Anita Paulsen

• Paulsen, Anita; Fegran, Liv; Hagen, Milada & Vistad, Ingvild (2025). Self-reported Sexual Health-Related Outcomes in Gynecological Cancer Survivors: Results from a Quasi-experimental Multicenter Intervention Study on Follow-up after Gynecological Cancer Treatment. Cancer Nursing. ISSN 0162-220X. doi: 10.1097/NCC.0000000000001493. Fulltekst i vitenarkiv Vis sammendrag

  Background: Gynecological cancer survivors often face sexual health challenges posttreatment, making interventions to address these issues essential. Objective: The aim of this study was to investigate changes in sexual health–related outcomes among gynecological cancer survivors comparing 2 different follow-up models. Methods: This preplanned substudy utilized data from the Lifestyle and Empowerment Techniques in Survivorship of Gynecologic Oncology study. Participants were assigned to either the intervention or control group based on their treatment hospital. The control group received standard follow-up care, whereas the intervention group received shared follow-up care with sexual health communication. Analyses included 686 participants with sexual activity as the primary outcome. Secondary outcomes included feelings of reduced physical attractiveness for all, sexual enjoyment and vaginal dryness (sexually active participants), and reasons for sexual inactivity (sexually inactive participants). Assessments were conducted at the end of treatment and at 6 and 12 months posttreatment. Results: No statistically significant group differences were found in any of the outcomes at 12 months. The intervention group showed a more favorable trend in sexual activity at 6 months, not sustained at 12 months. Both groups experienced an increase in vaginal dryness. The absence of a partner was the most common reason for sexual inactivity. Conclusions: Findings suggest that nurse-led sexual health communication during routine follow-up consultations may have a limited impact on the sexual health–related outcomes measured in this study. Implications for Practice: More intensive and individualized interventions may be necessary for significant improvements in the outcomes of this study.

• Robstad, Anja Nastasja; Paulsen, Anita; Vistad, Ingvild; Hott, Alexandra Christine; Berg, Kari Hansen & Øgård-Repål, Anita [Vis alle 9 forfattere av denne artikkelen] (2024). Experiences of pain communication in endometriosis: A meta-synthesis. Acta Obstetricia et Gynecologica Scandinavica. ISSN 0001-6349. s. 1–16. doi: 10.1111/aogs.14995. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: Endometriosis is the leading cause of chronic pelvic pain among women. The pain associated with endometriosis significantly impacts various aspects of patients' quality of life. A notable void in the literature is the absence of a systematic review exploring pain communication between patients with endometriosis and healthcare professionals. Hence, the aim of this qualitative systematic review was to synthesize findings on how patients with endometriosis experience communicating with healthcare professionals about pain and how healthcare professionals experience these interactions. Material and Methods: A systematic literature search was conducted related to patients with endometriosis and pain communication in CINAHL PLUS with full text and MEDLINE (via EBSCO host) on May 12, 2023, and updated January 26, 2024. Searches were supplemented by backward searching reference lists and forward searching citations of included reports in Scopus and Google Scholar. The review was guided by the four-step meta-synthesis methodology by Sandelowski and Barosso. Critical appraisal of included studies was conducted using Critical Appraisal Skill Program (CASP). Findings were analyzed thematically, using the approach described by Thomas and Harden. The meta-synthesis was based on a registered protocol in PROSPERO (CRD 42023425430), and the study is reported adhering to the PRISMA 2020 checklist. Results: Overall, 37 reports published from 2003 until 2023 contributed to the review, including 4842 participants. Through thematic analysis, we developed the following themes: “Navigating the double burden,” “Lack of mutual understanding,” and “The complexities of conveying pain.” Conclusions: The communication of pain between patients with endometriosis and healthcare professionals is complex, encompassing patterns of disbelief, normalization, and psychological attribution. Engaging in discussions about pain presents diverse challenges stemming from insufficient communication skills and assessment tools. Further research is warranted to comprehensively explore the perspectives of both patients and healthcare professionals, aiming to devise strategies that enhance communication and patient care.

