[Early and individualized cancer rehabilitation important].

Survivors of gynecological cancer experience physical, psychological and existential consequences. Late gastrointestinal and urinary bladder symptoms, sexual dysfunction, including underlying physical and relational aspects, as well as lymphedema and fatigue, are common complaints. This may lead to reduced quality of life and social functioning and cancer rehabilitation is needed.

To adjust and endure: a qualitative study of symptom burden in older people with multimorbidity.

Context: Older people with multimorbidity are vulnerable and often suffer from conditions that produce a multiplicity of symptoms and a reduced health-related quality of life.

Objectives: The aim of this study is to explore the experience of living with a high symptom burden from the perspective of older community-dwelling people with multi-morbidity.

Method: A qualitative descriptive design with semi-structured interviews, including 20 community-dwelling older people with multi-morbidity and a high symptom burden.

Quality indicators for palliative and end of life care: a review of Swedish policy documents.

Background: All patients with palliative and end of life care needs should be guaranteed equal and safe treatment and care, regardless of their disease or site of care. The inclusion of quality indicators in national guidelines and other guiding documents supports quality assurance and improvement in provision of care. The aim of this paper was to review existing quality indicators in national Swedish policy documents relevant to palliative and end of life care.

Understanding the role of an educational model in developing knowledge of caring for older persons with dementia.

Background: Statistics show that the number of older people in need of care is increasing worldwide, especially those with dementia. This implies demands on knowledge and competence among health care staff to care for them. In Sweden, Silviahemmet offers dementia care units the opportunity to become certified according to a special certification educational model.

Moments of homecoming among people with advanced dementia disease in a residential care facility.

This study concerns moments of homecoming among people with advanced dementia disease living in a residential care facility. Our main finding from participant observations with nine residents was that the residents showed moments of homecoming, i.e.

Decline in cognitive function due to diffuse axonal injury does not necessarily imply a corresponding decline in ability to perform activities.

Purpose: The study explored the direction of change (decline vs. improvement) after diffuse axonal injury (DAI) in the domains of the ICF: body structure, body function, and activity.

Methods: Thirteen patients with DAI were assessed by using diffusion tensor imaging (DTI) to measure body structure, the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) to measure body function, and the Assessment of Motor and Process Skills (AMPS) to measure activity.

Teenagers' reasoning about a parent's recent death in cancer.

Objective: The aim of the study was to explore how teenagers reason about a parent's recent death and about their life without that parent.

Method: A total of 10 teenagers (aged 14-19 years, 7 boys and 3 girls) were interviewed twice, 3-12 months after their parent's death. The interviews were carried out individually and as free-ranging conversations.

Short-term and long-term effects of a psycho-educational group intervention for family caregivers in palliative home care - results from a randomized control trial.

Background: Family caregivers in cancer and palliative care often face heavy responsibilities and feel insufficiently prepared for the situation as caregivers. This study evaluates short-term and long-term effects of a psycho-educational group intervention aiming to increase preparedness for family caregiving in specialized palliative home care.

Methods: The study design was a randomized control trial where family caregivers were allocated either to an intervention or control group.

Clear conscience grounded in relations: Expressions of Persian-speaking nurses in Sweden.

Background: Conscience is an important concept in ethics, having various meanings in different cultures. Because a growing number of healthcare professionals are of immigrant background, particularly within the care of older people, demanding multiple ethical positions, it is important to explore the meaning of conscience among care providers within different cultural contexts.

Research Objective: The study aimed to illuminate the meaning of conscience by enrolled nurses with an Iranian background working in residential care for Persian-speaking people with dementia.

Disability from a public health perspective.

At the Nordic School of Public Health (NHV), methods to alleviate problems with disability have been seen as an important part of actions to support public health. A programme for universal design was started in 2006. Some issues of public health perspectives on disability are presented in this paper, based on discussions from a PhD course held at the NHV.

Meanings of "acceptance" for patients with long-term pain when starting rehabilitation.

Purpose: The study aimed to elucidate the meaning of acceptance in relation to the lived body and sense of self when entering a pain rehabilitation programme.

Methods: Six women and three men with long-term pain were interviewed. The interviews were analysed according to interpretative phenomenological analysis.

Staff experiences of caring for patients with extended-spectrum β-lactamase-producing bacteria: A qualitative study.

Background: Patients who become carriers of antibiotic-resistant bacteria are sometimes stigmatized by health professionals. Staff members' fears of becoming infected could affect their willingness to care for these patients.

Methods: The purpose of this study was to increase the knowledge of what it means for staff in acute care settings and nursing homes to care for patients with extended-spectrum β-lactamase (ESBL)-producing bacteria.

Siblings' experiences of their brother's or sister's cancer death: a nationwide follow-up 2-9 years later.

Objective: The aim of this study was to examine siblings' experiences of their brother's or sister's cancer death and if these experiences influenced levels of anxiety 2-9 years later.

Methods: This nationwide survey was conducted in Sweden in 2009. All siblings who had a brother/sister who was diagnosed with cancer before the age of 17 years and who died before the age of 25 years during 2000-2007 were invited.

Enabling sense-making for patients receiving outpatient palliative treatment: A participatory action research driven model for person-centered communication.

