Bakgrund: I Sverige dog cirka 90 000 människor 2018 varav 25 procent avdödsfallen rörde sig om tumörsjukdomar enligt Socialstyrelsen. De psykosocialakonsekvenserna av att drabbas av cancer kan vara lika allvarliga som de fysiskaoch kan påverka den upplevda livskvaliteten. Inom det salutogena forskningsfältetsöker man förklaringar till hur hälsan kan stärkas genom att göra livet begripligt,hanterbart och meningsfullt. Syfte: sammanställa tidigare forskning om vilkenbetydelse känsla av sammanhang kan ha för upplevelsen av livskvaliteten hospatienter med cancer. Metod: Resultat: Fyra kategorier har identifierats. Underbegriplighet identifierades anpassad information kan förbättra livskvalitet.Information skapar förståelse för sin sjukdom vilket leder till att deltagarna lättarekan fatta egna beslut vilket kan bidra till upplevelse av god livskvalitet. Underbegreppet hanterbarhet identifierades att acceptera sin livskvalitet och försökaleva som vanligt. Genom att acceptera sin livssituation, ha fritidsintressen ochupprätthålla dagliga rutiner kan människan uppleva välbefinnande trots sinsjukdom. Under meningsfullhet identifierades relationer och delaktighet samtexistentiella tankar om liv och död. Konklusion: Känsla av sammanhang harbetydelse för deltagarnas upplevelse av livskvalitet, det som har visat sig vara avstörst betydelse är att ha nära relationer till andra. I vilken fas av sin sjukdomdeltagarna befann sig, verkade inte vara avgörande för vilken livskvalitetdeltagarna upplevde. / Background: In Sweden approximately 90 000 people died in 2018 and 25 percentof the deaths were tumor diseases according to the National Board of Health andWelfare. The psychosocial consequences of suffering from cancer can be asserious as the physical ones and can affect the quality of life. Within thesalutogenic field of research, one seeks explanations for how health can bestrengthened by making life understandable, manageable and meaningful. Aim: Tocompile and investigate what significance sense of coherence can have for thequality of life of patients with cancer. Method: A systematic literature review thathas compiled ten scientific studies with a qualitative approach has been executed.The articles have been read on the basis of Aaron Antonovsky's theory of sense ofcoherence. The contents of the articles are categorized based on the concepts ofcomprehensibility, manageability and meaningfulness. Result: Four categorieshave been identified: Within comprehensibility customized information canimprove the quality of life were identified. Information increases theunderstanding of the situation which in its turn can lead to a sense of good qualityof life. Within manageability accepting their quality of life and try to live as usualwere identified. By accepting one's life situation, having leisure interests, andmaintaining daily routines, one can experience well-being despite his/her illness.Under meaningfulness, the categories relationships, participation and existentialthought about life and death were identified. Having close and deep relationshipsturned out to give a meaningful life. Hoping, believing and planning ahead isimportant and increases the quality of life for the participants. Conclusion: Whathas proven to be the most importance in maintaining quality of life is to haveclose relationships with others. The participants were at different stages of theirillness, although it did not seem to determine what quality of life theyexperienced.

The aim of the thesis is to describe and analyse how a group of women experience that their every-day lives are affected during and after primary breast cancer treatment. The thesis is a consecutive, longitudinal study that takes an explorative qualitative approach. Seventy-one women younger than 60 years of age with primary breast cancer were consecutively included in the study. The women were interviewed four or five times over a period of 4 to 6 years from end of radiotherapy. The analyses of the interviews were inspired by grounded theory and narrative analysis.  The thesis encompasses four papers. Paper I focused on the women’s contact with health care. The results of this study indicate that it is crucial for patients in a vulnerable situation to be admitted into a supportive system – ‘admitted into a helping plan’ – that, more or less explicitly, displays a well-thought-out plan of care. This is a process built on individual relationships with members of the health-care staff, but it ends up in a relationship to health care as a helping system, a ‘safe haven’ to attach to. Study II explored the women’s ideas about what motivated and discouraged their return to work. The results illustrate that the meaning of work fluctuates over time and that the processes of returning to work are conditioned by the patients’ individual life situations. Returning to work was regarded as an important part of the healing process because of how it generated and structured the women’s everyday lives. Returning to work meant demonstrating well-being and normalcy after breast cancer. Study III examined how life was lived and valued during and after treatment for breast cancer compared to pre-cancer life. The analysis showed that being afflicted with breast cancer was evaluated from a context of the women’s former everyday lives and stressed that how the women experienced breast cancer was a matter of personal circumstances. Study IV focused on how the women experienced and dealt with their altered bodies. The results showed that the women followed three different body-mind trajectories that depended to a significant extent on the severity of side effects and bodily alterations that resulted from their treatments. Being afflicted by breast cancer implies vulnerability and losses, but it can also involve benefits and provide new perspectives on life. How the overall breast cancer experience is valued seems to be very much a matter of circumstances in everyday life. This thesis highlights circumstances that focus in particular on contacts with health care, the body, the work situation, and the family situation.