Region Midtjylland Aarhus University Hospital Helbred og mestring hos kvinder der opereres for ovarie cancer - fra ventetid til forberedelse Lene Seibæk, forskningssygeplejerske, ph.d. FSGOS Efterårsseminar 2013

Region Midtjylland Aarhus University Hospital Et offentligt sundhedsvæsen i bevægelse Flere ældre, ↑ behov for behandling Vækst i livsstilssygdomme og kroniske tilstande Biomedicinske og teknologiske fremskridt skaber ny behov og forventninger

Region Midtjylland Aarhus University Hospital Organisatoriske og faglige forandringer Supersygehuse Korte, fokuserede indlæggelsesforløb Inddragelse af patienter og pårørende i behandlingen

Region Midtjylland Aarhus University Hospital Helbred og mestring hos kvinder der opereres på mistanke om kræft i æggestokkene Styrke helbred og mestring i et omsorgsperspektiv Sundhedsfremme og rehabilitering som overordnet teoretisk ramme

Region Midtjylland Aarhus University Hospital Taksigelser Finansiering Kræftens Bekæmpelse, Komite for Psykosocial Kræftforskning Dansk Sygeplejeråd Det Sundhedsvidenskabelige Fakultet, Syddansk Universitet Region Midtjyllands Sundhedsvidenskabelige Forskningsfond Forskningspuljen, Århus Universitetshospital, Skejby Hede Nielsens Fond Hovedvejleder Lise Hounsgaard, lektor, ph.d. Enhed for Sygeplejeforskning, Syddansk Universitet Projektvejledere Lone Kjeld Petersen, overlæge, dr.med. & Jan Blaakær, professor, dr.med Gynækologisk – Obstetrisk afdeling, Aarhus Universitetshospital

Region Midtjylland Aarhus University Hospital Kræft i æggestokkene ↑ incidens ↑ mortalitet (Grann et al 2011) Comorbiditet 25 % (Robinson et al 2009) Recidiv 85 % (DGCD)

Region Midtjylland Aarhus University Hospital Kræft i æggestokkene Årsagen oftest ukendt Ikke sygdomsspecifikke symptomer Ingen sikker diagnose før operationen

Region Midtjylland Aarhus University Hospital Rammer for behandlingen Kræftpakker (National Cancer Plan III) Centralisering (Fago-Olsen et al 2010) Accelererede forløb (Kehlet 2002 )

Region Midtjylland Aarhus University Hospital Hvad er et menneske? Krop Person Deltager

Region Midtjylland Aarhus University Hospital ObjectiveMethodsMaterials Describe health, socio-economic status, and use of public healthcare Registries study Cross-sectional design Descriptive statistics 666 women Explore lived experiences Interview study Qualitative research interviews Text analysis 10 women Develop a supportive care programme Design of programme Surveyl health and coping Test the supportive care intervention Questionnaire study Follow-up design Descriptive statistics Baseline measurements Test measurements 149 women 145 women

Region Midtjylland Aarhus University Hospital ObjectiveMethodsMaterials Describe health, socio-economic status, and use of public healthcare Registries study Cross-sectional design Descriptive statistics 666 women Explore lived experiences Interview study Qualitative research interviews Text analysis 10 women Develop a supportive care programme Design of programme To survey health and coping Test the supportive care intervention Questionnaire study Follow-up design Descriptive statistics Baseline measurements Test measurements 149 women 145 women

Region Midtjylland Aarhus University Hospital ObjectiveMethodsMaterials Describe health, socio-economic status, and use of public healthcare Registries study Cross-sectional design Descriptive statistics 666 women Explore lived experiences Interview study Qualitative research interviews Text analysis 10 women Develop a supportive care programme Design programme To survey health and coping Test the supportive care intervention Questionnaire study Follow-up design Descriptive statistics Baseline measurements Test measurements 149 women 145 women (

Region Midtjylland Aarhus University Hospital ObjectiveMethodsMaterials Describe health, socio-economic status, and use of public healthcare Registries study Cross-sectional design Descriptive statistics 666 women Explore lived experiences Interview study Qualitative research interviews Text analysis 10 women Develop a supportive care programme Design programme To survey health and coping Test the supportive care intervention Questionnaire study Follow-up design Descriptive and comparative statistics Baseline measurements Test measurements 149 women 145 women

Region Midtjylland Aarhus University Hospital ObjectiveMethodsMaterials Describe health, socio-economic status, and use of public healthcare Registries study Cross-sectional design Descriptive statistics 666 women Explore lived experiences Interview study Qualitative research interviews Text analysis 10 women Develop a supportive care programme Design of programme Surveyl health and coping Test the supportive care intervention Questionnaire study Follow-up design Descriptive statistics Baseline measurements Test measurements 149 women 145 women

