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  • 1. Aamodt, A.
    et al.
    Gundersen, O. E.
    Loge, J. H.
    Wasteson, Elisabet
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Szczepanski, T.
    Case-based reasoning for assessment and diagnosis of depression in palliative care2010In: Proceedings - IEEE Symposium on Computer-Based Medical Systems, 2010, p. 480-485Conference paper (Refereed)
    Abstract [en]

    The goal of the research presented is to create a computational framework and system architecture for clinical decision support in palliative care. The application focused is the classification of depression. The method under investigation is case-based reasoning, motivated by the complexity of the domain and a lack of generalized principles of sufficient coverage and strength for diagnosis and treatment. A system architecture is described and exemplified through an implemented prototype. The outcome of the research so far is a system that captures the properties intended, and for which a clinical test set-up has been defined. © 2010 IEEE.

  • 2.
    Bjärtå, Anna
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Leiler, Anna
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Ekdahl, Johanna
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Wasteson, Elisabet
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Assessing Severity of Psychological Distress Among Refugees With the Refugee Health Screener, 13-Item Version2018In: Journal of Nervous and Mental Disease, ISSN 0022-3018, E-ISSN 1539-736X, Vol. 206, no 11, p. 834-839Article in journal (Refereed)
    Abstract [en]

    The recent inflow of refugees to Sweden has put pressure on health care as well as revealing a need for methods regarding assessment of refugees' mental health status. The present study investigated the use of the Refugee Health Screener (RHS; Hollifield et al., 2013) to distinguish among severity levels of symptoms of psychological distress in refugees. Refugees residing in asylum accommodations (n = 510) were screened with RHS-13, together with screeners for depression, anxiety, and posttraumatic stress disorder (PTSD). Risk for mild, moderate, or severe levels of depression, anxiety, or/and PTSD was used as screening proxy. Receiver operating characteristic analysis rendered cutoff scores of 11, 18, and 25, for mild, moderate, and severe symptoms, respectively. Evaluated against each symptom scale separately, cutoffs performed well. Cutoff 11, previously identified by Hollifield et al. (2016), was also confirmed. However, utilization of additional cutoffs could improve refugee mental health by guiding clinical decision making.

  • 3.
    Brenne, Elisabeth
    et al.
    Norwegian Univ Sci & Technol, European Palliat Care Res Ctr, Fac Med, N-7006 Trondheim, Norway.
    Loge, Jon Håvard
    Norwegian Univ Sci & Technol, European Palliat Care Res Ctr, Fac Med, N-7006 Trondheim, Norway.
    Kaasa, Stein
    Norwegian Univ Sci & Technol, European Palliat Care Res Ctr, Fac Med, N-7006 Trondheim, Norway.
    Heitzer, Ellen
    Med Univ Graz, Div Palliat Med, Dept Internal Med, Graz, Austria.
    Knudsen, Anne Kari
    Norwegian Univ Sci & Technol, European Palliat Care Res Ctr, Fac Med, N-7006 Trondheim, Norway.
    Wasteson, Elisabet
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology. Norwegian Univ Sci & Technol, European Palliat Care Res Ctr, Fac Med, N-7006 Trondheim, Norway.
    Depressed patients with incurable cancer: which depressive symptoms do they experience?2013In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 11, no 6, p. 491-501Article, review/survey (Refereed)
    Abstract [en]

    OBJECTIVE: Diagnosing depressive disorders in palliative care is challenging because of the overlap between some depressive symptoms and cancer-related symptoms, such as loss of appetite and fatigue. In order to improve future assessment of depression in palliative care, depressive symptoms experienced by patients receiving pharmacological treatment for depression were assessed and compared to the American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria for major depressive disorder.

    METHOD: Thirty Norwegian (n = 20) and Austrian (n = 10) patients with advanced cancer were included. Semistructured interviews on symptom experiences were conducted and transcribed verbatim. By the phenomenographic method, patients' symptom experiences were extracted and sorted by headings, first individually and then across patients. The patients subsequently rated 24 symptoms numerically including the DSM-IV depression criteria.

