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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
231

Disciplína bez pravidel? Etnografie Dialogického jednání s vnitřním partnerem / Discipline without rules? Ethnography of Dialogical Acting with the Inner Partner

Šlédrová, Jasňa January 2016 (has links)
The subject of this diploma thesis is Dialogical acting with the inner partner, which understands itself as psychosomatic introspective and self-developing discipline founded by Ivan Vyskočil. I approach dialogical acting through three conceptualizations of objects - as networks, fluid objects and fire objects. With these I explore different ways in which dialogical acting holds its shape as a discipline. I focus on the creation and continuous re-enactment of dialogical acting and its ambiguous relation to its founder Ivan Vyskočil. I analyze the stability and fluidity of rules that shape and define boundaries of the discipline and describe dialogical acting as a set of relations of changing entities and realities that are present and absent, and as passages that are enacted by the rearrangements of multiple specificities. I try to capture tensions that constitute the discipline. Dialogical acting aims at being an open discipline without rules. As rules re-emerge and tend to stabilize, the discipline develops strategies in the process of transferring knowledge that seek to destabilize the rules. Findings and conclusions of this thesis are based on participative observation of dialogical acting in the courses that take place on The Theatre Faculty of the Academy of Performing Arts in Prague, on...
232

Syskons band i våldets spår : En tvärsnittsstudie av våldsutsatta barns självskattade kvalitet i syskonrelationer / Sibling Relationships in the Wake of Violence : A Cross-sectional Study of Self-Reported Sibling Relationship Quality in Children Subjected to Child Maltreatment

Jakobsson, Timea, Möllerström, Alexandra January 2022 (has links)
Syskonrelationen är den längsta relationen i livet. Därtill utgör syskonrelationen en viktig arena för barns utveckling. Trots detta finns det få studier där syskonrelationen undersöks i relation till barnmisshandel. I följande studie undersöktes skillnader i den självskattade stöd- och konfliktnivån i syskonrelationen, mellan barn som rapporterade svår barnmisshandel och barn i en kontrollgrupp, samt om kön förändrade dessa skillnader. Vidare undersöktes om stöd- och konfliktnivån påverkade den upplevda nivån av psykosomatiska problem hos barn som rapporterade svår barnmisshandel. Studien genomfördes på ett urval av 1 392 pojkar och flickor mellan 15-16 år, med data från projektet Longitudinal Research on Development in Adolescence (LoRDIA). Barn som rapporterade svår barnmisshandel upplevde signifikant lägre stödnivå och signifikant högre konfliktnivå i sin syskonrelation, än barnen i kontrollgruppen. Skillnaderna var signifikanta både för pojkar och flickor, men pojkar upplevde ett signifikant lägre stöd i sin syskonrelation än flickor. Nivån av syskonstöd och syskonkonflikt påverkade emellertid inte nivån av psykosomatiska problem hos barn som rapporterade svår barnmisshandel. Effektstorlekarna var små i majoriteten av resultaten, vilket tyder på att syskonrelationer är komplexa fenomen som vid sidan av barnmisshandel och kön, även påverkas av en rad andra faktorer. Resultaten diskuteras i ljuset av tidigare forskning och i relation till anknytningsteori, kompensationshypotesen, kongruenshypotesen och könssocialisation. / The relation between siblings is one of the longest throughout the life span. Moreover, the sibling relationship constitutes an important context for children’s development. Nevertheless, in the context of child maltreatment, it remains largely understudied. In this study, we examined the differences in self-reported sibling support and sibling conflict, between children who reported severe child maltreatment and children in a control group, as well as if these differences were affected by gender. Furthermore, we examined whether the level of sibling support and sibling conflict affected the extent of psychosomatic problems experienced by children who reported severe child maltreatment. The study was conducted on a sample of 1 392 boys and girls between the ages of 15-16, using data from the research project Longitudinal Research on Development in Adolescence (LoRDIA). Children who reported severe child maltreatment experienced significantly less sibling support and significantly higher sibling conflict than the control group. These differences were significant for both boys and girls, although boys experienced significantly less sibling support than girls. The level of sibling support and sibling conflict, however, did not affect the extent of psychosomatic problems in children who reported severe child maltreatment. Effect sizes were small in the majority of the results, suggesting that sibling relationships is a complex phenomenon that, besides child maltreatment and gender, may be affected by a number of other factors as well. The results are discussed in light of previous research, and in relation to attachment theory, the compensation hypothesis, the congruence hypothesis, and gender socialization.
233

