BackgroundEvidence about rehabilitation of post COVID-19 condition is scarce. Yoga has been found beneficial in other chronic conditions and can be delivered in a digital format at home. The aim of the study was to explore the feasibility of teleyoga in persons with post COVID-19 condition by assessing adherence, safety, limited efficacy and experiences.MethodsPre-post mixed-method design. Participants were recruited from a post COVID-19 rehabilitation clinic. The intervention included standardised live-streamed teleyoga sessions twice/week for 7 weeks and individual yoga using a digital application during 12 weeks. Adherence to the teleyoga intervention was measured by registration of participation and by analysing the log in the application. Safety was measured by registration of serious adverse events. Limited efficacy examined trends in the predicted direction for better outcome in patients with a post-COVID condition in the 6-minute walk test, gait speed, cognition, health-related quality-of-life, mental distress, sleep and exercise motivation. We also assessed patients' experiences after the intervention.ResultsNine women and 2 men were enrolled, aged between 27 and 61 years, and duration of post COVID-19 3-12 months. Adherence: Half of the participants participated in more than 50% of the online yoga sessions. They enjoyed the digital format and the social aspect of the online yoga sessions. Some participants experienced that the yoga sessions of 60 min were too long. People with post COVID-19 felt motivated to participate, however they felt conflicted when other commitments took time away from yoga. Adherence to the yoga application varied, 6 patients used it less than 50% of the recommended time. Safety: Persons with post COVID-19 experienced symptoms due to their disease, which could increase during the yoga sessions that made it harder to participate. There were no reported serious adverse events. Limited efficacy: Participants expressed that they breathed more consciously and experienced relaxation and reduction of stress and anxiety. After 7 weeks of teleyoga there was a significant improvement in cognitive function (p-value = 0.048). No differences were found in the physical tests, health-related quality-of-life, anxiety and depression, sleep or in exercise motivation.ConclusionAdherence to the online yoga sessions was quite low and might be improved with shorter yoga sessions. Online yoga was safe, but some participants experienced an increase in symptoms. Teleyoga was associated with improved cognition, breathing and relaxation. The results show that online yoga could be feasible for people post COVID-19, but adaptation of the yoga-program may be required, especially as many patients experience an increase of symptoms. Furthermore, the teleyoga should be more flexible with regards to the duration and the number of sessions. As few participants were adherent to the application, the relevance and usefulness of this needs to be further explored.

Purpose: To explore the symptom cluster management process from the perspective of patients with lung cancer within the oncological care context. Methods: We used a constructivist grounded theory methodology to collect and analyze rich data from 15 patients with lung cancer via individual interviews and a two-dimensional symptom assessment scale. Results: A situational theoretical model describes the symptom cluster management process through the main category ‘To get through to survive’, with the category ‘Handling symptom clusters’ together with six sub-categories concerning the patients' management strategies and the category ‘Living with symptom clusters,’ together with two sub-categories describing the outcome in their daily life. Impacting conditions are incorporated in the model. Conclusions: Patients often feel left to their own devices to deal with symptom clusters and may not understand or foresee problematic circumstances as they manage their situations on a day-to-day basis. When symptoms are normalized and accepted, patients do not ask for support, or support is not being offered to them. Healthcare professionals should consider the peril of normalizing symptoms and the patients’ altered time perspective that stems from their approach of living one day at a time, in further development of nursing interventions and person-centered care for this population.

Purpose: Sexuality and body image are closely related to health-related quality of life (HRQoL), but these factors are less investigated in patients treated for lymphoma. Therefore, the aim of this study was to describe and explore the associations between sexuality, body image, comorbidities and HRQoL in patients treated for diffuse large B-cell lymphoma. Methods: A cross-sectional study with 257 patients (25% response rate) was conducted in 2019 using measures for sexuality, HRQoL and body image and data from the Swedish National Quality Registry for Leukemia–Subregistry for Lymphoma. Results: The participants had a mean HRQoL of 69.75 on a 1 to 100 scale, and the functional scales ranged from 68.50 for Role to 80.82 for Social functioning. The symptoms ranged from 5.56 for nausea and vomiting to 37.73 for fatigue. Regarding body image, the participants scored a total of 14.47 (reference values 10–40). The total score for Sexual adjustment was 3.02 (fair), and for the subscales Sexual Interest 2.63 (low), Sexual Relation 2.72 (low), Sexual Function 3.62 (high) and Sexual Satisfaction 3.50 (high). HRQoL was positively associated with Sexual Relation; however, negative body image and comorbidities showed negative associations. The model explains 39.6% of the variation in HRQoL. Conclusion: The positive impact of sexual relationships on HRQoL was highlighted, which emphasised the unfavourable effect of negative body image and comorbidities on HRQoL for lymphoma patients. Cancer nurses should address these topics with patients to improve their long-term well-being.

BackgroundFamily caregivers are essential in end-of-life care for cancer patients who wish to die at home. The knowledge is still limited regarding family caregivers needs and preferences for support and whether the preferences change during the patient's illness trajectory. Therefore, the aim was to explore family caregivers' preferences for support from home care services over time when caring for a family member with cancer at the end of life who wished to die at home.MethodsA qualitative method was applied according to Grounded Theory. Data was collected longitudinally over the illness trajectory by means of repeated individual interviews (n = 22) with adult family caregivers (n = 11). Sampling, data collection and data analysis were undertaken simultaneously in line with the constant comparative method.ResultsThe findings are captured in the core category "hold out in duty and love". The categories "having control and readiness for action" and "being involved in care" describe the family caregivers' preferences for being prepared and able to handle procedures, medical treatment and care, and to be involved by the healthcare personnel in the patient's care and decision making. The categories "being seen and confirmed" and "having a respite" describe family caregivers' preferences for support according to their own needs to be able to persevere in the situation.ConclusionDespite deterioration in the patient's illness and the increasing responsibility family caregiver struggle to hold out and focus on being in the present. Over time together with deterioration in the patient's illness and changes in the situation, they expressed a need for more intense and extensive support from the home care services. To meet the family caregivers' preferences for support a systematic implementation of a person-centred care model and multicomponent psycho- educational interventions performed by nurses can be proposed. Moreover, we suggest developing a tool based on the conceptual model generated in this study to identify and map family caregivers' needs and preferences for support. Such a tool can facilitate communication and ensure person-centred interventions.

