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Olesen ML, Seibaek L, Sekse RJT. Impaired sexual health among women treated for vulvar cancer: An integrated review. J Clin Nurs 2023; 32:6212-6228. [PMID: 37221928 DOI: 10.1111/jocn.16753] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 04/04/2023] [Accepted: 04/25/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND Although gynaecological cancer's negative effects on sexual function are well known, most studies on the subject have not included vulvar cancer patients or a multidimensional perspective on sexual health. Therefore, this review aimed to address this research gap and explored the impact of vulvar cancer on women's sexual health from a multidimensional perspective. METHODOLOGY An integrated review was conducted, as described by Whittemore and Knafl. The PubMed, CINAHL, PsycINFO and Embase databases were searched in March 2021 and updated in August 2022 and March 2023. The data were thematically analysed using NVivo, and the PRISMA-ScR and ENTREQ guidelines were followed. FINDINGS The following themes were identified in the 28 reviewed articles: impact of a changed female body, impact on women's sexual identity, consequences for women's sexual relationships and unmet needs and loneliness caused by taboos about sexual health. DISCUSSION Women's impaired sexual health after vulvar cancer points to a great need to understand and holistically investigate sexual health. In addition, healthcare professionals have an obligation to care for the sexual health issues of patients with vulvar cancer. However, most questionnaires used in the selected studies revealed a narrow understanding of sexual health and focused on sexuality as a genital activity. CONCLUSION The sexual health of women with vulvar cancer was tabooed and stigmatised for patients and healthcare professionals. Consequently, women received sparse sexual guidance, felt isolated and had unmet needs. IMPLICATIONS FOR CLINICAL PRACTICE Healthcare professionals need knowledge and training on how to break taboos and address the sexual needs of vulvar cancer patients. Systematic screenings for sexual health needs should be conducted using a multidimensional perspective. TRIAL AND PROTOCOL REGISTRATION The protocol was preregistered at the Open Science Framework (www.osf.io), registration DOI: https://doi.org/10.17605/OSF.IO/YDA2Q PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
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Affiliation(s)
- Mette Linnet Olesen
- Department of Gynecology, The Interdisciplinary Research Unit of Women's Children's and Families´ Health, Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Lene Seibaek
- Department of Gynaecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Institute of Health and Nature, Ilisimatusarfik, University of Greenland, Nuuk, Greenland
- Affiliated to Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
- Research Centre for Patient Involvement (ResCenPi), Aarhus University, Aarhus, Denmark
| | - Ragnhild Johanne Tveit Sekse
- VID Specialized University, Faculty of Health Sciences, Bergen, Norway
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
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Olesen ML, Rossen S, Jørgensen R, Langballe Udbjørg L, Hansson H. Usefulness of a Digitally Assisted Person-Centered Care Intervention: Qualitative Study of Patients' and Nurses' Experiences in a Long-term Perspective. JMIR Nurs 2023; 6:e46673. [PMID: 37200076 DOI: 10.2196/46673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 04/15/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Person-centered care responsive to individual preferences, needs, and values is recognized as an important aspect of high-quality health care, and patient empowerment is increasingly viewed as a central core value of person-centered care. Web-based interventions aimed at empowerment report a beneficial effect on patient empowerment and physical activity; however, there is limited information available on barriers, facilitators, and user experiences. A recent review of the effect of digital self-management support tools suggests a beneficial effect on the quality of life in patients with cancer. On the basis of an overall philosophy of empowerment, guided self-determination is a person-centered intervention that uses preparatory reflection sheets to help achieve focused communication between patients and nurses. The intervention was adapted into a digital version called digitally assisted guided self-determination (DA-GSD) hosted by the Sundhed DK website that can be delivered face-to-face, via video, or by the combination of the 2 methods. OBJECTIVE We aimed to investigate the experiences of nurses, nurse managers, and patients of using DA-GSD in 2 oncology departments and 1 gynecology department over a 5-year implementation period from 2018 to 2022. METHODS This qualitative study was inspired by action research comprising the responses of 17 patients to an open-ended question on their experience of specific aspects of DA-GSD in a web questionnaire, 14 qualitative semistructured interviews with nurses and patients who initially completed the web questionnaire, and transcripts of meetings held between the researchers and nurses during the implementation of the intervention. The thematic analysis of all data was done using NVivo (QSR International). RESULTS The analysis generated 2 main themes and 7 subthemes that reflect conflicting perspectives and greater acceptability of the intervention among the nurses over time owing to better familiarity with the increasingly mature technology. The first theme was the different experiences and perspectives of nurses and patients concerning barriers to using DA-GSD and comprised 4 subthemes: conflicting perspectives on the ability of patients to engage with DA-GSD and how to provide it, conflicting perspectives on DA-GSD as a threat to the nurse-patient relationship, functionality of DA-GSD and available technical equipment, and data security. The other theme was what influenced the increased acceptability of DA-GSD among the nurses over time and comprised 3 subthemes: a re-evaluation of the nurse-patient relationship; improved functionality of DA-GSD; and supervision, experience, patient feedback, and a global pandemic. CONCLUSIONS The nurses experienced more barriers to DA-GSD than the patients did. Acceptance of the intervention increased over time among the nurses in keeping with the intervention's improved functionality, additional guidance, and positive experiences, combined with patients finding it useful. Our findings emphasize the importance of supporting and training nurses if new technologies are to be implemented successfully.
