Bakgrund: Rökning skapar både ett fysiskt och ett psykologiskt beroende vilket gör vanan svår att bryta. En del av sjuksköterskans ansvarsområde är att arbeta hälsofrämjande och att använda sig av kunskapsbaserade metoder. En av dessa är Motivational Interviewing (MI) som är en patientcentrerad samtalsmetod som kan användas inom omvårdnad i syfte att hjälpa patienter till hälsofrämjande livsstilsförändringar. Inga tydliga riktlinjer finns dock för metodens effektivitet vid rökavvänjning. Syfte: Att undersöka forskningsresultat som stödjer eller avfärdar MI som rökavvänjningsmetod. Design: En litteraturöversikt användes i denna uppsats. Resultat: Resultatet sammanställdes utifrån den vetenskapliga litteraturen. Stöd framkom gällande rökstopp, minskat bruk av cigaretter, motivation, minskat röksug samt kostnadseffektivitet vid återfallsprevention. Avfärdande resultat framkom gällande rökstopp och kostnadseffektivitet vid rökstopp. Slutsats: Resultaten indikerar att metoden kan användas framgångsrikt om den anpassas efter de förutsättningar som ges gällande exempelvis patientens rökvanor och aktuella motivation. Mer forskning behövs dock. / Background: Smoking creates a physiological and psychological dependence which makes the habit difficult to break. Nurses are responsible, as part of their professional duty, to work with lifestyle prevention using evidence-based methods. One of them is Motivational Interviewing, MI, a patient-centered technique, which aims to help patients with health-promoting lifestyle changes. There are no clear guidelines regarding this method's efficiency on smoking cessation. Aim: To study the research findings that support or reject MI on smoking cessation. Design: A literature review was used to perform this study. Results: The results were extracted from the scientific literature. Support were found in relation to smoking cessation, reduced smoking, motivation, reduced temptation to smoke and cost-effectiveness on relapse prevention. However, rejection emerged regarding smoking cessation and cost-effectiveness on smoking cessation. Conclusion: The results indicate that the method can be successfully used if adjusted for the conditions given, for example the patient´s smoking history and current motivation. Further research is needed.

This study focuses on volunteers within the non-profit organization ‘WWOOF’ World Wide Opportunities on Organic Farming, which provides individuals the opportunity to experience a sustainable organic farming through volunteering.  As sustainability needs to be more valued within society and as individuals are seen to develop similar values from their social surrounding, the study examines how being a volunteer on a WWOOF farm influences the volunteer’s personal development. The material findings of 20 semi-structured interviews from previous WWOOF volunteers were collected and indicated four main outcomes: increased environmental awareness, community awareness, a sustainable lifestyle and personal growth among the volunteers. The outcomes are discussed in relation to the following main theories and concepts: sustainable worldview theory, symbolic interactionism, social identity theory, the Third Space and narrative identity theory. The sustainable societal values achieved among the volunteers indicated that being a volunteer on a WWOOF farm, can contribute to improve the global community

This thesis is a subset of a larger “parent” project under the direction of my supervisor, Dr. Cecilia Benoit. The purpose of the larger project is to seize an unique research opportunity that has emerged with the development and implementation of the HerWay Home (HWH) program, a community-based initiative for pregnant and early parenting women who face substance use and other challenges in the Greater Victoria Area. My research has capitalized on the pre-implementation phase of the HWH program between 2010-2011. Thirteen in-person semi-structured interviews were conducted with women who would likely be clients for the HWH program, based on their pregnancy experiences, substance use concerns and other life challenges. The goal of this research has been to explore these women’s pregnancy and postpartum narratives and investigate what, in their view, should be crucial components of the HWH intervention in the short and longterm. My findings indicate that, consistent with the literature on pregnant and early parenting women facing substance use and other life challenges, a range of complex, intertwined disadvantages exist in their lives that translate into multiple barriers to accessing continuous health and social care during their pregnancy and after the birth of their child. An adapted model of the Health Lifestyle Theory is used to frame the analysis of the data collected from this research. The results from this research support the argument that the life choices of the participants are constrained by structural life chances and socially determined inequities that systematically disadvantage and disempower them. The findings also reveal an implicit sense of agency in the women’s narratives, as well as key specifics about what they view as the main gaps in care and their desired program services. The findings will be relayed to HWH organizers, and used to inform the development and implementation of the program’s services. / Graduate

