Background: Cancer is one of the most common diseases in Sweden. When illness can no longer be cured, the patient is transferred to palliative care. The majority of palliative care is performed in hospitals. The goal of palliative care is to alleviate suffering and promote quality of life. Research has shown clear insufficiency in palliative care. From a patient perspective, insufficiency is mostly common in pain relief, communication and care environments. Aim: The aim of the literature review was to describe patients' experiences of palliative care in hospitals in the event of cancer. Method: This general literature review was based on twelve original articles with a qualitative approach that were analyzed using thematic analysis. Results: Three themes were identified: The importance of being seen as a whole person, The importance of pain relief and The importance of a good care environment. The patients were generally satisfied with the palliative care in the hospital. The importance of good pain relief and a good care environment at the hospital as well as a functioning communication with the care staff was emphasized. Conclusions: The patients who were cared for in the palliative care ward had different nursing experiences. Through patient experiences of palliative care, the nurse can increase the understanding of the patient's care needs. The knowledge can be used to give the patient an improved quality of life and alleviate suffering. / Bakgrund: Cancer är en av de vanligaste sjukdomarna i Sverige. När sjukdom inte längre går att bota övergår vården till att bli palliativ. En stor del av palliativ vård utförs på sjukhus. Målet med den palliativa vården är att lindra lidande och främja livskvaliteten. Forskning har påvisat tydliga brister inom den palliativa vården. Ur patientperspektiv är det framför allt brister inom smärtlindring, kommunikation och vårdmiljöns utformning. Syfte: Syftet med litteraturöversikten var att beskriva patienters upplevelser av palliativ vård på sjukhus vid cancersjukdom. Metod: En allmän litteraturöversikt baserad på tolv originalartiklar med kvalitativ ansats som analyserades med hjälp av tematisk analys. Resultat: Tre teman identifierades: Betydelsen av att bli sedd som en hel människa, Vikten av smärtlindring och Vikten av en god vårdmiljö. Patienterna var överlag nöjda med den palliativa vården på sjukhus. Vikten av en god smärtlindring och en bra vårdmiljö på sjukhuset samt en fungerande kommunikation med vårdpersonalen betonades. Slutsats: Patienterna som vårdades på palliativ vårdavdelning hade olika vårdupplevelser. Genom patientupplevelser av den palliativa vården kan sjuksköterskan öka förståelsen för patientens vårdbehov. Kunskapen kan användas för att ge patienten förbättrad livskvalité́ och lindra lidande.

<p><strong>Background                      </strong></p><p>There are different types of treatments for breast cancer, and these may be of surgical and non-surgical art. These treatments produce different side effects that can cause both physical and mental harm to the woman. The breast cancer can change the women's body image and relationships to their families. The women manage their lives in different ways depending on which culture they belong to. <strong></strong></p><p><strong>Aim                                    </strong></p><p>The aim of the study was to elucidate women’s experience of her body and the altered body in relation to breast cancer treatment.</p><p><strong>Method                              </strong></p><p>The method used was a literature review based on scientifically articles to overview the field of breast cancer. For the systematic and unsystematic search nine articles were found and used to present the results. <strong></strong></p><p><strong>Results                               </strong></p><p>The result was based on analyzes of the nine articles and three main themes revealed: To take control, To change and To meet the cultural ideal. <strong></strong></p><p><strong>Conclusion                         </strong></p><p>Women with breast cancer often experience hair loss as the most difficult part of the treatment. It’s therefore important that the women is prepared to what is going to happen for being able to handle the new situation. By preparing in different ways women handle their situation easier. It’s important for the women to feel normal and maintain their identity and role in the family. </p>

Background                      There are different types of treatments for breast cancer, and these may be of surgical and non-surgical art. These treatments produce different side effects that can cause both physical and mental harm to the woman. The breast cancer can change the women's body image and relationships to their families. The women manage their lives in different ways depending on which culture they belong to. Aim                                    The aim of the study was to elucidate women’s experience of her body and the altered body in relation to breast cancer treatment. Method                              The method used was a literature review based on scientifically articles to overview the field of breast cancer. For the systematic and unsystematic search nine articles were found and used to present the results. Results                               The result was based on analyzes of the nine articles and three main themes revealed: To take control, To change and To meet the cultural ideal. Conclusion                         Women with breast cancer often experience hair loss as the most difficult part of the treatment. It’s therefore important that the women is prepared to what is going to happen for being able to handle the new situation. By preparing in different ways women handle their situation easier. It’s important for the women to feel normal and maintain their identity and role in the family.

