This study examined the influence of social support on the relationship between posttraumatic stress disorder and comorbid psychopathology, suicidal behaviour, and mental and physical health functioning in the general population. Data came from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) (N=34,653). Results showed a differential impact of posttraumatic stress disorder and social support depending on gender. For men, social support had a moderating effect, where social support had a greater influence on the prevalence of comorbid psychopathology for men with posttraumatic stress disorder compared to those without the disorder. In contrast, social support had an additive effect for women, where social support was associated with decreased psychopathology and posttraumatic stress disorder was associated with increased psychopathology. This study suggests that social support should be included in the treatment of men with posttraumatic stress disorder and encouraged among women regardless of mental disorder diagnosis.

For employees to optimally perform at work, it is important that they are healthy. The employee is under constant work pressures that affects their health behaviour. The aim of this research is to look at the evident health risks of employees working within a financial institution, to analyze how physical activity influences these health risk factors and their medical costs. In this study a sample of 9860 self selected employees, aged between 18 and 64 (35.3 ± 10.7 years), was used. These employees are spread over all the provinces of South Africa and from all racial groupings. Differentiation was made between employees who were on chronic medication and those who were not. The Health Risk Assessment (HRA) questionnaire developed and provided by the medical aid of the institution was used as the analysis tool. Medical expenditures of the sample group were also provided by the medical aid and investigated. A national network of registered Biokineticists administered the implementation of the HRA, based on a set protocol. ANOVA was used for statistical data analysis - providing descriptive and summarising statistics. One-way analysis of variance was used to determine relationships between variables. It is clear from the descriptive data that the tendencies of selected health risks were high. The results also show that 37.6% (Diastolic) and 47.87% (Systolic) of the sample group comply with the normal borders of blood pressure. With regards to BM3, 32.3% were overweight and 25.3% within the boundaries of obesity. The average cholesterol of the group is 4.4mmol.L-l. The Physical activity levels were determined using an activity algorithm developed by the medical aid of the institution (described in detail in the thesis). Results show a low level of physical activity index (7.18 + 3.05) within the sample group. No statistical significance could be found between physical activity levels and medical expenditure, although those who are highly active seemed to have higher expenditure than those who are inactive. / Thesis (M.A. (Human Movement Science))--North-West University, Potchefstroom Campus, 2009.

