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Udo, C., Lövgren, M., Sveen, J., Bylund Grenklo, T., Alvariza, A. & Kreicbergs, U. (2019). A nationwide study of young adults’ perspectives on participation in bereavement research. Journal of Palliative Medicine
Open this publication in new window or tab >>A nationwide study of young adults’ perspectives on participation in bereavement research
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2019 (English)In: Journal of Palliative Medicine, ISSN 1096-6218, E-ISSN 1557-7740Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND:

Young adults represent a minority in research; they are often considered too young or too old for participation. There is sparse information, especially in bereavement research, regarding how this age group perceives research participation and what they consider beneficial or harmful.

AIM:

To explore how parentally bereaved and nonbereaved young adults perceive research participation.

DESIGN:

Qualitative analysis of free-text comments collected in a Swedish nation-wide survey.

SETTING/PARTICIPANTS:

Parentally cancer-bereaved and nonbereaved young adults between 18 and 25 years old living in Sweden.

RESULTS:

Five categories were identified from the free-text comments, three among the cancer-bereaved: (1) therapeutic to remember the deceased, (2) valuable to help others and improve care, and (3) short-term distressful-long-term beneficial, and two among the nonbereaved: (1) increased reflection and awareness about life, and (2) an opportunity to help others.

CONCLUSIONS:

It is important to invite young adults to participate in bereavement research. The results suggest that potential harm is minimal and that participating in bereavement research can have a beneficial effect on young adults.

Keywords
Bereavement research, young adult, comparison group
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29561 (URN)10.1089/jpm.2018.0630 (DOI)000461788800001 ()30892140 (PubMedID)
Available from: 2019-02-22 Created: 2019-02-22 Last updated: 2019-04-04Bibliographically approved
Udo, C., Svenningsson, I., Björkelund, C., Hange, D., Jerlock, M. & Petersson, E.-L. (2019). An interview study of the care manager function: Opening the door to continuity of care for patients with depression in primary care. Nursing Open, 6(3), 974-982
Open this publication in new window or tab >>An interview study of the care manager function: Opening the door to continuity of care for patients with depression in primary care
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2019 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 6, no 3, p. 974-982Article in journal (Refereed) Published
Abstract [en]

Aim: To explore experiences among patients with depression of contact with a care manager at a primary care centre.

Design: A qualitative explorative study.

Methods: During spring and summer 2016, 20 individual face-to-face interviews were conducted with patients with experience of care manager contact. The material was analysed using systematic text condensation.

Results: The participants described that having contact with a care manager was a support in their recovery process. Care became more available, and the structured continuous contact and the care manager's availability contributed to a trusting relationship. Having someone to share their burden with was a relief. However, it was described as negative when the care manager was perceived as inflexible and not open to issues that the participants felt a need to discuss. For the care manager contact to be successful, there is a need for flexibility and individually tailored contact.

Keywords
care manager, depression, patients, primary health care, qualitative study
National Category
Nursing
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-30598 (URN)10.1002/nop2.277 (DOI)31367421 (PubMedID)2-s2.0-85069795887 (Scopus ID)
Available from: 2019-08-06 Created: 2019-08-06 Last updated: 2019-08-12Bibliographically approved
Eilegård Wallin, A., Udo, C., Kreicbergs, U. & Lövgren, M. (2019). Cancer-bereaved siblings advice to peers: A nationwide follow-up survey. In: : . Paper presented at EAPC 2019: 16th World Congress of the European Association for Palliative Care, Global palliative care – Shaping the future, Berlin, 23-25 May 2019.
Open this publication in new window or tab >>Cancer-bereaved siblings advice to peers: A nationwide follow-up survey
2019 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-30020 (URN)
Conference
EAPC 2019: 16th World Congress of the European Association for Palliative Care, Global palliative care – Shaping the future, Berlin, 23-25 May 2019
Available from: 2019-05-23 Created: 2019-05-23 Last updated: 2019-05-23Bibliographically approved
Eilegård Wallin, A., Udo, C., Kreicbergs, U. & Lövgren, M. (2019). Cancer-bereaved siblings' advice to peers: a nationwide follow-up survey. Death Studies
Open this publication in new window or tab >>Cancer-bereaved siblings' advice to peers: a nationwide follow-up survey
2019 (English)In: Death Studies, ISSN 0748-1187, E-ISSN 1091-7683Article in journal (Refereed) In press
Abstract [en]

The aim of this nationwide survey was to explore, based on an open-ended question, cancer-bereaved siblings’ advice to peers with a brother or sister with cancer. Half of the advice related to being with the ill sibling and cherishing the time together. Other advice related to the value of communicating about the situation, letting go of guilt, and living life as usual. The results highlight the importance of health care professionals, family, and others facilitating for siblings to spend time together and communicate openly.