Purpose: The purpose of this thesis was to perform a scoping review of the current literature and available clinical practice guidelines to generate an understanding of the primary health care needs of women following treatment for breast cancer. Methods: Based on an extensive scoping review of the literature, research findings regarding the complications of breast cancer treatments and corresponding primary care interventions were synthesized. Additionally, validation of the findings of the scoping review was performed through semi-structured interviews with two primary care physicians and three post-treatment breast cancer patients. Results: Eleven broad categories related to the primary health care needs of women after undergoing treatments for breast cancer were identified. These included concerns related to: surgical complications, lymphedema, gynecologic and menopausal symptoms, psychosocial issues, additional primary cancers, cardiovascular implications, osteoporosis, lifestyle changes, fatigue, cognitive dysfunction, and pregnancy. Additionally, it was determined that the majority of existing clinical practice guidelines for breast cancer were outdated, and related to cancer detection and treatment as opposed to survivorship care. Summary: Findings from the scoping review and interviews demonstrate the vast range of primary care needs of women after undergoing treatment for breast cancer. Additionally, these results highlight the critical need for the development of a comprehensive set of current clinical practice guidelines which target primary care physicians and are specifically focused on the survivorship needs of women following breast cancer treatment. / Thesis (Master, Rehabilitation Science) -- Queen's University, 2011-07-22 16:09:35.682

Bakgrund: I dag överlever fler sin cancerdiagnos till följd av förbättrad biomedicinsk teknik. År 2018 rapporterade socialstyrelsen att 63 000 individer drabbats av malign cancer. Detta är ett stort nationellt hälsoproblem och ställer höga krav på hälso- och sjukvården. Cancer innebär fysiskt och psykiskt lidande för patienten och är grund till tröstande omvårdnad. Tröst har ifrågasatts som en omvårdnadsåtgärd samt om det är en uppgift som sjuksköterskan skall utföra. Syfte: Var att belysa vad patienten upplevde som tröstande vid livshotande cancersjukdom. Metod: En systematisk litteraturstudie med 10 vetenskapliga resultatartiklar varav nio med kvalitativ ansats och en med kvantitativ ansats som har granskats, bearbetats och analyserats med hjälp av Fribergs femstegsmodell (Friberg, 2017). Artiklarna har kvalitetsgranskats med hjälp av Carlsson och Eimans (2003) granskningsmall. Resultat: Tröst är mångdimensionellt och subjektivt. Kommunikation, utbildning och personcentrerad vård var viktiga för att patienten skall kunna erhålla tröst. Andra faktorer som gav patienten tröst var interaktion med sjuksköterskan, spirituell närvaro och hopp. Konklusion:Viktiga relationer gav patienten tröst och hopp. Relationen mellan spirituell närvaro och viktiga relationer stärkte varandra. Kommunikation och interaktion med sjuksköterska och annan hälso- och sjukvårdspersonal var betydelsefull för att erhålla en bättre livskvalitet samt finna en väg till tröst. När patienten upplevde sig komfortabel och ren i sin kropp kunde patienten uppleva sig stark och därigenom få framtidshopp samt behållen värdighet. / Background: Today, more people survive their cancer diagnosis as a result of improved biomedical technology. In 2018, the National Board of Health reported that 63,000 individuals were affected by malignant cancer. This is a major national health problem and places high demands on health care and hospitals. Cancer means physical and mental distress for the patient and is the basis for comforting nursing. However, comfort has been questioned as a nursing measure and whether it is a task that the nurse should perform. Aim: The aim was to enlighten what patients experience as comforting in a life-threatening cancer decease. Method: A general literature study with10 scientific articles, nine with qualitative approach and one with quantitative approach. Reviewed and analyzed by using Fribergs five step model (Friberg, 2017). The articles have been reviewed in accordance with Carlsson och Eimans (2003) schedule for review. Result: Consolation is multi-dimensional and subjective. Communication, education and person-centered care were important for the patient to receive comfort. Other factors that allowed the patient comfort was interaction with the nurse, spiritual presence and hope. Conclusion: Important relationships gave the patient consolation and hope. The relationship between spiritual precence and other close relations fortified eachother. Communication and interaction with the nurse and other health care professionals was important in obtaining a better quality of life and finding a way to consolation. When the patient felt comfortable and clean in his or her body, the patient could feel strong and thereby gain future hope and maintained dignity.

