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Wikman, Anna
Publications (10 of 26) Show all publications
Skoglund, C., Kallner, H. K., Skalkidou, A., Wikström, A.-K., Lundin, C., Hesselman, S., . . . Sundström Poromaa, I. (2019). Association of Attention-Deficit/Hyperactivity Disorder With Teenage Birth Among Women and Girls in Sweden. JAMA NETWORK OPEN, 2(10), Article ID e1912463.
Open this publication in new window or tab >>Association of Attention-Deficit/Hyperactivity Disorder With Teenage Birth Among Women and Girls in Sweden
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2019 (English)In: JAMA NETWORK OPEN, ISSN 2574-3805, Vol. 2, no 10, article id e1912463Article in journal (Refereed) Published
Abstract [en]

IMPORTANCE Attention-deficit/hyperactivity disorder (ADHD) is associated with a plethora of adverse health outcomes throughout life. While Swedish specialized youth clinics have carefully and successfully targeted risk of unplanned pregnancies in adolescents, important risk groups, such as women and girls with ADHD, might not be identified or appropriately assisted by these interventions. OBJECTIVES To determine whether women and girls with ADHD are associated with increased risk of teenage birth compared with their unaffected peers and to examine the association of ADHD with risk factors for adverse obstetric and perinatal outcomes, such as smoking, underweight or overweight, and substance use disorder. DESIGN, SETTING, AND PARTICIPANTS This nationwide cohort study included data from 6 national longitudinal population-based registries in Sweden. All nulliparous women and girls who gave birth in Sweden between January 1, 2007, and December 31, 2014, were included. Data analyses were conducted from October 7, 2018, to February 8, 2019. EXPOSURES Women and girls treated with stimulant or nonstimulant medication for ADHD (Anatomic Therapeutic Chemical classification code N06BA) in the Swedish Prescribed Drug Register between July 1, 2005, and December 31, 2014. MAIN OUTCOMES AND MEASURES Maternal age at birth. Secondary outcome measures were body mass index, smoking habits, and psychiatric comorbidities. RESULTS Among 384 103 nulliparous women and girls aged 12 to 50 years who gave birth between 2007 and 2014 included in the study, 6410 (1.7%) (mean [SD] age, 25.0 [5.5] years) were identified as having ADHD. The remaining 377 693 women and girls without ADHD (mean [SD] age, 28.5 [5.1] years) served as the control group. Teenage deliveries were more common among women and girls with ADHD than among women and girls without ADHD (15.3% vs 2.8%; odds ratio [OR], 6.23 [95% CI, 5.80-6.68]). Compared with women and girls without ADHD, those with ADHD were more likely to present with risk factors for adverse obstetric and perinatal outcomes, including smoking during the third trimester (OR, 6.88 [95% CI, 6.45-7.34]), body mass index less than 18.50 (OR, 1.29 [95% CI, 1.12-1.49]), body mass index more than 40.00 (OR, 2.01 [95% CI, 1.60-2.52]), and alcohol and substance use disorder (OR, 20.25 [95% CI, 18.74-21.88]). CONCLUSIONS AND RELEVANCE This study found that women and girls with ADHD were associated with an increased risk of giving birth as teenagers compared with their unaffected peers. The results suggest that standard of care for women and girls with ADHD should include active efforts to prevent teenage pregnancies.

Place, publisher, year, edition, pages
AMER MEDICAL ASSOC, 2019
National Category
Psychiatry Public Health, Global Health, Social Medicine and Epidemiology Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-400016 (URN)10.1001/jamanetworkopen.2019.12463 (DOI)000497997100014 ()31577361 (PubMedID)
Available from: 2019-12-19 Created: 2019-12-19 Last updated: 2019-12-27Bibliographically approved
Wikman, A., Axfors, C., Iliadis, S. I., Cox, J., Fransson, E. & Skalkidou, A. (2019). Characteristics of women with different perinatal depression trajectories. Journal of Neuroscience Research
Open this publication in new window or tab >>Characteristics of women with different perinatal depression trajectories
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2019 (English)In: Journal of Neuroscience Research, ISSN 0360-4012, E-ISSN 1097-4547Article in journal (Refereed) Epub ahead of print
Abstract [en]

