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  • 1. Bondesson, Tina
    et al.
    Petersson, Lena-Marie
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Alexanderson, Kristina
    Kjeldgård, Linnea
    Nilsson, Marie I
    A study to examine the influence of health professionals' advice and support on work capacity and sick leave after breast cancer surgery2016In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 24, no 10, p. 4141-4148Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim of this study was to investigate how women, shortly after breast cancer surgery, experienced encounters with, and information from, healthcare professionals regarding work and sick leave and if these experiences were associated with self-reported work capacity and sick leave.

    METHODS: This is a cross-sectional study based on questionnaire data from 605 women who had had breast cancer surgery, aged 20-63 years. Exclusion criteria were known distant metastases, pre surgical therapy, and/or previous breast cancer. Data on age, type of surgery, global health, and work environment were included as covariates in multivariable logistic regression analysis.

    RESULTS: Five percent of the women had not received any advice concerning work or sick leave. Women reporting receiving useful advice or support related to paid work had lower risk of reporting reduced physical or psychological/social work capacity due to the cancer or treatment (OR 0.46 (95 % CI 0.26-0.81) respective OR 0.45 (95 % CI 0.26-0.77)). There were no associations between having received useful advice or support concerning work and being on sick leave. Women encouraged to take sick leave had an OR of 2.17 (95 % CI 1.39-3.37) of being sickness absent. They also to a higher extent had reduced physical and psychological/social work capacity. Women who reported to have been encouraged to work were sickness absent to a lower extent (OR 0.64; 95 % CI 0.41-0.98) and reported higher physical work capacity.

    CONCLUSIONS: Work and sick leave is being discussed during consultations with women with breast cancer and the advice given seems to be in line with the women's subjective work capacity.

  • 2. Bränström, Richard
    et al.
    Petersson, Lena-Marie
    Saboonchi, Fredrik
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Alexanderson, Kristina
    Physical activity following a breast cancer diagnosis: Implications for self-rated health and cancer-related symptoms2015In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 19, no 6, p. 680-5Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Studies have consistently shown an association between physical activity and increased health and well-being after a cancer diagnosis. Nevertheless, large proportions of breast cancer survivors do not meet recommended levels of physical activity. The aim of this study was to describe physical activity levels during the first two years after being diagnosed with breast cancer, and to explore the predictive ability of physical inactivity on longer-term self-rated health, physical symptoms, and psychological distress.

    METHOD: Study participants were women recently having had a first breast cancer surgery at one of the three main hospitals in Stockholm between 2007 and 2009. A total of 726 women were included and responded to six questionnaire assessments during the 24 months following diagnosis.

    RESULTS: Less than one third of the participants were sufficiently physically active at baseline. Physical activity decreased after surgery, increased at 8 month follow-up, and subsequently decreased slightly during the subsequent follow-up period. Physical inactivity was related to reduced health, increased symptoms such as pain, depression, and anxiety.

    CONCLUSION: This study provides additional support for the beneficial consequences of being physically active after a breast cancer diagnosis and highlights a potential target for intervention. This study provides additional support showing that being physically active even at a very low level seems to result in health benefits. Physical activity should be encouraged among patients treated for breast cancer.

  • 3. Carlsson, Christina
    et al.
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Ideellt engagemang och närståendes insatser2014In: Omvårdnadens grunder: ansvar och utveckling, Lund: Studentlitteratur AB, 2014, 2, p. 197-223Chapter in book (Other academic)
  • 4. Carlsson, Christina
    et al.
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Ideellt engagemang och närståendes insatser2019In: Omvårdnadens grunder: Ansvar och utveckling / [ed] Anna Ehrenberg & Lars Wallin, Lund: Studentlitteratur AB, 2019, 3, p. 153-177Chapter in book (Other academic)
  • 5.
    Doveson, Sandra
    et al.
    Sophiahemmet University.
    Fransson, Per
    Axelsson, Lena
    Sophiahemmet University.
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Associations between experiences of treatment decision-making and treatment experiences during the first year of life-prolonging treatment among men with metastatic castration-resistant prostate cancerManuscript (preprint) (Other academic)
  • 6.
    Doveson, Sandra
    et al.
    Sophiahemmet University.
    Holm, Maja
    Sophiahemmet University.
    Axelsson, Lena
    Sophiahemmet University.
    Fransson, Per
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Facing life-prolonging treatment: The perspectives of men with advanced metastatic prostate cancer2021Conference paper (Other academic)
  • 7.
    Doveson, Sandra
    et al.
    Sophiahemmet University.
    Holm, Maja
    Sophiahemmet University.
    Axelsson, Lena
    Sophiahemmet University.
    Fransson, Per
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Facing life-prolonging treatment: The perspectives of men with advanced metastatic prostate cancer - An interview study2020In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 49, article id 101859Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Several life-prolonging treatment options have recently become available for metastatic castration-resistant prostate cancer. However, research regarding patient experiences while undergoing these treatments is scarce. The aim was to explore the perspectives of men when facing life-prolonging treatment of metastatic castration-resistant prostate cancer.

    METHOD: Qualitative interviews were conducted with 16 men as they were starting, undergoing or had completed their first life-prolonging treatment. Interpretive description was used for analysis.

    RESULTS: The results illuminate the complexity of facing life-prolonging treatment, with interlaced dimensions beyond just the outcome, and where the men described other dimensions of their lives in relation to the treatment. The results are presented as 4 themes; Considering treatment when the remainder of life is at stake, Preparing for the life-prolonging treatment after deciding to go through with it, Considering the prospect of the life-prolonging treatment not being successful and Reflecting on death and dying in the light of a life-limiting illness.

    CONCLUSIONS: The quality and content of the remainder of life are central for men when facing life-prolonging treatment of metastatic castration-resistant prostate cancer. This is important when weighing desired treatment outcomes against side effects, and when reflecting upon whether going through with treatment would be worth it or not. The results illuminate the importance of encouraging men at this stage to express expectations, hopes and fears regarding the treatment and the future when considering life-prolonging treatments. Nurses working with these patients are important in the decision-making process and in evaluating treatments, to detect needs for interventions.

