submitted in partial fulfillment of the requirements for the Master of Educational Psychology at the University of Zululand, 2010. / In this study the researcher wanted to find out if there were more adolescents with eating problems in single-gender or co-educational schools, if there was a specific age group that is more prone to develop a problem with eating and if there were any specific common factors that cause the development of eating problems. The study has been conducted with 200 subjects at four randomly selected high schools and 50 members of the Eating Disorder Support Group of the Westville Hospital in Durban, KwaZulu-Natal. Research questionnaires were developed with help of a panel of experts and clinicians in the field of Educational Psychology and two different institutions. Schools were chosen randomly and the principals of the schools, the parents and participants were debriefed and consent was given to conduct the study. Female learners from four (two single-gender and two co-educational) schools were selected with the stratified sampling method. One questionnaire with closed-ended questions was given to the learners of the different high schools and a questionnaire with open-ended questions was given to the members of the Eating Disorder Support Group. The quantitative data was analyzed with the help of the SPSS statistics programme and the Chi-square and linear-by-linear Chi-square correlation test was used to analyse the data. The qualitative data was captured by summarising common specific themes from responses to the open-ended questions. The study confirmed the researcher’s hypothesis that there are more adolescents with eating problems in single-gender schools than in co-educational schools. It was found that the older age group (17-18 years) seemed to be more prone to develop problems with eating. Furthermore, common themes such as low self-esteem, influences from the media, family unit and peers and pressure at school were identified as being reasons for developing eating problems. The research findings were important for the development of prevention and intervention programmes and added information to better understand the development of the problem in Durban, KwaZulu-Natal.

<p>I större städer är det vanligare med stress, oro och ångest. Av den anledningen fanns det skäl att tro att individer i storstäder skiljde sig från individer på landsbygden även gällande annan psykisk ohälsa. Studiens syfte var att undersöka om det fanns någon skillnad i ungdomars självrapporterade ätbeteende respektive kroppsuppfattning beroende på urbanisationsgrad, kön och BMI. Deltagarna i undersökningen var 140 gymnasieelever indelade i två grupper, storstad och tätort, utifrån urbanisationsgrad. Undersökningsmaterialet bestod främst av The Eating Attitudes Test (EAT-26), några frågor från Eating Disorder Inventory-2 samt Figure Rating Scale. Resultaten visade att det inte fanns någon skillnad i ungdomars ätbeteende respektive kroppsuppfattning beroende på urbanisationsgrad, men däremot beroende på kön och BMI.</p>

I större städer är det vanligare med stress, oro och ångest. Av den anledningen fanns det skäl att tro att individer i storstäder skiljde sig från individer på landsbygden även gällande annan psykisk ohälsa. Studiens syfte var att undersöka om det fanns någon skillnad i ungdomars självrapporterade ätbeteende respektive kroppsuppfattning beroende på urbanisationsgrad, kön och BMI. Deltagarna i undersökningen var 140 gymnasieelever indelade i två grupper, storstad och tätort, utifrån urbanisationsgrad. Undersökningsmaterialet bestod främst av The Eating Attitudes Test (EAT-26), några frågor från Eating Disorder Inventory-2 samt Figure Rating Scale. Resultaten visade att det inte fanns någon skillnad i ungdomars ätbeteende respektive kroppsuppfattning beroende på urbanisationsgrad, men däremot beroende på kön och BMI.

<p>Aim: The overall aim of this thesis was to acquire knowledge about daily life with focus on eating problems during the trajectory of care for patients with head and neck cancer treated with radiotherapy. Method: The data in study I were gained from medical and nursing records of 50 patients. Documented parameters of eating problems, their causes and consequences, and undertaken interventions were collected before treatment, during radiotherapy, and one, six, and twelve months after completion of treatment, using a study-specific audit instrument. Data were analysed with descriptive and inferential non-parametric statistics. In study II eight patients were interviewed during the radiotherapy treatment period with focus on experiences of eating problems. In study III nine patients were interviewed six to twelve weeks after treatment with the focus on experiences of daily life during the trajectory of care having eating problems. In study IV twelve patients were interviewed about their conceptions of the significance of a supportive nursing care clinic during the whole trajectory of care. Data were analysed with interpretative phenomenology (II, III) and phenomenography (IV). Findings: The four studies showed that being a patient in the trajectory of care often meant that life was disturbed and threatened. This was partly due to the eating problems and their consequences, which could occur during the whole trajectory of care (I, III, IV) but was experienced as most intense and severe during radiotherapy (II) and the nearest weeks after completion of radiotherapy (III, IV). The disturbances and threats experienced due to eating problems could affect the whole person as they were physical (I-IV), psychological, social and existential (II, III). The experiences of eating problems due to the tumour and its treatment and the experience of having cancer per se were strongly connected as one phenomenon, which disturbed and threatened the informants’ daily life. The other part that disturbed the patients’ life was the waiting in suspense. A long and trying waiting in uncertainty was experienced due to lack of knowledge and support, practical as well as emotional. This was most pronounced during pauses in radiotherapy (III) and after completion of the treatment when the lack of support from the health care was obvious (I, II, III). The patients were then most often left to their own devices. In order to endure, they needed both inner strength, described as own coping strategies, and strength from outside, described as support from family, friends and health care professionals (II, III). The nurse clinic was found to give a hand to hold during the whole trajectory of care (IV). It could meet these patients’ needs of knowledge, care and support, both concerning practical measures related to the eating problems and other side-effects of the treatment, and concerning their emotional needs. In addition the nurse clinic could support the relatives in their worries and anxiety (IV). Conclusion: This thesis showed the necessity of continuous assessment, treatment and evaluation of patients’ problems, and the patients’ needs of information and support throughout the trajectory of care.</p>

