Mental health issues have been the primary focus of much of the health research concerning lesbian, gay, and bisexual (LGB) individuals over the previous decade. Studies have demonstrated that LGB individuals experience psychological distress due to prejudice and discrimination (Lewis, Derlega, Berndt, Morris, & Rose, 2002; Meyer, Schwartz, & Frost, 2008; Rostosky, Riggle, Horne, & Miller, 2009). Health researchers have not given the physical health of LGB individuals the same level of attention (Dibble, Eliason, & Christiansen, 2007). The Gay and Lesbian Medical Association (GLMA; 2001) asserted that little was known about LGB physical health disparities and called for more research in this area. However, the Institute of Medicine (2011) showed that comparatively little is known about LGB physical health. There is growing evidence from population-based studies that LGB individuals may be at greater risk than heterosexuals for many physical health conditions (Cochran & Mays, 2007; Dilley, Simmons, Boysun, Pizacani, & Stark, 2010; Sandfort, Bakker, Schellevis, & Vanwesenbeeck, 2009). Many of these studies (e.g., Cochran & Mays, 2007; Sandfort et al., 2009) referred to the stigmatization of LGB individuals; however, none of these studies empirically explored the relation between stigmatization and physical health in LGB individuals. The goal of this study was to test the utility of Meyer’s (2003) minority stress model as a means of explaining the physical health of LGB individuals in the context of a heterosexist society. This study investigated empirical questions about minority stress factors, physical health, and coping self-efficacy (CSE) of LGB individuals. Five-hundred fifteen LGBidentified adult participants (n = 222 women and n = 293 men) were recruited to complete a web-based survey. Participants were primarily recruited through online forums sponsored by LGB-affirming organizations. Results indicated that higher expectations of rejection based on sexual identity, internalized homonegativity, and LGBbased victimization predicted greater reported physical symptoms severity (PSS). CSE fully mediated the relation between expectation of rejection and physical symptom severity and internalized homonegativity and PSS. CSE partially mediated the relation between victimization and PSS. The document proposed several clinical and systemic interventions that may benefit physical health in LGB individuals.

Higher education institutions in South Africa are undergoing transformation because of increasing student numbers, government and the private sector relying on tertiary institutions to assist in solving problems in addition to the globalisation of knowledge. University staff is continuously faced major changes. Immense pressure is placed on academic institutions, including support staff. Support staff are constantly faced with increasing job demands and decreasing job resources. This imbalance and the increase of job stress over a prolonged period of time can lead to the devastating result of burnout. The objective of this study was to investigate the relationship between task characteristics, burnout, health and life satisfaction in a higher education institution in the North West Province. A cross-sectional design was used. The study population (N=334) consisted of support staff members of higher education institutions in the North West Province. The Job Demands-Resources Scale (JDRS), The Maslach Burnout Inventory - GS (MBI-GS), the Health subscale of the ASSET and The Satisfaction with Life Scale (SWLS) were used as measuring instruments. Descriptive statistics (for example, means, standard deviations and kurtosis) were used to analyse the data. Pearson correlations and multiple regression analyses were used to assess the relationships between job demands, job resources, burnout, physical health, psychological health and life satisfaction. The correlation coefficients indicated that exhaustion was positively related to psychological ill-health. Cynicism correlated negatively with growth opportunities. Multiple regression analysis showed that overload and growth opportunities predicted 26% of the variance for exhaustion and 29% of the variance in cynicism. Exhaustion predicted 24% of the variance for physical ill-health and 37% of the variance for psychological ill-health. Psychological ill-health predicted 16% of the variance of life satisfaction. Recommendations for future research and the organisation were made. / Thesis (M.A. (Industrial Psychology))--North-West University, Potchefstroom Campus, 2007.