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  • 8.
    Doveson, Sandra
    et al.
    Sophiahemmet University.
    Holm, Maja
    Sophiahemmet University.
    Fransson, Per
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    A matched comparision of symptoms, quality of life and functioning between men with prostate cancer with and without metastases: A long-term follow-up2021Conference paper (Other academic)
  • 9.
    Doveson, Sandra
    et al.
    Sophiahemmet University.
    Holm, Maja
    Sophiahemmet University.
    Fransson, Per
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Identification of early symptoms and changes in QoL and functioning among men with primary localized prostate cancer who later develop metastases: A matched, prospective study2022In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To identify early symptoms and changes in QoL among men with primary localized prostate cancer (PC) who later develop metastases.

    METHODS: From an ongoing prospective study of 3.885 men with localized PC, primarily treated with radiotherapy (RT), a subsample of men developing metastatic PC (mPC) following the first year after the start of RT and that had died during the follow-up (mPC group, n = 107) were matched against men who did not develop metastases (non-mPC group, n = 214). Data were collected using the EORTC QLQ-C30 and PCSS instruments. Non-parametric tests were performed for comparisons at baseline, end of RT, 3 months, and 1, 2, 3, and 5 years after RT.

    RESULTS: The final sample consists of 317 men (mPC n = 106; non-mPC n = 211) who had completed at least one questionnaire. Initially, symptom levels were generally low and QoL and functioning high in both groups. An increasing difference between the groups was found, where the mPC group gradually deteriorated from the 2-year follow-up. Significant differences were found for several outcomes at 3 and 5 years. In a sensitivity analysis, where metastatic patients were removed from the time-point of verified metastases, most differences did not remain significant. Significant deterioration over time was seen within both groups for some outcomes.

    SIGNIFICANCE OF RESULTS: The results indicate that unmet supportive needs occur over time among these men. Worsening QoL or functioning and symptoms may be difficult to recognize when the development is gradual over several years, and with various access to systematic follow-up in late phases. This highlights the need for continuous monitoring of PC patients to detect needs for supportive interventions early and throughout the disease course, also among those with non-metastatic disease who have undergone curatively intended treatment.

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  • 10.
    Doveson, Sandra
    et al.
    Sophiahemmet University.
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Fransson, Per
    Axelsson, Lena
    Sophiahemmet University.
    Men's experiences related to decision-making in life-prolonging treatments of metastatic castration-resistant prostate cancer: A wish for a process adapted to personal preferences: A prospective interview studyManuscript (preprint) (Other academic)
  • 11.
    Doveson, Sandra
    et al.
    Sophiahemmet University.
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Fransson, Per
    Axelsson, Lena
    Sophiahemmet University.
    Mäns erfarenheter av beslutsfattande om livsförlängande behandlingarvid obotlig, avancerad prostatacancer: En önskan om en personligt anpassad process2022Conference paper (Other academic)
  • 12. Eriksson, L
    et al.
    Bergkvist, Karin
    Sophiahemmet University.
    Ljungman, P
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Winterling, J
    Sick leave after allogeneic stem cell transplantation and its association with life satisfaction2018Conference paper (Other academic)
  • 13. Eriksson, Linda
    et al.
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Bergkvist, Karin
    Sophiahemmet University.
    Ljungman, Per
    Winterling, Jeanette
    Important factors associated with sick leave after allogeneic haematopoietic stem cell transplantation: A 1-year prospective study2021In: Journal of cancer survivorship, ISSN 1932-2259, E-ISSN 1932-2267, Vol. 15, no 6, p. 933-941Article in journal (Refereed)
    Abstract [en]

    PURPOSE: This study examines sick leave (SL) and factors associated with full-time SL 1 year after allogeneic haematopoietic stem cell transplantation (allo-HSCT) in patients of working age from 2009 to 2016 (n = 122).

    METHODS: Questionnaire data were collected on admission to the allo-HSCT unit, at 7 months and 1 year after allo-HSCT. Associations between factors and SL were analysed using logistic regression analyses.

    RESULTS: One year after allo-HSCT, 76% of participants were on SL, with 36% on full-time SL. In univariable analyses, chronic graft-versus-host-disease (cGvHD) (OR 3.07; 95% CI 1.34-7.07; p = 0.01), having symptoms of depression at 7 months (OR 4.81; 95% CI 1.69-13.69; p = 0.00) and low levels of vocational satisfaction at 7 months after treatment (OR 3.27; 95% CI 1.27-8.41; p = 0.01) were associated with full-time SL 1 year after allo-HSCT. cGvHD (OR 3.43; 95% CI 1.35-8.73; p = 0.01) and having symptoms of depression at 7 months after allo-HSCT (OR 3.37; 95% CI 1.2-11.58; p = 0.02) remained significant in multivariable analysis.

    CONCLUSION: The majority of allo-HSCT survivors were on SL 1 year after treatment, and cGvHD, low vocational satisfaction and depressive symptoms were associated with full-time SL 1 year after allo-HSCT.

    IMPLICATIONS FOR CANCER SURVIVORS: Healthcare professionals need to be observant of and manage the consequences of cGvHD and patients' symptoms of depression in order to support them appropriately in their return-to-work process.

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  • 14.
    Holm, Maja
    et al.
    Sophiahemmet University.
    Doveson, Sandra
    Sophiahemmet University.
    Lindqvist, Olav
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Fransson, Per
    Quality of life in men with metastatic prostate cancer in their final years before death: a retrospective analysis of prospective data2018In: BMC Palliative Care, E-ISSN 1472-684X, Vol. 17, no 1, article id 126Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Quality of Life (QoL) is the most important outcome for patients in palliative care along with symptom alleviation. Metastatic prostate cancer (mPC) is a life-threatening illness, and hence, a palliative care approach may be beneficial to this group. Over time, new life-prolonging treatments have been developed for men with mPC, but the possibility to prolong life should also be balanced against the men's QoL, particularly because there are side effects involved with these treatments. The aim of this study was to evaluate QoL, functioning and symptoms in men with mPC during their final years before death.