    RESULTS: Lowered mood and a diminished motivational drive were prominent and reflected the two main DSM-IV symptom criteria. A relentless focus on their actual situation, restlessness, disrupted sleep, feelings of worthlessness, feelings of guilt, and thoughts of death as a solution were variably experienced. Appetite and weight changes, fatigue and psychomotor retardation were indistinguishable from cancer symptoms. All these symptoms reflected DSM-IV symptom criteria. Some major symptoms occurred that are not present in the DSM-IV symptom criteria: despair, anxiety, and social withdrawal. The numerical ratings of symptoms were mainly in accordance with the findings from the qualitative analysis.

    SIGNIFICANCE OF RESULTS: Despair, anxiety, and social withdrawal are common symptoms in depressed patients with incurable cancer, and, therefore, hypothesized as candidate symptom criteria. Other symptom criteria might need adjustment for improvement of relevance in this group of patients.

  • 4.
    Bring, Annika
    et al.
    Department of Neuroscience, Physiotherapy, Uppsala University, Husargatan 3, 75124 Uppsala, Sweden .
    Bring, Johan
    University of Gävle, Gävle, Sweden .
    Söderlund, Anne
    Department of Neuroscience, Physiotherapy, Uppsala University, Husargatan 3, 75124 Uppsala, Sweden .
    Wasteson, Elisabet
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Åsenlöf, Pernilla
    Department of Neuroscience, Physiotherapy, Uppsala University, Husargatan 3, 75124 Uppsala, Sweden .
    Coping Patterns and Their Relation to Daily Activity, Worries, Depressed Mood, and Pain Intensity in Acute Whiplash-Associated Disorders2013In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 20, no 2, p. 293-303Article in journal (Refereed)
    Abstract [en]

    There is a lack of knowledge regarding how individuals with acute whiplash-associated disorders (WAD) appraise and cope with situation-specific stressors. The aim of the study was to describe the daily process of coping reported in a daily coping assessment by individuals with acute WAD within 1 month after the accident. More specifically, profiles of coping strategies were identified and patterns between stressors, primary and secondary appraisals, and coping strategy profiles were described in relation to reported level of activity, worries, depressed mood and pain intensity during the day. A descriptive and exploratory design was applied. Two hundred and twenty-nine whiplash-associated disorders-daily coping assessment (WAD-DCA) collected during seven consecutive days from 51 participants with acute WAD in Sweden, were included. Cluster analysis was used to obtain coping strategy profiles and data were graphically visualised as patterns through the coping process. When measuring coping as a daily process relating to the specific stressful situation, different coping process patterns appeared. During days with a high degree of physical and mental well-being, high self-efficacy beliefs seemed to be working as an important secondary appraisal, whereas during days with a low degree of physical and mental well-being primary appraisals of the stressor as a threat and catastrophic thoughts were present in the coping process. Early identification of situational- and individual-specific stressors, appraisals and coping efforts as measured by the WAD-DCA may contribute to the understanding of the coping process in the acute stage of WAD and its possible impact on recovery and adjustment.

  • 5.
    Bring, Annika
    et al.
    Department of Neuroscience, Uppsala University, Box 593/BMC, Husargatan 3, Uppsala, 75124, Sweden.
    Söderlund, Anne
    Department of Physiotherapy, School of Health, Care and Social Wellfare, Västerås, Sweden.
    Wasteson, Elisabet
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Asenlof, Pernilla
    Department of Neuroscience, Uppsala University, Box 593/BMC, Husargatan 3, Uppsala, 75124, Sweden.
    Daily stressors in patients with acute whiplash associated disorders2012In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, no 21, p. 1783-1789Article in journal (Refereed)
    Abstract [en]

