Bakgrund: Välbefinnande berör alla yrkeskategorier, inte minst hälso- och sjukvårdspersonal. Det är viktigt att uppleva välbefinnande för att kunna utföra god omvårdnad. Ett nytt mätinstrument kallat Job-Related Social Well-Being Scale (JSWS) har utvecklats av Ali Kazemi och har testats bland personal inom skolan och industrin men inte inom hälso- och sjukvård. Syfte: Syftet med denna studie var att bland hälso- och sjukvårdspersonal undersöka applicerbarheten hos ett mätinstrument avsett att mäta socialt välbefinnande på arbetet. Metod: Denna pilotstudie hade en kvantitativ ansats. Datainsamlingen med JSWS och KASAM gjordes genom webbaserade enkäter som distribuerades till hälso- och sjukvårdspersonal inom primärvården vid två tillfällen. Antal möjliga respondenter var 188, vid första mättillfället besvarade 27 respondenter enkäten och vid andra mättillfället 11 respondenter. Spearmans rangkorrelation användes för att studera applicerbarheten. Som jämförelseinstrument användes den korta versionen av KASAM-formuläret. Resultat: Test-retest var signifikant (rs=0.90; p<0.01). Stabilitet över mätinstrument samt kriterievaliditet visade på en ickesignifikant korrelation (rs=0.327; p<0.1) mellan JSWS och KASAM. Konklusion: Denna pilotstudie visade att metoden bör förbättras för att få högre svarsfrekvens så att generaliseringar kan göras. Stabilitet över mätinstrument och kriterievaliditet indikerar att i en huvudstudie med fler respondenter skulle resultatet hamna på en signifikant nivå. / Background: Wellbeing at work concerns all professionals, including healthcare professionals. It is important to experience wellbeing for being able to take care of patients. A new instrument, Job-Related Social Well-Being Scale (JSWS), developed by Ali Kazemi has been tested among professionals in school and industry, not among healthcare professionals. Aim: The aim of this pilot study was among healthcare professionals study the applicability of an instrument intended to measure social wellbeing at work. Method: This pilot study had a quantitative approach. The datacollection with JSWS and the short version of Sense of Coherence (SOC-13)  was done through webbased survey distributed to professionals in primary healthcare at two occasions, to 188 possible respondents. The number of respondents in the first measurement were 27 and in the second 11. Spearmans rankcorrelation (rs) was used to study the applicability. SOC-13 was used as the comparison instrument. Results: The test-retest is significant (rs=0.90; p<0.01). The equivalence and criterion validity shows a non significant correlation (rs=0.327; p<0.1) between JSWS and SOC-13. Conclusion: This pilot study showed that the method should be improved to recieve more respondents so generalizations can be done. Equivalence and criterion validity indicates that in a main study with more respondents, the results would be at a significant level.

