Gynecological cancer is cancer that occurs in the female reproductive organs, and the most common forms are endometrial-, ovarian-, cervical- and vulvar cancer. Disease and treatment can affect the individual on several levels and have psychological, physiological and social consequences. Sexual health is defined as a state where physical, emotional, mental and social well-being is related to sexuality and is not only the absence of disease or function. Although the research on sexuality and sexual health within this patient group has increased, knowledge gaps regarding the psychosocial needs of the patients remain. 

The aim was to highlight women's experiences of sexual health after being diagnosed with gynecological cancer, with focus on how disease and treatment can affect sexuality, body image and identity. A literature review using a non-systematic search method was conducted, and the results were compiled through an integrated data analysis using an inductive approach. The database searches were conducted in PubMed and CINAHL and resulted in 15 scientific articles that formed the results. All articles, which included both qualitative and quantitative articles, were quality-reviewed. 

The results include three main categories and six subcategories. The main categories were named: Psychological and psychosocial aspects of sexual health, Physical changes in the body and their impact on sexuality and body image, and Communication and relational experiences of sexual health. The conclusion highlights how gynecological cancer and its treatment affect women's experiences of their sexual health on several levels, both physically, mentally and socially. Bodily changes, mental illness and norms around femininity and sexuality affect women's sexual well-being and relationships. Communication and support from partners and healthcare professionals emerged as important for women's recovery. The study highlights the need for a person-centered and norm-conscious approach where healthcare professionals actively initiate conversations about sexual health and pay attention to women's individual needs after gynecological cancer. 

Background

Palliative care is directed toward people with life-threatening or incurable illnesses, with the aim of preserving the patient's quality of life, relieve pain, reduce anxiety and plan for the future. Within palliative care, sexual health is an important part and should be acknowledged to the same extent as general health. Despite this, it is common for patients in the palliative phase to have limited opportunities to discuss their sexual health with healthcare professionals. The nurse's role is to provide person-centered care to patients inthe palliative phase in which sexual health is included.

Aim

The aim was to describe patients' experiences of sexual health in palliative care.

Method

This literature review applied a non-systematic approach and is based on 13 different scientific articles identified through systematic searches in the databases PubMed, CINAHL and PsycInfo. Data collection was conducted using specific limitations and clearly defined search terms. All articles were quality assessed using the assessment criteria provided by Sophiahemmet University, after which the results were systematically analyzed using an integrated analysis method.

Results

Four main categories were identified: Experiences of information about support within sexual health, Psychological aspects of sexual health, Physical barriers and Sexual satisfaction and intimacy. The results showed that sexual health was a significant and important aspect for patients in the palliative phase; however, there was a lack of supportand information from the healthcare professionals. The majority of patients experienced changes in, and sometimes deterioration of, their sexual health in relation to their illness.

Conclusions

The literature review describes how most patients in the palliative phase confirm that sexual health continues to be of great importance, but that healthcare professionals rarely address the topic as an opportunity for discussion. The lack of information causes suffering for patients, affecting all dimensions of the individual and their quality of life.

INTRODUCTION: Chronic conditions are a significant global health challenge that adversely affects the quality of care for patients with type 2 diabetes (T2D). To evaluate and improve the quality of care, the Patient Assessment Chronic Illness Care (PACIC-5As) tool has been developed. It is the most widely used tool designed to assess the perceived quality of care among individuals with chronic conditions, including diabetes. Nevertheless, it has not yet been culturally adapted and validated in the Ethiopian context. Therefore, this study aimed to translate, culturally adapt, and evaluate the psychometric properties of the PACIC-5As tool in Ethiopia.

METHODS: A multicenter cross-sectional study was conducted among individuals with type 2 diabetes from March 24, 2025, to May 5, 2025, in the Amhara region's comprehensive specialized referral hospitals. A systematic random sampling technique was used to select the study participants. Data were collected through face-to-face interviews. The tool consists of 26 items and 5 domains. Content validity was assessed at both the individual and scale levels. Internal consistency was evaluated using Cronbach's alpha (α) and composite reliability (CR), with a value ≥ 0.70 considered acceptable. Confirmatory factor analysis (CFA) was conducted to evaluate model fit and factor structure. Model fit was assessed using the absolute and incremental fit indices and interpreted based on the recommended thresholds. Convergent validity was computed using average variance extracted (AVE), with a value ≥ 0.4 considered adequate, while discriminant validity was evaluated using AVE and inter-construct correlations.