Perceived parental alcohol problems and psychosomatic complaints : A cross-sectional study of adolescents in Sweden

Syed, Numan Raza January 2022 (has links)
This study examined the association between Swedish adolescents’ self-reported psychosomatic health complaints and parental alcohol drinking problems controlling for sociodemographic characteristics. Data was obtained from a nationally representative sample from 2021, the national survey of the Swedish Council for Information on Alcohol and Other Drugs (CAN) survey. Our study sample had 9,032 students from grades 9 (15-16 years) and 11 (17-18 years) from randomly selected 350 schools in Sweden. Adolescents’ self-reported psychosomatic complaints were coded into dependent variable. The main independent variable was adolescents’ perceived parental alcohol drinking problems, measured by the Children of Alcoholics Screening Test (CAST-6) scale. Adolescents’ self-reported sociodemographic characteristicswere were control variables. We performed a chi2 significance test and binary logistic regression analysis. Adolescents with perceived parental drinking problems had higher odds of reporting psychosomatic complaints than adolescents with no perceived parental drinking problems. This association remained statistically significant in a fully adjusted model with all control variables. The association was stronger among grade 9 adolescents than grade 11 adolescents. Adolescents with perceived parental drinking problems were more likely to report subjective psychosomatic health complaints. Besides universal programes, this vulnerable group of adolescents and parents might benefit more from targeted interventions in schools and healthcare centres.
234

Vliv volejbalu na zdravotní stav hráčů / Health Effects of volleyball players

Hrbáčková, Markéta January 2021 (has links)
Title: The influence of volleyball on sports and after sports life of players Objectives: The aim of this work is to find out in a comprehensive way the extent to which players are affected by long-term performance in an active volleyball team, how it affects the psychosomatic state of players and the possible impact of the game on the life of the player even after their sports career. Methods: The thesis uses many-case exploratory studies with data collection through structured questionnaire forms and supplementary interviews. A total of 60 respondents participated in this qualitative research. The obtained data was examined by using the thematic analysis method. Tables and accompanying reports were used as an output form, formulating the researched phenomena and connecting the research with the theoretical part of the work. Results: The collected data emphasized the importance of respecting the personalities of the players in all aspects. They confirmed the importance of harmony between the physical and mental aspects of the approach to training and game, and thus emphasized the psychosomatic unity that must be respected by the coach if the goal is a top notch game of the team as a whole. The research further confirmed that the background of the players lies not only in the broader social context...
235

Depressive Symptom Severity, Stressful Life Events, and Subclinical Atherosclerosis in African American Adults

