Bakgrund: Många arbetsmiljöproblem kretsar kring psykosociala faktorer. Relationen mellan krav, kontroll och socialt stöd har betydelse för hälsan. Riskökning för psykiskt lidande ses när både lågt socialt stöd och låg kontroll upplevs. Arbetstid och bristande kontroll har visat samband med bl.a. gastrointestinala problem och sömnstörningar. Brandpersonal har ett farligt yrke och inom brandmannayrket finns många stressorer som påverkar hälsan. Få studier finns gällande brandpersonals upplevelse av krav, kontroll och stöd kopplat till stressrelaterade symtom i arbetet. Det är betydelsefullt att undersöka förekomst av detta, då ohälsa kan få konsekvenser för individen, arbetsgruppen och hela samhället. Syfte: Kartlägga förekomst av stressrelaterade symtom och samband med krav, kontroll och socialt stöd hos brandpersonal i Sverige. Metod: Studien var en del av en tvärsnittsundersökning gällande brandpersonals hälsa där 476 personer deltog. Korrelationsanalyser med Spearmans korrelationskofficient utfördes. Resultat: Låg förekomst av sömn- och magbesvär sågs hos brandpersonalen. Samband påvisades där krav och socialt stöd korrelerade med sömnbesvär och magbesvär. Sömnbesvär och magbesvär korrelerade signifikant. Kön korrelerade med magbesvär. Konklusion: Förekomsten av mag- och sömnbesvär var låg och deltagarna mådde relativt bra. Vidare forskning kring friskfaktorer hos brandpersonal samt fler studier med andra variabler jämfört med krav, kontroll och stöd behövs. / Background: Many health and safety problems revolve around psychosocial factors. The relationship between demand, control and social support affect our health. Increased risk for mental suffering exists when low social support and low control is experienced. Working hours and lack of control can be associated with gastrointestinal- and sleeping problems. Firefighters have a dangerous occupation and many stressors affect the firefighter´s health. Few studies have investigated demand, control and support linked to stress-related symptoms at work for firefighters, it is important to investigate this though it may affect the individual, workgroup and society. Purpose: Identify occurrence of stress related symptoms and their relationship with demand, control and social support in Swedish firefighters. Method: The study was part of a cross-sectional study of firefighter's health, 476 people attended. Correlation analyzes with Spearman's korrelationskofficiens was performed. Results: Low prevalence of sleep- and stomach problems was seen. Correlation was found where demand and social support correlated with sleep- and stomach problems. Sleep- and stomach problems correlated significantly. Gender and stomach problems also correlated. Conclusion: The incidence of sleep- and stomach problems was low and participants felt relatively good. Further research on health factors of firefighters and more studies with other variables compared with demand, control and support is needed.

The ETSU dental hygiene program is very competitive and rigorous for those admitted. Student dental hygienists may experience higher levels of anxiety and more stressors while completing their course work and clinical hours than they have previously experienced in general education and prerequisite courses. These increased number of stressors and higher levels of anxiety may have negative impacts on students’ academic performance and success in clinical learning environments. A better understanding of the actual need for a stress reduction and anxiety management curriculum will facilitate creating and implementing this type of curriculum. A total of 44 current ETSU dental hygiene students were included in the study, juniors (55%) and (45%) seniors. Nearly all respondents reported their current stress and anxiety levels are affecting their lives (97.5%). Consistently over a third of students who completed surveys from the ETSU dental hygiene program are experiencing physical symptoms of stress and anxiety including headaches, gastrointestinal distress, trouble sleeping, eating too much or too little daily, tense muscles, worry or phobias, anger or hostility, irritability or hostility, and nervousness 2-3 times a week. The average stress level of the 44 ETSU dental hygiene students reported on a 1-10 scale was a 7.65. Nearly half (40%) of all ETSU dental hygiene students currently enrolled reported their stress level as 8 out of 10 with 10 defined as “I can only think of my stress and anxiety”. Further research including an educational intervention to help teach students skills and coping mechanisms to manage and reduce stress and anxiety was recommended.