The aim of this study was to develop and evaluate the effect of a prenatal hypnotherapeutic programme on the maintenance and promotion of postpartum psychological well-being of a group of first-time mother. Relevant literature on pregnancy, early motherhood and psychological well-being were explained in order to abstract important facets and perspectives to use as a background for the development and implementation of an intervention programme for the facilitation of psychological well-being of first-time mothers. Theoretical perspectives on, and practical applications of, clinical hypnosis were further analysed and used as foundation for the development of the hypnotherapeutic intervention. A hypnotherapeutic programme was developed, based on existing theoretical knowledge regarding pregnancy, childbirth and early motherhood, as well as clinical hypnosis, with specific emphasis on Ericksonian principles and ego state therapy techniques, enriched from the perspective of psychofortology. The empirical study consisted of a quantitative component and a qualitative component. In the quantitative component, a pretest-posttest-follow-up comparative design was implemented, with random assignment of participants to the experimental and control groups within the limits of practicalities. Both groups, each consisting of 23 women in their first pregnancy, completed the following questionnaires: (i) Perception of Labour and Delivery Scale (PLD), adapted from Padawer et al. (1988). Feelings about the baby and relationship with the baby (FRB), adapted from Wwllett and Parr (1997), Maternal Self- Confidence Scale (MSC), adapted from Ruble et al. (1990) and Maternal Self-Efficacy Scale (MSE) (Teti & Gelfand, 1991), to explore aspects of psychological well-being related to early motherhood; (ii) The Edinburgh Postnatal Depression Scale (EPDS) ofCox et al. (1987) and the General Health Questionnaire (GHQ) (Goldberg & Hillier, 1979), to investigate aspects of psychological well-being as evident by the absence of pathology; and (iii) the Satisfaction with Life Scale (SWLS) (Diener et al., 1985), the Affectometer 2 (AFM) (Kammann & Flett, 1983), the Sense of Coherence Scale (SOC) of Antonovsky (1979) and the Generalised Self-efficacy Scale (GSE), developed by Schwarrer, (1993), to measure general psychological well-being. The Stanford Hypnotic Clinical Scale (SHCS) (Morgan & Hilgard, 1978) was used for the experimental group to assess hypnotisabili. The qualitative component consisted of in-depth interviews and an analysis of written responses of mothers in the experimental group. They commented on their experience of the programme and its impact at two weeks and ten weeks postpartum. Results from the empirical study indicated that the experimental group showed significantly more symptoms of depression and symptomatology during the prenatal evaluation than the control group. Since the experimental group was possibly more vulnerable than the control group in a psychological sense, the effect of the intervention programme could not be deduced from a pure comparison of postnatal evaluation scores between the groups. Therefore, it was decided to explore the significance of differences within each of the experimental and control groups, as well as between the experimental and control group, using the mean difference scores between prenatal and postnatal evaluation on each variable. Results indicate that the hypnotherapeutic programme was effective in enhancing most aspects of psychological well-being within the experimental group. This strengthened sense of psychological well-being was evident both in the immediate postpartum period and at ten weeks postpartum. The control group showed a spontaneous increase in psychological well-being later in the postpartum period. The programme thus assisted mothers in the more vulnerable experimental group to experience a stronger sense of psychological well-being sooner after the baby's birth. The experimental and control groups were further compared on the mean differences in prenatal versus postnatal scores on measures of psychological well-being. The results suggest that the hypnotherapeutic intervention contributed to an enhanced sense of psychological well-being in mothers in the experimental group, in comparison to the control group, during the early postpartum period, as measured by variables related to motherhood, absence of pathology and general psychological well-being. At ten weeks postpartum, the differences between the experimental and control group were less obvious. However, a very important finding was that mothers in the experimental group continued to show a significant improvement in psychological well-being as indicated by the absence of pathology. Specifically, there was a continued decrease in depression and general symptoms of pathology. Findings from the quantitative study were supported by remarks by mothers in postpartum and follow-up interviews, as well as their written responses, as part of a qualitative exploration of their experience of the programme and its impact on them. The findings give compelling evidence that a hypnotherapeutic intervention, focusing on the enhancement of strengths and inner resources, could alleviate depression and psychological distress during the perinatal period, as well as prevent the exacerbation of symptoms. Findings from the current study indicate that the developed prenatal hypnotherapeutic programme was effective in enhancing the psychological well-being of mothers experiencing a first pregnancy. Recommendations for clinical practice and further research were made, based on the current research findings. The contribution of the current study lies in the fact that it is the first to explore pregnancy, childbirth and early motherhood from a salutogenidfortigenic perspective, and to utilise hypnosis to facilitate psychological well-being in this context. It contributed to scientific knowledge in the fields of developmental psychology, psychofortology and clinical hypnosis. / Thesis (Ph.D. (Psychology))--Potchefstroom University for Christian Higher Education, 2003.