Berntson, Jessica January 2015 (has links)
Indiana University-Purdue University Indianapolis (IUPUI) / Prospective epidemiologic evidence indicates that both stressful life events (SLEs) and depression are associated with an increased risk of subclinical atherosclerosis and cardiovascular disease (CVD) events. Even though stressful life events (SLEs) and depression co-occur and may act together to influence cardiovascular disease (CVD) risk, these psychosocial factors have been mainly examined in isolation. For instance, depression may moderate the relationship between SLEs and CVD outcomes. I hypothesized that depressive symptoms would potentiate the deleterious effect of SLEs on subclinical atherosclerosis. This hypothesis is plausible, given that depressed adults exhibit exaggerated and prolonged sympathetic nervous system, hypothalamic-pituitary-adrenal (HPA) axis, and inflammatory responses to stress, which in turn could promote atherosclerosis. As compared to their nondepressed counterparts, depressed individuals may also be more likely to engage in maladaptive methods to cope with SLEs (e.g., increased tobacco use, alcohol use, and consumption of low-nutrient, energy dense foods), which could also promote atherosclerosis. I examined cross-sectional data from 274 to 279 (depending on the outcome measure) older, African American adults (mean age = 66 years, 67% female) with no evidence of clinical CVD or dementia who participated in the St. Louis African American Health-Heart study (2009–2011). Number of SLEs was assessed using the Life Events Calendar, a structured interview. From this interview, a continuous SLEs variable was computed (number of adult SLEs: 0, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11+). Severity of depression symptoms was measured using the 17-item Hamilton Rating Scale for Depression (HAM-D). Two measures of subclinical atherosclerosis were obtained: carotid intima-media thickness (CIMT; assessed by ultrasonography) and coronary artery calcification (CAC; assessed by multi-detector computerized tomography). I conducted linear (CIMT) and logistic (CAC) regression models, first adjusted for demographics (age, sex, education) and then fully-adjusted (demographics; mean arterial pressure; low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C); hemoglobin A1c; BMI; tobacco use; diabetes diagnosis; and use of antihypertensitve, lipid lowering, antidiabetic, and antidepressant medications). No main effects of SLEs or HAM-D were found for CIMT or CAC. There were also no SLEs by HAM-D interactions for CIMT or CAC. Because the current results are largely inconsistent with prior literature and there is a paucity of studies utilizing African American samples, future research is needed to examine the independent and interactive associations of SLEs and depressive symptoms with measures of subclinical atherosclerosis. If the present results are replicated, it may suggest that SLEs, depressive symptoms, and their interactive effect are not cardiotoxic among African American adults.
236

Abrechnungsverhalten von Leistungen zur psychosomatischen Grundversorgung bei niedergelassenen Ärzten

Mertens, Ralph Eugen 18 July 2005 (has links)
Datensätze der von Berliner Ärzten abgerechneten psychosomatischen und psychiatrischen Leistungen des Einheitlichen Bewertungmaßstabs (EBM) in den Jahren 1995-1997 werden im zeitlichen Verlauf untersucht und mit Veränderungen der Leistungsdefinition verglichen. Die Abrechnungsdaten werden nach Fachrichtung, Geschlecht und Stadtteil des abrechnenden Arztes gruppiert und mit Daten zur Qualifikation des Arztes - aus einem von Berliner Ärzten beantworteten Kurzfragebogen zur psychosomatischen Grundversorgung (PSGV) - korreliert. Hypothesen zu strukturellen Unterschieden beim Abrechnungsverhalten innerhalb der Ärzteschaft werden formuliert. Weiterhin wird untersucht, wie das Abrechnungsverhalten von Ärzten durch Änderungen in der Gebührenordnung beeinflußt wird. Zuletzt wird nach Kriterien gesucht, die den Bedarf an PSGV quantifizieren. Die in der Arbeit postulierten Hypothesen lassen sich wie folgt beantworten: (H 1.a.): Das Geschlecht des Arztes spielt für die Abrechnungshäufigkeit psychosomatischer Leistungsziffern keine Rolle. (H 1.b.): Ärzte im Westteil Berlins rechnen häufiger Leistungen der PSGV ab als ihre Ostberliner Kollegen. (H 1.c.): Gesprächstherapien werden von Ärzten mit hoher Balintgruppenerfahrung häufiger durchgeführt. (H 2.a.): Die therapeutische Leistungsziffer 851 wird trotz besserer Bewertung ab dem Jahr 1996 nicht häufiger abgerechnet. (H2.b.): Die Budgetierung einer Leistung verringert deren Abrechnungshäufigkeit. (H3.a.): Ärzte rechnen seltener Leistungen der PSGV ab als sie es aufgrund der geschätzten Häufigkeit psychosomatischer Erkrankungen am eigenen Patientenklientel könnten. Zufällig findet sich in der Datenanalyse ein statistischer Fehler. Die bereitgestellten Leistungsstatistiken der KV-Berlin stellen in Bezug auf den Mittelwert keine korrekten Abrechnungsgegebenheiten dar. Die asymmetrische Verteilung der Abrechnungsdaten läßt sich durch Angabe des Median und eines Perzentilenbereiches besser beschreiben als der derzeitig ausgewiesene arrhythmetische Mittelwert. Die Leistungsmengenausweitungen nach Einführungen des EBM ab dem Jahr 1996 können auch durch diesen Umstand mitverursacht worden sein. Bei der Literaturbetrachtung fällt auf, dass die Morbidität psychischer und psychosomatischer Erkrankungen zunimmt und diese einen hohen volkswirtschaftlichen Schaden in Hinblick auf Krankheitszeiten und Medikamentenkosten verursachen. Qualitätsverbessernde Maßnahmen in der PSGV können effektiv Krankheitskosten reduzieren. / Data sets about psychosomatic and psychiatric services from “Einheitlichen Bewertungmaßstabs” (EBM), which were deducted from Berliner physicians during the years 1995 -1997 will be researched in a time dependent process and will be compared to the change of definition of achievement. The billing data will be grouped according to the field, gender and district of the accounting physician, and will be correlated with data which comes from a short questionnaire, answered by Berlin physicians, about the psychosomatic primary health care, for the qualification of the physician. Hypotheses of structural distinctions from the account behaviour, within the Medical profession, will be formulated. Furthermore, it will be examined, how the account behaviour of the physicians will be affected by change in the tariff. Lastly, we will be searching for criteria, which will quantify the demand of psychosomatic primary health care. The postulated hypotheses in this work can be answered as follows: (H 1.a.): The gender of the physician is irrelevant to the settlement frequency of the psychosomatic output figures. (H 1.b.): Physicians in West Berlin account for services from psychosomatic primary health care more often then there colleagues in East Berlin. (H 1.c.): Physicians with high Balint group experience administer more client-centered therapies. (H 2.a.): Despite the better valuation starting from the year 1996, the therapeutic output figure 851 does not become more frequently accounted for. (H 2.b.): The budgeting of an achievement reduces their account frequency. (H 3.a.): Physicians account more rarely for services of psychosomatic primary health care as they could do it due to the estimated frequency psychosomatic diseases of there own patient clientele. A statistic error is coincidental in the data analysis. The provided statistical activities of the KV-Berlin don’t represent correct account conditions in reference to the median. The asymmetrical distribution of the billing data can be better described by the indication of the median and a percentile range, than by the current stated arrhythmetic median. The expansions of achievement quantities after changing of the EBM, starting from the year 1996, could be, among other things, caused by this circumstance. During the examination of the literature, it becomes noticeable, that the morbidity of psychological and psychosomatic diseases increases, and these cause high economical damage in terms of illness times and medication cost. Quality-improving measures in the psychosomatic primary health care can effectively reduce disease costs.
237