    Purpose: Stressors in acute whiplash associated disorders (WAD), as reported on a daily basis, have hitherto been neglected in research. The primary aim of this study was to describe the most stressful daily situation or event reported by individuals with acute WAD within a month of a whiplash trauma. Another aim was to describe the meaning and significance of these daily stressors, i.e. primary appraisal. Method: A descriptive design with a content analysis approach was used. 260 WAD-daily coping assessments (WAD-DCA) generated during 1 week by 51 participants with acute WAD were included in the study. Stressors were analysed using qualitative content analysis. Results: The reported stressors generated 13 categories covering a wide range of stressful situations in daily life related to (i) work, (ii) physical symptoms, (iii) feelings and cognitions, (iv) family and home responsibilities and (v) recreation. The majority of the stressors were appraised as "expected" as well as "disabling". Most threatening stressors were related to work, driving and feelings/cognitions. Conclusions: The wide variety of stressors indicates that it is not only pain itself that influences daily life in acute WAD. Early identification of individual and situation-specific stressors gives new data regarding what bothers individuals suffering from WAD after a collision and may be helpful in understanding the coping process in relation to specific stressors and stressor appraisals.

  • 6.
    Knudsen, Anne Kari
    et al.
    NTNU, Univ Trondheim Hosp, European Palliat Care Res Ctr, Dept Canc Res & Mol Med,Fac Med, N-7006 Trondheim, Norway .
    Aass, Nina
    Univ Oslo, Fac Med, N-0315 Oslo, Norway.
    Heitzer, Ellen
    Med Univ Graz, Dept Internal Med, Div Palliat Med, Graz, Austria .
    Klepstad, Pal
    Fac Med, Dept Circulat & Med Imaging, N-7006 Trondheim, Norway .
    Hjermstad, Marianne Jensen
    NTNU, Univ Trondheim Hosp, European Palliat Care Res Ctr, Dept Canc Res & Mol Med,Fac Med, N-7006 Trondheim, Norway .
    Schippinger, Walter
    Med Univ Graz, Dept Internal Med, Div Palliat Med, Graz, Austria .
    Brenne, Elisabeth
    NTNU, Univ Trondheim Hosp, European Palliat Care Res Ctr, Dept Canc Res & Mol Med,Fac Med, N-7006 Trondheim, Norway .
    Kaasa, Stein
    NTNU, Univ Trondheim Hosp, European Palliat Care Res Ctr, Dept Canc Res & Mol Med,Fac Med, N-7006 Trondheim, Norway .
    Wasteson, Elisabet
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Interviews with patients with advanced cancer-another step towards an international cancer pain classification system2012In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 20, no 10, p. 2491-2500Article in journal (Refereed)
    Abstract [en]

    Patients' involvement in the development of assessment tools is recommended, and the European Palliative Care Research Collaborative has adhered to this when developing a shared language for cancer pain, an international assessment and classification system. Study objectives were to investigate how patients ranked the relevance of several previously identified pain domains, to investigate patients' perception of the pain experience and to disclose additional, relevant pain domains for cancer pain classification to those identified in the literature. Semistructured interviews with advanced cancer patients treated with opioids were performed and analysed verbatim. Patients scored the relevance of predefined pain domains on an 11-point Numerical Rating Scale. Thirty-three Norwegian and Austrian patients were included (16 females and 17 males); the mean age was 63 years, and the mean Karnofsky performance score was 65. The ranking of domains was as follows etiology (mean Numerical Rating Scale score, 8.5), duration (8.0), intensity (7.4), coping (7.1), physical (5.9) and psychological functioning (5.8). Sleep was identified as a new candidate domain to include in the system. The patients emphasised consequences of having pain, for example, poor physical functioning and psychological distress. Previously identified pain domains were confirmed to be relevant to the patients; however, the ranking differed from the experts' ranking. Sleep disturbances may be added as a domain in a future classification system.

  • 7.
    Leiler, Anna
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology. 202100-4524.
    Bjärtå, Anna
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Ekdahl, Johanna
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Wasteson, Elisabet
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    High levels of psychological distress among asylum seekers and refugees in Sweden2018Conference paper (Other academic)
    Abstract [en]

    In 2015 there was an unforeseen increase of refugees worldwide. In order to face the high rates of psychological distress refugees suffer, the AMIR-project created a model for early assessment and intervention of mental health among refugees. Previous research might not be applicable to the groups seeking asylum in Europe from 2015, so as a first step, a study aiming to estimate the prevalence of mental health problems was conducted.  

