Bakgrund: Evidens styrker att teamrehabilitering är en lämplig rehabiliteringsform för patienter med reumatiska sjukdomar. Gruppträning har i tidigare studier visat goda resultat för personer med reumatisk sjukdom. Dock är forskning om den subjektiva upplevelsen av gruppträningen bristfällig. Syfte: Syftet med studien är att ur ett socialkognitivt perspektiv undersöka vilka upplevelser och erfarenheter deltagare med reumatisk sjukdom fått av den gruppträning som ingår i teamrehabiliteringen. Metod: Studien har en kvalitativ design med induktiv ansats. Semistrukturerade intervjuer utfördes. Fem deltagare inkluderades och det insamlade materialet analyserades genom en kvalitativ innehållsanalys. Resultat: Det framkom att deltagarna hade en positiv uppfattning om teamrehabiliteringen och att de tog med sig många erfarenheter därifrån. Samhörigheten i gruppen framhölls särskilt av deltagarna. Resultatet visar också att deltagarna fick ökad förståelse om träningens effekt i relation till välmående och smärthantering. Slutsats: Gruppträning skapar en samhörighet som skapar förutsättningar för en ökad förståelse för sin situation. Erfarenheten att leva med en reumatisk sjukdom kan sammanföra personer och bidrar till att ett erfarenhets- och kunskapsutbyte sker. Många av upplevelserna och erfarenheterna som framkom kunde kopplas till begrepp inom den socialkognitiva teorin. Större och kvantitativa studier inom ämnet gör det möjligt överföra studiens resultat till en större population. / Background: Evidence proving the team rehabilitation is an appropriate rehabilitation for patients with rheumatic diseases. Group training has previously shown good result for people with rheumatic disease. Research on the subjective experience of group training is deficient. Objective: The purpose of this study is that from a social cognitive perspective investigate the perceptions and experiences of participants with rheumatic disease received by the group exercise as part of the rehabilitation. Method: The study has a qualitative design with inductive approach. Semi-structured interviews were conducted. Five participants were included and the collected material was analyzed by qualitative content analysis. Result: It was revealed that the participants had a positive perception of the team rehabilitation and they brought with them many experiences from there. The connection within the group was particularly emphasized by the participants. The result also shows that the participants had increased understanding of the benefits of exercise in relation to well-being and pain management. Conclusion: The experience of living with a rheumatic disease can bring together people and contributes to the experience and knowledge exchange takes place. Many of the experiences and the experiences that emerged could be linked to concepts in the social cognitive theory.

INTRODUÇÃO: A dermatite atópica (DA) é uma doença inflamatória crônica, comum, da pele que afeta a vida das crianças. No tratamento desta doença tem-se, cada vez mais, demonstrado a importância e a necessidade de desenvolver ações educacionais/ terapêuticos, multidisciplinares focadas em informações sobre o manejo da doença para os pacientes desenvolverem um melhor curso da doença e, consequentemente, melhor prognóstico. OBJETIVOS: Este estudo tem como objetivo apresentar os resultados de um jogo educativo/terapêutico, especialmente desenvolvido, para crianças dos 7 aos 12 anos de idade, com intenção de possibilitar o acesso a informações e aumentar a adesão ao tratamento de pacientes jovens com dermatite atópica de uma forma lúdica e eficiente. MÉTODOS: O jogo foi estruturado em cinco grandes grupos para emular as situações vividas pelas crianças: família, escola, consultório médico, amigos e sentimentos. O planejamento foi realizado a partir de um script anterior, que foi contextualizado em situações de jogo, através dele procurou-se adaptar o conteúdo e argumentos, narrativa, procurando associar o jogo, as intenções pedagógicas, características cognitivas das crianças dessa faixa etária, bem como a desejada abordagem