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  • 1. Bränström, Richard
    et al.
    Petersson, Lena-Marie
    Saboonchi, Fredrik
    Wennman-Larsen, Agneta
    Sophiahemmet Högskola.
    Alexanderson, Kristina
    Physical activity following a breast cancer diagnosis: Implications for self-rated health and cancer-related symptoms2015Ingår i: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 19, nr 6, 680-5 s.Artikel i tidskrift (Refereegranskat)
    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.

  • 2. Janczewska, Izabella
    et al.
    Kapraali, Marjo
    Saboonchi, Fredrik
    Sophiahemmet Högskola.
    Nekzada, Q
    Wessulv, A
    Khoshkar, J
    Marouf, F
    Gorsetman, J
    Risberg, D
    Lissing, M
    Wirström, G
    Sandstedt, B
    Clinical application of the multigene analysis test in discriminating between ulcerative colitis and Crohn's disease: a retrospective study2012Ingår i: Scandinavian journal of gastroenterology, ISSN 1502-7708, Vol. 47, nr 2, 162-9 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Abstract Methods. The newly described - multigene analysis test (DiBiCol) identifying 7 inflammatory bowel disease (IBD)-specific genes in colonic mucosal biopsy differentiating between ulcerative colitis (UC) and Crohn's disease (CD) with active inflammation - is a new addition to existing methods with a higher stated sensitivity and specificity. Method biopsy material from 78 patients with a complicated course diagnosed as most probably UC in 38, CD in 18 and inflammatory bowel disease unclassified (IBDU) in 22 were investigated by DiBiCol. Results. DiBiCol showed a pattern consistent with CD in 13 patients with UC and led to change of diagnosis in 3 patients and a strong suggestion of CD in 8 patients. A total of 2 patients remained as UC. DiBiCol showed a pattern of UC in 4 patients of 18 with CD leading to a changing of diagnosis to UC in 3 patients, but the fourth remained as CD. In 22 patients with IBDU DiBiCol showed a pattern consistent with UC in 7 cases and with CD in 13 cases. A new evaluation 1 year after the DiBiCol allowed the assessment of clinical diagnosis in 10 patients confirmed in 9 of 10 patients by DiBiCol. In patients with acute flare of colitis the clinical diagnosis corresponded in 10 of 12 UC and in 5 of 6 CD cases. Summary. Adopting the DiBiCol test led to a change of the primary diagnosis in a significant number of patients with the initial diagnosis of UC and CD and suggested a clinically probable diagnosis in most of the patients with IBDU and in those with an acute flare of colitis.

  • 3. Jäghult, S
    et al.
    Saboonchi, Fredrik
    Sophiahemmet Högskola.
    Johansson, Unn-Britt
    Sophiahemmet Högskola.
    Wredling, Regina
    Kapraali, M
    Stress as a trigger for relapses in IBD: a case-crossover studyArtikel i tidskrift (Refereegranskat)
  • 4. Jäghult, Susanna
    et al.
    Saboonchi, Fredrik
    Sophiahemmet Högskola.
    Johansson, Unn-Britt
    Sophiahemmet Högskola.
    Wredling, Regina
    Kapraali, Marjo
    Factor structures of the Swedish version of the RFIPC: investigating the validity of measurements of IBD patient's worries and concerns2010Ingår i: Gastroenterology Research, ISSN 1918-2805, Vol. 3, nr 5, 191-200 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Worries and concerns of patients with IBD comprise an important negative factor in their HRQOL. The Rating Form of Inflammatory Bowel Disease Patient Concerns (RFIPC) was developed to describe the nature and degree of the worries and concerns of IBD patients. In the original version, the specific issues of worries are divided into four separate factors. These factors provide useful information about HRQOL and the kind of worries and concerns which are most important to the patient. However, the Swedish version of the RFIPC is often scored using a single sum score, implying that all the specific issues of worries stem from a single general worry factor. The aim of this study was to validate the factor structure of the Swedish version of the RFIPC.Methods: A sample consisting of 195 patients with IBD filled out the RFIPC. Confirmatory factor analysis was performed to examine fit of three hypothesized models of factor structure. Spearman’s correlation and Mann-Whitney analysis were used to follow up the results.Results: The single-factor model displayed poor fit indices. The four-factor model marked substantive improvement, but still remains inadequate. The final four-factor model permitting correlated error terms between some items displayed the most adequate fit.  Conclusions: The factorial structure of the RFIPC, as suggested in the original version, was able to be replicated with a slight modification in the Swedish version. The separate factors identified in this structure provide more detailed information about the worries and concerns of IBD patients as these components of worries are different related to HRQOL and general health.