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Affiliation(s)
- Mette Linnet Olesen
- Department of Gynecology, The Interdisciplinary Research Unit of Women's, Children's and Families' Health, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Sine Rossen
- Copenhagen Centre for Cancer and Health, Municipality of Copenhagen, Copenhagen, Denmark
| | - Rikke Jørgensen
- Unit for Psychiatric Research, Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | | | - Helena Hansson
- Department of Paediatric and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Zoffmann V, Jørgensen R, Graue M, Biener SN, Brorsson AL, Christiansen CH, Due-Christensen M, Enggaard H, Finderup J, Haas J, Husted GR, Johansen MT, Kanne KL, Hope Kolltveit BC, Krogslund KW, Lie SS, Lindholm AO, Marqvorsen EHS, Mathiesen AS, Olesen ML, Rasmussen B, Rothmann MJ, Simonsen SM, Tackie SHS, Thisted LB, Tran TM, Weis J, Kirkevold M. Person-specific evidence has the ability to mobilize relational capacity: A four-step grounded theory developed in people with long-term health conditions. Nurs Inq 2023:e12555. [PMID: 37062853 DOI: 10.1111/nin.12555] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/28/2023] [Accepted: 03/31/2023] [Indexed: 04/18/2023]
Abstract
Person-specific evidence was developed as a grounded theory by analyzing 20 selected case descriptions from interventions using the guided self-determination method with people with various long-term health conditions. It explains the mechanisms of mobilizing relational capacity by including person-specific evidence in shared decision-making. Person-specific self-insight was the first step, achieved as individuals completed reflection sheets enabling them to clarify their personal values and identify actions or omissions related to self-management challenges. This step paved the way for sharing these insights and challenges in a relationship with a supportive health professional, who could then rely on person-specific evidence instead of assumptions or a narrow disease perspective for shared decision-making. Trust in the evidence encouraged the supportive health professional to transfer it to the interdisciplinary team. Person-specific evidence then enhanced the ability of team members to apply general evidence in a meaningful way. The increased openness achieved by individuals through these steps enabled them to eventually share their new self-insights in daily life with other people, decreasing loneliness they experienced in self-management. Relational capacity, the core of the theory, is mobilized in both people with long-term health conditions and healthcare professionals. Further research on person-specific evidence and relational capacity in healthcare is recommended.
