The number of people aged 60 years and over has doubled since 1980and the World Health Organization predicts that the population of over60s will reach 2 billion by the year 2050. An ageing population poses bothchallenges and opportunities for society and for individuals. Whilst theseare positive statements, increases in life spans do not directly lead to increasesin health spans. The naturally occurring ageing process can leadto reductions in functionality and, in order to address this, scholars haveargued the benefits of regularly engaging in physical activity, and especiallyresistance training. Therefore, an important challenge for modernsociety is to develop strategies that delay the onset of disease, such as interventionsthat include physical activity. This licentiate thesis investigatesolder women’s physical activity in a resistance training context and howthis affects different aspects of their health.The overall aim of the thesis is to explore healthy and physically activeolder women’s experiences of what maintains and enhances their healthafter starting resistance training.This thesis used a quantitative and a qualitative approach to investigatea group of old adult women. Data collection was structured in questionnaires(n=32) with one intervention group and one control group for thepaper I, and focus group interviews (n=14) in paper II. Paper I studied theeffects of resistance training on physically active and healthy olderwomen. Paper II relates to the women who continued to exercise after theresistance training intervention ended in order to explore their health resources.The theoretical framework used in this thesis is a movement towardshealth as explained by salutogenic theory.This thesis showed that resistance training has positive effects on psychologicalwell-being and is important because it not only benefits thosewho are physically inactive, but also those who are already physically activeand healthy.From a salutogenic perspective, physical activity provides a meaningful,comprehensible and manageable way for older women to engage in theongoing process of maintaining health.

<p>Under lång tid har hälsoarbetet bestått av insatser inom det patogena området som fokuserar på orsaker till ohälsa och sjukdom. Utifrån ett salutogent perspektiv söks istället hälsans ursprung. Perspektivet utgår från vilka faktorer som gör att människor mår bra och vidmakthåller hälsan trots omständigheter som bidrar till att de är eller har varit utsatta för potentiellt sjukdomsframkallande biologiska eller psykosociala faktorer. Syftet med studien var att studera lantbrukares upplevelse av hälsa, med avsikt att beskriva salutogena faktorer för hälsa som kan vara användbara i hälsofrämjande arbete. Datainsamlingen har skett genom en postenkät till 300 lantbrukare i Skåne. Frågeformuläret innehöll frågor om arbetsförhållanden, stress, ekonomi, sociala kontakter, samt hälsa. Studien framhäver vikten av en positiv arbetsupplevelse som en signifikant påverkansfaktor för den salutogena hälsan. Det som framförallt bidrar till en positiv arbetsupplevelse är god social kontakt och en bra ekonomi. Sådana faktorer bör uppmärksammas för framtida hälsofrämjande insatser riktade till lantbrukare.</p> / <p>The health related work has included patogenesis interventions during a long term with focus on poor health and illness. Salutogenesis is a different perspective which emanates from factors that contribute to health and well-being. Salutogenesis explains why people stay well and even are able to improve their health in stressful situations. The aim of the study was to explore farmers´ health with intentions to describe salutogenic factors for health, that can be used in health promotion work. In a cross-sectional survey 300 farmers in Scania received a questionnaire with questions on work situation, stress, economy, social support and health. The study indicates how essential it is to have a positive work experience which has a significant impact on the salutogenic health experience. Good social contacts and good economy are factors that improve the positive work experience. These factors are important in future work with health promotion among farmers.</p>

Under lång tid har hälsoarbetet bestått av insatser inom det patogena området som fokuserar på orsaker till ohälsa och sjukdom. Utifrån ett salutogent perspektiv söks istället hälsans ursprung. Perspektivet utgår från vilka faktorer som gör att människor mår bra och vidmakthåller hälsan trots omständigheter som bidrar till att de är eller har varit utsatta för potentiellt sjukdomsframkallande biologiska eller psykosociala faktorer. Syftet med studien var att studera lantbrukares upplevelse av hälsa, med avsikt att beskriva salutogena faktorer för hälsa som kan vara användbara i hälsofrämjande arbete. Datainsamlingen har skett genom en postenkät till 300 lantbrukare i Skåne. Frågeformuläret innehöll frågor om arbetsförhållanden, stress, ekonomi, sociala kontakter, samt hälsa. Studien framhäver vikten av en positiv arbetsupplevelse som en signifikant påverkansfaktor för den salutogena hälsan. Det som framförallt bidrar till en positiv arbetsupplevelse är god social kontakt och en bra ekonomi. Sådana faktorer bör uppmärksammas för framtida hälsofrämjande insatser riktade till lantbrukare. / The health related work has included patogenesis interventions during a long term with focus on poor health and illness. Salutogenesis is a different perspective which emanates from factors that contribute to health and well-being. Salutogenesis explains why people stay well and even are able to improve their health in stressful situations. The aim of the study was to explore farmers´ health with intentions to describe salutogenic factors for health, that can be used in health promotion work. In a cross-sectional survey 300 farmers in Scania received a questionnaire with questions on work situation, stress, economy, social support and health. The study indicates how essential it is to have a positive work experience which has a significant impact on the salutogenic health experience. Good social contacts and good economy are factors that improve the positive work experience. These factors are important in future work with health promotion among farmers.

