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Nordin, Karin
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Publications (10 of 81) Show all publications
Henriksson, A., Igelström, H., Arving, C., Nordin, K., Johansson, B. & Demmelmaier, I. (2020). The Phys-Can study: meaningful and challenging - supervising physical exercise in a community-based setting for persons undergoing curative oncological treatment.. Physiotherapy Theory and Practice, 1-10
Open this publication in new window or tab >>The Phys-Can study: meaningful and challenging - supervising physical exercise in a community-based setting for persons undergoing curative oncological treatment.
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2020 (English)In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, p. 1-10Article in journal (Refereed) Epub ahead of print
Abstract [en]

Introduction: Supervised exercise may improve physical function and quality of life during oncological treatment. Providing supervised exercise to all patients at hospitals may be impractical, with community-based settings (e.g. public gyms) as a possible alternative. To facilitate implementation, knowledge about the experiences of professionals who deliver exercise programs in community-based settings is crucial.Objective: To explore how physical therapists and personal trainers experience supervising exercise in a community-based setting for persons undergoing curative oncological treatment. Methods: Nine physical therapists and two personal trainers (coaches) were interviewed individually. The semi-structured interviews lasted 33-67 minutes and were analyzed using thematic analysis. Results: Two main themes emerged: "A meaningful task" and "A challenging task," with nine sub-themes. The coaches experienced supervising exercise for persons undergoing treatment as meaningful, as they became a link between oncology care and health promotion. They grew more confident in the role and ascertained that exercising during treatment was feasible. Challenges included managing side effects of treatment and contradictory information from oncology care staff at hospitals, advising patients not to exercise.Conclusion: Supervising exercise for persons undergoing oncological treatment in a community-based setting may be highly rewarding for professionals who deliver exercise programs, which is promising for implementation. However, patients receive contradictory information about exercise, which may prevent physical activity. Also, supervising exercise for persons undergoing oncological treatment requires skills training; this is suggested for inclusion in educational programs for physical therapists and others. Future research should focus on strategies for cooperation between oncology care and health promotion.

Keywords
Oncology, exercise, physical therapist
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-406979 (URN)10.1080/09593985.2020.1737995 (DOI)32166992 (PubMedID)
Note

Birgitta Johansson and Ingrid Demmelmaier contributed equally to this manuscript.

Available from: 2020-03-23 Created: 2020-03-23 Last updated: 2020-03-25
Arving, C., Assmus, J., Thormodsen, I., Berntsen, S. & Nordin, K. (2019). Early rehabilitation of cancer patients: An individual randomized stepped-care stress-management intervention.. Psycho-Oncology, 28(2), 301-308
Open this publication in new window or tab >>Early rehabilitation of cancer patients: An individual randomized stepped-care stress-management intervention.
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2019 (English)In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 28, no 2, p. 301-308Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To evaluate the effects of an individual stepped-care stress-management intervention for cancer patients on cancer-related stress reactions (intrusion/avoidance), and secondarily on psychological distress (anxiety/depression) and emotional reactivity (impatience/hostility).

METHODS: Consecutively 291 cancer patients were included in a randomized controlled intervention study. Patients randomized to the intervention who did not report clinically significant stress levels (n = 72) after the first counseling session participated in only one counseling session and a follow-up (Step 1). The remaining patients (n = 66) received an additional three to eight sessions, depending on individual needs (Step 2). The intervention used techniques derived from cognitive behavioral therapy (CBT) such as daily registration of events and behaviors as well as scheduled behavioral and physical activity, along with short relaxation exercises. The intervention was completed within 26 weeks of inclusion. The Impact of Event Scale, Hospital Anxiety and Depression Scale, and Everyday Life Stress Scale were used to evaluate effects for 2 years.

RESULTS: The linear mixed effects model analysis showed a difference between the randomization groups in favor of the intervention for avoidance and intrusion after the first 6 weeks (P = 0.001 and P = 0.003) and for emotional reactivity after 17 weeks (P = 0.007). There were no differences in psychological distress. Decreases in cancer-related stress reactions and depression were noted for the Step 2 intervention.

CONCLUSIONS: An individual stepped-care stress-management intervention for cancer patients, performed by specially educated health professionals using techniques derived from CBT, seems beneficial for cancer patients and may therefore be a realistic complement to routine cancer care.

