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  • 1.
    Blomberg, Karin
    et al.
    Örebro University, Department of Health Sciences.
    Ternestedt, Britt-Marle
    Örebro University, Department of Health Sciences.
    Törnberg, Sven
    Tishelman, Carol
    How do women who choose not to participate in population-based cervical cancer screening reason about their decision?2008In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 17, no 6, p. 561-569Article in journal (Refereed)
    Abstract [en]

    In Stockholm, Sweden, women are invited to a cost-free population-based cervical cancer screening programme (PCCSP) at regular intervals. Despite this, many women choose not to attend screening at all or to take opportunistic tests instead. This study explores bow women who actively declined participation in the PCCSP reasoned about their choice. Qualitative telephone interviews and fax, messages from women who actively declined participation in the PCCSP were analysed inductively. The manner in which women defined and conceptualized distinctions between, and the roles and responsibilities of, both private and public spheres were found to be central in explanations of decision making. Factors related to women's decisions not to participate in screening at all include a lack of confidence in the benefits of screening, previous negative health care and preventive experiences, a belief in one's own ability to discern health changes or a belief that one was not at risk for cervical cancer, as well as a number of unconventional standpoints on social and political issues. Women who chose not to participate in the organized PCCSP, but who did use private opportunistic screening, generally motivated this with direct or indirect criticism of the screening programme itself. Not only was the examination itself sensitive but also all facets of the PCCSP, from invitation letter on, were found to influence women's decisions. Using Jepson et A's ethical framework to peruse the evidence-base underlying women's 'informed decision-making' about CCS is suggested to be more constructive than discussing potential participants' knowledge versus lack of knowledge.

  • 2.
    Blomberg, Karin
    et al.
    Örebro University, Department of Nursing and Caring Sciences. Karolinska institutet.
    Tishelman, Carol
    Karolinska Institutet.
    Britt-Marie, Ternestedt
    Örebro University, Department of Nursing and Caring Sciences. Ersta Sköndal högskola.
    Tension between the Public and Private: How women who choose not to participate in population-based cervical cancer screening reason about their decision2006In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 15, no 2, p. 432-Article in journal (Refereed)
  • 3.
    Chen, Ruoqing
    et al.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Wallin, Amanda Regodón
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Selinus, Eva Norén
    Centre for Psychiatry Research & Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Sjölander, Arvid
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Fall, Katja
    Örebro University, School of Medical Sciences. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.
    Valdimarsdóttir, Unnur
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
    Czene, Kamila
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Fang, Fang
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Psychiatric disorders among children of parents with cancer: a Swedish register-based matched cohort study2018In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 27, no 7, p. 1854-1860Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate the risk of psychiatric disorders among children of parents with cancer in a nationwide population-based setting.

    METHODS: Based on Swedish national registers, the study included 101,339 children with parental cancer diagnosed either during pregnancy (N=1,047) or after birth (N=100,292) that were born during 1983-2000. For each exposed child, we randomly selected 10 unexposed children from the general population after individual matching by year of birth and sex. The matched cohort was followed during 2001-2010. Clinical diagnoses of psychiatric disorders and use of prescribed psychiatric medications were identified for all children. Cox regression and logistic regression were used to evaluate the associations of parental cancer with psychiatric disorder diagnosis and psychiatric medication use respectively.

    RESULTS: Parental cancer during pregnancy was not associated with the risk of psychiatric disorders overall, although paternal cancer during pregnancy was associated with a higher risk of psychiatric medication use among females. Parental cancer after birth was associated with higher risks of psychiatric disorder diagnoses, particularly stress reaction and adjustment disorders (males:hazard ratio[HR]:1.24, 95% confidence interval[CI]:1.08-1.43; females:HR:1.27, 95%CI:1.14-1.41), and use of psychiatric medication (males:odds ratio[OR]:1.09, 95%CI:1.04-1.13;females:OR:1.14, 95%CI:1.10-1.18). The positive associations were stronger for parental cancer with poor expected survival and for parental death after cancer diagnosis.

    CONCLUSIONS: Parental cancer, primarily the life-threatening cancer, might confer a higher risk of psychiatric disorders among children. These findings have potential implications for healthcare professionals in providing targeted support to children living with a parent with cancer.