Objectives: In clinical palliative cancer care, the diversity of patient concerns over time makes information provision a critical issue, the demands of information-seeking patients presenting a challenge to both the communicative and organizational skills of the health provider. This study puts forward a practice model for communication between patients, their family members, and professional health providers during ongoing palliative chemotherapy; a model which supports the providers in enabling person-centered communication.

Method: A constant comparative analysis adapted to participatory action research was applied.

The Recovery Process When Participating in Cancer Support and Rehabilitation Programs in Sweden.

The aim was to illuminate the meaning of participating in support and rehabilitation programs described by people diagnosed with cancer. Nineteen persons were interviewed in focus groups and face-to-face. Data were analyzed with a qualitative phenomenological hermeneutical method for researching lived experiences.

A population-level study of place of death and associated factors in Sweden.

Aims: The aims of this study were to examine, on a population level, where people die in Sweden, and to investigate associations between place of death and underlying cause of death, socioeconomic and environmental characteristics, with a particular interest in people dying from life-limiting conditions typically in need of palliative care.

Methods: This population-level study is based on death certificate data for all deceased individuals in Sweden in 2012, with a registered place of death (n=83,712). Multivariable logistic regression was performed to investigate associations between place of death and individual, socioeconomic and environmental characteristics.

Palliative Care Research--A Systematic Review of foci, designs and methods of research conducted in Sweden between 2007 and 2012.

Background: In 2007, a literature review was undertaken of palliative care research from Sweden during the 1970s-2006, paving the way for a follow-up study to explore the recent developments. The aim was to systematically examine palliative care research from Sweden between 2007 and 2012, with special attention to methods, designs and research foci.

Methods: A literature review was undertaken.

Ambulance clinicians' experiences of relationships with patients and significant others.

Background: Ambulance clinicians (ACs) have to provide advanced care and treatment to patients in a challenging and emotionally demanding environment, therefore they establish interpersonal relationships embracing both patients and significant others. Relationships in emergency care were earlier found to be short-lived and lacking a holistic understanding of the patient. In their relationship with the ambulance clinicians, it is for patients to surrender and become dependent, which may be interpreted as both a negative and a positive experience.

Utilization of palliative care principles in nursing home care: Educational interventions.

Objective: This study is part of the overarching PVIS (Palliative Care in Nursing Homes) project aimed at building competence in palliative care for nursing home staff. Our objective was to describe nursing home staff's attitudes to competence-building programs in palliative care.

Method: Three different programs were developed by specialist staff from three local palliative care teams.

Meanings of at-homeness at end-of-life among older people.

Maintaining the well-being of older people who are approaching the end-of-life has been recognised as a significant aspect of well-being in general. However, there are few studies that have explicitly focused on at-homeness among older people. This study aims to illuminate meanings of at-homeness among older people with advancing illnesses.

Self-transcendence (ST) among very old people--its associations to social and medical factors and development over five years.

Aims And Objectives: The aims of this study were to describe the associations between ST and psychological and physical wellbeing among oldest old people and to test the influence of negative life events on ST, and the predictive value of the self-transcendence scale (STS) for mortality.

Background: ST has been identified as a valuable resource for transcending psychological and physical suffering and has been related to psychological wellbeing and higher quality of life.

Design: The study design was correlational, prospective, and longitudinal.

Use of the Preparedness for Caregiving Scale in Palliative Care: A Rasch Evaluation Study.

Context: Studies have shown that family carers who feel more prepared for the caregiver role tend to have more favorable experiences. Valid and reliable methods are needed to identify family carers who may be less prepared for the role of supporting a person who needs palliative care.

Objectives: The aim of this study was to evaluate the measurement properties of the original English version and a Swedish version of the Preparedness for Caregiving Scale (PCS).

Health-related quality of life--from the perspective of mothers and fathers of adult children suffering from long-term mental disorders.

There is a lack of studies on mothers' and fathers' experiences of Health-Related Quality of Life (HRQOL) associated with caregiving of adult children suffering from mental disorder. A cross-sectional study was therefore carried out with 108 mothers and 43 fathers. Data were collected by means of the Short Form Health Survey (SF-36), the Hospital Anxiety and Depression Scale (HADS), the Family Involvement and Alienation Questionnaire (FIAQ) and the Burden Assessment Scale (BAS).

Factors associated with feelings of reward during ongoing family palliative caregiving.

Objective: Of the few studies that have paid attention to feelings of reward in family palliative caregiving, most are retrospective and examine the experiences of bereaved family caregivers. Although feeling rewarded has been described as an influence that may facilitate the way family caregivers handle the caregiving situation, no study has sought to identify the factors associated with feelings of reward while providing ongoing family palliative care. The aim of this study, therefore, was to identify influential factors in feelings of reward experienced by family palliative caregivers.

Providing Palliative Care in a Swedish Support Home for People Who Are Homeless.

Despite high frequencies of multiple, life-limiting conditions relating to palliative care needs, people who are homeless are one of the most underserved and rarely encountered groups in palliative care settings. Instead, they often die in care places where palliative competence is not available. In this qualitative single-case study, we explored the conditions and practices of palliative care from the perspective of staff at a Swedish support home for homeless people.