While it is a presumably accepted fact that rural and farming communities represent an important sector in the life of every nation due to their contribution to food security and nutrition, there is limited available empirical knowledge on their lives. This study intended to explore the health profile of the rural and farming communities in South Africa, and to explore the relationships between the physical and psychological health, the needs and quality of life facets of a specific group of farm workers and to provide guidelines for intervention in the said areas. This objective was achieved through a literature review, empirical study and suggested guidelines for bio psychosocial health promotion. The end product of this study is presented in three separate, but related manuscripts or articles. A holistic conceptual framework was adopted in the literature review and is described in manuscript 1. This overview focused on life on farms and in rural areas through both the social and natural sciences lenses in a parallel and integrative manner. The needs domain was conceptualised in its broad and narrow uses, and health was broadly defined in terms of the World Health Organization's (WHO, 1999:6) conceptualisation. The term "rural" was narrowly described for the purposes of the current study, i.e. according to the typical descriptive aspects of population dynamics, geographic, economic and other social considerations. Although studies from elsewhere in the world were used to provide a clearer picture of rural contexts, the focus was on available local South African literature. The literature review suggested a situation of serious disparities in the lives of the rural communities in comparison to their counterparts living in urbanised settings in South Africa. They suffer poor socioeconomic status, poor access to services, physical infrastructure problems, food insecurity and nutritional problems, physical and mental health problems, and violence and violations of their human rights. Manuscript 2 reports on an empirical, mixed-methods investigation that was conducted on a convenience sample of 52 farm workers (18-60 years) from three farms near Potchefstroom, in the North West Province. All participants completed quantitative measures and interviews were conducted with a random sample of 25 participants. As a conceptual framework, health was defined comprehensively in terms of physical, psychological and social dimensions (World Health Organization, 1999). Psychological well-being was defined on a continuum from symptoms of stress to a focus on strengths, capacities, mental well-being or psychological health (Wissing & Van Eeden, 2002, 1997; Deci & Ryan, 2000; Ryan & Frederick, 1997) and measured with the Sense of Coherence Scale (SOC) Scale (Antonovsky, 1987), the Satisfaction With Life Scale (SWLS) (Diener, Emmons, Larsen & Griffin, 1985), the Affectometer 2 (AFM) (Kammann & Flett, 1983), the General Health Questionnaire (GHQ) (Goldberg & Hiller, 1979) the Need Satisfaction Scale (NSC) (La Guardia et al., 2000), and the Subjective Vitality Scale (SVS) (Ryan & Frederick, 1997). Quality of life was operationalised in terms of the Quality of Life Inventory (QOLI) (Frisch, 1994). Physical health was operationalised in terms of standardised measures of blood pressure heart rate body mass index, waist-hip ratio and a nutritional intake measure, the Quantitative Food Frequency Questionnaire (QFFQ) (Vorster et al. 2000). Participants reported relatively poor states of physical health nutritional deficiencies poor mental health and poor quality of life. In manuscript 3 specific guidelines for the promotion of the bio psychosocial health of farm workers were suggested to address the specific and identified problems in an integrated manner. The guidelines were grouped into operational and administrative/bureaucratic interventions. Recommendations were also made for further exploration of the relationship between the farm workers' context and the bio psychosocial health indicators. Farm workers suffer problems of physical and psychological distress as well as shortages of health care providers, lack of the necessary health infrastructure and other social and physical infrastructure amenities. For successful and sustainable interventions health professionals and health workers, policy makers and bureaucrats, human rights activists and rural/farm employee organisations as well as the broader social movement and other interested/affected parties need to jointly contribute to health programmes aimed at addressing the challenges facing rural communities in general, and farm workers in particular. / Thesis (Ph.D. (Psychology))--North-West University, Potchefstroom Campus, 2009.

Extensive research documents the deleterious effects of being victimized by peers on adolescents’ mental health. In contrast, the impact of peer victimization on physical health remains largely unexplored. Studies suggest that peer victimization is a salient interpersonal stressor for adolescents that interferes with discrete aspects of physical health. However, past studies typically collapse the various forms of victimization together (i.e., physical, relational); examine single health indicators; and fail to test the effects of victimization prospectively. A limited understanding of the nature and course of physical health across adolescence and young adulthood also hinders the existent research. The present study tests the structure, stability, and patterns of change in a multidimensional model of physical health among a large, representative sample of young people across a six-year period and four waves of data. It then examines the concurrent and prospective associations between physical and relational victimization and physical health outcomes (physical symptoms, subjective well-being, health-risk behaviours, and health-promoting behaviours) across adolescence and young adulthood. Data from the Healthy Youth Survey (HYS) were collected four times between 2003 and 2009. Participants were 662 young people (aged 12 to 18 years at Time [T] 1; 342 girls). By T4, participants were 18 to 25 (n = 459). Age at T1 and SES were covariates, and models compared effects for males and females. Latent growth curve modeling was performed. Confirmatory Factor Analysis supported the structure of five distinct health outcomes that were invariant over time and by sex. Univariate latent growth curve modeling established linear patterns of change in each health outcome across time. Peer victimization was examined as a time-varying covariate of health, whereby the repeated victimization measures predicted concurrent and longitudinal health outcomes over and above the average growth trajectory of that outcome. Each time-varying covariate model fit the data well. As expected, physical and relational victimization were associated with poorer physical health both within and across time; however, effects varied by victimization type, by sex, and by health outcome. Relational and physical victimization were associated with more concurrent physical symptoms, but only relational victimization predicted more symptoms at subsequent time points. Relational and physical victimization predicted poorer subjective health and fitness within and across time. Physical victimization was associated with poorer nutrition for the whole sample. Findings suggest that peer victimization puts adolescents at risk of several immediate and long-term physical health difficulties. This study highlights the unique effects of physical and relational victimization and that males and females respond differently to victimization experiences. / Graduate / 0622 / 0620 / ahager23@uvic.ca

