Research examining the relationship between psychological distress and health behaviors is limited, as most of these studies examine one type of psychological distress and relate it to one type of health behavior. To address this limitation, an exploratory study was conducted that included online self-report measures of a wide range of positive health behaviors (Health Behavior Checklist; HBC) and a wide range of different types of psychological distress (Brief Symptom Inventory; BSI). Participants were 762 undergraduate students from the University of Central Florida (55% female). Results revealed that the total BSI score showed statistically significant negative correlations with the HBC total score and all four HBC subscales. Thus, participants reporting more overall psychological distress reported that they engaged in fewer positive health behaviors, across all health behavior subtypes. Stepwise regressions that examined the nine BSI subscales and their relationship with the HBC total score revealed that the Hostility subscale of the BSI was the strongest and most consistent predictor of positive health behaviors (in a negative direction). Stepwise regressions also revealed additional relationships of the BSI subscales of Depression and Phobia to particular HBC subscales. The results of this exploratory study provide an initial model on the relationships of particular types of psychological distress that are related to particular types of health behaviors, which will inform future studies on this important topic area.

Syftet med denna kunskapsöversikt var att belysa olika aspekter av det kunskapsläge som finns idag sett till icke-suicidalt självskadebeteende bland unga kvinnor. Uppsatsens frågeställning var: Hur konstrueras och beskrivs ämnet icke-suicidalt självskadebeteende hos unga kvinnor i valda delar av forskningslitteraturen? Uppsatsen är en selektiv kunskapsöversikt som består av 11 primärdokument och resultaten analyserades med hjälp av en socialkonstruktionistisk teoribildning. Resultaten visade att kvinnor är överrepresenterade vad gäller icke-suicidalt självskadebeteende med fokus på att skära/rispa sig, men att det kan bero på vad forskaren väljer för inkluderings- och exkluderingskriterier i sin studie. Primärdokumenten vittnar om olika orsaker till varför unga kvinnor avsiktligen skadar sig själva, såväl inre som yttre faktorer är avgörande och samspelar med varandra. De unga kvinnorna upplevde att skärandehandlingen var ett effektivt sätt att hantera negativa känslor och att känna emotionell lättnad. Det fanns en stark korrelation mellan självskadehandlingar och dysfuntionella familjeförhållanden. Att självskada genom att skära samt rispa sig blev ett sätt att kanalisera svåra känslor men även att kommunicera med omgivningen då de unga kvinnorna inte lärt sig att på ett mer välgörande sätt uttrycka svåra känslor. De unga kvinnorna internaliserar omgivningens förväntningar – att vara ”den självskadande” – och skapar utifrån dessa en identitet. / The purpose of this systematic review was to highlight different aspects of the state of knowledge available today in terms of non-suicidal self-injury among young women. The question at issue was: How does the research literature – selected parts of it – construct and discuss the topic of non-suicidal self-harm in young women? The paper is a selective knowledge survey consisting of 11 primary document and the results were analyzed using a social constructionist theory. The results showed that women are overrepresented in terms of non-suicidal self-injury with a focus on cutting/scratch, but it may depend on what the researcher selects for inclusion and exclusion criteria in their study. Primary documents show various reasons why young women deliberately harm themselves, both internal and external factors are crucial and interact with each other. The young women felt that the cutting action was an effective way to deal with negative emotions and to feel emotional relief. There was a strong correlation between self-harm acts and dysfunctional family relationships. The young women learned to self-harm as a way to channel hard feelings but also to communicate with the environment because they had not learned to communicate difficult emotions in a more beneficial way. The young women internalize the expectations of - to be "the self-harming young woman” - and creates an identity from these expectations.

