Thesis (Ph. D.)--University of Washington, 2003. / Vita. Includes bibliographical references (leaves 86-97).

Bakgrund Arbetet och dess psykosociala arbetsmiljöfaktorer är av betydelse för välbefinnande i arbetslivet. Syftet med detta examensarbete var att undersöka sambandet mellan arbetsmiljöfaktorer, arbete-livsbalans och arbetsrelaterat välbefinnande samt att identifiera förklaringsfaktorer för välbefinnande i arbetslivet. Metod En kvantitativ tvärsnittsstudie genomfördes med insamlad data från ett pågående projekt, GodA-projektet. Anställda inom tre kommunalt ägda bolag i Gästrikland (n = 303) fick år 2013 besvara en enkät. Utifrån denna har ett antal frågeställningar valts ut för att besvara föreliggande studies syfte. Deskriptiv statistik har använts för sociodemografisk karakteristika och statistisk modellering genom linjära regressionsanalyser för undersökning av samband. Resultat Ett signifikant samband återfanns mellan vissa arbetsmiljöfaktorer (upplevelse av den psykosociala arbetsmiljön, motivation, ledarskap, arbetsförmåga), arbete-livsbalans och välbefinnande i arbetslivet. Huvudresultatet indikerar att dessa variabler har ett signifikant förklaringsvärde för välbefinnande i arbetslivet. Dessa förklarar 40 % av variansen i utfallsvariabeln. Slutsats Arbete-livsbalans och vissa arbetsmiljöfaktorer (uppfattning om den psykosociala arbetsmiljön, motivation, ledarskap, arbetsförmåga) kan predicera arbetsrelaterat välbefinnande. Upplevelsen av den psykosociala arbetsmiljön har visat sig ha det starkaste sambandet med arbetsrelaterat välbefinnande och kan förklaras av att denna inkluderar en samlad bedömning av flertalet olika arbetsmiljöfaktorer och arbete-livsbalans. Med utgångspunkt i tvärsnittsstudiers metodologiska svagheter behövs fler studier av longitudinell art för att kunna dra säkrare slutsatser kring undersökta samband. / Background The work and its psychosocial work factors are important for well-being at work. The purpose of this study was to examine the relationship between work environmental factors, work-life balance and work-related well-being, and to identify explanatory factors for the well- being at work. Method A quantitative cross-sectional study was carried out with data collected from an ongoing project, the GodA-study. Employees within three municipally owned companies in Gästrikland (n = 303) answered a questionnaire in 2013. Based on this, a number of questions were selected to answer the present study’s aim. Descriptive statistics were used for socio- demographic characteristics and statistical modeling by stepwise linear regression analyzes for the study of the relationship. Results A significant association was found between certain work environmental factors (perception of the psychosocial work environment, motivation, leadership, work ability), work- life balance and work-related well-being. The main result indicates that these variables have a significant explanatory value for the well-being at work. These explain 40% of the variance in the outcome variable. Conclusions Work-life balance and certain work environmental factors (perception of the psychosocial work environment, motivation, leadership, work ability) can predict work-related well-being. The perception of the psychosocial work environment has been shown to have the strongest association with work-related well-being and could be explained by the fact that it includes an overall assessment of several different working environment factors and work-life balance. Based on cross-sectional studies’ methodological weaknesses, more studies of longitudinal nature are needed to draw more reliable conclusions.