Abstract Background: The World Health Organization has expressed a great concern about the increasing prevalence of childhood obesity. Region Västra Götaland (VGR) has developed a web based program to support school nurses in their work to promote health among children with obesity. Previous research on childhood obesity emphasizes the importance of support from nurses and how their work is organized. Aim: The aim of the study is, firstly, to explore school nurses experiences with health promotion work among obese children. Secondly, to investigate whether school nurses use the salutogenic theory of health. Method: A qualitative study design was adopted. Data in form of semi structured interviews was collected from seven school nurses in the VGR. A directed content analysis was used for the analysis of the data. Results: The results are presented in three categories from the Tannahill health promotion model; health education, prevention and health protection. A new category emerged from the interviews and to be significant for the nurses´ work; organization. The last category was the salutogenic theory. The possibility to work in a health promotion manner became hard because of inadequate resources. However, we found that health education, prevention and health protection were areas of daily attention. The school nurses´ work was based on the salutogenic theory. Conclusion: School nurses were aware of the importance of health promotion. Overall, there was a feeling of diffuse guidelines for working in a health promotion manner (with childhood obesity), although a web-based tool was available. We recommend the use of a new model for daily practice capturing the key elements of health promotion.

Attetion Deficit Hyperactivity Disorder, ADHD, är den vanligaste barnpsykiatriska diagnosen.Syftet med denna studie var att beskriva hur skolsköterskan erfar skolsituationen för elevermed ADHD-diagnos. Fyra till sex procent av alla elever i skolan har denna diagnos (ADHD).Skolsköterskan har i sin dagliga kontakt med elever möjlighet att tidigt upptäcka och även tillviss del förhindra utvecklandet av komplikationer. Orsaken till ADHD består främst avgenetiska anlag men sociala faktorer finns och de påverkar hur svår utvecklingen blir.Metoden var en kvalitativ innehållsanalys med induktiv ansats beskriven av Lundman ochHällgren Graneheim. Datainsamlingen gjordes genom intervjuer med sex skolsköterskor. Urdatamaterialet framträdde temat Att förväntas vara som andra, men inte kunna med treunderteman. Resultaten kan användas till att öka förståelsen för elever med ADHD och derasskolsituation. Förhoppningsvis kan insikten om problemets svårighetsgrad öka motivationenatt förbättra situationen i skolan för alla elever och vuxna. Det finns många saker sompåverkar situationen för elever med ADHD, med rätt resurser och förutsättningar gesmöjlighet att påverka elevens utveckling i positiv riktning. / Attention Deficit Hyperactivity Disorder, ADHD, is today the most common psychiatricdiagnosis among children. The purpose of this study was to describe school nurses̛experiences of the school situation of pupils with ADHD. Four to six percent of all schoolpupils have been diagnosed with this illness. Due to her daily contact with school children,the school nurse has the opportunity to assist in early detection of ADHD, and can to someextent even prevent the development of possible complications. Genetic predisposition is theprimary cause of ADHD but social factors affect the severity of its development. The methodin this study was qualitative content analysis with an inductive approach described byLundman och Hällgren Graneheim. The data collection was made through interviews with sixschool nurses. Based on the analysis, the theme; Expected to be like the others, but also notbeing able, emerged with three subthemes. The results can be used to increase theunderstanding of pupils with ADHD in their school situation. Hopefully, awareness of theproblem severity increases motivation to improve the situation in schools for all studentsand adults. There are many things that affect the situation for children with ADHD. With theright resources and conditions the opportunity to influence students' development in apositive direction occurs.

An individual´s health is an important quality and asset to the individual, as well as to organizations and communities. The health of a human being is affected by the whole life situation, where the work place forms a significant part. The work place is an arena that can contribute to creating ill-health. In the light of increasing work- related ill-health in our society, it is important today to work with health-promoting initiatives in order to improve the well-being of people. It is advisable that an appointed key person at the work place works with health-promoting efforts. This person could very well be a health inspirer. The aim of this study was to make a closer examination and analysis of how health inspirers within the Social Services in Umeå identify themselves with their assignment . Ten health inspirers took part in a qualitative interview study. The result showed that the assignment of the health inspires was to work with conveying knowledge and motivating their co-workers to a healthy behavior which in turn would lead to well-being and good health. The support and feedback by the manager and co-workers were important factors in motivating the health inspirers for the assignment. More distinct frameworks and guidelines proved to be factors that very well could have facilitated the work of the health inspirers.