Vi läkare är också människor : Kroatiska allmänläkares vård av patienter med psykiska hälsoproblem

Vidačić, Jasna January 2009 (has links)
<p>Allmänläkare i primärvården är den första vårdgivare som människor i behov av psykisk hjälp möter. Det saknas forskning om behandling av psykiskt sjuka inom primärvården i enskilda länder. I syfte att hitta nya frågeställningar och få djupare förståelse av hur primärvården fungerar med avseende på psykiskt sjuka intervjuades elva allmänläkare i en kroatisk stad. Insamlade data från intervjuerna strukturerades och bearbetades genom en induktiv tematisk analys. Resultaten visar att allmänläkare upplever en hög arbetsbelastning. Deras tid för samtal med psykiskt sjuka är väldigt begränsad. Behandling med psykofarmaka blir ofta det enda vårdalternativet. Psykosociala problem och psykotrauma förekom ofta som konsekvens av krig. Sjukpensionering av krigsveteraner med PTSD-diagnos blev en omdiskuterad fråga. Undersökningen visar att det kan bli ansträngande för allmänläkare att behandla psykisk ohälsa. De behandlar dessutom majoriteten av psykiskt sjuka men deras vård kompletteras inte med några psykosociala tjänster. Behovet av psykiskt stöd blir inte bemött hos många patienter.</p>
238

Effets d’un programme prénatal de groupe adressé aux couples parentaux pour prévenir la dépression postnatale des femmes de classes moyenne et défavorisée habitant en Catalogne Nord et en France Sud

