SAMMANFATTNING Bakgrund: I Sverige lever knappt 10 000 barn med cancer och 85% av de barn som drabbas botas. Både cancersjukdomen och den onkologiska behandlingen påverkar dessa barn fysiskt, psykiskt och socialt. Hela organsystem kan påverkas negativt och många drabbas av fatigue. Syfte: Syftet var att undersöka resultaten av den senaste forskningen gällande biopsykosociala effekter av fysisk träning för barn som är under pågående onkologisk behandling, eller som nyligen genomgått behandling. Metod: Genom litteratursökningar i databaserna PEDro och PubMed valdes fyra randomiserade kontrollerade studier ut. Väsentliga data från studierna extraherades och sedan bedömdes studierna avseende relevans och kvalitet. Slutligen bedömdes sammantagen preliminär evidens. Resultat: Interventionerna innehöll fysisk träning med inslag av konditionsträning, styrketräning, stretching samt träning av psykologiska funktioner. Interventionstiden varierade mellan åtta veckor och sex månader. Antalet deltagare varierade mellan 68–222. För utfallen fatigue och muskelstyrka i nedre extremitet påvisades en signifikant förbättring. Den preliminära evidensen bedömdes vara låg. Slutsats: Resultatet av denna översikt stärker betydelsen av fysisk träning för populationen. Sättet som träningen administreras på, påverka givna utfall där interaktion med andra deltagare samt träningsledare har en stor inverkan. Således kan man konstatera att fysisk träning är fördelaktigt för populationen och det finns ett värde i att utgå från ett biopsykosocialt perspektiv vid utformning av träning. / ABSTRACT Background: The prevalence of children with cancer is barely 10 000 in Sweden and 85% are cured. The disease itself, as well as the treatment affects children physically, mentally, and even socially. Organ systems are negatively affected, and fatigue is a common side effect. Objective: The aim was to investigate results of the latest research on the biopsychosocial effects of physical training for children undergoing oncological treatment, or children who recently have received treatment. Method: For this systematic review, four randomized controlled trials were selected through literature searches in the databases PEDro and PubMed. Essential data from the studies were extracted and relevance and quality of each trial were assessed. Finally, the overall preliminary evidence was evaluated. Results: The interventions included physical exercise with elements of aerobic exercises, strength training, stretching and psychological tasks. The intervention duration varied between eight weeks and six months, and the number of participants ranged from 68 to 222. A significant improvement was demonstrated regarding fatigue and muscle strength in the lower extremity. The preliminary evidence was considered low. Conclusions: The effects of physical exercise in this review reinforce the importance of exercise for the population. The administration of physical exercise should be considered, as interactions with other children as well as trainers seemingly have a considerable beneficial impact. Thus, this indicates that physical activity is beneficial for this population and that implementation of a biopsychosocial perspective is favorable in this setting.

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This thesis investigates the acceptability and efficacy of Functional Imagery Training (FIT), a motivational intervention for weight-management. FIT is based on Elaborated Intrusion Theory, delivered in the style of Motivational interviewing (MI), and designed to promote sustained behaviour change and address cravings. It trains the habitual use of affective, goal-directed mental imagery of personal incentives, using imagery to plan behaviours, anticipate obstacles, and mentally try out solutions from previous successes. Participants are taught to update their imagery from their experience, and to generalise their imagery skills to new goals. In study 1, focus groups explored problems and wishes in regards to weight-management, including reactions to Functional Imagery Training (FIT) as a possible intervention. The issue of waning motivation and the desire for motivational app support was expressed in all groups. Participants were positive about FIT. Study 2 was an uncontrolled pilot trial of FIT. Eleven out of 17 participants (65%) lost 5% body weight or more by three months. Participants continued to lose weight during an unsupported 12-month period and experienced mean weight loss of 6kg (SD= 5.7; d=1.06) and mean waistline reduction of 11.5 cm (SD= 7.4; d=1.56) at 15 months. Study 3 compared the impact of FIT with MI on motivation and self-efficacy, over the first month of a randomised controlled trial (RCT) for weight-loss. Structured elicitation and training in goal-related imagery, i.e., FIT, increased motivation and self-efficacy for weight-loss relative to MI. Study 4 was the RCT for weight-loss, comparing FIT and MI over an intervention-supported six-month period, followed by six months unsupported. The FIT group achieved clinically meaningful weight-loss at 6 months (M kg-loss=4.11) and continued weight-loss at 12 months (M kg-loss=6.44); the MI group stabilised by 12 months (M kg-loss=.67), after minimal weight loss at 6 months (M kg-loss=.74). Study 5 qualitatively explored experiences of MI and FIT RCT participants, upon completing the 6-month intervention phase. MI participants wished for continued therapist- support and feared relapse. FIT participants described a mind-set-change and were confident they could maintain changes and overcome challenges using imagery techniques. Given the demonstrated benefit of motivational imagery in weight-control, FIT should be considered and further tested as an intervention for health behaviour change.

The thesis deals with connections between completion of reduced course and self-efficacy of obese people. The theoretical part deals with definition of obesity, its prevalence and aspects of its treatment. A chapter of the theoretical part focuses on self-efficacy and its connections to obesity and physical activity. The last part is about general self-efficacy. The empirical part describes physical activity of obese respondents, changes in their physical activity self-efficacy and their general self-efficacy after completion of reduced course. The questionnaires about the level of physical activity and physical activity self-efficacy were created by author of the thesis. General self-efficacy was measured by General self-efficacy scale. Data were obtained in the first and last lesson of reduced courses. A paired-samples t-test was conducted to compare changes in both areas of self-efficacy. It has been found that frequency of respondents physical activity was insufficient. The results suggest that connection between completion of reduced course and general self-efficacy exist. On the other hand there was not significant difference between individual's physical self-efficacy before reduced course and after its completion. Keywords: obesity, self-efficacy, physical activity self-efficacy, general...