National Category
Nursing
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-29656 (URN)10.1080/07481187.2019.1595220 (DOI)000466681700001 ()2-s2.0-85064499307 (Scopus ID)
Available from: 2019-03-12 Created: 2019-03-12 Last updated: 2019-05-17Bibliographically approved
af Winklerfelt Hammarberg, S., Hange, D., André, M., Udo, C., Svenningsson, I., Björkelund, C., . . . Westman, J. (2019). Care managers can be useful for patients with depression but their role must be clear: a qualitative study of GPs’ experiences. Scandinavian Journal of Primary Health Care, 37(3), 273-282
Open this publication in new window or tab >>Care managers can be useful for patients with depression but their role must be clear: a qualitative study of GPs’ experiences
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2019 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 37, no 3, p. 273-282Article in journal (Refereed) Published
Abstract [en]

Objective: Explore general practitioners’ (GPs’) views on and experiences of working with care managers for patients treated for depression in primary care settings. Care managers are specially trained health care professionals, often specialist nurses, who coordinate care for patients with chronic diseases.

Design: Qualitative content analysis of five focus-group discussions.

Setting: Primary health care centers in the Region of Västra Götaland and Dalarna County, Sweden.

Subjects: 29 GPs.

Main outcome measures: GPs’ views and experiences of care managers for patients with depression.

Results: GPs expressed a broad variety of views and experiences. Care managers could ensure care quality while freeing GPs from case management by providing support for patients and security and relief for GPs and by coordinating patient care. GPs could also express concern about role overlap; specifically, that GPs are already care managers, that too many caregivers disrupt patient contact, and that the roles of care managers and psychotherapists seem to compete. GPs thought care managers should be assigned to patients who need them the most (e.g. patients with life difficulties or severe mental health problems). They also found that transition to a chronic care model required change, including alterations in the way GPs worked and changes that made depression treatment more like treatment for other chronic diseases.

Conclusion: GPs have varied experiences of care managers. As a complementary part of the primary health care team, care managers can be useful for patients with depression, but team members’ roles must be clear.

Keywords
Care manager, collaborative care, depression
National Category
Health Sciences
Research subject
Health and Welfare, Care Manager - Vårdsamordnare som spindeln i nätet för patienter med depression i primärvården
Identifiers
urn:nbn:se:du-30119 (URN)10.1080/02813432.2019.1639897 (DOI)000482039500002 ()31286807 (PubMedID)2-s2.0-85068716545 (Scopus ID)
Available from: 2019-06-03 Created: 2019-06-03 Last updated: 2019-09-13Bibliographically approved
Melin-Johansson, C., Lagerin, A., Lind, S., Lövgren, M., Sveen, J. & Udo, C. (2019). End-of-life communication from a life cycle perspective: a register study. In: : . Paper presented at EAPC: 16th World Congress of the European Association for Palliative Care, Global palliative care – Shaping the future, Berlin, 23-25 May 2019.
Open this publication in new window or tab >>End-of-life communication from a life cycle perspective: a register study
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2019 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Health Sciences
Research subject
Health and Welfare, Brytpunktssamtal vid palliativ vård i livets slutskede – innehåll och konsekvenser
Identifiers
urn:nbn:se:du-30033 (URN)
Conference
EAPC: 16th World Congress of the European Association for Palliative Care, Global palliative care – Shaping the future, Berlin, 23-25 May 2019
Available from: 2019-05-23 Created: 2019-05-23 Last updated: 2019-05-23Bibliographically approved
Lövgren, M., Kreicbergs, U. & Udo, C. (2019). Family talk intervention in paediatric oncology: a pilot study protocol. BMJ Paediatrics Open, 3(1), Article ID e000417.
Open this publication in new window or tab >>Family talk intervention in paediatric oncology: a pilot study protocol
2019 (English)In: BMJ Paediatrics Open, ISSN 2399-9772, Vol. 3, no 1, article id e000417Article in journal (Refereed) Published
Abstract [en]

Introduction: There is evidence that families with a child diagnosed with cancer need psychosocial support throughout the illness trajectory. Unfortunately, there is little research into psychosocial interventions for such families, especially interventions where the entire family is involved. The aim of this pilot study is therefore to evaluate a psychosocial intervention, the family talk intervention(FTI), in paediatric oncology in terms of study feasibility and potential effects.

