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Rejsen gennem ingenmandsland

– kvinders oplevelse af at være i behandlingsforløb for brystkræft
Travelling through no-man’s land – women’s experience of being treated for breast cancer
RN, MEst, PhD, Professor, Centre for Quality & Patient Safety Research Western Healthcare Partnership, School of Nursing and Midwifery, Deakin University, Geelong Victoria Australia
MPH, lektor , Center for forskning i Aldring og Demens, VIA University College.
Cand. psyk. Phd. , Metodecenter for Velfærd, VIA University College
Cand.cur., lektor, ph.d. studerende, Sygeplejerskeuddannelsen i Holstebro
Klinisk udviklingskoordinator, MKS , Onkologisk afdeling, Hospitalsenheden Vest
Cand. cur., lektor, ph.d. , Center for forskning i Aldring og Demens, VIA University College

Koordinering af kræftforløb har stort fokus i Danmark. Der har igennem de sidste 10 år været stort fokus på at lette de organisatoriske overgange i kræftforløbene. Studiets formål var at få indsigt i kvinders oplevelser af organisatoriske overgange i forbindelse med at være i behandling for brystkræft. Der blev udført 12 kvalitative, semistrukturerede interview med kvinder midt i deres behandlingsforløb. Analysen bestod af en systematisk tekstkondensering for at identificere meningsbærende enheder, der blev kodet til to temaer: 1) kvindernes oplevelse af manglende kontrol af selve behandlingsforløbet – hvem holder styr på mig? og 2) kvindernes oplevelse af manglende sammenhæng i overgangene mellem afdelingerne. Undersøgelsen viser, at et øget fokus på at lette overgangene i behandlingsforløbet kan være med til at øge kvindernes oplevelse af kontrol, og dermed mulighederne for at klare de udfordringer, der er i et kræftbehandlingsforløb. Her spiller sygeplejersker som koordinator en meget vigtig rolle i at skabe overblik og kontinuitet, som er grundelementerne i at klare de udfordringer, der er i at gå fra at være syg til at blive rask og fremadrettet mestre livet. Disse sygeplejersker skal have en tæt relation til kvinderne udover kun sikre, at forløbstiderne overholdes.

Nøgleord: Brystkræft, forløbskoordinator, livsovergange, organisatoriske overgange, teori om overgange, transition

Cancer case management has attracted major focus in Denmark. During the past 10 years, there has been focus on relieving the organizational transitions in the cancer processes. The purpose of this study was to gain insight into women’s experience of the organizational transitions in connection with being treated for breast cancer. Twelve qualitative, semi structured interviews were conducted with women half way through their treatment. The analysis consisted of a systematic text condensation to identify meaningful units coded to two themes: 1) the women’s experience of lack to little control with the treatment process – who is keeping track of me? and 2) the women’s experience of lack of cohesion in the transitions between departments. Studies show, that increasing awareness on easing the challenges in the treatment process, plays a factor in increasing the women’s experience of control, and thereby the possibility of developing coping mechanisms. Nurses play an integral role as a case manager in creating overview and continuity, which are the key elements in manage the challenge from being sick to becoming well and able to cope life. The case manager not only ensures that the treatment process is as scheduled but must build a close relationship with the women.

Keywords: Breast cancer, case management, life transitions, organizational transitions, transition theory
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