  • 4.
    Edvardsson, Tanja
    et al.
    Örebro University, School of Health and Medical Sciences.
    Ahlström, Gerd
    Being the next of kin of a person with a low-grade glioma2008In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 17, no 6, p. 584-591Article in journal (Refereed)
    Abstract [en]

    There is a paucity of knowledge for health-care professionals who come into contact with next of kin of persons diagnosed with low-grade gliomas. Therefore, the aim of this study was to explore the experience of being the next of kin of an adult person diagnosed with a low-grade glioma. Twenty-eight next of kin of persons with a low-grade glioma were interviewed. The data were subjected to qualitative content analysis. A quantitative data analysis was added to explore how the themes from the qualitative analysis occurred among different next of kin. Four main themes emerged: Extremely stressful emotions, Being invisible and neglected, Changed relations and roles, and Enabling strength in everyday life. The first of these occurred mainly in the early period of illness. This theme was especially predominant in the case of the patient's parents. The theme of Changed relations and roles occurred more often among next of kin some years after the person's diagnosis. The most statements occurred in all four themes were by female next of kin. Many next of kin requested emotional support for themselves and indicated that it is important that health-care staff should not forget them.

  • 5.
    Hjelmstedt, Sofia
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Norberg, Annika Lindahl
    Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden.
    Montgomery, Scott
    Örebro University, School of Medical Sciences. Karolinska Institutet, Stockholm, Sweden.
    Hovén, Emma
    Karolinska Institutet, Stockholm, Sweden.
    Sick leave among parents of children with cancer in Sweden: A national cohort study2016In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 25, no SP. S3, p. 82-82Article in journal (Other academic)
  • 6.
    Rissanen, Ritva
    et al.
    Dept Publ Hlth & Caring Sci, Uppsala Univ, Uppsala, Sweden.
    Arving, Cecilia
    Dept Publ Hlth & Caring Sci, Uppsala Univ, Uppsala, Sweden.
    Ahlgren, Johan
    Örebro University Hospital. Department of Oncology, Gävle Hospital, Gävle, Sweden; Centre of Clinical Research, County of Gävleborg, Uppsala University, Gävle, Sweden.
    Cernvall, Martin
    Dept Publ Hlth & Caring Sci, Uppsala Univ, Uppsala, Sweden.
    Nordin, Karin
    Dept Publ Hlth & Caring Sci, Uppsala Univ, Uppsala, Sweden; Dept Global Publ Hlth & Primary Care, Univ Bergen, Bergen, Norway.
    Cognitive processing in relation to psychological distress in women with breast cancer: a theoretical approach2014In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 23, no 2, p. 222-228Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluable a cognitive procession model developed by Creamer and colleagues, this study examined the longitudinal relationship between intrusion and psychological distress, via avoidance, in women with breast cancer.

    Methods: Participants included 189 patients who were newly diagnosed with breast cancer. The longitudinal association between intrusion, avoidance and psychological distress and the mediating role of avoidance between intrusion and psychological distress were examined. Intrusion was measured at inclusion (T1), avoidance at 3 months post-inclusion (T2) and psychological distress at 12 months post-inclusion (T3).

    Results: Results suggested that avoidance at T2 did not mediate the relationship between intrusions at T1 and psychological distress at T3.

    Conclusion: The results did not provide support for Creamer's model in an early-stage breast cancer population, which suggests that early-stage breast cancer patient's process trauma differently from late-stage cancer patients. Therefore, it might be suggested that early-stage and late-stage cancer patients require different types of support and treatment for the distress experienced.

  • 7.
    Östlund, Ulrika
    et al.
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Wennman-Larsen, Agneta
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Persson, Carina
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Gustavsson, Petter
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Wengström, Yvonne
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Mental health in significant others of patients dying from lung cancer2010In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 19, no 1, p. 29-37Article in journal (Refereed)
    Abstract [en]

    Objective: Definitions and measures of significant others' mental health vary, but stress processes have been associated with caregiver outcomes of this kind. Thus, various mental health outcomes probably appear, either as specific responses to particular types of caregiver stressors, or as part of a general response resulting from an accumulation of various stressors. The present study explores the occurrence of symptoms of strain with regard to depression, exhaustion, and emotional well-being in significant others of patients dying from lung cancer, and how these symptoms coexist. Methods: Measures used were the Montgomery Asberg Depression Rating Scale, the OLdenburg Burnout Inventory, and the Swedish Health-Related Quality of Life Survey. Data from 84 significant others of patients dying from lung cancer were collected at a time-point during the last 4 months before the patients died and subsequently analysed. The occurrence of symptoms of strain was established by creating cut-off scores from the general population. To explore how the different symptoms coexisted, hierarchical agglomerative cluster analyses were conducted using Ward's method. Results: Approximately 40% of the significant others reported symptoms of strain for each of the three outcomes, and a coexistence was found since the significant others clustered as subgroups, ranging from 'high on all scales' to 'low on all scales'. Conclusion: A considerable proportion of the significant others were thus negatively affected in terms of mental health. We conclude that being a significant other of a person dying from lung cancer most likely results in a general response to this major life event. Copyright (C) 2009 John Wiley & Sons, Ltd.

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