Background: Breast cancer is the most common type of cancer among women globally. When a woman suffers from breast cancer the main responsibility of care is often taken by her relatives. The problem with relative care is that the relatives' conditions for providing care look different and that their own health risks being affected. Aim: The aim was to highlight relatives' experiences of providing care to a female family member with breast cancer. Method: The method was a general qualitative literature review with 11 articles that were analyzed through a qualitative content analysis. Result: Two categories were identified; The challenges of care and Support in care. Within The challenges of care two sub-categories were identified; The difficulties of providing care and The feeling that everyday life was tested. Within Support in care two sub-categories were identified; The feeling of strengthening the woman and Need to be guided. Conclusion: Relatives experienced several difficulties in providing care. The increased burden on today´s health care means that the responsibility for the patient's care increases for relatives, which was difficult to handle. Relatives still feel that their efforts make a difference. Although research emphasizes the importance of looking after the needs of all family members and increasing the scope for family-focused nursing, there is a continuing need for further research on relatives' experiences of family-focused nursing in today's care and nursing.

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Neuroblastoma (NB), an extracranical solid tumor, is among the most prevalent cancers affecting children, particularly those under the age of five. High-risk NB presents a survival rate just below 50 %. Angiogenesis, a crucial process in NB, is induced by various pro-angiogenic factors. The compound SU11657 has demonstrated efficacy in inhibiting angiogenesis and tumor progression. Tumor-associated macrophages (TAMs) and Tumor-associated neutrophils (TANs) contribute to tumor progression, including angiogenesis, and their heightened levels within the tumor has been correlated with a poor clinical prognosis. This study aimed to quantify TANs and TAMs in NB tumors through manual assessment and the development of an automated digital image analysis. Unfortunately, due to time constraints, TAMs were not subjected to detailed analysis. Immunohistochemistry using antibody ab2557 and DAB staining was employed, and cell content analysis was performed through both manual assessment and digital analysis using QuPath. Successful differentiation of TANs was achieved with ab2557. The manual assessment observed a decrease of TANs between the control and treatment groups in UB7 and UB8, with UB7 being statistically significant (p<0.05), based on a two-tailed t-test. QuPath analysis noted increases in the percentages of TANs between the control and treatment groups, with the t-tests being non-significant (p>0.05). While digital image analysis is gaining importance in clinical applications, imperfections persist, underscoring the imperative for further research and development to accurately distinguish biomarkers.

Children who have survived a brain tumor often experience late consequences as a result of the tumor itself, and/or treatment. The child’s ability to engage in daily activities may be restricted by these late consequences. Examples of these late consequences are challenges with their activity levels and engagement in daily activities. Therefore, it is important to study these children’s late consequences over time. The aim of the thesis is to use data from medical and school records linked to ICF, to investigate how the participation problems/ restrictions of children that completed cancer directed treatment for a brain tumor tend to occur simultaneously with codes from other ICF components, over time. For the present research the inclusion criteria were children that were followed by the habilitation service, school and health care for at least 4 years after completing their brain tumor treatment. Seven children were included in the study. For each child, records were obtained from habilitation, school and health care and a complete retrospective screening was conducted between February 2022 and April 2022. Problems in relation to everyday life were identified and linked to ICF codes and domains. Descriptive statistics was used to analyze the data, in order to see the re-occurrences of the ICF domains during the time and observe the trajectory and intensity of the problems. The results revealed that the problems linked to body functions were the most frequently mentioned ICF domain by all three services as well as over time. Problems over time related to activity and participation were less focused and little emphasis were focused on problems related to the environment. The pattern over time was very individual. In order to more prominent focus on the child’s everyday functioning, follow-up guidelines should also include the child's functioning in everyday life, and not only areas related to body function. To conclude, when caring for these children, it is important to also focus on the child’s function in everyday life and to individualize the care since the pattern of problems over time seems to be very individual. / <p></p><p></p> / Using ICF to Describe Problems With Functioning in Everyday Life for Children Who Completed Treatment for Brain Tumor: An Analysis Based on Professionals' Documentation

Multi-ion radiotherapy has been suggested as a new way to treat cancer, combining the radiological advantages of lighter and heavier ions in a single treatment to improve plan robustness and increase LETd in the target. To succeed, multi-ion radiotherapy requires a treatment planning system capable of computing dose for and optimising multi-ion treatment plans. In this project, prototypical multi-ion radiotherapy treatment planning support has been implemented in the RayStation treatment planning system. The existing dose engine for helium and carbon ion beams has been extended to support protons, oxygen and neon ions, and support has been added for dose computation and plan optimisation for any combination of these ion species. The implemented functionality has been evaluated in two phantom cases and a patient case. Multi-ion treatment plans have been shown to outperform carbon ion treatment plans in terms of simultaneously providing plan robustness, uniform RBE-weighted dose and high LETd. In the patient case, the multi-ion plan displayed significant improvements in the ability to "paint" high LETd in the target. Clinical studies are required to determine to what extent this new modality increases treatment quality in practice.

