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BACKGROUND: Informing the public about lifestyle-related risk factors for colorectal cancer (CRC) is central for cancer prevention. More knowledge is needed about the public’s perceptions of CRC risk and how it relates to their lifestyle decisions, in order to design and communicate risk information effectively. This study aims to explore how the general public perceives risk factors for CRC, their risk of developing CRC, and their willingness to make lifestyle changes to reduce their CRC risk. The study also explores their experiences of, and preferences for, lifestyle-related risk communication and cancer prevention in the community.

METHODS: The study employed an explorative qualitative design. Semi-structured interviews were conducted between May 2024 and January 2025 with 25 individuals from the general public in Sweden, including women and men aged 22 to 80 years. The data were analysed using reflexive thematic analysis as described by Braun and Clarke.

RESULTS: Four themes with 10 sub-themes were identified. The first theme, Information void leaves room for uninformed assumptions, describes participants’ limited understanding of CRC and its risk factors, resulting in assumptions about risks based on stereotypical and intuitive beliefs. In the second theme, Colorectal cancer risk – one of many competing aspects in the pursuit of a fulfilling life, participants described balancing values and factors beyond health risks that influenced their motivation and ability to adopt healthy lifestyle habits. The third theme, Need for comprehensible information that addresses actual knowledge gaps, describes that participants requested credible and personally engaging risk information that provides actionable advice without instilling worry or blaming individuals. The fourth theme, Community interventions should facilitate healthier behaviours but not restrict individuals’ personal choice, describes participants’ reflections on a shared responsibility for cancer prevention, emphasizing that society should support a healthy lifestyle without excessively interfering in individuals lives.

CONCLUSIONS: There was a clear need for more information about CRC and associated lifestyle risks. As individuals balance competing values in their lifestyle decisions, risk information must be nuanced and respectful of personal priorities and communicated carefully in a positive and supportive way to raise awareness and encourage healthy choices.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-026-26737-2.

Objectives

Systemic mastocytosis (SM) is a rare hematopoietic disease, in which gastrointestinal (GI) problems are common. There are no valid instruments for assessing GI problems in patients with SM. As the symptoms often mimic irritable bowel syndrome (IBS), the objective was to assess the validity of instruments designed to measure IBS related GI problems in this group of patients.

Methods

The study was performed as an exploratory multimethod study. The Gastrointestinal Symptom Rating Scale (GSRS) and the Visceral Sensitivity Index (VSI) were found to be the most appropriate and were administered to 393 adults with SM. The response rate was 78%. Of these, 147 (48%) reported having GI-problems due to SM and were thus included in this study. Reliability was assessed using Cronbach’s alpha, whereas construct validity was examined through exploratory factor analysis.

Results

Internal consistency measured with Cronbach’s alpha coefficient was overall good/excellent for the GSRS total scale (α = 0.88) and subscales (α = 0.72–0.84) and for the VSI (α = 0.93). The exploratory factor analysis revealed four factors for the GSRS (indigestion, diarrhea, constipation, pain/reflux) and two factors for the VSI (worries related to internal GI symptoms, external factors related to GI problems).

Conclusions

Based on our results, we propose using the GSRS for measuring physical GI problems and the VSI for measuring psychosocial consequences and/or worries related to GI problems in the SM population. The instruments could be used to highlight GI problems in both clinical care and research

Clinical trial.gov registration

Trial registration number: NCT06065007

Background

Breast cancer (BC) is the most common cancer among women. Promoting healthy lifestyle behaviours at the population level has the potential to prevent a substantial proportion of cases. Preventive interventions should be grounded in the target population’s existing beliefs and perceptions. Therefore, this study aimed to explore women’s perceptions of BC, their attitudes toward engaging in preventive behaviours, and their needs for risk information.

Methods

Semi-structured individual interviews were conducted during spring 2025, with 16 Swedish women, aged 24–68. The interview guide was informed by The Common-Sense Model of Self-Regulation. The data were inductively analysed using thematic analysis.

Results

Four themes were developed. (I) Experience and representation shape women´s emotional and cognitive preunderstanding: Women had clear perceptions of the consequences of BC but were largely uninformed about BC causes. They struggled to envision how lifestyle factors could influence BC risk, due to knowledge gaps about underlying mechanisms and because it did not correspond with the affected women they knew. (II) Self-perceived risk: a mix of feelings and compensating reasoning: Women had difficulties assessing their own risk due to uncertainty about whether their lifestyle was healthy enough and some acknowledged that their logical reasoning was overshadowed by their emotions. (III) Willingness to change lifestyle: it is more than reduced risk of breast cancer: Efforts to pursue a healthy lifestyle were mostly guided by its impacts on present wellbeing. (IV) Constructing uplifting messages that reach and teach without blame: Current information in society was perceived as too general. The women therefore requested more actionable and uplifting messages educating them about why something poses a risk factor.