RESULTS: A total of 520 study participants were enrolled, and 517 (99.4%) were included in the study. The overall mean summary score of PACIC-5As-ET was 2.68 (±0.62). The content validity index at the item and scale levels ranged from 80% to 100%, with an inter-rater agreement of 95%. The Cronbach's alpha and composite reliability (CR) of the PACIC-5As-ET were 0.93. The Cronbach's alpha values for the subscales ranged from 0.71 (Assist) to 0.82 (Arrange). The test-retest reliability of PACIC-5As-ET was 0.94. The model fit indices were χ²/df (2.79), RMSEA (0.06), SRMR (0.08), GFI (0.89), and CFI (0.40). The AVE value of the overall PACIC-5As-ET was 0.93, and the subscales ranged from 0.47 (Advise) to 0.59 (Arrange).

CONCLUSIONS: The Amharic version of the PACIC-5As-ET tool demonstrated excellent internal consistency and acceptable validity for assessing the perceptions of patients with T2D. The absolute fit indices were generally within the recommended range, whereas the incremental fit indices were low. Therefore, support for the hypothesized five-factor structure is limited and should be interpreted with caution.

BACKGROUND: Few pregnant women meet activity guidelines, and about half experience pelvic girdle pain (PGP), with 10% developing chronic symptoms. PGP is multifactorial and tailored physical activity and exercise can reduce pain. A web-based self-care program, Women-In-Motion (WIM), was developed to support physical activity during pregnancy and help prevent and manage PGP.

AIM: The study aim was to explore pregnant women's experiences with and perceptions of WIM for managing physical activity and PGP to optimize quality of life during pregnancy. A second aim was to use the results for improvements of WIM.

METHOD: A qualitative approach was employed using focus groups, conducted digitally or in hybrid formats. Pregnant women, gestational weeks <30, were invited. The participants had access to the program one to five weeks prior to focus groups. All sessions were recorded, transcribed, and analysed using a combination of Krueger and Casey's constant comparison method and Graneheim and Lundman's inductive content analysis.

RESULTS: . WIM was seen as helping reduce barriers to physical activity while providing biopsychosocial pain insights. Varying support needs indicate more individualized approaches.

CONCLUSION: Overall, participants experienced the WIM program to enhance their confidence, and their shared perceptions of diverse needs will inform program revisions.

BACKGROUND: When a child has a life-threatening illness, guidelines emphasise the importance of providing holistic support to the whole family. Conversations about existential issues are essential in this support, yet staff often lack formal training in communication, particularly when addressing such issues as life and death. This qualitative study explored how paediatric healthcare professionals in Sweden experience and approachconversations about existential issues with children and their families facing life-threatening illness.

METHODS: Eight professionals representing different disciplines and paediatric palliative care settings took part in individual interviews, analysed using an interpretative description approach.

RESULTS: The results show that healthcare professionals experienced the existential conversations with families as emotionally intense, ethically complex, yet meaningful. A balance between courage, presence, sensitivity, and professional boundaries was crucial, as well as the need for collegial support. The importance of honest communication and age-appropriate ways of talking about illness and death was emphasized. They stressed that communication should be empathetic and culturally sensitive, without ready-made solutions, and based on the unique needs of the family. They also described organizational factors that influenced their ability to engage in existential conversations with the families.

CONCLUSIONS: Maintaining an open approach to existential conversations is essential to how these dialogues are carried out. Such an approach includes creating workplaces with an organizational culture that encourages existential conversations with patients and families. The importance of both personal and professional development is also emphasized, where collegial support and structures that promote professional growth, such as supervision and debriefing, strengthen the ability to address existential issues.