Bakgrund En stor del av de patienter som frekvent söker vård lider av psykosomatiska sjukdomar (MUPS) och somatiseringssyndrom (MUS). Båda dessa tillstånd grundar sig i psykiska påfrestningar men yttrar sig i form av fysiska symptom. Stress är en psykisk påfrestning som är mycket utbredd i vårt samhälle idag. När människan utsätts för stress startar en rad olika fysiska processer i kroppen, som en del av vår överlevnadsinstinkt. Trots det är det många som stressar sig sjuka. Då kroppen inte får chans till återhämtning ökar risken för ohälsa med risk för psykosomatiska sjukdomar och somatiseringssyndrom som följd. Syfte Studiens syfte var att belysa upplevelser hos patienter med psykosomatiska sjukdomar och somatiseringssyndrom i den somatiska vården. Metod En litteraturöversikt valdes som metod, där 16 artiklar inkluderades. Artiklarna var av kvantitativ eller kvalitativ metod och analyserades enligt metoden integrerad analys. Resultat Patienter med MUPS/MUS lider av ohälsa och remitteras runt till olika vårdenheter utan att få den hjälp de behöver. Detta innebär ytterligare påfrestning på hälsan hos dessa patienter. Starka känslor såsom utanförskap, oro, skam och rädsla för sin egna ohälsan genomsyrar dessa patienters upplevelser. Kunskapen för dessa sjukdomstillstånd är bristfällig och det saknas tydliga riktlinjer och behandlingsmetoder inom vården. Slutsats Stigmatisering kring psykisk ohälsa skapar skam och utanförskap, vilket patienter med MUPS/MUS i stor utsträckning upplever. Bristande kunskap har visat på ineffektiv behandling vilket dessutom medför enorma kostnad för samhället. Sambandet mellan kropp och själ får inte förbises. Sjukvårdspersonal bör därför utbildas i att se den psykologiska faktorn bakom de fysiologiska symptomen. / Background A large proportion of patients who frequently seek health care suffer from psychophysiologic disorders (MUPS) and somatoform disorders (MUS). Both of these conditions derive from mental illness yet they manifest as physical symptoms. Stress is a psychological phenomenon which is widely spread in our society today. When a person is exposed to stress, a variety of physical reactions commence within our body, due to our survival instinct. In spite of this, a lot of people become physically and mentally ill from stress. When our body is deprived of recovery, there is a higher probability for lack of health and therefore the risk of developing psychophysiologic disorder and somatoform syndromes increases. Aim The purpose of the study was to illuminate patients with psychophysiologic disorders and somatoform disorders and their experiences within the somatic healthcare. Method A literature review has been conducted with an including total of 16 articles. The chosen articles consisted of quantitative or qualitative methods, analyzed according to the integrated analysis method. Results Patients with MUPS/MUS suffer from lack of health and are often referred to various care units without getting the help they need. This leads to further distress with a decreased health experience. Strong emotions such as exclusion, anxiety, shame and fear of lacking health permeate these patients' experiences. The knowledge regarding these conditions are insufficient and no distinct guidelines nor clear treatments exist within the healthcare system. Conclusions The stigmatization regarding mental illness leads to feelings of shame and exclusion for these patients. The lack of knowledge leads to ineffective treatment, which also entails an increased economic burden for the society. The relationship between the body and the soul must not be overlooked. Healthcare professionals need to be educated in the ability to recognize the underlying psychological factors behind the physiological symptoms.