Keywords
anxiety, cancer, counseling, depression, life stress, linear mixed effects model, methods derived from cognitive behavioral therapy, oncology, psychological, stress disorders
National Category
Nursing Applied Psychology
Identifiers
urn:nbn:se:uu:diva-368522 (URN)10.1002/pon.4940 (DOI)000459808800010 ()30408282 (PubMedID)
Available from: 2018-12-05 Created: 2018-12-05 Last updated: 2019-03-21Bibliographically approved
Mazzoni, A.-S., Carlsson, M., Berntsen, S., Nordin, K. & Demmelmaier, I. (2019). "Finding my own motivation" - A Mixed Methods Study of Exercise and Behaviour Change Support During Oncological Treatment. International Journal of Behavioral Medicine, 26(5), 499-511
Open this publication in new window or tab >>"Finding my own motivation" - A Mixed Methods Study of Exercise and Behaviour Change Support During Oncological Treatment
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2019 (English)In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 26, no 5, p. 499-511Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Exercising during oncological treatment is beneficial but challenging for persons with cancer and may require strategies to increase motivation. Behaviour change support, including specific behaviour change techniques (BCTs), have been used to facilitate exercise in persons undergoing oncological treatment, but more detailed knowledge from an individual perspective is needed to inform clinical practice. The aims were to explore the motivational experiences of exercise combined with behaviour change support, and to describe how specific BCTs were valued among persons exercising during oncological treatment. METHODS: A mixed-methods study was conducted using semi-structured interviews (n = 18) and a questionnaire (n = 229). Participants with breast, colorectal or prostate cancer who completed or dropped out of a six-month exercise programme during oncological treatment were included. The interviews were analysed with thematic analysis and the questionnaire with descriptive statistics (median and interquartile range). RESULTS: The participants underwent a motivational process through the exercise programme. By experiencing 'Health gains and mastery', 'Learning', 'Affinity', 'Commitment', and 'Managing challenges', they found incentives that fostered feelings of autonomy, competence and relatedness, leading to an increased motivation to exercise. Social support from coaches, structuring the physical environment with scheduled sessions, self-monitoring with resistance training log, and feedback based on heart rate monitor and fitness tests were the most valued BCTs. CONCLUSIONS: The results indicate the importance of finding incentives and creating an environment that fosters autonomy, competence and relatedness to motivate persons to exercise during oncological treatment. Some BCTs appear particularly useful and may be used by health professionals to increase patients' motivation to exercise.

Keywords
Behaviour change techniques, Cancer, Incentives, Physical activity, Qualitative research, Self-determination theory
National Category
Cancer and Oncology Physiotherapy
Identifiers
urn:nbn:se:uu:diva-392500 (URN)10.1007/s12529-019-09809-z (DOI)000489300800006 ()31441015 (PubMedID)
Funder
Swedish Cancer Society, 15 0841Swedish Research Council, 521-2013-2734
Available from: 2019-09-05 Created: 2019-09-05 Last updated: 2019-11-06Bibliographically approved
Börjesson, S., Nordin, K., Fjällskog, M.-L., Rissanen, R., Peterson, M. & Arving, C. (2018). Colored body images reveal the perceived intensity anddistribution of pain in women with breast cancer treated with adjuvant taxanes:: a prospective multi-method study of pain experience. Scandinavian Journal of Pain, 581-591
Open this publication in new window or tab >>Colored body images reveal the perceived intensity anddistribution of pain in women with breast cancer treated with adjuvant taxanes:: a prospective multi-method study of pain experience
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2018 (English)In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, p. 581-591Article, review/survey (Refereed) Published
Abstract [en]

Background and aims:

Breast cancer is the most prevalent adult cancer worldwide. A broader use of screening for early detection and adjuvant systemic therapy with chemotherapy has resulted in improved survival rates. Taxane-containing chemotherapy is one of the cornerstones of the treatment. However, taxane-containing chemotherapy may result in acute chemotherapy-induced nociceptive and neuropathic pain. Since this pain may be an additional burden for the patient both during and after taxane chemotherapy, it is important to rapidly discover and treat it. There is yet no gold standard for assessing taxane-induced pain. In the clinic, applying multiple methods for collecting information on pain may better describe the patients’ pain experiences. The aim was to document the pain during and after taxane through the contribution of different methods for collecting information on taxane-induced pain. Fifty-three women scheduled for adjuvant sequential chemotherapy at doses of ≥75 mg/m2 of docetaxel and epirubicin were enrolled in the study.