Bakgrund: Studier har visat att sjuksköterskor hade bristande kunskap om psykisk hälsa, bristande färdigheter att vårda patienter med självskadebeteende och få eller inga möjligheter att utveckla dessa färdigheter. Sjuksköterskor ansåg att det fanns behov av utbildning och träning inom detta område. Ett holistiskt synsätt innebar att sjuksköterskor ser patienten ur alla perspektiv. Syfte: Syftet var att beskriva hur interventioner påverkar sjuksköterskors bemötande av självskadande och suicidala patienter inom somatisk sjukvård, samt att översiktligt beskriva vilka interventioner som använts. Metod: Litteratursökning gjordes i databaserna PubMed och PsycINFO. 12 vetenskapliga artiklar med kvantitativ, kvalitativ eller mixad design kvalitetsgranskades, analyserades och sammanställdes till en litteraturöversikt. Resultat: Interventionerna påverkade sjuksköterskor genom att de förbättrade bemötandet av suicidala patienter och patienter med självskadebeteende. Attityder, kunskap, förståelse och uppfattning, trygghet och färdigheter förbättrades samt ett behov av fortsatt utbildning sågs efter interventioner. Diskussion: En kombination av flera utbildningsmetoder gav goda resultat. En positiv attityd skapade förtroendeingivande relationer. Kunskap, förståelse och medvetenhet gav bättre förutsättningar för adekvat bemötande. Ett holistiskt synsätt var en förutsättning för en hållbar vård. Slutsats: Litteraturöversikten visade att det framgångsrikt med enkla medel går att förbättra bemötandet av suicidala och patienter med självskadebeteende och därför rekommenderas att alla sjukvårdsavdelningar får möjlighet till en sådan utbildning. / Background: Studies have shown an insufficient knowledge in mental health among nurses. They had a lack of skills in caring for patients who self-harm and suicidal patients and were offered few or no opportunities to develop these skills. Nurses considered a need for education and training in this area. In a holistic view the nurse should see the patient from all perspectives. Aim: The aim was to describe how interventions affect nurses’ caring for suicidal patients and patients who self-harm in physical health care and to give a brief description of these interventions. Method: Articles were searched in the PubMed and PsycINFO databases. Twelve scientific researches with quantitative, qualitative and mixed method where examined, reviewed, analyzed and compiled into a literature review. Results: The interventions affected the nurses by improving their attitude, enhancing their knowledge, understanding, awareness and self-confidence and developing their skills and a need for further education in the caring of suicidal and self-harming patients. Discussion: A combination of interventions gave good results. A positive attitude created confident relationships. Knowledge, understanding and awareness created conditions for an adequate care. A holistic view was essential for a sustainable care. Conclusion: This review showed that the care of self-harming and suicidal patients could be improved with simple means and was therefore recommended to all health care staff.