Tyrimo objektas - 16-19 m. Kauno ir Šiaulių gimnazijų moksleivių fizinio aktyvumo, žalingų įpročių ir subjektyvaus sveikatos vertinimo sąsajos. Tyrimo tikslas: įvertinti Kauno ir Šiaulių gimnazijų 16-19 m. moksleivių fizinio aktyvumo, žalingų įpročių ir subjektyvaus sveikatos vertinimo sąsajas. Uždaviniai: 1. Nustatyti moksleivių fizinį aktyvumą lyties, amžiaus ir gyvenamosios vietos aspektu. 2. Nustatyti moksleivių žalingų įpročių paplitimą lyties, amžiaus ir gyvenamosios vietos aspektu. 3. Atskleisti moksleivių fizinio aktyvumo, žalingų sveikatai įpročių ir subjektyvios sveikatos vertinimo tarpusavio ryšį. Hipotezė: fiziškai pasyvesni moksleiviai labiau linkę į žalingus įpročius ir skundžiasi prastesne sveikata. Tyrimo imtis ir organizavimas. Anketinė apklausa buvo vykdoma 2013 m. lapkričio 2014 m. sausio mėnesiais Kaune ir Šiauliuose, kiekvienam tiriamajam taikant anketavimo metodą. Iš viso apklausta 316 moksleivių. Iš jų 161 Kauno mieste ir 155 Šiauliuose. Išvados: 1. Pakankamai fiziškai aktyvūs buvo tik 28,9 proc. visų apklaustų moksleivių. Buvo nustatyta, kad vaikinų dalis, kurie laisvalaikio metu mankštindavosi kasdien arba beveik kasdien buvo dvigubai didesnė dalis negu merginų. 18-19 m. amžiaus moksleiviai rečiau buvo fiziškai aktyvūs kasdien ar beveik kasdien negu 16-17 m. amžiaus mokiniai. Nustatyta, kad Šiaulių mieste kiekvieną dieną fizine veikla užsiiminėjo 33,8 proc., tuo tarpu Kauno mieste kasdien ar beveik kasdien aktyvių moksleivių buvo tik 24,2 proc. 2... [toliau žr. visą tekstą] / Subject – the relationships between physical activity, unhealthy lifestyle-related habits and self-rated health of 16-19 year old students of gymnasium schools of Kaunas and Šiauliai cities. Aim of the study: to assess the relationship between physical activity, unhealthy lifestyle-related habits and self-rated health of 16-19 year old students of gymnasium schools of Kaunas and Šiauliai cities. Objectives: 1. To evaluate physical activity of the students according to age, gender and place of residence. 2. To assess the prevalence of unhealthy lifestyle-related habits of the students in respect of the aspect of age, gender and place of residence. 3. To reveal the relationships between physical activity, unhealthy lifestyle-related habits and self-rated health. Hypothesis: those students who are physically passive tend to have more of unhealthy lifestyle-related habits and worse perceived health. Sample and organization. A questionnaire survey was conducted in the period of November, 2013, – January, 2014 in Kaunas and Šiauliai with the questionnaire survey method applied to each of the responder. In total 316 students were surveyed, of which 161 – In Kaunas and 155 – in Šiauliai city. Conclusions: 1. Only 28.9 % of all the responders met the WHO physical activity criteria. The part of boys who during their leisure time did exercises on a daily or almost daily basis was twice bigger than the one of girls. 18-19 year old students appeared to be less frequently physically active... [to full text]

Background: Due to various factors, such as the restructuring of the South African Police Service (SAPS) in 1996, Police Social Work Services decided to broaden the scope of its services by developing and introducing proactive personnel capacity building programmes (PCBP's). Fifteen PCB programmes had been developed by 1999, which gave rise to the need for a comprehensive impact assessment of these programmes. This resulted in the Evaluation of Personnel Capacity Building Programmes (EPCBP) research project that was launched in 2001. The evaluation of the Healthy Lifestyle and Coping with Change programmes formed part of this comprehensive study. Objectives: The primary aim of the study was to determine the effect of the Healthy Lifestyle (HLS) and Coping with Change (CWC) programmes on the knowledge, attitude and behaviour of SAPS personnel. Method: The comparison group pre-test and post-test design and triangulation were used during this research. Six measuring scales and a presenter's evaluation questionnaire were developed and completed by 196 (HLS) and 184 (CWC) experimental group respondents, 38 (HLS) and 41 (CWC) comparison group members and 10 (HLS) and 7 (CWC) presenters. Results: With the help of various measuring instruments and the triangulation of measurements, it was determined that the Healthy Lifestyle and Coping with Change programmes had a practical significant effect on the knowledge, attitude and behaviour of the respondents. It was concluded that these programmes were effective tools in the hands of Police Social Work Service (PSWS) because they not only empowered SAPS personnel to lead more productive professional lives, but also enhanced their personal well-being. / Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2006.