    METHODS: This is a retrospective analysis of data from a long-term prospective study of men (n = 3885) with prostate cancer from two regions in Sweden. Validated questionnaires asking about participants' QoL, functioning and symptoms were used to collect data. From the overall study, 190 men with mPC were identified. They were stratified into three groups, depending on the amount of time that had passed between the last questionnaire and their death; < 6 months, 6-18 months and > 18 months before death.

    RESULTS: Men with mPC generally rated their QoL poorly compared to established clinically significant threshold values. The group of men that were < 6 months before death rated their QoL, functioning and several symptoms significantly worse than the two other groups. Men that died after the year 2006 reported lower QoL and functioning and more pain and fatigue than those who died before 2006.

    CONCLUSION: The results in this study indicate that men with mPC have unmet needs with regards to QoL and symptoms. A palliative care approach, alongside possible life-prolonging treatments, that focuses on QoL and symptom relief, may serve as an important frame to give the best support to these men in their final years of life.

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  • 15. Jakobsson, Sofie
    et al.
    Alexanderson, Kristina
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Taft, Charles
    Ringsberg, Karin C
    Self-rated health over a two-year period after breast cancer surgery: prospective ratings and retrospective rating by means of a health-line2020In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: There are difficulties in clinical assessment of patients' health, and there is a need for evaluating instruments that measures self-rated health over time and that are based on the patient's own experiences of their health situation.

    AIM: To describe the trajectory of self-rated health given in a retrospective health-line and its correspondence with the ratings of health given at six different time points during 2 years following a first breast cancer surgery.

    DESIGNS AND METHODS: An explorative prospective cohort study presented according to the STROBE guideline. At six time points, 459 women (26-63 years) completed assessments of self-rated health during 2 years following a first breast cancer surgery. Subsequently, the women retrospectively rated health month by month over the two years by means of a health-line. The women were included consecutively in 2007-2009, last data collection was performed in 2012. Statistical analyses were used to compare the health-line with previous ratings.

    RESULTS: Most women (74-88%) rated their health as good, very good or excellent at all six time points. Health-line ratings were somewhat lower than the ratings made at the actual time-point; however, the illustrated trajectories back in time followed the same patterns as the women had reported during the two years. The lowest ratings of self-rated health were reported at four months after surgery. The retrospective illustrations varied greatly, and poorer health was reported by women undergoing chemotherapy, with lower education and who reported more life events.

    CONCLUSIONS: Even if the retrospective ratings by the health-line were somewhat lower than the ratings at the actual time-point, the health-line captures the health trajectory. The individual graphic illustration by means of a health-line may serve as a basis for assessment and support patient health narratives. The findings indicate that life event, lower education and chemotherapy influence concurrent and retrospective self-assessment of health.

  • 16. Nilsson, Marie I
    et al.
    Petersson, Lena-Marie
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Olsson, Mariann
    Vaez, Marjan
    Alexanderson, Kristina
    Adjustment and social support at work early after breast cancer surgery and its associations with sickness absence2013In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 22, no 12, p. 2755-62Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: As half of the women with breast cancer are of working ages and usually survive, knowledge is needed on how to support them early regarding work-related problems caused by treatments. Most previous studies have focused on individual and disease-related factors, whereas few have focused on work-related factors such as work adjustment and social support. The aim of this study was to investigate received and perceived social support from supervisor and colleagues as well as work adjustments, and their associations with sickness absence, among women who recently had had breast cancer surgery.

    METHOD: Inclusion criteria were as follows: women aged 20-63 years, living in Stockholm County, treated surgically for a first diagnosis of breast cancer, literate in Swedish, without pre-surgical chemotherapy or known distant metastases. Included in the study were 605 women who worked at diagnosis and that had answered a questionnaire within eight weeks of inclusion. Descriptive statistics, univariate, and multivariable logistic regression analyses were applied to estimate odds ratios (OR) with 95% confidence intervals (CI) for the likelihood of being sickness absent.

    RESULTS: Most women perceived and received social support and work adjustment after breast cancer surgery. Low adjustment (OR = 2.14; 95% CI, 1.45-3.18) and less social support (OR = 1.80; 95% CI, 1.16-2.78) were significantly associated with being sickness absent. Adjusting for sociodemographics, strenuous work posture, and treatment did not attenuate these associations.

    CONCLUSION: Adjustment at work and social support from employer are associated with sickness absence and needs to be explored in discussions on return to work after breast cancer surgery. Copyright © 2013 John Wiley & Sons, Ltd.

  • 17. Nilsson, Marie I
    et al.
    Saboonchi, Fredrik
    Alexanderson, Kristina
    Olsson, Mariann
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Petersson, Lena-Marie
    Changes in importance of work and vocational satisfaction during the 2 years after breast cancer surgery and factors associated with this2016In: Journal of cancer survivorship, ISSN 1932-2259, E-ISSN 1932-2267, Vol. 10, no 3, p. 564-572Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The purpose of this study is to investigate how women, during the 2 years following breast cancer surgery, rate importance of work and vocational satisfaction, and baseline factors associated with rating over time.

    METHODS: A prospective cohort study of 692 women aged 20-63 included about 4 weeks after a first breast cancer surgery. Register data on treatment and data from six repeated questionnaires during a 2-year follow-up (at baseline, 4, 8, 12, 18, 24 months) were used in two-way mixed repeated analysis of variance and mixed repeated measures analysis of covariance.

    RESULTS: The women rated importance of work (m = 3.74; sd 0.88) (maximum 5) and vocational satisfaction (m = 4.30; sd 1.38) (maximum 6) high during the 2 years. Women with planned chemotherapy rated lower vocational satisfaction and especially so at 4 months after inclusion (F 1, 498 = 8.20; p = 0.004). Higher age, better physical, and mental/social work ability at baseline influenced rating of vocational satisfaction. Supportive colleagues was an important covariate that significantly affected ratings of importance of work as well as vocational satisfaction, i.e., women with better support rated on average higher on these outcomes. The effect of chemotherapy disappeared after including the abovementioned baseline covariates.

    CONCLUSIONS: Women diagnosed with breast cancer in the following 2 years rate importance of work and vocational satisfaction high, which are associated to lower work ability and social support.