Conclusion

The study found that women primarily learned about the impact of BC on patients’ lives through media stories, which often evoked fear and sadness. Perceived preventive actions were largely limited to early detection through self-examination and participation in screening programs. However, there were knowledge gaps regarding BC causes that current information in society fails to address. To guide women’s health decisions, risk communication should prioritize evidence-based explanations of how risk factors influence BC risk, rather than relying primarily on personal narratives.

AIM: To explore what healthcare staff and staff in pharmacies experiences, as challenges, and possibilities in handling and use medications by foreign-born persons or their relatives, and how necessary information is exchanged between different units in the healthcare chain to prevent medication errors.

DESIGN: A qualitative explorative single-unit case study in a primary healthcare centre, with connected home care and pharmacies in an immigrant-dense area.

METHODS: Individual semi-structured interviews with 17 respondents, including pharmacists, physicians and registered nurses, were conducted between May and December 2022, in Sweden. Inductive qualitative content analysis was applied.

RESULTS: Six categories were identified: limited knowledge about medications, lack of knowledge about the Swedish system for medication prescriptions and pharmacy regulations, insufficient time to develop trusting relations, communication to support medication management, tools for facilitating safe use of medications and problems in exchange of information in the healthcare chain.

CONCLUSION: Good communication is both a challenge and a prerequisite for safe medication management by well-informed patients. To ensure patient safety, it is crucial to establish ways to communicate with patients about their medications, regardless of their language skills. Improving communication within the healthcare chain is essential to prevent medication errors.

IMPLICATION FOR THE PROFESSION AND PATIENT CARE: Understanding the complexity of medication management and preventing medication errors requires staff to communicate effectively with patients at all steps in the healthcare chain to identify their informational and educational needs.

IMPACT: This study provides a comprehensive understanding of the importance of communication within the healthcare chain, including prescribing physicians, nurses, pharmacists and patients, to prevent medication errors.

REPORTING METHOD: COREQ checklist.

PATIENT OR PUBLIC CONTRIBUTION: This study focused on staff at a healthcare centre and two pharmacies.

Background

Addressing obesity and overweight is crucial for cancer prevention. However, ensuring that such efforts do not harm individuals with obesity requires careful consideration to avoid reinforcing the widespread stigmatisation of individuals with obesity. This study aims to explore how individuals who have overweight or obesity perceive cancer risk information addressing obesity as a cancer risk factor.

Methods

Semi-structured interviews were conducted during autumn 2023 and spring 2024, with 11 Swedish men and women, aged 24 to 70 years, who self-assessed as having overweight or obesity. The collected data were analysed using reflexive thematic analysis as described by Braun and Clarke.ResultsThe first theme, Reflecting on personal risk, included the subthemes: It is about me and my body and Awareness can be a burden. The second theme, Healthcare encounters: building trust and providing support, included the subthemes: Past encounters influence how risk information is perceived, Need to act and succeed, and Consider receptivity and power imbalances. The third theme, Distribution of responsibility and blameworthiness, included subthemes: Being personally blamed and fearing increased discrimination and A need for shared responsibility.

Conclusion

Participants experienced that risk information, when presented as simplified associations between obesity and cancer, felt personally relevant but difficult to act upon, and therefore burdensome to bear. Consequently, the information risks failing to prevent cancer and may instead cause harm to the people it purports to benefit. Participants suggested several ways to improve the provision and benefit of such information, including introducing multiple ways to act to reduce cancer risk that goes beyond weight reduction, and raising public awareness of the causes of obesity. Efforts to communicate risk, both to the public and to patients, require better ethical considerations of their benefits and harms. Furthermore, risk communicators should act with compassion and responsibility.

Background

Older adults are vulnerable to medicine-related harm due to age-related changes in pharmacokinetics and pharmacodynamics.

Aim

The aim of this study was to adapt and test a tool for longitudinal monitoring of medicine-related symptoms in older adults.

Method

The PHArmacotherapeutical Symptom Evaluation-20 tool was adapted from a four-point to an 11-point scale (PHASE-20–Australian version) and administered to residents at the initial interview and again at the 4-week follow up in an aged-care facility, located in South Australia, Australia. The Edmonton Symptom Assessment Scale (ESAS) tool was used as a comparator to evaluate how the adapted tool tracks symptoms overtime. Symptoms reported using the PHASE-20–Australian version were compared with adverse effects of medicines in use listed in the Australian product information. The test–retest reliability of the adapted tool was also evaluated. Ethical approval was granted by the University of South Australia Human Research Ethics Committee (Reference no: HREC205098) and the study conforms to the Australian National statement on ethical conduct in human research. Informed consent was obtained from all participants via the distribution of project information sheets and completion of written consent forms.