Några bidragande faktorer till övervikt och fetma är levnadsvanor som innefattar inaktivitet och felaktiga kostvanor. Personer med övervikt och fetma kan få hjälp från primärvården att påverka vikten till det bättre. Syfte med studien var att undersöka vilka erfarenheter personer med övervikt och fetma har av samtal om levnadsvanor med distriktssköterskan. Studien genomfördes som integrativ litteraturstudie vilket ger djupare förståelse för ett visst fenomen inom hälso-och sjukvården. Litteraturstudiens resultat baseras på 16 vetenskapliga artiklar. I analysen framkom fyra kategorier: Betydelsen av att bli motiverad, betydelsen av egen inställning till samtal om levnadsvanor, betydelsen av distriktssköterskans kommunikativa förmåga, betydelsen av distriktssköterskans kunskap och kompetens. Distriktssköterskans kommunaktion var avgörande för hur patienten upplevde samtalet om levnadsvanor. När distriktssköterskan tillsammans med patienten satte upp mål och råden individanpassades motiverades patienten att ändra levnadsvanor. Patienternas motivation minskade när de upplevde att råden de fått var generella. Vissa patienter upplevde att distriktssköterskan inte hade tillräckligt med kunskap för att hantera övervikt och fetma. Kategorierna visar sig överensstämma med Penders hälsofrämjande arbetsmodell som förklaringsmodell för förståelse för patientens motivation till ändrade levnadsvanor. / Some factors that contribute to overweight and obesity are lifestyle related and comprise a lack of physical activity and poor nutrition. Overweight and obese individuals may seek medical attention and acquire advice on how to lose their weight. The purpose of this study was to look into the experiences of the overweight and obese patients pertaining to lifestyle conversations with the district nurse. The study was conducted as an integrative literature overview, which enables a better understanding of a certain phenomenon within medical service. The results consist of sixteen scientific articles. The analysis reveals four categories: the significance of becoming motivated, the significance of one’s own attitude towards conversations about lifestyle, the significance of the district nurse’s communicative skills and the district nurse’s knowledge and competence. The communicative skills of the district nurse played a pivotal role in how the conversations about lifestyle were perceived by the patients. When the district nurse and the patient set individual goals together, the patient appeared more motivated to make a lifestyle change. On the other hand, the motivation of the patient decreased when the advice received was too generalized. Moreover, some patients believed that the district nurse was not adequately knowledgeable to deal with overweight and obesity. The categories correlate with Pender's health-promoting model as an explanation of patients' motivation in changing their lifestyles.