Methods and analysis: This pretest/post-test intervention pilot study is based on families with a child diagnosed with cancer. All families that include at least one child aged 6–19 years (ill child and/or sibling) at one of the six paediatric oncology centres in Sweden between September 2018 and September 2019 will be asked about participation. The intervention consists of six meetings with the family (part of the family or the entire family), led by two interventionists. The core elements in the interventionare to support the families in talking about the illness and related subjects, support the parents in understandingthe needs of their children and how to support them and support the families in identifying their strengths and howto use them best. Mixed methods are used to evaluatethe intervention (web-based questionnaires, interviews, field notes and observations). Self-reported data from all family members are collected at baseline, directly after the intervention and 6 months later. Study outcomes are family communication, knowledge about the illness, resilience, quality of life and grief.

Ethics and dissemination: The study has been approved by the Regional Ethical Review Board in Stockholm (Dnr 2018/250-31/2 and 2018/1852–32). Data are processed in coded form, accessible only to the research team and stored at Ersta Sköndal Bräcke University College in a secure server.

Trial registration: ClinicalTrials. gov IdentifierNCT03650530, registered in August 2018.

National Category
Health Sciences
Research subject
Health and Welfare, Stödprogram för familjer där ett barn har cancer
Identifiers
urn:nbn:se:du-29352 (URN)10.1136/bmjpo-2018-000417 (DOI)30815590 (PubMedID)
Available from: 2019-02-01 Created: 2019-02-01 Last updated: 2019-04-04Bibliographically approved
Udo, C., Forsman, H., Jensfelt, M. & Flink, M. (2019). Perceptions of knowledge, research use and evidence-based practice among Swedish medical social workers – a qualitative study. In: : . Paper presented at European Conference for Social Work Research 2019 (ECSWR), 10-12 april, Leuven, Belgium.
Open this publication in new window or tab >>Perceptions of knowledge, research use and evidence-based practice among Swedish medical social workers – a qualitative study
2019 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Background and aim: With the intention to do more good than harm, it is important to rely on practice that is rooted in evidence-based guidelines so that clients are given the exact care they need. Thus, from a client safety perspective, the social worker needs to apply evidence-based practice (EBP). Learning more about the medical social workers’ perceptions of EBP has the potential to contribute to an increased understanding of how best available knowledge can be implemented in medical social work settings to provide high quality and safe practice to clients. Therefore the aim of this study was to explore medical social workers’ perceptions of evidence-based practice (EBP), including factors relevant for the successful implementation of evidence into medical social work practice.

Methods: This is a qualitative study. Eight focus group interviews were conducted that included 27 medical social workers. Data were analyzed using qualitative content analysis.

Results: Analysis resulted in two categories: “knowledge in practice” and “challenges in relation to the implementation of EBP” and four subcategories: “practice based on research evidence or experience”, “obtaining new evidence of practice”, “research and the social work context”, and “barriers and facilitating factors”. Participants tended to perceive EBP as theoretical and positivistic while perceiving their own knowledge as eclectic and experience-based. Although they perceived the relevance of research findings to their practice, they expressed a need for support to translate research into policy and practice. They also reported that studies about their specific work were scarce.

Conclusion and implications: The facilitating factors suggested by the medical social workers which concerned, e.g., a specially designated person responsible for supporting the increased use of research findings, support for prioritization of time, increased opportunities for the sharing of knowledge, and time for consultations, need to be considered when promoting the implementation of EBP within medical social work settings. The medical social workers’ suggestion for the facilitation of knowledge exchange needs further investigation.