Mental illness affects more women than men in the United States. Poor mental health in reproductive-age women has negative implications on population health. The purpose of this quantitative, correlational study was to examine the relationship between household structure and frequency of mental distress, with consideration of the mediation social-emotional support provides for reproductive-age women. The social ecological model was the theoretical framework for this research, in which frequency of mental distress related to the individual-level of the human-environment interaction construct. Household structure and social-emotional support were examined at the relationship-level. Pearson's correlation coefficient and linear regression were used to conduct a cross-sectional analysis of the 2010 Behavioral Risk Factor Surveillance System data set with a total sample size of 65,269 women, 18-44 years old. The confounding variables, health care access, race, income, marital status, number of children in the household, and pregnancy status, were included in the analysis. Although social-emotional support significantly influenced both household structure and frequency of mental distress, significance was not found between household structure and frequency of mental distress indicating that mediation does not exist. This study provides researchers and practitioners information about household structure that should be considered when designing innovative, nonprofessional support programs at the community-level. Positive social change implications include an understanding of the relationship between complex variables associated with social-emotional support, which could improve community support programs focused on mental health wellness of reproductive-age women.

Conselho Nacional de Desenvolvimento Científico e Tecnológico / Introdução: A preocupação em torno do uso irracional de psicofármacos tem sido observada em diversos países, constituindo-se uma questão importante para a saúde pública mundial. No Brasil, a promoção do uso racional de psicofármacos é um desafio para a atenção primária, sendo importante caracterizar sua dimensão psicossocial. Objetivos. O artigo 1, com características descritivas, tem como objetivo caracterizar o uso de psicofármacos em unidades de saúde da família segundo a presença de transtornos mentais comuns (TMC) e segundo as principais características socioeconômicas e demográficas. O artigo 2, com um caráter analítico, tem como objetivo avaliar o papel da rede social no uso de cada um destes psicofármacos segundo a presença de TMC. Métodos O estudo utiliza um delineamento seccional e abarca a primeira fase de coleta de dados de dois estudos em saúde mental na atenção primária. Esta se deu em 2006/2007 para o estudo 1 (Petrópolis, n= 2.104) e em 2009/2010 para o estudo2 (São Paulo, n =410, Rio de Janeiro, n= 703, Fortaleza , n=149 e Porto Alegre, n= 163 participantes). Ambos os estudos possuem o mesmo formato no que se refere à coleta de dados, seu processamento e revisão, resultando em uma amostra de 3.293 mulheres atendidas em unidades de saúde da família de cinco diferentes cidades do país. Um questionário objetivo com perguntas fechadas foi utilizado para a coleta de informações socioeconômicas e demográficas. O uso de psicofármacos foi avaliado através de uma pergunta aberta baseada no auto-relato do uso de medicamentos. A presença de TMC foi investigada através do General Health Questionnaire, em sua versão reduzida (GHQ-12). O nível de integração social foi aferido através do índice de rede social (IRS), calculado a partir de perguntas sobre rede social acrescentado ao questionário geral. No estudo descritivo (artigo 1), a frequência do uso de antidepressivos e o uso de benzodiazepínicos na população de estudo foram calculadas para cada cidade, tal como a frequência do uso destes psicofármacos entre as pacientes com transtornos mentais comuns. A distribuição do uso de cada um destes psicofármacos segundo as principais características socioeconômicas, demográficas e segundo transtornos mentais comuns foi avaliada através do teste de qui-quadrado de Pearson. No estudo analítico (artigo 2), a associação entre o nível de integração social e o uso exclusivo de cada um dos psicofármacos foi analisada através da regressão logística multivariada, com estratificação segundo a presença de TMC. Resultados: A frequência do uso de psicofármacos foi bastante heterogênea entre as cidades, destacando-se, porém, a importância do uso de benzodiazepínicos frente ao uso de antidepressivos em sua maioria. A proporção do uso de psicofármacos, sobretudo antidepressivos, foi predominantemente baixa entre as pacientes com TMC. Entre elas, o uso de antidepressivos mostrou-se positivamente associado ao isolamento social, enquanto o uso de benzodiazepínicos associou-se negativamente a este. Conclusão: Os resultados colaboram para a caracterização do uso de psicofármacos em unidades de saúde da família e para a discussão acerca de sua racionalidade. Destaca-se a importância de avaliar a dimensão psicossocial que envolve o uso destas substâncias com vistas