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  • 1.
    Widgren, Ylva
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Fransson, Per
    Umeå University.
    Efverman, Anna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Acupuncture in patients undergoing cancer therapy: few users although high interest and belief in acupuncture2022In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 30, no S1, p. 118-Article in journal (Refereed)
    Abstract [en]

    Introduction

    Since patients ask for acupuncture for cancer-therapy induced side-effects, and pre-existing expectations, i.e. beliefs, in a treatment may modify outcomes, the aim of this study was to investigate the use of acupuncture, interest, and belief in acupuncture effects among patients undergoing cancer therapy.

    Methods

    The study participants (n=457 of 507, 90% responded) cross-sectionally during radiotherapy answered a questionnaire regarding their use of, interest and belief in acupuncture treatment.

    Results

    Of the patients (mean age 65 years, 48% men, 37% had breast cancer, 32% prostate cancer), four (1%) patients used acupuncture during cancer therapy, while 368 (83%) expressed an interest in receiving acupuncture and (63%) believed acupuncture to be effective for at least one of 17 requested symptoms, most commonly pain (56% of the patients) and muscle tension(40%). They believed acupuncture to be effective for mean value 3 of 17 requested symptoms. Women (p<0.001), and patients 41-65 years (p<0.001), expressed a stronger belief in acupuncture effects than others.

    Conclusions

    Men and older patients expressed weaker beliefs in acupuncture effects than others, indicating the importance of collecting expectancy data in future acupuncture efficacy studies. The high interest and beliefs in acupuncture indicate that acupuncture should be available for side effects where acupuncture has proven effects. Older men might need more encouragement on positive expected outcomes of the acupuncture treatment than others.

  • 2.
    Widgren, Ylva
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Region Västernorrland.
    Fransson, Per
    Umeå University; Umeå University Hospital.
    Efverman, Anna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Acupuncture in patients undergoing cancer therapy: Their interest and belief in acupuncture is high, but few are using it2022In: Integrative Cancer Therapies, ISSN 1534-7354, E-ISSN 1552-695X, Vol. 21, p. 1-11Article in journal (Refereed)
    Abstract [en]

    Objectives: Since pre-existing expectations, that is, beliefs, in a treatment may modify outcomes, and acupuncture studies often fail to measure expectations, we wanted to investigate the use of acupuncture, interest, and belief in acupuncture effects among patients undergoing cancer therapy.

    Method: A cross-sectional design, where the participants answered a study-specific questionnaire with questions regarding their use of, interest and belief in acupuncture treatment.

    Results: A total of 457 patients with cancer (48% men, mean age 65 years) answered the questionnaire. Acupuncture was used by 4 (1%) patients during their cancer therapy, and 368 (83%) expressed an interest in receiving acupuncture. Of the 457 patients, 289 (63%) believed acupuncture to be effective for at least 1 of 17 requested symptoms, most commonly pain (56% of the patients) and muscle tension (40%). They believed acupuncture to be effective for a mean value 3 of the 17 requested symptoms. Women (P < .001), and patients 41 to 65 years (P < .001), expressed a stronger belief in acupuncture effects than others.

    Conclusions: Men and older patients expressed weaker beliefs in acupuncture effects than other patients, indicating the importance of collecting expectancy data in future randomized sham-controlled acupuncture studies to be able to treat expectancy as an effect-modifier. The high interest and beliefs in acupuncture effects found also indicate that acupuncture should be available for patients with cancer, for side effects where acupuncture has shown to be effective. In a clinical setting, older men might need more encouragement regarding positive expected outcomes of the acupuncture treatment than younger women.