Maternal perinatal depression (PND), a common mental disorder with a prevalence of over 10%, is associated with long-term health risks for both mothers and offspring. This study aimed at describing characteristics related to background and lifestyle, pregnancy, delivery, and postpartum of different PND trajectories defined according to the onset of depressive symptoms. Participants were drawn from a large population-based cohort study in Uppsala, Sweden (n = 2,466). Five trajectory groups of depressive symptom onset were created using the Edinburgh Postnatal Depression Scale ≥13 (pregnancy) or ≥12 points (postpartum): (a) healthy (60.6%), (b) pregnancy depression (8.5%), (c) early postpartum onset (10.9%), (d) late postpartum onset (5.4%), and (e) chronic depression (14.6%). In multinomial logistic regressions, the associations between trajectories and the included characteristics were tested using the healthy trajectory as reference. Background characteristics (younger age, lower education, unemployment) were primarily associated with pregnancy depression and chronic depression. Characteristics associated with all PND trajectories were smoking prior to pregnancy, migraine, premenstrual mood symptoms, intimate partner violence, interpersonal trauma, negative delivery expectations, pregnancy nausea, and symphysiolysis. Nulliparity, instrumental delivery, or a negative delivery experience was associated with early postpartum onset. Postpartum factors (e.g., infantile colic, lack of sleep, low partner support, and bonding difficulties) were associated with early and late postpartum onset together with chronic depression. The findings suggest that different PND trajectories have divergent characteristics, which could be used to create individualized treatment options. To find the most predictive characteristics for different PND trajectories, studies with even larger and more diverse samples are warranted.

Keywords
depression, depressive disorder, mental disorders, mothers, postpartum, pregnancy, self-reports
National Category
Obstetrics, Gynecology and Reproductive Medicine Psychiatry
Identifiers
urn:nbn:se:uu:diva-378699 (URN)10.1002/jnr.24390 (DOI)30723972 (PubMedID)
Available from: 2019-03-08 Created: 2019-03-08 Last updated: 2019-04-11Bibliographically approved
Hesselman, S., Wikström, A.-K., Skalkidou, A., Sundström Poromaa, I. & Wikman, A. (2019). Neighborhood deprivation and adverse perinatal outcomes in Sweden: A population-based register study. Acta Obstetricia et Gynecologica Scandinavica, 98(8), 1004-1013
Open this publication in new window or tab >>Neighborhood deprivation and adverse perinatal outcomes in Sweden: A population-based register study
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2019 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 98, no 8, p. 1004-1013Article in journal (Refereed) Published
Abstract [en]

Introduction: Neighborhood deprivation has been associated with adverse perinatal outcomes but it is unclear to what extent maternal and social risk factors explain the association and how a stressful environment per se contributes.

Material and methods: A population-based register study including 218 030 deliveries in Sweden between January 2013 and July 2017 was conducted. Exposure was living in a deprived or severely deprived area defined by the National Operations Department of the Swedish Police Authority. Adverse perinatal outcomes included preterm births, small-for-gestational-age births and stillbirths. A propensity score-based method was used to control for individual baseline characteristics. Associations were investigated with logistic regression analyses and risk estimates are presented as crude (OR) and adjusted odds ratio (aOR) with 95% confidence interval (CI).

Results: Living in a deprived neighborhood in Sweden was associated with extremely preterm births (deprived area OR 1.50, 95% CI 1.07-2.11, severely deprived OR 1.90, 95% CI 1.40-2.58), small-for-gestational-age birth (deprived OR 1.45, 95% CI 1.31-1.60, severely deprived OR 1.85, 95% CI 1.69-2.03) and stillbirth (deprived OR 1.62, 95% CI 1.17-2.26, severely deprived OR 1.56, 95% CI 1.11-2.19). After accounting for individual maternal and social risk factors, the risk of small for gestational age in severely deprived areas remained (aOR 1.45, 95% CI, 1.19-1.75).