Methods:

Prospective pain assessments were done on a visual analog scale (VAS) before and during each cycle of treatment for about 5 months, and using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire’s (EORTC-QLQ-C30) two pain questions at baseline, 3 months, and 12 months. Participants scoring pain on the VAS >30 and undergoing an interview also colored their pain on a body image during treatment and at 12 months.

Results:

Surprisingly widespread, intense pain was detected using a multi-method approach. The colored body image showed pain being perceived on 51% of the body surface area during treatment, and on 18% 12 months after inclusion. In general, the pain started and peaked in intensity after the first cycle of taxane. After Cycle 3, most women reported an increase in pain on the VAS. Some women continued to report some pain even during the epirubicin cycles. The VAS scores dropped after the last chemotherapy cycle, but not to the baseline level. At baseline, 3 months and 12 months after inclusion, the women who estimated VAS >30 reported higher levels of pain on the pain questions of the EORTC-QLQ-C30.

Conclusions:

This study contributes information on how different pain assessment tools offer different information in the assessment of pain. The colored body image brings another dimension to pain diagnostics, providing additional information on the involved body areas and the pain intensities as experienced by the women. A multi-method approach to assessing pain offers many advantages. The timing of the assessment is important to properly assess pain.

Implications:

Pain relief needs to be included in the chemotherapy treatment, with individual assessment and treatment of pain, in the same way as is done in chemotherapy-triggered nausea. There is a time window whereby the risk of pain development is at its highest within 24–48 h after receiving taxane chemotherapy. Proper attention to pain evaluation and treatment should be in focus during this time window.

Place, publisher, year, edition, pages
Berlin/Boston: , 2018
National Category
Cancer and Oncology
Research subject
Caring Sciences
Identifiers
urn:nbn:se:uu:diva-356212 (URN)10.1515/sjpain-2018-0050 (DOI)000451213600006 ()29949517 (PubMedID)
Funder
Swedish Cancer Society, 100001
Available from: 2018-07-23 Created: 2018-07-23 Last updated: 2019-01-18Bibliographically approved
Vassbakk-Brovold, K., Berntsen, S., Fegran, L., Lian, H., Mjåland, O., Mjåland, S., . . . Kersten, C. (2018). Lifestyle changes in cancer patients undergoing curative or palliative chemotherapy: is it feasible?. Acta Oncologica, 57(6), 831-838
Open this publication in new window or tab >>Lifestyle changes in cancer patients undergoing curative or palliative chemotherapy: is it feasible?
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2018 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 57, no 6, p. 831-838Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: This study aimed to explore the feasibility of an individualized comprehensive lifestyle intervention in cancer patients undergoing curative or palliative chemotherapy.

MATERIAL AND METHODS: At one cancer center, serving a population of 180,000, 100 consecutive of 161 eligible newly diagnosed cancer patients starting curative or palliative chemotherapy entered a 12-month comprehensive, individualized lifestyle intervention. Participants received a grouped startup course and monthly counseling, based on self-reported and electronically evaluated lifestyle behaviors. Patients with completed baseline and end of study measurements are included in the final analyses. Patients who did not complete end of study measurements are defined as dropouts.

RESULTS: More completers (n = 61) vs. dropouts (n = 39) were married or living together (87 vs. 69%, p = .031), and significantly higher baseline physical activity levels (960 vs. 489 min.wk-1, p = .010), more healthy dietary choices (14 vs 11 points, p = .038) and fewer smokers (8 vs. 23%, p = .036) were observed among completers vs. dropouts. Logistic regression revealed younger (odds ratios (OR): 0.95, 95% confidence interval (CI): 0.91, 0.99) and more patients diagnosed with breast cancer vs. more severe cancer types (OR: 0.16, 95% CI: 0.04, 0.56) among completers vs. dropouts. Improvements were observed in completers healthy (37%, p < 0.001) and unhealthy dietary habits (23%, p = .002), and distress (94%, p < .001). No significant reductions were observed in physical activity levels. Patients treated with palliative intent did not reduce their physical activity levels while healthy dietary habits (38%, p = 0.021) and distress (104%, p = 0.012) was improved.

