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Background: Prolonged grief disorder (PGD) has been added to the ICD-11 and DSM-5-TR. The Traumatic Grief Inventory-Self Report Plus (TGI-SR+) assesses self-rated PGD intensity as defined in ICD-11 and DSM-5-TR. The TGI-SR + is available in multiple languages, but has not been validated yet in Norwegian. Objective: The aim of this study was to evaluate the psychometric properties of the Norwegian TGI-SR + . Method: Bereaved adults ( N  = 307) whose child or sibling died ≥6 months ago due to a sudden or violent loss completed the TGI-SR + and measures for posttraumatic stress, depression, and precursor PGD symptoms. We examined the factor structure and internal consistency of the ICD-11 and DSM-5-TR PGD items. Convergent validity and known-groups validity was evaluated. Probable PGD cases, pair-wise agreement between diagnostic scoring rules for both PGD criteria-sets, and cut-off scores were calculated. Results: The 1-factor model for ICD-11 and DSM-5-TR PGD showed the best fit and demonstrated good internal consistency. Convergent validity was supported by strong associations between summed ICD-11 and DSM-5-TR PGD scores and summed posttraumatic stress, depression, and precursor prolonged grief scores. Known-groups validity was supported by PGD intensity being related to educational level and time since loss. The perfect pair-wise agreement was reached using the ICD-11 and DSM-5-TR PGD diagnostic scoring rules. The optimal cut-off score for detecting probable PGD cases, when summing all TGI-SR + items, was ≥73. Conclusions: The Norwegian TGI-SR + seems a valid and reliable instrument to assess ICD-11 and DSM-5-TR PGD intensity after losing a child or sibling under traumatic circumstances.

Purpose: To summarize evidence on the effects of multidisciplinary psychosocial rehabilitation interventions for adult cancer patients on fatigue, quality of life, participation, coping, and self-efficacy. Materials and methods: We searched MEDLINE, Embase, PyscINFO, PEDro, OT Seeker, Sociological Abstracts, CINAHL, and Cochrane CENTRAL for randomized controlled trials. Two reviewers selected articles independently. Results: Thirty-one articles were included and four meta-analyses were conducted. The results of one meta-analysis was statistically significant when comparing multidisciplinary psychosocial interventions to standard care on fatigue among breast cancer patients (standardized mean differences [SMD] 0.30 (95% confidence interval [CI] 0.04, 0.56)) at 2-6 months follow-up. However, no significant results were revealed on health-related quality of life among breast cancer (SMD 0.38 (95% CI -0.40, 1.16)), prostate cancer (SMD 0.06 (95% CI -0.18, 0.29)), and patients with different cancer diagnoses (SMD 0.06 (95% CI -0.14, 0.25)) at follow-up. One study reported on effects of interventions on participation, and four studied the outcomes of coping and self-efficacy. Conclusions: Multidisciplinary psychosocial interventions may decrease fatigue among breast cancer patients. There is an urgent need for rigorous designed trials in cancer rehabilitation, preferably on fatigue, participation, and coping or self-efficacy. The interventions need to be thoroughly described.Implications for rehabilitationMultidisciplinary psychosocial interventions may reduce fatigue among breast cancer patients.The effects of multidisciplinary psychosocial interventions among cancer patients on health-related quality of life, participation, and coping are unclear.Urgent need for a systemic approach to the development and conduction of multidisciplinary psychosocial interventions, ideally based on guidelines for complex interventions.Need of larger and more rigorously conducted randomized controlled trials investigating the effects of these rehabilitation interventions on fatigue, participation and coping.

Background: Cancer coordinators (CCs) operate at both patient and system levels in order to provide patients with tailored and coordinated services. In common with international CCs, Norwegian CCs denote notable progress in their patient-focused work, while reporting ongoing challenges in carrying out system-focused tasks. However, little is known about the barriers and facilitators for CCs' system-level work., Objective: The aim of this study was to explore Norwegian CCs' experiences of barriers and facilitators for enacting system-focused tasks., Methods: The study applies a qualitative method, conducting an interpretative data inquiry of semistructured in-depth interviews with 26 Norwegian CCs. The data were analyzed using thematic analysis and discussed in light of previous research and salutogenic theory., Results: The analyses revealed 3 main themes: (1) "understanding the role and local cancer care," (2) "systems for care delivery in primary healthcare," and (3) "commitment to collaboration." Where present, the themes could represent important facilitators, whereas their absence could depict notable challenges to CCs system-focused work. Over time, as CCs were able to mobilize resources, they were able to gradually turn initial challenges into facilitators in the context of system-level work., Conclusions: Cancer coordinators encounter cognitive, practical, and relational topics that impact their system-focused activities. Adopting a salutogenic focus can help CCs mobilize resources needed to turn challenges into facilitators for system-level work., Implications for Practice: Cancer care coordination cannot be undertaken by CCs alone. Cancer coordinators' embedding in multidisciplinary teams, common systems for care provision, meaningful work relations, and professionals' commitment to cancer care represent important facilitators for CCs' system-focused tasks.

