Show simple item record

dc.contributor.advisorGro Rosvold, Berntsen
dc.contributor.authorHansen, Frank
dc.date.accessioned2023-10-03T11:23:49Z
dc.date.available2023-10-03T11:23:49Z
dc.date.issued2023-10-18
dc.description.abstract<p><i>Background:</i> Persons diagnosed with cancer often suffer from long-term illness and have complex needs. Survival rates for cancer are increasing, although survivors’ quality of life may be severely compromised following cancer treatment. The National Cancer Strategy (2018-2022) aims to enhance individual care and quality of life for Norwegian cancer patients. In the past decade, person-centered care (PCC) has increased in importance to become a principal goal for both patients and public healthcare services. To achieve this goal, greater knowledge of what actually matters to people living with cancer is needed. <p><i>Aim:</i> As a contribution to such knowledge, the overall aim of this study is to learn more about long-term cancer pathways from the perspectives of the ill people concerned. What is a pathway from the participants´ perspectives? What matters to them during this period of illness? <p><i>Method:</i> This is a qualitative longitudinal study. Ten persons diagnosed with colorectal cancer were followed closely over approximately one year. This thesis is empirically based on 46 in-depth interviews with the participants during this period. The data were analyzed using qualitative content analysis, involving a search for themes and patterns across the interviews. <p><i>Results:</i> Illness is dynamic, not static. The participants’ goals, needs and values changed over time. PCC is here discussed in relation to the main points of the articles: medical pluralism, the model of social drama and what mattered to the participants. These three aspects of care may enhance our understanding of PCC in a cancer pathway, but from different perspectives. Therefore, this thesis is a contribution to the field of PCC in a Norwegian context. <p><i>Concluding remarks:</i> The knowledge gained from this study could be used to understand and further develop person-centered cancer care. Medical pluralism, model of social drama and knowledge about what matter to patients during a pathway may be of interest to legislators, cancer organizations, educational institutions or others who wish to learn about cancer pathways from a patient perspective.en_US
dc.description.abstract<p>Norsk tittel: På bedringens vei <p><i>Bakgrunn:</i> Personer med kreft lider ofte av langvarig sykdom og har sammensatte behov. Overlevelsesraten for kreft øker, men livskvaliteten kan bli alvorlig svekket etter kreftbehandling. Nasjonal kreftstrategi (2018-2022) har som mål å styrke individuell omsorg og livskvalitet for norske kreftpasienter. I det siste tiåret har personsentrert kreftomsorg økt i betydning og blitt et mål for både pasienter og offentlige helsetjenester. For å nå dette målet trengs mer kunnskap om hva som faktisk betyr noe for mennesker som lever med kreft. <p><i>Mål:</i> Som et bidrag til slik kunnskap er det overordnede målet med denne studien å lære mer om langvarige forløp ved kreft fra pasientenes perspektiv. Hva er et forløp fra pasientens perspektiv? Hva er viktig for dem? Hva gjør dem for å bli bedre? <p><i>Metode:</i> For å lære om forløp ved kreft fra pasientperspektivet har vi utført en kvalitativ longitudinell studie. Ti personer diagnostisert med tykktarmskreft ble fulgt tett over omtrent ett år. Denne avhandlingen er empirisk basert på 46 dybdeintervjuer med deltakerne i denne perioden. Dataene ble analysert ved hjelp av kvalitativ innholdsanalyse, som innebar å finne temaer og mønstre på tvers av intervjuene. <p><i>Resultater:</i> Sykdom er dynamisk, ikke statisk. Deltakernes mål, behov og verdier endret seg over tid. PCC diskuteres her i forhold til hovedpunktene i artiklene: medisinsk pluralisme, modell for sosialt drama og hva som var viktig for deltakerne. Disse tre aspektene kan forbedre vår innsikt i pasientenes forløp og PCC fra forskjellige perspektiver. Derfor er denne oppgaven et bidrag til feltet PCC i en norsk kontekst. <p><i>Avsluttende bemerkninger:</i> Kunnskapen fra denne studien kan brukes til å forstå og videreutvikle personsentrert kreftomsorg. Medisinsk pluralisme, modell for sosialt drama og kunnskap om hva som betyr noe for pasienter underveis kan være av interesse for lovgivere, kreftorganisasjoner, utdanningsinstitusjoner eller andre som ønsker å lære om forløp ved kreft fra et pasientperspektiv.en_US
