KVINNORS UPPLEVELSE AV SIN SEXUALITET EFTER CYSTEKTOMI

Bakgrund: Kunskapen om kvinnors upplevelser om sin sexualitet efter en cystektomi är ytterst begränsad i den vetenskapliga litteraturen. Kvinnor som står inför cystektomi har ofta frågor kring hur och om ingreppet kan komma att påverka deras sexualitet och då kan sjuksköterskor uppleva att kunskapen saknas för att bemöta dessa frågor. Syfte: Syftet med denna studie var att beskriva kvinnors upplevelser av sin sexualitet efter genomgången cystektomi. Metod: En kvalitativ intervjustudie utfördes. Totalt sju kvinnor som var 75 år eller yngre och som hade opererats med cystektomi för ett år sedan eller mer inkluderades. Materialet har analyserats med innehållsanalys enligt Burnard m.fl. (2008).Resultat: I denna studie framkom att kvinnor kan uppleva en Minskad sexuell motivation, detta var det tema som framkom vid analysen. Temat styrks av följande sju kategorier: Minskat eget behov av samlag, Minskad egen sexuell lust, Minskad egen sexuell njutning, minskat behov av samlag hos partnern, minskad sexuell respons från partnern, behov av och tid för sexuell rehabilitering samt stomins påverkan på sexualiteten. Kvinnorna beskrev att deras egen sexualitet till stor del utgick från deras partner och de upplevde en negativ påverkan på sin egen sexualitet på grund av deras partners minskade behov och förmåga till sexuella akter. Slutsats: Kvinnorna i denna studie upplevde en minskad sexuell motivation efter en cystektomi. Dock är det oklart om enbart operaration var orsak till förändringen. Den minskade motivationen hade börjat redan vid insjuk-nandet och påverkats också av den egna och partners eventuella sam-sjuklighet och stigande ålder. Då flera problem var kopplat till smärta och blödning vid samlaget, saknade kvinnorna och hade ett stort behov av mer information kring hur läkningsprocessen ser ut och om hur sexualiteten kan komma att påverkas efter cystektomi. Eftersom en stor del av kvinnornas egna sexualitet kopplades till partnern är det viktigt att även partnern involveras i samtal som rör sexualiteten. Sjuksköterskan har här en stor roll att fylla.Background: Knowledge about women’s experiences regarding their sexuality after cystectomy seems limited in the scientific literature. Often women have questions about how the cystectomy will affect their sexuality and nurses might experience a lack of knowledge to manage these questions.Aim: The aim of this study was to describe Women’s experiences of their sexuality after they had undergone cystectomy.Method: A qualitative study was carried out. A total of seven women who were 75 years old or younger and had undergone cystectomy at least a year ago were included. The material was analyzed through content analysis according to Burnard et al. (2008).Resultat: The theme that emerges in the analysis was that the women experienced a reduced sexuell motivation. Seven categories explained this theme: reduced need for sexual intercourse, reduced sexual desire, reduced sexual pleasure, partners reduced need for sexual intercourse, reduced sexual response from the partner, need and time for sexual rehabilitation and the stomas effect on their sexuality. The women described that their sexuality was largely based on their partners, and they experienced a negative impact on their sexuality due to their partners reduced need and ability for sexual acts.Conclusion: Womens sexuality was highly affected after they had undergone cystectomy and their motivation for sexual acts was reduced. It is unclear whether surgery alone was the cause of this change. Women experienced a lack of information and had a need for more information about the healing process after the operation and how the cystectomy could affect their sexuality. The women expressed that a large part of their sexuality was based on their partner and therefore it is important to involve the partners in the sexual information and counseling. Here the Nurse has an important role