Results

Nineteen residents (mean age ± standard deviation [84.4 ± 8.0 years]) completed the initial assessment and 17 completed the follow up. Seventy-two percent of the symptoms reported using the PHASE-20–Australian version matched the common or very common adverse effects listed in the Australian product information for the medicines used by the residents. The PHASE-20–Australian version showed a strong positive correlation with ESAS scores (rho = 0.744, p < 0.001). Changes in PHASE-20–Australian version scores correlated moderately to strongly with changes in ESAS scores (rho = 0.658, p < 0.004). The adapted tool had acceptable test–retest reliability (intraclass correlation coefficient = 0.738).

Conclusion

The score of PHASES-20–Australian version correlated well with a tool validated for longitudinal monitoring of symptoms and demonstrated acceptable test–retest reliability. Further studies are needed to confirm its validity for longitudinal monitoring of medicine-related symptoms.

Background: The ongoing global migration has led to multicultural societies, with many migrants who do not speak the official language in the host country. This could contribute to communication problems with staff in healthcare and a risk to patient safety. Research on patient safety in medication use in migrants is an under-researched area. The aim was to explore diverse foreign-born people's experiences and perceptions of self-management of medication and determine if home-based practice patterns have implications on medication safety, and what factors may support safe medication use.

Methods: A qualitative explorative study, with individual semi-structured interviews and participant observations in the patients' home. Qualitative content analysis was applied.

Results: A purposeful sample of 15 foreign-born persons identified by healthcare staff as having language difficulties in Swedish that may pose a safety risk in connection with medication use at home, was selected. Three categories were identified. The first category showed respondents being dependent on another person, having experiences of not receiving information about their medications due to language barriers, having difficulties getting access to the healthcare centre and feeling distrusted/misunderstood. The second category showed respondents being independent and self-motivated Although they struggled, they managed to get access/contact with the healthcare centre themselves and felt understood/listened to by the staff. The last category concerned factors that facilitating medication use; such as having a medication list in the respondents' own language and offering a choice of language on the answering machine at the healthcare centre. Although they knew it was impossible to get an interpreter at the pharmacy, they felt safe knowing there was always a solution for receiving understandable information.

Conclusion: The findings highlighted that language barriers can complicate the communication between migrants and the healthcare, which can affect the medication safety. Understanding of this group is essential to improve the cooperation between patients and staff, leading to culturally congruent care. This knowledge should be used in healthcare to understand the gap in communication to increase patient safety. Further research from other angles, e.g. pharmacy/healthcare staff and relatives is needed to identify and evaluate facilitation to improve the outcome of the intended medication treatment.

BACKGROUND: Informing individuals about their risk of cancer can sometimes have negative consequences, such as inflicting unnecessary worry and fostering stigma. This study aims to explore how patients diagnosed with breast or colorectal cancer perceive and experience risk communication, particularly concerning the increased focus on lifestyle behaviors as the cause of cancer.

METHODS: Semi-structured interviews were conducted during autumn 2023, with 23 Swedish individuals, aged 34 to 79 years, diagnosed with breast or colorectal cancer. The collected data were analyzed using inductive thematic analysis described by Braun & Clark. The study adopted an experiential orientation grounded in critical realism.

RESULTS: Five themes with ten sub-themes were identified: Thoughts and feelings about the causes of cancer, Moralizing messages and negative encounters, The need to take action, Balancing uncertain risks and a fulfilling life, and Societal benefits of risk communication. The participants expressed that knowledge of the the cause of cancer is closely related to the possibility of taking preventive action against relapses. Ability to take action was also perceived important for their well-being. Therefore, risk information entails both feelings of self-blame and hope for the future. Participants asked for both information and lifestyle support from healthcare professionals. Lifestyle interventions and patient support groups were solicited and perceived as an important aspect of cancer survivals' well-being, and may help to reduce the cancer-related stigma.

CONCLUSION: Individuals that have or have had breast or colorectal cancer, including those leading healthy lifestyles, found moralistic risk information offensive, leading to feelings of shame when thinking about other peoples thoughts. Balancing information involves providing transparent, evidence-based information while considering individual and social contexts, avoiding stigmatization and blame, and supplementing information with support.

  Aim

To describe what registered nurses' experience to be important to job satisfaction in nursing home settings.

Design

This is a qualitative study based on data from individual interviews.

Methods

Sixteen registered nurses working in nursing homes were interviewed, and their responses were analysed with systematic text condensation.

Results

A total of six categories were developed to describe various aspects of job satisfaction among registered nurses at nursing homes: meaningfulness is essential, to possess control and manageability is central, a possibility to balance daily challenges with professional development, supportive leadership is imperative, the nursing team's competence and companionship, and being confident in one's own profession.

Conclusion

In the present study, meaningfulness was essential to job satisfaction, and work was experienced to be meaningful and engaging when the demands were manageable, the workload controllable, and when the registered nurses felt supported by management and co-workers. Conversely, if the demands were too high, the workload was beyond their control and the nurses felt unsupported, then the work felt meaningless and thus unsatisfactory.