DISCUSSION: Favorable and possibly clinical relevant lifestyle changes were observed in cancer patients undergoing curative or palliative chemotherapy after a 12-month comprehensive and individualized lifestyle intervention. Palliative patients were able to participate and to improve their lifestyle behaviors.

National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-337282 (URN)10.1080/0284186X.2017.1413247 (DOI)000434437300017 ()29239243 (PubMedID)
Available from: 2017-12-21 Created: 2017-12-21 Last updated: 2018-09-18Bibliographically approved
Jakobsson Larsson, B., Ozanne, A. G., Nordin, K. & Nygren, I. (2017). A prospective study of quality of life in amyotrophic lateral sclerosis patients. Acta Neurologica Scandinavica, 136(6), 631-638
Open this publication in new window or tab >>A prospective study of quality of life in amyotrophic lateral sclerosis patients
2017 (English)In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 136, no 6, p. 631-638Article in journal (Refereed) Published
Abstract [en]

OBJECTS: The aim of this prospective and longitudinal study was to describe individual quality of life in patients with amyotrophic lateral sclerosis (ALS) and its correlations with physical function and emotional well-being from diagnosis and over time.

MATERIALS AND METHODS: Thirty-six patients were included in the study. Individual quality of life was measured with the Schedule of Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW), illness severity was assessed using the Amyotrophic Lateral Sclerosis Functional Rating Scale (ALS FRS-R), and emotional distress was measured using the Hospital Anxiety and Depression Scale (HADS). Data were collected from diagnosis and thereafter, every six months for a period of two years. Twelve patients completed the 24-month follow-up.

RESULTS: Family, friends and own physical health were important for overall quality of life, from diagnosis and during the disease progression. Most patients had good quality of life, which remained stable, despite changed physical functions. Several patients scored above the cut-off score for doubtful and clinical anxiety and depression early on after diagnosis, and there was a significant decrease in anxiety over time. Soon after diagnosis, there was a correlation between depression and quality of life.

CONCLUSION: The family, social relations and own physical health are important for overall quality of life in patients with ALS. Thus, supporting the family and facilitating so that patients can continue to stay in contact with friends are important aspects during the disease. Conducting an early screening for depression can be important for preventing decreased quality of life.

Keywords
amyotrophic lateral sclerosis, emotional well-being, physical function, quality of life
National Category
Clinical Medicine
Identifiers
urn:nbn:se:uu:diva-327077 (URN)10.1111/ane.12774 (DOI)000414488000007 ()28523721 (PubMedID)
Available from: 2017-08-02 Created: 2017-08-02 Last updated: 2018-02-19Bibliographically approved
Mazzoni, A.-S., Nordin, K., Berntsen, S., Demmelmaier, I. & Igelström, H. (2017). Comparison between logbook-reported and objectively-assessed physical activity and sedentary time in breast cancer patients: an agreement study. BMC sports science, medicine and rehabilitation, 9, Article ID 8.
Open this publication in new window or tab >>Comparison between logbook-reported and objectively-assessed physical activity and sedentary time in breast cancer patients: an agreement study
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2017 (English)In: BMC sports science, medicine and rehabilitation, ISSN 2052-1847, Vol. 9, article id 8Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Increasing physical activity (PA) and decreasing sedentary time (ST) have important health effects among breast cancer patients, a growing population group. PA and sedentary behaviors are complex multi-dimensional behaviors and are challenging to monitor accurately. To date few studies have compared self-reports and objective measurement in assessing PA and ST in women undergoing breast cancer treatments. The aim of the present study was to compare self-reports and objective measures for assessing daily time spent in moderate-intensity physical activity (MPA), vigorous-intensity physical activity (VPA) and ST in women undergoing breast cancer treatments.

METHODS: Baseline data from 65 women with breast cancer scheduled to undergo adjuvant treatment was included. Daily time spent in MPA, VPA and ST was assessed by a study-specific logbook and the SenseWear Armband mini (SWA). The level of agreement between the two measurement methods was then determined by performing Bland-Altman plots with limits of agreements, and calculating Spearman's rank correlation coefficients.

RESULTS: The mean difference between the logbook and SWA with limits of agreement was 14 (±102) minutes for MPA, 1 (±21) minute for VPA and -196 (±408) minutes for ST, respectively. The logbook reported an average of 34 and 50% higher values than the SWA for MPA and VPA, as well as an average of 27% lower values for ST (P < 0.05). The Spearman's rank correlation coefficients showed that the differences between the methods increased as the average amount of time spent in PA and ST increased (P < 0.01).