Ortiz, Maria Assumpta 04 1900 (has links)
La dépression postnatale (DP) est un problème de santé publique très fréquent dans différentes cultures (Affonso et al, 2000). En effet, entre 10% à 15% des mères souffrent d’une symptomatogie dépressive ainsi que l’indiquent Gorman et al. (2004). La prévention de la DP est l’objectif de différents programmes prénatals et postnatals (Dennis, 2005; Lumley et al, 2004). Certains auteurs notent qu’il est difficile d’avoir accès aux femmes à risque après la naissance (Evins et al, 2000; Georgiopoulos et al, 2001). Mais, les femmes fréquentent les centres de santé pendant la grossesse et il est possible d’identifier les cas à risque à partir des symptômes prénataux dépressifs ou somatiques (Riguetti-Veltema et al, 2006); d’autant plus qu’un grand nombre de facteurs de risque de la DP sont présents pendant la grossesse (O’Hara et Gorman, 2004). C’est pourquoi cette étude fut initiée pendant le premier trimestre de la grossesse à partir d’une détection précoce du risque de DP chez n= 529 femmes de classes moyenne et défavorisée, et, cela, au moyen d’un questionnaire validé utilisé à l’aide d’une entrevue. L’étude s’est effectuée dans trois villes : Barcelone, Figueres, et Béziers au cours des années 2003 à 2005. Objectif général : La présente étude vise à évaluer les effets d’un programme prénatal de groupes de rencontre appliqué dans la présente étude chez des couples de classe socioéconomique non favorisée dont les femmes sont considérées comme à risque de dépression postnatale. L’objectif spécifique est de comparer deux groupes de femmes (un groupe expérimental et un groupe témoin) par rapport aux effets du programme prénatal sur les symptômes de dépression postnatale mesurés à partir de la 4ème semaine après l’accouchement avec l’échelle EPDS. Hypothèse: Les femmes participant au programme prénatal de groupe adressé aux couples parentaux, composé de 10 séances hebdomadaires et inspiré d’une orientation psychosomatique présenteront, au moins, un taux de 6% inférieur de cas à risque de dépression postnatale que les femmes qui ne participent pas, et cela, une fois évaluées avec l’échelle EPDS (≥12) 4 semaines après leur accouchement. Matériel et méthode: La présente étude évaluative est basée sur un essai clinique randomisé et longitudinal; il s’étend de la première ou deuxième visite d’échographie pendant la grossesse à un moment situé entre la 4ème et la 12ème semaine postnatale. Les participants à l’étude sont des femmes de classes moyenne et défavorisée identifiées à risque de DP et leur conjoint. Toutes les femmes répondant aux critères d’inclusion à la période du recrutement ont effectué une entrevue de sélection le jour de leur échographie prénatale à l’hôpital (n=529). Seules les femmes indiquant un risque de DP furent sélectionnées (n= 184). Par la suite, elles furent distribuées de manière aléatoire dans deux groupes: expérimental (n=92) et témoin (n=92), au moyen d’un programme informatique appliqué par un statisticien considérant le risque de DP selon le questionnaire validé par Riguetti-Veltema et al. (2006) appliqué à l’aide d’une entrevue. Le programme expérimental consistait en dix séances hebdomadaires de groupe, de deux heures et vingt minutes de durée ; un appel téléphonique entre séances a permis d’assurer la continuité de la participation des sujets. Le groupe témoin a eu accès aux soins habituels. Le programme expérimental commençait à la fin du deuxième trimestre de grossesse et fut appliqué par un médecin et des sages-femmes spécialement préparées au préalable; elles ont dirigé les séances prénatales avec une approche psychosomatique. Les variables associées à la DP (non psychotique) comme la symptomatologie dépressive, le soutien social, le stress et la relation de couple ont été évaluées avant et après la naissance (pré-test/post-test) chez toutes les femmes participantes des deux groupes (GE et GC) utilisant : l’échelle EPDS (Cox et al,1987), le Functional Social Support Questionnaire (Broadhead et al, 1988), l’évaluation du stress de Holmes et Rahe (1967) et, l’échelle d’ajustement dyadique de Spanier (1976). La collecte des données prénatales a eu lieu à l’hôpital, les femmes recevaient les questionnaires à la fin de l’entrevue, les complétaient à la maison et les retournaient au rendez-vous suivant. Les données postnatales ont été envoyées par les femmes utilisant la poste locale. Résultats: Une fois évalués les symptômes dépressifs postnatals avec l’échelle EPDS entre la 4ème et la 12ème semaine postnatale et considérant le risque de DP au point de césure ≥ 12 de l’échelle, le pourcentage de femmes à risque de DP est de 39,34%; globalement, les femmes étudiées présentent un taux élevé de symptomatologie dépressive. Les groupes étant comparables sur toutes les variables prénatales, notons une différence dans l’évaluation postnatale de l’EPDS (≥12) de 11,2% entre le groupe C et le groupe E (45,5% et 34,3%). Et la différence finale entre les moyennes de l’EPDS postnatal est de 1,76 ( =11,10 ±6,05 dans le groupe C et =9,34 ±5,17 dans le groupe E) ; cette différence s’aproche de la limite de la signification (p=0,08). Ceci est dû à un certain nombre de facteurs dont le faible nombre de questionnaires bien complétés à la fin de l’étude. Les femmes du groupe expérimental présentent une diminution significative des symptômes dépressifs (t=2,50 / P= 0,01) comparativement au pré-test et indiquant une amélioration au contraire du groupe témoin sans changement. Les analyses de régression et de covariance montrent que le soutien social postnatal, les symptômes dépressifs prénatals et le stress postnatal ont une relation significative avec les symptômes dépressifs postnatals (P<0,0001 ; P=0.003; P=0.004). La relation du couple n’a pas eu d’impact sur le risque de DP dans la présente étude. Par contre, on constate d’autres résultats secondaires significatifs: moins de naissances prématurées, plus d’accouchements physiologiques et un plus faible taux de somatisations non spécifiques chez les mères du groupe expérimental. Recommandations: Les résultats obtenus nous suggèrent la considération des aspects suivants: 1) il faudrait appliquer les mesures pour détecter le risque de DP à la période prénatale au moment des visites d’échographie dont presque toutes les femmes sont atteignables; il est possible d’utiliser à ce moment un questionnaire de détection validé car, son efficacité semble démontrée; 2) il faudrait intervenir auprès des femmes identifiées à risque à la période prénatale à condition de prolonger le programme préventif après la naissance, tel qu’indiqué par d’autres études et par la demande fréquente des femmes