国立情報学研究所で電子化したコンテンツを使用している。

国立情報学研究所で電子化したコンテンツを使用している。

The proportion of the worlds population over the age of 65 has increased significantly during the last century and is projected to keep increasing, with the largest growth in the sector of the population over age 75. With the growth in the population of older people it is more likely than ever before that occupational therapists will have contact with older people. Occupational therapy has much to offer older people and their well-being, ensuring that they live not only longer, but importantly, live well as they understand it. / Well-being is a core concept within occupational therapy. Achievement of well-being on the part of the client is a goal of therapy. However, examination of occupational therapy and other health related literature, reveals that the meaning or understanding of well-being in play is often not articulated and at times well being appears as a contested concept in the literature (Stanley & Cheek 2003b). The meaning of well-being is often assumed, or conflated with other concepts such as life satisfaction and happiness. Further, how people achieve well-being is unclear and in most occupational therapy literature the perspective of the older person with regard to well-being is missing. In light of this omission there is the potential for a lack of congruence between the principles of occupational therapy designed to promote well being, and the perspective of the older person as to what well being actually is. Such incongruence has the potential to make well-being an elusive goal of therapy. In response, this study uses grounded theory to explore how older people perceive and understand well-being. / Grounded theory was used in the study because of its ability to generate theoretical propositions in an area where little is known (Stanley & Cheek 2003a). Fifteen participants over the age of 75, living in the community in one metropolitan city of Australia, were selected by opportunistic, snowball and theoretical sampling. In-depth interviews were conducted and analysed using the tenets of traditional grounded theory. / The central category to emerge was that to experience well-being older people had to perceive that they were in control. Participants in the study sought to avoid the perception of not being in control brought about by challenges to equilibrium, such as loss of capacities and loss of relationships. To perceive that they were in control participants used routine, needed to have choices and maintain independence. They used the basic social process of trading off to increase their perception of being in control. Trading off was used to exchange occupations that were no longer within their capacity, for occupations that were, or for other people to complete those tasks in order for the person to perceive that they were in control. Other categories that supported perceived control and the ability to use trading off were personal resources, feeling comfortable and secure and an attitude of its up to me. Thus well-being emerged as a dynamic interaction between the older person, their physical and social environment, and the demands of the occupations they wished to engage in order to have perceived control. / Given this new knowledge about the importance of perceived control to older people and their well-being, occupational therapists can look for ways of working with older people to ensure they perceive they are in control and are able to use trading off in order to attain well being. The major contribution that this study makes to occupational therapy knowledge is an explication of older peoples understandings and perceptions of well-being, particularly given that well-being is a central concept within occupational therapy. Knowledge about the use of trading off also contributes to the theoretical propositions relating to the process of occupational adaptation. / Thesis (PhDHealthSciences)--University of South Australia, 2006.

