Sammanfattning Bakgrund: Det sker en digital utveckling i samhället och även inom vården. Det används redan digitala verktyg globalt och till viss del i Sverige. Det finns ett ökat söktryck inom vården och för att möta vårdbehovet behövs en hållbar utveckling av de befintliga vårdresurserna. Målet är att kunna fortsätta ge patienterna en god och jämlik vård. Det finns bristande kunskap om fysioterapeuters uppfattningar att stödja patienter i rehabilitering via digitala applikationer. Syfte: Att beskriva fysioterapeuters uppfattningar om att stödja patienter i rehabilitering med hjälp av digitala applikationer.  Metod: Kvalitativ studie med beskrivande och explorativ design, där data analyserats med innehållsanalys med induktiv ansats. Sex fysioterapeuter som arbetat i sex månader till 22 år med rehabilitering har intervjuats. Intervjuerna genomfördes med en semistrukturerad intervjuguide. Resultat: Dataanalysen resulterade i elva underkategorier och fyra kategorier: ”Möjligheter och önskemål i tillämpning”, ”Begräsningar i användning”, ”Skapar tydligare träningsinstruktioner och förbättrad kommunikation” och ”Ökad närhet till behandling”. Slutsats: Resultatet visade att informanterna såg möjligheter och begränsningar med att tillämpa rehabiliteringsappar i sitt patientarbete och lyfte särskilt möjligheter till tydligare träningsinstruktioner och förbättrad kommunikation samt ökad närhet till behandling som fördelar en app skulle kunna ge i patientarbetet. / Abstract Background: There is a digital development in society as well as in healthcare. Digital tools are already in use worldwide and to some extent in Sweden. There is an increased demand for healthcare and a sustainable development of the existing resources is key to handle that. The goal is to keep providing good and equal care for all patients. There is a lack of knowledge about how physiotherapists to support patients in rehabilitation through digital applications. Aim: To describe physiotherapists perception of supporting patient´s in their rehabilitation using digital applications. Method: Qualitive study with descriptive and explorative design. Using content analysis with an inductive approach. Six physiotherapists who have worked with rehabilitation between six months to 22 years were interviewed. The interviews used a semi-structured interview guide. Results: The data analysis resulted in eleven sub-categories and four categories: “Opportunities and requests of application for usage”, “Limitations in usage”, “Creating clear training instructions and improved communication” and “Increased proximity to treatment”. Conclusion: The results showed that the informants saw opportunities and limitations in usage of digital applications to support patients in various physiotherapeutic operations. They highlighted that an app could provide clearer training instructions, improved communication, and increased proximity to treatment, all of which would benefit patient care.

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Sammanfattning Bakgrund: Vanligt vid artros är låg aktivitetsnivå. I behandlingsprogrammet artrosskola är fysisk träning en intervention. Predicerande faktorer för om beteendet fysisk träning kommer utföras är self-efficacy samt rörelserädsla. Syfte: Syftet var att studera variablerna rörelserädsla och self-efficacy för fysisk träning hos personer med höft- och eller knäartros innan och efter deltagande i artrosskola samt korrelationen avseende skillnaden mellan för- och eftermätning för variablerna. Metod: En icke-experimentell longitudinell enkätstudie med två mätpunkter för ett urval om 22 personer deltog i studien. Mätinstrumenten var Tampaskalan för kinesiofobi- svensk version (TSK-SV) och self-efficacy för fysisk träning skalan (S-ESES). Dataanalysen utfördes med Wilcoxons tecken rangtest samt Spearmans rangkorrelationstest. Resultat: Signifikant skillnad mellan skattad TSK-SV förelåg före respektive efter deltagande i artrosskola (p=0,049). Effektstorleken värderades som medelstor. Ingen signifikant skillnad förelåg mellan skattad S-ESES innan och efter deltagande i artrosskola (p=0,116). Effektstorleken värderades som liten. Lågt signifikant samband förelåg mellan skillnader mellan för- och eftermätning gällande self-efficacy för fysisk träning och rörelserädsla. Slutsats: Resultatet visade på en minskad rörelserädsla och en korrelation mellan förändringarna gällande variablerna. Vidare studier med artrosskola som en kontrollerad oberoende variabel krävs för att möjliggöra kausala slutsatser gällande artrosskolans inverkan på variablerna. / Abstract  Background: Common in osteoarthritis are low activity level. Self-management is a rehabilitation program that includes physical exercise. Self-efficacy and fear of movement can determine if physical activity will be performed.  Aim: The aim of the study was to examine the variables fear of movement and self-efficacy for physical exercise for people with hip-and or knee osteoarthritis before and after participation in self-management program, and to investigate the correlation between the pre-post differences in the variables. Methods: Non-experimental longitudinal questionnaire survey with two measurement points. 22 participants participated. Measurements used were Tampa scale for the kinesiophobia-Swedish version (TSK-SV) and Swedish version of the Exercise Self-efficacy scale (S-ESES). Wilcoxon's tecken-rank test and Spearman's rank correlation test were used to analyze data. Results: A significant difference between estimated TSK-SV before and after the intervention (p=0,049), medium effect size. No significant difference between estimated S-ESES before and after the intervention (p=0,116), small effect size. Difference between the measuring points showed low correlation between fear of movement and self-efficacy for exercise. Conclusion: Fear of movement decreased and there was a correlation between the difference of the variables. Future studies require a controlled independent variable to enable causal conclusion between the interventions impact on the variables.