ao desenvolvimento de estratégias de cuidado mais efetivas / Introduction: Concerns about irrational use of psychotropic drugs has been observed in many countries, becoming an important issue for global public health. In Brazil, the promotion of rational use of psychotropic drugs is a challenge for primary care, therefore it is important to characterize its psychosocial dimension. Objectives This dissertation consists of two articles. Article 1, with descriptive characteristics, aims to characterize the use of psychotropic drugs in family health units, according to major socioeconomic and demographic characteristics and according to the presence of common mental disorders (CMD). Article 2, with an analytical character, aims to evaluate the role of social networks in the use of each of these psychotropic drugs, according to the presence of CMD. Methods The study has a cross-sectional design and integrates baseline data from two previous studies on mental health in primary care . Data collection took place in 2006/2007 for the study 1 (Petropolis, n = 2.104) and in 2009/2010 for the study2 (São Paulo, n = 410, Rio de Janeiro, n = 703, Fortaleza - n = 149 and Porto Alegre, n = 163 participants). Although performed in different periods, both studies have the same format as regards data collection, processing and review, resulting in a sample of 3293 women attending family health units from five different cities. An objective questionnaire with closed questions was used to collect socioeconomic and demographic information. Psychotropic use was assessed through an open-ended question based on self-reporting of drug use. The presence of CMD was investigated by the General Health Questionnaire in its reduced version (GHQ-12). The level of social integration was evaluated through the social network index (IRS), calculated from questions about social network added to the general questionnaire. In the descriptive study (Article 1), the frequency of antidepressants and benzodiazepines use in the study population were calculated for each city, such as the frequency of the use of psychotropic drugs among patients with common mental disorders. The distribution of the use of each of these psychoactive drugs according to major socioeconomic and demographic characteristics and according to the presence of common mental disorders was assessed by Pearsons chi-square test. In the analytical study (Article 2), the association between the level of social integration and the exclusive use of each of psychotropic drugs was analyzed by multivariate logistic regression, stratified according to the presence of TMC. Results: The frequency of psychotropic medication use was quite heterogeneous among cities, emphasizing, however, the importance of the use of benzodiazepines against the use of antidepressants in most of the cities. The proportion of use of psychotropic medication, particularly antidepressants, was predominantly low among patients with CMD. Among these, antidepressants use was positively associated with social isolation, while benzodiazepines use was negatively associated. Conclusion: This study collaborates to characterize the use of antidepressants and benzodiazepines in family health units and to discuss about their rationality. The results highlight the importance of assessing the psychosocial dimension that involves the use of these substances in order to develop strategies to promote its rational use in primary care.

Conselho Nacional de Desenvolvimento Científico e Tecnológico / Introdução: A preocupação em torno do uso irracional de psicofármacos tem sido observada em diversos países, constituindo-se uma questão importante para a saúde pública mundial. No Brasil, a promoção do uso racional de psicofármacos é um desafio para a atenção primária, sendo importante caracterizar sua dimensão psicossocial. Objetivos. O artigo 1, com características descritivas, tem como objetivo caracterizar o uso de psicofármacos em unidades de saúde da família segundo a presença de transtornos mentais comuns (TMC) e segundo as principais características socioeconômicas e demográficas. O artigo 2, com um caráter analítico, tem como objetivo avaliar o papel da rede social no uso de cada um destes psicofármacos segundo a presença de TMC. Métodos O estudo utiliza um delineamento seccional e abarca a primeira fase de coleta de dados de dois estudos em saúde mental na atenção primária. Esta se deu em 2006/2007 para o estudo 1 (Petrópolis, n= 2.104) e em 2009/2010 para o estudo2 (São Paulo, n =410, Rio de Janeiro, n= 703, Fortaleza , n=149 e Porto Alegre, n= 163 participantes). Ambos os estudos possuem o mesmo formato no que se refere à coleta de dados, seu processamento e revisão, resultando em uma amostra de 3.293 mulheres atendidas em unidades de saúde da família de cinco diferentes cidades do país. Um questionário objetivo com perguntas fechadas foi utilizado para a coleta de informações socioeconômicas e demográficas. O uso de psicofármacos foi avaliado através de uma pergunta aberta baseada no auto-relato do uso de medicamentos. A presença de TMC foi investigada através do General Health