CONCLUSIONS: The results imply that the two measurement methods have limited agreement and cannot be used interchangeably.

Keywords
Activity monitor, Breast neoplasms, Exercise, Measurement accuracy, Sedentary lifestyle
National Category
Physiotherapy
Identifiers
urn:nbn:se:uu:diva-319631 (URN)10.1186/s13102-017-0072-2 (DOI)000397925300001 ()28373907 (PubMedID)
Funder
Swedish Cancer Society, 15 0841Swedish Research Council, 521-2013-2734
Available from: 2017-04-06 Created: 2017-04-06 Last updated: 2017-04-13Bibliographically approved
Berntsen, S., Aaronson, N. K., Buffart, L., Börjeson, S., Demmelmaier, I., Hellbom, M., . . . Nordin, K. (2017). Design of a randomized controlled trial of physical training and cancer (Phys-Can) - the impact of exercise intensity on cancer related fatigue, quality of life and disease outcome. BMC Cancer, 17(1), Article ID 218.
Open this publication in new window or tab >>Design of a randomized controlled trial of physical training and cancer (Phys-Can) - the impact of exercise intensity on cancer related fatigue, quality of life and disease outcome
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2017 (English)In: BMC Cancer, ISSN 1471-2407, E-ISSN 1471-2407, Vol. 17, no 1, article id 218Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Cancer-related fatigue is a common problem in persons with cancer, influencing health-related quality of life and causing a considerable challenge to society. Current evidence supports the beneficial effects of physical exercise in reducing fatigue, but the results across studies are not consistent, especially in terms of exercise intensity. It is also unclear whether use of behaviour change techniques can further increase exercise adherence and maintain physical activity behaviour. This study will investigate whether exercise intensity affects fatigue and health related quality of life in persons undergoing adjuvant cancer treatment. In addition, to examine effects of exercise intensity on mood disturbance, adherence to oncological treatment, adverse effects from treatment, activities of daily living after treatment completion and return to work, and behaviour change techniques effect on exercise adherence. We will also investigate whether exercise intensity influences inflammatory markers and cytokines, and whether gene expressions following training serve as mediators for the effects of exercise on fatigue and health related quality of life.

METHODS/DESIGN: Six hundred newly diagnosed persons with breast, colorectal or prostate cancer undergoing adjuvant therapy will be randomized in a 2 × 2 factorial design to following conditions; A) individually tailored low-to-moderate intensity exercise with or without behaviour change techniques or B) individually tailored high intensity exercise with or without behaviour change techniques. The training consists of both resistance and endurance exercise sessions under the guidance of trained coaches. The primary outcomes, fatigue and health related quality of life, are measured by self-reports. Secondary outcomes include fitness, mood disturbance, adherence to the cancer treatment, adverse effects, return to activities of daily living after completed treatment, return to work as well as inflammatory markers, cytokines and gene expression.

DISCUSSION: The study will contribute to our understanding of the value of exercise and exercise intensity in reducing fatigue and improving health related quality of life and, potentially, clinical outcomes. The value of behaviour change techniques in terms of adherence to and maintenance of physical exercise behaviour in persons with cancer will be evaluated.

TRIAL REGISTRATION: NCT02473003 , October, 2014.

Keywords
Behaviour change techniques, Biological mechanism, Cancer, Fatigue, Physical exercise, Quality of life, Randomized controlled trial
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-319059 (URN)10.1186/s12885-017-3197-5 (DOI)000397448100002 ()28347291 (PubMedID)
Funder
Swedish Cancer Society, CAN 2012/621 CAN 2012/631 CAN 2015/414Swedish Research Council, K2014-99X
Available from: 2017-03-31 Created: 2017-03-31 Last updated: 2017-11-29Bibliographically approved
Igelström, H., Berntsen, S., Demmelmaier, I., Johansson, B. & Nordin, K. (2017). Exercise during and after curative oncological treatment: a mapping review. Physical Therapy Reviews, 22(3/4), 103-115
Open this publication in new window or tab >>Exercise during and after curative oncological treatment: a mapping review
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2017 (English)In: Physical Therapy Reviews, ISSN 1083-3196, E-ISSN 1743-288X, Vol. 22, no 3/4, p. 103-115Article in journal (Refereed) Published
Abstract [en]

Background: By mapping the existing literature on exercise oncology, gaps in knowledge can be identified, and future directions for research can be pointed out.