évaluées. L’intervention prénatale de groupe n’est pas suffisante pour éviter le risque de DP chez la totalité des femmes. C’est pourquoi une troisième recommandation consisterait à : 3) ajouter des interventions individuelles pour les cas les plus graves et 4) il paraît nécessaire d’augmenter le soutien social chez des femmes défavorisées vulnérables car cette variable s’est révélée très liée au risque de dépression postnatale. / Postnatal depression (PD) is a universal problem for public health (Affonso and al, 2000),as indicated in studies on its prevalence as between 10% and 15% (Gorman and al, 2004). The prevention of this problem is the main objective of several programs that are applied before and after birth (Dennis, 2004; Lumley and al, 2004). Some authors have noted that it is difficult to access women who are most at risk in the postnatal stage (Evins and al, 2000;Georgiopoulos and al, 2001). During pregnancy, women use healthcare centres very often and it is possible to detect the risk of having PD. There are also many women who indicate a risk of PD due to somatic or depressive symptoms (Riguetti-Veltema and al, 2006), above all, because the majority of risk factors are present during pregnancy (O’Hara and Gorman,2004). Therefore, this study was started during the first three months of pregnancy with early detection of women at risk based on a validated questionnaire used in the interview. The study was carried out in three cities: Barcelona, Figueres (north of Catalonia) and Béziers (south of France), between 2003 and 2005. General aim: This study intends to assess the effects of a prenatal group program directed at future parents on postnatal depression symptoms in women considered at risk. The specific aim is compare the depressive postnatal symptoms of the women in the experimental group with the depressive postnatal symptoms of the women in the control group. Hypothesis: The women taking part in the prenatal group program (directed at future parents, with 10 weekly sessions, and based on a psychosomatic approach) present, at least a 6% lower rate of postnatal depression than women who did not take part, once assessed with the EPDS (≥12) scale 4 weeks after the birth. Materials and method: This assessment study is a random, longitudinal clinical trial; it starts from the first or second ultrasound scan of the pregnancy and concludes between the 4th and 12th postnatal week. Those taking part in the study are women of middle, low, or very low socioeconomic status who have been identified as being at risk of PD, and their partners or husbands. All the women (n=529) fulfilling the criteria for being included during the selection period have been interviewed at the hospital on the same day as the antenatal scan. Only women indicating a risk of PD were selected (n=184). They were then distributed into two random groups (n=92) experimental group (EG) and (n=92) control group (CG) – by means of a software program in which a statistic considering PD risk, according to the validated questionnaire developed by Riguetti-Veltema et al (2006) used in the interview,was applied. The experimental program consisted of 10 weekly sessions of two hours twenty minutes long; a telephone calls between sessions to be ensured the continuity of the participants in the program. The control group had access to the usual care and assistance. The experimental program started at the end of the second trimester of the pregnancy and was put into practice by specially trained midwives, who led the birth preparation sessions using a psychosomatic approach. The variables associated to PD (not psychotic), such as, for example, prenatal depressive symptoms, social support, stress, and couple relationships were assessed before and after the birth (pre/post-test) in all the women from both study groups (EG and CG), using the EPDS scale (Cox et al,1987), the Functional Social Support Questionnaire (Broadhead et al, 1988), the stress test developed by Holmes and Rahe (1967), and the Spanier dyadic adjustment scale (1976). The prenatal data was gathered at the hospital where the women received the questionnaire, which they filled in at home and returned on their following visit. The postnatal data was sent by mail by the women taking part in the study. Results: Once the depression symptoms were assessed with the EPDS scale between the 4th and 12th postnatal week, and considering PD risk at the cutting point (≥ 12) of the scale, the percentage of women with a risk of PD is 39.34%; globally, the women studied have a high rate of risk of PD. We noticed that the two groups were comparable in all the prenatal variables, and that there is a difference in the EPDS (≥12) postnatal assessment of 11.2% between group C and group E (45.5% and 34.3%, respectively). In the postnatal analysis between both groups, the difference of means of the postnatal EPDS is 1.76( x =11.10 ±6.05 in group C and x =9.34 ±5.17 in group E); this difference only approaches the significance limit (p=0.08). This is due to several factors; the number of correctly filled-in questionnaires in the last part of the study, among them.The control group has an evolution without modifications between pre- and post-natal assessments, with a very slight increase in symptoms after the birth (t=-0.92 / P=0.36). In contrast, women from the experimental group have a significant decrease in depression symptoms (t=2.50/P= 0.01), in comparison to the pre-test. Recommendations: The results obtained suggest we consider the following aspects: 1)measures to detect the risk of PD during the prenatal period should be applied, when women come for their antenatal scans, because practically all women are willing to be approached; it is possible to use, in that moment, a validated detection tool, since its effectiveness appears to be demonstrated; 2) although the prenatal group intervention seems effective, it is not a sufficient strategy to significantly prevent the risk of PD. Women identified at risk during the prenatal period, therefore, should be worked with on condition that the preventive program is prolonged after the birth, as other studies have indicated, and as the women under study have indicated with a strong demand for continuity; 3) individual interventions should be added for more serious cases; and finally, 4) it is necessary to increase social support for low-income, vulnerable women,because this variable is very related with the risk of PD. Keywords : postnatal depressive symptoms, depression postnatal risk, social support, stress, couple relationship, psychosomatic approach, randomized trial, prenatal group programme, low socio-economic level women.
239