KVINNORS UPPLEVELSE AV SIN SEXUALITET EFTER CYSTEKTOMI

Bakgrund: Kunskapen om kvinnors upplevelser om sin sexualitet efter en cystektomi är ytterst begränsad i den vetenskapliga litteraturen. Kvinnor som står inför cystektomi har ofta frågor kring hur och om ingreppet kan komma att påverka deras sexualitet och då kan sjuksköterskor uppleva att kunskapen saknas för att bemöta dessa frågor. Syfte: Syftet med denna studie var att beskriva kvinnors upplevelser av sin sexualitet efter genomgången cystektomi. Metod: En kvalitativ intervjustudie utfördes. Totalt sju kvinnor som var 75 år eller yngre och som hade opererats med cystektomi för ett år sedan eller mer inkluderades. Materialet har analyserats med innehållsanalys enligt Burnard m.fl. (2008).Resultat: I denna studie framkom att kvinnor kan uppleva en Minskad sexuell motivation, detta var det tema som framkom vid analysen. Temat styrks av följande sju kategorier: Minskat eget behov av samlag, Minskad egen sexuell lust, Minskad egen sexuell njutning, minskat behov av samlag hos partnern, minskad sexuell respons från partnern, behov av och tid för sexuell rehabilitering samt stomins påverkan på sexualiteten. Kvinnorna beskrev att deras egen sexualitet till stor del utgick från deras partner och de upplevde en negativ påverkan på sin egen sexualitet på grund av deras partners minskade behov och förmåga till sexuella akter. Slutsats: Kvinnorna i denna studie upplevde en minskad sexuell motivation efter en cystektomi. Dock är det oklart om enbart operaration var orsak till förändringen. Den minskade motivationen hade börjat redan vid insjuk-nandet och påverkats också av den egna och partners eventuella sam-sjuklighet och stigande ålder. Då flera problem var kopplat till smärta och blödning vid samlaget, saknade kvinnorna och hade ett stort behov av mer information kring hur läkningsprocessen ser ut och om hur sexualiteten kan komma att påverkas efter cystektomi. Eftersom en stor del av kvinnornas egna sexualitet kopplades till partnern är det viktigt att även partnern involveras i samtal som rör sexualiteten. Sjuksköterskan har här en stor roll att fylla.Background: Knowledge about women’s experiences regarding their sexuality after cystectomy seems limited in the scientific literature. Often women have questions about how the cystectomy will affect their sexuality and nurses might experience a lack of knowledge to manage these questions.Aim: The aim of this study was to describe Women’s experiences of their sexuality after they had undergone cystectomy.Method: A qualitative study was carried out. A total of seven women who were 75 years old or younger and had undergone cystectomy at least a year ago were included. The material was analyzed through content analysis according to Burnard et al. (2008).Resultat: The theme that emerges in the analysis was that the women experienced a reduced sexuell motivation. Seven categories explained this theme: reduced need for sexual intercourse, reduced sexual desire, reduced sexual pleasure, partners reduced need for sexual intercourse, reduced sexual response from the partner, need and time for sexual rehabilitation and the stomas effect on their sexuality. The women described that their sexuality was largely based on their partners, and they experienced a negative impact on their sexuality due to their partners reduced need and ability for sexual acts.Conclusion: Womens sexuality was highly affected after they had undergone cystectomy and their motivation for sexual acts was reduced. It is unclear whether surgery alone was the cause of this change. Women experienced a lack of information and had a need for more information about the healing process after the operation and how the cystectomy could affect their sexuality. The women expressed that a large part of their sexuality was based on their partner and therefore it is important to involve the partners in the sexual information and counseling. Here the Nurse has an important role

Narratives of Teachers and Teacher Unions in Swedish Facebook Rebellion Groups

This study examines narratives about the teaching profession and teacher unions that Swedish teachers jointly produce in two teachers’ rebellion groups on Facebook, which is followed by a total of around 20,000 teachers. A sample of 33 posts and 2,445 comments were analysed using a narrative approach. The findings highlight narratives in which teachers wish to return to “the good old days”, struggle with everyday frustrations, call for a strike as an immediate solution, and describe hypothetical futures presenting the opportunity for proactive action and call teacher unions to dialogue rather than wait for them to satisfy the teachers’ demands.