Adolescence is a time of experimentation and exploration. For many young people, a feature of this developmental period is the initiation of substance use. Whilst the majority of young people do not go on to develop substance use problems, any substance use has potential for danger. The current body of literature on the prevention of substance use problems suggests that in order to advance understanding, researchers must adopt a risk-focused approach. There is a wide range of indices that have been cited as risk factors for the development of substance use disorders. Chapter 2 explores some of the aetiological models and literature on risk factors with specific reference to psychological wellbeing, studies highlighting comorbid relationships between adolescent mental health and substance use problems, and the functional value of substances in relation to well-being. Although attention to psychological risk factors has received increased press in the literature, the number of controlled, longitudinal studies is relatively small. A review of recent studies (Chapter 3) indicates that the presence of anxiety, depression, low self-esteem or behavioural problems such as delinquency represent psychological risk factors for the development of later substance use problems, however findings are inconsistent and many studies do not examine differential predictive utility by substance or gender. Thus, Study 1 of this research aimed to add to this body of work by exploring the prediction of alcohol, cannabis and other illicit substance use at age fifteen from key indicators of psychological well-being taken at age thirteen. The data from a normative sample of high school students indicated subtle differences in trajectory for young males and females and effects specific to different drug categories. Delinquency emerged as the most consistent predictor in both males and females. Low self-esteem was also an important indicator for future female marijuana use and marijuana intoxication and both male and female other illicit substance use. The findings highlighted the need for a greater contextual understanding of the relationship between delinquency, self-esteem and substance use. The second study sought to provide a deeper understanding of these issues by examining the perceived functional value of substances in relation to psychological wellbeing, by means of a qualitative study of a group of young people who had experienced problems with their substance use. Chapter 4 explores the limited phenomenological research in this area, with a focus on studies which have used methods of measurement that highlight the perspective of young people. Using a Consensual Qualitative Research approach, Study 2 builds on the drug type and gender contrasts noted in Study 1, and explores the interface between substance use and psychological well-being in depth using a clinical population. A number of key functions are identified by young people, with evidence of both convergence and divergence across drug categories (alcohol, cannabis, other illicit substances). Interviewees reported six functions common to all substances; social connectedness, improve affect, positive self-transformation, better coping with problems, fun and laughter, and feeling intoxicated. Nine additional functions were identified in relation to cannabis and other illicit substances. Several gender differences were also noted, with males tending to report more positive reinforcement from alcohol and cannabis, and young females more frequently describing benefits related to use of other illicit substances. The concluding chapter (Chapter 5) reviews the main findings across both studies and their implications for theory, practice, and future research. Overall, the findings of the research provide support for both problem behaviour and adaptive models of adolescent substance use, and indicate that young people are capable of reflecting on their substance use experiences. Incorporating the wisdom of young people into risk frameworks may enhance prevention, education and intervention efforts.

Abstract By 2020 the World Health Organisation has predicted that depression will be the largest cause of disease burden in the world (Ellen, 2002). This study investigated the effects of three interventions (Explanatory Style, Conflict Resolution, and Exercise) on the level of well-being of adolescents from the middle years of schooling. The research consisted of three studies. Study 1 involved the design of a Student Perception Questionnaire. The 28¬–item Student Perception Questionnaire was created to measure the outcomes of the three interventions and was trialled on 215 Middle School students. A Principal Components analysis with Varimax rotation was performed on the data retrieved from the respondents, and all items were retained on the questionnaire, although four factors did not show a .30 loading. Study 2, a Pilot Study, was conducted with three students to trial the interventions and measures in preparation for the final study. It included the collection of qualitative and quantitative data. The qualitative data was gained from interviews held with the students, parents, and teachers. Study 2 revealed that the interventions and the measures used to determine the effectiveness of the interventions would be suitable for Study 3. Study 3 was the full intervention that involved 25 students in an intervention group and six students in a no-intervention group. The 25 students were allocated to six groups that were engaged in a counterbalanced design study using the Explanatory Style, Conflict Resolution, and Exercise interventions. The group of six students was used as a comparison group. The results showed that students in the intervention group experienced a reduction of internalising behaviours such as withdrawal and depressive symptoms following all three interventions. The program as a whole was successful in reducing depressive symptoms and the interventions individually also significantly reduced depressive symptoms. The intervention group developed more optimistic thinking styles following the explanatory style intervention. Analysis of parent data revealed that parents of the intervention group were experiencing significant feelings of incompetence and guilt towards themselves as parents. In the members of the no-intervention group, having good social skills and a strong support network of friends and family were protective factors against depressive symptoms. The thesis showed that interventions can be used with adolescents that are effective in reducing depressive symptoms and do not have negative side effects, such as those associated with medications.