Résumé : Introduction L’adoption de saines habitudes de vie (SHV) dès le jeune âge constitue une stratégie gagnante contre l’excès de poids (EP). Or, la promotion d’un mode de vie sain auprès des parents visant à les encourager et les soutenir auprès de leur enfant pour qu’ils adoptent de SHV est essentielle. À ce titre, l’infirmière occupe une position privilégiée. En ce sens, elle doit se questionner sur les approches à privilégier. But Mettre en lumière, en partenariat avec des infirmières œuvrant auprès de familles avec jeunes enfants, des pistes de solution afin de soutenir les parents dans l’adoption de SHV pour leurs enfants. Objectifs 1) informer les infirmières en estimant la prévalence de l’EP des jeunes enfants de leur région; 2) décrire les représentations sociales (RS) du poids et des habitudes de vie selon les parents d’un enfant d’âge préscolaire; 3) explorer le point de vue des infirmières concernant des stratégies d’intervention visant à promouvoir les SHV à la lumière des résultats des objectifs précédents et 4) déterminer les priorités parmi les stratégies proposées en collaboration avec des parents, experts et intervenants du réseau de la santé. Méthode Recherche-action en 4 cycles. Chaque cycle correspond à un objectif de l’étude. L’amorce de la réflexion le cycle 1 - Enquête transversale en contexte de vaccination - 259 enfants de 4-5 ans pesés et mesurés. Nourrir la réflexion, le cycle 2 - Entrevues semi-dirigées - 14 parents d’enfants âgés de 4-5 ans de poids normal et en EP. Passer à l’action les cycles 3 et 4, le cycle 3 - Groupe de discussion - 8 infirmières et 2 nutritionnistes et le cycle 4 - En 3 séquences 1) groupe de discussion auprès de parents, 2) questionnaire acheminé par courriel aux experts et 3) groupe de discussion auprès de participantes ayant collaboré au cycle 3. Résultats Cycle 1 - prévalence estimée de 26,3 % d’EP (20,1 % embonpoint - 6.2 % obésité). Cycle 2 - RS du poids, 1) le poids est un enjeu de santé pour les parents d’un enfant de poids normal ou 2) l’apparence potelée s’avère normale pour les parents d’un enfant en EP. RS des habitudes de vie, pour tous les parents il s’agit d’un défi exigeant. Cycle 3 et 4 - Pistes de solution proposées : viser la conscientisation et la sensibilisation des parents fondées sur leur point de vue et celui des intervenants impliqués en se basant sur le développement des aptitudes des personnes (familles) à faire des choix éclairés, l’accessibilité à l’information et la réorientation des services à la communauté. Conclusion L’étude illustre un processus de concertation en regard d’une problématique de santé pour arriver à dégager une action efficace basée sur les besoins du milieu. // Abstract : Introduction Adopting healthy lifestyle habits (HLH) starting at a young age has proven to be successful in preventing overweight (OW). It is therefore vital to present a healthy lifestyle to parents in such a way as to encourage and support them and their young child as they adopt HLH. Nurses are in an ideal position to fulfill this role; to do so, they must find the best possible ways of proving support to parents. Objective In conjunction with the nurses working with the families of young children, highlight possible solutions that will support parents in their efforts to adopt a healthy lifestyle for their children. Goals 1) inform nurses of the prevalence of OW in young children in their region of intervention; 2) describe the social representations of weight and lifestyle, according to the parents of preschool-age child; 3) explore nurses’ opinions on the intervention strategies aimed at promoting HLH, given the results of goals 1 and 2; and 4) in collaboration with parents, experts and members of the health-care system, prioritize the proposed intervention strategies. Method Action research in four phases. Each phase corresponds to a study goal. Phase 1 – Initiate Planning – Cross-sectional survey during preschool vaccination - 259 children aged 4-5 years are weighed and measured. Phase 2 – Planning Continues – Semi-structured interviews - 14 parents of normal-weight and OW children aged 4-5 years. Phases 3 and 4 – From Planning to Action - Phase 3 – Discussion group with 8 nurses and two dieticians and Phase 4 – In three parts 1) discussion group with parents, 2) questionnaire e-mailed to experts, and 3) discussion group with individuals who participated in Phase 3. Results Phase 1 – estimated incidence of OW is 26.3% (20.1% had excess body weight; 6.2% were obese). Phase 2 - Social representations of weight, 1) weight is a health issue for parents of normal-weight children or 2) the chubbiness of OW children seems normal to their parents. Social representations of lifestyle: for all participating parents, this was a difficult challenge. Phase 3 and 4 - Proposed solutions: based on input by the parents’ and nurses involved, devise initiatives aimed at raising parental awareness, and focus on developing the skills that people (i.e., families) need to make informed choices, making information more accessible and redirecting community services. Conclusion The study illustrates a consultation process on a health issue that led to identifying effective action based on community needs.