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Affiliation(s)
- Vibeke Zoffmann
- The Interdisciplinary Research Unit of Women's, Children's and Families' Health, Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen K, Denmark
| | - Rikke Jørgensen
- Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Marit Graue
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Sigrid Normann Biener
- Department of Public Health, University of Copenhagen, Copenhagen K, Denmark
- Survivorship Unit, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anna Lena Brorsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Cecilie Holm Christiansen
- The Interdisciplinary Research Unit of Women's, Children's and Families' Health, Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | - Mette Due-Christensen
- Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK
- Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Helle Enggaard
- Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark
- Research Unit for Child and Adolescent Psychiatry, Unit for Psychiatric Research and Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
| | - Jeanette Finderup
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Josephine Haas
- Department of Clinical Science and Education, Karolinska Institute, Södersjukhuset, Stockholm, Sweden
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | | | | | - Katja Lisa Kanne
- Department of Infectious Diseases Centre of Excellence for Health, Immunity, and Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
- Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen Ø, Denmark
| | - Beate-Christin Hope Kolltveit
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
- Vossevangen Medical Center, Voss, Norway
| | | | - Silje S Lie
- Faculty of Health, VID Specialized University, Sandnes, Norway
| | - Anna Olinder Lindholm
- Department of Clinical Science and Education, Karolinska Institute, Södersjukhuset, Stockholm, Sweden
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Emilie H S Marqvorsen
- The Interdisciplinary Research Unit of Women's, Children's and Families' Health, Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen K, Denmark
| | - Anne Sophie Mathiesen
- The Interdisciplinary Research Unit of Women's, Children's and Families' Health, Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
- Department of Endocrinology, Center for Cancer and Organ Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen Ø, Denmark
| | - Mette Linnet Olesen
- The Interdisciplinary Research Unit of Women's, Children's and Families' Health, Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
- Department of Gynaecology, Juliane Marie Centre: Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | - Bodil Rasmussen
- Department of Public Health, University of Copenhagen, Copenhagen K, Denmark
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Mette Juel Rothmann
- Faculty of Health Sciences, University of Southern Denmark and Steno Diabetes Center, Odense M, Denmark
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
| | - Susan Munch Simonsen
- Centre for Human Resources and Education, The Capital Region of Denmark, Hellerup, Denmark
| | - Sara Huld Sveinsdóttir Tackie
- The Interdisciplinary Research Unit of Women's, Children's and Families' Health, Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | - Lise Bjerrum Thisted
- Klinik for Senfølger efter Kraeft, Klinisk Onkologisk Afdeling og Palliative Enheder, Sjaellands Universitetshospital - Roskilde, Roskilde, Denmark
| | - Trang Minh Tran
- The Interdisciplinary Research Unit of Women's, Children's and Families' Health, Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | - Janne Weis
- Department of Neonatology, Juliane Marie Centre: Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | - Marit Kirkevold
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
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Linnet Olesen M, Jørgensen R. Impact of the person-centred intervention guided self-determination across healthcare settings-An integrated review. Scand J Caring Sci 2023; 37:37-59. [PMID: 36524250 DOI: 10.1111/scs.13138] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 11/10/2022] [Accepted: 11/19/2022] [Indexed: 12/23/2022]
Abstract
AIM To review the evidence of the existing literature on the impact of guided self-determination across methodologies in different healthcare settings. METHODS An integrated five-stage review. RESULTS Forty-five eligible papers were included. Guided self-determination was applied in full- or small-scale, or combined with another intervention or approach in different healthcare settings handling, for example diabetes, stroke survivorship, schizophrenia, attention-deficit hyperactivity disorder and medical disorder, gynaecological and breast cancer, endometriosis, persons with chronic pain, persons in haemodialysis and intensive care survivors. The included studies covered 12 randomised trials, 26 qualitative and seven papers of different methodology. A statistically significant effect was found in three trials. Six main themes describe the qualitative findings across papers on patients: (1) Guided self-determination reduces disease-related loneliness, (2) Insight enables integration of life and disease, (3) Reflection sheets-appreciated but challenging tool to prompt insights and person-specific knowledge, (4) New person-specific knowledge enables person-centred support, (5) Feeling seen and believed in a new and trusted relationship and (6) Exchange of knowledge enables the development of life skills. Four themes describe the healthcare professionals' experience: (1) Change of usual practice-a decision from above, (2) A new role-unlearning previous behaviour and need for support, (3) Reflection sheets as facilitators and barriers and (4) Discovering the benefits of changing to a person-centred approach. CONCLUSION Overall, guided self-determination proved to have a great impact on patient important outcomes and was useful and well-accepted by the majority of patients and healthcare professionals. Albeit guided self-determination is not a 'one size fits all' method. Continuous training and supervision of professionals are a necessary mean when implementing guided self-determination to enhance adoption and sustainability in clinical practice.