    IMPLICATIONS FOR CANCER SURVIVORS: Work is a very important aspect in life also after a cancer diagnosis, which has to be acknowledged when discussing treatment and rehabilitation plans with women with breast cancer. Furthermore, workplace support needs to be assessed as this is an influential factor.

  • 18. Olsson, M
    et al.
    Nilsson, M
    Fugl-Meyer, K
    Petersson, LM
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Kjeldgård, L
    Alexanderson, K
    Life satisfaction of women of working age shortly after breast cancer surgery2017In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 26, no 3, p. 673-684Article in journal (Refereed)
    Abstract [en]

    PURPOSE:

    To explore, among women of working age, satisfaction with life as a whole and with different life domains, and its associations with social and health variables, shortly after breast cancer surgery.

    METHODS:

    This cross-sectional study included 605 women, aged 20-63 years, who had had breast cancer surgery with no distant metastasis, pre-surgical chemotherapy, or previous breast cancer. Associations between LiSat-11 and demographic and social factors as well as health- and treatment-related variables were analysed by multivariable logistic regression.

    RESULTS:

    Compared with Swedish reference levels, the women were, after breast cancer surgery, less satisfied with life, particularly sexual life. Women working shortly after breast cancer surgery were more often satisfied with life in provision domains compared with the reference population. Although most included variables showed associations with satisfaction, after adjustment for all significantly associated variables, only six variables-having children, being in work, having emotional and informational social support, and having good physical and emotional functioning-were positively associated with satisfaction with life as a whole. The odds ratios for satisfaction were higher in most life domains if the woman had social support and good emotional and cognitive functioning.

    CONCLUSIONS:

    One month after breast cancer surgery, satisfaction with different life domains was associated primarily with social support and health-related functioning. However, this soon after surgery, treatment-related variables showed no significant associations with life satisfaction. These results are useful for planning interventions to enhance e.g. social support and emotional as well as cognitive functioning.

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  • 19. Petersson, Lena-Marie
    et al.
    Vaez, Marjan
    Nilsson, Marie I
    Saboonchi, Fredrik
    Alexanderson, Kristina
    Olsson, Mariann
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Sickness absence following breast cancer surgery: a two-year follow-up cohort study2018In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 2, p. 715-724Article in journal (Refereed)
    Abstract [en]

    RATIONALE AND AIM: Most women of working ages with limited breast cancer (BC) have returned to work within the first year after diagnosis. However, little is known about what is happening during this year regarding sickness absence and return to work. Also, the knowledge is very limited about the occurrence of part-time sickness absence after BC diagnosis. Therefore, the aim of this study was to describe occurrence, extent and length of SA during a two-year follow-up after BC surgery and to analyse the association between being SA and type of cancer treatment.

    METHODS: In this prospective cohort study, 497 women responded to questionnaires about different aspects of sickness absence at six occasions during two years after primary BC surgery (at baseline and after 4, 8, 12, 18 and 24 months). Treatment information was obtained from the National breast cancer register. Multinomial logistic regression was used to calculate odds ratios (OR) for likelihood of being sickness absent more than once.

    RESULTS: Two-thirds of the women were sickness absent at baseline; this proportion decreased, especially during the first eight months. At 24 months, 13% were sickness absent. Of all women, 27% never reported sickness absence and 14% were sickness absent at most of the six survey times. At eight months, many had shifted from full- to part-time sickness absence. Women with chemotherapy and/or advanced BC surgery had higher ORs for being sickness absent at most of the follow-ups.

    CONCLUSIONS: Most women returned to work within the first eight months after BC surgery and of those sickness absent after that, most had been part-time sickness absent. Thus, it is important to differentiate between part- and full-time sickness absence in future studies. Special attention should be paid to the impact of chemotherapy and type of surgery on the likelihood of being sickness absent.

  • 20. Rönningås, Ulrika
    et al.
    Fransson, Per
    Holm, Maja
    Sophiahemmet University.
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Prostate-specific antigen (PSA) and distress: a cross-sectional nationwide survey in men with prostate cancer in Sweden2019In: BMC Urology, E-ISSN 1471-2490, Vol. 19, no 1, article id 66Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The prostate-specific antigen (PSA) -value is often used during the prostate cancer trajectory as a marker of progression or response to treatment. Concerns about PSA-values are often expressed by patients in clinical situations. Today there is a lack of larger studies that have investigated the association between PSA-value and distress. The aim was to investigate the association between PSA-values and distress adjusted for sociodemographic factors, hormonal therapy and quality of life (QoL), among men with prostate cancer.

    METHODS: In this cross-sectional survey of 3165 men with prostate cancer, members of the Swedish Prostate Cancer Federation, answered questions about sociodemographic factors, PSA, distress, QoL and treatments. Descriptive statistics, and bivariate and multivariable analyses were performed. The result was presented based on four PSA-value groups: 0-19, 20-99, 100-999, and ≥ 1000 ng/ml.

    RESULTS: Of the men, 53% experienced distress. An association between distress and PSA-values was found where higher PSA-values were associated with higher OR:s for experiencing distress in the different PSA-groups: 0-19 ng/ml (ref 1), 20-99 ng/ml (OR 1.25, 95% CI 1.01-1.55), 100-999 ng/ml (OR 1.47, 95% CI 1.12-1.94), ≥1000 ng/ml (OR 1.77, 95% CI 1.11-2.85). These associations were adjusted for sociodemographic factors and hormonal therapy. In the multivariable analyses, beside PSA-values, higher levels of distress were associated with being without partner or hormonal therapy. When adding QoL in the multivariable analysis, the association between PSA and distress did not remain significant.

    CONCLUSION: These results indicate that the PSA-values are associated with distress, especially for those with higher values. However, to be able to support these men, continued research is needed to gain more knowledge about the mechanisms behind the association between emotional distress and PSA-values.

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  • 21. Rönningås, Ulrika
    et al.
    Holm, Maja
    Sophiahemmet University.
    Doveson, Sandra
    Sophiahemmet University.
    Fransson, Per
    Beckman, Lars
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Signs and symptoms in relation to progression, experiences of an uncertain illness situation in men with metastatic castration-resistant prostate cancer: A qualitative study2022In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 31, no 4, article id e13592Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Signs and symptoms are important in monitoring prostate cancer, but there is a lack of understanding about the men's interpretation of signs and symptoms in relation to disease progression in advanced phases of the disease. The aim was to illuminate the experience of signs and symptoms in relation to disease progression in men with metastatic castration-resistant prostate cancer (mCRPC).