Subjects rated 12 female body shapes with respect to their physical attractiveness, and the extent to which they would be expected to possess various personality characteristics. The shapes were varied using 3 levels of overall weight and 4 levels of body shapeliness. The sample was modified to control for socioeconomic factors and results are based on 297 undergraduates from Caucasian, African American, and Hispanic racial backgrounds. Loglinear analyses revealed that men and women, regardless of racial background, rated shapely underweight females as most physically attractive, sexy, and ideal for a woman, followed by normal weight figures of similar proportion. African Americans, women in particular, judged the shapely normal weight figures more favorably than the other subjects. Multidimensional scaling and subsequent frequency analyses showed that those figures judged as most attractive, sexy, and ideal were also expected to be fairly emotionally stable, and most successful and interpersonally competitive, but least faithful, kind, and family-oriented. Overweight female shapes, while rated as least physically attractive, sexy, and emotionally stable, were expected to be most family-oriented, kind, and faithful. Shapely normal weight figures were judged to be attractive and sexy, and were assumed to possess a moderate amount of the personality traits in question. The results suggest that Caucasian and Hispanic subjects prefer shapely underweight women, while African Americans, particularly women, find shapely underweight and shapely normal weight women to be physically appealing. African American women also rate shapely normal weight women favorably with respect to personality traits. This perceptual difference may help inoculate them from developing eating disturbances and account for the low prevalence rate of eating disorders in African Americans compared to women of other racial backgrounds. It is suggested that future research identify those beliefs, values or behaviors that seem to inoculate African American women from developing eating disorders. Once identified, mental health professionals may facilitate their development in those women who are likely to have eating problems.

Aim: The overall aim of this thesis was to acquire knowledge about daily life with focus on eating problems during the trajectory of care for patients with head and neck cancer treated with radiotherapy. Method: The data in study I were gained from medical and nursing records of 50 patients. Documented parameters of eating problems, their causes and consequences, and undertaken interventions were collected before treatment, during radiotherapy, and one, six, and twelve months after completion of treatment, using a study-specific audit instrument. Data were analysed with descriptive and inferential non-parametric statistics. In study II eight patients were interviewed during the radiotherapy treatment period with focus on experiences of eating problems. In study III nine patients were interviewed six to twelve weeks after treatment with the focus on experiences of daily life during the trajectory of care having eating problems. In study IV twelve patients were interviewed about their conceptions of the significance of a supportive nursing care clinic during the whole trajectory of care. Data were analysed with interpretative phenomenology (II, III) and phenomenography (IV). Findings: The four studies showed that being a patient in the trajectory of care often meant that life was disturbed and threatened. This was partly due to the eating problems and their consequences, which could occur during the whole trajectory of care (I, III, IV) but was experienced as most intense and severe during radiotherapy (II) and the nearest weeks after completion of radiotherapy (III, IV). The disturbances and threats experienced due to eating problems could affect the whole person as they were physical (I-IV), psychological, social and existential (II, III). The experiences of eating problems due to the tumour and its treatment and the experience of having cancer per se were strongly connected as one phenomenon, which disturbed and threatened the informants’ daily life. The other part that disturbed the patients’ life was the waiting in suspense. A long and trying waiting in uncertainty was experienced due to lack of knowledge and support, practical as well as emotional. This was most pronounced during pauses in radiotherapy (III) and after completion of the treatment when the lack of support from the health care was obvious (I, II, III). The patients were then most often left to their own devices. In order to endure, they needed both inner strength, described as own coping strategies, and strength from outside, described as support from family, friends and health care professionals (II, III). The nurse clinic was found to give a hand to hold during the whole trajectory of care (IV). It could meet these patients’ needs of knowledge, care and support, both concerning practical measures related to the eating problems and other side-effects of the treatment, and concerning their emotional needs. In addition the nurse clinic could support the relatives in their worries and anxiety (IV). Conclusion: This thesis showed the necessity of continuous assessment, treatment and evaluation of patients’ problems, and the patients’ needs of information and support throughout the trajectory of care.

Eating problems and nutritional status were studied in a consecutive series of 104 stroke patients admitted to emergency hospital care. During their stay in hospital eating problems were observed in 46 patients. Certain common types of eating problems were identified: aberrant eating behaviour as regards chewing,lokalization or swallowing, eating small amounts, hoarding of food in the mouth, leakage of food from the mouth and unawareness of eating problems. Poor nutritional status occurred in 16 % of the patients on admission and in 22 % on discharge from the stroke unit. A subgroup of 32 patients hospitalized for 21 days or longer was studied for three weeks. On at least one occasion during these three weeks a poor nutritional status was observed in 18 patients, of whom 17 had eating problems. All subjects who had eating problems during their hospital stay, plus those patients without eating problems but with neurological deficits and those living in a nursing home one year after the stroke (n=36) were selected for a longitudinal study 18 months after the onset of stroke. Eating problems were identified in 23 of these patients during their hospital stay while 21 had such problems when they were followed up. Two patients who could not eat due to severe dysphagia (after a stroke) for three years and 18 months respectively, were successfully trained to eat normally. One patient exhibited impaired oral and hypopharyngeal function and the other impaired hypo- pharyngeal function and a spastic crico-pharyngeal muscle. In both patients training in swallowing was the main remedical measure and one of them also had a myotomy of the spastic muscle. / <p>[2] s., s. 1-45: sammanfattning, s. 49-130: Härtill 6 uppsatser</p> / digitalisering@umu