ANTECEDENTES: Sintomas somatoformes são freqüentes e estão associados com sofrimento mental na população geral e em diversos níveis de atenção. Grande parte da interações que subjazem a estas associações são pouco conhecidas ou mesmo desconhecidas. OBJETIVOS E MÉTODOS: A partir de revisão bibliográfica, investigar: a) a história dos quadros clínicos de somatização; b) suas diversas categorias segundo conceitos contemporâneos psiquiátricos e não-psiquiátricos (transtornos somatoformes, transtornos dissociativos-conversivos, síndrome da fadiga crônica, fibromialgia, síndrome do cólon irritável etc.); c) fatores associados e hipóteses etiológicas para estes fenômenos. Através de dados provenientes do Estudo de Área de Captação do Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (Andrade et al., 1994) - um estudo transversal de morbidade física e psiquiátrica que entrevistou uma amostra representativa dos bairros paulistanos de Vila Madalena e Jardim América - explorar a prevalência e classificação de sintomas físicos relatados, em especial aqueles sem explicação médica (SEM). Avaliar através de regressão logística as associações entre: a) síndromes somatoformes e variáveis demográficas; b) síndromes somatoformes e uso de medicamentos e serviços de saúde; c) sintomas físicos de qualquer tipo (QT) e SEM com variáveis demográficas; e d) sintomas físicos QT e SEM com transtornos mentais. Pesquisar, através de análise de classes latentes de respostas dicotômicas para a presença ou não de 36 sintomas físicos SEM: a) agrupamento de indivíduos em classes (análise de aglomeração, ou cluster); e b) agrupamento de sintomas em dimensões (análise fatorial). Foram realizadas 1.464 entrevistas com o Composite International Diagnostic Interview (CIDI), entrevista estruturada diagnóstica para transtornos mentais, incluindo transtornos somatofomes e dissociativos; e um caderno de variáveis demográficas, doenças físicas crônicas, uso de serviços médicos ou psicológico e consumo de medicamentos. RESULTADOS: Ausência de associação entre síndomes somatoformes e variáveis demográficas. Associação entre síndromes somatoformes e maior uso de serviços de saúde e de medicamentos. Associação de características demográficas com certos sintomas físicos QT e SEM. Sintomas físicos QT e SEM estão associados com transtornos mentais de uma forma geral. Alguns sintomas físicos (desmaios, dispnéia, dores no peito, dores nos membros, formigamento, metrorragia, fraqueza muscular, nó na garganta, poliúria, taquicardia e tonturas) encontram-se associados com vários dos transtornos mentais testados. Os indivíduos se aglomeraram em duas classes, uma pauci- e outra polissintomática; a classe polissintomática se mostrou associada com doenças físicas, transtornos mentais e uso de serviços de saúde. Os sintomas se agruparam em um único fator, indicando a existência de uma dimensão de somatização na população geral. / BACKGROUND: Somatoform symptoms are frequent and are associated with mental distress in several settings and in the general population. Many of these interactions are not well understood or not understood at all. OBJECTIVE AND METHODS: Based on bibliographical research, to investigate: a) the history of somatization-related illnesses; b) its many categories according to contemporary psychiatric and non-psychiatric concepts (somatoform disorders, dissociative-conversive disorders, chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome etc.); c) associated factors and etiological hypothesis for these phenomena. Using data available from the University of São Paulo Institute of Psychiatry Epidemiologic Catchment Area Study (Andrade et al., 1994) - a cross-sectional survey of physical and psychiatric morbidity which interviewed a representative sample of São Paulo city boroughs of Vila Madalena and Jardim América - to explore the prevalence and classification of reported physical symptoms in general, and specifically those which are medically unexplained (MU). To appraise, using logistic regression, the following associations: a) somatoform syndromes and demographic variables; b) somatoform syndromes and use of medication and health services; c) MU symptom and any type (AT) of symptom with demographic variables; and d) MU and AT physical symptoms with mental disorders. To probe, through latent class analysis of yes or no answers for 36 MU physical symptoms: grouping of subjects in classes (cluster analysis); and b) grouping of symptoms in dimensions (factor analysis). One-thousand, four-hundred and sixty-four interviews were performed using the Composite International Diagnostic Interview (CIDI), structured diagnostic interview for mental disorders, including somatoform and dissociative disorders; and a form of demographic variables, chronic physical diseases, use of medical and psychological services and medication intake. RESULTS: No association between somatoform syndromes and demographic variables. Association between somatoform syndromes and increased use of services and medication intake. Association between demographic variables and certain MU/AT symptoms. Physical symptoms AT/MU are associated with mental disorders, in general. Some physical symptoms (fainting, dyspnea, chest pain, arm or leg pain, tingling, heavy menses, muscle weakness, lump in throat, polyuria, palpitations and dizziness) are associated with many of the studied mental disorders. Subjects were clustered into two classes, with low and high symptom scoring; the high scoring class was associated with physical diseases, mental disorders, use of health services and medication intake. Symptoms were grouped into one single factor, pointing to the existence of a somatization dimension in the general population.