Background: Diseases partly depending on lifestyle is a global problem. Lifestyle changes with in the areas of tobacco, physical activity, diet and alcohol can reduce the risk of developing this diseases. To change habits and lifestyle is often difficult and takes time. Strengthening a person's belief in their ability to change can facilitate change. Motivational Interviewing (MI) is a counseling method that aims to provide support for lifestyle change. The person's own perspective is in focus. The counselor is trying to explore and understand it through empathically listening, and find the person's own motivation. Aim: To compile research of the usability of Motivational Interviewing at lifestyle change in the areas of tobacco, physical activity, diet and alcohol. Method: A literature study based on 13 articles of quantitative and qualitative approaches. Result: MI was useful at lifestyle change related to the areas of tobacco, physical activity, diet and alcohol, the highest usability was found at smoking cessation. No effect was found for diabetes and physical activity. MI improved the belief to commit lifestyle change. Emphatically listening facilitated lifestyle change. Conclusion: MI was useful at lifestyle change related to the areas of tobacco, physical activity, diet and alcohol, the highest usability was found at smoking cessation. MI improved the belief to commit lifestyle change and made persons more ready to change. Follow up improved the outcome. / Bakgrund: Sjukdomar som till viss del beror på levnadsvanor är ett globalt problem. Livsstilsförändringar inom områdena tobak, fysisk aktivitet, kost samt alkohol kan minska risken utveckla dessa sjukdomar. Förändring av levnadsvanor är ofta svårt och tidskrävande. Att stärka en människas tro på att hon/han kan förändras underlättar för att genomföra en förändring. Motiverande samtal (MI) är en samtalsmetod som syftar till att ge stöd till livsstilsförändring. Personens egna perspektiv är i fokus. Genom empatiskt lyssnande försöker rådgivaren utforska och förstå det, samt finna individens egen motivation till förändring. Syfte: Att sammanställa forskning om användbarheten av motiverande samtal vid livsstilsförändringar inom områdena tobak, fysisk aktivitet, kostvanor samt alkohol Metod: En litteraturstudie gjord på 13 artiklar, ansatser av kvantitativa och kvalitativa. Resultat: MI var användbart vid livsstilsförändringar relaterat till områdena, mest användbart vid rökstopp. Ingen effekt fanns vid diabetes och fysisk aktivitet. MI ökade tilltron till att kunna genomföra livsstilsförändringar. Empatiskt lyssnande av behandlaren underlättade för förändring. Slutsats: MI var användbart vid livsstilsförändringar relaterat till områdena tobak, fysisk aktivitet, kost samt alkohol, mest användbart vid rökning. MI ökade tilltron att kunna genomföra en livsstilsförändring, samt gjorde människor mer redo för den. Upplevelsen av att inte bli tillrättavisad underlättade för förändring. Uppföljning förbättrade utkomsten

Bakgrund: Diabetes mellitus typ 2 är en sjukdom som ökar i befolkningen världen över. Sjukdomen kan ge allvarliga komplikationer som påverkar patientens hälsa. En central del i behandlingen är att förändra ohälsosamma levnadsvanor. Syfte: Syftet var att beskriva distriktssköterskans erfarenhet av hur de motiverar patienter med diabetes mellitus typ 2 till livsstilsförändringar. Metod: En kvalitativ ansats med semistrukturerade intervjuer genomfördes där fem distriktssköterskor intervjuades. Materialet analyserades enligt Graneheim och Lundmans innehållsanalys. Resultat: I studien framkom vikten av att distriktssköterskan skapade en god relation med patienten för att motivera till livsstilsförändringar. Deltagarna i studien belyste vikten av att finna stöd i patientens omgivning genom att engagera familjen och genom stöd från andra patienter. Det framkom även att patienterna blev motiverade till livsstilsförändringar genom att deltagarna var en god pedagog. Det var av betydelse att samarbeta med andra professioner och att patienterna fick individanpassad information, till hjälp använde sig distriktssköterskan av olika pedagogiska metoder för att öka deras motivation. Slutsats: För att