Narratives of Teachers and Teacher Unions in Swedish Facebook Rebellion Groups

This study examines narratives about the teaching profession and teacher unions that Swedish teachers jointly produce in two teachers’ rebellion groups on Facebook, which is followed by a total of around 20,000 teachers. A sample of 33 posts and 2,445 comments were analysed using a narrative approach. The findings highlight narratives in which teachers wish to return to “the good old days”, struggle with everyday frustrations, call for a strike as an immediate solution, and describe hypothetical futures presenting the opportunity for proactive action and call teacher unions to dialogue rather than wait for them to satisfy the teachers’ demands

Narratives of Teachers and Teacher Unions in Swedish Facebook Rebellion Groups

This study examines narratives about the teaching profession and teacher unions that Swedish teachers jointly produce in two teachers’ rebellion groups on Facebook, which is followed by a total of around 20,000 teachers. A sample of 33 posts and 2,445 comments were analysed using a narrative approach. The findings highlight narratives in which teachers wish to return to “the good old days”, struggle with everyday frustrations, call for a strike as an immediate solution, and describe hypothetical futures presenting the opportunity for proactive action and call teacher unions to dialogue rather than wait for them to satisfy the teachers’ demands

Synliggörande, dokumentation och en förändrad lärarprofession i förskolan

Målet med vårt projekt har varit att – via det systematiskt dokumenterade kvalitetsarbetet – studera förskollärarprofessionen i den förskola som synliggörs och formas genom kombinationen av marknadsanpassning och ökad statlig kontroll. Våra specifika frågeställningar har varit: Hur hanterar förskollärarna kraven på synliggörande? Hur framställs och framställer sig lärarna i den synliggjorda förskolan? Vilka sidor av förskollärarprofessionen lyfts fram och vilka tystas ner? Vilka förskoleideal visas upp och vilka visas inte upp i förskolans dokumentation

Swedish teachers' and school leaders' rebellion groups on Facebook- collective formations and administrators as gatekeepers

This article explores Swedish teachers' and school leaders' Facebook rebellion groups as a medium where professional needs and actions can be formulated. Data consist of interviews with administrators representing the rebellion groups. Based on a theoretical perspective of teacher agency we searched for experiences and visions related to contextual aspects expressed in the groups. The results indicate a common experience of lacking resources among the groups. Through a well-balanced agency, they search for support among politicians in their striving to improve working conditions. However, the groups might develop different conditions for participating due to the formation of group-specific conversational climate about what is desirable and possible to post and discuss. Discussions on work-related issues might certainly be affected and the rebellion groups might contribute to preserve the specificity of each level in the school system. A split in the teachers' rebellion group indicates virtual relationships between professionals are easy to give up in favour of new formations, making the virtual groups vulnerable. The results raise the question about changing cultural aspects and what it means to be a professional teacher/school leader. Will teacher agency in the future be dependent on participation in such social media groups

Women's experience of sexuality after radical cystectomy : a qualitative study

PURPOSE: The aim of this study was to explore how women experienced sexuality after radical cystectomy due to bladder cancer. METHODS: We performed an interview study with qualitative design with content analysis. Inclusion criteria were age below 75 years. In total 10 women, with a median age of 64 years at surgery, were interviewed at median 24 months post radical cystectomy. RESULTS: The 10 women described sexual life as affected after surgery but they all tried to find ways to overcome the new situation together with their partner. The overall theme was 'A balance between emotional and physical closeness' emerged from 30 codes that were condensed into five subcategories and two categories: 'A sensual relationship' and 'A sexual relationship'. The first category constituted the subcategories 'Feeling of intimacy' and 'The importance of the relationship'. The category 'A sexual relationship' was revealed from the subcategories 'Reluctance to engage in sexual activity' and 'Partner inability to engage in sexual activity', and 'Acting for sexual rehabilitation'. CONCLUSIONS: The uncertainty that the women felt about their anatomical changes after radical cystectomy created a sexual anxiety and reluctance to resume intercourse. Even though the surgery had a major impact on their sexual life, the women tried to be sexually active. However, the meaning of sexual life was not just having sexual activity but also included closeness, affirmation, affection, and feeling attractive. Sexual counseling at an appropriate timepoint is essential to assure a balance between emotional and physical closeness, i.e. to regain sexual health