Objective: The facilitation of complex cancer rehabilitation interventions in primary health care has become of growing importance to meet the bio-psycho-social needs of cancer survivors. However, the delivery of cancer rehabilitation is debated and services are underutilised. Cancer coordinators (CCs) provide patients with coordinated services throughout the trajectory. Little is known about CCs' rehabilitation-focused tasks. This study's objective was to explore Norwegian CCs' experiences with cancer rehabilitation interventions in primary health care., Methods: Data were obtained via two focus group interviews with 12 participants, analysed using thematic analysis and discussed using Salutogenesis, a theory for health promotion., Results: The analysis revealed three themes: (a) "A missing link" to cancer rehabilitation in primary health care, (b) Aiming to put cancer rehabilitation "in the spotlight," (c) The need to build a system for rehabilitation service delivery., Conclusion: CCs experience a lacking focus on and missing systems for cancer rehabilitation in primary health care. CCs aim to improve local practices by advocating patients' needs and educating professionals. CCs must be supported via education and training in system-level work, an increased policy focus and resources for cancer rehabilitation. More research is required into how CCs may facilitate cancer rehabilitation in primary health care., (© 2019 John Wiley & Sons Ltd.)

Young adult cancer patients (YACPs), aged 18-35 years when diagnosed with cancer, are in a vulnerable transitioning period from adolescence to adulthood, where cancer adds a tremendous burden. However, YACPs' challenges and coping strategies are under-researched. The objective of this study was to explore what challenges YACP experience during their treatment, and what coping strategies they applied to them. We conducted a qualitative study with a phenomenological-hermeneutic design, including retrospective, semi-structured interviews of 16 YACPs who had undergone cancer treatment. Data were analysed using thematic analysis and interpreted applying the Cognitive Activation Theory of Stress (CATS). We found "coping with changes and uncertainty" as overarching topic for YACPs' challenges, particularly related to five themes, including (1) receiving the diagnosis, (2) encountering the healthcare system, (3) living with cancer, (4) dealing with the impact of the treatment and (5) reactions from the social network. YACPs' coping strategies applied to these challenges varied broadly and ranged from maladaptive strategies, such as neglecting the situation, to conducive emotional or instrumental approaches to manage their challenges. The findings call for age-specific needs assessments, information and support for YACPs, and their families in order to facilitate YACPs' coping during their treatment., (© 2017 John Wiley & Sons Ltd.)

Background: There is a growing need for strategies to improve coordinated, tailored services in cancer care to meet the comprehensive needs of cancer patients. In Norway, cancer coordinators (CCs) have been established to improve coordination and patient-centeredness of services. Little is known about how CCs engage to provide patients with the needed services and support throughout the treatment., Objective: The aim of this study was to explore how Norwegian CCs experience their role and how they enact it in order to enhance coordinated cancer care., Methods: The study encompasses a qualitative, hermeneutic approach, conducting semistructured in-depth interviews of 26 Norwegian CCs. The data were analyzed using thematic analysis and discussed in the light of the salutogenic theory., Results: Cancer coordinators take a holistic approach to patient care, including both patient- and system-level activities. "Providing coordinated cancer care" emerged as an overarching topic for their role. This topic was elaborated by 3 main themes: (1) finding their place and creating their function, (2) meeting the needs of cancer patients and helping them cope, (3) promoting well-functioning cancer care systems., Conclusions: Cancer coordinators evolved diversely, in adaption to the local context and patients' needs. The functions' diversity challenged the implementation and external role recognition. Cancer coordinators seemed to apply a salutogenic, resource-focused orientation in order to support a positive development at both the patient and the system levels., Implications for Practice: The findings reinforce the call for holistic, patient-centered services in cancer care. Cancer coordinators need appropriate support from the local management to establish the role and local collaborations.