    Methods. Five hundred and ten refugees participated at open screenings conducted at refugee housing facilities. Of the participants, 367 were asylum seekers and 143 had received a residence permit. Instruments included measures of depressive symptoms, anxiety, risk of having PTSD and quality of life.

    Preliminary results. A high percentage of individuals (56-58.4%) reported clinically significant levels of depression, anxiety and risk of having PTSD. Prevalence estimates were significantly higher among asylum seekers than among those who had received their residence permit. Quality of life was generally rated below population norms and correlated significantly with mental health outcomes.

    Conclusions. Individuals residing in refugee housing facilities show high levels of psychological distress. Asylum seekers are worse off than those having received a residence permit. Actions should be taken to improve conditions in housing facilities, to shorten the time awaiting the asylum decision and to provide psychosocial support to help individuals manage their distress during the time of waiting.

    Key words: Refugee – asylum seeker – mental health – quality of life - prevalence

  • 8.
    Leiler, Anna
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Bjärtå, Anna
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Ekdahl, Johanna
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Wasteson, Elisabet
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Mental Health and Quality of Life among Asylum Seekers and Refugees Living in Refugee Housing Facilities in Sweden2019In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 54, no 5, p. 543-551Article in journal (Refereed)
    Abstract [en]

    In 2015, there was a high influx of refugees to Sweden, creating an extreme situation where individuals were forced to remain in large housing facilities for long periods. The present study aims to describe the mental health and quality of life of these individuals. 

    Methods. Data, based on 510 individuals, were obtained by means of a questionnaire at open screenings conducted at or nearby refugee housing facilities. Of the participating refugees, 367 were asylum seekers and 143 had received a residence permit but were still awaiting a more permanent housing solution. The questionnaire included measures of depressive symptoms (PHQ-9), symptoms of anxiety (GAD-7), risk of having post traumatic stress disorder (PC-PTSD), and quality of life (WHOQOL-BREF).

    Results. Of the total sample, 56-58.4% reported clinically significant levels of symptoms of depression, anxiety and risk of having PTSD. Prevalence estimates were higher among asylum seekers than among those who had received their residence permit. Quality of life was generally rated below population norms and correlated negatively with mental health outcomes.

    Conclusions. Individuals residing in refugee housing facilities show high levels of psychological distress and rate their quality of life as low. Asylum seekers score higher than those having received a residence permit. These results are troublesome since the wait time for asylum decisions has lengthened considerably after 2015. The results of the present study calls for the urgency of societal actions to shorten the asylum process wait time and improve conditions at the housing facilities.  

  • 9.
    Leiler, Anna
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Hollifield, Michael
    War Survivors Institute, Long Beach, CA, USA.
    Wasteson, Elisabet
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Bjärtå, Anna
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Suicidal ideation and severity of distress among refugees residing in asylum accommodations in Sweden2019In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 15, article id 2751Article in journal (Refereed)
    Abstract [en]

    Refugees worldwide suffer high levels of distress and are at increased risk for death by suicide. The Refugee Health Screener (RHS) was developed to screen for emotional distress among refugees and can be used to assess distress severity. This paper examines the association between distress severity and suicidal ideation in a sample of refugees residing in asylum accommodations. Data from the RHS and item 9 on the Patient Health Questionnaire-9 (PHQ-9) was analyzed. Results showed that individuals at moderate and severe levels of distress were much more likely to exhibit suicidal ideation than individuals with low levels of distress. Even though we cannot conclude that individuals with low levels of distress do not have thoughts of ending their lives, further suicide assessment is warranted in asylum seekers with moderate to severe distress on the RHS. 