psicológica para lidar com a doença. O jogo estava disponível através do formato swf2 permitindo usar em casa ou no escritório do médico. Para testar o jogo foi feito um estudo experimental "antes-depois", incluindo crianças de 7-12 anos de idade, com dermatite atópica. Trinta e três crianças brincavam individualmente. O desfecho analisado foi o grau de conhecimento e habilidades de gerenciamento de sintomas da dermatite atópica após o uso do jogo por 30 dias, avaliado por um questionário de conhecimentos sobre a doença. Todas as crianças e seus pais expressaram suas opiniões sobre o jogo através de um outro questionário de opinião. A coleta de dados foi realizada no período entre 2009 e 2010, e a análise foi realizada utilizando SPSS 17,0 entre 2010 e 2011. RESULTADOS: As trinta e três crianças utilizaram o jogo uma vez e responderam ao questionário antes de jogar, e, deste total, 15 responderam ao questionário pela segunda vez. Verificou-se que as crianças que usaram o jogo aumentaram seu conhecimento sobre a doença em 5 pontos (questionário sobre DA), IC 95%: 3,5-6,1. CONCLUSÃO: A ampliação do uso do território virtual, tais como os jogos e internet, podem desenvolver novas oportunidades para tratamento médico e psicológico permitindo a projeção de sentimentos, desejos, frustrações e outras manifestações de usuários, sejam eles crianças ou adultos jovens, e permitir a aquisição de informações sobre o manejo da doença de uma forma lúdica e agradável para pacientesjovens. / INTRODUCTION: Atopic dermatitis (AD) is a common chronic inflammatory skin disease that affects children’s life. The treatment of AD has increasingly shown the importance and need to develop educational/therapeutic, multidisciplinary actions focused on information about the management of the disease for the patients to have a better disease course and prognosis. OBJECTIVES: This study aims to present the results of an educational/therapeutic game for children from 7 to 12 years old, developed to disseminate information and increase adherence to treatment of young patients with atopic dermatitis in a playful and efficient way. METHODS: The game was structured into five major groups to emulate the situations experienced by children: family, school, doctor’s office, friends and feelings. The planning was carried out from a previous script which was contextualized in game situations, through a script that sought to adapt the content and narrative arguments, seeking to associate game play, pedagogical intentions, cognitive characteristics of children in this age group as well as the desired psychological approach for coping with the disease, in that situation. The game was available through the swf2 format enabling to use either at home or at the doctor’s office. To test the game was made an experimental “before-after” study, including 7-12 years- old children with atopic dermatitis. Thirty three children played individually. The analyzed outcome was the degree of knowledge and management abilities of atopic dermatitis symptoms after using the game for thirty days, verified by a questionnaire of knowledge about the disease. All children and their parents expressed their opinions about the game through an opinion questionnaire. Data collection was performed in the period between 2009 and 2010, and the analysis was performed using SPSS 17.0 between 2010 and 2011. RESULTS: A total of 33 children used the game once and answered the questionnaire before playing, and, from this total, 15 answered the questionnaire for a second time. It was found that children who used the game increased their knowledge about the disease in 5 points (questionnaire on AD), 95% CI: 3.5 to 6.1. CONCLUSION: The expanded use of virtual territories, such as the games and the internet, to develop new opportunities for medical and psychological treatment enable the projection of feelings, desires, frustrations and other manifestations of users, whether they are children or young adults, and enable the acquisition of information on the disease management in a playful and enjoyable way for young patients.