Sleep is an essential part of life, and obtaining quality sleep is important for various areas of functioning. Behaviors to promote sleep include physical activity, managing stress, reducing anxiety symptoms, maintaining a consistent sleep schedule, and obtaining bright light exposure. Many of these behaviors overlap with benefits observed from pet ownership (PO). The present study aimed to examine the relation between PO and sleep as well as moderators and mediators of this relation. Four research questions were examined: 1) Is PO significantly related to sleep? 2) Does gender moderate the relation between PO and sleep? 3) Do sleep-promoting behaviors (i.e., physical activity, perceived stress, anxiety symptoms, bright light exposure, sleep-wake variability) mediate the relation between PO and sleep? 4) Do the mediating effects of the sleep-promoting behaviors on the relation between PO and sleep depend on the regularity of walking? Participants (N = 1,250; 80.8% White; 50.5% men) residing in the United States reported on their sleep, physical activity, perceived stress, anxiety symptoms, and light exposure. Participants were 25.5% non-pet owners (NPO), 24.1% cat-only owners (CO), 25.7% dog-only owners (DO), and 24.7% owned dogs and cats (DCO). Data analyses included ANCOVA, Moderation, Parallel Mediation, and Conditional Process Modeling. Key findings included that PO was significantly related to sleep, with NPO sleeping worse than PO (CO/DO/DCO combined) and DCO reporting the best sleep of all four PO groups. The relation between PO and sleep did not significantly differ for men and women. The relation was significantly mediated by anxiety symptoms, perceived stress, light exposure, and sleep-wake variability depending on the groups compared and scoring methods used. Anxiety symptoms and perceived stress were the most robust mediators of the relation between PO and sleep. Walking regularity did not change the mediating effects between PO and sleep. This study is one of the first to examine daytime mechanisms of the relation between PO and sleep. The findings provide a foundation for future research examining how the integration of PO and sleep-promoting behaviors can improve adherence to sleep health recommendations, thus improving owners’ sleep.

This article reviews research and professional trends in the field of health psychology and behavioral medicine. I also discuss recent research on stress, immune system, behavioral change and health promotion. An increasing focus on the human immunodeficiencyvirus (HN/AIDS) is very important given the Rde of health psychology in terms of prevencing further spread of the epidemic and in maintaining a good qualiry of life. I examined psychosocial and immune system stress responses in individuals before and after their nocification of HN status andas a consequence of stress management intervention procedures. Psychological and social factors in the development of illness are considered. / Este articulo revisa líneas de investigación y profesionales en el campo de la psicología de la salud y la medicina conductual. Se discuten investigaciones recientes acerca del estrés, el sistema inmunológico, los cambios conducruales y la promoción de la salud. Un énfasis en el virus de inmunodeficiencia (HN/SIDA) es muy importante dado el rol de la psicología de la salud para prevenir la expansión de la epidemia y mantener una buena calidad de vida. Se han examinado las respuestas psicosociales y del sistema inmunológico de individuos antes y después de ser notificados de su status de HN y como consecuencia de los procedimientos de intervención para manejar el estrés. Se consideran los factores psicológicos y sociológicos en el desarrollo de la enfermedad.

Objective: Dog owners have been shown to walk more per week compared to non-dog owners; however, 60% of dog owners are still not walking their dogs at intensities sufficient to reap optimal health benefits. The aim of this study was to evaluate the feasibility, acceptability, and efficacy of a 9-week feasibility randomized controlled trial involving a program of six weekly scheduled instructor-led group dog walks supplemented with theory-based strategies to encourage increased dog walking among dog owners in Greater Victoria, BC. Methods: This study was based on the multi-process action control (M-PAC) framework and utilized an open parallel randomized controlled trial design involving experimental and waitlist-control group participants. Quantitative data was collected using pedometers and self-report measures. A program evaluation survey was administered upon the completion of the study. Primary outcomes examined the feasibility and acceptability of the program; secondary outcomes analyzed pedometry and self-report moderate-to-vigorous physical activity (MVPA) data; and tertiary outcomes observed changes in participants’ perceptions of M-PAC constructs. Percentage calculations were used to obtain primary outcomes, and analysis of covariance (ANCOVA; controlling for baseline) was performed to examine secondary and tertiary outcomes to explore the direction of effects and obtain a first estimate of expected effect sizes. Eligibility: Male and female adults aged 18+ living in Greater Victoria, BC, who owned at least one healthy and friendly dog aged six months and above, who were not meeting recommended guidelines of 150 minutes of MVPA per week, and who were medically cleared to participate. Results: Feasibility outcomes included 74 interested responses, 23% recruitment rate (n = 17), 94% retention rate (n = 16), and 94% adherence rate (n = 15). Program participants were overall (very) satisfied with the program – worksheets (62.5%), program instructor (100%), various program/group dog walks logistics (75% to 100%). Total weekly step counts and average daily step counts, MVPA dog walking, and MVPA with dog increased at the end of the program and at follow-up, resulting in large effect sizes when compared to the waitlist-control group. MVPA dog walking and total MVPA (with and without dog) exceeded recommended guidelines at follow-up. Positive changes across time were observed for dog responsibility and M-PAC constructs of affective judgments, opportunity, planning, identity, and habit, resulting in medium and large effect sizes when compared to the waitlist-control group. Conclusions: This six-week group dog walking program is overall feasible, acceptable, and efficacious in encouraging increased dog walking and MVPA among dog owners. Attendance at weekly scheduled instructor-led group dog walks and exposure to the M-PAC construct worksheets resulted in program participants’ adoption and maintenance of positive behavioral changes at the end of the program and at follow- up. Program participants reported enjoying the program and being (very) satisfied with it. It is recommended for future studies to refine/modify initial recruitment strategies and eligibility criteria, reimburse medical/veterinarian clearance costs to reduce cost-related barriers to participation, offer a variety of options for program delivery (e.g., different locations/schedules/seasons, online programs, multi-site study) to accommodate more participants, and apply the M-PAC framework to a larger sample. / Graduate