A cross-sectional survey was undertaken to examine the impact of organizational support on work-family conflict experienced by Taiwanese working women. A stress model of work and family interference was applied in the Taiwanese context; the current study examined whether the results of western studies of work-family conflict can be generalised to the Taiwanese population. The enactment of the Gender Equality of Employment Law in Taiwan in 2002 was a further impetus for the research. The study examined the effects of organizational family-friendly policies and cultural support of family responsibilities on work-family conflict and well-being. Women (aged between 15 and 64 years) in paid employment working in three public universities in northern Taiwan formed the sample population for this research. Stratified random sampling by occupation was used to enhance representativeness. The total sample consisted of 441 participants, made up of 288 general staff and 153 academic staff. The data was collected with several tested and widely used instruments (including the Family-Friendly Policies Usage and Satisfaction Questionnaires, Work-Family Culture Questionnaire, Work-Family Conflict Scale, Job Satisfaction Questionnaire, Family Satisfaction Questionnaire, Perceived Stress Scale, and Physical Symptoms Inventory). Descriptive analysis was used to examine demographic variables and all the measures; correlation analysis was used to examine the relationships between selected research variables; T-test, chi-square test and one-way ANOVA were used to characterize the differences between groups. Hierarchical multiple regression was performed to test the research hypotheses. The findings showed that work-family conflict was strongly linked with lower job and family satisfaction, greater stress and more severe physical ailments. Implementing family-friendly policies and creating a supportive work environment can help working women to manage their work-family conflict and improve their health outcomes. A supportive organizational culture has been confirmed by this research as important in preventing the negative consequences of work-family conflict. However, such conflict did not predict the levels of physical symptoms. Employer-supported dependant care policies were not associated with the level of work-family conflict. In addition, organizational cultural support did not predict the usage of family-friendly policies. This study has provided evidence that some relationships could be generalised, across western and Chinese societies, between organizational support and work-family conflict, and between work-family conflict and an individual's well-being, although specificities within each cultural remain and require different methods of assessment. In conclusion, a western theoretical model of work-family conflict was found to be acceptable and feasible to implement within the Taiwanese population, since the majority of the hypotheses were supported. This research provided valuable information for healthcare professionals, policy makers and organizations, presenting ways to help working women to manage the conflicting demands of work and family roles better.