Conclusions: The contextual effect of living in a deprived neighborhood on the risk of extremely preterm births, small-for-gestational-age births and stillbirths was to a high extent explained by individual factors of women residing in exposed areas, yet remained for small-for-gestational-age births in severely deprived areas after adjustment for maternal and social risk factors.

Place, publisher, year, edition, pages
WILEY, 2019
Keywords
neighborhood deprivation, premature birth, residence characteristics, small for gestational age, stillbirth
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-391289 (URN)10.1111/aogs.13582 (DOI)000476678100008 ()30779118 (PubMedID)
Funder
Swedish Research Council, 2014-3561Swedish Research Council, 523-2014-07605
Available from: 2019-08-22 Created: 2019-08-22 Last updated: 2019-08-22Bibliographically approved
Hastie, R., Bergman, L., Cluver, C. A., Wikman, A., Hannan, N. J., Walker, S. P., . . . Hesselman, S. (2019). Proton Pump Inhibitors and Preeclampsia Risk Among 157 720 Women: A Swedish Population Register-Based Cohort Study. Hypertension, 73(5), 1097-1103
Open this publication in new window or tab >>Proton Pump Inhibitors and Preeclampsia Risk Among 157 720 Women: A Swedish Population Register-Based Cohort Study
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2019 (English)In: Hypertension, ISSN 0194-911X, E-ISSN 1524-4563, Vol. 73, no 5, p. 1097-1103Article in journal (Refereed) Published
Abstract [en]

Preeclampsia is a hypertensive disorder of pregnancy with a high rate of maternal and neonatal morbidity and mortality. The only definite treatment is delivery. Preclinical investigations have identified proton pump inhibitors (PPIs), which are commonly used to treat reflux during pregnancy, as a potential treatment for preeclampsia. The aim of this study was to determine the association between PPI use during pregnancy and preeclampsia risk in a population-based register cohort. Using the Swedish Pregnancy Register, we conducted a cohort study of nulliparous pregnant women delivering from January 2013 to July 2017. Associations between PPI use and preeclampsia were investigated using logistic regression analyses with risk estimates presented as crude and adjusted odds ratios (aOR) with 95% CI. Of 157 720 nulliparous pregnant women, 6051 (3.8%) reported PPI use during pregnancy. PPI use during any point of pregnancy was associated with an increased risk of overall preeclampsia (aOR of 1.17; 95% CI, 1.04-1.32) and preeclampsia at term (aOR of 1.20; 95% CI, 1.04-1.39). However, PPI use recorded after 28 gestational weeks was associated with a reduced risk of preterm (delivery <37 weeks) preeclampsia (aOR of 0.63; 95% CI, 0.41-0.96) and early (delivery <34 weeks) preeclampsia (aOR of 0.41; 95% CI, 0.20-0.82). These findings highlight the heterogeneity of this disease, with a potential role PPIs for preventing preterm preeclampsia when used in close proximity to disease onset. Targeting PPI use to women at greatest risk of preterm preeclampsia may help prevent this severe form of disease.

Keywords
preeclampsia, pregnancy, prevention, proton pump inhibitors, risk
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-387603 (URN)10.1161/HYPERTENSIONAHA.118.12547 (DOI)000469352400029 ()30636550 (PubMedID)
Available from: 2019-06-26 Created: 2019-06-26 Last updated: 2019-10-30Bibliographically approved
Hellstadius, Y., Malmström, M., Lagergren, P., Sundbom, M. & Wikman, A. (2019). Reflecting a crisis reaction: Narratives from patients with oesophageal cancer about the first 6 months after diagnosis and surgery. Nursing Open, 6(4), 1471-1480
Open this publication in new window or tab >>Reflecting a crisis reaction: Narratives from patients with oesophageal cancer about the first 6 months after diagnosis and surgery
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2019 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 6, no 4, p. 1471-1480Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of the study was to describe patients' experiences of emotional adaption following treatment for oesophageal cancer from diagnosis to 6 months after surgery.

Design: A qualitative interview study using an inductive approach was carried out.