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Affiliation(s)
- Mette Linnet Olesen
- The Interdisciplinary Research Unit of Women's, Children's and Families' Health & Gynecological Department, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Rikke Jørgensen
- Aalborg University Hospital - Psychiatry, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Dehn P, Munch Simonsen S, Olesen ML. Multidimensional factors determine skill acquisition development in Guided
Self‐Determination
: A qualitative study. Scand J Caring Sci 2022; 37:549-560. [PMID: 36533327 DOI: 10.1111/scs.13140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/26/2022] [Indexed: 12/23/2022]
Abstract
AIM The aim of the study was to investigate nurses' skill acquisition in Guided Self-Determination according to the Dreyfus model of skill acquisition and Patricia Benner's studies based on the same model. BACKGROUND Globally, person-centred care is acknowledged as an essential aspect of quality in health care. To succeed with person-centred care methods and skills are necessary. Guided Self-Determination is a person-centred method developed in the field of nursing. The method represents a new way of skill acquisition requiring knowledge of how skills are acquired, unfolded and best supported in Guided Self-Determination. DESIGN Qualitative interview study. METHOD From January 2019 to August 2019, 16 nurses were interviewed about their experiences of learning and using Guided Self-Determination in three different gynaecological settings: cancer, endometriosis and sexual abuse. The study was registered with the Danish Data Protection Agency (file no.: VD-2018-445, I-Suite no.: 6700). RESULTS The spectrum in Guided Self-Determination acquisition skills ranged from following schematical procedures in a rigorous way to an extended understanding of exploring and supporting the person-centred concept. Two main themes were identified: Elements in the transition of knowledge from theory to practice and Aspects associated with Guided Self-Determination skill acquisition. CONCLUSIONS Nurses practised Guided Self-Determination at different levels. Quantity of practising Guided Self-Determination was not the only aspect determining rapid progression. The Dreyfus model lacked several explanatory components of skill acquisition, such as personal dispositions, preferences, motivation, personal values and context.
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Affiliation(s)
- Pernille Dehn
- Department of Obstetrics and Gynaecology Aarhus University Hospital Aarhus N Denmark
- Department of Gynaecology, Juliane Marie Centre Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark
| | - Susan Munch Simonsen
- Section for Competence Development Centre for Human Resources Hellerup, The Capital Region of Denmark Denmark
| | - Mette Linnet Olesen
- Department of Gynaecology, Juliane Marie Centre Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark
- Childrens and families Health Department, Juliane Marie Centre Interdiciplinary Research Unit for Womens Copenhagen Denmark
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6
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Dehn P, Strømberg C, Linnet Olesen M. The patient's agenda: nurses' experience of learning and using guided self-determination. Scand J Caring Sci 2021; 36:120-130. [PMID: 33570207 DOI: 10.1111/scs.12969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 01/22/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Health care has seen a shift towards person-centred care to encompass the entirety of a person's needs and preferences, but research is sparse on healthcare professionals learning and using person-centred care. AIM To investigate nurses' experiences of learning and using the person-centred method guided self-determination (GSD) in three different gynaecological settings and to determine whether, and potentially, how new tasks introduced by the GSD method influence their professional identity. DESIGN A qualitative interview study conducted between January 2019 and January 2020. METHOD We conducted 16 semi-structured interviews with nurses educated in using GSD. Applying inductive and deductive reasoning, we analysed the interviews using thematic analysis. The study was registered with the Danish Data Protection Agency (file no.: VD-2018-445, I-Suite no.: 6700). RESULTS The analysis generated three main themes with two subthemes each: (a) prerequisites and barriers to learning and using GSD in terms of personal factors and organisational and method-related factors; (b) new knowledge and understanding of illness with the subthemes expanded understanding of illness and a different relationship; and (c) nursing undergoing change with the subthemes, a new role and a professional self shaped through interaction with other professions. CONCLUSIONS Although other professionals may have either supported or challenged the use of GSD, most nurses indicated that it supplemented their professional role and identity as they gained new knowledge about person-centred challenges and felt more confident. When introducing GSD in nursing, the organisation must not only consider individual characteristics, multidisciplinary collaboration and communication but also plan individual education and supervision. This is necessary because all these factors affect how a new professional role is constructed and adopted, not to mention how it influences the nurses' perception of their professional identity and use of GSD. Establishing a helpful person-centred environment must also be considered.