Vliv psychosomatické situace matek v těhotenství na prenatální vývoj dítěte / Influence of the psychosomatic situation of mothers in pregnancy on the prenatal development of the child and condition of newborn after delivery

ŠIMEČKOVÁ, Alžběta January 2019 (has links)
Pregnancy is a period full of changes. The perception of life values by the woman and her partner are varied, changes in the life style are encountered and their roles in the life are also altered. The pregnant woman feels that nothing will be like before. She is very sensitive and also easily vulnerable. Contrastingly to the routine prenatal care, prenatal psychology searches for answering questions what the feelings in the pregnancy are in terms of the psychosocial situation, and what the impacts of this course on the newborn condition after the delivery are. The scope of the work is aimed at the importance and forms of the prenatal attachment, course and its impact on the newborn. The targets of the Diploma Work entitled "Effects of the psychosomatic situation of pregnant women on the child prenatal development" are as follows: 1) to assess the pregnant woman psychosomatic situation, 2) to evaluate the influence of psychosomatic situation on prenatal development of child 3) to determine the measure of the pregnant woman (dis)comfort throughout three trimesters and 4) to evaluate the newborn condition after the delivery. Thirty pregnant women were addressed. Fifteen women reflected on the proposal and agreed with completing an anonymous standardized scale. The respondents were contacted within a period of February 2017 to February 2018. The research sample group included the women and their newborns. The choice was intentional. The women completed the Freybergh scale, which is focused on monitoring the psychosocial situation of pregnant women. It comprised 70 questions divided into seven categories. They were answered through the mediation of a compiled web reference at http://mail.scac.cz/mrIWeb/mrIWeb.dll?I.Project=V31_TEHOTENSTVI_PORIZOVANI. The statistically processed results indicated the measure of the deprivationof pregnant women in particular trimesters and condition of the newborn after the delivery based on the pregnancy experienced. The Atlas programme was employed for the qualitative research to develop an anchored statement. From the sample group of 15 women and their 405 answers, 2% of answers were recorded corresponding to an intermediate degree of deprivation. Every respondent suffered frommild deprivation. The results of the present study will find their applications particularly to branches of prenatal psychology and gynaecology. They will serve as pilot results for a CEP project planned.
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Problemet utan namn? : Neuroser, stress och kön i Sverige från 1950 till 1980 / The Problem that had no Name? : Neurosis, Stress and Gender in Sweden 1950-1980