• Paulsen, Anita; Vistad, Ingvild & Fegran, Liv (2023). Nurse–patient sexual health communication in gynaecological cancer follow-up: A qualitative study from nurses' perspectives. Journal of Advanced Nursing. ISSN 0309-2402. 79(12). doi: 10.1111/jan.15755. Fulltekst i vitenarkiv Vis sammendrag

  Aim To explore nurse–patient sexual health communication from the perspectives of nurses trained to address sexual health in gynaecological cancer follow-up. Design A qualitative hermeneutic approach. Methods Individual semi-structured interviews with 10 nurses at five different hospitals in Norway were conducted in March and April 2021. A Gadamerian-inspired research method was used in the analysis. Results Three main themes with six sub-themes were identified. The three main themes were: (1) building relationships through communication, (2) practice makes perfect—the importance of experience and knowledge, and (3) personal attitudes as promoters or inhibiters of sexual health communication. Conclusion This study provides valuable insights into nurse–patient sexual health communication from the perspectives of nurses. The nurses in this study experienced the importance of having a good, respectful nurse–patient relationship as the foundation for sexual health communication. The professional confidence gained through experience and knowledge was emphasized, including the significance of how attitudes and taboos can influence sexual health communication. Impact The main findings of this study indicate that training in sexual health communication and the possibility of addressing sexual health repeatedly give nurses skills and professional confidence to address sexual health in cancer follow-up. Our study indicates that sexual health communication can be achieved in a clinical setting without being overly resource demanding. Our results may also motivate nurses to enhance their knowledge about sexual health in cancer follow-ups.

• Paulsen, Anita; Vistad, Ingvild & Fegran, Liv (2023). Gynecological cancer survivors' experiences with sexual health communication in nurse-led follow-up consultations. Acta Obstetricia et Gynecologica Scandinavica. ISSN 0001-6349. s. 1–10. doi: 10.1111/aogs.14749. Fulltekst i vitenarkiv Vis sammendrag

  Introduction Gynecological cancer and its treatment may cause sexual difficulties in terms of physical and psychosocial health. Considering the essential role that nurses play in cancer care, they are well positioned to be ideal providers for addressing sexual health concerns in the follow-up phase of gynecological cancer. The aim of this study was to gain in-depth knowledge of how gynecological cancer survivors experience sexual health communication in nurse-led follow-up consultations. Material and methods Using a qualitative hermeneutic approach, we conducted individual semi-structured interviews with 17 women from five different hospitals in Norway between April 4, 2022, and June 2, 2022. The women participated in a large intervention study on cancer follow-up that included sexual health as one of several topics addressed by trained nurses in three consultations in the first year of follow-up. A five-stage Gadamerian-inspired research method was utilized for data collection and analysis. Results We identified three themes: (1) the importance of nurses listening to the women's own perceptions of sexuality, (2) post-treatment sexual challenges influence the women's need to communicate about sexual health, and (3) nursing communication can help women regain their sexual health. Conclusions Women who have undergone treatment for gynecological cancer find communication with trained nurses regarding sexual health beneficial. We recommend integration of trained nurses in the follow-up team. The nurses should adjust communication according to each gynecological cancer survivor's unique understanding of sexuality and inform women with sexual health concerns at that end of treatment, that sexual health can improve during follow-up.

• Sekse, Ragnhild Johanne Tveit; Blåka, Gunnhild; Buestad, Ingjerd; Tengesdal, Ellen; Paulsen, Anita & Vika, Margrethe Elin (2014). Education and counselling group intervention for women treated for gynaecological cancer: does it help? Scandinavian Journal of Caring Sciences. ISSN 0283-9318. 28(1), s. 112–121. doi: 10.1111/scs.12024. Fulltekst i vitenarkiv

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• Paulsen, Anita; Fegran, Liv & Vistad, Ingvild (2026). Seksuell helse ved gynekologisk kreft : Kvinners erfaringer med kommunikasjon. doi: https:/kreftrehabilitering.no/kreftrehab-2026-takk/. Fulltekst i vitenarkiv
• Paulsen, Anita (2026). Seksuell helse - helhetlig sykepleie ved alvorlig sykdom. Fulltekst i vitenarkiv Vis sammendrag

  NSF Agder gleder oss stort til å samle sykepleiere fra hele regionen til faglig inspirasjon, kollegialt fellesskap og gode opplevelser.