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Affiliation(s)
- Pernille Dehn
- Juliane Marie Centre, Department of Gynaecology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Charlotte Strømberg
- Juliane Marie Centre, Department of Gynaecology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Mette Linnet Olesen
- Juliane Marie Centre, Department of Gynaecology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Juliane Marie Centre, Department of Gynaecology and Women's and Children's Health Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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Simonsen SM, Strømberg C, Zoffmann V, Hartwell D, Olesen ML. About me as a person not only the disease - piloting Guided Self-Determination in an outpatient endometriosis setting. Scand J Caring Sci 2020; 34:1017-1027. [PMID: 31875661 DOI: 10.1111/scs.12810] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 11/28/2019] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Endometriosis is a chronic disease affecting 5-10% of women in the reproductive age. Despite surgical and medical treatment, many women struggle with pain, infertility, sexual dysfunction, depression, distress and reduced workability, affecting their overall quality of life. The usual follow-up procedures may not support the women's self-management of this condition. Therefore, person-centred empowerment-based approaches are needed. AIM To assess if the implementation of the Guided Self-Determination method targeted women with complex endometriosis appeared feasible and supported self-management. METHODS Guided Self-Determination was offered to 10 out-patients with complex endometriosis. Each of the women had five conversations based on prefilled disease-specific reflection sheets. A qualitative evaluation was conducted in 2016-2017 covering semi-structured, telephone interviews and focus group interviews, which were analysed using thematic analysis. Additionally, we assessed if the women changed the self-reported questionnaires, Endometriosis Health Profile 30 and the Patient Activation Measure from before and after the conversations. RESULTS We identified four themes: feeling alone with the disease; establishing a meaningful relationship with healthcare professionals in a traditional hospital setting; person-specific knowledge facilitated new behaviours and; accepting a chronic condition - the beginning of a process. All dimensions of the Endometriosis Health Profile 30 and the Patient Activation Measure appeared to improve at two weeks and so did almost all the dimensions of Endometriosis Health Profile 30 after 1 year. CONCLUSIONS The implementation of the Guided Self-Determination method appeared feasible and the women developed self-management skills in relation to endometriosis and its symptoms. This was achieved by increasing insight into their needs and behaviours and gaining new knowledge about the disease itself. The before-and-after assessment suggested benefit of the intervention, but this should be further tested in a randomised trial.
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Affiliation(s)
- Susan Munch Simonsen
- Department of Gynecology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Centre for Human Resources and Education, The Capital Region of Denmark, Denmark
| | - Charlotte Strømberg
- Department of Gynecology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Vibeke Zoffmann
- Research Unit Women's and Children's Health, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Copenhagen University, Copenhagen, Denmark
| | - Dorte Hartwell
- Department of Gynecology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Mette Linnet Olesen
- Department of Gynecology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Research Unit Women's and Children's Health, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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8
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Sekse RJT, Dunberger G, Olesen ML, Østerbye M, Seibaek L. Lived experiences and quality of life after gynaecological cancer-An integrative review. J Clin Nurs 2019; 28:1393-1421. [PMID: 30461101 PMCID: PMC7328793 DOI: 10.1111/jocn.14721] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/07/2018] [Accepted: 11/03/2018] [Indexed: 01/09/2023]
Abstract
Aim and objectives To review the literature on Nordic women's lived experiences and quality of life (QoL) after gynaecological cancer treatment. Background While incidence and survival are increasing in all groups of gynaecological cancers in the Nordic countries, inpatient hospitalisation has become shorter in relation to treatment. This has increased the need for follow‐up and rehabilitation. Design Integrative literature review using the Equator PRISMA guidelines. Methods The review was selected, allowing inclusion of both experimental and nonexperimental research. The search included peer‐reviewed articles published 1995–2017. To frame the search strategy, we applied the concept of rehabilitation, which holds a holistic perspective on health. Results Fifty‐five articles were included and were contextualised within three themes. Physicalwell-being in a changed body encompasses bodily changes comprising menopausal symptoms, a changed sexual life, complications in bowels, urinary tract, lymphoedema and pain, bodily‐based preparedness and fear of recurrence. Mental well-being as a woman deals with questioned womanliness, the experience of revitalised values in life, and challenges of how to come to terms with oneself after cancer treatment. Psychosocial well-being and interaction deals with the importance of having a partner or close person in the process of coming to terms with oneself after cancer. Furthermore, the women needed conversations with health professionals around the process of coping with changes and late effects, including intimate and sensitive issues. Conclusion Years after gynaecological cancer, women have to deal with fundamental changes and challenges concerning their physical, mental and psychosocial well‐being. Future research should focus on how follow‐up programmes can be organised to target the multidimensional aspects of women's QoL. Research collaboration across Nordic countries on rehabilitation needs and intervention is timely and welcomed. Relevance to clinical practice To ensure that all aspects of cancer rehabilitation are being addressed, we suggest that the individual woman is offered an active role in her follow‐up.