Introduktion: Munhälsan har stor betydelse för den allmänna hälsan och påverkar livskvalitén. God munhälsa innebär att munnen är fri från sjukdomar såsom cancer. Tidigare studier visar på att cancerbehandlingar kan ge orala biverkningar som påverka munhälsan negativt, vilket leder till ett ökat lidande för patienterna och ger en ökad belastning på vården.  Syfte: Syftet är att beskriva patienters upplevelser av sin munhälsa under och efter en cancerbehandling oavsett diagnos och behandling.  Metod: Allmän litteraturstudie baserad på kvalitativa studier. Resultaten från studierna som uppfyllde syftet analyserades med hjälp av en artikel skriven av Popenoe, Langius-Eklöf, Stenwall och Jervaeus, som är en praktisk guide för att analysera allmänna litteraturstudier i tre steg. Sammanlagt analyserades 22 artiklar.  Resultat: Analysen resulterade i fyra kategorier och elva subkategorier. Kategorierna var: fysiska förändringar, psykosociala upplevelser, behov av information och stöd och copingstrategier. Studierna visar på att orala biverkningar från olika cancerbehandlingar har en stor påverkan på patienternas upplevda munhälsa.  Slutsats: Studiens resultat indikerar på att patienterna påverkas av de orala biverkningarna i olika omfattningar. Bristande information, bemötande och stöd från sjukvården gällande deras orala biverkningar bidrog till ett ökat lidande för patienterna. Studiens resultat anses vara av klinisk relevans för sjuksköterskor som arbetar med patienter med cancer, för att kunna förebygga vårdlidande och ge en individuellt anpassad vård. / Introduction: Oral health is important for general health and affects the quality of life. Good oral health means that the mouth is free from diseases such as cancer. Previous studies show that cancer treatments can cause oral side effects that affect oral health negatively, which leads to increased suffering for patients and an increased burden on care. Aim: The aim is to describe patients` experiences of their oral health during and after cancer treatment regardless of diagnosis and treatment. Method: General literature study based on qualitative studies. The results of the studies that fulfilled the purpose were analyzed using an article by Popenoe, Langius-Eklöf, Stenwall, and Jervaeus, which is a practical guide for analyzing general literature reviews in three steps. In total 22 articles were analyzed.  Result: The analysis resulted in four categories and eleven subcategories. The categories were: physical changes, psychosocial experiences, need for information, and support and coping strategies. Studies show that oral side effects from various cancer treatments have a major impact on patients' perceived oral health. Conclusions: The result of the study indicates that the patients are affected by the oral side effects to varying degrees. Lack of information, response, and support from health care regarding their oral side effects contributed to increased suffering for the patients. The result is considered to be of clinical relevance for nurses who work with cancer patients, to be able to prevent suffering from care and provide individually tailored care.

Psychological distress is a common problem associated with cancer. The main objective of the present study was to test the Hospital Anxiety and Depression Scale (HADS) in a sample of Ethiopian cancer patients and to compare the results with those obtained from a sample in Germany. Data were collected from 256 cancer patients who visited the University of Gondar Hospital between January 2019 and June 2019 using the HADS, the European Organization for Research and Treatment of Cancer Quality of Life questionnaire (EORTC QLQ-C30), and the Multidimensional Fatigue Inventory MFI-20. The reliability of the HADS was good, with Cronbach’s α coefficients of 0.86 (anxiety), 0.85 (depression), and 0.91 (total scale). The Ethiopian cancer patients were more anxious (M = 7.9) and more depressed (M = 9.3) than the German patients (M = 6.8 for anxiety and M = 5.5 for depression). Only a weak level of measurement invariance was detected between the Ethiopian and the German sample. In the Ethiopian sample, anxiety and depression were associated with tumor stage (high levels in stage 4) and treatment (high levels for patients not receiving surgery and chemotherapy). Both anxiety and depression were significantly associated with all of the EORTC QLQ-C30 and MFI-20 scales. The HADS proved to be applicable for use with Ethiopian cancer patients. The high level of anxiety and depression present in that group indicates a need for psychosocial care.