Björk, Maria January 2011 (has links)
Focusing on Sweden between 1950 and 1980, this doctoral dissertation analyzes and problematizes the process in which a discourse about neurosis and nervous troubles gradually evolved into a discourse about stress. The thesis aims to show how the medical and general discussion about diffuse or vague symptoms transformed and rearticulated ideas and views on society and man, citizenship, gender roles, and medicine. It shows how the discourse on neuroses tended to locate sickness and deviance in the individual, whereas its subsequent transformation into a discourse on stress located the pathological in an external, societal sphere. A particularly prominent issue in the study concerns the role that gender, and in particular female gender, has played in these discourses, and how the place of the feminine can be understood in relation to stress and neuroses. The dissertation shows that female gender was not central to the discourse on neuroses and stress  during the studied period. On the contrary, gender was subordinated to ideas about man and citizenship within the greater context of society and culture. The dissertation takes its starting point in the Swedish 1950’s, often characterized as the era of ”The Strong Society” or ”The People’s Home”. During this period, the neurosis discourse was fixed and remained unchanged. In practice, neurosis was a diagnosis that provided such symptoms that were otherwise difficult to measure and assess with a theory of origin. Neuroses were believed to principally affect a certain category of individuals, who, due to their constitution or disposition, were held to be particularly susceptible to neurotic sufferings. During the 1960s the belief in The Strong Society and its notion of ideal citizenship began to crumble. It was against this background that the Swedish medical profession started discussing ”stress”. Stress, in contrast, could afflict anyone and everyone, according to “the father of stress” Hans Selye and Swedish stress researchers. Stress was assumed to be a potential cause of ”nervous troubles” and disease, but was never considered to be a disease in itself. The concept of the individual as a citizen now gave way for the notion of the individual as a primarily biological organism. Within the stress discourse in the 1960s, the primacy of the universal normal (male) man was a recurring focal point. In the 1970s, the stress researchers distanced themselves from Selyes’ concept of stress by focusing on individual factors. In the discussion about stress during the 1970s, the ”constitutionally weak” individual of the 1950s and the biological organism of the 1960s blended into a hybrid construction of a unique, biological individual.

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