Abstract By 2020 the World Health Organisation has predicted that depression will be the largest cause of disease burden in the world (Ellen, 2002). This study investigated the effects of three interventions (Explanatory Style, Conflict Resolution, and Exercise) on the level of well-being of adolescents from the middle years of schooling. The research consisted of three studies. Study 1 involved the design of a Student Perception Questionnaire. The 28¬–item Student Perception Questionnaire was created to measure the outcomes of the three interventions and was trialled on 215 Middle School students. A Principal Components analysis with Varimax rotation was performed on the data retrieved from the respondents, and all items were retained on the questionnaire, although four factors did not show a .30 loading. Study 2, a Pilot Study, was conducted with three students to trial the interventions and measures in preparation for the final study. It included the collection of qualitative and quantitative data. The qualitative data was gained from interviews held with the students, parents, and teachers. Study 2 revealed that the interventions and the measures used to determine the effectiveness of the interventions would be suitable for Study 3. Study 3 was the full intervention that involved 25 students in an intervention group and six students in a no-intervention group. The 25 students were allocated to six groups that were engaged in a counterbalanced design study using the Explanatory Style, Conflict Resolution, and Exercise interventions. The group of six students was used as a comparison group. The results showed that students in the intervention group experienced a reduction of internalising behaviours such as withdrawal and depressive symptoms following all three interventions. The program as a whole was successful in reducing depressive symptoms and the interventions individually also significantly reduced depressive symptoms. The intervention group developed more optimistic thinking styles following the explanatory style intervention. Analysis of parent data revealed that parents of the intervention group were experiencing significant feelings of incompetence and guilt towards themselves as parents. In the members of the no-intervention group, having good social skills and a strong support network of friends and family were protective factors against depressive symptoms. The thesis showed that interventions can be used with adolescents that are effective in reducing depressive symptoms and do not have negative side effects, such as those associated with medications.

Adolescence is a time of experimentation and exploration. For many young people, a feature of this developmental period is the initiation of substance use. Whilst the majority of young people do not go on to develop substance use problems, any substance use has potential for danger. The current body of literature on the prevention of substance use problems suggests that in order to advance understanding, researchers must adopt a risk-focused approach. There is a wide range of indices that have been cited as risk factors for the development of substance use disorders. Chapter 2 explores some of the aetiological models and literature on risk factors with specific reference to psychological wellbeing, studies highlighting comorbid relationships between adolescent mental health and substance use problems, and the functional value of substances in relation to well-being. Although attention to psychological risk factors has received increased press in the literature, the number of controlled, longitudinal studies is relatively small. A review of recent studies (Chapter 3) indicates that the presence of anxiety, depression, low self-esteem or behavioural problems such as delinquency represent psychological risk factors for the development of later substance use problems, however findings are inconsistent and many studies do not examine differential predictive utility by substance or gender. Thus, Study 1 of this research aimed to add to this body of work by exploring the prediction of alcohol, cannabis and other illicit substance use at age fifteen from key indicators of psychological well-being taken at age thirteen. The data from a normative sample of high school students indicated subtle differences in trajectory for young males and females and effects specific to different drug categories. Delinquency emerged as the most consistent predictor in both males and females. Low self-esteem was also an important indicator for future female marijuana use and marijuana intoxication and both male and female other illicit substance use. The findings highlighted the need for a greater contextual understanding of the relationship between delinquency, self-esteem and substance use. The second study sought to provide a deeper understanding of these issues by examining the perceived functional value of substances in relation to psychological wellbeing, by means of a qualitative study of a group of young people who had experienced problems with their substance use. Chapter 4 explores the limited phenomenological research in this area, with a focus on studies which have used methods of measurement that highlight the perspective of young people. Using a Consensual Qualitative Research approach, Study 2 builds on the drug type and gender contrasts noted in Study 1, and explores the interface between substance use and psychological well-being in depth using a clinical population. A number of key functions are identified by young people, with evidence of both convergence and divergence across drug categories (alcohol, cannabis, other illicit substances). Interviewees reported six functions common to all substances; social connectedness, improve affect, positive self-transformation, better coping with problems, fun and laughter, and feeling intoxicated. Nine additional functions were identified in relation to cannabis and other illicit substances. Several gender differences were also noted, with males tending to report more positive reinforcement from alcohol and cannabis, and young females more frequently describing benefits related to use of other illicit substances. The concluding chapter (Chapter 5) reviews the main findings across both studies and their implications for theory, practice, and future research. Overall, the findings of the research provide support for both problem behaviour and adaptive models of adolescent substance use, and indicate that young people are capable of reflecting on their substance use experiences. Incorporating the wisdom of young people into risk frameworks may enhance prevention, education and intervention efforts.

