Current Research

The researcher collaborates on and mentors junior colleagues’ projects in cancer rehabilitation and health-promoting work, including Make My Day-Cancer (Principal Investigator: Dr. Emelie Mälstam) and Cancer Rehabilitation in Critically Ill Patients with Cancer (where Anna Efverman is the principal supervisor for doctoral student Linnéa Abrahamsson, specialist intensive care nurse; Principal Investigator: Dr. Katarina Holmberg).

Anna Efverman also participates in the leadership development programme Personal Leadership for Academic Leaders and currently leads four research projects.

Can-Work-S: Promoting Work and Health in Cancer

Increasing cancer survival rates have dramatically increased the need for support for work participation and improved health, including both health-related quality of life and work-related well-being, during cancer rehabilitation.

The six-year interdisciplinary research programme is conducted through national and international collaboration and includes four subprojects:

1. Project 1 investigates work participation and health through a longitudinal questionnaire study with seven years of follow-up. Symptoms, quality of life, functional ability in everyday life and work, physical activity, and other lifestyle factors are studied during and after cancer treatment and compared with matched population controls.
2. Project 2 longitudinally interviews individuals with cancer during and after treatment, healthcare professionals, social insurance officers, and first-line managers about factors that facilitate or hinder work participation and health, as well as their views on how supportive interventions should be designed.
3. Project 3 analyses long-term consequences of cancer for labour market participation and health, including comorbidities and healthcare utilisation, through longitudinal registry data comparisons over a 20-year period.
4. Project 4 develops the cancer rehabilitation intervention Can-Work-S to maximise usability and effectiveness in promoting work participation and health. A randomised controlled trial evaluates its effects on work participation, health-related quality of life, work-related well-being, and cost-effectiveness. The implementation process of the evidence-based intervention in clinical practice will also be studied.

The programme is expected to generate important new knowledge on how work participation and health can be improved during and after cancer treatment, benefiting individuals with cancer and their families, healthcare services, employers, and society at large.

Status: Data collection for Projects 1–3 has been completed, and findings are continuously being published. Project 4 is ongoing.

External funding: The programme is funded by Forte’s six-year programme grant (2021 call on Challenges in Working Life), the Swedish Cancer Society, and additional funders.

Doctoral students: Kristina Tödt (physiotherapist), Linda Eklund (occupational therapist), Jessica Nordlander (physiotherapist), and Linda Rundgren (healthcare counsellor).

Postdoctoral researchers: Dr. Katarina Holmberg and affiliated researchers Dr. Maria Fjell, Dr. Per Fessé, Dr. Sara Larsson Fällman, and Dr. Kristina Tödt

Positive communication reinforces positive treatment expectations of not feeling sick during cancer chemotherapy

Nausea and vomiting during chemotherapy are known to negatively affect quality of life, but less is known about the role of healthcare professionals’ communication and patients’ self-care strategies.

A randomised controlled trial investigates whether treatment expectations and perceived nausea differ between patients receiving positive versus neutral communication from healthcare professionals. Communication was delivered during standard care, genuine Western acupuncture, or sham acupuncture using a non-penetrating telescopic blunt needle.

Data are collected through questionnaires, medical records, and physiological measurements. The study evaluates the effects of healthcare communication and patient expectations regarding treatment outcomes.

A longitudinal follow-up study examines factors associated with quality of life, daily and physical activity, and work participation. Patients with diverse experiences have also been interviewed about the impact of nausea and the importance of communication and treatment expectations during chemotherapy.

Status: Data collection has been completed, and results are continuously being published.

External funding: The project is funded by several organisations, including the Cancer Research Foundation in Northern Sweden and the Swedish Breast Cancer Association.

Researchers: Dr. Ylva Widgren works as postdoctoral researcher in the project, while Dr. Johan Paulin contributes expertise in health psychology.

Neuropathy in cancer survivors who have undergone neurotoxic chemotherapy

The addition of neurotoxic chemotherapy agents to standard cancer treatment has significantly improved survival rates but frequently causes peripheral neuropathy. Research is needed to identify and monitor chemotherapy-induced neuropathy over time using reliable measurement methods, and to understand its impact on quality of life and functioning in everyday life and work.

In a randomised controlled trial, cancer survivors with chemotherapy-induced neuropathy received either genuine acupuncture or sham acupuncture. Outcomes included neuropathic symptoms, quality of life, and functioning, assessed through questionnaires, clinical examinations, and neurophysiological measures.

Longitudinal follow-up studies aim to identify factors associated with persistent symptoms and reduced quality of life. A self-care intervention will be developed and evaluated to reduce these negative consequences.

Status: Data collection has been completed, and findings are continuously being published.

External funding: The project has been funded by the Swedish Cancer Society, regional cancer foundations, and regional research councils.

From Evidence to Practice: Physical Activity and Rehabilitation in Cancer and Chronic Conditions

As scientific evidence supporting physical activity and other healthcare interventions in cancer rehabilitation and chronic illness continues to grow, effective implementation of evidence-based knowledge into clinical practice becomes increasingly important.

Several projects have been completed, are ongoing, or are being planned to study implementation processes. This implementation research contributes to ensuring that evidence-based knowledge is rapidly and effectively translated into clinical practice.

Other parts of the project examine how patient-reported outcome measures and other assessment methods can be used to identify and monitor the consequences of cancer and its treatment in a person-centred way.

Status: Data collection has been completed in several studies, with ongoing publication of results and continued planning of future studies.

Doctoral student: Linda Rundgren contributes research on the implementation of national cancer care guidelines in clinical practice.

Doctoral School – Cancer Care Research: Interprofessional Co-Creation (CaTS)

To meet future healthcare needs, new knowledge is required from clinically relevant cancer care research focusing on care, rehabilitation, and public health aspects across all phases of cancer care, with the aim of achieving equitable, high-quality cancer care.

Cancer care research must be challenge-driven, interprofessional, and co-created together with patients, relatives, and healthcare organisations.

The doctoral school Cancer Care Research: Interprofessional Co-Creation (CaTS) will offer:

1. Networking activities for doctoral students that promote interprofessional national and international collaboration and co-created cancer care research.
2. Doctoral courses in cancer care research focusing on interprofessional collaboration, person-centred care, co-creation, and implementation strategies for integrating new knowledge into cancer care practice.

Course content includes co-creation, complex interventions, implementation science, caring science, cancer rehabilitation, self-care, behaviour change, quality of life, palliative care, and vocational rehabilitation.

The doctoral school is coordinated by the University of Gävle in collaboration with senior interdisciplinary cancer researchers and educators from several Swedish universities and healthcare regions, with elements of international collaboration.

CaTS is aimed at clinically active doctoral students from different healthcare professions and focuses on how co-creation and interprofessional collaboration can generate new knowledge that is successfully translated into cancer care practice.

Status: CaTS will launch in January 2027. Information and recruitment activities will take place during autumn 2026.

External funding: CaTS is funded by the Swedish Cancer Society for 2027–2029.