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Families' life situation when living with cancer: aspects of health and family sense of coherence
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. (Family Nursing)ORCID iD: 0000-0001-9443-8473
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: To investigate families’ perceived life situation when living with cancer, with a focus on health and family sense of coherence.

Methods: Study I is a population-based register study that explored how cancer influenced the health of cohabitating partners of persons with cancer in Sweden by examining the onset of new diagnoses, health care use, and health care costs among the partners. Study II focused on familial interaction patterns for families living with cancer in a palliative phase, based on family interviews, and analysed using Gadamerian hermeneutics. In study III, Family Sense of Coherence scale (S-FSOC-S) was culturally adapted and evaluated for reliability and validity, using psychometric analyses. Study IV explored associations between family sense of coherence and hope, anxiety, and symptoms of depression using descriptive statistics and nested linear regression.

Results: Study I showed that the partners of persons with cancer had significantly increased health care use and health care costs both one and two years after the cancer diagnosis, and that use patterns and costs varied according to the type of cancer that had been diagnosed. Study II revealed that the familial interaction patterns were adjusted in response to changes in family life - changes which encompassed three different, but interrelated, patterns: power dynamics in the family, the “secret game” in the family, and multifaceted closeness and distance in the family. Study III suggested that S-FSOC-S is useful for assessing familial coherence and shows satisfactory reliability and validity. Study IV showed that stronger family sense of coherence was associated with higher hope and lower anxiety and symptoms of depression levels in both persons with cancer and their family members.

Conclusions: Families’ life situation was affected by the cancer diagnosis, which had an impact on both individual family members and the family as a unit. The type of cancer may help to determine partners’ risk of ill health. The changed familial interaction patterns increased the families’ ability to deal with family life without hurting each other. The S-FSOC-S is a useful instrument for assessing family sense of coherence and can help identify families with weak family sense of coherence, who may need professional support.

Place, publisher, year, edition, pages
Växjö: Linnaeus University Press, 2017. , p. 69
Series
Linnaeus University Dissertations ; 299/2017
Keywords [en]
Cancer, Family interviews, Family sense of coherence, Health, Palliative care, Psychometric evaluation
National Category
Nursing
Research subject
Health and Caring Sciences
Identifiers
URN: urn:nbn:se:lnu:diva-68768ISBN: 978-91-88357-94-6 (print)OAI: oai:DiVA.org:lnu-68768DiVA, id: diva2:1157452
Public defence
2017-12-08, v159, Stagneliusgatan 14b, Kalmar, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2017-11-16 Created: 2017-11-16 Last updated: 2017-11-16Bibliographically approved
List of papers
1. Familial Interaction Patterns During the Palliative Phase of a Family Member Living With Cancer
Open this publication in new window or tab >>Familial Interaction Patterns During the Palliative Phase of a Family Member Living With Cancer
2017 (English)In: Journal of Hospice and Palliative Nursing, ISSN 1522-2179, E-ISSN 1539-0705, Vol. 19, no 1, p. 67-74Article in journal (Refereed) Published
Abstract [en]

This study aimed to illuminate aspects of familial interactions when 1 member is in the palliative phase of his/her cancer course. An individual cancer diagnosis influences the entire family, often requiring daily life changes for all members. Current research has examined individual family member perspectives; family system nursing studies are warranted. Narrative family interviews were conducted on 13 families living with cancer. The interviews were transcribed and analyzed according to a hermeneutic method. Analyses revealed the following: Family interaction patterns were adjusted in response to changes in family life, which encompassed 3 different, but interrelated, patterns: (1) power dynamics in the family, (2) the "secret game" in the family, and (3) multifaceted closeness and distance in the family. It is crucial to adopt a family perspective during palliative care to meet each unique family's needs. Health care facilitators should be aware of the complex dynamics and challenges that these families encounter. This will help obtain a greater understanding of factors underlying effective palliative care.

Keywords
cancer, family nursing, family relations, palliative care
National Category
Nursing
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-60798 (URN)10.1097/NJH.0000000000000310 (DOI)000392286500009 ()
Available from: 2017-02-21 Created: 2017-02-21 Last updated: 2018-05-17Bibliographically approved
2. The effects of a cancer diagnosis on the health of a patient's partner: a population-based registry study of cancer in Sweden
Open this publication in new window or tab >>The effects of a cancer diagnosis on the health of a patient's partner: a population-based registry study of cancer in Sweden
Show others...
2016 (English)In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 25, no 5, p. 744-752Article in journal (Refereed) Published
Abstract [en]

The aim of this population-based registry study was to explore how cancer influences the health of partners, by examining the onset of new diagnoses for partners, health care use and health care costs among partners living with patients with cancer. The sample consisted of partners of patients with cancer (N = 10 353) and partners of age- and sex-matched controls who did not have cancer (N = 74 592). Diagnoses, health care use and health care costs were studied for a continuous period starting 1 year before the date of cancer diagnosis and continued for 3 years. One year after cancer diagnosis, partners of patients with cancer had significantly more mood disorders, reactions to severe stress and ischaemic heart disease than they exhibited in the year before the diagnosis. Among partners of patients with cancer, the type of cancer was associated with the extent and form of increased health care use and costs; both health care use and costs increased among partners of patients with liver cancer, lung cancer, colon cancer and miscellaneous other cancers. The risk of poorer health varied according to the type of cancer diagnosed, and appeared related to the severity and prognosis of that diagnosis.

Keywords
cancer, health care costs, health care use, partner's health, population-based registry study
National Category
Cancer and Oncology General Practice Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Natural Science, Medicine; Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-56074 (URN)10.1111/ecc.12487 (DOI)000383567800005 ()27028409 (PubMedID)2-s2.0-85027940632 (Scopus ID)
Available from: 2016-09-16 Created: 2016-08-31 Last updated: 2018-05-17Bibliographically approved

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