A dor é uma das principais causas de sofrimento humano, comprometendo a qualidade de vida das pessoas e refletindo no seu estado físico e psicossocial. Em crianças e adolescente com câncer a dor pode ser causada pela própria doença, pelo tratamento e pelos procedimentos, potencializada pelo medo, ansiedade e incerteza. Tendo em vista as múltiplas dimensões que envolvem a dor da criança e do adolescente com câncer e que a caracteriza como um fenômeno complexo, os objetivos do presente estudo são descrever as vivências dos profissionais de saúde no cuidado à criança e ao adolescente com câncer em situações de dor, durante o processo de hospitalização, e analisá-las buscando fundamentação em algumas idéias acerca da complexidade enfocadas por Edgar Morin. Nesta pesquisa, de natureza qualitativa, utilizou-se a entrevista como recurso de coleta de dados. Participaram do estudo 16 profissionais da equipe de saúde do setor de onco-hematologia pediátrica de um hospital-escola do município de Ribeirão Preto. Os dados empíricos indicam que os profissionais reconhecem a importância da avaliação da dor, mas sua operacionalização é percebida como um desafio. Apontam as limitações do uso de escalas e no manejo da dor destacam como primordial a abordagem farmacológica. Manifestam sentimentos de impotência, angústia e sofrimento com a situação de dor. Permitem também vislumbrar possibilidades apresentadas pelos próprios profissionais, tais como a composição de equipes fixas integradas em um trabalho interdisciplinar e o envolvimento da família no cuidado. Os resultados apontam ainda para a necessidade de distinguir os múltiplos enfoques dos profissionais e compor uma unidade de cuidado em que esses enfoques sejam articulados de forma a atender ao cuidado das múltiplas dimensões da dor em crianças e adolescentes com câncer. Para que essa unidade de cuidado seja viabilizada ressalta-se a necessidade de articulação de todos os profissionais envolvidos no atendimento às situações de dor da criança e do adolescente com câncer hospitalizado por meio de um projeto comum, construído conjuntamente. / Pain is one of the main causes of human suffering, affecting people’s quality of life and reflecting in their physical and psychosocial condition. In children and adolescents with cancer, pain can either be caused by the disease itself, by the treatment or by the procedures and is reinforced by fear, anxiety and uncertainty. In view of the multiple dimensions involved in pain of children and adolescents with cancer, which characterize it as a complex phenomenon, this study aims to describe the experiences of health professionals in care for children and adolescents with cancer in pain situations during the hospitalization process and analyze them on the basis of some of Edgar Morin’s ideas of complexity. This qualitative research used interviews as a data collection instrument. Study participants were 16 professionals from the pediatric blood cancer health team of a school hospital in Ribeirão Preto, Brazil. Empirical data point out that, although the professionals recognize the importance of pain evaluation, its operationalization is seen as a challenge. They point towards the limitations of using pain scales and highlight the basic importance of the pharmacological approach for pain coping. Participants show feelings of powerlessness, anguish and suffering in view of the pain situation of children and adolescents with cancer. They also disclose possibilities, such as the composition of fixed teams, integrated in an interdisciplinary service, and family involvement in care. Results also indicate the need to distinguish between multiple professional focuses and to establish a care unit that allows for the articulation of these focuses, so as to attend to the multiple pain dimensions of children and adolescents with cancer. With a view to the practicability of this care unit, we highlight the need for articulation between all professionals involved in care for pain situations in hospitalized children and adolescents with cancer, through a common and jointly constructed project.