BackgroundThe psychosocial needs of families in which a parent is affected by life-threatening illness and has dependent children are extensive. However, few family-based interventions have been scientifically evaluated and even fewer have been evaluated long term. Therefore, the specific objectives of this study were to describe the parents' perceptions of the timing and length of FTI in relation to the illness trajectory, to explore what activities learnt by the FTI still were practiced in the long-term and what content of FTI was perceived as most valuable to cope in the long-term.MethodsThis qualitative study involved a follow-up with nine parents (ill parents, n = 3, coparents, n = 6) 4 to 5 years after participating in FTI, where one parent was cared for in specialised palliative homecare. FTI is a psychosocial family-based intervention that consists of 6-11 manual-based meetings with the families led by an educated interventionist. FTI focuses on facilitating family communication about illness-related subjects, supporting parenting, and making the children's needs visible. The data collection consisted of interviews and was analysed according to the phenomenographic method, focused on variations in perceptions.ResultsThe parents perceived FTI as a way to alleviate feelings of loneliness, and some families were still using the obtained communication tools at the time of the interview. They also perceived that FTI contributed to the children being more open about their own feelings and thoughts. However, the parents wanted extended support after FTI ended based on their individual needs, for example, during and after bereavement, deteriorated health or occasional challenges faced by children in crisis. The parents perceived the peer support gained in conjunction with FTI as important social and emotional support both during and after the intervention. The interventionists were perceived as professional persons who promoted open and honest communication during FTI.ConclusionFTI is found to promote family communication both in a short- and long-term perspectives according to parents. They also found FTI useful in reducing their feelings of loneliness. Support over a longer period of time is desired and extra FTI meetings may strengthen the family as a whole in parallel with additional support for parents and children during the illness trajectory and in bereavement. They received support in dealing with strong and difficult emotions and learned conversational techniques that they still used at the time of the interview, indicating that the lessons learnt was integrated and valuable many years after the last FTI meeting.

AimThis scoping review investigated and descriptively summarised previous research about fundamental nursing, its focus (what care needs are described, how is it described and by whom is it described), continuity of care (is it described in relation to fundamental nursing) and possible nursing interventions or activities targeting older people's fundamentals of care needs in home- or facility-based care.MethodsThis scoping review was carried out following the steps of Arksey and O'Malley's methodology and PRISMA-ScR reporting guidelines. Searches were conducted in PubMed via NIH, CINAHL via EBSCO and PsycInfo via ProQuest for the time period between January 2002 and May 2023.ResultsForty-two studies were included where the majority had been conducted in a facility-based care context. Nutrition-or rather nutritional care activities targeting eating and drinking-was the most frequently described fundamental care needs addressed. After this came personal care such as cleansing, dressing, oral care, skin, and foot care. Few studies addressed more than one fundamental care need at the time. The nursing staff described fundamental nursing as complex, comprehensive, and demanding. Older people and relatives described a gap between the fundamental nursing provided and their perceived need for support. Less attention was given to older peoples relational and psychosocial needs. Identified nursing interventions mainly targeted physical care needs. Our findings also implied that interventions focusing on fundamental nursing were described as feasible in practice with favourable or moderate results, while long-term effects were difficult to detect. No studies were identified focusing on fundamental nursing in relation to outcomes such as continuity of care.ConclusionFundamental nursing was mainly described in relation to physical care needs, which were essentially conducted within facility-based care contexts. Interventions and activities primarily focused on one fundamental need at the time, mainly within the physical domain. No nursing interventions were identified focusing on relational and psychosocial needs where continuity of care can be viewed as a relevant outcome. Such limited focus are especially concerning as research has highlighted the importance of that older people with complex care needs can benefit from a holistic and person-centred approach i.e. fundamental nursing.

Background: Conveying information to parents is a core part of pediatric oncology nursing; however, most published interventions do not tailor information to individual parental needs. Objective: To evaluate the effect on parental illness-related stress of person-centered information provided to parents of children with cancer. Methods: A multicenter, unblinded randomized controlled trial with two parallel arms recruiting parents of children diagnosed within the past two months from two tertiary children’s cancer centers in Sweden. Parents were randomized using sealed envelopes prepared and opened by an independent person. Parents in the intervention arm met four times with experienced nurses trained in the intervention, whereas controls received standard care. The effect of the intervention was measured five times regarding parents’ illness-related stress. Secondary outcomes were psychosocial states, experiences with healthcare providers, and received information. Further, we collected process data on the intervention’s content and fidelity. Results: Of the 32 parents included and analyzed in the study, 16 were randomized to the intervention, which addressed a broad variety of topics. The intervention increased parents’ knowledge about the biophysiological and functional aspects of their child’s illness, but it had no measurable effect on their distress. Discussion: Although fidelity to the intervention protocol was sufficient, the study was flawed by recruitment difficulties, primarily due to organizational factors, which may have prevented us from observing any possible effects on psychosocial distress. Having a person-centered perspective could be promising for future studies aimed at parents of children with cancer. (Registered at Clinicaltrials.gov, number NCT02332226.).