• Paulsen, Anita (2026). Foredrag om Elise Ottesen-Jensen på arrangementet Oppdagelser: Forskningshistoriens banebrytende kvinner (Universitetet i Agder). doi: https:/www.uia.no/bibliotek/arrangementer/oppdagelser/program/. Fulltekst i vitenarkiv Vis sammendrag

  I mars 2026 inviterer Universitetsbiblioteket i Agder i samarbeid med Senter for likestilling til en nyskapende foredragsserie med tittelen:

• Paulsen, Anita; Helmersen, Migle & Gjellestad, Marianne (2026). Innlegg om erfaringer fra tre kull med EVU i Kvinnehelse. Fulltekst i vitenarkiv
• Paulsen, Anita (2026). Seksuell helse. Fulltekst i vitenarkiv
• Paulsen, Anita & Robstad, Anja Nastasja (2026). Tre år etter «Den store forskjellen»: Har vi begynt å lytte til kvinnene? - fvn.no. Fulltekst i vitenarkiv Vis sammendrag

  Da den offentlige utredningen Den store forskjellen (NOU 2023:5) ble lagt frem i 2023, dokumenterte den ikke bare betydelige kunnskapshull om kvinnehelse. Den viste også noe mer grunnleggende: Kvinners egne erfaringer har i for liten grad blitt vektlagt i møte med helsetjenesten.

• Paulsen, Anita (2025). Kommunikasjon om seksuell helse i gynekologisk kreftoppfølging. Fulltekst i vitenarkiv
• Paulsen, Anita (2025). Kreft og seksualitet. Hvordan kan kreftsykepleier snakke om seksualitet med sine pasienter? Fulltekst i vitenarkiv
• Vistad, Ingvild & Paulsen, Anita (2025). Nye og bedre måter for å følge opp kvinner etter gynekologisk kreft. Fulltekst i vitenarkiv Vis sammendrag

  Vi starter lørdagsuniversitetet i 2025 med å løfte frem et forskningsprosjekt som prøver ut nye måter å følge opp kvinner som har hatt kreft. Prosjektet utforsker mulighetene for en bedre oppfølging av kvinner etter gynekologisk kreft ved hjelp av digitale hjelpemidler, og en mer hensiktsmessig oppgavedeling i tjenestene. Dette er viktig i seg selv, men kan også gi inspirasjon og overføringsverdi til også andre felt. Prosjektet heter LETSGO, og er forankret på Sørlandets sykehus og Universitetet i Agder, og til lørdagsuniversitetet i Arendal i februar kommer prosjektleder og overlege på Sørlandets sykehus, professor Ingvild Vistad, og prosjektmedarbeider og sykepleier på Sørlandets sykehus, universitetslektor og doktorgradsstipendiat ved UiA, Anita Paulsen

• Skogedal, Magnus Nødland & Paulsen, Anita (2025). Kreften tok ikke livet – men lysten. [Journal]. Forskning.no. doi: https:/www.forskning.no/kreft-kvinnehelse-partner/kreften-tok-ikke-livet-men-lysten/2540685. Fulltekst i vitenarkiv Vis sammendrag

  For mange kvinner som overlever underlivskreft, forsvinner sexlysten og den intime delen av livet. Helsevesenet spør sjelden. Partneren gjør det kanskje heller ikke.

• Strand, Hilde Kristin & Paulsen, Anita (2025). Dette er ikke noe for en utålmodig person, tenkte Anita. [Journal]. Khrono. doi: https:/www.khrono.no/dette-er-ikke-noe-for-en-utalmodig-person-tenkte-anita/974085. Fulltekst i vitenarkiv Vis sammendrag

  Hun gikk fra å være skikkelig god til å ikke være det. Men å ta doktorgrad har vært de beste årene i arbeidslivet, mener Anita Paulsen.