    METHOD: Thirty longitudinal interviews were conducted with 11 men undergoing life-prolonging treatment for mCRPC. Conventional content analysis was used.

    RESULTS: The results illuminate an uncertainty that the men experience when interpreting signs and symptoms. The overarching theme was The experience of an uncertain illness situation within the framework of progression, with four subthemes: Symptoms triggering thoughts about disease progression; Making sense of signs, also in the absence of symptoms; Making sense of symptoms during treatment; Progression triggering thoughts about the remainder of life.

    CONCLUSION: In the uncertain illness situation, the men strive to make sense of signs and symptoms based on previous experiences and in relation to disease progression. Understanding the men's perspectives on signs and symptoms in this late phase may help health care professionals communicate about disease progression considering the balance between treatment outcome and quality of life.

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  • 22. Saboonchi, Fredrik
    et al.
    Petersson, Lena-Marie
    Alexanderson, Kristina
    Bränström, Richard
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Expecting the best and being prepared for the worst: structure, profiles, and 2-year temporal stability of dispositional optimism in women with breast cancer2016In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 25, no 8, p. 957-963Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Dispositional optimism is viewed as a key personality resource for resiliency and has been linked to adjustment among women with breast cancer. The aim was to examine (a) the psychometric proprieties of Life Orientation Test-Revised (LOT-R), (b) the potential independence and co-occurrence of positive and negative dimensions of future outcome expectancies, (c) the longitudinal invariance of LOT-R and the temporal stability of dispositional optimism over 2 years following surgery, and (d) the predictive impact of optimism and pessimism on emotional distress among women with breast cancer.

    METHODS: Data from a prospective study (n = 750) of women with breast cancer were acquired shortly after surgery, and the women were followed up for 2 years. Assessments of LOT-R, Hospital Anxiety and Depression Scale, treatment-related, and demographic variables were subjected to structural equation modeling analysis.

    RESULTS: A bidimensional and temporarily invariant structure of LOT-R displayed acceptable fit indices. Three profiles of future expectancies consisting of optimists, pessimists, and ambiguous were identified. Temporal stability in optimism and pessimism over 2 years was established. Women with higher education displayed higher degrees of pessimism. Baseline dispositional optimism inversely predicted emotional distress at 2 years.

    CONCLUSIONS: The LOT-R should be approached as a bidimensional measure. Co-occurrence of optimism and pessimism may indicate a cautious defensive coping effort in women with breast cancer. The importance of systematic efforts to enhance optimism as well as the capacity to acknowledge both positive and negative future expectancies is emphasized. Copyright © 2015 John Wiley & Sons, Ltd.

  • 23. Saboonchi, Fredrik
    et al.
    Petersson, Lena-Marie
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Alexanderson, Kristina
    Brännström, Richard
    Vaez, Marjan
    Changes in caseness of anxiety and depression in breast cancer patients during the first year following surgery: patterns of transiency and severity of the distress response2014In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 18, no 6, p. 598-604Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Psychological distress is prevalent in patients with breast cancer and is viewed as a non-pathological occurrence. Severe distress and mental disorder display a substantial overlap in both conceptual contexts and studies in oncological settings. A domain that may contribute to distinguishing non-pathological distress from signs of potential disorder is the transiency of distress.

    AIM: To examine the transiency of distress response in breast cancer patients by investigating the changes in clinical caseness of depression and anxiety during one year following surgery.

    METHODS: Data on the Hospital Anxiety and Depression Scale from a cohort of 715 women with breast cancer on three assessments within one year following breast surgery were subjected to Generalized Estimation Equation Analysis, McNemar's test, and logistic regression.

    RESULTS: There was a significant decrease in the proportions of anxiety cases from baseline (37.7%) to 4 months (26.7%) but no significant change from 4 to 12 months. Caseness in depression significantly increased from baseline (18.5%) to 4 months (21.5%) but decreased to 15.3% at 12 months. Only experience of major adverse life events contributed to 12 months caseness of anxiety and depression beyond baseline caseness.

    DISCUSSION: The average decrease in caseness of anxiety and depression a year following surgery lends support to the view of distress as a transient non-pathological response. A subgroup of patients, however, displayed enduring or recurrent severe distress indicating the presence of potential disorder. The findings emphasize the importance of screening and follow up monitoring of distress.

  • 24. Saboonchi, Fredrik
    et al.
    Petersson, Lena-Marie
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Alexanderson, Kristina
    Vaez, Marjan
    Trajectories of anxiety among women with breast cancer: A proxy for adjustment from acute to transitional survivorship2015In: Journal of psychosocial oncology, ISSN 0734-7332, E-ISSN 1540-7586, Vol. 33, no 6, p. 603-619Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Anxiety is one of the main components of distress among women with breast cancer (BC), particularly in the early stages of the disease. Changes in anxiety over time may reflect the process of adjustment or lack thereof. The process of adjustment in the traverse of acute to transitional stages of survivorship warrants further examination.

    AIM: To examine the trajectory of anxiety and the specific patterns that may indicate a lack of adjustment within two years following BC surgery.

    METHODS: Survey data from a two-year prospective cohort study of 725 women with BC were analyzed by Mixture Growth Modelling and logistic regression and analysis of variance.

    RESULTS: A piece wise growth curve displayed the best fit to the data, indicating a significant decrease in anxiety in the first year, followed by a slower rate of change during the second year. Four classes of trajectories were identified of which a High Stable anxiety class showed the most substantive indications of lack of adjustment. This subgroup was predominantly characterized by sociodemographic variables such as financial difficulties.

    CONCLUSION: Our results support an emphasize on the transitional nature of the stage that follows the end of primary active treatment, and imply a need for supportive follow up care for those who display lack of adjustment at this stage.