  • 5. Jäghult, Susanna
    et al.
    Saboonchi, Fredrik
    Sophiahemmet Högskola.
    Johansson, Unn-Britt
    Sophiahemmet Högskola.
    Wredling, Regina
    Sophiahemmet Högskola.
    Kapraali, Marjo
    Identifying predictors of low health-related quality of life among patients with inflammatory bowel disease: comparison between Crohn's disease and ulcerative colitis with disease duration2011Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, nr 11-12, 1578-1587 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim.  To identify predictors of low health-related quality of life among patients with inflammatory bowel disease and make a comparison between Crohn's disease and ulcerative colitis with disease duration. Background.  Studies have shown that patients with inflammatory bowel disease rate their health-related quality of life lower, as compared with a general population. Design.  Survey. Methods.  In this study, 197 patients in remission were included and divided into a Crohn's disease group and an ulcerative colitis group. Each group was also divided into separate groups whether the patients had short disease duration or long disease duration. Generic instruments, combined with disease-specific questionnaires, were used for measuring health-related quality of life. Results.  The analysis showed a non-significant effect for diagnosis, but a significant effect for disease duration showing that the patients with short disease duration had lower scores of health-related quality of life compared with patients with long disease duration. A significant interaction between diagnosis and disease duration was also revealed. Conclusion.  Patients with longer disease duration experienced a better health-related quality of life than patients with short disease duration. Patients with Crohn's disease and short disease duration have the lowest health-related quality of life and are in greatest need of education and support. Relevance to clinical practice.  It is important to identify which patients' are in the greatest need of education and support.

  • 6.
    Lauffs, Monica
    et al.
    Sophiahemmet Högskola.
    Ponzer, Sari
    Saboonchi, Fredrik
    Sophiahemmet Högskola.
    Lonka, Kirsti
    Hylin, Uffe
    Mattiasson, Anne-Cathrine
    Sophiahemmet Högskola.
    Cross-cultural adaptation of the Swedish version of Readiness for Interprofessional Learning Scale (RIPLS)2008Ingår i: Medical education, ISSN 1365-2923, Vol. 42, nr 4, 405-11 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    CONTEXT: Interprofessional learning activities in health care are being gradually introduced on an international basis and therefore cross-cultural and internationally collaborative research into the outcomes of these activities is needed. Hence, it is necessary not only to translate research instruments into the language of the culture in which they are to be used, but also to adapt them culturally if they are to fulfil the testing purposes for which they are intended. It is also necessary to test a translated instrument in order to ensure that it retains its intended psychometric properties. METHODS: In the present study, the Readiness for Interprofessional Learning Scale (RIPLS) was adapted for use in a Swedish student population. Cross-cultural adaptation was performed according to recommended guidelines. The Swedish version was tested on a group of students from various health care professions (n = 214). Cronbach's alpha coefficient was adopted to ensure internal consistency. RESULTS: Minor discrepancies during the different translation processes were identified and corrected. Confirmatory factor analysis suggests that the model had an acceptable fit, implying that the factor structure of the scale did not undergo any significant changes by being subjected to translation. The psychometric qualities of the instrument were comparable with those of the English-language version. CONCLUSIONS: This study presents the cross-cultural adaptation of the RIPLS and demonstrates that its subscale Teamwork and Collaboration is the only reliable subscale. The other 2 subscales (Professional Identity, and Roles and Responsibilities) probably require further scrutiny and development, at least in the Swedish population.