Background: As psychosis is often a lifelong disorder, improved health-related quality of life (HRQoL) can be a relevant treatment goal. Persons with psychosis have significantly reduced physical health. Research has demonstrated a great excess of mortality due to cardiovascular diseases, as psychosis may lead to an inactive lifestyle and difficulties making healthy lifestyle choices. Metabolic side effects of second-generation antipsychotics are also common. Many are therefore affected by the metabolic syndrome. The overall situation calls for action by developing health promotion interventions suitable for this group. In recent years, there has been an increased interest in the physical health of persons with psychosis. However, efforts have not been optimally tailored to the needs of this group, and health care services have not done enough, despite being aware of the problem. Aim: The general aim of this thesis was to study HRQoL, and metabolic risk factors in persons with psychosis, and by a health promotion intervention and through the participants’ own perspective contribute to an improvement in lifestyle interventions. Methods: Study 1 had a cross-sectional cohort study design that was carried out in specialised psychiatric outpatient departments in Sweden. The patients (n=903) were diagnosed with a psychotic disorder and invited consecutively to participate. A prospective population-based study of public health in the south-east of Sweden (n=7238) served as reference group. Patients were assessed using psychiatric questionnaires, including the Global Assessment of Functioning (GAF). Health-related quality of life was assessed using the EQ5D, both for patients and the population. Several other health status outcomes relevant to the metabolic syndrome were measured, together with lifestyle habits and clinical characteristics. Study II, III and IV were based on a lifestyle intervention for persons with psychosis. Study II was a longitudinal intervention study with a matched reference sample. The purpose of the lifestyle intervention  was to promote a healthier lifestyle by combining theoretical education with physical activities. The intervention group consisted of 42 participants. A matching procedure was made in which two individuals per participant were matched (n=84) into a reference group. The reference sample was matched for sex, BMI class, and being of as similar an age as possible. Socio-demographics were collected and metabolic risk factors relevant to the metabolic syndrome were measured. Symptom severity was measured using Clinical Global Impression (CGI), and HRQoL was assessed using EQ5D. Measurements were made at baseline and at a one-year follow-up. In study III, a qualitative exploratory study was conducted in order to explore prerequisites for a healthy lifestyle. Data were collected through individual interviews (n=40), using a semi-structured interview guide with participants who had undergone the lifestyle intervention. Data were collected 6–7 months after the intervention had been completed. Conventional content analysis was used. Study IV was also based on these 40 interviews and aimed to describe how persons with psychosis perceive participation in a lifestyle intervention. A phenomenographic analysis approach was used. Results/conclusions: Persons with psychosis are at great additional risk of physical comorbidity. Almost half of the patients met the criteria for metabolic syndrome. In addition, persons with psychosis had significantly lower HRQoL in all dimensions in the EQ5D, except for the pain/discomfort dimension. The only risk factor included in the metabolic syndrome that was associated with lower HRQoL was elevated blood pressure. Raised LDL-cholesterol was also related to lower HRQoL, together with low GAF, older age, high BMI, and female gender. The intervention study demonstrated that HRQoL was significantly improved in the intervention group when comparing EQ-VAS at baseline and at the one-year follow-up. It can be concluded that our intervention was not powerful enough to influence the metabolic factors to any greater extent. The key prerequisite for a healthy lifestyle seemed to be a wish to take part in the society and a longing to live like everybody else. However, many became stuck in a constant state of planning instead of taking action towards achieving a healthy lifestyle. Support by health care professionals is therefore also a prerequisite for a healthy lifestyle. This support should target the transition from thought to action and facilitate the participants’ ability to mirror themselves against healthy people in society by introducing activities they perceive that “common people” do. The challenge for health care professionals is to find a moderate intervention level that does not underestimate or overestimate the person’s capacity. This can facilitate continued participation, and participants can thereby find new social contacts and achieve health benefits.

A multivariate model of health self-perceptions was postulated based upon a comprehensive set of health related variables suggested by previous bivariate research. Components of the model included measures of health attitudes, health practices, health locus of control, a measure of stress/ coping, and a physical health measure. A stratified random sampling technique was used to select 10 8 subjects based upon the external measure of physical health which included categories ranging from disability-severe to symptom free-high energy level. All subjects completed a health questionnaire comprised of measures of the model components, two measures of health self-perceptions, and the Health Resource Task, an author designed instrument measuring a subject's ability to generate flexible health alternatives/resources. Bivariate correlational analysis revealed that the physical health, stress/coping, health practices, and locus of control measures and certain of the health attitude subscales were significantly correlated to general health self-ratings. A multivariate model including these variables accounted for almost 50 percent of the variance in one of the general health self-ratings measures and approximately 38 percent of the variance in the Health Resource Task. Suggestions for refining the proposed model were made.