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  • 3.
    Widgren, Ylva
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Region Hospital of Sundsvall-Härnösand, County Council of Västernorrland, Sundsvall, Sweden.
    Silén, Marit
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Wåhlin, Ingrid
    Region Kalmar, Research Section, Kalmar, Sweden.
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Fransson, Per
    Umeå University, Umeå, Sweden.
    Efverman, Anna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Chemotherapy-induced Emesis: Experienced Burden in Life, and Significance of Treatment Expectations and Communication in Chemotherapy Care2023In: Integrative Cancer Therapies, ISSN 1534-7354, E-ISSN 1552-695X, Vol. 22Article in journal (Refereed)
    Abstract [en]

    Objective: Because antiemetics have become more effective and integrative therapies such as acupuncture are used in combination with antiemetics, people receiving chemotherapy for cancer today might expect less emesis than in the past. It is not previously described if and how people receiving modern antiemetics during chemotherapy experience emesis. The objective of this study was to describe experiences regarding emesis among persons undergoing emetogenic chemotherapy, and how it affects their quality of life, daily life and work. A further aim was to describe views on the significance of treatment expectations and communication with healthcare personnel while undergoing chemotherapy for cancer.

    Method: Fifteen participants (median age 62 years, n = 1 man and n = 14 women, with breast (n = 13) or colorectal (n = 2) cancer) undergoing adjuvant or neo-adjuvant highly or moderately emetogenic chemotherapy were interviewed individually. The data were then analyzed using inductive thematic analysis.

    Results: Three themes described the participants’ experiences: “Your whole life is affected, or continues as usual,” covering descriptions of emesis limiting some participants’ everyday lives, while others experienced no emesis at all or had found ways to manage it. Overall, participants described satisfaction with their antiemetic treatment. “Experiences and expectations more important than information”, that is, the participants reported wanting all the information they could get about possible adverse effects of treatment, although they believed previous experiences were more important than information in creating expectations about treatment outcomes. The participants reported that being seen as a unique person was of utmost importance: “Meet me as I am.” This creates trust in healthcare personnel and a feeling of safety and security in the situation.

    Conclusions: These findings underline the importance of person-centered care and support in creating positive treatment expectations. Future research is called for regarding the potential antiemetic effects of positive communication regarding strengthening positive treatment expectations during emetogenic chemotherapy.

  • 4.
    Widgren, Ylva
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Silén, Marit
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Wåhlin, Ingrid
    Region Kalmar.
    Lindberg, Magnus
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Fransson, Per
    Umeå universitet.
    Efverman, Anna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Patients’ experiences of emesis and the significance of treatment expectations and communication during chemotherapy for cancer2023In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 31, no S1, p. s39-, article id 399Article in journal (Refereed)
    Abstract [en]

    Introduction

    Since antiemetics have become more effective, it seems plausible that patients nowadays expect less emesis than in the past. To gain a deeper understanding of the patients’ caring needs during emetogenic chemotherapy used today, the aim was to describe patients’ experiences of chemotherapy-induced emesis and how it afects quality of life, daily life, and work. Further, to describe views of the signifcance of their treatment expectations and the communication with the health care personnel when undergoing chemotherapy for cancer.

    Methods

    Fifteen patients (median age 62 years, n=1 man and n=14 women, with breast (n=13) or colorectal (n=2) cancer), undergoing adjuvantor neo-adjuvant highly or moderately emetogenic chemotherapy were interviewed individually. The data were then analyzed using inductive thematic analysis.

    Results

    Three themes described the patients’ experiences: ”The whole life gets affected, or goes on as usual”, covering descriptions of how some patients experienced the emesis to limit their everyday lives, while others experienced no emesis at all or had found ways to manage it; ”Information is important for creating expectations, but experiences even more”, i.e., the patients expressed that they wanted all the information they could get about possible adverse efects from the treatment, even though they believed previous experiences to be more important than information for creating expectations about treatment outcomes. Overall, the participants described satisfaction with their antiemetic treatment; and ”Meet me as I am”, including the participants expressed being seen as a unique person to be the of utterly importance. It creates trust in the health care personnel and a feeling of safety and security in the situation.

    Conclusions

    These findings underline the importance of person-centered care ands upport in creating positive treatment expectations. Future research is welcomed regarding potential antiemetic efects of positive communication, strengthening positive treatment expectations during emetogenic chemotherapy

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