  • 7. Lundh, Lars-Gunnar
    et al.
    Saboonchi, Fredrik
    Sophiahemmet Högskola.
    Wangby, Margit
    The role of personal standards in clinically significant perfectionism: a person-oriented approach to the study of patterns of perfectionism2008Ingår i: Cognitive Therapy and Research, ISSN 0147-5916, E-ISSN 1573-2819, Vol. 32, nr 3, 333-50 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Clinically significant perfectionism is defined as patterns of perfectionism which are over-represented in clinical samples and under-represented in non-clinical samples. The present study contrasted two hypotheses about what characterizes clinically significant perfectionism: the two-factor theory and perfectionism/acceptance theory. First, a person-oriented approach by means of cluster analysis was used to identify typical patterns of perfectionism. These clusters were then cross-tabulated with two clinical samples (patients with social phobia and patients with panic disorder) and a non-clinical sample. The results showed that patterns of clinically significant perfectionism combined high Concern over Mistakes (CM) and Doubts about Action (DA) with high Personal Standards (PS) (and to a lesser extent also high Organization)--which is consistent with perfectionism/acceptance theory, but at odds with the two factor theory. The results illustrate the value of a person-oriented methodological approach as a complement to the traditional variable-oriented approach.

  • 8.
    Löfvenmark, Caroline
    et al.
    Sophiahemmet Högskola.
    Saboonchi, Fredrik
    Sophiahemmet Högskola.
    Edner, Magnus
    Billing, Ewa
    Mattiasson, Anne-Cathrine
    Evaluation of an educational programme for family members of patients living with heart failure: a randomised controlled trial2013Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, nr 1-2, 115-126 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims and objectives.  To evaluate the effect of a group-based multi-professional educational programme for family members of patients with chronic heart failure with regard to quality of life, depression and anxiety. The secondary aim was to investigate the impact of social support and sense of coherence on changes in quality of life, anxiety and depression during the period of the study. Background.  When a person is diagnosed with heart failure, the daily life of the family members is also affected. Design.  Randomised controlled trial. Methods.  A total of 128 family members were randomly assigned to participate in a multi-professional educational programme or a control group. Analysis of variance and regression analysis were used. Results.  There were no significant differences in anxiety, depression or quality of life between the intervention group and control group. Adequacy of social network was the only independent variable that explained levels of anxiety and depression after 12 months beyond baseline levels of anxiety (p < 0·001, R(2)  = 0·35) and depression (p = 0·021, R(2)  = 0·37). Younger family members were found to have a higher quality of life (p < 0·01). Conclusion.  Improved disease-related knowledge may need to be combined with other target variables to induce desired effects on depression, anxiety and quality of life of family members. Antecedents of depression and anxiety, such as sense of control, may need to be specifically targeted. Our results also suggest that intervention aimed at enhancing social support may be beneficial for family members. Relevance to clinical practice.  Anxiety and depression did not decrease nor did quality of life improve after the intervention. An educational programme for family members with a component specifically targeting anxiety, depression and quality of life warrants testing. Furthermore, it is important that health care providers understand the influence of social support on anxiety, depression and quality of life when interacting with family members.

  • 9.
    Lööf, Helena
    et al.
    Sophiahemmet Högskola.
    Johansson, Unn-Britt
    Sophiahemmet Högskola.
    Welin Henriksson, Elisabet
    Lindblad, Staffan
    Saboonchi, Fredrik
    Sophiahemmet Högskola.
    Development and psychometric testing of the Swedish version of the Body Awareness Questionnaire2013Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 69, nr 7, 1643-1651 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim

    This paper is a report of the development and psychometric testing of the Swedish version of the Body Awareness Questionnaire to measure bodily focus of attention.

    Background

    The Body Awareness Questionnaire has been identified as an instrument with excellent psychometric properties within the concept of body awareness. It has been used in both research and clinical settings in different contexts. However, a validated Swedish version is not available.

    Method

    A cross-sectional design was applied for adaptation of the Body Awareness Questionnaire and psychometric validation. Data were collected between autumn 2009 and spring 2011 from 120 patients diagnosed with rheumatoid arthritis, and from 120 students. The ‘concurrent think aloud’ method was used in a pre-test to determine the usability of the questionnaire. Cronbach's alpha was used to test the internal consistency, and confirmatory factor analysis was performed to test the construct validity.

    Results

    According to the confirmatory factor analysis, neither the one-factor model nor the four-factor model tested in this study fulfilled the pre-specified criteria in accordance with the Comparative Fit Index, Standardized Root Mean Squared Residual and the Root Mean Square Error of Approximation. The value of Cronbach's alpha for the Swedish version of the Body Awareness Questionnaire was satisfactory.