Evidence suggests that child behavior, parent mental health, parent supervision, and home environment conditions impact a child’s risk of injury. Vulnerable families are at greater risk for the occurrence of child behavior problems, poor health, decreased supervision, and hazardous home conditions. Consistent with a model that proposes that parent, child, and environment factors interact within the lens of sociocultural factors to predict injury, the current study aimed to test a statistical model with maternal physical health and child externalizing behaviors as predictors of child injury, and home hazards and supervision as mediators of these relations. Analyses were conducted using a nationally representative sample of 3,288 vulnerable mother-child dyads. Results showed significant relations between parent physical health and child injury, and child aggression and child injury, though home hazards and supervision did not mediate either of these relations. Further research should continue to examine the mechanisms of action in the parent health- child injury relation so that injury prevention interventions can be developed.

Thesis advisor: Janet E. Helms / Previous theory and research on Asian American/Pacific Islanders' (AAPI) racism experiences indicate that anti-AAPI racism is stressful and related to increased physical and psychological symptoms when the two types of symptoms have been investigated as separate constructs. However, cultural models of AAPIs' health postulate that AAPIs experience distress as interrelated physical and psychological symptoms, but no studies have explored whether racism experiences are similarly related to increases in both physical and psychological symptoms. Also, few studies of AAPI health and racism have included racial identity schemas as psychological constructs that potentially interact with experiences of self-reported anti-Asian racism and health symptoms. To better understand how racism experiences, racial identity, and physical and psychological health are related, the present study examined relationships among frequent and distressing anti-AAPI institutional, cultural, and individual racism experiences, racial identity attitudes, and physical and psychological symptoms. U.S.-born AAPIs of Chinese or Korean heritage (N =203) completed a demographic questionnaire, the People of Color Racial Identity Attitudes Scale (Helms, 2011), the Asian American Race-Related Stress Index (Liang, Li, and Kim, 2004), the Pennebaker Inventory of Limbic Languidness (Pennebaker, 1992), and the Kessler-10 (Kessler et al., 2002). Canonical correlation analyses were used to investigate relationships among the variables. Several patterns were identified. Three patterns were significantly, but not strongly related to being of male gender. They were: (a) frequent and distressing experiences of institutional, cultural, and individual racism experiences were related to increased physical and psychological symptoms; (b) institutional racism experiences were associated with increased levels of Dissonance (racial confusion) and Immersion (own-group idealization); and, (c) high levels of Dissonance and low levels of Internalization were related to more psychological and fewer physical symptoms and being of male gender. One pattern was significantly, but not strongly related to being of female gender, wherein high levels of both Dissonance and Immersion were related to increased levels of physical and psychological symptoms. Finally, one pattern was related to being of Chinese ethnicity, wherein cultural racism experiences were associated with high Conformity (White cultural orientation) and Dissonance. Results were discussed with respect to how researchers can assess racism and racial identity-related distress more accurately by using holistic health measures. Methodological limitations of the study and implications for research and practice are discussed. / Thesis (PhD) — Boston College, 2013. / Submitted to: Boston College. Lynch School of Education. / Discipline: Counseling, Developmental, and Educational Psychology.

Survivors of adolescent and young adult (AYA) cancer endure a range of symptoms and side effects, including weight gain, unfavourable changes in body composition, physical disfigurements, and tissue damage, which can impair their physical and psychological health. Identifying and optimizing interventions that can mitigate negative side effects are necessary. Whereas physical activity has been identified as one such intervention for child and older adult cancer survivors, the evidence for survivors of AYA cancer is far less convincing to put forward recommendations and argue for integrating physical activity into practice. Research seeking to understand if/how and under what circumstances physical activity is related to physical and psychological outcomes is of particular importance to guide care aimed at relieving cancer-related damage and distress. This research program sought to address this through three interrelated studies, which progressed sequentially. Study One examined the clarity, appropriateness, and relevancy of eight widely used questionnaires assessing self-reported physical activity and psychological outcomes. Cognitive interviews were conducted with seven survivors of AYA cancer who were representative of individuals likely to participate in future research. Findings from this study indicated most of the questionnaires tested could be used to assess self-reported physical activity and psychological outcomes among survivors of AYA cancer with or without slight modifications. After incorporating participants’ feedback into the questionnaires, Study Two was conducted to: (1) examine the cross-sectional relationships between physical self-perceptions and self-esteem (physical and global), and (2) explore if physical activity and/or self-efficacy for physical activity moderated these relationships. Correlation analyses were conducted, and as hypothesized, physical self-perceptions and physical and global self-esteem were positively related. Hierarchical multivariate linear regression analyses showed that self-efficacy for physical activity moderated the relationship between physical self-perceptions and physical self-esteem (but not global self-esteem), such that at higher levels of self-efficacy for physical activity, the magnitude of the association between physical self-perceptions and physical self-esteem was greater. Physical activity did not moderate the relationship between physical self-perceptions and physical or global self-esteem. These findings provide empirical evidence that physical self-perceptions and self-esteem (physical and global) are related and suggest self-efficacy for physical activity may serve to strengthen the relationship between physical self-perceptions and physical self-esteem among survivors of AYA cancer. However, more work exploring if/how and under what circumstances physical activity is implicated in this relationship is needed via experimental study designs. In Study Three, a two-arm, mixed-methods randomized controlled trial (RCT) designed to test a 12-week physical activity intervention among survivors of AYA cancer was piloted. The objectives of this study were to assess the feasibility and acceptability of trial methods and the intervention. Findings suggest modifications to the methods and intervention are required. Making the trial multi-site, using multiple recruitment strategies, refining assessments of directly-measured physical activity behaviour and aerobic capacity, and incorporating behavioural support into the intervention may improve feasibility and acceptability. This study highlights the value of pilot trials and provides useful data that can be used to optimize trial methods and physical activity interventions for this population. Collectively, the studies comprising this thesis lay the foundation for further testing of if/how and under what circumstances physical activity and physical and psychological outcomes are related in survivors of AYA cancer. Findings offer researchers and practitioners information to aid in the development of theoretically- and empirically-based interventions seeking to mitigate the adverse effects of cancer and its treatments in this population.