• Helmersen, Migle; Gjellestad, Marianne & Paulsen, Anita (2025). Starter landets første studium i kvinnehelse. [Internet]. NRK distriktsnyheter Sørlandet. Fulltekst i vitenarkiv
• Paulsen, Anita; Vistad, Ingvild & Fegran, Liv (2024). 207 Gynecological cancer survivors' experiences with sexual health communication in nurse-led follow-up consultations. doi: https:/eposters.emma.events/esgo2024eposters/poster/Poster_152041/Poster_152041.jpg?ver=1. Fulltekst i vitenarkiv
• Paulsen, Anita & McFadzean, Ida (2024). Fraværet av et nei er ikke et ja - fvn.no. Fulltekst i vitenarkiv Vis sammendrag

  Det er på høy tid at vi krever endring i hvordan rettssystemet håndterer overgrepssaker. Når domstolene frikjenner overgripere til tross for at de anerkjenner at samtykke ikke var til stede, sender vi et signal om at opplevelsen til de som utsettes for overgrep, ikke tas på alvor.

• Helmersen, Migle; Gjellestad, Marianne & Paulsen, Anita (2024). Starter landets første studium i kvinnehelse. [Journal]. Mediehuset Fædrelandsvennen. Fulltekst i vitenarkiv
• Paulsen, Anita; Vistad, Ingvild & Fegran, Liv (2023). Sexual health communication in gynecological cancer follow-up. doi: https:/www.nfks.no/NACS2023-program/. Fulltekst i vitenarkiv
• Paulsen, Anita; Vistad, Ingvild & Fegran, Liv (2023). CN49 Nurse–patient sexual health communication in gynecological cancer follow-up: A qualitative study from nurses’ perspectives. doi: https:/www.annalsofoncology.org/action/showPdf?pii=S0923-7534%2823%2902480-8. Fulltekst i vitenarkiv
• Thorhallsdottir, Dora & Paulsen, Anita (2023). #11 - Sex, lyst, og tørre slimhinner - Hetebølgen | Podcast on Spotify. Fulltekst i vitenarkiv Vis sammendrag

  Listen to this episode from Hetebølgen on Spotify. Mindre sexlyst – et symptom eller et resultat? Nedsatt lyst og smerte ved samleie er blant de største utfordringene kvinner møter på i overgangsalderen, forteller Anita Paulsen. Anita er sexolog og deler spesifikke tips til hvordan du kan få fart på sexlivet igjen.  Hosted on Acast. See acast.com/privacy for more information.

• Langhelle, Trude Hammer; Paulsen, Anita; Fredly, Kjellaug & Sekse, Ragnhild Johanne Tveit (2021). Sexuell helse på alvor II/II. Slik arbeider sexologiske rådgivere. Tidsskriftet sykepleien. ISSN 0806-7511. 109(11), s. 42–49. doi: 10.4220/Sykepleiens.2021.83187. Fulltekst i vitenarkiv
• Langhelle, Trude Hammer; Paulsen, Anita; Fredly, Kjellaug & Sekse, Ragnhild Johanne Tveit (2021). Seksuell helse på alvor 1:2. Sykepleiere kan hjelpe pasientene til bedre seksuell helse. Sykepleien. ISSN 0039-7628. 109(1), s. 34–41. doi: 10.4220/Sykepleiens.2021.83207. Fulltekst i vitenarkiv
• Langhelle, Trude Hammer; Fredly, Kjellaug; Paulsen, Anita & Sekse, Ragnhild J Tveit Sekse (2021). Sexuell helse på alvor II. Slik arbeider sexologiske rådgivere. Sykepleien Forskning. ISSN 1890-2936. Fulltekst i vitenarkiv
• Langhelle, Trude Hammer; Paulsen, Anita; Fredly, Kjellaug & Sekse, Ragnhild J Tveit Sekse (2021). Sexuell helse på alvor 2:2 Slik arbeider sexologiske rådgivere. Tidsskriftet sykepleien. ISSN 0806-7511. 109(11), s. 42–49. doi: 10.4220/Sykepleiens.2021.83207. Fulltekst i vitenarkiv
• Paulsen, Anita (2025). Sexual health communication in gynecological cancer follow-up care. Gynecological cancer survivors’ and nurses’ experiences with sexual health communication and its impact on sexual health related outcomes. Universitetet i Agder. ISSN 9788284272597. Fulltekst i vitenarkiv Vis sammendrag