Bakgrund: Patienter med psykossjukdom har generellt sämre fysisk hälsa än övriga befolkningen till följd av symtom av psykossjukdomen, livstilsvanor delvis relaterat till symtomen och biverkningar av antipsykotisk läkemedelsbehandling. Forskning styrker detta dock har hälso- och sjukvården inte lyckats hjälpa patientgruppen på ett tillfredsställande sätt. Tidigare studier tyder på att sjuksköterskor inom psykosvården är medvetna om problemet men uppfattningar rörande hur omvårdnadsarbetet ska se ut skiljer sig. Syfte: Syfte med föreliggande studie är att beskriva specialistsjuksköterskors uppfattningar om fysisk hälsa hos patienter med psykossjukdom. Ytterligare syfte är att beskriva det hälsofrämjande arbetet som utförs samt specialistsjuksköterskornas uppfattningar om detta arbete. Metod: Strukturerade intervjuer gjordes med sex sjuksköterskor på fem öppenvårdsmottagningar i tre sjukvårdsområden i Stockholm. Informanterna hade arbetat på nuvarande mottagning i minst ett år och var specialistutbildade i psykiatrisk omvårdnad. Kvalitativ innehållsanalys valdes som metod vid analysen av materialet. Resultat: Sjuksköterskorna hade kunskap och medvetenhet om patientgruppen som riskgrupp. På samtliga mottagningar fanns rutiner och riktlinjer för arbetet med patienters fysiska hälsa men inte tillräckligt med resurser för att arbeta utifrån dessa på ett tillfredsställande sätt. Sjuksköterskorna efterlyste mer tid och personal för detta arbete samt ett bättre samarbete med den övriga vården. Diskussion: Studiens resultat ställs mot tidigare forskning och mot den personcentrerade omvårdnadsteorin enligt McCormack och McCance, där teorin hjälper till att förklara resultatet utifrån en vårdrelation patient och sjuksköterska emellan. / Background: Patients with psychosis generally have poorer physical health than the general population due to symptoms of psychosis disease; lifestyle habits partly related to symptoms and side effects of antipsychotic drug treatment, which is confirmed by research. Health care has, however, failed to assist these patients in a satisfactory manner. Previous studies suggest that nurses in psychosis care are aware of the problem although beliefs regarding how nursing should be organized differ. Aim: The aims of this study are to describe the specialist nurses' perceptions of physical health in patients with psychosis. A further aim is to describe the health promotion work done and furthermore specialist nurses' perceptions about this work. Methods: Structured interviews were conducted with six nurses at five outpatient clinics in three health regions in Stockholm. The informants had worked at the present clinic at least for one year and were specialized in psychiatric nursing. The method chosen for analysis of the material was Qualitative content analysis. Resultats: The nurses had knowledge and awareness of the patient group as a risk group. At all clinics there were procedures and guidelines for working with patients' physical health, but not enough resources to adhere on these in a satisfactory manner. The nurses asked for more time and personnel for this work and a better collaboration with other health care clinics. Discussions: The results of the study was compared to previous research and to the person-centered nursing theory according to McCormack and McCance, where the theory helps to explain the results from a healthcare relationship between patient and nurse.

The findings of this PhD provide a significant contribution to early intervention research. The ability to detect those at ultra-high risk for psychosis (UHR) has been made possible in recent years. It is well known that people with serious mental illness have poor physical health, yet prior to this PhD little was known about the physical health of UHR individuals. This PhD explores the physical health and lifestyle of the UHR group, and makes recommendations for the development of a physical health intervention. A range of methods have been used including quantitative and qualitative methods, systematic reviews and meta-analyses, and a clinical audit. Therefore, a multifaceted approach to investigate the physical health and lifestyle of UHR individuals has been taken. Papers 1-3 suggest UHR individuals are more likely to live an unhealthy lifestyle than their peers. This includes lower levels of physical activity, and higher levels of substance use (generally cannabis, tobacco and alcohol). Paper 4 contains a clinical audit showing physical health and lifestyle factors are not monitored routinely in early detection services, despite the UHR phase being an ideal opportunity to intervene. Living an unhealthy lifestyle can have a detrimental effect on physical and mental health. Papers 1-4 emphasise the need to intervene to promote a healthy lifestyle for the UHR group. In line with the Medical Research Guidelines for the development of complex interventions, a theoretical model is applied in Paper 5. The final paper presents a qualitative study with UHR individuals, their parents and clinicians to explore barriers and facilitators to living a healthy lifestyle and inform the development of a physical health intervention. A final evidence synthesis includes recommendations for future work and the clinical implications of this thesis. The findings of this PhD provide an important and timely contribution to early intervention research. Prior to this work, the physical health of UHR individuals had been largely under researched. For the first time, this PhD presents evidence to suggest individuals at ultra-high risk for psychosis experience cardiovascular risk, and there is an opportunity to intervene to promote physical health. Although not all UHR individuals will develop psychosis, many will continue to experience difficulties with their mental health. Given that this group are also more likely to live an unhealthy lifestyle, it is important to take a holistic approach to treating those at imminent risk for psychosis, considering both mental and physical health.