Knä- och höftplastik är bland de vanligaste kirurgiska ingreppen och har en stor positiv inverkan för den enskilda individens livskvalitet. Det har utarbetats flera vårdmodeller för patientkategorin som genomgår en knä- eller höftplastik, dels för att minska vårdkostnader men även för att förbättra vården. Det behövs emellertid mera kunskap om patientens upplevelse eftersom vården är i ständig utveckling. Studiens syfte var att beskriva patientens upplevelse av hemgång från en specialiserad elektiv enhet, den första postoperativa dagen efter knä- eller höftplastik, och första tiden efteråt. Telefonintervjuer utfördes med 12 patienter, och analyserades enligt kvalitativ innehållsanalys, med en induktiv ansats. Resultatet utmynnade i fem huvudkategorier med respektive underkategorier. Huvudkategorierna som framkom var; Den betydelsefulla hemmiljön, Information från sjukhuset, Oundvikligt hjälpbehov, Återhämtningens utmaningar och Hälsofrämjande kontakt. Informanterna delade en positiv upplevelse av hemgång den första postoperativa dagen och kunde hantera eventuella svårigheter på ett adekvat sätt, på egen hand eller med stöd av medskickad dokumentation, anhöriga eller kontakt med sjukhuset. Hemgång dagen efter knä- eller höftplastik upplevs som tryggt. / Knee and hip arthroplasty are among the most common surgeries available today and have a great impact on the quality of life of the individual. Several care models have been developed for patients having had knee or hip arthroplasty, not only to address the cost of healthcare, but also to improve the quality of the care itself. However, more knowledge about a patients experience following surgery is required as the care is continually progressing. The purpose of this study was to document the experience of a patient following a knee or hip arthroplasty. We aim to document their experiences returning home from a specialized elective unit, their first day post operation, as well as the initial period of recovery. Phone call interviews were carried out with 12 patients, and analyzed according to qualitative content analysis with inductive approach. The results were divided into five main categories, each with their own sub-categories. The main categories were; the importance of the home environment, information from the hospital, the necessity of help, challenges of recovery and health promotion contact. The participants reported a positive experience returning home after the first postoperative day and were able to handle potential issues in an adequate manner; on their own, with support from informative documentation, with help from relatives or through contact with the hospital. The experience of returning home the first day post operation, after a knee or hip arthroplasty is considered comfortable.

Syfte och frågeställningar: Syftet med studien var att utifrån ett salutogent perspektivundersöka professioners uppfattningar om och yrkeserfarenheter av att upptäcka tidigasignaler på stress och hur dessa kan hanteras. De frågeställningar som besvaras är; I) Vilkauttryck tar sig dagens psykiska ohälsa i arbetslivet? II) Hur kan individen upptäcka tidiga varningssignaler på stress? III) Vilka strategier kan individen tillämpa för att främja sin förmåga att hantera stress? IV) Vad anses vara hälsofrämjande på de olika systemnivåerna?Metod: Studien utgår ifrån en kvalitativ forskningsmetod med inspiration av den fenomenografiska ansatsen. Metoden för insamlad data bestod av semistrukturerade intervjuer. Resultat: Resultatet har presenterats i fyra huvudkategorier - Gränslöst arbete, Tidiga varningssignaler på stress, Hantering av stress, Hälsofrämjande arbetssätt, tillsammans med åtta subkategorier - Ett individualistiskt samhälle, Krav och prestationer, Bakomliggande orsaker, En mindre hållbar situation, Individens egna val, Individ- och gruppnivå, Organisationsnivå, Samhällsnivå. Konklusion: Symptom som trötthet, oro och sömnsvårigheter är varningssignaler på stress. Att arbeta med hälsofrämjande insatser på ett tidigt studium är en framgångsfaktor som respondenterna talar om. Det är viktigt att vara lyhörd för tidiga symptom och bakomliggande orsaker, det vill säga att ta reda på "vad det är som prasslar". / Purpose and issues: The purpose of the study was to examine, from a salutogenic perspective, professionals' perceptions and work experiences of detecting early signals on stress in working life and how they can be managed. The questions to be answered are: I)What are the expressions of mental illness in working life today? II) How can the individual discover early warning signals on stress? III) What strategies can the individual apply to promote his/her ability to cope with stress? IV) What is considered to be a health promotionfor the different system levels? Methods: The study design is qualitative inspired by the phenomenographic approach. Semistructured interviews were used for collecting data. Results: Four main categories emerged - Borderless work, Early warning signals of stress, Managing stress, Working in a health promotion manner. Eight subcategories were found –An individualistic society, Demands and achievements, Underlying causes, An unsustainable situation, The individual's own choices, Individual- and group level, Organizational level and environmental- and societal level. Conclusion: Symptoms such as fatigue, anxious and insomnia are warning signals of stress. Working in a health promotion manner in early stages is a success factor mentioned by the respondents. It is important to be responsive to early symptoms and underlying causes, that is, to examine "what is the rustle".