Made available in DSpace on 2013-01-07T15:55:00Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 22.pdf: 1358732 bytes, checksum: 2728a2675c29f1ff014ec2a448dc4e2b (MD5) Previous issue date: 2010 / A presente dissertação tenciona investigar algumas práticas, saberes e categorias psiquiátricas em jogo em três experiências individuais que envolveram loucura, assassinato e simulação de loucura no Rio de Janeiro do início do século XX (entre 1901 e 1921). Os atores médicos envolvidos nestes casos ligavam-se aos principais espaços e instituições da psiquiatria na cidade: o Serviço Médico-Legal da Polícia, o Pavilhão de Observações do Hospício Nacional de Alienados, o Hospício Nacional de Alienados e a sua Seção Lombroso, embrião do Manicômio Judiciário do Rio de Janeiro. Procuramos, todavia, não esquecer a experiência desses sujeitos enredados pela psiquiatria, suas trajetórias evivências, percepções e sofrimentos, assim como os discursos de outros atores acerca desses casos, como a imprensa e intelectuais de expressão do período. Tentamos, por um lado, compreender alguns dos principais influxos sócio-culturais sobre a prática psiquiátrica produzida nos espaços citados. Por outro, buscamos situar alguns conflitos e questões internas à psiquiatria do período, analisando suas estratégias na construção do diagnóstico de simulação de loucura e sua heterogeneidade de concepções em jogo na construção de algumas categorias de doença mental. Os casos aqui focados, embora com elementos diversos, possuem alguns ingredientes comuns como: o crime de homicídio, a intervenção da imprensa, a comoção pública, o trágico e, principalmente, o intercurso do saber médico-psiquiátrico.

INTRODUÇÃO: A dermatite atópica (DA) é uma doença inflamatória crônica, comum, da pele que afeta a vida das crianças. No tratamento desta doença tem-se, cada vez mais, demonstrado a importância e a necessidade de desenvolver ações educacionais/ terapêuticos, multidisciplinares focadas em informações sobre o manejo da doença para os pacientes desenvolverem um melhor curso da doença e, consequentemente, melhor prognóstico. OBJETIVOS: Este estudo tem como objetivo apresentar os resultados de um jogo educativo/terapêutico, especialmente desenvolvido, para crianças dos 7 aos 12 anos de idade, com intenção de possibilitar o acesso a informações e aumentar a adesão ao tratamento de pacientes jovens com dermatite atópica de uma forma lúdica e eficiente. MÉTODOS: O jogo foi estruturado em cinco grandes grupos para emular as situações vividas pelas crianças: família, escola, consultório médico, amigos e sentimentos. O planejamento foi realizado a partir de um script anterior, que foi contextualizado em situações de jogo, através dele procurou-se adaptar o conteúdo e argumentos, narrativa, procurando associar o jogo, as intenções pedagógicas, características cognitivas das crianças dessa faixa etária, bem como a desejada abordagem psicológica para lidar com a doença. O jogo estava disponível através do formato swf2 permitindo usar em casa ou no escritório do médico. Para testar o jogo foi feito um estudo experimental "antes-depois", incluindo crianças de 7-12 anos de idade, com dermatite atópica. Trinta e três crianças brincavam individualmente. O desfecho analisado foi o grau de conhecimento e habilidades de gerenciamento de sintomas da dermatite atópica após o uso do jogo por 30 dias, avaliado por um questionário de conhecimentos sobre a doença. Todas as crianças e seus pais expressaram suas opiniões sobre o jogo através de um outro questionário de opinião. A coleta de dados foi realizada no período entre 2009 e 2010, e a análise foi realizada utilizando SPSS 17,0 entre 2010 e 2011. RESULTADOS: As trinta e três crianças utilizaram o jogo uma vez e responderam ao questionário antes de jogar, e, deste total, 15 responderam ao questionário pela segunda vez. Verificou-se que as crianças que usaram o jogo aumentaram seu conhecimento sobre a doença em 5 pontos (questionário sobre DA), IC 95%: 3,5-6,1. CONCLUSÃO: A ampliação do uso do território virtual, tais como os jogos e internet, podem desenvolver novas oportunidades para tratamento médico e psicológico permitindo a projeção de sentimentos, desejos, frustrações e outras manifestações de usuários, sejam eles crianças ou adultos jovens, e permitir a aquisição de informações sobre o manejo da doença de uma forma lúdica e agradável para pacientesjovens. / INTRODUCTION: Atopic dermatitis (AD) is a common chronic inflammatory skin disease that affects children’s life. The treatment of AD has increasingly shown the importance and need to develop educational/therapeutic, multidisciplinary actions focused on information about the management of the disease for the patients to have a better disease course and prognosis. OBJECTIVES: This study aims to present the results of an educational/therapeutic game for children from 7 to 12 years old, developed to disseminate