Adolescence is a time of experimentation and exploration. For many young people, a feature of this developmental period is the initiation of substance use. Whilst the majority of young people do not go on to develop substance use problems, any substance use has potential for danger. The current body of literature on the prevention of substance use problems suggests that in order to advance understanding, researchers must adopt a risk-focused approach. There is a wide range of indices that have been cited as risk factors for the development of substance use disorders. Chapter 2 explores some of the aetiological models and literature on risk factors with specific reference to psychological wellbeing, studies highlighting comorbid relationships between adolescent mental health and substance use problems, and the functional value of substances in relation to well-being. Although attention to psychological risk factors has received increased press in the literature, the number of controlled, longitudinal studies is relatively small. A review of recent studies (Chapter 3) indicates that the presence of anxiety, depression, low self-esteem or behavioural problems such as delinquency represent psychological risk factors for the development of later substance use problems, however findings are inconsistent and many studies do not examine differential predictive utility by substance or gender. Thus, Study 1 of this research aimed to add to this body of work by exploring the prediction of alcohol, cannabis and other illicit substance use at age fifteen from key indicators of psychological well-being taken at age thirteen. The data from a normative sample of high school students indicated subtle differences in trajectory for young males and females and effects specific to different drug categories. Delinquency emerged as the most consistent predictor in both males and females. Low self-esteem was also an important indicator for future female marijuana use and marijuana intoxication and both male and female other illicit substance use. The findings highlighted the need for a greater contextual understanding of the relationship between delinquency, self-esteem and substance use. The second study sought to provide a deeper understanding of these issues by examining the perceived functional value of substances in relation to psychological wellbeing, by means of a qualitative study of a group of young people who had experienced problems with their substance use. Chapter 4 explores the limited phenomenological research in this area, with a focus on studies which have used methods of measurement that highlight the perspective of young people. Using a Consensual Qualitative Research approach, Study 2 builds on the drug type and gender contrasts noted in Study 1, and explores the interface between substance use and psychological well-being in depth using a clinical population. A number of key functions are identified by young people, with evidence of both convergence and divergence across drug categories (alcohol, cannabis, other illicit substances). Interviewees reported six functions common to all substances; social connectedness, improve affect, positive self-transformation, better coping with problems, fun and laughter, and feeling intoxicated. Nine additional functions were identified in relation to cannabis and other illicit substances. Several gender differences were also noted, with males tending to report more positive reinforcement from alcohol and cannabis, and young females more frequently describing benefits related to use of other illicit substances. The concluding chapter (Chapter 5) reviews the main findings across both studies and their implications for theory, practice, and future research. Overall, the findings of the research provide support for both problem behaviour and adaptive models of adolescent substance use, and indicate that young people are capable of reflecting on their substance use experiences. Incorporating the wisdom of young people into risk frameworks may enhance prevention, education and intervention efforts.

Adolescence is a time of experimentation and exploration. For many young people, a feature of this developmental period is the initiation of substance use. Whilst the majority of young people do not go on to develop substance use problems, any substance use has potential for danger. The current body of literature on the prevention of substance use problems suggests that in order to advance understanding, researchers must adopt a risk-focused approach. There is a wide range of indices that have been cited as risk factors for the development of substance use disorders. Chapter 2 explores some of the aetiological models and literature on risk factors with specific reference to psychological wellbeing, studies highlighting comorbid relationships between adolescent mental health and substance use problems, and the functional value of substances in relation to well-being. Although attention to psychological risk factors has received increased press in the literature, the number of controlled, longitudinal studies is relatively small. A review of recent studies (Chapter 3) indicates that the presence of anxiety, depression, low self-esteem or behavioural problems such as delinquency represent psychological risk factors for the development of later substance use problems, however findings are inconsistent and many studies do not examine differential predictive utility by substance or gender. Thus, Study 1 of this research aimed to add to this body of work by exploring the prediction of alcohol, cannabis and other illicit substance use at age fifteen from key indicators of psychological well-being taken at age thirteen. The data from a normative sample of high school students indicated subtle differences in trajectory for young males and females and effects specific to different drug categories. Delinquency emerged as the most consistent predictor in both males and females. Low self-esteem was also an important indicator for future female marijuana use and marijuana intoxication and both male and female other illicit substance use. The findings highlighted the need for a greater contextual understanding of the relationship between delinquency, self-esteem and substance use. The second study sought to provide a deeper understanding of these issues by examining the perceived functional value of substances in relation to psychological wellbeing, by means of a qualitative study of a group of young people who had experienced problems with their substance use. Chapter 4 explores the limited phenomenological research in this area, with a focus on studies which have used methods of measurement that highlight the perspective of young people. Using a Consensual Qualitative Research approach, Study 2 builds on the drug type and gender contrasts noted in Study 1, and explores the interface between substance use and psychological well-being in depth using a clinical population. A number of key functions are identified by young people, with evidence of both convergence and divergence across drug categories (alcohol, cannabis, other illicit substances). Interviewees reported six functions common to all substances; social connectedness, improve affect, positive self-transformation, better coping with problems, fun and laughter, and feeling intoxicated. Nine additional functions were identified in relation to cannabis and other illicit substances. Several gender differences were also noted, with males tending to report more positive reinforcement from alcohol and cannabis, and young females more frequently describing benefits related to use of other illicit substances. The concluding chapter (Chapter 5) reviews the main findings across both studies and their implications for theory, practice, and future research. Overall, the findings of the research provide support for both problem behaviour and adaptive models of adolescent substance use, and indicate that young people are capable of reflecting on their substance use experiences. Incorporating the wisdom of young people into risk frameworks may enhance prevention, education and intervention efforts.