Aim: The aim of the study was to investigate attitude and practice to prescribe physical activity accordingly FaR® rules among personal at the specialized department of the University Hospital. Methods: A quantitative cross-sectional study was used to answer the purpose. The data were collected using specially designed questionnaire. That contained 11 questions related to interest and complications to use FaR® as a treatment method. A total of 38 individuals participated in the study. The data were analyzed by a descriptive approach through statistical program SPSS. Results: Participants (physicians and nurses) showed very positive attitude to promote physical activity among their patients to achieve better treatment results. In general, both physicians and nurses were positive to the FaR®, as a special tool. However, only 30% of the practitioners who participated in this study used FaR® in their daily practice.  Not scepticism or lack of time was primarily reasons of so low implementation of FaR®. Lack of knowledge about details of FaR® prescription and clear instructions how to do that were perceived as the main obstacle to the prescription of the FaR®. Conclusion: The results showed that there exists clearly positive attitude to use FaR® as an element of treatment of hospitals patients. Obtained results indicate the necessity of better information about the FaR® as a method and more clearly described routine and orders how to implement this method. / Syfte: Syftet med studien var att undersöka vilka faktorer som påverkar förskrivningen av FaR® utav den legitimerade personalen på en medicinsk thorax division vid ett universitets sjukhus. Metod: För att besvara syftet användes en enkät. Totalt 38 personer deltog i studien. De fick besvara ett frågeformulär med 11 frågor om kunskap, utbildning, attityd och praktisk tillämpning av FaR®. Resultat: Resultatet visade att alla respondenter hade en mycket god attityd och inställning till användningen av fysisk aktivitet som terapeutiskt instrument och till förskrivning av FaR®. Dock förskrev endast 30 procent av personalen FaR®. Knappt hälften hade fått någon utbildning inom FaR® och kunskapsbrist om förskrivningen av FaR® var det främsta hindret till förskrivningen av FaR®. I kommentarer till frågan om upplevda hinder till förskrivningen av FaR®, noterade många respondenter också brist på rutin, instruktion och detaljerad beskrivning av FaR® i praktiken. Slutsats: Enligt denna undersökning finns det en positiv attityd bland sjukhusets personal till användningen av FaR®. Varken underskattning av FaR® eller tidsbrist kunde räknas som aktuella hinder till förskrivningen. Men det som kan anses påverka förskrivningen negativt är att det fanns en stor kunskapsbrist om hur förskrivningen av FaR® går till. Om personalen skulle få utbildning skulle troligtvis förskrivningen öka.

Bakgrund: elevers hälsa och delaktighet har stor betydelse för deras skolprestationer, trivsel och möjlighet att fungera i skolmiljön. Goda skolprestationer är en skyddsfaktor för unga eftersom det minskar sannolikheten för sviktande hälsa, både psykisk och fysisk. Alla elever, inom grund- och gymnasieskola, ska ha tillgång till en samlad elevhälsa där skolsköterskan ingår. Delar av skolsköterskans arbete är lagstadgat, exempelvis de hälsosamtal som ska erbjudas alla elever.   Syfte: Syfte med denna studie var att få ökad kunskap om vad som beskrivs som framgångsfaktorer för att elever ska uppleva delaktighet i sitt hälsosamtal eller i andra samtal/möten med sin skolsköterska. Metod: Systematisk litteraturstudie där data består av fem artiklar. Analysen gjordes med hjälp av kvalitativ innehållsanalys med induktiv ansats.   Resultat: Sex underkategorier trädde fram som sedan byggde upp tre kategorier. Kategorierna var 1. Äkta delaktighet. 2. Skolmiljö som främjar delaktighet och hälsa 3. Relationer och maktförhållanden.  Förutom dessa kategorier framträdde ett övergripande tema som kallades det måste vara ”på riktigt” som utgör det latenta resultatet. Resultatet visade att elever upplevde delaktighet när de fick vara med och definiera sina egna behov och vara aktiva redan under planeringsstadiet av sin undervisning. Hälsofrämjande åtgärder ska ha en förankring i elevens verklighet för att främja delaktighet. Hierarkier och maktförhållanden i skolmiljö hade betydelse för lärande. Äkta delaktighet byggde på att lämna över makten till eleverna och som pedagog eller skolsköterska handleda mot självständigt lärande. Konklusion: Delaktighet har en central roll i hälsofrämjande arbete och det finns samband mellan upplevd delaktighet i skolmiljön och självskattad hälsa. Samma främjande faktorer för delaktighet som forskningen beskriver i mötet mellan pedagog och elev kan gälla i hälsosamtalet och i andra mötet mellan skolsköterska och elev. Att inte vara delaktig signalerar ett utanförskap och då finns en ökad risk för ohälsa. / Background: pupils’ health and participation are important for their performance in school and for their well-being within the school environment. Good school performance is a protective factor for young people as it reduces the likelihood for declining health, both mental and physical. All pupils in primary- and secondary school should have access to a comprehensive student healthcare in which the school-nurse is included.  Some parts of the school-nurses work are legally regulated, for example the health-dialogue that should be offered to every pupil.   Propose: the aim of this study was to get more knowledge of what is described as success factors for pupils to experience participation in their health-dialogue or other meetings with the school-nurse.   Method: systematic literature review of five articles. The analysis was done using qualitative content analysis with inductive approach.   Results: six sub-categories emerged which then were joined together as three categories. 1. Genuine participation. 2. School-environment that promotes participation and health. 3. Relationships and power. In addition to these categories a theme emerged from the latent result: an overarching theme called it has to be “for real”. The results show that pupils experience participation when they are allowed to define their own needs and can be involved in their education already at the planning stage. Health promotion, based on participation, should have a presence in the reality of pupils. Hierarchies and power relationships in the school environment was important for the learning process. Genuine participation was based on handing over power to the students and as a teacher or school nurse you must tutor towards independent learning.   Conclusion: Participation has a central role in health promotion and there is a correlation between perceived participation in the school environment, and self-rated health. The same promoting factors for participation as the research describes between educator and pupils also may apply in the health-dialogue and other meetings between the school nurse and the student. When pupils are not able to participate, it increases the risk of exclusion and illness.