Bakgrund: Årligen diagnostiseras 350 000 nya patienter med oral cancer i världen. Denna cancer klassas som en av de vanligaste cancerformerna. Oral cancer påverkar munhälsan och cancerbehandlingarna medför ofta svåra biverkningar där fysiska symptom riskerar att bli ihållande vilket kan leda till psykiska och sociala svårigheter. Det primära omvårdnadproblemet är att sjuksköterskor saknar tillräcklig kunskap för att utföra evidensbaserad omvårdnad för denna patientgrupp. Syfte: Syftet var att beskriva patienters upplevelser av att ha oral cancer. Metod: En litteraturstudie där tio vetenskapliga artiklar granskats på ett strukturerat vis. Resultat: I resultatet framkom fyra huvudkategorier: Upplevelser av fysiska utmaningar, Upplevelser av psykiska utmaningar, Upplevelser av sociala utmaningar samt Upplevelser av hanterbarhet och acceptans. Upplevelser av fysiska utmaningar var grundat i smärta, tal, ät och sväljsvårigheter. Psykiska utmaningar bestod huvudsakligen av oro och rädsla. I sociala utmaningar upplevde patienterna svårigheter att interagera med andra människor. Upplevelser av hanterbarhet och acceptans innefattar patienternas strategier att hantera och acceptera den nya livssituationen. Konklusion: Patienters upplevelser av oral cancer är viktiga att uppmärksamma då forskning visar att tidigt insättande av omvårdnadsåtgärder är relevanta utifrån fysiska, psykiska och sociala perspektiv. Sjuksköterskor avsaknad av relevant grundkunskap om oral hälsa kräver därför kontinuerlig utbildning om munhälsa och förebyggande omvårdnadsåtgärder. / Background: Annually, 350,000 new patients are diagnosed with oral cancer in the world. This cancer is classified as one of the most common forms of cancer. Oral cancer affects oral health and cancer treatments often cause severe side effects where physical symptoms risk becoming persistent, which can lead to psychological and social difficulties. The primary nursing problem is that nurses lack sufficient knowledge to perform evidence-based nursing for this patient group. Aim: The purpose was to describe patients' experiences of having oral cancer. Method: A literature study where ten scientific articles were reviewed in a structured manner. Results: The results revealed four main categories: Experiences of physical challenges, Experiences of psychological challenges, Experiences of social challenges and Experiences of manageability and acceptance. Experiences of physical challenges were based on pain, speech, eating and swallowing difficulties. Mental challenges mainly consisted of worry and fear. In social challenges, patients experienced difficulty interacting with other people. Experiences of manageability and acceptance include the patients' strategies to manage and accept the new life situation. Conclusion: Patients' experiences of oral cancer are important to pay attention to as research shows that early initiation of nursing measures is relevant based on physical, psychological and social perspectives. Nurses lacking relevant basic knowledge about oral health therefore require continuous education about oral health and preventive nursing measures.