    Conclusion

    Our results indicate that the two models tested in this study do not provide a good fit to the observed data. Further refinement and testing of the Swedish version of the Body Awareness Questionnaire is therefore required. The concept of body awareness may

  • 10.
    Lööf, Helena
    et al.
    Sophiahemmet Högskola.
    Johansson, Unn-Britt
    Sophiahemmet Högskola.
    Welin Henriksson, Elisabet
    Lindblad, Staffan
    Saboonchi, Fredrik
    Pain and fatigue in adult patients with rheumatoid arthritis: association with body awareness, demographic, disease-related, emotional and psychosocial factors2013Ingår i: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 3, nr 2, 293-300 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Patients and clinicians report pain and fatigue as key outcome measures in rheumatoid arthritis. Fatigue and pain are a major concern to patients. Aim: The objective of this study was to examine fatigue and pain in adult patients with rheumatoid arthritis (RA) and to investigate the association between pain and fatigue with body awareness, demographic, disease-related, emotional and psychosocial factors. Method: Data were collected from a sample of patients with RA (n = 120) recruited from a Rheumatology clinic in a large university hospital in Stockholm, Sweden. Eligible for inclusion were patients between 20 - 80 years of age and with a confirmed diagnosis of RA. Fatigue was measured using the Multidimensional Assessment of Fatigue (MAF) scale, while the Visual Analogue Scale (VAS) was used to assess components of pain. A multiple stepwise regression analysis was performed to evaluate factors related to fatigue and pain. In the first step a univariate analysis of variance (ANOVA) was used for all relevant independent factors. In the next step backwards stepwise regression was applied. Result: Fatigue was significantly associated with the Disease Activity Score 28-joints (DAS 28) (p = 0.049), the Body Awareness Questionnaire (BAQ) (p = 0.006), the Positive Affect (PA) scale (p = 0.008) and no smoking (p = 0.021). Pain was significantly associated with the EuroQol EQ-5D (p = 0.008) and the DAS 28 (p = 0.001). The adjusted R-square was 28.6% for fatigue and 50.0% for pain. Conclusion: This study clearly demonstrates that fatigue and pain in patients with RA appear to be associated with disease-related factors. Furthermore, fatigue was related to body awareness and emotional factors, and pain was related to health related quality of life.

  • 11.
    Lööf, Helena
    et al.
    Sophiahemmet Högskola.
    Saboonchi, Fredrik
    Welin Henriksson, Elisabet
    Lindblad, Staffan
    Johansson, Unn-Britt
    Sophiahemmet Högskola.
    "Pain and fatigue in adult patients with rheumatoid arthritis: association with demographic factors, disease related factors, body awareness, emotional and psychosocial factors"2012Ingår i: Arthritis and Rheumatism, ISSN 0004-3591, E-ISSN 1529-0131, Vol. 64, nr 10 (suppl), 671-672 s.Artikel i tidskrift (Refereegranskat)
  • 12.
    Lööf, Helena
    et al.
    Sophiahemmet Högskola.
    Saboonchi, Fredrik
    Sophiahemmet Högskola.
    Welin Henriksson, Elisabet
    Lindblad, Staffan
    Johansson, Unn-Britt
    Sophiahemmet Högskola.
    Psychometric testing of the body awareness questionnaire in an Swedish sample of patients diagnosed with rheumatoid arthritis2012Ingår i: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 71, nr Suppl 3, 734- s.Artikel i tidskrift (Refereegranskat)
  • 13.
    Nahlén Bose, Catarina
    et al.
    Sophiahemmet Högskola.
    Elfström, Magnus L
    Björling, Gunilla
    Persson, Hans
    Saboonchi, Fredrik
    Patterns and the mediating role of avoidant coping style and illness perception on anxiety and depression in patients with chronic heart failure2016Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, nr 4, 704-713 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: Emotional distress in patients with chronic heart failure (CHF) predicts mortality, hospital readmission and quality of life. The patient's avoidant coping style and beliefs about the disease have been linked to emotional distress in CHF. However, the pattern and transmitting effects of these variables are indefinite.

    AIM: This study aimed to examine the links between and the potential mediating role of illness perceptions and avoidant coping style on depression and anxiety in patients with CHF.

    METHOD: Self-assessment data from 103 patients with CHF were subjected to path analysis in two hypothesised models. The outcome measures were coping styles, illness perception, anxiety and depression.

    RESULTS: Avoidant coping had a direct adverse effect on anxiety and depression. The perception of symptom burden and personal control, significantly mediated the effect between avoidant coping and anxiety and depression.

