Å bli levertransplantert grunnet kolorektalcancer : Pasientopplevelser ved levertransplantasjon på grunn av levermetastaser etter kolorektalcancer

Formål: Å beskrive unike pasientopplevelser hos pasienter som har gjennomgått levertransplantasjon grunnet levermetastaser etter kolorektalcancer. Teoretisk forankring: Begrepsdefinisjon med aktuell teori og forskning rundt begrepene livskvalitet og håp. Metode: Utforskende og beskrivende studie med dybdeintervju av informanter 6 måneder etter transplantasjonen. Totalt 9 intervjuer ble gjennomført. Datamaterialet ble transkribert verbatim kort tid etter at intervjuene fant sted. For analysen ble det brukt kvalitativ innholdsanalyse slik den beskrives av Kvale (1997). Resultater: Median alder på pasientene var 56 år. Totalt 10 pasienter ble inkludert, hvorav 9 intervjuer ble gjennomført. En informant døde ved intervjutidspunktet grunnet spredning av kreftsykdom. Tre temaer fremkom gjennom analyseprosessen: Livet i gave på nytt, å leve mellom håp og fortvilelse og tilbake til hverdagen. Første temaet tar for seg gleden og takknemligheten respondentene følte etter å ha fått mulighet til å gå gjennom behandling som kunne forlenge deres liv. Det å få behandling i en så alvorlig situasjon resulterte blant annet i at de fikk et nytt perspektiv på livet. Det andre temaet beskriver utfordringen respondentene opplevde i forhold til det å leve i et skifte mellom håp og fortvilelse. Det siste temaet omhandler respondentenes ønske om å leve hverdagen som de tidligere hadde gjort. Det omhandler deres fysiske form, eventuelle bivirkninger av medisiner og deres forhold til sine nærmeste. Konklusjon: Studien indikerer at de pasienter som blir levertransplantert grunnet kolorektalcancer og levermetastaser opplevde dette som en god erfaring. Pasientene opplevde å leve et godt liv etter transplantasjonen. Sjansen for et forlenget liv ble sett på som mer betydningsfullt enn risikoen knyttet til transplantasjonen og bivirkninger grunnet medisinering

"A bit of everything": Health literacy interventions in chronic conditions- a systematic review

Objective: To systematically evaluate health literacy (HL) interventions in chronic conditions by exploring theoretical perspectives, intervention content and effectiveness. Method: We searched MEDLINE, Cochrane, CINAHL, EMBASE, ERIC, Web of Science and PsycINFO. Standardised systematic review methods were used, and sequences informing our research question were extracted and analysed. The study includes a descriptive summary of the included papers. Results: We included 39 unique interventions, with diabetes and heart disease as the most targeted chronic conditions. Fifty-four percent of papers included a definition of HL, but the studies showed significant hetero-geneity of theoretical underpinnings, modes, measures and content. We identified 23 HL measures, mostlyassessing functional HL. The HL interventions were often more complex than the measures indicated. A significant change in HL was found in 28 studies. Study quality was generally poor. Conclusions: Interventions optimizing HL appear important to improve health outcomes in chronic conditions. To ensure cumulative knowledge development of this field we need theory-based interventions, consistency in methods and more tailored and comprehensive measures to capture the interventions’ complexity. Practice implications: A more valid understanding of HL interventions and measurements is needed to reach an agreed understanding of their components and intentions.publishedVersio

"A bit of everything": Health literacy interventions in chronic conditions- a systematic review

Objective: To systematically evaluate health literacy (HL) interventions in chronic conditions by exploring theoretical perspectives, intervention content and effectiveness. Method: We searched MEDLINE, Cochrane, CINAHL, EMBASE, ERIC, Web of Science and PsycINFO. Standardised systematic review methods were used, and sequences informing our research question were extracted and analysed. The study includes a descriptive summary of the included papers. Results: We included 39 unique interventions, with diabetes and heart disease as the most targeted chronic conditions. Fifty-four percent of papers included a definition of HL, but the studies showed significant hetero-geneity of theoretical underpinnings, modes, measures and content. We identified 23 HL measures, mostlyassessing functional HL. The HL interventions were often more complex than the measures indicated. A significant change in HL was found in 28 studies. Study quality was generally poor. Conclusions: Interventions optimizing HL appear important to improve health outcomes in chronic conditions. To ensure cumulative knowledge development of this field we need theory-based interventions, consistency in methods and more tailored and comprehensive measures to capture the interventions’ complexity. Practice implications: A more valid understanding of HL interventions and measurements is needed to reach an agreed understanding of their components and intentions