  • 10.
    Sarkadi, Anna
    et al.
    Uppsala University, Uppsala.
    Warner, Georgina
    Uppsala University, Uppsala.
    Salari, Raziye
    Uppsala University, Uppsala.
    Fängström, Karin
    Uppsala University, Uppsala.
    Durbeej, Natalie
    Uppsala University, Uppsala.
    Lampa, Elin
    Uppsala University, Uppsala.
    Baghdasaryan, Zaruhi
    Uppsala University, Uppsala.
    Osman, Fatumo
    Uppsala University, Uppsala.
    Gupta Löfving, Sandra
    Uppsala University, Uppsala.
    Perez Aronsson, Anna
    Uppsala University, Uppsala.
    Feldman, Inna
    Uppsala University, Uppsala.
    Sampaio, Filipa
    Uppsala University, Uppsala.
    Ssegonja, Richard
    Uppsala University, Uppsala.
    Calam, Rachel
    University of Manchester, Manchester, United Kingdom.
    Bjärtå, Anna
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Leiler, Anna
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Rondung, Elisabet
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Wasteson, Elisabet
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Oppedal, Brit
    Norwegian Institute of Public Health, Oslo, Norway.
    Keeshin, Brooks
    University of Utah, Salt Lake City, UT, United States.
    Evaluation of the Teaching Recovery Techniques community-based intervention for unaccompanied refugee youth experiencing post-traumatic stress symptoms (Swedish UnaccomPanied yOuth Refugee Trial; SUPpORT): study protocol for a randomised controlled trial2020In: Trials, ISSN 1745-6215, E-ISSN 1745-6215, Vol. 21, no 1, article id 63Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In 2015, 162,877 persons sought asylum in Sweden, 35,369 of whom were unaccompanied refugee minors (URMs). Refugee children, especially URMs, have often experienced traumas and are at significant risk of developing mental health problems, such as symptoms of post-traumatic stress disorder (PTSD), depression and anxiety, which can continue years after resettlement. The Swedish UnaccomPanied yOuth Refugee Trial (SUPpORT) aims to evaluate a community-based intervention, called Teaching Recovery Techniques (TRT), for refugee youth experiencing PTSD symptoms.

    METHODS/DESIGN: A randomised controlled trial will be conducted in which participants will be randomly allocated to one of two possible arms: the intervention arm (n = 109) will be offered the TRT programme, and the waitlist-control arm (n = 109) will receive services as usual, followed by the TRT programme around 20 weeks later. Outcome data will be collected at three points: pre-intervention (T1), post-intervention (T2; about 8 weeks after randomisation) and follow-up (T3; about 20 weeks after randomisation).

    DISCUSSION: This study will provide knowledge about the effect and efficiency of a group intervention for URMs reporting symptoms of PTSD in Sweden. TRIAL REGISTRATION: ISRCTN, ISRCTN47820795. Prospectively registered on 20 December 2018.

  • 11.
    Vikstrom, Nils Hansson
    et al.
    Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden..
    Wasteson, Elisabet
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
    Lindam, Anna
    Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden..
    Samuelsson, Eva
    Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden..
    Anxiety and depression in women with urinary incontinence using E-health2020In: International Urogynecology Journal, ISSN 0937-3462, E-ISSN 1433-3023Article in journal (Refereed)
    Abstract [en]

    Introduction and hypothesis Previous studies have found high prevalence rates of anxiety and depression in women with urinary incontinence (UI). This study investigates the prevalence in women who had turned to eHealth for treatment of UI and identifies possible factors associated with depression. Methods We analyzed data from two randomized controlled trials evaluating eHealth treatment for UI, including 373 women with stress UI (SUI), urgency UI (UUI), or mixed UI (MUI). We used the Hospital Anxiety and Depression Scale (HADS) and defined a score of >= 8 as depression or anxiety. The ICIQ-UI-SF questionnaire was used to score incontinence severity. Logistic regression was used to determine factors associated with depression and anxiety. Results Women with UUI or MUI were older than women with SUI, mean age 58.3 vs 48.6 years (p = <0.001). Four out of five participating women had a university education. The prevalence of anxiety and depression in women with SUI was 12.4% and 3.2% respectively. In women with MUI/UUI, 13.8% had anxiety and 10.6% had depression. In multivariate analyses, the odds ratio of having depression was 4.2 (95% CI = 1.4-12.3) for women with MUI/UUI compared with SUI when controlling for other risk factors. Conclusion The odds of depression in women with MUI/UUI were increased compared with SUI. The prevalence of anxiety and depression was considerably lower than reported in large cross-sectional surveys. Socioeconomic differences may partly explain this finding, as the use of eHealth still is more common among highly educated women.