Syftet med studien har varit att med fokus på organisationsförändringar undersöka vilka bakomliggande orsaker som ligger till grund för hur en Region i Sverige arbetar med införandet av egna slutenvårdsplatser inom abstinensvård, utifrån de nationella målen för god vård och hur införandet av sådana vårdplatser kan komma att påverka vården. Genom att analysera Regionens egen utredningsrapport tillsammans med den revisionsrapport som externa konsulter skapat på uppdrag av Regionen, har denna kvalitativa fallstudie bidragit till en övergripande bild av bakomliggande orsaker som ligger till grund för beslutet. För att ge en fördjupad förståelse för dessa bakomliggande orsaker har studien kompletterats med en intervju där områdeschefen för Regionens beroendevård har bidragit med sin kunskap inom området. Resultatet tyder på att upphandlad abstinensvård kan försvåra säkerställandet av vårdens kvalitet, då det är problematiskt för den offentliga sektorn att kontrollera och utvärdera vård som tillhandahålls av privata vårdgivare. / The aim of the study has been to focus on organizational changes to examine the underlying causes of the Regions decision to implement a new unit for withdrawl treatment, based on the national goals for good health care and how the implementation of such new unit can affect provided care. By analyzing the Regions own enquiry report along with a review report made by external consultants on behalf of the Region, this qualitative study has compiled a general comprehension of underlying causes that the decision to open a new unit is based upon. For a deeper understanding of the underlying causes a supplementary interview took place with the area manager of the withdrawl treatment in this Region, who added knowledge to the study. The result indicates that outsourced health care can lead to difficulties in ensuring the quality of good care, because it is problematic for the public sector to control and evaluate care provided by private care givers.

Bakgrund: Systematiskt arbetsmiljöarbete kan förebygga ohälsa och olycksfall på arbetsplatser. Genom god arbetsmiljö kan kvalitén på utfört arbete öka, arbetet göras mer hållbart för arbetstagare och vården mer patientsäker. Syfte: Syftet med studien var att undersöka hur tandhygienister inom privat tandvårdssektor upplever sin organisatoriska och sociala arbetsmiljö. Metod: Metoden var en kvantitativ tvärsnittsstudie med enkät som mätinstrument. Urvalet bestod av tandhygienister inom privat sektor i en region i södra Sverige. Insamlade data analyserades i SPSS med Spearman’s Rho korreationsanalys. Resultat: Enkäten besvarades av 28 tandhygienister som generellt visade positiva upplevelser gällande organisatorisk och social arbetsmiljö [OSA]. Fler antal anställda tandhygienister gav ökade upplevelser av att utvecklas i arbetet ( = 0,404, p = 0,033) och att behöva arbeta utöver planerad arbetstid ( = –0,477, p = 0,010). Fler yrkesaktiva år som tandhygienist ökade upplevelsen av meningsfullt arbete ( = 0,404, p = 0,033). Slutsats: Utöver de identifierade salutogena faktorerna i resultatet sågs utvecklingspotential för OSA inom dimensionen förändringsarbete. För att få förståelse och orsak till upplevd OSA kan vidare forskning via kvantitativ ansats vara av värde för att identifiera salutogena faktorer som kan bidra till förbättrad OSA. / Background: Systemically work environment enhancing work can prevent illness and accidents among employees at workplaces. Maintaining a good working environment can improve the quality of performed work, become more sustainable and increase patient safety. Aim: To investigate how dental hygienists in private dental sector experience their organizational and social work environment. Method: A cross-sectional study with questionnaire as measuring instrument was performed. The sample consisted of dental hygienists in private dental sector in Sweden. Data were processed in SPSS through Spearman’s Rho correlation analysis. Results: 28 dental hygienists responded to the questionnaire and reported positive experiences regarding organizational and social work environment [OSA] in general. A higher number of employed dental hygienists reported more positive experiences of work development ( = 0,404, p = 0,033) and required to work beyond working hours ( =–0,477, p = 0,010). More professional years as dental hygienist increased positive experiences of meaningful work ( = 0,404, p = 0,033). Conclusion: In addition to the identified salutogenic factors in the results, protentional for development regarding OSA was found in the dimension reorganization. To gain understanding and reasons for experienced OSA, research via qualitative approach would be valuable to identify salutogenic factors that may contribute to improved OSA.