Questionnaire, em sua versão reduzida (GHQ-12). O nível de integração social foi aferido através do índice de rede social (IRS), calculado a partir de perguntas sobre rede social acrescentado ao questionário geral. No estudo descritivo (artigo 1), a frequência do uso de antidepressivos e o uso de benzodiazepínicos na população de estudo foram calculadas para cada cidade, tal como a frequência do uso destes psicofármacos entre as pacientes com transtornos mentais comuns. A distribuição do uso de cada um destes psicofármacos segundo as principais características socioeconômicas, demográficas e segundo transtornos mentais comuns foi avaliada através do teste de qui-quadrado de Pearson. No estudo analítico (artigo 2), a associação entre o nível de integração social e o uso exclusivo de cada um dos psicofármacos foi analisada através da regressão logística multivariada, com estratificação segundo a presença de TMC. Resultados: A frequência do uso de psicofármacos foi bastante heterogênea entre as cidades, destacando-se, porém, a importância do uso de benzodiazepínicos frente ao uso de antidepressivos em sua maioria. A proporção do uso de psicofármacos, sobretudo antidepressivos, foi predominantemente baixa entre as pacientes com TMC. Entre elas, o uso de antidepressivos mostrou-se positivamente associado ao isolamento social, enquanto o uso de benzodiazepínicos associou-se negativamente a este. Conclusão: Os resultados colaboram para a caracterização do uso de psicofármacos em unidades de saúde da família e para a discussão acerca de sua racionalidade. Destaca-se a importância de avaliar a dimensão psicossocial que envolve o uso destas substâncias com vistas ao desenvolvimento de estratégias de cuidado mais efetivas / Introduction: Concerns about irrational use of psychotropic drugs has been observed in many countries, becoming an important issue for global public health. In Brazil, the promotion of rational use of psychotropic drugs is a challenge for primary care, therefore it is important to characterize its psychosocial dimension. Objectives This dissertation consists of two articles. Article 1, with descriptive characteristics, aims to characterize the use of psychotropic drugs in family health units, according to major socioeconomic and demographic characteristics and according to the presence of common mental disorders (CMD). Article 2, with an analytical character, aims to evaluate the role of social networks in the use of each of these psychotropic drugs, according to the presence of CMD. Methods The study has a cross-sectional design and integrates baseline data from two previous studies on mental health in primary care . Data collection took place in 2006/2007 for the study 1 (Petropolis, n = 2.104) and in 2009/2010 for the study2 (São Paulo, n = 410, Rio de Janeiro, n = 703, Fortaleza - n = 149 and Porto Alegre, n = 163 participants). Although performed in different periods, both studies have the same format as regards data collection, processing and review, resulting in a sample of 3293 women attending family health units from five different cities. An objective questionnaire with closed questions was used to collect socioeconomic and demographic information. Psychotropic use was assessed through an open-ended question based on self-reporting of drug use. The presence of CMD was investigated by the General Health Questionnaire in its reduced version (GHQ-12). The level of social integration was evaluated through the social network index (IRS), calculated from questions about social network added to the general questionnaire. In the descriptive study (Article 1), the frequency of antidepressants and benzodiazepines use in the study population were calculated for each city, such as the frequency of the use of psychotropic drugs among patients with common mental disorders. The distribution of the use of each of these psychoactive drugs according to major socioeconomic and demographic characteristics and according to the presence of common mental disorders was assessed by Pearsons chi-square test. In the analytical study (Article 2), the association between the level of social integration and the exclusive use of each of psychotropic drugs was analyzed by multivariate logistic regression, stratified according to the presence of TMC. Results: The frequency of psychotropic medication use was quite heterogeneous among cities, emphasizing, however, the importance of the use of benzodiazepines against the use of antidepressants in most of the cities. The proportion of use of psychotropic medication, particularly antidepressants, was predominantly low among patients with CMD. Among these, antidepressants use was positively associated with social isolation, while benzodiazepines use was negatively associated. Conclusion: This study collaborates to characterize the use of antidepressants and benzodiazepines in family health units and to discuss about their rationality. The results highlight the importance of assessing the psychosocial dimension that involves the use of these substances in order to develop strategies to promote its rational use in primary care.