information and increase adherence to treatment of young patients with atopic dermatitis in a playful and efficient way. METHODS: The game was structured into five major groups to emulate the situations experienced by children: family, school, doctor’s office, friends and feelings. The planning was carried out from a previous script which was contextualized in game situations, through a script that sought to adapt the content and narrative arguments, seeking to associate game play, pedagogical intentions, cognitive characteristics of children in this age group as well as the desired psychological approach for coping with the disease, in that situation. The game was available through the swf2 format enabling to use either at home or at the doctor’s office. To test the game was made an experimental “before-after” study, including 7-12 years- old children with atopic dermatitis. Thirty three children played individually. The analyzed outcome was the degree of knowledge and management abilities of atopic dermatitis symptoms after using the game for thirty days, verified by a questionnaire of knowledge about the disease. All children and their parents expressed their opinions about the game through an opinion questionnaire. Data collection was performed in the period between 2009 and 2010, and the analysis was performed using SPSS 17.0 between 2010 and 2011. RESULTS: A total of 33 children used the game once and answered the questionnaire before playing, and, from this total, 15 answered the questionnaire for a second time. It was found that children who used the game increased their knowledge about the disease in 5 points (questionnaire on AD), 95% CI: 3.5 to 6.1. CONCLUSION: The expanded use of virtual territories, such as the games and the internet, to develop new opportunities for medical and psychological treatment enable the projection of feelings, desires, frustrations and other manifestations of users, whether they are children or young adults, and enable the acquisition of information on the disease management in a playful and enjoyable way for young patients.

Bakgrund: Långvarig smärta antas drabba var femte person i Sverige och bland dem är rörelserädsla vanligt. Rörelserädsla är komplext och kan påverka en person biomedicinskt, psykologiskt och socialt, varför fysioterapeuten bör använda ett beteendemedicinskt arbetssätt. Forskning har visat att fysioterapeuter har svårt att identifiera psykosociala faktorer kopplade till rörelserädsla. Syfte: Att studera hur fysioterapeuter beskriver sitt arbete med patienter med rörelserädsla relaterat till långvarig smärta. Metod: En kvalitativ intervjustudie genomfördes. Sju fysioterapeuter från olika typer av verksamheter rekryterades genom ett ändamålsenligt bekvämlighetsurval. Data analyserades manifest med en induktiv ansats. Resultat: Analysen resulterade i fem kategorier med tre till fem underkategorier vardera: “Uppfattning om utmärkande drag och beteenden hos patienter med rörelserädsla”, “Grundförutsättningar för ett framgångsrikt arbete”, “Identifiera och skapa förståelse för patientens rörelserädsla”, “Strategier för att förändra tankar och känslor i samband med rörelse” och “Omständigheter som kan göra arbetet utmanande eller svårt”. Slutsats: Ett biopsykosocialt och beteendemedicinskt arbetssätt beskrevs användas vid arbetet med dessa patienter. Arbetet beskrevs som komplext och utmanande för en fysioterapeut att hantera ensam. Teamarbete, tydliga målsättningar och en god relation mellan parterna uttrycktes vara viktigt för att lyckas. / Background: Chronic pain is assumed to affect every fifth person in Sweden and fear of movement is common. Fear of movement is complex and affects a person biomedically, psychologically and socially, why physiotherapist's should use a behavioral medicine approach. Research has shown that physiotherapist's have difficulty identifying psychosocial factors involved in fear of movement. Aim: To study how physiotherapist's describe their work with patients with fear of movement related to chronic pain. Method: A qualitative interview study was conducted. Seven physiotherapist's were recruited through a purposive convenience sample. Data was analyzed manifestly with an inductive approach. Result: The analysis resulted in five main categories: “Perception of distinguishing features and behaviors in patients with fear of movement”, “Essential prerequisites for successful work”, “Identify and create understanding of the patient's fear of movement”, “Strategies for changing thoughts and emotions related to movement” and “Circumstances that can make the work challenging or difficult”. Conclusion: A biopsychosocial and behavioral medicine approach was described to be used when working with these patients. The work was described as challenging for physiotherapist's to handle alone. Teamwork, clear goal setting and a good patient-therapist relationship were expressed to be important.