There is a plethora of research circulating in the academic word related to Indigenous hunters and how industrial development is affecting their traditional lifestyles; of particular concern are the toxic exposures derived from these industrial activities as well as the effects these are having on animal and human health. However, relatively little research exists on the ways in which non-Indigenous hunters are being impacted by and perceive the environmental risks posed by industrial activities (i.e., mining contaminants). The purpose of this study was two-fold: to investigate whether there is a relationship between hunting practices of non-Indigenous hunters and their health status and personal wellbeing as well as examining how the perception of environmental risk associated with mining contaminants might affect the hunting practices, health and wellbeing of non-Indigenous hunters living in northeastern Ontario communities. The study involved survey questionnaires that were distributed in four northeastern Ontario communities (Onaping Falls, Porcupine, Wawa, and Hearst) where a total of 390 hunters, non-hunters, and former hunters voluntarily participated. Findings from this study indicated a few relationships between hunting practice variables (discarding/giving away animals and hunting near mine or tailings sites) and general health, physical health, and physical health readiness variables but no relationships with personal wellbeing. Furthermore, significant associations were found between two hunting practice variables (hunting near mine tailings and discarding/giving away hunted animals) and the two risk perception variables. In addition, worrying about mining contaminants was significantly associated with reduced levels of mental health and personal wellbeing. Despite the significant associations, few hunters took actions as a result of their concern or worry over mining contaminants although it must be noted that only a minority of hunters always or very frequently hunted near mine or tailings sites. Either hunters did not perceive the risks as being high or they merely have a high risk tolerance. Further research is required to delve deeper into the issues explored in this research study.

abstract: The purpose of this constructivist grounded theory study was to explore the perceptions of adult female sexual assault victims/survivors about their wellbeing: their definitions and descriptions of wellbeing; the impact of the assault on wellbeing; and barriers and facilitators to achieving wellbeing following assault. Feminist theory provided the sensitizing concepts for this research. Data were collected via semistructured interviews with 22 adult women who had experienced at least one episode of sexual assault at or above the age of 18. Data analysis included first, second, and third level coding techniques, memo writing, and data displays. Participants experienced negative effects to their overall wellbeing as well as to the wellbeing domains of physical, mental, career/economic/financial, relational, and spiritual. The findings of this study support wellbeing as a core category encompassing the five domains listed above, also described in the literature. The participants also confirmed and expounded in depth on the dynamic, interactive, and overlapping nature of each of the domains of wellbeing and their ability to enhance, maintain, or worsen health status and overall wellbeing. In addition, a new construct emerged that cut across all domains, that of safety, and the overarching significance of culture was recognized. Additional research should continue to explore wellbeing in diverse populations of sexual assault victims/survivors. Additional research should also explore the significance and function of safety in sexual assault victims/survivors. Formal and informal supporters of sexual assault victims/survivors should be aware of the complex ways that sexual assault affects women. In addition, they should be aware of helpful resources for sexual assault victims/survivors. / Dissertation/Thesis / Doctoral Dissertation Nursing and Healthcare Innovation 2015

abstract: Interest in health and wellness has significantly increased in today's society. Living a healthy and active lifestyle is suggested to promote overall physical and psychological well-being. This study explored the effects of wearing a Fitbit Zip activity monitor and the impact of expressing mindfulness on levels of physical activity. It was predicted that expressing mindfulness, as measured by the use of present-tense language during the daily emotional writing task, would moderate the relationship between wearing a Fitbit Zip activity monitor and change in physical activity. Specifically, it was hypothesized daily monitoring would only lead to increased activity among those higher in mindful language. Over the course of five days, participants were asked to wear a Fitbit Zip and to complete a daily questionnaire and writing task at the end of each evening. On the last day of the study, participants completed a follow-up assessment, which suggested that the combination of wearing a Fitbit Zip activity monitor and expressing more mindfulness throughout the week increased levels of physical activity. An important issue for future research is to conduct this study for a longer period of time in order to get more variability in the data. However, despite the limitations of the design, these findings suggest that activity monitoring may be a promising way to promote healthy lifestyle change. / Dissertation/Thesis / M.S. Psychology 2014