Objectives: This review aimed to map diagnoses and outcome measures targeted in reviews and describe the effects on those outcomes. Further, the aim was to map exercise intervention characteristics being reviewed and the effects depending on these characteristics, and to discuss implications for future research.

Methods: A systematic search was performed in PubMed, Cinahl, PSYCHInfo, and Cochrane Library. Reviews including physical activity and exercise intervention trials in adult patients during or after curative oncological treatment were included. Reference lists were scanned in order to find additional relevant papers.

Results: Twenty-three reviews were included in the present study. The majority included mixed forms of cancers. Significant improvements were reported on physical fitness, cancer-related fatigue (CRF), health-related quality of life, physical function, psychological outcomes, lymphedema-related symptoms, biological markers, and physical activity level. Four reviews targeted time point for implementation of exercise intervention. There were slightly greater effects on CRF, physical fitness, and walking distance from implementation after completed treatment. Two reviews comparing exercise types reported superior effects from combinations of aerobic exercise and resistance training compared to aerobic or resistance training alone. One review targeted exercise intensity, and the results indicated a greater effect from moderately intense exercise compared to high intense exercise. One review assessed behaviour change techniques in exercise trials and suggested the use of programme goal-setting, self-monitoring, and generalization of behaviour to promote adoption and maintenance of exercise behaviour.

Conclusion: Exercise seems to be beneficial during and after curative oncological treatment in several types of cancer. A higher reporting of exercise intervention details is essential in future exercise intervention trials and there is still a need for large, randomized trials, especially in forms of cancer other than breast cancer.

National Category
Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:uu:diva-315747 (URN)10.1080/10833196.2016.1262109 (DOI)000414044200002 ()
Available from: 2017-02-20 Created: 2017-02-20 Last updated: 2018-03-22Bibliographically approved
Lindgren, P., Stadin, M., Blomberg, I., Nordin, K., Sahlgren, H. & Ingvoldstad Malmgren, C. (2017). Information about first trimester screening and self-reported distress among pregnant women and partners - Comparing two methods of information giving in Sweden.. Acta Obstetricia et Gynecologica Scandinavica, 96(10), 1243-1250
Open this publication in new window or tab >>Information about first trimester screening and self-reported distress among pregnant women and partners - Comparing two methods of information giving in Sweden.
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2017 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 96, no 10, p. 1243-1250Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Balanced information prior to prenatal diagnosis (PND) aims to help expectant parents to make an informed choice. However, it is important that the information does not increase the expectant parents' psychological distress. The aim was to examine psychological distress among expectant parents, before and after receiving information about PND, to evaluate the possible differences between two different procedures of information giving, and to evaluate the association between satisfaction with the information and psychological distress.

MATERIAL AND METHODS: A longitudinal design, based on questionnaire data from 380 expectant parents from four counties in Sweden. The measurement points; T1, before the information about PND was given and T2, two weeks after the prenatal screening or 15 weeks of gestation. The Hospital Anxiety and Depression Scale (HADS) and the Swedish version of the Cambridge Worrying Scale (CWS) measured psychological distress. The Satisfaction with Genetic Counseling Scale (SCS) measured satisfaction with information about PND.

RESULTS: The rate of psychological distress was stable among the pregnant women, but decreased among their partners, after the information was received. General anxiety and the social-medical dimension of pregnancy-related worry decreased among the participants who received information, using the more distinct two-stage process (group A), but was unchanged in group B (less distinct two-stage process). Health-related worry decreased in both groups, whereas relational worry and level of depressive symptoms were unchanged in both groups.

CONCLUSION: Information about PND does not increase the psychological distress among expectant parents. A more distinct two-stage process of information giving might even decrease their anxiety.

Keywords
Prenatal diagnosis, anxiety, first trimester combined screening, informed choice, psychological distress, worry
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-327076 (URN)10.1111/aogs.13195 (DOI)000411689100013 ()28742930 (PubMedID)
Available from: 2017-08-02 Created: 2017-08-02 Last updated: 2017-12-15Bibliographically approved
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