  • 25. Saboonchi, Fredrik
    et al.
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Alexanderson, Kristina
    Petersson, Lena-Marie
    Examination of the construct validity of the Swedish version of Hospital Anxiety and Depression Scale in breast cancer patients2013In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 22, no 10, p. 2849-2856Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To examine the construct validity of the Swedish version of Hospital Anxiety and Depression Scale (HAD) in women with breast cancer. METHOD: Acquired data on HAD from 727 women who recently had breast cancer surgery, were aged 20-63 years and worked before diagnosis, and had no previous breast cancer (n = 725) were subjected to confirmatory factor analysis examining the viability of three hypothesized measurement models. RESULTS: The analysis showed adequate fit to the data for both bi-dimensional and three-factorial models of HAD. The single-factorial model, however, was shown to have inferior fit to the data. Substantive correlations were found between anxiety and depression in the bi-dimensional model, and negative affectivity and anxiety in the three-factorial model of HAD. CONCLUSIONS: The findings support the utility of scoring procedure based on the original bi-dimensional model, but add indication of co-occurrence of anxiety and depression in this patient population. The discriminant validity of a third factor of negative affectivity in a three-factorial model, however, remains unclear.

  • 26. Söderman, M
    et al.
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Alexanderson, K
    Friberg, E
    Experiences of positive encounters with healthcare professionals among women on long-term sickness absence due to breast cancer or due to other diagnoses: A nationwide survey2019In: BMC Public Health, E-ISSN 1471-2458, Vol. 19, no 1, article id 349Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Experiences of encounters with professionals have been shown to influence return to work (RTW) among sickness absentees in general. The aim was to gain knowledge on experiences of encounters with healthcare professionals and the ability to RTW among women on long-term sickness absence (SA) due to breast cancer (BC) compared to among women on long-term SA due to other diagnoses.

    METHODS: Analyses of questionnaire data about experiences of encounters with healthcare professionals among 6197 women aged 19-65 years and on a SA spell lasting 4-8 months. Of those, 187 were on SA due to BC. Descriptive statistics and adjusted (for age, birth country, educational level, depressive symptoms) logistic regression analyses with 95% confidence intervals (CI) were conducted.

    RESULTS: About 95% in both groups of women stated that they had experienced positive encounters with healthcare, and a minority, about 20%, had experienced negative encounters. Four specific types of positive encounters had been experienced to a lesser extent by women with BC: "allowed me to take own responsibility" (odds ratio (OR) 0.6; 95% CI 0.4-0.8), "encouraged me to carry through my own solutions" (OR 0.5; 95% CI 0.4-0.7), "made reasonably high demands" (OR 0.6; 95% CI 0.4-0.9), and "sided with me/stood on my side" (OR 0.6; 95% CI 0.4-0.8). Among the women with BC, 46% stated that positive encounters promoted their ability to RTW compared to 56% among the others.

    CONCLUSION: Most of the women had experienced positive encounters and about half stated that positive encounters promoted their ability to RTW, although a slightly smaller proportion of the women with BC stated that. This study emphasizes that not only medical treatment but also encounters may influence the ability to RTW, something that is of clinical importance.

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  • 27. Söderman, M
    et al.
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Alexanderson, K
    Friberg, E
    Positive encounters with healthcare among women sickness absent with breast cancer or with other diagnoses2017Conference paper (Other academic)
  • 28. Söderman, M
    et al.
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Hoving, J L
    Alexanderson, K
    Friberg, E
    Interventions regarding physicians' sickness certification practice: A systematic literature review with meta-analyses2022In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 40, no 1, p. 104-114Article, review/survey (Refereed)
    Abstract [en]

    OBJECTIVE: A variety of interventions aiming to influence physicians' sickness certification practice have been conducted, most are, however, not evaluated scientifically. The aim of this systematic literature review was to obtain updated knowledge about interventions regarding physicians' sickness certification practice and to summarize their possible effects, in terms of sickness absence (SA) or return to work (RTW) among patients.

    METHODS: We searched PubMed and Web of Science up through 15 June 2020 and selected peer-reviewed studies that reported effects of controlled interventions that aimed to improve physicians' sickness certification practice and used SA or RTW among patients as outcome measures. Meta-analyses were conducted using random-effect models.

    RESULTS: Of the 1399 identified publications, 12 studies covering 9 interventions were assessed as relevant and included in the review. Most (70%) were from the Netherlands, two had a controlled, and seven a randomized controlled study design. All interventions included some type of training of physicians, and two interventions also included IT-support. Regarding the outcomes of SA/RTW, 30 different effect measures were used. In the meta-analyses, no statistically significant effect in favor of the interventions was observed for having any RTW (i.e. first, partial, or full) nor full RTW.

    CONCLUSIONS: The individual studies showed that physicians' sickness certification practice might be influenced by interventions in both the intended and non-intended direction, however, no statistically significant effect was indicated by the meta-analysis. The included studies varied considerably concerning intervention content and effect measures.KEY POINTSThe knowledge is very limited regarding the content of interventions directed to physician's sickness certification practiceThe identified interventions included some type of training of physicians, and some of them also included IT-support for physiciansThere was a great heterogeneity among the interventions concerning effect measures used regarding return to work among patientsThe individual studies showed that physicians' sickness certification practice might be influenced by interventions in both intended and non-intended directions, however, the overall meta-analysis did not indicate an effect.

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  • 29. Söderman, Mirkka
    et al.
    Friberg, E
    Alexanderson, K
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Women's experiences of encounters with healthcare professionals' regarding work after breast-cancer surgery and associations with sickness absence: a 2-year follow-up cohort study2019In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 27, no 4, p. 1197-1206Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Breast cancer (BC) is the most common cancer among women, and half of those diagnosed are of working age. Positive encounters regarding work from healthcare professionals have been shown to promote return to work among sickness absentees in general. However, the knowledge about encounters possible associations with sickness absence (SA) in women with BC is scarce.

    AIM: To explore if women had experienced encounters regarding work from healthcare professionals during the first year after BC surgery and if this was associated with SA during the second year after surgery, controlled for treatment and sociodemographic effects.