Food plays a vital role in daily life, not only physically but also psychologically, socially, and existentially. People experiencing homelessness often face difficulties in accessing food. This study aimed to explore experiences of food and mealtimes among people experiencing homelessness using a qualitative descriptive design. Individual interviews were conducted with 15 participants recruited from an inpatient ward specializing in care for people living in homelessness. The data were analyzed using inductive qualitative content analysis, with an emphasis on remaining close to the participants' own descriptions. The findings provide insight into the different ways in which people experiencing homelessness manage their daily food strategies. Furthermore, how people perceive physical suffering related to hunger, but also on how support from aid organizations is experienced, and how moral boundaries may shift when the need for food becomes urgent. The intricate interplay between food insecurity, substance use, and social marginalization is explored. The study concludes that limited and unpredictable access to food has significant consequences for everyday life among people experiencing homelessness, underscoring the need for respectful and inclusive support systems within nursing practice and public policy.

BACKGROUND: Ensuring that national governance and healthcare systems include the organization and provision of palliative care in all care settings for all patients in need is a global imperative. In cancer care, early palliative care can improve quality of life for patients and families and receiving specialised palliative care increases opportunities for care and death in the preferred place, which for a majority is the own home. In Sweden, national general health policy only vaguely addresses palliative care, leading to the introduction of specific guidelines in 2013. These coexist with national disease-specific guidelines for cancer care that are ambiguous in their conceptualisation and inclusion of palliative care. From a governance and organisation perspective, place of death serves as a key indicator of palliative care infrastructure and organisation. Since policy initiation in 2013, hospital has remained the predominant place of death in Sweden. Further, regional disparities persist and are influenced by factors such as age, sex, and access to specialised services, pointing to inequities and unsatisfactory governance and organisation of palliative care. The aim of this study was to explore the perspectives of cancer care leads and patient representatives on national governance and organisation of palliative cancer care.

METHODS: Interpretive description methodology was used to generate and inductively analyse data from group discussions and individual interviews with 36 cancer- and palliative care leads, and patient representatives from the six Swedish regional cancer centres.

RESULTS: The analysis revealed patterns of interdependent conditions that, from the perspectives of cancer care leads and patient representatives shape the governance and organisation of palliative cancer care and seemingly trigger ambiguity regarding responsibilities and inequalities in service provision: Multilevel knowledge gaps about palliative care; Challenges and complexities of providing palliative care in a fragmented healthcare system; and Policy impact and ownership problems.

CONCLUSIONS: The study revealed significant challenges in national palliative cancer care governance, primarily due to a multilevel knowledge gap about palliative care, a fragmented healthcare system, and non-directive national policies. Integration of mandatory national minimum requirements for palliative care in national policy, and clearer standards for palliative care resource allocation are needed. Comprehensive strategies and coordinated efforts that can be uniformly implemented across regions, and establishing national collaborative spaces for regional stakeholders are essential to ensure equitable and timely access to palliative care for all patients with advanced cancer.

This article introduces the MOSI (Medical Yoga Standardized Intervention) theoretical framework, developed to address challenges in the systematic implementation of yoga into healthcare, including intervention heterogeneity and the absence of clinically operational theoretical structures. Informed by long-term clinical application, structured feedback from healthcare professionals, and insights derived from research studies and implementation experience, including patient perspectives - an iterative conceptual analysis and interdisciplinary collaboration guided the development of this framework. It establishes a structured taxonomic derivation and theoretical architecture that operationalizes traditional yoga principles into a clinically applicable structure of a four-layer model comprising four interconnected layers - Self-Care Aspects, Intentional Layer, Practice Layer, and Awareness Layer. The MOSI theoretical framework addresses methodological needs in standardization and implementation, providing a unified language and a structured theoretical foundation to support standardized, reproducible, and clinically applicable yoga intervention design and implementation.

OBJECTIVES: The HOPE spiritual assessment tool (HOPE tool), developed by Anandarajah and Hight, is a clinician-administered tool used to support the identification of patients' existential, spiritual, and religious concerns. In Sweden, a foundational translation exists, but a culturally adapted version suited to a secular and multicultural context is lacking. This study aimed to develop a culturally adapted Swedish version (HOPE-SE) and assess its comprehensibility (face validity) and perceived relevance and coverage (content validity) among specialized palliative care professionals.