A dor é uma das principais causas de sofrimento humano, comprometendo a qualidade de vida das pessoas e refletindo no seu estado físico e psicossocial. Em crianças e adolescente com câncer a dor pode ser causada pela própria doença, pelo tratamento e pelos procedimentos, potencializada pelo medo, ansiedade e incerteza. Tendo em vista as múltiplas dimensões que envolvem a dor da criança e do adolescente com câncer e que a caracteriza como um fenômeno complexo, os objetivos do presente estudo são descrever as vivências dos profissionais de saúde no cuidado à criança e ao adolescente com câncer em situações de dor, durante o processo de hospitalização, e analisá-las buscando fundamentação em algumas idéias acerca da complexidade enfocadas por Edgar Morin. Nesta pesquisa, de natureza qualitativa, utilizou-se a entrevista como recurso de coleta de dados. Participaram do estudo 16 profissionais da equipe de saúde do setor de onco-hematologia pediátrica de um hospital-escola do município de Ribeirão Preto. Os dados empíricos indicam que os profissionais reconhecem a importância da avaliação da dor, mas sua operacionalização é percebida como um desafio. Apontam as limitações do uso de escalas e no manejo da dor destacam como primordial a abordagem farmacológica. Manifestam sentimentos de impotência, angústia e sofrimento com a situação de dor. Permitem também vislumbrar possibilidades apresentadas pelos próprios profissionais, tais como a composição de equipes fixas integradas em um trabalho interdisciplinar e o envolvimento da família no cuidado. Os resultados apontam ainda para a necessidade de distinguir os múltiplos enfoques dos profissionais e compor uma unidade de cuidado em que esses enfoques sejam articulados de forma a atender ao cuidado das múltiplas dimensões da dor em crianças e adolescentes com câncer. Para que essa unidade de cuidado seja viabilizada ressalta-se a necessidade de articulação de todos os profissionais envolvidos no atendimento às situações de dor da criança e do adolescente com câncer hospitalizado por meio de um projeto comum, construído conjuntamente. / Pain is one of the main causes of human suffering, affecting people’s quality of life and reflecting in their physical and psychosocial condition. In children and adolescents with cancer, pain can either be caused by the disease itself, by the treatment or by the procedures and is reinforced by fear, anxiety and uncertainty. In view of the multiple dimensions involved in pain of children and adolescents with cancer, which characterize it as a complex phenomenon, this study aims to describe the experiences of health professionals in care for children and adolescents with cancer in pain situations during the hospitalization process and analyze them on the basis of some of Edgar Morin’s ideas of complexity. This qualitative research used interviews as a data collection instrument. Study participants were 16 professionals from the pediatric blood cancer health team of a school hospital in Ribeirão Preto, Brazil. Empirical data point out that, although the professionals recognize the importance of pain evaluation, its operationalization is seen as a challenge. They point towards the limitations of using pain scales and highlight the basic importance of the pharmacological approach for pain coping. Participants show feelings of powerlessness, anguish and suffering in view of the pain situation of children and adolescents with cancer. They also disclose possibilities, such as the composition of fixed teams, integrated in an interdisciplinary service, and family involvement in care. Results also indicate the need to distinguish between multiple professional focuses and to establish a care unit that allows for the articulation of these focuses, so as to attend to the multiple pain dimensions of children and adolescents with cancer. With a view to the practicability of this care unit, we highlight the need for articulation between all professionals involved in care for pain situations in hospitalized children and adolescents with cancer, through a common and jointly constructed project.

The aim of this study was to provide a short German self-report measurement, assessing subjective CRCI for a broad variety of cancer survivors. For this purpose, the AFI (Attentional Function Index) was translated into German and psychometric properties have been presented in the following publication among a sample of 1312 haematological cancer survivors. In the resulting article the factorial structure of the German translation of the AFI, the internal consistency among the total score and each subscale, construct validity and the associations of the AFI sum score with medical and socio-demographic variables are provided. Comparisons to the English version are additionally drawn. With the validated AFI, researchers and clinicians in German-speaking countries may now have new tool to assess, and thus improve an important component of QoL in cancer survivors [38].