Long-term functional outcomes after radical cystectomy with ileal bladder substitute: does the definition of continence matter?

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/Open To access publisher's full text version of this article click on the hyperlink at the bottom of the pageFunctional outcomes after ileal bladder substitution reflect the expectations of future patients at a particular centre. The aim of this study was to use validated questionnaires and a pad-weighing test to investigate functional outcomes after neobladder reconstruction at long-term follow-up in patients at a single centre.During 2005 - 2015, 75 patients received a Studer ileal bladder substitute at the Department of Urology, Malmö. Forty-six of these patients were alive for follow-up and were evaluated using the pad-weighing test and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF), the Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF).Five of 37 evaluable patients (14%) were considered fully continent, reporting a pad-weighing test result of 0 g and an ICIQ-UI-SF score of 0. The median ICIQ-UI-SF score was 8 [interquartile range (IQR) 3-11], and seven patients (17%) were continent according to the ICIQ-UI-SF score only. In the pad-weighing test, 28 out of 37 patients (76%) reported 0 g day-time leakage whereas only 12 out of 37 patients (32%) reported 0 g night-time leakage. At follow-up, nine out of 39 (23%) of evaluable male patients were potent. The median ICIQ-UI-SF score was significantly lower during the second half of the study period [4 (IQR 0-8) vs 10 (IQR 6-14); p = .003]. The inverse applied to the median IIEF score [5 (IQR 3-12) vs 2 (IQR 1-4); p = .02].Functional outcomes at long-term follow-up after radical cystectomy and Studer ileal bladder substitute were at best modest in this series. Better outcomes during the second half of the study period might be explained by improved patient selection and a refined surgical technique, but possibly also by longer follow-up of patients during the first half of the period resulting in a more pronounced time-dependent decline in functional outcomes.Swedish Cancer Society Lund University Medical Faculty (ALF

Urodrill - a novel MRI-guided endoscopic biopsy technique to sample and molecularly classify muscle-invasive bladder cancer without fractionating the specimen during transurethral resection

The current diagnostic pathway for patients with muscle-invasive bladder cancer (MIBC), which involves with computed tomography urography, cystoscopy, and transurethral resection of the bladder (TURB) to histologically confirm MIBC, delays definitive treatment. The Vesical Imaging-Reporting and Data System (VI-RADS) has been suggested for MIBC identification using magnetic resonance imaging (MRI), but a recent randomized trial reported misclassification in one-third of patients. We investigated a new endoscopic biopsy device (Urodrill) for histological confirmation of MIBC and assessment of molecular subtype by gene expression in patients with VI-RADS 4 and 5 lesions on MRI. In ten patients, Urodrill biopsies were guided by MR images to the muscle-invasive portion of the tumor via a flexible cystoscope under general anesthesia. During the same session, conventional TURB was subsequently performed. A Urodrill sample was successfully obtained in nine of ten patients. MIBC was verified in six of nine patients, and seven of nine samples contained detrusor muscle. In seven of eight patients for whom a Urodrill biopsy sample was subjected to RNA sequencing, single-sample molecular classification according to the Lund taxonomy was feasible. No complications related to the biopsy device occurred. A randomized trial comparing this new diagnostic pathway for patients with VI-RADS 4 and 5 lesions and the current standard (TURB) is warranted. Patient summary: We report on a novel biopsy device for patients with muscle-invasive bladder cancer that facilitates histology analysis and molecular characterization of tumor samples