  • 12.
    Wasteson, Elisabet
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Mood disorders in patients with cancer: Editorial2011In: The Lancet Oncology, ISSN 1470-2045, E-ISSN 1474-5488, Vol. 12, no 2, p. 114-115Article in journal (Other academic)
  • 13.
    Wasteson, Elisabet
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Brenne, Elisabeth
    Higginson, Irene J
    Hotopf, Matthew
    Lloyd-Williams, Mari
    Kaasa, Stein
    Håvard Loge, Jon
    Depression assessment and classification in palliative cancer patients: a systematic literature review2009In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 23, no 8, p. 739-753Article, review/survey (Refereed)
    Abstract [en]

    The objective of this study was to review the literature on depression in palliative cancer care in order to identify which assessment methods and classification systems have been used in studies of depression. Extensive electronic database searches in PubMed, CancerLit, CINAHL, PsychINFO, EMBASE and AgeLine as well as hand search were carried out. In the 202 included papers, 106 different assessment methods were used. Sixty-five of these were only used once. All together, the Hospital Anxiety and Depression Scale (HADS) was the most commonly used assessment method. However, there were regional differences and while the HADS dominated in Europe it was quite seldom used in Canada or in the USA. Few prevalence and intervention studies used assessment methods with an explicit reference to a diagnostic system. There were in total few case definitions of depression. Among these, the classifications were in general based on cut-off scores (77%) and not according to diagnostic systems. The full range of the DSM-IV diagnostic criteria was seldom assessed, i.e. less than one-third of the assessments in the review took into account the duration of symptoms and 18% assessed consequences and impact upon patient functioning. A diversity of assessment methods had been used. Few studies classified depression by referring to a diagnostic system or by using cut-off scores. Evidently, there is a need for a consensus on how to assess and conceptualize depression and related conditions in palliative care.

     

     

  • 14.
    Wasteson, Elisabeth
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Sandelin, Kerstin
    Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden .
    Brandberg, Y
    Karolinska Inst, Dept Pathol & Oncol, Stockholm, Sweden.
    Wickman, M
    Molecular Medicine and Surgery, Karolinska Institutet, Stockholm.
    Arver, B
    Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.
    High satisfaction rate ten years after bilateral prophylactic mastectomy - a longitudinal study2011In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 20, no 4, p. 508-513Article in journal (Refereed)
    Abstract [en]

    High satisfaction rate ten years after bilateral prophylactic mastectomy - a longitudinal study Women from families with an increased risk for breast/ovarian cancer have undergone bilateral prophylactic mastectomy (BPM) since the early 1990s at the Karolinska University Hospital in Sweden. Perceptions of BPM as reported by the first women who underwent the procedure have previously been evaluated on a short-term basis (1-3 years). The present study aims to evaluate the long-term (10 years) physical and psychological consequences of BPM in the same cohort of women. Some of the very first women to undergo BPM participated in the present interview study (n= 13). The semi-structured interviews focused on the women's long-term experiences related to BPM and immediate breast reconstruction. Overall, the women were satisfied with their decision to undergo BPM and perceived a negligible remaining risk of getting breast cancer. For most women, the operation had not resulted in changes in family life or lifestyle (n= 8), although some described that the relationship with their spouse was affected (8/13), either in a negative (n= 5) or positive (n= 3) way. The cosmetic results were mainly positive (n= 10). Recurrent counselling and support during the whole process of decision, treatment and follow up is recommended.

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