Keywords
Evidence-based practice, Focus group interviews, Medical social worker
National Category
Social Work
Identifiers
urn:nbn:se:du-29622 (URN)
Conference
European Conference for Social Work Research 2019 (ECSWR), 10-12 april, Leuven, Belgium
Available from: 2019-03-07 Created: 2019-03-07 Last updated: 2019-03-07Bibliographically approved
Udo, C., Kreicbergs, U., Axelsson, B., Björk, O. & Lövgren, M. (2019). Physicians working in oncology identified challenges and factors that facilitated communication with families when children could not be cured. Acta Paediatrica
Open this publication in new window or tab >>Physicians working in oncology identified challenges and factors that facilitated communication with families when children could not be cured
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2019 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aim: We explored physicians’ experiences of communicating with families when their child had cancer and a cure was no longer an option, by focusing on barriers and facilitating factors.

Methods: Physicians from the six cancer centres in Sweden took part in focus group discussions from December 2017 and May 2018 and the data were analysed using qualitative content analysis. Focus groups enabled us to gather individual and shared perspectives.

Results: The 35 physicians (20 male) had a mean age of 47 (range 31-74) and a mean of 11 years’ experience in oncology, ranging from under one year to 43 years. They reported communication challenges when a cure was not possible, namely: emotional and mental drain, lack of mutual understanding and uncertainty about communication skills. They also reported facilitating factors: flexibility in complex conversations, the child’s position in the conversations, continuity and trusting relationships, support from colleagues and having discussed the potentially life-threatening nature of cancer from the very start of treatment.

Conclusion: Physicians working in paediatric oncology perceived challenges and facilitating factors in their communication with families when a cure was not an option. Training to overcome communication issues could support the early integration of palliative care and curative treatment.

Keywords
childhood cancer, challenges, communication, paediatric oncology, palliative care
National Category
Health Sciences
Research subject
Health and Welfare, Brytpunktssamtal vid palliativ vård i livets slutskede – innehåll och konsekvenser
Identifiers
urn:nbn:se:du-30219 (URN)10.1111/apa.14903 (DOI)000475166700001 ()31206784 (PubMedID)
Note

Open Access APC beslut 9/2019

Available from: 2019-06-13 Created: 2019-06-13 Last updated: 2019-07-30Bibliographically approved
Svenningsson, I., Petersson, E.-L., Udo, C., Westman, J., Björkelund, C. & Wallin, L. (2019). Process evaluation of a cluster randomised intervention in Swedish primary care: using care managers in collaborative care to improve care quality for patients with depression.. BMC Family Practice, 20(1), Article ID 108.
Open this publication in new window or tab >>Process evaluation of a cluster randomised intervention in Swedish primary care: using care managers in collaborative care to improve care quality for patients with depression.
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2019 (English)In: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 20, no 1, article id 108Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The collaborative care model with a care manager has previously generated beneficial results for patients with depression in terms of decreased burden of depression symptoms. A care manager function has been tested in Sweden in the PRIM-CARE RCT with successful results. The aim of the present study was to evaluate the process of implementing care managers in collaborative care for patients with depression in Swedish primary health care in the PRIM-CARE RCT.

METHODS: The study followed UK Medical Research Council guidance for process evaluation. Field notes from the implementation of the PRIM - CARE RCT were used, as well as data collected from five focus group discussions with General Practitioners (n = 29) and three focus group discussions with care managers (n = 11). Data were analysed with content analysis.

RESULTS: Training sessions, careful preparation and extensive initial support to the care manager and staff at the Primary Care Centres were important ingredients in the implementation. The close access to facilitators, the recurrent peer support meetings, and the weekly newsletter strengthened the care manager function.

CONCLUSIONS: A complex intervention adapted to the Swedish primary care context focusing on a care manager function for patients with depression could be performed through a stepwise implementation process. Financial support from the health care regions included in the study helped to reduce the impact of identified barriers. This process evaluation has revealed new and important knowledge for primary care development concerning infrastructure and organization building, knowledge sharing, and facilitating factors and barriers.

TRIAL REGISTRATION: NCT02378272 Care Manager - Coordinating Care for Person Centered Management of Depression in Primary Care (PRIM - CARE). Registered March 4 2015. Retrospectively registered.

Keywords
Accessibility, Care manager, Collaborative care, Continuity, Depression, Facilitator, Primary health care, Process evaluation
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-30592 (URN)10.1186/s12875-019-0998-4 (DOI)000477585300002 ()31351444 (PubMedID)2-s2.0-85069940111 (Scopus ID)
Available from: 2019-08-06 Created: 2019-08-06 Last updated: 2019-08-12
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-2853-0575

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