distriktssköterskan ska kunna motivera sina patienter till livsstilsförändringar måste informationen de ger vara individanpassad, vilket kan göras genom olika pedagogiska metoder. En viktig förutsättning för att lyckas med ett förändringsarbete är att distriktssköterskan skapar en god relation med sina patienter genom att etablera ett förtroende. / Background: Diabetes mellitus type 2 is a disease that is increasing in the population worldwide. The disease can cause severe complications that affect patient health. An important part is to change unhealthy habits. Purpose: The aim was to describe the district nurse's experience of how they motivate patients with type 2 diabetes to lifestyle changes. Method: A qualitative approach with semistructured interviews were conducted and five district nurses were interviewed. The material was analyzed according to Graneheim and Lund's content analysis. Results: The study revealed that it was important that the district nurse created a good relationship with the patient to motivate lifestyle changes. Study participants highlighted the importance of support in the patient's environment by involving family and other patients. It also emerged that the participants motivated by being a good teacher and to work with other professionals. Personalized information and different kinds of pedagogical methods were used to increase the patient's motivation. Conclusion: To be able to motivate their patients to lifestyle changes the district nurse must provide information individually to their patients which can be done through various teaching methods. It´s also important to create a good relationship with their patients by establish trust.

Bakgrund: Osunda levnadsvanor skapar ökad risk att drabbas av livsstilsrelaterade sjukdomar vilket innebär en utmaning för sjukvården. I klinisk praxis ska sjuksköterskor arbeta hälsofrämjande och personcentrerat. Motiverande samtal är en stödjande och evidensbaserad metod som genom vägledning syftar till att stärka personens egen motivation till livsstilsförändring. Syfte: Att beskriva sjuksköterskors erfarenhet av att arbeta med motiverande samtal vid livsstilsförändringar. Metod: Examensarbetet är en litteraturöversikt där 11 vetenskapliga artiklar som sökts fram i Cinahl complete och PubMed har granskats med Fribergs analysmetod för att besvara syftet. Resultat: Sjuksköterskors erfarenheter av motiverande samtal vid livsstilsförändringar presenteras i resultatet under tre teman; upplevelser av motiverande samtal, förutsättningar för motiverande samtal och förhållningssätt i arbetet med motiverande samtal. Diskussion: Diskussionen fördes utifrån Rosemarie Rizzo Parses teori Human becoming och vetenskaplig litteratur. Sjuksköterskors erfarenheter av arbete med motiverande samtal vid livsstilsförändringar diskuterades genom tre teman; personcentrerad vård, delaktighet i en jämlik vårdrelation och utveckling. / Background: Unhealthy living habits create an increased risk of suffering from lifestyle-related illnesses, which poses a challenge for healthcare. In clinical praxis nurses should work through a health promoting and person-centered approach. Motivational interviewing is a supportive and an indicative evidence based approach to lifestyle changes that through compassion aims to strengthen the person's own motivation for change. Aim: To describe nurses' experiences of working with motivational interviewing with lifestyle changes. Method: The thesis work is a literature review of 11 scientific articles searched for in Cinahl complete and PubMed that have been examined using Fribergs analysis method. Results: Nurse's experiences with motivating interviewing about lifestyle changes are presented in the results under three themes; experiences of motivational interviewing, prerequisites for motivational interviewing and approaches of working with motivational interviewing. Discussion: The discussion was based on Rosemarie Rizzo Parse's theory Human Becoming and Scientific Literature. Nurses' experiences of working with motivational interviewing in lifestyle changes are highlighted through three themes; person centered care, participation in an equal care relationship and development.