Methods: Participants were recruited from two university hospitals in Sweden. Ten patients who had been operated for oesophageal cancer with curative intent 6 months earlier and consented to participate in the study were included. Patients who had a disease recurrence were not eligible for inclusion. Participants were interviewed with a semi-structured interview approach. Data were analysed using qualitative content analysis.

Results: One overarching theme was identified; Experiencing a crisis reaction, which comprised three key categories; (a) From emotionally numb to feeling quite alright; (b) From a focus on cure to reflections about a whole new life; and (c) From a severe treatment to suffering an emaciated, non-compliant body, derived from 14 distinct sub-categories.

Conclusion: This study highlights the process of emotional adaptation following oesophageal cancer surgery that patients describe when reflecting back on the first 6 months postoperatively pointing to a crisis reaction in this early postoperative period.

Keywords
adaptation, interviews, nurses, nursing, oesophageal cancer, qualitative
National Category
Nursing Gastroenterology and Hepatology
Identifiers
urn:nbn:se:uu:diva-400577 (URN)10.1002/nop2.348 (DOI)000480004500001 ()31660175 (PubMedID)
Funder
Swedish Society of Medicine, SLS-501311
Available from: 2019-12-27 Created: 2019-12-27 Last updated: 2020-04-03Bibliographically approved
Woodford, J., Wikman, A., Einhorn, K., Cernvall, M., Grönqvist, H., Romppala, A. & von Essen, L. (2018). Attitudes and Preferences Toward a Hypothetical Trial of an Internet-Administered Psychological Intervention for Parents of Children Treated for Cancer: Web-Based Survey. Journal of Medical Internet Research, 5(4), Article ID e10085.
Open this publication in new window or tab >>Attitudes and Preferences Toward a Hypothetical Trial of an Internet-Administered Psychological Intervention for Parents of Children Treated for Cancer: Web-Based Survey
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2018 (English)In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 5, no 4, article id e10085Article in journal (Refereed) Published
Abstract [en]

Background:

Clinical trials are often challenged with issues of recruitment and retention. Little is known concerning general attitudes and preferences toward trial design and willingness to participate among parents of children treated for cancer. Furthermore, willingness to participate in internet-administered psychological interventions remains unexplored. In this study, we examined attitudes and preferences of the population regarding study procedures for a hypothetical trial of an internet-administered psychological intervention. In addition, differences in the response rate between modes of study invitation and willingness to engage in internet-administered interventions were examined.

Objective:

The primary objective of this study was to examine attitudes and preferences toward participating in an internet-administrated psychological intervention. The secondary objective was to examine the response rates and help-seeking behavior among parents of children treated for cancer.

Methods:

A cross-sectional, Web-based survey was conducted with parents of children who had completed cancer treatment. This Web-based survey examined self-reported emotional distress, prior help-seeking and receipt of psychological support, past research participation, attitudes toward research, preferences concerning recruitment procedures, and attitudes toward different types of trial design.

Results:

Of all the parents invited, 32.0% (112/350) completed the survey, with no difference in response rate between modes of study invitation (χ21=0.6, P=.45). The majority (80/112, 71.4%) of parents responded that they had experienced past emotional distress. Responses indicated high (56/112, 50.0%) or somewhat high trust in research (51/112, 45.5%), and the majority of parents would accept, or maybe accept, internet-administered psychological support if offered (83/112, 74.1%). In addition, responses showed a preference for postal study invitation letters (86/112, 76.8%), sent by a researcher (84/112, 75.0%) with additional study information provided on the Web via text (81/112, 72.3%) and video (66/112, 58.9%). Overall, parents responded that trials utilizing a waiting list control, active alternative treatment control, or a patient-preference design were acceptable.

Conclusions:

Parents of children treated for cancer appear willing to participate in trials examining internet-administered psychological support. Findings of this study will inform the design of a feasibility trial examining internet-administered psychological support for the population.

