Symptoms and need for individualised support during the first year after primary treatment for breast cancer-A qualitative study.

BACKGROUND: The survival rate among patients with breast cancer is high. It is well described that after primary treatment patients may experience symptoms and concerns but the needs and resources during the first year to manage everyday life are not well described. AIM: To describe experiences of symptom distress, needs and support during the first year after primary treatment for breast cancer from the perspectives of patients and healthcare professionals. DESIGN: Qualitative descriptive. METHODS: Data collection through individual interviews with patients (n = 17) and a focus group interview with healthcare professionals (n = 7). Data was analysed using thematic analysis and resulted in three themes. RESULTS: The first theme, 'Struggling with symptoms and changes in everyday life' shows how symptoms and concerns interfered with the everyday life of patients and in some situations even impeded them. Patients try to adapt to their new situation by creating new routines and managing symptoms through self-care. The second theme, 'Adaption in a period of uncertainty' describes thoughts about cancer recurrence and doubts about continuing with the endocrine therapy if symptoms prolong. In the third theme, 'Support and need for individualized follow-up care' healthcare professionals described that they provide support by being available and by giving both verbal and written information. Patients expressed that the information could be too general and voiced a need for more individually tailored support. CONCLUSION: During the first year after primary treatment, patients with breast cancer describe how they try to manage by themselves, but express both unmet needs and a wish for extended and more individually tailored support. The healthcare professionals recognised that patients lack a structured plan for the first year and the need for continued support. This stresses a need for development of care models with special consideration towards individualised support after breast cancer treatment. NO PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public involvement in the design or conduct of the study. The interview study was not considered to benefit from involving patients or healthcare professionals when designing the interview guides as they were developed through literature and previous research of patients treated for breast cancer.

Parents' experiences of the caring encounter in the ambulance service-A qualitative study.

AIMS AND OBJECTIVES: To explore the experiences of the caring encounter in the ambulance service among parents to children aged 0-14 years. BACKGROUND: The care provided by the ambulance team is often associated with emergency medicine, traumatology and disaster medicine. But to develop care in the ambulance service, it is imperative to understand what the parents want and value in the care for their child. DESIGN: A qualitative study design was used. METHODS: Interviews was used for data collection, 16 caring encounters described by 14 parents were analysed using qualitative content analysis. Reporting of this research adheres to the COREQ guidelines. RESULTS: The parents described the importance of giving the family enough time in the situation, creating a safe environment and involving the parents in the care. In cases where the parents felt insecure, there had been lack of communication and lack of sensitivity, and the ambulance team did not invite the parents to be participate in the care. CONCLUSIONS: There is a need to strengthen the family-centred care in the ambulance service. Not inviting the parents in the care and use of equipment that was nonfunctioning or not adjustable for the children's age caused lack of trust and increased the level of stress among the parents. The parents had a positive experience and felt included when the team were calm, responsive and gave them the chance to be participants in their child's care. RELEVANCE TO CLINICAL PRACTICE: The prehospital emergency care nurses need to be prepared for caring of children and their parents. The ambulance team also need to understand their role in providing care of children. Lack of confidence in treating children may be perceived as nonfamily-centred care. There is need of further training concerning family-centred care in the ambulance service.