dc.description.doctoraltypeph.d.en_US
dc.description.popularabstractSurvival rates for cancer are increasing, although survivors’ quality of life may be decreased following cancer treatment. Since many people suffer from cancer and various conditions after treatment, it is important to learn more about what matters to patients. What does a cancer pathway look like, and which action do people undertake to heal? To learn more about life with illness, we followed 9 people diagnosed with cancer over a period of 1 year. We interviewed the same people every quartal with a main focus on what mattered most to them last period. In the beginning, many got subtle symptoms. When they got cancer diagnosis, many experienced this as a shock. At this moment, biomedical cancer treatment mattered most, but later many other kinds of actions, such as being in nature and travel, were emphasized as most important. The result was a model of cancer as journey through different phases. I think that the findings and the patients´ voices in this thesis may contribute to a better understanding of life with illness from patients´ point of view. The information from the patients may change cancer care to be more in line with patients´ needs, values and goals.en_US
dc.description.sponsorshipThis work was supported by the Northern Norway Regional Health Authority (Helse Nord RHF) and The Norwegian Cancer Society (Kreftforeningen)en_US
dc.identifier.urihttps://hdl.handle.net/10037/31407
dc.language.isoengen_US
dc.publisherUiT The Arctic University of Norwayen_US
dc.publisherUiT Norges arktiske universiteten_US
dc.relation.haspart<p>Paper 1: Hansen, F., Berntsen, G.K.R. & Salamonsen, A. (2018). "What matters to you?" A longitudinal qualitative study of Norwegian patients' perspectives on their pathways with colorectal cancer. <i>International Journal of Qualitative Studies on Health and Well-being, 13</i>(1), 1548240. Also available in Munin at <a href=https://hdl.handle.net/10037/14334>https://hdl.handle.net/10037/14334</a>. <p>Paper 2: Hansen, F., Berntsen, G.K.R. & Salamonsen, A. (2019). Patient pathways as social drama: a qualitative study of cancer trajectories from the patient’s perspective. <i>International Journal of Qualitative Studies on Health and Wellbeing, 14</i>(1), 1639461. Also available in Munin at <a href=https://hdl.handle.net/10037/15828>https://hdl.handle.net/10037/15828</a>. <p>Paper 3: Hansen, F., Berntsen, G.K.R. & Salamonsen, A. (2020). Medical pluralism in the aftermath of cancer: health seeking actions and cancer patients’ shaping of trajectories to healing. <i>Anthropology & Medicine, 27</i>(3), 330-346. (Accepted manuscript version). Published version available at <a href=https://doi.org/10.1080/13648470.2019.1676637>https://doi.org/10.1080/13648470.2019.1676637</a>.en_US
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2023 The Author(s)
dc.subject.courseIDDOKTOR-003
dc.subjectVDP::Social science: 200::Social anthropology: 250en_US
dc.subjectVDP::Samfunnsvitenskap: 200::Sosialantropologi: 250en_US
dc.subjectVDP::Medical disciplines: 700::Health sciences: 800en_US
dc.subjectVDP::Medisinske Fag: 700::Helsefag: 800en_US
dc.title.alternativePå bedringens veien_US
dc.titleOn the path to healing - A qualitative longitudinal study of colorectal cancer patients’ accounts of trajectories to healing in Norwayen_US
dc.typeDoctoral thesisen_US
dc.typeDoktorgradsavhandlingen_US


File(s) in this item

Thumbnail
Thumbnail

This item appears in the following collection(s)

Show simple item record