This qualitative, explorative, descriptive and contextual study was aimed at exploring and describing secondary teachers’ experiences in dealing with adolescent learners displaying mental distress in Gaborone. Moreover, recommendations were proposed for the support needed by secondary teachers who interact with adolescents learners in order to curb mental distress in schools. The sampling method that was used to identify 21 secondary school teachers who participated in this study was purposive. Focus group discussions, as well as field notes, were used to collect data, which were analysed using a thematic analysis. An array of factors that could lead to delays in identifying adolescent learners with mental distress, such as large student numbers and insufficient resources to meet their needs, learners showing signs of mental distress not being taken seriously, lack of parental involvement, relegating parental duties and lack of trust were revealed by the findings. The researcher observed that approaches to support, such as policy guides, parental involvement, peer education and life skills training were best suited to address mental distress in schools as noted by participants. The participants shared the various ways they employed to deal with mental distress in adolescent learners, and suggested strategies that they, together with parents and other stakeholders, could engage in to address these factors. The identified strategies provided a contextual way of establishing recommendations to overcome adolescent mental distress. These included, but were not limitted to, the engagement by parents in mental health problems in schools, as well as policy reviews, and restructuring the referral system. / Health Studies / M. P. H.

Made available in DSpace on 2016-04-29T13:31:05Z (GMT). No. of bitstreams: 1 Milena Silva Lisboa.pdf: 2266750 bytes, checksum: c612ce5b1cd2adcb9eaae054136d6b19 (MD5) Previous issue date: 2013-08-02 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / This research proposes the investigation of the relationships between homeless (in particular, when they experience mental distress) and health services, focus on the ways they establish support networks, including social, family and institutional resources. The central question of this research addresses how health care networks are setup (especially mental health netwoks), triggered by homeless cared by a team from the Family Health Program for Homeless (PSF-SD), and what are the effects of this care (support the suffering in the territory and production of mental health or institutionalization and social cleaning). During one year, we conducted an ethnography to understand the care relationships established between a team of PSF-SD and homeless, especially following ten cases of psychosocial suffering considered as mental illness. We reflect on the power of the device's PSF-SD, which relies primarily on the ties generated between staff and patients and the care performed in the daily life at the city streets, but that, by themselves, do not account for the needs regarding the mental health of homeless. Our findings revealed the disconnection of the mental health network and the fragile sustenance of the mental suffering in the territory, which keeps the homeless with severe mental distress as depository of the ancient treatment of madness based on social exclusion and disciplining. Their virtual dangerousness and their abnormality performed in the public domain constitute the basis for the lack of assistance of substitute services, which end up creating a circuit of chronicity, produced by constant denials of care network. This circuit works as a vector, centripetal, pointing to the segregation of this institutional residue (the dangerous and abnormal mad homeless ) in a psychiatric hospital. We conclude that the PSF-SD is a device that could break the trap of institutionalization of homeless with severe mental distress, in that, acting as extitution, could articulate the network and sustain mental health care relationships and accountability within and in the interstitial space established "between" institutions / Essa pesquisa tem como proposta a investigação dos relacionamentos entre pessoas em situação de rua (e em especial, quando experimentam sofrimento mental) e os serviços