Background: Chronic low back pain (CLBP) is common in primary care worldwide. A patient-centered biopsychosocial approach has been shown to be effective for treatment of CLBP. Research has shown that strength training can reduce pain, increase function, increased self-confidence as well as counteract fear of movement. Purpose: To investigate physiotherapists' experiences of using strength training for individuals with CLBP.Method: A qualitative interview study with descriptive design was conducted. A purposive convenience sample was applied, resulting in six physiotherapists being interviewed. The collected material was analyzed by a manifest inductive content analysis. Result: The analysis resulted in five categories as well as 15 subcategories. The categories were "Patients need to be motivated to perform strength training", "Strength training needs to be individualized", "Pain and fear is an obstacle to strength training", "Strength training has beneficial effects" and "Strength training often combined with other treatment".  Conclusion: The conclusion was made that treating CLBP using strength training was complex. The physiotherapists' experiences emphasized the difficulties, benefits, and drawbacks of using strength training for CLBP, as well as emphasizing the benefits of using individualized training together with behavioral medicine and a holistic approach. / Bakgrund: Långvarig ländryggssmärta är vanligt förekommande inom primärvården världen över. Ett patientcentrerat förhållningssätt där biopsykosociala faktorer tas i beaktning har visats effektiv i behandlingen av patientgruppen. Styrketräning vid långvarig smärta kan ge en effekt av minskad smärta, ökad funktion, ökat självförtroende och kan användas för att motarbeta rörelserädsla.Syfte: Att undersöka fysioterapeuters erfarenheter vid användning av styrketräning som behandling av individer med långvarig ländryggssmärta. Metod: En kvalitativ intervjustudie med deskriptiv design genomfördes. Ett ändamålsenligt bekvämlighetsurval tillämpades vilket resulterade i att sex fysioterapeuter intervjuades utifrån en semistrukturerad intervjuguide. Det insamlade materialet analyserades genom en manifest induktiv innehållsanalys. Resultat: Dataanalysen resulterade i fem kategorier och 15 underkategorier, Kategoriernas namn var ”Patienterna behöver motiveras till att utföra styrketräning”, ”Styrketräningen behöver individanpassas”, ”Rädsla och smärtan utgör ett hinder för styrketräningen”, ”Styrketräning ger goda effekter” och ”Styrketräning ofta i kombination med annan behandling”.  Slutsats: Slutsatsen drogs att ordinering av styrketräning vid långvarig ländryggssmärta var komplext. Fysioterapeuternas erfarenheter belyser svårigheter med att nyttja styrketräning vid långvarig ländryggssmärta, styrketräningens styrkor och begräsningar samt att det är fördelaktigt att arbeta individanpassat med ett beteendemedicinskt helhetsperspektiv.

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Recognizing and understanding the potentially powerful roles that religiousness and spirituality (RS) may serve in the prevention and amelioration of disease, as well as symptom management and health related quality of life, significantly enhances research and clinical efforts across many areas of behavioral medicine. This article examines the knowledge established to date and suggests advances that remain to be made. We begin with a brief summary of the current knowledge regarding RS as related to three exemplary health conditions: (a) cardiovascular disease; (b) cancer; and, (c) substance abuse. We then focus on particular concerns for future investigations, emphasizing conceptual issues, possible mediators and moderators of relationships or effects, and methodology. Our discussion is framed by a conceptual model that may serve to guide and organize future investigations. This model highlights a number of important issues regarding the study of links between RS and health: (a) RS comprise many diverse constructs, (b) the mechanisms through which RS may influence health outcomes are quite diverse, and (c) a range of different types of health and health relevant outcomes may be influenced by RS. The multidimensional nature of RS and the complexity of related associations with different types of health relevant outcomes present formidable challenges to empirical study in behavioral medicine. These issues are referred to throughout our review and we suggest several solutions to the presented challenges in our summary. We end with a presentation of barriers to be overcome, along with strategies for doing so, and concluding thoughts.