    CONCLUSIONS: Avoidant coping style appears to influence not only emotional distress, but also a malignant symptom perception and low sense of control over the illness.

  • 14. Nahlén, Catarina
    et al.
    Saboonchi, Fredrik
    Sophiahemmet Högskola.
    Coping, sense of coherence and the dimensions of affect in patients with chronic heart failure2010Ingår i: European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology, ISSN 1873-1953, Vol. 9, nr 2, 118-25 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Living with chronic heart failure has an impact on several important dimensions of an individual's life. A patient's use of coping strategies may influence his or her health condition and emotional well-being. AIM: To investigate factors that may relate to the coping strategies used by individuals with chronic heart failure and how the coping strategies are associated with positive and negative affect. METHODS: A cross-sectional research design was used. The participants provided demographic data and filled out three questionnaires: Sense of Coherence scale, Brief COPE and Positive Affect Negative Affect Schedule. RESULTS: No differences in relation to coping strategies were found with regard to New York Heart Association class. Substance use was associated with gender and age. Sense of coherence was negatively associated with denial, behavioural disengagement, venting and self-blame, and positively associated with acceptance. It was found that avoidant coping positively and sense of coherence negatively, predicted negative affect. Problem focused coping positively predicted positive affect. Socially supported coping predicted both negative and positive affect. CONCLUSION: The present study found that the employment of different coping strategies and sense of coherence had an impact on affect and therefore also the emotional well-being among patients with chronic heart failure.

  • 15. Nilsson, Marie I
    et al.
    Saboonchi, Fredrik
    Alexanderson, Kristina
    Olsson, Mariann
    Wennman-Larsen, Agneta
    Sophiahemmet Högskola.
    Petersson, Lena-Marie
    Changes in importance of work and vocational satisfaction during the 2 years after breast cancer surgery and factors associated with this2016Ingår i: Journal of cancer survivorship, ISSN 1932-2259, E-ISSN 1932-2267, Vol. 10, nr 3, 564-572 s.Artikel i tidskrift (Refereegranskat)
    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.

  • 16. Nürnberg Damström, D
    et al.
    Saboonchi, Fredrik
    Sophiahemmet Högskola.
    Sackey, P V
    Björling, Gunilla
    Sophiahemmet Högskola.
    A preliminary validation of the Swedish version of the critical-care pain observation tool in adults2011Ingår i: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 55, nr 4, 379-386 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Assessing pain in critically ill patients can be complicated, especially for those unable to communicate. A recently developed pain assessment tool, the Critical-Care Pain Observation Tool (CPOT), has been shown to be a reliable tool for pain assessment in the Intensive Care Unit (ICU). The aim of the study was to validate the Swedish version of the CPOT. Methods: Conscious and unconscious adults were observed during two procedures: one non-nociceptive procedure (NNP) (arm- and face wash) and one nociceptive procedure (NP) (turning). In total, there were 240 patient assessments pre-, per- and post-procedure performed by two independent staff members at rest, during and 15 min after the different procedures. Measures of interrater reliability, internal consistency and discriminant validity of the CPOT were obtained to examine the properties of the Swedish version of CPOT. Results: The results provide indications of good agreement between the independent raters (ICC=0.84). There was an adequate discriminant validity of the Swedish version of CPOT established by a significant peak for CPOT scores during the NP (per-procedure). There was also a consistent pattern of significant correlations between CPOT and the mean artery pressure (ρ=0.32-0.45). Conclusion: The Swedish version of the CPOT is a suitable instrument for assessing pain in critically ill adults. The overall reliability and validity measures converge with findings from previous studies of the CPOT, but in order to achieve enhanced generalizability of the CPOT, we encourage further evaluation of CPOT in broader groups of critically ill patients.

  • 17. Petersson, Lena-Marie
    et al.
    Vaez, Marjan
    Nilsson, Marie I
    Saboonchi, Fredrik
    Alexanderson, Kristina
    Olsson, Mariann
    Wennman-Larsen, Agneta
    Sophiahemmet Högskola.
    Sickness absence following breast cancer surgery: a two-year follow-up cohort study2017Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Artikel i tidskrift (Refereegranskat)
    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.