de saúde, atentando para os modos como são estabelecidas redes de sustentação, incluindo recursos sociais, familiares e institucionais. A pergunta central da investigação se dirige à como se configuram as redes de cuidado (especialmente em saúde mental) acionadas por pessoas em situação de rua acompanhadas por uma equipe do Programa de Saúde da Família Sem Domicílio e quais são os efeitos deste cuidado (sustentação do sofrimento no território, produção de saúde mental ou institucionalização e higienização social). Foi realizada uma etnografia durante um ano das relações de cuidado estabelecidas entre uma equipe do PSF-SD e pessoas em situação de rua, especialmente acompanhando dez casos de sofrimento psicossocial considerado como doença mental. Refletimos sobre a potência do dispositivo do PSF-SD, que se sustenta fundamentalmente nos vínculos produzidos entre a equipe e seus pacientes, no acolhimento e no cuidado exercido no cotidiano das ruas da cidade, mas que, por si mesmos, não dão conta das necessidades referentes à saúde mental das pessoas em situação de rua. Apontamos, então, a desarticulação da rede de assistência em geral, e em especial, da saúde mental e a pouca sustentação do sofrimento psíquico intenso no território, o que mantém o louco de rua como depositário do antigo tratamento social fundamentado na exclusão e disciplinamento da loucura. Sua virtual periculosidade e sua anormalidade encenada em domínio público constituem a base para a desassistência dos serviços substitutivos, que acabam criando um circuito de cronificação, produzido pelas constantes recusas de atendimento da rede. Este circuito funciona como vetor, centrípeto, que aponta para a segregação deste resíduo institucional (o louco de rua, perigoso e anormal) em hospital psiquiátrico. Concluímos que o PSF-SD é um dispositivo que poderia romper com a armadilha de institucionalização do louco de rua, na medida em que, atuando como extituição, poderia articular a rede em saúde mental e sustentar relações de cuidado e responsabilização no território e no espaço intersticial que se estabelece entre instituições

Abstract Leukemia treatment has been implicated to be responsible for a diversity of long-term adverse effects (Pui 2008), which can occur even years after diagnosis and can seriously impair survivors’ performance status and quality of life (Campbell et al. 2007, Zeltzer et al. 2008). The aim of the present work was to assess health-related quality of life in long-term survivors of acute lymphoblastic leukemia (ALL), and to find out whether vocational rehabilitation can promote the coping at work of young people who take part in a training intervention or help them find employment. Neuropsychological testing was performed on 64 survivors. Cranial irradiation had been administered to 44 of the survivors, while 20 survivors had been treated solely with chemotherapy. A control group consisted of 45 healthy young adults. We found that young adult survivors of childhood ALL treated with cranial irradiation had clear progressive deficits in their neurocognitive functioning at a mean of 20 years after diagnosis compared with healthy controls. Non-irradiated ALL survivors performed significantly better, but even they had statistically significant impairments in some of the neuropsychological test scores compared with the controls. Rand-36-Item health Survey (RAND-36) was used to assess subjective HRQoL, depressive symptoms were assessed with Beck Depression Inventory (BDI-21), and mental distress with General Health Questionnaire (GHQ-12) in 74 survivors of ALL. The control group consisted of 146 healthy young adults selected from local population registry. ALL survivors showed good HRQoL scores in comparison to the control group. Patients who had been treated for an ALL relapse and had received the most intensive chemo- and radiotherapy had significantly higher scores on mental health and vitality than the controls. Survivors of ALL report fewer depressive symptoms and equal mental well-being compared to healthy controls. Nine out of 63 survivors were selected for rehabilitation based on their occupation and psychosocial difficulties. The occupational rehabilitation course improved physical fitness and decreased overweight in long-term survivors of ALL, but impaired their