Bakgrund: När en person drabbas av bröstcancer påverkas även deras anhöriga, särskilt partnern till den som är sjuk. Med ett stigande antal cancerfall har antal anhörigvårdare ökat, vilket har lett till en ökning av sjukskrivningar bland partners till den bröstcancersjuka. För att kunna bemöta anhörigas omvårdnadsbehov på ett adekvat sätt krävs utökad kunskap kring deras upplevelser av livet med en bröstcancersjuk kvinna. Syfte: Syftet var att beskriva anhörigas upplevelse av att leva med en kvinnlig partner som genomgår en bröstcancerbehandling.  Metod: En litteraturöversikt med kvalitativ metod genomfördes. Totalt 12 artiklar inkluderades via sökningar i databaserna CINAHL, MEDLINE och Pubmed. Artiklarna har analyserats enligt Fribergs femstegsmodell.  Resultat: Litteraturöversiktens resultat bestod av två teman och fem subteman. Teman var att uppleva barriärer till följd av partnerns sjukdom och att axla rollen som anhörigvårdare. Resultatet visade att anhöriga till personer med bröstcancer upplevde en förändrad vardag med förändrade roller, vilket försämrade deras psykiska och fysiska välbefinnande. Familjesammanhållningen sågs som betydande för att kunna hantera vardagen med närvaro av sjukdom.  Slutsats: För att främja anhörigas välbefinnande är det viktigt att hantera både de känslomässiga och praktiska aspekterna av deras upplevelse. Genom att arbeta familjefokuserat kan sjuksköterskan främja till anhörigas delaktighet i sin partners vård, vilket kan svara på deras behov av information, kunskap och strategier. Detta kan hjälpa anhöriga att tydliggöra deras roll som anhörigvårdare.  Nyckelord: cancer, partner, anhörig, upplevelse, familjefokuserad omvårdnad. / Background: When a person is affected by breast cancer, their relatives are also affected, especially the partner of the person who is ill. With an increasing number of cancer cases, the number of family caregivers has also increased, according to research this has led to an increase in sick leave among partners of the breast cancer patient. In order to be able to respond to the nursing needs of relatives in an adequate way, increased knowledge is required regarding their experiences of life with a woman with breast cancer. Aim: The aim was to describe relatives' experience of living with a female partner undergoing breast cancer treatment. Method: A literature review with a qualitative method was conducted. A total of 12 articles were included via searches in the databases Cinahl, MEDLINE and Pubmed. The articles have been analyzed according to Friberg's five-step model. Result: The results of the literature review consisted of two themes and five subthemes. The themes were experiencing barriers as a result of the partner's illness and assuming the role of family carer. The results showed that relatives of people with breast cancer experienced a changed everyday life with changed roles, which affected their psychological and physical well-being. Family cohesion was seen as important in being able to manage everyday life with the presence of illness. Conclusion: In order to promote the well-being of relatives, it is important to manage both the emotional and practical aspects of their experience. By working family-focused, the nurse can promote relatives' participation in their partner's care, which can respond to their need for information, knowledge and strategies. This can help relatives clarify their role as relative carers. Keywords: cancer, partner, relative, experience, family-focused nursing.

Titel: Patienters upplevelser av diagnos och behandling vid akut myeloisk leukemi    Bakgrund: Akut myeloisk leukemi (AML) är den vanligaste formen av akut leukemi. Behandlingen och symtomen är påfrestande och långvariga, vilket inverkar på patienters livskvalitet. Genom god personcentrerad vård kan sjuksköterskan försöka tillgodose många av behoven som patienten kan få under vårdtiden.  Syfte: Att beskriva patienters upplevelser av att diagnostiseras med och genomgå behandling mot akut myeloisk leukemi. Metod: En litteraturöversikt med kvalitativ metod och induktiv ansats. Efter sökning i databaserna Cinahl, PubMed och PsyINFO samt artikelgranskning inkluderades tolv artiklar. Artiklarna analyserades genom Fribergs fem steg.  Resultat: Genom en sammanställning av artiklarna framkom det två olika teman (känslomässiga reaktioner och förändrad kroppsuppfattning) och sex olika subteman (att få ett obegripligt besked, känsla av att få svår och komplex information, känsla av isolering, förändrat utseende relaterat till symtom, fysiska symtom relaterat till behandling och känsla av att vara en börda). Slutsatser: I litteraturöversikten framkom det att beskedet om diagnosen var obegripligt. Patienterna upplevde att sjuksköterskan hade svårt att förmedla den komplexa informationen personcentrerat. Behandlingstiden orsakade att patienterna upplevde sig isolerade och att symtomen (illamående, trötthet och håravfall) påverkade patienternas vardagliga liv negativt. Sjuksköterskans stöd och undervisning relaterat till symtomhantering och omvårdnadsåtgärder till såväl patient och anhöriga är avgörande för att minska de negativa känslorna som framkom i resultatet.  Nyckelord: Cancer, cytostatikabehandling, personcentrerad vård, stamcellstransplantation