    METHODS: A prospective cohort study of 690 Swedish women with primary BC, aged 24-63 years included after surgery. Descriptive statistics and adjusted logistic regression (age, birth country, education, self-rated health, treatment) with 95% confidence intervals (CI) were used.

    RESULTS: Eighty percent of the women had experienced encounters regarding work. Women who got advice and support regarding work (adjusted odds ratio (OR) 0.5; 0.3-0.9) or were encouraged to work (adjusted OR 0.6; 0.3-0.9) had less SA. A larger proportion of those encouraged to work had less advanced cancer, surgery, hormone, or radiotherapy. Consistently, women encouraged to be on SA had more SA, but this was partly explained by disease or treatment factors (crude OR 1.6; 1.1-2.4, adjusted OR 1.2 (0.8-1.9) since a larger proportion of those with more advanced cancer, surgery, or chemotherapy had more SA.

    CONCLUSION: Most women experienced encounters regarding work, and the nature of these encounters were associated with SA 2 years after BC surgery.

  • 30. Söderman, Mirkka
    et al.
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Alexanderson, Kristina
    Svärd, Veronica
    Friberg, Emilie
    Oncologists' experiences of and prerequisites for sickness certification tasks: A nationwide questionnaire study2021In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 30, no 4, article id e13414Article in journal (Refereed)
    Abstract [en]

    Oncologists frequently have sickness certification (SC) consultations, however, little is known about their experiences of such tasks.

    OBJECTIVE: To investigate oncologists' experiences of organisational prerequisites for SC tasks, and if lack of resources was related to experiencing SC as problematic.

    METHOD: Questionnaire data from 342 oncologists in Sweden were used for descriptive statistics and to calculate odds ratios (OR) with 95% confidence intervals (CI).

    RESULTS: The majority (92.2%) had SC consultations weekly; 17.8% of the oncologists experienced such consultations as problematic weekly. About a third appreciated the national guidelines for SC (34.5%) and had joint routines/policies regarding SC at their clinic (29.7%). Experiencing SC consultations as problematic was associated with stating not having enough resources for such work (OR 3.47; 95% CI 1.92-6.25). Lack of resources was associated with: experiencing lack of competence in insurance medicine (3.34; 1.92-5.82), conflicts with patients regarding SC (4.22; 1.96-9.07), finding it problematic to manage the two roles as medical expert and as the patient's treating physician (3.31; 2.04-5.34), or to assess work capacity (2.28; 1.46-3.56).

    CONCLUSION: Although oncologists often had SC tasks, most did not experience them as problematic weekly. However, lack of resources for SC tasks was associated with experiencing SC as problematic.

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  • 31.
    Wallin, Jeanette
    et al.
    Sophiahemmet University.
    Jacobson, Stefan H
    Axelsson, Lena
    Sophiahemmet University.
    Lindberg, Jenny
    Persson, Carina I
    Stenberg, Jenny
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Discrepancy in responses to the surprise question between hemodialysis nurses and physicians, with focus on patient clinical characteristics: A comparative study2023In: Hemodialysis International, ISSN 1492-7535, E-ISSN 1542-4758, Vol. 27, no 4, p. 454-464Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: The surprise question (SQ) "Would I be surprised if this patient died within the next xx months" can be used by different professions to foresee the need of serious illness conversations in patients approaching end of life. However, little is known about the different perspectives of nurses and physicians in responses to the SQ and factors influencing their appraisals. The aim was to explore nurses' and physicians' responses to the SQ regarding patients on hemodialysis, and to investigate how these answers were associated with patient clinical characteristics.

    METHODS: This comparative cross-sectional study included 361 patients for whom 112 nurses and 15 physicians responded to the SQ regarding 6 and 12 months. Patient characteristics, performance status, and comorbidities were obtained. Cohen's kappa was used to analyze the interrater agreement between nurses and physicians in their responses to the SQ and multivariable logistic regression was applied to reveal the independent association to patient clinical characteristics.

    FINDINGS: Proportions of nurses and physicians responding to the SQ with "no, not surprised" was similar regarding 6 and 12 months. However, there was a substantial difference concerning which specific patient the nurses and physicians responded "no, not surprised", within 6 (κ = 0.366, p < 0.001, 95% CI = 0.288-0.474) and 12 months (κ = 0.379, p < 0.001, 95% CI = 0.281-0.477). There were also differences in the patient clinical characteristics associated with nurses' and physicians' responses to the SQ.

    DISCUSSION: Nurses and physicians have different perspectives in their appraisal when responding to the SQ for patients on hemodialysis. This may reinforce the need for communication and discussion between nurses and physicians to identify the need of serious illness conversations in patients approaching the end of life, in order to adapt hemodialysis care to patient preferences and needs.

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  • 32.
    Wallin, Jeanette
    et al.
    Sophiahemmet University.
    Jacobsson, Stefan H
    Axelsson, Lena
    Sophiahemmet University.
    Lindberg, Jenny
    Persson, Carina I
    Stenberg, Jenny
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Discrepancy of clinical appraisal between hemodialysis nurses' and physicians' responses to the surprise question2023Conference paper (Other academic)
  • 33.
    Wennman-Larsen, Agneta
    et al.
    Sophiahemmet University.
    Alexanderson, Kristina
    Olsson, Mariann
    Nilsson, Marie I
    Petersson, Lena-Marie
    Sickness absence in relation to breast and arm symptoms shortly after breast cancer surgery2013In: Breast, ISSN 0960-9776, E-ISSN 1532-3080, Vol. 22, no 5, p. 767-772Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To determine whether and, to what extent, breast and arm symptoms are associated with sick leave (SL) shortly after breast cancer (BC) surgery, and to investigate the associations of these symptoms and different surgical procedures with SL, adjusting for age and work posture. Women (n = 511), aged 26-63 years, who worked ≥75% before a BC diagnosis, were included within 12 weeks of surgery. RESULTS: 31% reported breast symptoms and 22% arm symptoms; and, of these, 47% reported both. Having strenuous work postures increased the OR for being on SL most (OR 2.60), followed by breast symptoms (OR 2.40), more extensive axillary (OR 2.24) or breast surgery (OR 2.13), and arm symptoms (OR 2.06). CONCLUSIONS: Breast and arm symptoms are as strongly associated with being on SL as types of breast and/or axillary surgery. Early self-reported symptoms are important to consider in guidelines for SL and rehabilitation after BC surgery.