HRQoL. Our findings support the idea that ALL survivors’ subjective experience of well-being is possibly affected by a repressive adaptive style. / Tiivistelmä Leukemiahoidoilla on todettu olevan pitkäaikaisvaikutuksia (Pui 2008), jotka voivat ilmetä jopa vuosia diagnoosin jälkeen heikentäen sairaudesta selvinneiden toimintakykyä ja elämänlaatua (Campbell et al. 2007, Zeltzer et al. 2008). Tämän tutkimuksen tavoitteena oli arvioida akuutista lymfaattisesta (ALL) leukemiasta selvinneiden terveyteen liittyvää elämänlaatua pitkällä aikavälillä sekä selvittää, voidaanko ammatillisen kuntoutuksen avulla edistää interventioon osallistuneiden työssä selviytymistä tai työllistymistä. Neuropsykologiseen tutkimukseen osallistui 64 ALL pitkäaikaisselviytyjää. Heistä 44 oli saanut pään alueen sädehoitoa ja 20 pelkästään solunsalpaajahoitoa. Verrokkiryhmässä oli 45 tervettä nuorta aikuista. Havaitsimme, että lapsuudessa pään alueen sädehoitoa saaneilla ALL-selviytyjillä oli verrokkeihin verrattuna selkeitä progressiivisia muutoksia neurokognitiivisessa toimintakyvyssä keskimäärin 20 vuotta diagnoosista. Ne, jotka eivät olleet saaneet sädehoitoa suoriutuivat huomattavasti paremmin, mutta heilläkin havaittiin tilastollisesti merkittäviä puutoksia joillakin neuropsykologisten testien osa-alueilla verrokkeihin verrattuna. 74 entisen ALL-potilaan terveyteen liittyvää elämänlaatua (HRQoL) mitattiin Rand-36 -mittarilla, masennusoireita Beckin masennustestillä (BDI-21) ja henkistä hyvinvointia General Health Questionnaire -mittarilla (GHQ-12). Verrokkiryhmäksi valittiin väestörekisteristä 146 tervettä nuorta aikuista. ALL-ryhmässä tutkittavien terveyteen liittyvää elämänlaatua mittaavat pisteet olivat hyvät verrokkiryhmään verrattuna. Ne potilaat, joita oli hoidettu leukemian uusiutumisen takia ja jotka olivat saaneet intensiivisintä solunsalpaaja- ja sädehoitoa saivat huomattavasti paremmat pisteet psyykkisen hyvinvoinnin ja vitaalisuuden osa-alueilla kuin verrokit. ALL -selviytyjät raportoivat vähemmän masennusoireita, ja he arvioivat psyykkinen hyvinvointinsa yhtä hyväksi kuin verrokit. Yhdeksän ALL pitkäaikaisselviytyjää osallistui heille suunnattuun ammatilliseen kuntoutusinterventioon. Ammatillinen kuntoutuskurssi paransi ALL -selviytyjien fyysistä suorituskykyä ja vähensi ylipainoa, mutta heikensi terveyteen liittyvää elämänlaatua. Tutkimustulokset tukevat ajatusta, että repressiivinen adaptaatio voi vaikuttaa lapsuusiän leukemiasta selvinneiden subjektiiviseen hyvinvoinnin kokemukseen.

Introduktion: Sjukvårdspersonal runt om i världen har stått på frontlinjen i stressiga arbetsmiljöer och tagit hand om COVID-19-patienter sedan SARS-CoV-2 förklarades som en global pandemi. Under pandemiska förhållanden står sjukvårdspersonal inför specifika utmaningar, där vissa leder till symptom på psykisk ohälsa. Statliga resurser till sjukvårdspersonal har ofta avsatts för kortsiktiga insatser. Långsiktiga investeringar med fokus på främjande av sjukvårdpersonalens psykiska hälsa behövs för att förhindra förvärrade folkhälsoproblem på grund av SARS-CoV-2. Syfte: Studiens syfte var att belysa hur sjukvårdspersonal rapporterar att deras psykiska hälsa påverkats av SARS-CoV-2-pandemin och vilka erfarenheter från tidigare interventioner för psykisk hälsa som skulle kunna vara användbara för att förbättra sjukvårdspersonals psykiska hälsa genom att belysa några exempel. Metod: En systematisk litteraturöversikt genomfördes, där 20 vetenskapliga artiklar inkluderades och analyserades med tematisk analys. Resultat: Totalt nio teman identifierades: psykisk ohälsa hos sjukvårdspersonal, SARS-CoV-2-pandemin, interventioner för psykisk hälsa, vårdkvalitet, säkerhetskultur, arbetsplatsbaserade tillvägagångssätt, mindfulness och konstaktivitetsmetoder, biomarkörbaserade tillvägagångssätt samt tekniska tillvägagångssätt. Viktiga fynd i denna litteraturöversikt är att teman säkerhetskultur och vårdkvalitet är associerade med de andra teman. Slutsats: När tillvägagångssätt implementeras i insatser för sjukvårdspersonals psykiska hälsa som främjar säkerhetskultur och vårdkvalitet främjar det också, enligt resultaten i denna översikt, långsiktiga effekter på individuell psykisk hälsa hos sjukvårdspersonal. Detta bör omedelbart beaktas av dem som utvecklar nya program för att främja psykisk hälsa