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Unga vuxna tenderar att spendera mer tid på sociala medier än på någon annan daglig aktivitet, där det populäraste sättet att kommunicera är genom att dela bilder. Samtidigt har intresset för hälsa och fitness hos allmänheten ökat de senaste åren. Tidigare studier påvisar att ett ständigt fokus på hälsa och fitness kan leda till låg självkänsla och missnöje över sin kropp. Majotiteten av de tidigare studierna har fokuserat på de negativa hälsoutfallen med sociala medier och påverkan på människors hälsa. Syftet med studien var att ur en neutral synvinkel, beskriva unga kvinnors upplevelser samt påverkan av sociala mediers exponering av kost och träning. En kvalitativ metod tillämpades med två fokusgrupper där deltagarna rekryterades via ett strategiskt urval med kriterierna: kvinna, mellan 18-30 år samt använder sig av minst två sociala medier. Vid analys av data tillämpades en manifest innehållsanalys med induktiv ansats. Resultatet visar att sociala medier används mellan sex till tio timmar om dagen och de vanligaste sociala medierna är Facebook och Instagram. Det framkom både positiva och negativa hälsoutfall med exponeringen, som motivation och inspiration samt upplevd press och ångest, men trots de negativa effekterna upplevde respondenterna exponeringen som övervägande positiv. / Young adults tend to spend more time on social media than on any other daily activity, where the most popular way to communicate is by sharing pictures. At the same time, interest in health and fitness among the public has increased in recent years. Previous studies indicate that a constant focus on health and fitness can lead to low self-esteem and dissatisfaction with one´s body.  The majority of the previous studies have focused on the negative aspects of social media and the impact on people's health. The aim of the study was to describe young women´s experiences, and the impact of social media exposure of diet and exercise, from a neutral point of view. A qualitative method was applied with two focus groups where participants were recruited through a purposive sample with the criteria: woman between 18-30 years and the use of at least two social media. A manifest content analysis with an inductive approach was applied in the analysis of the data. The result shows that social media is used between six and ten hours a day and the most common social medias are Facebook and Instagram. Both positive and negative aspects of exposure were revealed, such as motivation and inspiration, and perceived pressure and anxiety, but despite the negative effects, respondents experienced exposure predominantly positive.

