Pär Salander

Umeå University, Umeå, Västerbotten, Sweden

Are you Pär Salander?

Claim your profile

Publications (50)159.31 Total impact

  • Pär Salander
    Psycho-Oncology 07/2015; DOI:10.1002/pon.3905 · 4.04 Impact Factor
  • Pär Salander
    [Show abstract] [Hide abstract]
    ABSTRACT: To the Editor:Now and then, I unfortunately come across studies that I do not find very meaningful. One such study is that of Rabow and Knish [1] that was recently published in Supportive Care in Cancer. This study had two purposes. The first was to evaluate whether an intervention in the form of a single visit to a symptom management service was facilitating for a sample of patients in palliative care. The second was to study the associations between symptoms, quality of life, and ‘spiritual’ well-being in the same patient group. I will not dwell on the first part of the study, but will focus on the second. The authors state that the reason for studying the associations was that previous studies were based on sample sizes that were too small and that more rigorous studies were needed. However, in my mind, a large sample size is not a ‘wild card’ for leaving out other criteria for scientific rigour. Let me critically comment on two points:‘Spirituality’ is a complex and controversial ...
    Supportive Care Cancer 12/2014; 23(4). DOI:10.1007/s00520-014-2569-5 · 2.50 Impact Factor
  • Pär Salander
    Psycho-Oncology 12/2014; 23(12):1439-40. DOI:10.1002/pon.3713 · 4.04 Impact Factor
  • Source
    Pär Salander · Katarina Hamberg
    Academic medicine: journal of the Association of American Medical Colleges 11/2014; 89(11):1430. DOI:10.1097/ACM.0000000000000492 · 3.47 Impact Factor
  • Pär Salander
    European Journal of Cancer Care 11/2014; 23(6):819-20. DOI:10.1111/ecc.12196 · 1.76 Impact Factor
  • Pär Salander · Maria Sandström
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective Reflection groups for clinicians, often called Balint groups, are a way of refining professional competence in health care. This study presents a model for reflective practice in a group setting and describes the kinds of troublesome cases that medical residents are concerned about. Methods From 2005 to 2012 a Balint-inspired reflective forum has been a part of the academic seminar program for physicians in training in a Department of Oncology at a Swedish university. The present study is focused on all 63 cases presented in the forum. Results The cases were categorized into three kinds of challenges: Communication challenges in the patient-physician relationship, Communication challenges in organizational matters, and Communication challenges with close relatives of the patient. Conclusion The study tells us something about the vulnerability of being a medical resident and the identified challenges have bearings on medical education curricula as well as on how the training of junior physicians is organized. Practice implications The cases are contextual and multifaceted, and a forum of this kind might therefore be regarded as a potential way to develop professional competence and to refine communication in clinical practice. A structured evaluation of the forum would be valuable.
    Patient Education and Counseling 10/2014; 97(1). DOI:10.1016/j.pec.2014.06.008 · 2.60 Impact Factor
  • Pär Salander · Mirjam Bergknut · Roger Henriksson
    [Show abstract] [Hide abstract]
    ABSTRACT: Background. Lung cancer is associated with biomedical and psychological symptoms as well as a generally poor prognosis. When healthcare staff communicate with lung cancer patients it is essential that they consider the patients' own views of the situation to avoid putting unnecessary strain upon the patients' shoulders. The purpose of the present study is to better understand how a group of patients with lung cancer reflects upon their new life situation after diagnosis and primary treatment. Method. Fifteen patients with non-small cell lung cancer were consecutively included and, where possible, repeatedly interviewed during the course of the disease process. The 29 interviews were conducted in a thematically structured narrative form that facilitated a dialog between the interviewer and the patient. The interviews covered experiences with health care, living an everyday life, and thoughts about the future. Findings and reflections. By focusing on how the patients more or less preconsciously elaborated mentally with their vulnerable situation, it was possible to detect different mental manoeuvres that they used as a way of creating hope. The patients distanced themselves from their disease, relied on a feeling of a sound body, idealised treatment possibilities, relied on healthy behaviour, focused on a concrete project, found that they were better off than others, and took solace in the fact that there were patients who had successfully managed the disease. Discussion. The patients were not passive victims in the face of their diagnosis, but were actively trying to find ways of looking at their despairing situation in a positive light. A creative process for psychological survival had thus been initiated by the patients. We suggest that acknowledging this process should be the starting point from which physicians can engage in hope work with their patients.
    Acta oncologica (Stockholm, Sweden) 06/2014; 53(9):1-7. DOI:10.3109/0284186X.2014.921725 · 3.71 Impact Factor
  • Pär Salander