A series of acts which were passed during the apartheid era have undoubtedly deprived the marginalized groups, namely, the so called Coloureds, Indians and the black majority their political rights. Apartheid policies enshrined in the then constitution, ill-considered the wellbeing and wellness of these groups, while at the same time, a white minority was solely privileged. Being the victims of segregation, the deprived groups continuously suffered from the political, and socio-economic setbacks, which disabled them to lead healthy lifestyles. Racial division which was prevalent in many workplaces, particularly in the mining sector, disadvantaged many of them, blacks in particular, to perform skilled labour. They were therefore destined to perform unskilled labour which classified them as cheap labourers, hence meagre wages. The results of segregation bore the fruits of abject poverty which impacted negatively on many. Problems of housing and infrastructure are still confronting many households to date since scores of them are 'shack dwellers' nationwide, living in squalid conditions which are a threat to their health. Overcrowding and poor teaching and learning were prime causes of learners to discontinue their education prematurely. High dropout rates became prevalent mostly in rural areas, where schooling accommodation was limited. Schools can only be safe places of teaching and learning when all horrifying acts of violence such as sexual abuse, rape, intimidation, assaults, bullying and murder are urgently eliminated. All the stakeholders in education should collectively work together to ensure that health promotion in schools is maintained. Against the abovementioned background the primary aim of this research was to determine what health promotion entails within the context of a selected group of 10 primary schools in the Southern Region of the North West Province. A qualitative research methodology was selected to achieve this outcome. Data was gathered by means of focus group interviews. The transcriptions were analysed generating items that were labeled as main categories and subcategories. Pertaining the main categories it was evident that are several aspects that can determine the health and well-being in a school. These include: the leadership of the school, the role of the parents, the duties of the educators, the existence of plans and the policy concerning HIV/Aids. / Thesis (M.Ed.)--North-West University, Potchefstroom Campus, 2007.

Many South Africans experience the severe impact of the HIVIAIDS pandemic. The AlDS orphan, specifically, has to suffer the adverse effects of this relentless worldwide catastrophe. The HIVIAIDS orphan is not just another orphan, but someone who suffers from exceptional pressures which may lead to depression, hopelessness and psychological trauma later in life (Coombe, 2003) In order to function well in these circumstances, nterventions that target resilient functioning are needed to empower the AlDS orphan. The purpose of this study was to document, by means of a literature review and empirical research, the phenomenon of resilience among AlDS orphans. In order to achieve this goal, it was necessary to elucidate the concepts HIV/AIDS, pandemic, impacts of the pandemic on South Africa and its orphans, resilience and empowerment of orphans. The aim of the empirical research was to investigate the phenomenon of resilience among HIVIAIDS orphans by conducting both survey and phenomenological research and to compare the functioning of resilient and non-resilient orphans. Some of the important findings include: South African AlDS orphans face multiple risk; the participants of this study show remarkable resilience in spite of adversity; and the resilient AlDS orphans in this study alluded to several intrapersonal and interpersonal protective factors which contribute to their resilience. The findings were used to generate guidelines for individuals, families, education and community stakeholders who interact with AlDS orphans and wish to intervene meaningfully in order to empower AlDS orphans towards (continued) resilient functioning. / Thesis (M.Ed.)--North-West University, Vaal Triangle Campus, 2007.

Many South Africans experience the severe impact of the HIVIAIDS pandemic. The AlDS orphan, specifically, has to suffer the adverse effects of this relentless worldwide catastrophe. The HIVIAIDS orphan is not just another orphan, but someone who suffers from exceptional pressures which may lead to depression, hopelessness and psychological trauma later in life (Coombe, 2003) In order to function well in these circumstances, nterventions that target resilient functioning are needed to empower the AlDS orphan. The purpose of this study was to document, by means of a literature review and empirical research, the phenomenon of resilience among AlDS orphans. In order to achieve this goal, it was necessary to elucidate the concepts HIV/AIDS, pandemic, impacts of the pandemic on South Africa and its orphans, resilience and empowerment of orphans. The aim of the empirical research was to investigate the phenomenon of resilience among HIVIAIDS orphans by conducting both survey and phenomenological research and to compare the functioning of resilient and non-resilient orphans. Some of the important findings include: South African AlDS orphans face multiple risk; the participants of this study show remarkable resilience in spite of adversity; and the resilient AlDS orphans in this study alluded to several intrapersonal and interpersonal protective factors which contribute to their resilience. The findings were used to generate guidelines for individuals, families, education and community stakeholders who interact with AlDS orphans and wish to intervene meaningfully in order to empower AlDS orphans towards (continued) resilient functioning. / Thesis (M.Ed.)--North-West University, Vaal Triangle Campus, 2007.