ANTECEDENTES: Sintomas somatoformes são freqüentes e estão associados com sofrimento mental na população geral e em diversos níveis de atenção. Grande parte da interações que subjazem a estas associações são pouco conhecidas ou mesmo desconhecidas. OBJETIVOS E MÉTODOS: A partir de revisão bibliográfica, investigar: a) a história dos quadros clínicos de somatização; b) suas diversas categorias segundo conceitos contemporâneos psiquiátricos e não-psiquiátricos (transtornos somatoformes, transtornos dissociativos-conversivos, síndrome da fadiga crônica, fibromialgia, síndrome do cólon irritável etc.); c) fatores associados e hipóteses etiológicas para estes fenômenos. Através de dados provenientes do Estudo de Área de Captação do Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (Andrade et al., 1994) - um estudo transversal de morbidade física e psiquiátrica que entrevistou uma amostra representativa dos bairros paulistanos de Vila Madalena e Jardim América - explorar a prevalência e classificação de sintomas físicos relatados, em especial aqueles sem explicação médica (SEM). Avaliar através de regressão logística as associações entre: a) síndromes somatoformes e variáveis demográficas; b) síndromes somatoformes e uso de medicamentos e serviços de saúde; c) sintomas físicos de qualquer tipo (QT) e SEM com variáveis demográficas; e d) sintomas físicos QT e SEM com transtornos mentais. Pesquisar, através de análise de classes latentes de respostas dicotômicas para a presença ou não de 36 sintomas físicos SEM: a) agrupamento de indivíduos em classes (análise de aglomeração, ou cluster); e b) agrupamento de sintomas em dimensões (análise fatorial). Foram realizadas 1.464 entrevistas com o Composite International Diagnostic Interview (CIDI), entrevista estruturada diagnóstica para transtornos mentais, incluindo transtornos somatofomes e dissociativos; e um caderno de variáveis demográficas, doenças físicas crônicas, uso de serviços médicos ou psicológico e consumo de medicamentos. RESULTADOS: Ausência de associação entre síndomes somatoformes e variáveis demográficas. Associação entre síndromes somatoformes e maior uso de serviços de saúde e de medicamentos. Associação de características demográficas com certos sintomas físicos QT e SEM. Sintomas físicos QT e SEM estão associados com transtornos mentais de uma forma geral. Alguns sintomas físicos (desmaios, dispnéia, dores no peito, dores nos membros, formigamento, metrorragia, fraqueza muscular, nó na garganta, poliúria, taquicardia e tonturas) encontram-se associados com vários dos transtornos mentais testados. Os indivíduos se aglomeraram em duas classes, uma pauci- e outra polissintomática; a classe polissintomática se mostrou associada com doenças físicas, transtornos mentais e uso de serviços de saúde. Os sintomas se agruparam em um único fator, indicando a existência de uma dimensão de somatização na população geral. / BACKGROUND: Somatoform symptoms are frequent and are associated with mental distress in several settings and in the general population. Many of these interactions are not well understood or not understood at all. OBJECTIVE AND METHODS: Based on bibliographical research, to investigate: a) the history of somatization-related illnesses; b) its many categories according to contemporary psychiatric and non-psychiatric concepts (somatoform disorders, dissociative-conversive disorders, chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome etc.); c) associated factors and etiological hypothesis for these phenomena. Using data available from the University of São Paulo Institute of Psychiatry Epidemiologic Catchment Area Study (Andrade et al., 1994) - a cross-sectional survey of physical and psychiatric morbidity which interviewed a representative sample of São Paulo city boroughs of Vila Madalena and Jardim América - to explore the prevalence and classification of reported physical symptoms in general, and specifically those which are medically unexplained (MU). To appraise, using logistic regression, the following associations: a) somatoform syndromes and demographic variables; b) somatoform syndromes and use of medication and health services; c) MU symptom and any type (AT) of symptom with demographic variables; and d) MU and AT physical symptoms with mental disorders. To probe, through latent class analysis of yes or no answers for 36 MU physical symptoms: grouping of subjects in classes (cluster analysis); and b) grouping of symptoms in dimensions (factor analysis). One-thousand, four-hundred and sixty-four interviews were performed using the Composite International Diagnostic Interview (CIDI), structured diagnostic interview for mental disorders, including somatoform and dissociative disorders; and a form of demographic variables, chronic physical diseases, use of medical and psychological services and medication intake. RESULTS: No association between somatoform syndromes and demographic variables. Association between somatoform syndromes and increased use of services and medication intake. Association between demographic variables and certain MU/AT symptoms. Physical symptoms AT/MU are associated with mental disorders, in general. Some physical symptoms (fainting, dyspnea, chest pain, arm or leg pain, tingling, heavy menses, muscle weakness, lump in throat, polyuria, palpitations and dizziness) are associated with many of the studied mental disorders. Subjects were clustered into two classes, with low and high symptom scoring; the high scoring class was associated with physical diseases, mental disorders, use of health services and medication intake. Symptoms were grouped into one single factor, pointing to the existence of a somatization dimension in the general population.