METHODS:  = 3) who provided structured written feedback and participated in cognitive debriefing interviews. The written evaluation was summarized descriptively. The interviews were analyzed using descriptive content analysis of transcripts of the digitally recorded interviews.

RESULTS: Experts generally perceived HOPE-SE as understandable, acceptable, and clinically useful for initiating conversations about existential, spiritual, and religious concerns. Feedback led to minor wording refinements, clarification of potentially sensitive formulations, and the addition of a brief consent-based introduction to support timing and patient autonomy. The final HOPE-SE was approved by all experts and by the original HOPE author.

SIGNIFICANCE OF RESULTS: HOPE-SE provides the first expert-reviewed Swedish conversation guide addressing existential, spiritual, and religious needs, intended to support spiritual history-taking in a multicultural healthcare context. Patient studies are needed to evaluate content validity and implementation in Swedish settings.

BACKGROUND: Thyroid hormones (TH) and neurotransmitter orexin (ORX) are implicated in the regulation of metabolism. Abdominal weight gain is common in primary hypothyroidism (PH).

METHODS: Our aim was to investigate whether TH affected peripheral weight gain, waist circumference (WC) and low-density lipoprotein cholesterol (LDL-C), before and 6 months after L-thyroxine substitution therapy. A secondary aim was to investigate the role of ORX.

RESULTS: Weight gain was positively correlated with improvement in QoL (r = 0.72, p = 0.003) and with CSF ORX levels in the 15 included patients (r = 0.78, p = 0.001). Increased WC, which was not associated with QoL changes, correlated negatively with free thyroxine levels, after 6 months of treatment, in both CSF (r = -0.71, p = 0.003) and serum (r = -0.64, p = 0.0097). Increased LDL-C correlated negatively with CSF free thyroxine levels after 6 months of treatment (r = -0.74, p = 0.003).

CONCLUSION: The marked correlations with CSF levels of thyroxine and ORX suggest that hypothalamic mechanisms participate in the regulation of WC and weight during L-thyroxine therapy, highlighting the need for individualized treatment of the metabolic disturbances seen in PH.

SHORT COMMUNICATION: Through evaluating the dynamics of body weight and waist circumference during the initial treatment of primary hypothyroidism, a positive correlation was found between orexin levels in CSF and the change in body weight. Furthermore, negative correlations were found between CSF free thyroxine levels and the changes in waist circumference and serum LDL-C levels. These findings emphasize the importance of finding future individualized treatment strategies in primary hypothyroidism, particularly regarding metabolic disturbances.

BACKGROUND: The psychosocial needs of families involving a child with a life-limiting or life-threatening condition are well recognized. However, evidence-based interventions that address the needs of the entire family remain scarce, even though family health can be maintained and supported if interventions encompass each individual family member, as well as the family as a unit. The aim was to evaluate the family talk intervention (FTI), regarding family communication, and psychosocial health, for families involving a child with a life-limiting or life-threatening condition.

METHODS: This pre-post study without a control group involved families of children with a life-limiting or life-threatening condition receiving FTI at a pediatric hospital and a hospice in Sweden. The study is registered at clinicaltrials.gov (ID NCT05020158, date of registration: 23 August 2021). FTI is a family-based intervention with the goal of facilitating family communication about illness-related topics, e.g., prognosis, support parenting, and making all children's needs visible. In total, 105 participants from 29 families were included. Surveys measuring self-assessed family communication and satisfaction, anxiety, resilience, parenting skills, and children's mental problems were answered at three time points: baseline (before intervention), at the end of the intervention, and six months later. Changes over time were analyzed using linear mixed-effects models.

RESULTS: Significant improvements were reported in family communication, family satisfaction, parenting skills, and levels of anxiety over time. Children's mental health problems were reduced over time regarding emotional symptoms, conduct problems, peer relationship difficulties, and hyperactivity. No changes were found regarding resilience.

CONCLUSION: The results suggest that FTI contributes to improved family communication and psychosocial health for families involving a child with a life-limiting or life-threatening condition. This highlights the value of a systemic approach that actively involves all family members.