Adolescence is a time of experimentation and exploration. For many young people, a feature of this developmental period is the initiation of substance use. Whilst the majority of young people do not go on to develop substance use problems, any substance use has potential for danger. The current body of literature on the prevention of substance use problems suggests that in order to advance understanding, researchers must adopt a risk-focused approach. There is a wide range of indices that have been cited as risk factors for the development of substance use disorders. Chapter 2 explores some of the aetiological models and literature on risk factors with specific reference to psychological wellbeing, studies highlighting comorbid relationships between adolescent mental health and substance use problems, and the functional value of substances in relation to well-being. Although attention to psychological risk factors has received increased press in the literature, the number of controlled, longitudinal studies is relatively small. A review of recent studies (Chapter 3) indicates that the presence of anxiety, depression, low self-esteem or behavioural problems such as delinquency represent psychological risk factors for the development of later substance use problems, however findings are inconsistent and many studies do not examine differential predictive utility by substance or gender. Thus, Study 1 of this research aimed to add to this body of work by exploring the prediction of alcohol, cannabis and other illicit substance use at age fifteen from key indicators of psychological well-being taken at age thirteen. The data from a normative sample of high school students indicated subtle differences in trajectory for young males and females and effects specific to different drug categories. Delinquency emerged as the most consistent predictor in both males and females. Low self-esteem was also an important indicator for future female marijuana use and marijuana intoxication and both male and female other illicit substance use. The findings highlighted the need for a greater contextual understanding of the relationship between delinquency, self-esteem and substance use. The second study sought to provide a deeper understanding of these issues by examining the perceived functional value of substances in relation to psychological wellbeing, by means of a qualitative study of a group of young people who had experienced problems with their substance use. Chapter 4 explores the limited phenomenological research in this area, with a focus on studies which have used methods of measurement that highlight the perspective of young people. Using a Consensual Qualitative Research approach, Study 2 builds on the drug type and gender contrasts noted in Study 1, and explores the interface between substance use and psychological well-being in depth using a clinical population. A number of key functions are identified by young people, with evidence of both convergence and divergence across drug categories (alcohol, cannabis, other illicit substances). Interviewees reported six functions common to all substances; social connectedness, improve affect, positive self-transformation, better coping with problems, fun and laughter, and feeling intoxicated. Nine additional functions were identified in relation to cannabis and other illicit substances. Several gender differences were also noted, with males tending to report more positive reinforcement from alcohol and cannabis, and young females more frequently describing benefits related to use of other illicit substances. The concluding chapter (Chapter 5) reviews the main findings across both studies and their implications for theory, practice, and future research. Overall, the findings of the research provide support for both problem behaviour and adaptive models of adolescent substance use, and indicate that young people are capable of reflecting on their substance use experiences. Incorporating the wisdom of young people into risk frameworks may enhance prevention, education and intervention efforts.