    Palliative and Supportive Care 05/2014; 13(01):1-2. DOI:10.1017/S1478951514000480 · 0.98 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Most studies of the psychosocial needs of patients with head and neck cancers' (HNC) use predefined categories and explicitly ask for specified needs. These studies are important but should be complemented with inductive studies based on patients' own descriptions of experiences. The present qualitative study is such a contribution. In repeated interviews positive and negative incidents were collected from 137 patients with HNC, and these experiences were categorized in dimensions expressing needs. A core category-'being included-neglected by a helping system'-emerged from the narrated incidents and it was based on the dimensions 'engagement', 'competence' and 'information'. The findings are easily related to attachment-theory by stressing the significance of establishing trustful relationships with the health care staff, as attachment figures, who respond flexibly and sensitively to the patient's needs. In the constitution of health care as a helping system, all encounters between the patient and health care staff matters. Further research should preferably focus on the creation of guidelines for the constitution of health care as a helping system, i.e. how the found factors of a helping system can be operationalized in clinical practice.
    Journal of Psychosocial Oncology 03/2014; 32(3). DOI:10.1080/07347332.2014.897289 · 1.04 Impact Factor
  • Pär Salander
    Patient Education and Counseling 09/2013; DOI:10.1016/j.pec.2013.08.026 · 2.60 Impact Factor
  • Pär Salander
    Psycho-Oncology 09/2013; 22(9):2156. DOI:10.1002/pon.3360 · 4.04 Impact Factor
  • Source
    Jenny Andersson · Pär Salander · Katarina Hamberg
    [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE: Gender bias exists in patient treatment, and, like most people, health care providers harbor gender stereotypes. In this study, the authors examined the gender stereotypes that medical students hold about patients. METHOD: In 2005, in Umeå, Sweden, the authors collected 81 narratives written by patients who had undergone cancer treatment; all information that might reveal the patients' gender was removed from the texts. Eighty-seven medical students read 40 or 41 narratives each, guessed the patient's gender, and explained their guess. The authors analyzed the students' explanations qualitatively and quantitatively to reveal the students' gender stereotypes and to determine whether those stereotypes had any predictive value for correctly guessing a patient's gender. RESULTS: The students' explanations contained 21 categories of justifications, 12 of which were significantly associated with the students guessing one gender or the other. Only three categories successfully predicted a correct identification of gender; two categories were more often associated with incorrect guesses. CONCLUSIONS: Medical students enter their training program with culturally shared stereotypes about male and female patients that could cause bias during their future careers as physicians. To prevent this, medical curricula must address gender stereotypes and their possible consequences. The impact of implicit stereotypes must be included in discussions about gender bias in health care.
    Academic medicine: journal of the Association of American Medical Colleges 05/2013; 88(7). DOI:10.1097/ACM.0b013e318295b3fe · 3.47 Impact Factor
  • Pär Salander
    Patient Education and Counseling 04/2013; 92(2). DOI:10.1016/j.pec.2013.03.014 · 2.60 Impact Factor
  • Pär Salander
    Archive for the Psychology of Religion / Archiv für Religionspychologie 01/2013; 35(1):147-148. DOI:10.1163/15736121-12341251 · 0.34 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE: This 2-year follow-up study explores aspects of body image after mastectomy due to breast cancer. MATERIALS AND METHODS: This population-based study included 76 women living in northern Sweden who, during November 2006 to October 2007, underwent mastectomy due to breast cancer. The women completed a questionnaire entitled "Life After Mastectomy (LAM)" 10 months after the mastectomy and again 2 years later. We used SPSS version 18.0 for data processing and analysis. RESULTS: The findings indicate that few significant changes in body image had taken place during the 2-year interval between the first and second completion of the questionnaire. An exception was a significant decrease in feelings of sexual attractiveness and comfort during sexual intimacy. At follow-up, 21% of the women had undergone breast reconstruction (BR). They were significantly younger than the women who had not had BR (53 vs. 63 years). Besides being younger, no other significant differences could be found between those women who had undergone BR and those who had not. The fact that the decrease in sexual attractiveness and feelings of comfort during sexual intimacy also applied to the subgroup of women who had had BR may therefore be surprising. A better understanding of issues related to breast cancer treatment and sexual function is vital. CONCLUSION: It is important for health care professionals to be aware of problems related to sexual intimacy and to be prepared not just to provide information about these, but also to reflect on expectations vs. reality together with the women.