  • 18.
    Saboonchi, Fredrik
    Sophiahemmet Högskola.
    Den skapande människans tolerans:  2012Ingår i: Tolerera: en antologi om intolerans och tolerans ur ett psykologiskt perspektiv / [ed] Jon Brunberg, Stockholm: Jon Brunberg Förlag , 2012, 17-37 s.Kapitel i bok, del av antologi (Övrig (populärvetenskap, debatt, mm))
  • 19.
    Saboonchi, Fredrik
    et al.
    Sophiahemmet Högskola.
    Lundh, Lars-Gunnar
    Perfectionism, anger, somatic health, and positive affect2003Ingår i: Personality and Individual Differences, ISSN 0191-8869, E-ISSN 1873-3549, Vol. 35, nr 7, 1585-99 s.Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The associations between perfectionism, anger, somatic health, and positive affect were examined in 184 Swedish adults from a randomly selected population sample. Somewhat unexpectedly, trait anger was found to be associated with self-oriented perfectionism rather than with socially prescribed perfectionism. Both socially prescribed perfectionism and self-oriented perfectionism showed weak positive correlations with self-reported somatic complaints, particularly symptoms of tension and fatigue, and more clearly in women than in men, whereas other-oriented perfectionism appeared as a predictor of whether the participants were undergoing medical treatment or not. Finally, the results did not support the notion of self-oriented perfectionism representing a positive, adaptive dimension of perfectionism; on the contrary, this dimension was found to be negatively associated with positive affect.

  • 20.
    Saboonchi, Fredrik
    et al.
    Sophiahemmet Högskola.
    Lööf, Helena
    Sophiahemmet Högskola.
    Body awareness, perfectionism and pain2009Ingår i: Psychology and Health, ISSN 0887-0446, E-ISSN 1476-8321, Vol. 24, nr Supp 1, 347-347 s.Artikel i tidskrift (Refereegranskat)
  • 21. Saboonchi, Fredrik
    et al.
    Petersson, Lena-Marie
    Alexanderson, Kristina
    Bränström, Richard
    Wennman-Larsen, Agneta
    Sophiahemmet Högskola.
    Expecting the best and being prepared for the worst: structure, profiles, and 2-year temporal stability of dispositional optimism in women with breast cancer2016Ingår i: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 25, nr 8, 957-963 s.Artikel i tidskrift (Refereegranskat)
    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.

  • 22. Saboonchi, Fredrik
    et al.
    Petersson, Lena-Marie
    Wennman-Larsen, Agneta
    Sophiahemmet Högskola.
    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 response2014Ingår i: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 18, nr 6, 598-604 s.Artikel i tidskrift (Refereegranskat)
    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.

  • 23. Saboonchi, Fredrik
    et al.
    Petersson, Lena-Marie
    Wennman-Larsen, Agneta
    Sophiahemmet Högskola.
    Alexanderson, Kristina
    Vaez, Marjan
    Trajectories of anxiety among women with breast cancer: A proxy for adjustment from acute to transitional survivorship2015Ingår i: Journal of psychosocial oncology, ISSN 0734-7332, E-ISSN 1540-7586, Vol. 33, nr 6, 603-619 s.Artikel i tidskrift (Refereegranskat)
    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.

  • 24. Saboonchi, Fredrik
    et al.
    Wennman-Larsen, Agneta
    Sophiahemmet Högskola.
    Alexanderson, Kristina
    Petersson, Lena-Marie
    Examination of the construct validity of the Swedish version of Hospital Anxiety and Depression Scale in breast cancer patients2013Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 22, nr 10, 2849-2856 s.Artikel i tidskrift (Refereegranskat)
    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.

  • 25.
    Wennman-Larsen, Agneta
    et al.
    Sophiahemmet Högskola.
    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?2016Ingår i: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 22, 1-7 s.Artikel i tidskrift (Refereegranskat)
  • 26.
    Wennman-Larsen, Agneta
    et al.
    Sophiahemmet Högskola.
    Petersson, Lena-Marie
    Saboonchi, Fredrik
    Alexanderson, Kristina
    Vaez, Marjan
    Consistency of breast and arm symptoms during the first two years after breast cancer surgery2015Ingår i: Oncology Nursing Forum, ISSN 0190-535X, E-ISSN 1538-0688, Vol. 42, nr 2, 145-155 s.Artikel i tidskrift (Refereegranskat)
    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.

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