Keywords
Cancer, Parents, eHealth, Clinical Trial, Depression, Anxiety
National Category
Health Sciences Clinical Medicine Psychology
Research subject
Psychology; Health Care Research
Identifiers
urn:nbn:se:uu:diva-357971 (URN)10.2196/10085 (DOI)000453827700001 ()
Funder
Swedish Research Council, K2015-99X-20836-08-4Swedish Cancer Society, 140790
Available from: 2018-11-29 Created: 2018-11-29 Last updated: 2019-09-10Bibliographically approved
Wikman, A., Kukkola, L., Börjesson, H., Cernvall, M., Woodford, J., Grönqvist, H. & von Essen, L. (2018). Development of an Internet-Administered Cognitive Behavior Therapy Program (ENGAGE) for Parents of Children Previously Treated for Cancer: Participatory Action Research Approach. Journal of Medical Internet Research, 20(4), Article ID e133.
Open this publication in new window or tab >>Development of an Internet-Administered Cognitive Behavior Therapy Program (ENGAGE) for Parents of Children Previously Treated for Cancer: Participatory Action Research Approach
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2018 (English)In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 20, no 4, article id e133Article in journal (Refereed) Published
Abstract [en]

Background: Parenting a child through cancer is a distressing experience, and a subgroup of parents report negative long-term psychological consequences years after treatment completion. However, there is a lack of evidence-based psychological interventions for parents who experience distress in relation to a child’s cancer disease after end of treatment.

Objective: One aim of this study was to develop an internet-administered, cognitive behavior therapy–based, psychological, guided, self-help intervention (ENGAGE) for parents of children previously treated for cancer. Another aim was to identify acceptable procedures for future feasibility and efficacy studies testing and evaluating the intervention.

Methods: Participatory action research methodology was used. The study included face-to-face workshops and related Web-based exercises. A total of 6 parents (4 mothers, 2 fathers) of children previously treated for cancer were involved as parent research partners. Moreover, 2 clinical psychologists were involved as expert research partners. Research partners and research group members worked collaboratively throughout the study. Data were analyzed iteratively using written summaries of the workshops and Web-based exercises parallel to data collection.

Results: A 10-week, internet-administered, cognitive behavior therapy–based, psychological, guided, self-help intervention (ENGAGE) was developed in collaboration with parent research partners and expert research partners. The content of the intervention, mode and frequency of e-therapist support, and the individualized approach for feedback were modified based on the research partner input. Shared solutions were reached regarding the type and timing of support from an e-therapist (eg, initial video or telephone call, multiple methods of e-therapist contact), duration and timing of intervention (eg, 10 weeks, 30-min assessments), and the removal of unnecessary support functions (eg, removal of chat and forum functions). Preferences for study procedures in future studies testing and evaluating the intervention were discussed; consensus was not reached for all aspects.

Conclusions: To the best of our knowledge, this study is the first use of a participatory action research approach to develop a psychological intervention for parents of children previously treated for cancer and to identify acceptable study procedures. Involvement of parents with lived experience was vital in the development of a potentially relevant and acceptable intervention for this population.

Keywords
cognitive therapy; psychology, clinical; e-therapy; community participation; Sweden
National Category
Psychology Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-349408 (URN)10.2196/jmir.9457 (DOI)000430392800001 ()29669710 (PubMedID)
Funder
Swedish Research Council, K2015-99X-20836-08-4Swedish Cancer Society, 140790
Available from: 2018-04-26 Created: 2018-04-26 Last updated: 2018-06-19Bibliographically approved
Anandavadivelan, P., Wikman, A., Martin, L., Rueb, C., Johar, A., Malberg, K. & Lagergren, P. (2018). Extent of dumping symptoms and its association with malnutrition following surgery for oesophageal cancer. Paper presented at 25th Annual Conference of the International Society for Quality of Life Research (ISOQOL), 24-27 October 2018, Dublin, Ireland.. Quality of Life Research, 27(Supplement 1), S76-S76
Open this publication in new window or tab >>Extent of dumping symptoms and its association with malnutrition following surgery for oesophageal cancer
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2018 (English)In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 27, no Supplement 1, p. S76-S76Article in journal, Meeting abstract (Other academic) Published
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-369220 (URN)10.1007/s11136-018-1946-9 (DOI)000445248500186 ()
Conference
25th Annual Conference of the International Society for Quality of Life Research (ISOQOL), 24-27 October 2018, Dublin, Ireland.
Note