    European journal of oncology nursing: the official journal of European Oncology Nursing Society 10/2012; DOI:10.1016/j.ejon.2012.09.002 · 1.79 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Scand J Caring Sci; 2012 Meaning of work and the returning process after breast cancer: a longitudinal study of 56 women Background:  An increasing number of women survive breast cancer and a majority return to work. However, findings based on mean values may conceal individual processes that need to be better understood to discuss meaningful rehabilitation. Aim:  The purpose of this study is to describe the sick-leave pattern of a group of Swedish women with primary breast cancer but foremost to explore their ideas about what motivates and discourages their return to work. Method:  Fifty-six women were repeatedly interviewed over a period of 18-24 months. Interview sections that clearly illustrated the women's experiences and ideas about work were categorized using the comparative similarities-differences technique. Findings:  The average length of sick leave was 410 days (range 0-942). Six months after the first day of sick leave, 29% worked at least their previous service grade. At 12 months, 55% and at 18 months 57% did so. Those treated with chemotherapy had in average more than twice as large sick leave as those who did not. Three categories emerged. 'Motives for not returning to work' consists of four subcategories: 'I'm still too fragile to return to work'; 'My workplace is a discouraging place'; 'I took an opportunity to pause' and 'I've lost the taste for work'. 'Motives for returning' consists of two sub-categories: 'Work generates and structures my everyday life' and 'I miss my workplace'. Finally, 'Transition in work approach' reflects a changed approach to work. Conclusion:  The meaning of work varies over time, but first and foremost work was regarded as an important part of the healing process as it restores the disruption of everyday life. Guidelines cannot be reduced to a linear relationship with biomedical variables but the individual context of everyday life must be considered.
    Scandinavian Journal of Caring Sciences 06/2012; 27(2). DOI:10.1111/j.1471-6712.2012.01026.x · 0.89 Impact Factor
  • Source
    Pär Salander
    Acta oncologica (Stockholm, Sweden) 12/2011; 51(4):541-60. DOI:10.3109/0284186X.2011.639389 · 3.71 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Because of early detection and advanced treatment options, more women with breast cancer survive after mastectomy and thus have to face the choice of living with or without a reconstructed breast for many years to come. This article investigates these women's narratives about the impact of mastectomy on their lives, as well as their reflections on breast reconstruction. Fifteen women were strategically chosen from a previous population-based study on mastectomy. They were contacted for further exploration in thematic narrative-inspired interviews 4.5 years after mastectomy. Three types of storylines were identified. In the first storyline, the mastectomy was described as "no big deal"; losing a breast did not disturb the women's view of themselves as women, and breast reconstruction was not even worth consideration. In the second storyline, the women described the mastectomy as shattering their identity. Losing a breast implied losing oneself as a sexual being, a woman, and a person. The third storyline fell in between the other two; the sense of femininity was wounded, but not to the extent that they felt lost as women. Our findings suggest that the experience of mastectomy due to breast cancer is very much individual and contextual. Losing a breast may be of minor or major importance. Healthcare practitioners should be attentive to how the women themselves experience the personal meaning of losing a breast and guard against vague preconceptions based on the breast-sexuality-femininity discourse and its connection to what the patient needs.
    Cancer nursing 11/2011; 35(5):E41-8. DOI:10.1097/NCC.0b013e31823528fb · 1.93 Impact Factor
  • U. Fallbjörk · P. Salander · B. H. Rasmussen
    European Journal of Cancer 09/2011; 47. DOI:10.1016/S0959-8049(11)71420-4 · 4.82 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The survival of women with breast cancer has improved. There are many studies available describing different aspects of how the illness and its treatment affect the women. Usually these studies are cross-sectional and focus on assessments of a sample of women at a single point in time during post-treatment. These studies are important but of limited value if we are interested in understanding more about breast cancer in a life context. The present study is a contribution. A consecutive sample of 39 women was followed up by means of repeated thematic interviews about how they lived their lives, from the end of radiation therapy to a point four years later, i.e. 4.5-5 years post diagnosis. Four different groups of women emerged. Largely, the first group evaluated the cancer initiated transformation of their lives in a positive way. The breast cancer helped them depart from a career treadmill or to positive interpersonal experiences. In the second group the cancer and its treatment seemed to pass without marked traces. The cancer made a difference for the third group, but both in positive and negative ways. A different life perspective or improved relationships were weighted against troublesome side effects from treatment. Finally, in the fourth group a bodily decline due to side effects and other health problems was predominant and this obstructed their chances of living a good life. The narratives showed that being diseased by breast cancer has different impacts depending on how the woman lives her life - it is very much a matter of transition in a life context. The results are furthermore discussed in relation to adaptation and coping theory.
    Acta oncologica (Stockholm, Sweden) 04/2011; 50(3):399-407. DOI:10.3109/0284186X.2010.547216 · 3.71 Impact Factor

Publication Stats

548 Citations
159.31 Total Impact Points

Institutions

  • 1995–2014
    • Umeå University
      • • Department of Social Work
      • • Department of Radiation Sciences
      Umeå, Västerbotten, Sweden
  • 1999
    • Norrlands universitetssjukhus
      Umeå, Västerbotten, Sweden