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  • 1.
    Björklund, Margereth
    et al.
    Nordiska ministerrådet, Nordic School of Public Health NHV.
    Sarvimäki, Anneli
    Nordiska ministerrådet, Nordic School of Public Health NHV.
    Berg, Agneta
    Kristianstad University College, Kristianstad, Sweden.
    Health promoting contacts as encountered by individuals with head and neck cancer2009In: Journal of Nursing and Healthcare of Chronic Illness, ISSN 1752-9816, E-ISSN 1752-9824, Vol. 1, no 3, p. 261-268Article in journal (Refereed)
    Abstract [en]

    Aim.  To describe the characteristics of health promoting contacts with health professionals as encountered by individuals with head and neck cancer.

    Background.  Head and neck cancer has a profound and chronic impact on the individual’s everyday life, e.g. physical problems that hinder speaking, breathing, eating and drinking. Furthermore, fear and uncertainty can lead to long-term psychological and psychosocial problems. The National Institute of Public Health in Sweden advocates that all care contacts should improve the quality of the individual’s health.

    Design.  A qualitative descriptive and explorative design was used. Eight participants were interviewed in the year 2005 and a qualitative thematic content analysis of the data was performed.

    Findings.  Health promoting contacts were defined as contacts where health care professionals contribute positively to the well-being of individual patients. Characteristics include being available, engaged, respectful and validating. Three themes were identified: being believed in one’s illness story; having a working relationship with health professionals and receiving individualised, tailored care.

    Conclusions.  Health promoting contacts were experienced mainly during the treatment phase, when patients had daily contact with specific, qualified health professionals. Although the interview questions focused on health promoting contacts, nearly half of the contacts were experienced as not health promoting. Feelings of abandonment were particularly manifested before and after treatment. The starting point for achieving health promoting contact lies in understanding the patient’s lifeworld in relation to health, illness and suffering and focusing on the individual’s personal strengths and health resources.

    Relevance to clinical practice.  The findings highlighted the importance of ensuring that patient interests and concerns are core considerations in health care. The participants viewed continuing individualised, tailored care and access to ear, nose and throat healthcare professionals as highly important.

  • 2.
    Björklund, Margereth
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Sarvimäki, Anneli
    The Nordic School of Public Health, Gothenburg.
    Berg, Agneta
    Högskolan Kristianstad, Avdelningen för Hälsovetenskap.
    Living with head and neck cancer: a profile of captivity2010In: Journal of Nursing and Healthcare of Chronic Illness, ISSN 1752-9816, E-ISSN 1752-9824, Vol. 2, no 1, p. 22-31Article in journal (Refereed)
    Abstract [en]

    Aim. To illuminate what it means to live with head and neck cancer.

    Background. Patients could experience head and neck cancer as more emotionally traumatic than other cancers because of visible disfigurement and its life-threatening impact on vital functions. This long-term illness often leads to lifestyle changes such as to physical function, work and everyday tasks, interpersonal relationships and social functioning.

    Design. This study used a qualitative and explorative longitudinal and prospective design with semi-structured interviews and open-ended questions. Twenty-one interviews were conducted with six participants with newly diagnosed or newly recurrent head and neck cancer. The analysis was descriptive and interpretive.

    Findings. The participants were living 'in captivity' in the sense that their symptoms were constant reminders of the disease. Our findings also revealed existential loneliness and spiritual growth, as interpreted within six themes: altered sense of affiliation; hostage of health care; locked up in a broken body, but with a free spirit; confined in a rogue body, forced dependency on others, and caught up in a permanent illness trajectory.

    Conclusions. Living with head and neck cancer involves emotional and existential vulnerability. The participants and their next of kin experienced insufficient support from health services and inadequate coordination between phases of their lengthy illness trajectory. These findings call for changes in oncological rehabilitation and management. Patient care must take a holistic view of everyone involved, centring on the individual and the promotion of health. A care coordinator could navigate between the individual patient needs and appropriate health services, hopefully with results that lessen the individual's emotional and existential confinement.

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