Background: Cancer is a leading cause of death. For this reason, cancer is commonly perceived as a potentially fatal disease that causes both current and future existential suffering. In recent years, research has revealed that patients' implementation of coping strategies has increased the manageability and control of cancer. Aim: The purpose of this study was to examine which coping strategies adult patients with malignant diseases/cancer use, and how their coping strategies affect their health. Method: A literature review was conducted. The articles were analyzed through a four-step model and based on four qualitative and four quantitative scientific articles in order to contribute to evidence-based knowledge. Two themes and seven subthemes were analysed in the result. Results: What emerged in the results showed that the patient's external resources as the environment was an important support, followed by internal resources as personal abilities where faith and hope were central components. Seven subthemes were identified consisted of seeking professional support, find support from social networks, self-destruction, maintain a positive attitude, self-efficacy, acceptance and turn to their faith. Patients experienced improved health during the disease progression when using coping strategies. Conclusion: Coping strategies improve the patient's health by managing the disease and suffering, which may be accomplished using the patient's internal and external resources for management. By assisting the patient in employing appropriate coping mechanisms, the nurse can promote a higher quality of life, reduce suffering, and promote health.

Bakgrund: Runt 429 000 barn drabbas årligen av cancer världen över. Att leva med cancer och genomgå behandlingar är en svår utmaning för barn och närstående. Coping är ett verktyg som hjälper individer möta påfrestande situationer. Många studier belyser copingstrategier använda av föräldrar och andra personer nära cancerdrabbade barn, men underlaget är inte lika stort gällande barns egna beskrivningar av sin coping. Av denna anledning är det väsentligt att identifiera använda copingstrategier ur barns perspektiv. Syfte: Syftet med litteraturstudien var att beskriva vilka copingstrategier barn med cancer använder sig av för att hantera sjukdomen och dess behandling. Metod: Studien är en beskrivande litteraturstudie. Databassökningen genomfördes i PubMed. Sökningen resulterade i tio artiklar där åtta var kvalitativa, en var kvalitativ med mixad metod och en var kvantitativ. Framkomna data analyserades genom tematisk dataanalys. Huvudresultat: Barn med cancer använde olika copingstrategier som kategoriseras som problemfokuserade, emotionsfokuserade och meningsskapande copingstrategier. Till problemfokuserade copingstrategier hörde ”Symtomlindring och underlättande av behandling”, ”Information, kunskap och insikt” samt ”Anpassning och bibehållande av en normal vardag”. I emotionsfokuserade copingstrategier återfanns ”Stöd och känslohantering”, ”Distrahering och undvikande” samt ”Acceptans, motivation och framtidshopp”. Meningsskapande copingstrategier var ”Positiv omvärdering” och ”Personlig utveckling och att se sjukdomen som en utmaning”. Slutsats: Barn med cancer använder olika copingstrategier för att hantera sin sjukdom och dess behandling. Strategierna tillämpas växelvis beroende på situation och syftet med användningen av vald copingstrategi är individuell. Genom ökad kännedom kring ämnet kan cancerdrabbade barn erbjudas personcentrerad vård och lämpligt stöd. / Background: About 429 000 children are annually affected by cancer worldwide. Living with cancer and undergoing treatment is a difficult challenge for children and close relatives. Coping is a tool that helps individuals face stressful situations. Many studies shed light on coping strategies used by parents and other people close to children affected by cancer, but the basis is not as extensive regarding children's own descriptions of their coping. For this reason, it is essential to identify used coping strategies from children's perspective. Aim: The purpose of the literature study was to describe which coping strategies children with cancer use to manage the disease and its treatment. Method: The study is a descriptive literature study. The database search was conducted in PubMed. The search resulted in ten articles, eight of which were qualitative, one was qualitative with a mixed method and one was quantitative. The data were analyzed through thematic data analysis. Main results: Children with cancer used different coping strategies categorized as problem-focused, emotion-focused and meaning-making coping strategies. Problem-focused coping strategies included “Symptom relief and facilitation of treatment”, “Information, knowledge and insight” and “Adaptation and maintaining a normal everyday life”. In emotion-focused coping the strategies found were “Support and emotion management”, “Distraction and avoidance” and “Acceptance, motivation and hope for the future”. Meaning-focused coping strategies were “Positive reappraisal” and “Personal development and seeing the disease as a challenge”. Conclusion: Children with cancer use different coping strategies to deal with their illness and its treatment. The strategies are applied alternately depending on the situation and the purpose of using the chosen coping strategy is individual. Through increased awareness of the subject, children affected by cancer can be offered person-centred care and appropriate support.