Meeting Abstract: 1115

Available from: 2018-12-11 Created: 2018-12-11 Last updated: 2018-12-11Bibliographically approved
Wiman, H., Ander, M., Woodford, J., Hasselblad, T., Grönqvist, H., Ljungman, G., . . . von Essen, L. (2018). Guided Internet-Administered Self-Help to Reduce Symptoms of Anxiety and Depression Among Adolescents and Young Adults Diagnosed with Cancer During Adolescence: Lessons Learned. Paper presented at 50th congress of the International Society of Paediatric Oncology (SIOP), November 16-19, 2018, Kyoto, Japan.. Pediatric Blood & Cancer, 65(suppl.2), S597-S597
Open this publication in new window or tab >>Guided Internet-Administered Self-Help to Reduce Symptoms of Anxiety and Depression Among Adolescents and Young Adults Diagnosed with Cancer During Adolescence: Lessons Learned
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2018 (English)In: Pediatric Blood & Cancer, ISSN 1545-5009, E-ISSN 1545-5017, Vol. 65, no suppl.2, p. S597-S597Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
WILEY, 2018
National Category
Cancer and Oncology Hematology Pediatrics
Identifiers
urn:nbn:se:uu:diva-365107 (URN)000445195005115 ()
Conference
50th congress of the International Society of Paediatric Oncology (SIOP), November 16-19, 2018, Kyoto, Japan.
Available from: 2018-11-16 Created: 2018-11-16 Last updated: 2018-11-16Bibliographically approved
Anandavadivelan, P., Wikman, A., Johar, A. & Lagergren, P. (2018). Impact of weight loss and eating difficulties on health-related quality of life up to 10 years after oesophagectomy for cancer. British Journal of Surgery, 105(4), 410-418
Open this publication in new window or tab >>Impact of weight loss and eating difficulties on health-related quality of life up to 10 years after oesophagectomy for cancer
2018 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 105, no 4, p. 410-418Article in journal (Refereed) Published
Abstract [en]

Background: Severe weight loss is experienced by patients with eating difficulties after surgery for oesophageal cancer. The aim of this prospective cohort study was to asssess the influence of eating difficulties and severe weight loss on health-related quality of life (HRQoL) up to 10years after oesophagectomy.

Methods: Data on bodyweight and HRQoL were collected at 6months, 3, 5 and 10years in patients who underwent surgery for oesophageal cancer in Sweden between 2001 and 2005. Exposures were percentage weight loss, and eating difficulties defined by the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-OES18 questionnaire. Outcomes were HRQoL scores from the EORTC QLQ-C30 questionnaire. Repeated-measures ANOVA, adjusting for potential confounders, was used to assess the association between eating difficulties and weight loss (4 exposure groups) and HRQoL scores at each time point. Mean score differences (MDs) between time points or exposure groups were defined as clinically relevant in accordance with evidence-based interpretation guidelines.

Results: In total, 92 of 104 10-year survivors (885 per cent) responded to the questionnaires. Weight loss was greatest within 6months of surgery. Patients with eating difficulties with or without weight loss reported clinically and statistically significantly worsened HRQoL in almost all aspects. The largest MD was seen between 5 and 10years after surgery for global quality of life, physical, role and social function (MD -22 to -30), as well for fatigue, nausea, dyspnoea, insomnia, appetite loss and diarrhoea (MD 24-36).

Conclusion: Eating difficulties are associated with deterioration in several aspects of HRQoL up to 10years after surgery for oesophageal cancer.

Place, publisher, year, edition, pages
WILEY, 2018
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-351753 (URN)10.1002/bjs.10686 (DOI)000426495200013 ()29160918 (PubMedID)
Funder
Swedish Research CouncilSwedish Cancer SocietySwedish Society of MedicineThe Cancer Research Funds of Radiumhemmet
Available from: 2018-06-01 Created: 2018-06-01 Last updated: 2018-06-01Bibliographically approved
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