The aim of this study was to describe the experiences of women with fear of childbirth regarding the support provided by the midwife during pregnancy and childbirth. Current research shows that fear of childbirth is a common phenomenon that negatively affects women’s psychological well-being, as well as their experiences of pregnancy and childbirth and their confidence in their ability to give birth. The midwife has a central role in identifying, caring for, and supporting these women and it is therefore important to understand how this support is experienced by the women themselves. 

The chosen method was a literature review with a systematic and structured approach in which 15 scientific articles with a qualitative design were analyzed. The data collection was carried out using the CINAHL and PubMed databases. Furthermore, an integrated analysis method was used to identify main categories and subcategories. The results showed three central main categories: relational and emotional support, informative and preparatory support, and support in participation and control. Within the identified main categories, the findings showed that trust, continuity of care, and respectful treatment were important factors in reducing fear of childbirth. Individualized information combined with supportive conversations was also found to be important. This contributed to strengthening the women's sense of participation and control during pregnancy and childbirth.

The results in this study showed that when there was a lack of above, childbirth fear, anxiety and insecurity increased. The conclusion indicates that when there is individualized and adapted support from the midwife it can help and strengthen women with fear of childbirth. There are considerable opportunities to reduce this suffering and improve maternity care.  The aim of this study was to describe the experiences of women with fear of childbirth regarding the support provided by the midwife during pregnancy and childbirth. Current research shows that fear of childbirth is a common phenomenon that negatively affects women’s psychological well-being, as well as their experiences of pregnancy and childbirth and their confidence in their ability to give birth. The midwife has a central role in identifying, caring for, and supporting these women and it is therefore important to understand how this support is experienced by the women themselves. The chosen method was a literature review with a systematic and structured approach in which 15 scientific articles with a qualitative design were analyzed. The data collection was carried out using the CINAHL and PubMed databases. Furthermore, an integrated analysis method was used to identify main categories and subcategories. The results showed three central main categories: relational and emotional support, informative and preparatory support, and support in participation and control. Within the identified main categories, the findings showed that trust, continuity of care, and respectful treatment were important factors in reducing fear of childbirth. Individualized information combined with supportive conversations was also found to be important. This contributed to strengthening the women's sense of participation and control during pregnancy and childbirth. The results in this study showed that when there was a lack of above, childbirth fear, anxiety and insecurity increased. The conclusion indicates that when there is individualized and adapted support from the midwife it can help and strengthen women with fear of childbirth. There are considerable opportunities to reduce this suffering and improve maternity care.  

Background

Cancer is one of the leading causes of death globally. In cases of incurable cancer, care transitions to palliative care, with a focus on symptom relief and quality of life from a holistic perspective. Person-centered care, together with the nurse’s ability to alleviate suffering and promote well-being, constitutes a central part of care. Nevertheless, research shows that healthcare does not always meet patient’s individual needs, highlighting the need for increased knowledge about patients experiences of living with incurable cancer.

Aim

To describe how adult patients experience living with incurable cancer.

Method

A non-systematic literature review was conducted, in which 13 scientific original research articles from PubMed and CINAHL were selected using a qualitative methodological approach. The articles were quality assessed based on Sophiahemmet university’s assessment criteria and synthesised through an integrated data analysis.

Results

The findings show that patients with incurable cancer experience physical, psychological, social and existential impacts, with these dimensions interacting with one another. Pain, fatigue and impaired functioning affect daily life and independence, while worry, anxiety and fear of the future were commonly reported. Existential questions concerning meaning and death emerged as central. Relationships with relatives and healthcare professionals could represent both support and burden. Patients’ also developed strategies to manage their situation through adaptation, hope, meaning and the search for support and control.

Conclusions

Living with incurable cancer involves complex suffering that affects the whole person. The results show that nursing care needs to be based on a person centered and holistic perspective, in which the patients’ individual experiences, needs and resources are considered. Nurses have a central role in alleviating suffering, supporting hope, and promoting quality of life by addressing physical, psychological, social, and existential aspects. Increased knowledge of patients’ experiences can contribute to the development of nursing care and create better conditions for meeting patients with incurable cancer in a dignified and individually adapted manner.