Region Midtjylland Aarhus University Hospital

Region Midtjylland Aarhus University Hospital Hovedresultater - levevilkår Ældre (62.5 år) Moderat til svært systemisk syge (61%) Middel til svært overvægtige (43 %) Folkeskole højeste uddannelse (42 %) Pensionerede (61 %) Bor alene (44 %) Økonomi under gennemsnit (75 %)

Region Midtjylland Aarhus University Hospital ObjectiveMethodsMaterials Describe health, socio-economic status, and use of public healthcare Registries study Cross-sectional design Descriptive statistics 666 women Explore lived experiences Interview study Qualitative research interviews Text analysis 10 women Develop a supportive care programme Design of programme To survey health and coping Test the supportive care intervention Questionnaire study Follow-up design Descriptive statistics Baseline measurements Test measurements 149 women 145 women

Region Midtjylland Aarhus University Hospital

Region Midtjylland Aarhus University Hospital Hovedresultater - Erfaringer Diagnose og behandlingsstart skelsættende livsbegivenheder Selvom den diagnostiske proces er langstrakt og krævende, bibeholdes tilliden til sundhedsvæsenet Skabelse af sygdoms-fri zoner samt opretholdelse af et hverdagsliv udgør væsentlige mestringsstrategier Behovet for information tiltager Gode sociale relationer repræsenterer en unik ressource; tilsvarende udgør mindre gode relationer en belastning Fysisk velvære styrker håb og livsmod

Region Midtjylland Aarhus University Hospital Datakilder Registre Interview 666 kvinder → besøg Praktiserende læger: 66.5 % Gynækolog: 5.4 %

Region Midtjylland Aarhus University Hospital

Region Midtjylland Aarhus University Hospital Forskellige perspektiver Viden fra Registre Alment helbred Levevilkår Sundhedsvæsenets organisering Socioøkonomiske forudsætninger for helbredelse Viden fra Interview Mestringsstrategier Erfaringer med symptomer Handlekraft og viden Personlige forudsætninger for helbredelse

Region Midtjylland Aarhus University Hospital ObjectiveMethodsMaterials Describe health, socio-economic status, and use of public healthcare Registries study Cross-sectional design Descriptive statistics 666 women Explore lived experiences Interview study Qualitative research interviews Text analysis 10 women Develop a supportive care programme Design programme To survey health and coping Test the supportive care intervention Questionnaire study Follow-up design Descriptive statistics Baseline measurements Test measurements 149 women 145 women (

Region Midtjylland Aarhus University Hospital Setting Center for ovarie cancer kirurgi Ambulatorium og afdeling har samme personale

Region Midtjylland Aarhus University Hospital Præoperativ optimering - fra ventetid til forberedelse

Region Midtjylland Aarhus University Hospital ObjectiveMethodsMaterials Describe health, socio-economic status, and use of public healthcare Registries study Cross-sectional design Descriptive statistics 666 women Explore lived experiences Interview study Qualitative research interviews Text analysis 10 women Develop a supportive care programme Design programme To survey health and coping Test the supportive care intervention Questionnaire study Follow-up design Descriptive and comparative statistics Baseline measurements Test measurements 149 women 145 women

Region Midtjylland Aarhus University Hospital

Region Midtjylland Aarhus University Hospital Hovedresultater – Intervention Alment helbred – fysisk Størstedelen indenfor standardniveau Præoperativ optimering forbedrede tilstanden hos de mest syge Alment helbred - mentalt Under standardniveau, også hos kvinder der fik afkræftet deres kræftdiagnose De mest syge oplevede yderligere forringelse Mestrings-kapacitet Svarende til normalområdet

Region Midtjylland Aarhus University Hospital Igangværende og fremtidig forskning Håb og livsmod Comfort and well-being - the physical dimension of hope Familien som med - og modspiller i et kræftbehandlingsforløb "Når jeg føler vi er på samme hold" - patientperspektiver på samarbejde i sundhedsvæsenet Præoperativ optimering - test af intervention i RCT

Region Midtjylland Aarhus University Hospital Har fremtidens patient brug for sygepleje? Alment helbred En patient – mange sygdomme Følger af sygdom og behandling Håb og livsmod Information Interaktion

Region Midtjylland Aarhus University Hospital Hvilken sygepleje bliver der brug for? Værdier Helhedsorienteret Relationel Individorienteret Ressourcer Hverdagsliv Livsmod Aktivitet Samarbejde Patient Netværk Tværfaglighed

Region Midtjylland Aarhus University Hospital