  • 34.
    Wennman-Larsen, Agneta
    et al.
    Sophiahemmet University.
    Nilsson, Marie
    Saboonchi, Fredrik
    Olsson, Mariann
    Alexanderson, Kristina
    Fornander, Tommy
    Sandelin, Kerstin
    Petersson, Lena-Marie
    Can breast cancer register data on recommended adjuvant treatment be used as a proxy for actually given treatment?2016In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 22, p. 1-7Article in journal (Refereed)
  • 35.
    Wennman-Larsen, Agneta
    et al.
    Sophiahemmet University.
    Petersson, Lena-Marie
    Saboonchi, Fredrik
    Alexanderson, Kristina
    Vaez, Marjan
    Consistency of breast and arm symptoms during the first two years after breast cancer surgery2015In: Oncology Nursing Forum, ISSN 0190-535X, E-ISSN 1538-0688, Vol. 42, no 2, p. 145-155Article in journal (Refereed)
    Abstract [en]

    PURPOSE/OBJECTIVES:

    To examine the severity and development of breast and arm symptoms separately during the two years following breast cancer surgery, and to examine whether previously defined predictors of arm symptoms are associated with breast symptoms.
.

    DESIGN:

    Prospective cohort study with two-year follow-up. 
.

    SETTING:

    Three institutions in the Stockholm, Sweden, region.
.

    SAMPLE:

    645 women, aged 20-63 years, enrolled within 12 weeks of surgery for primary breast cancer. 
.

    METHODS:

    Baseline register and questionnaire data with five follow-ups were submitted to descriptive, inferential, and logistic regression analysis.
.

    MAIN RESEARCH VARIABLES:

    Severity of breast and arm symptoms measured by the European Organisation for Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire.
.

    FINDINGS:

    Most participants had undergone breast-conserving 
surgery and sentinel lymph node dissection, and were scheduled for postoperative radiation therapy. Overall mean levels of breast and arm symptoms were low, but with large individual variations. At all six time points, the mean levels of breast symptoms were significantly higher than those of arm symptoms. Overall, the mean level of both types of symptoms decreased during follow-up. A body mass index (BMI) of 25 or greater and breast symptoms at eight months were associated with having breast symptoms at two years. Arm symptoms at baseline and at eight months, and radiation therapy and a BMI of 25 or greater were associated with having arm symptoms at two years.
.

    CONCLUSIONS:

    Breast symptoms show different patterns of change and are not associated with the same factors as arm symptoms.
.

    IMPLICATIONS FOR NURSING:

    For nurses monitoring women treated for breast cancer, the results of this study provide knowledge regarding the importance of early symptom identification and long-term symptoms after treatment.

  • 36.
    Wennman-Larsen, Agneta
    et al.
    Sophiahemmet University.
    Svärd, Veronica
    Alexanderson, Kristina
    Friberg, Emilie
    Factors of decisive importance for being in work or not during two years after breast cancer surgery: Content analysis of 462 women's open answers2021In: BMC Women's Health, E-ISSN 1472-6874, Vol. 21, no 1, article id 332Article, review/survey (Refereed)
    Abstract [en]

    BACKGROUND: Paid work is one of the most important aspects in life among working-aged women diagnosed with breast cancer. Despite several attempts, no previous study provides a comprehensive overview from the women's perspective about factors of importance for being able to work or not. Therefore, the aim of this study was to gain knowledge about factors that women themselves state are of decisive importance for being able to work or not during the first two years after breast cancer surgery.

    METHODS: Data was collected in a two-year follow-up questionnaire within the frame of a prospective cohort study of working-aged women who had undergone breast cancer surgery. 749 were included in the questionnaire study and of the 616 (82%) responding women, 462 (75%) wrote statements on an open-ended question about factors of decisive importance for being able to work or not work during the past two years. The statements were analyzed with content analysis.

    RESULTS: Five categories of factors of importance for being able to  work or not were identified, each covering several sub-categories: Health and wellbeing, Contacts and encounters, Flexibility and adjustment possibilities, Socioeconomic consequences from working/not working, and Own motivation and characteristics. A wide variety of factors were mentioned by the women and the findings give a multifaceted picture of many single but interrelated factors of decisive importance for being able to work/not work. The importance of flexibility in the return-to-work process was stressed, as well as the importance of supportive encounters from, e.g., colleagues, managers, as well as relatives.

    CONCLUSIONS: The results give a comprehensive overview over a variety of different types of factors for being able to return to/remain in work or to not work after breast cancer surgery, adding new knowledge about e.g. the importance of colleagues, and the women's own preferences or characteristics. These are factors that different stakeholders, both from healthcare but also from the work place and the insurance office, need to be aware of and collaborate around to support women with breast cancer during the period of treatment, rehabilitation and return to work.

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  • 37. Winterling, J
    et al.
    Johansson, E
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Petersson, L-M
    Ljungman, P
    Alexanderson, K
    Occupational status among adult survivors following allo-SCT2014In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 49, no 6, p. 836-42Article in journal (Refereed)
    Abstract [en]

    Being in work or the equivalent is an important goal after allo-SCT and is used as an indicator of recovery. The aim was to elucidate occupational status and factors associated with work among SCT survivors. Adults in working age with a haematological disease (n=177) were followed up within a median of 8 (range 28) years post allo-SCT. Predictors of not being in work at all or working part-time because of sick leave, disability pension or early old-age pension were analyzed using logistic regression analyses. At diagnosis, 82% of the participants were working full-time and 2% were on sick leave or old-age pension. At follow-up, 52% were working full-time, 27% were working part-time and 17% were on sick leave, disability pension or old-age pension. Not working at all was associated with multi-morbidity (P=0.01) and poorer health (P=0.00). Working part-time was associated with a higher age at diagnosis (P=0.00), being a woman (P=0.03), being born abroad (P=0.03) and multi-morbidity (P=0.00). In conclusion, the majority of survivors were in paid work at follow-up; however, a substantial number were not working or worked part-time.

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