  Background: Gynecological cancer and its treatment modalities can significantly impact sexual health and diminish quality of life. Cancer treatments, such as surgery, chemotherapy, and radiation, may lead to both physical, psychological and relational challenges, including sexual dysfunction, body image concerns, and changes in intimate relationships. Despite these profound effects, sexual health is often under-addressed by health care providers in routine follow-up care for cancer survivors. This thesis introduces a new approach to cancer follow-up care that emphasizes the importance of sexual health communication between gynecological cancer survivors and nurses. By integrating structured sexual health communication into nurse-led consultations in follow-up care of gynecological cancer, the goal is to address the need for information and guidance on sexual health. Aim: The overall aim of this thesis was to explore the experience of sexual health communication between gynecological cancer survivors and nurses and its impact on sexual health related outcomes when sexual health is routinely addressed in nurse-led follow-up consultations. The thesis had three specific objectives: 1) to gain insight into how nurses experienced sexual health communication in nurse-led follow-up consultations (Paper I), 2) to gain insight into how gynecological cancer survivors experienced sexual health communication in nurse-led follow-up consultations (Paper II) and 3) to compare changes in sexual health-related outcomes between gynecological cancer survivors receiving sexual health communication during nurse-led follow-up consultations, and survivors receiving standard follow-up care (Paper III). Design, methods and samples: This thesis has a multimethod design and consists of three separate studies: two qualitative studies (Papers I and II) based on qualitative interviews with gynecological cancer survivors and nurses, and one quantitative study (Paper III) based on sexual health-related outcomes in two groups receiving different follow-up care. The two interview studies followed a hermeneutic method based on the philosophy of Hans-Georg Gadamer and included 27 interviews with gynecological cancer survivors (n=17) and nurses (n=10). The quantitative study was longitudinal, prospective, and comparative, utilizing patient-reported data and data from medical records from 686 gynecological cancer survivors, divided into an intervention group (n=343) and a control group (n=343). The intervention group received nurse-led follow-up consultations which focused on communication about sexual health, while the control group received standard follow-up care. The primary outcome was sexual activity. Secondary outcomes included feelings of reduced physical attractiveness for all participants, and vaginal dryness and sexual enjoyment specifically for sexually active participants. For sexually inactive women, the reasons for sexual inactivity were also assessed. Outcomes were compared between the two groups at the end of treatment (baseline), six months, and 12 months post-treatment. Results: The results of this thesis show that sexual health communication was well-received as part of the follow-up care for both gynecological cancer survivors (Paper II) and nurses (Paper I). Survivors expressed that sexual health communication with nurses helped them regain a sense of normalcy posttreatment, with many emphasizing the importance of individualized, respectful communication. Nurses felt that their ability to address sexual health improved through repeated practice. However, there were no significant differences between the intervention and control groups in the sexual health-related outcomes (Paper III). At six months, the intervention group showed a greater increase in sexual activity compared to the control group, but this difference was not statistically significant and not sustained by 12 months. Similarly, feelings of reduced physical attractiveness diminished in the intervention group at six months, but this was already statistically significant at end of treatment and is thereby difficult to interpretate. No significant differences were found in vaginal dryness or sexual enjoyment between the two groups at any time point. The absence of a sexual partner remained a primary reason for inactivity across both groups. Conclusion: The thesis collectively addresses the process of sexual health communication from the perspectives of both gynecological cancer survivors and nurses and its impact on sexual health related outcomes. Paper I laid the groundwork by exploring nurses’ experiences, Paper II provides the survivors’ perspective on these interactions, and Paper III evaluates the real-world effectiveness of sexual health communications impact on sexual health-related outcomes. Although the findings suggest that sexual health communication may not have a significant impact on the long-term outcomes we selected, it may play a role in enhancing patient satisfaction and addressing immediate concerns posttreatment.

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