Connections to the Land: the Politics of Health and Wellbeing in Arviat, Nunavut is about traditional knowledge as process. The thesis examines the relationships between Inuit Qaujimajatuqangit (IQ) [“the Inuit way of doing things”; traditional knowledge (TK);], Inuit perceptions of health and wellbeing and the land; and what the relationships mean for integrated coastal and ocean management. Among Arviat Inuit (Arviarmiut), IQ, health and wellbeing and the land are tightly interconnected. When one relationship is stressed, disruptions occur throughout the whole system. IQ is embedded in Inuit perceptions of health and wellbeing, and to be healthy, Inuit maintain they must interact with the land in Inuit ways. In 2004, issues surrounding the nature of IQ, its control, production, documentation and legitimation were contested by Arviarmiut. Inuit strongly resented input from academics, resource managers, scientists or other southern “experts”. Arviarmiut sensitivities regarding IQ were in part the result of the rapid social change that had occurred over the last half century. Social systems suffered upheaval as colonial processes and institutions impacted values, networks, families and identity. The rate of change did not allow for time for traditional systems to adapt, and aspects of social change happened out of sync with each other resulting in dysfunction. Arviat’s history of relocation, uneven social change and expanded communication ability all affected the formation of IQ. Through participatory research, participant observation, interviews and network-building with Inuit organizations, the research explores IQ as process and the interconnections with the land and wellbeing. It recommends greater integration of Inuit into resource management planning and decision-making in ways consistent with IQ; and allowing Inuit to decide what processes and policies are most appropriate for them.

Bakgrund: Sett över världen har förekomsten av fetma nästintill fördubblats sedan 1980-talet. Runt om i världen dör årligen 3,4 miljoner vuxna människor till följd av övervikt och fetma. Utöver det dör människor av diabetes, hjärt- kärlsjukdomar och cancer som många gånger kan kopplas till deras kroppsvikt. Syfte: Syftet är att beskriva hur vuxna med övervikt och fetma upplever sin hälsa. Metod: En litteraturöversikt av 12 vetenskapliga artiklar med kvalitativ metod. Resultat: Övervikt och fetma påverkar hälsan vilket innefattar det fysiska, psykiska och sociala välbefinnandet. Personer med övervikt och fetma isolerar sig, känner skuld och skam samtidigt som de undviker fysiska gruppaktiviteter eftersom de oroar sig för medmänniskors blickar och kommentarer. Personer upplever att deras hälsa påverkas negativt och att de hämmas i sin vardag. Slutsatser: Om sjuksköterskan har en ökad förståelse för hur personer med övervikt och fetma upplever sin hälsa, kan det bidra till att det blir enklare för sjuksköterskan att bemöta personerna. Övervikt och fetma är ett växande hälsoproblem därför behövs vidare forskning inom ämnet. / Background: Seen over the world the occurrence of obesity has doubled since the 1980s. All around the world 3,4 million adults die each year in consequence of overweight and obesity.  Additionally there are people who die because of diabetes, cardiovascular diseases and cancer, which are many times connected with their body weight. Purpose: The purpose is to describe how adults with overweight and obesity experience their health. Method: A literature review of 12 scientific articles with a qualitative method. Results: Overweight and obesity affects the health including the physical, psychological and social wellbeing. People with overweight and obesity isolate themselves, feel guilt and shame in the same time as they avoid physical activities because they are concerned about how people will look at them or what they will say. People experience that it has a negative impact on their health and that it diminishes them in their everyday life. Conclusion: If nurses have an increased understanding for how people with overweight and obesity experience their health, it could contribute to a better and easier approach from the nurse to these people. Overweight and obesity is a growing health issue, which needs further research.

The University of Salford has developed a program in order to improve the control of lower limb orthotics thus improving the ability of paraplegics to walk. Although the system is greatly needed for rehabilitation it is hoped that the final system would enable paraplegics to walk in the community. The present project, which is based on previous designs such as the R. G. O (Reciprocating Gait Orthbsis), strives to add external power at the hips of the R. G. O. The constructed prototype is made of a mechanical skeleton with each leg driven by a brushless motor and a lead screw. The main purpose of this project is to design a control system to control the motion of the legs. The first step in achieving this task was to model the various components of the system separately and then derive a model using system identification that will describe the behaviour of the whole system. The starting point was a mechanical device with two motors mounted one at either hip. A full mathematical analysis of the system is carried out. Once a mathematical model is derived for the RG. O with the two motors it can be used to carry out real time simulations using MATLAB. Once the model is derived it must be validated to make sure it is actually a mathematical representation of the system. The identified model is usually very accurate as it is based on the actual system performance. Then real time simulations of the theoretical and the identified model are compared. If the theoretical model behaves in the same way as the identified model then it is validated and may be used for further work. The models derived using system identification were validated and gave a good comparison when compared to real data. A pole placement controller was designed and tested based on these models. The controller performance was tested with the orthosis unloaded, loaded with artificial loads (a plaster leg weighing 10 Kg). The controller managed to follow the pre-set trajectory reasonably well. The orthosis was then tested with a volunteer in it. Again the performance was very encouraging. The fmal Project will be P. C driven System with the possibility of using NiCAD Batteries as the power source. The main tools, which will be used in order to carry out simulations and comparisons of theoretical and practical results, are MATLAB. The software used was C.