för att stödja sjukvårdspersonal i effekterna av pandemin. / Introduction: Healthcare workers around the world have stood on the front lines in stressful work-environments, caring for COVID-19 patients since SARS-CoV-2 was declared a global pandemic. Under pandemic conditions healthcare workers face specific challenges, where some lead to symptoms of mental illness. Governmental resources to the healthcare workforce have often been allocated to short-term efforts. Long-term investments focusing on mental health promotion for HCW are needed to prevent worsening public health issues due to SARS-CoV-2. Aim: The aim of the study was to illuminate how HCW report that their mental health has been affected by the SARS-CoV-2 pandemic and what experiences from previous mental health interventions that may be useful in promoting HCW mental health by highlighting some examples. Methods: A systematic literature review was conducted, including 20 scientific articles analyzed with thematic analysis. Results: A total of nine themes were identified: mental distress in HCW, SARS-CoV-2 pandemic, mental health interventions, quality of care, safety culture, workplace-based approaches, mindfulness and art activity approaches, biomarker-based approaches as well as technology approaches. Important findings in this literature review are the themes safety culture and quality of care being associated with the other themes. Conclusion: When implementing approaches in mental health interventions for HCW that promote safety culture and quality of care, it also promotes, according to the findings in this review, long-term effects in individual mental health in HCW. This should be urgently taken into consideration by those developing new mental health promotion programs to support HCW in the effects of the pandemic.

This research takes an autoethnographical approach to exploring the connections between being a nurse, doing nursing work, and experiencing a mental illness. Data is comprised of autoethnographical stories from 18 nurses. Drawing on Lyotard’s (1988) postmodern philosophy of ‘regimes of phrases’ and ‘genres of discourse,’ the nurses’ stories yielded three motifs: Nursing, Tangata Whaiora (people seeking wellness) and Bullying. Motifs are recurring topical, emotional and contextual patterns which have been created in this research by means of the formation of collective stories from the content of the nurses’ stories, artwork, fictional vignettes and poetry. Interpretation of the motifs was undertaken by identifying and exploring connected or dissenting aspects within and between the motifs. Using Fine’s (1994) notion of hyphenated lives, the spaces between these aspects were conceptualised as hyphens. The Nursing motif revealed a hyphen between the notion of the nurses as selfless and tireless carers, and the mastery requirements of professionalism. The nurses’ hope for caring, belonging, expertise and ‘goodness’ were also features of the nursing motif. The Tangata Whaiora motif revealed the hyphen between being a compliant patient and a self-determined person seeking wellness, and also foreshadowed the notion that the nursing identity does not ‘permit’ the dual identities of nurse and tangata whaiora. This research has found that nurses who have experienced, or are vulnerable to, mental illness negotiate a nexus of hyphens between societal, professional and personal expectations of the nurse. Ongoing unsuccessful negotiation of their identities is exhausting and leads to enduring distress. At times, negotiation is not possible and the nurse is immobilised in a differend of silence and injustice. At such times, the only resolution possible for the nurse is to leave the nursing profession. Bullying surfaced as a feature of the hyphen between the nursing and tangata whaiora identities, as well as being a part of each identity as colonising, silencing and/or discriminatory acts. Successful negotiation between and among the nursing and tangata whaiora hyphens requires a radical restructuring of the nursing image and culture across the education, workplace and personal/clinical areas. Three strategies are proposed for the discipline of nursing to achieve this change: transformatory education, a conscientisation programme, and mandatory emancipatory clinical supervision.