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Affiliation(s)
- Ragnhild Johanne Tveit Sekse
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Sciences, University of Bergen, Bergen, Norway
| | - Gail Dunberger
- Department of Health Care Science, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - Mette Linnet Olesen
- Research Unit Womens and Childrens Health Department, Copenhagen, Denmark.,Department of Gynaecology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Maria Østerbye
- AU Library, Health Sciences Aarhus University, Aarhus C, Denmark
| | - Lene Seibaek
- Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus N, Denmark
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9
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Olesen ML, Duun-Henriksen AK, Hansson H, Ottesen B, Andersen KK, Zoffmann V. A person-centered intervention targeting the psychosocial needs of gynecological cancer survivors: a randomized clinical trial. J Cancer Surviv 2016; 10:832-41. [PMID: 26902366 DOI: 10.1007/s11764-016-0528-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 02/15/2016] [Indexed: 02/01/2023]
Abstract
PURPOSE We investigated the effect of a person-centered intervention consisting of two to four nurse-led conversations using guided self-determination tailored to gynecologic cancer (GSD-GYN-C) on gynecological cancer survivors' quality of life (QOL), impact of cancer, distress, anxiety, depression, self-esteem, and self-reported ability to monitor and respond to symptoms of recurrence. METHODS We randomly assigned 165 gynecological cancer survivors to usual care (UC) plus GSD-GYN-C or UC alone. Self-reported QOL-cancer survivor (QOL-CS) total score and subscale scores on physical, psychological, social, and spiritual well-being were assessed before randomization and at 3 and 9 months after randomization using t tests. Bonferroni and Pipper corrections were applied for multiple testing adjustments. RESULTS At 9 months, the GSD-GYN-C plus UC group scored significantly higher on the QOL-CS total scale (P = 0.02) and on the QOL-CS physical well-being subscale (P = 0.01), compared to women receiving UC alone. After adjusting for baseline scores, only the difference in the physical well-being subscale was statistically significant. No other measured outcomes differed between the intervention and control groups after baseline adjustment. CONCLUSION We observed higher physical well-being 9 months after randomization in the GSD-GYN-C group, as compared to women receiving usual care. IMPLICATIONS FOR CANCER SURVIVORS The results suggest that the person-centered intervention GSD-GYN-C may improve physical well-being in gynecological cancer survivors. However, further testing is needed.
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Affiliation(s)
- Mette Linnet Olesen
- Women's and Children's Health Research Unit, Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.
| | | | - Helena Hansson
- Women's and Children's Health Research Unit, Juliane Marie Centre, Copenhagen, Denmark
| | - Bent Ottesen
- Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Klaus Kaae Andersen
- Statistics, Bioinformatics and Registry, The Danish Cancer Society Research Centre, Copenhagen, Denmark
| | - Vibeke Zoffmann
- Women's and Children's Health Research Unit, Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark
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Linnet Olesen M, Graungaard AH, Husted GR. Deciding treatment for miscarriage - experiences of women and healthcare professionals. Scand J Caring Sci 2014; 29:386-94. [DOI: 10.1111/scs.12175] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 07/17/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Mette Linnet Olesen
- Research Unit for Women's and Children's Health Department 7821; Copenhagen University Hospital; Rigshospitalet; Copenhagen Ø Denmark
| | - Anette H. Graungaard
- Department of Public Health; Section of general Practice; Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
| | - Gitte R. Husted
- The Paediatric Department; Nordsjaellands Hospital Hilleroed; University of Copenhagen; Hilleroed Denmark
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Olesen ML, Madsen J. Boiling of strange quark matter in the early Universe: Strangeness conservation and nonequilibrium conditions. Phys Rev D Part Fields 1993; 47:2313-2323. [PMID: 10015822 DOI: 10.1103/physrevd.47.2313] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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