Mental health issues are widespread on college campuses. However, the majority of these individuals do not seek help. Prior research suggests many factors which may be related to mental health help-seeking including age, gender, and prior treatment experience. There has however been little work considering the context of the college campus on mental health help-seeking, specifically the influence of campus culture. Accounting for the context of mental health help-seeking may help to determine which social groups have the greatest influence on mental health treatment processes. The purpose of this study was to explore the relationship between perceived peer, student body, and faculty/administrator perspectives on different aspects influencing mental health help-seeking including attitudes towards treatment, stigma, and treatment barriers. Two hundred and twelve participants were recruited for the study. Data supported mediation for personal attitudes and barriers for the relationship between campus culture variables and mental health help-seeking. Implications for campus mental health policy efforts and directions for future studies are discussed.

Researchers consistently conclude that finances and health are the two most significant factors associated with retirement decision-making and a successful retirement experience. Retirement planning is one mechanism by which individuals prepare for the retirement transition; however, retirement planning routinely emphasizes financial concerns, often to the exclusion of health or other significant aspects of retirement. Retirement planning is an increasingly relevant topic at a time when the population is aging, company-sponsored pensions and retiree benefits have diminished significantly, and reform is being sought for the long-standing social programs that have provided support for generations of older Americans. From a financial perspective, few would question the positive benefits associated with retirement planning; however, preparing for a healthy retirement is equally important. If a relationship between retirement planning and health status were to be established, Americans might find increased public and private support for individual retirement planning efforts, particularly among more vulnerable populations such as minorities and women. This dissertation explores the notion that engagement in retirement planning is associated with health status through three studies. Utilizing data from the Health and Retirement Study (HRS), the first article explores prevalence of plans for retirement among worker and retiree respondents, and compares health and other key characteristics associated with planning among the two sub-samples. The second and third articles focus on time order relationships between health status and retirement planning, with article two addressing the question of whether onset of poor health precedes planning for retirement and article three examining health status of planners versus non-planners, over time, to determine whether those who engage in retirement planning are more likely to realize better health outcomes. A brief review of th e health, retirement, and retirement planning literature provides the theoretical framework for these research questions and related hypotheses.This dissertation consists of five chapters. Chapter 1 is an introduction to the retirement planning and health literature, Chapters 2-4 describe the series of three studies conducted, and Chapter 5 discusses the overall conclusions as well as future directions for research.

Aim: The overall aim of the present thesis was to describe and examine primary care nurses´ self-reports on training, use and performance as well as experiences and actual performance of MI. Method: One qualitative and three quantitative studies were conducted among primary care nurses. A study-specific questionnaire was sent to 980 primary care nurses and 673 (69%) responded (Study I). Semi-structured interviews were conducted with 20 MI trained primary care nurses (Study II). MI sessions between 12 (Study III) respective 23 (Study IV) primary care nurses and patients (total 32 respective 50 sessions) were audio-recorded. Data were analyzed using qualitative content analysis, Motivational Interviewing Integrity Code, Motivational Interviewing Sequential Code for Observing Process Exchanges and statistical analysis. Results: The findings showed that primary care nurses reported and experienced lack of training in MI and lack of prerequisites for using MI (Study I-II), while training, knowledge, prerequisites and time were associated with use of MI. They also reported and experienced that MI facilitated their work with patients (Study I-II) as well as elicited their own ability to motivate and be empathetic (Study II). About half of the primary care nurses reported that they used MI (Study I), and none of the nurses (Study III) achieved the approved skill levels in MI in their recorded sessions. They overestimated their performance on six of eight aspects of MI (Study III). The most frequently used nurse talk in the recorded sessions was neutral, which is not consistent with MI. Questions and reflections directed toward change were most likely to be followed by change talk among patients (Study IV). Conclusions: Self-reported knowledge about MI and personal as well as workplace prerequisites for using it were associated with self-reported use of MI. Participating nurses´ experienced that MI requires openness, practice, support, feedback and willingness. The participating primary care nurses did not achieve approved levels of MI skills in their recorded MI sessions. Patients´ change talk is more likely to occur after open questions, complex reflections as well as after questions and reflections directed toward change. / <p>Finansisärer: Högskolan i Gävle, STROKE-Riksförbundet, Hjärt-lung fonden och Erik, Karin and Gösta Selander Stiftelse</p>

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