What is the Primary Care Behavioral Health (PCBH) model of service delivery? Clinician innovators, administrators, and researchers have continued to refine the answer to this question. In the same way a recipe for mac n cheese provides the resources needed (i.e., ingredients), processes to make the dish, and expected outcomes (e.g., number of servings), a comprehensive operational definition for PCBH is needed to help improve the rigor of research being conducted. This recipe can also help clinicians/administrators identify a basic recipe for PCBH that standardizes the necessary components and amounts to achieve the expected outcomes. In this editorial, we provide a comprehensive operational recipe for PCBH based on current research. We are calling people to assist us by (a) utilizing the recipe to help improve the reporting and rigor of PCBH research and (b) applying the proposed operational definitions and targets within the recipe to help us refine and validate them. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Bakgrund: Personer med Parkinsons sjukdom är inte lika fysiskt aktiva som friska individer och uppnår således inte rekommendationerna för fysisk aktivitet. Fysioterapi och fysisk träning är således en viktig del i behandlingen av sjukdomen. Enligt författarnas kännedom saknas det svenska studier som undersöker beteendemedicinska faktorer av hur personer med Parkinsons sjukdom upplever fysisk träning i största allmänhet utan begränsningar till specifik träningsform eller program. Syfte: Att undersöka hur personer med Parkinsons sjukdom upplever fysisk träning. Metod: Kvalitativ design med induktiv ansats. Ett ändamålsenligt bekvämlighetsurval användes där sju informanter inkluderades. Datainsamling genom individuella intervjuer med en semistrukturerad intervjuguide. Materialet analyserades med en kvalitativ innehållsanalys och grupperades i kategorier och underkategorier.  Resultat: Dataanalysen resulterade i 16 underkategorier och fem kategorier; “Träningens påverkan på individens funktioner och förmågor”, “Tankar och erfarenheter kring begränsningar och behov”, “Vad som driver individen till utförande av träning”, “Socialt stöd i relation till träning” samt “Fysisk aktivitet som anses vara träning”. Slutsats: Resultatet beskriver att informanterna upplevde träningen som bra och viktig, och något som hade en positiv effekt på fysiska, psykiska och sociala faktorer. Vidare beskrev informanterna betydelsen av att träna i grupp med andra som också hade Parkinsons sjukdom. / Background: People with Parkin's disease are not as physically active as healthy people and thus do not achieve the recommendations for physical activity. Physiotherapy and physical training are an important part of the treatment of the disease. According to the authors' knowledge, there are no Swedish studies that investigate behavioral factors of how people with Parkinson's disease experience physical exercise in the general public, without restrictions to a specific form of exercise or program. Aim: To investigate how people with Parkinson's disease experience physical exercise. Method: A qualitative design with an inductive approach. A purposeful convenience sample was used where seven informants were included. Data collection through individual interviews with a semi-structured interview guide. The material was analyzed with a qualitative content analysis and grouped into categories and subcategories. Results: The data analysis resulted in 16 subcategories and five categories; "The impact of exercise on the individual's functions and abilities", "Thoughts and experiences regarding limitations and needs", "What drives the individual to exercise", "Social support in relation to exercise" and "Physical activity that is considered to be exercise". Conclusion: The result describes that informants experienced the training as good and important, and something that had a positive effect on physical, psychological and social factors. Furthermore, the informants described the importance of exercising in a group with others who also had Parkinson's disease.