There is a dearth of literature on the experiences of people with physical health conditions who make disability benefit claims and live as a benefit claimant, particularly since the recent and ongoing changes to the benefits system in the UK. This research aimed to explore the social processes that impact on people with a physical health condition who have experienced a loss of or change in disability benefits, particularly in relation to their identity and their relationships with society. In-depth interviews were conducted with fifteen people with physical health conditions or disabilities. Data was analysed using Grounded Theory methods and a theoretical model was co-constructed. Participants experienced the benefits system as dehumanising, and felt that they lived in a judgemental society, where they were perceived as 'scroungers' and faced discrimination from others. These experiences negatively affected their mental and physical health and wellbeing. Participants often internalised the stigma surrounding disability benefit claimants and they attempted to resist this in order to maintain a preferred sense of self. The findings demonstrate the significant impact of benefit changes on wellbeing and identity. The research highlights important implications for Psychologists, as well as staff in healthcare, the benefits system, and government.

År 2008 var 43 miljoner barn under fem år diagnostiserade med fetma. Fetma anses som en kronisk/långvarig sjukdom och ett folkhälsoproblem med behov av förebyggande arbete för att förhindra framtida konsekvenser. För beräkning av kroppsfett används Body Mass index (BMI). BMI är det mått som används världen runt och räknas genom att dividera kroppsvikt i kilogram med längd i meter i kvadrat. Att ungdomarna drabbas av fetma beror främst på dåliga matvanor, obegränsad tillgång till kalorier i form av kolhydrater och fett ofta i kombination med mindre fysisk aktivitet. Detta kan leda till uppkomst av andra sjukdomar exempelvis diabetes och hjärtkärlsjukdomar längre fram i livet. Syftet med studien är att beskriva barn och ungdomars upplevelse av att leva i en överviktig kropp, samt att belysa föräldrars medverkan till och påverkan på ungdomarnas viktproblem. Metoden som användes är en kvalitativ litteraturstudie genom analys av flera artiklar. Artiklarna söktes i Cinahl och Pubmed databaser och 11 kvalitativa artiklar granskades enligt Fribergs (2006) modell. Vårt resultat kan sammanfattas i två huvudteman Upplevelsen av egna kroppen och Föräldrars medverkan. Subteman i första temat är: Konsekvenser av övervikt – mobbning; Vikten av fysisk aktivitet; Välbefinnande och Brist på stöd. Andra temats subteman är: Att vara en bra förebild; Socioekonomiska hinder och kulturella skillnader och Skuldkänslor. I diskussionen beskrivs kroppens betydelse på barn och ungdomars självkänsla. Föräldrarnas stöd är väsentligt i kampen mot fetman. Fokus ska inte bara läggas på barnen utan på familjen som helhet. För att kunna förebygga utvecklingen av övervikt och fetma hos barn och ungdomar behöver närstående mer kunskap och information. / Program: Sjuksköterskeutbildning

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