The findings of this multi-site study emphasise the importance of Organisational Culture for integrating clinical information systems into intensive care units. A novel model, the Iterative Systems Integration Model, has two principle components, these being Organisational Culture and the Actual Usefulness of the clinical information system. The model is derived from empirical data collected in four intensive care sites in England and Denmark, with one site being used to validate the model. The model highlights clinical information systems as directly affecting the work processes of the sites investigated, which in turn affect the Organisational Culture and Actual Usefulness of the clinical information system used, and these features affect clinical information system integration. This forms an iterative process of change as clinical information systems are introduced and integrated. Intensive care units are complex organisations, with complex needs and work processes. The impact of clinical information systems on these work processes is investigated in this thesis using Role Activity Diagrams. These diagrams are analysed to show that although clinical work processes are consistent at each site, the information processes differ. Intensive care information processes are found to have the potential to be much simplified with the introduction of seamless clinical information systems. Qualitative data collectio n methods were deployed, i. e., observations, interviews, and shadowing of clinical staff, together with a questionnaire at each site for further validation. Data were analysed using grounded theory to extract salient variables, which informed the development of the model. These factors were indicative of the Organisational Culture of the sites investigated and the Actual Useftilness of the clinical information systems being used. It was posited that clinical information systems that reconcile expectations of both hospital management and clinical staff - and that have the potential to adapt to their organisational environment - have a greater chance of surviving in complex environments such as intensive care. Despite decades of Health Infon-flatics, no such systems exist in their entirety; this research shows that 'ancient problems' of clinical information systems integration are still prevalent, and presents the Iterative Systems Integration Model, the application of which may assist with the integration of clinical information systems in intensive care.

Contemporary conceptual models of health emphasize the importance of patient-based outcomes and recognize the complexity involved in their assessment. Various health conditions, personal, social, and environmental factors, are all thought to contribute to individual’s quality of life. However, the impact of orthodontic treatment on Oral Health-related Quality of Life (OH-QOL) outcomes in children has not yet been systematically studied. Hence, this research was planned to assess the effect orthodontic treatment has on pediatric OH-QOL outcomes. Further, the important moderational role of children’s psychological assets on OH-QOL reports is explored. Following completion of a preliminary study to confirm the psychometric properties of the Child Perception Questionnaire (CPQl1-14), the current two-phase study was undertaken. This consisted of a cross-sectional study examining the relationship among Self-Esteem (SE), malocclusion, and OH-QOL, and a longitudinal study examining the influence of orthodontics and children’s Psychological Wellbeing (PWB) on OH-QOL reports. This PhD dissertation is presented in the “Publishable Style”. The journals which hold the copyrights for the papers published from this thesis have given permission for the reproduction of the text and figures for this dissertation. The preliminary data confirmed that the CPQ11-14 is sensitive to change when used with children receiving orthodontic treatment. Our cross-sectional findings indicated that the impact of malocclusion on OH-QOL is substantial in children with low SE and identified SE as a salient determinant of OH-QOL in children seeking orthodontic treatment. Longitudinal data, on the other hand, detected significant improvement of OH-QOL outcomes after orthodontic treatment. As postulated, these improvements were most evident for the social and emotional domains of OH-QOL. However, covariate analysis emphasized the important role psychological factors play in moderating OH-QOL reports, as children with better PWB were more likely to report better OH-QOL regardless of their orthodontic treatment status. These results substantiate the validity of contemporary models of patient-based outcomes linking biological, personal, social, and environmental factors. Researchers and clinicians are encouraged to adopt this forward thinking approach when dealing with children with oro-facial conditions. Further studies with larger samples and longer follow-ups would be of value to expand on these findings.