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Background: Forensic psychiatric care means restricted freedom during a long period of care. The restriction leads among other things to a loss of independent decision-making in relation to physical health in terms of time outdoors, diet and exercise. Previous research highlights how deteriorating physical health seems to go hand in hand with mental illness. In addition, nurses experience health promoting and disease prevention work within forensic psychiatric inpatient care as a challenge. Aim: To describe patients' experiences of maintaining physical health in forensic psychiatric inpatient care. Method: The study has a qualitative design with an inductive approach. Semi-structured interviews were conducted with ten patients from two forensic psychiatric clinics in central Sweden. Data was analyzed using qualitative content analysis. Results: The patients' experiences are illuminated through four categories: to feel restricted, to be able to adapt to a new situation, to utilize healthcare resources and to have access to support which were further clarified by six subcategories. This led to the overarching theme of reclaiming physical health through support and adaptation in a new environment. Conclusions: The person-centered approach needs to be given even greater space within forensic psychiatric inpatient care. Consequently, nurses need to take advantage of patients' experiences to a greater extent in order to, along with the patient, find the way forward in the maintenance of physical health during the period of care. Keywords: Forensic psychiatric inpatient care, patients' experiences, physical health, qualitative content analysis, semi-structured interviews, Tidal model

Studien syftar till att undersöka begreppet välbefinnande hos äldre personer och vilka faktorer som kan öka de äldre personernas välbefinnande. Studien syftar även till att tillföra kunskap kring äldre inom det sociala arbetet. Det teoretiska ramverket består av fyra teorier som medför en ökad kunskap kring äldres välbefinnande. Teorierna är Eriksons psykosociala teori, teorin om gerotranscendens, känslan av sammanhang (KASAM) och Maslows behovshierarki. Den metod som har använts är kvalitativ metod där semistrukturerade intervjuer har genomförts med respondenter som är yrkesverksamma med äldre personer. I arbetet har sju respondenter intervjuats. För att få fram det viktigaste från intervjuerna genomfördes en tematisk analys av de transkriberade texterna.  I resultatet framkommer det att den fysiska hälsan påverkar den psykiska hälsan och möjligheten till social interaktion. Det framkommer även att samhället har ett stort ansvar för att beakta äldre personers egna intressen, kulturer och att inte se de äldre som en homogen grupp. Detta gäller särskilt när aktiviteter för att främja äldres hälsa skapas och i arbetet för att möjliggöra en mer hälsosam livsstil. Där ingår även att skapa sociala sammanhang för äldre då resultatet påvisar hur viktigt sammanhang är för äldre.  Slutsatsen och diskussionen resonerar kring välbefinnandets betydelse för de äldre, på vilka sätt det existentiella samtalet kan öka välbefinnandet hos äldre och hur sociala aktiviteter bör se till äldres verkliga intressen och inte utgå från ett normativt perspektiv. / The study aims to explore the concept of well-being in elderly and which factors can increase well-being in the elderly. The study also aims to add knowledge to social work with elderly. The theoretical framework consists of four theories that lead to increased understanding about the wellbeing of the elderly. The theories are Erikson´s stages of psychosocial development, the theory of gerotranscendence, sense of coherence (SOC) and Maslow´s hierarchy of needs. The method that is used is a qualitative method where semi-structured interview with respondents that in their profession work with elderly. In this study seven respondents have been interviewed. Thematic analysis was used to take out the most important parts from the transcriptions of the interviews.  The results show that physical health has an impact on mental health and the possibility of social interaction. Furthermore, is shows that society has a responsibility to consider elderly´s own interests, cultures and not see the elderly as a homogenous group. This is important to consider when activities to promote the health of the elderly are created and, in work, to enable a healthier lifestyle. This also includes creating social connections for the elderly because it is an important factor for their well-being. The conclusion and discussion resonate around the importance of well-being for the elderly, in which ways the existential conversation can increase the well-being of the elderly and how social activities should look to the real interests of the elderly and not from a normative perspective.

幸福、快樂的人生，自古以來是人類所努力追求的目標，心流經驗(flow experience)以內在動機為基礎，闡述了透過心流經驗的正向感受，提升個體自我成長與生活品質的途徑。本研究主要目的以心流理論為架構，來探討休閒中之心流經驗、休閒體驗與身心健康間的關係，並進一步瞭解不同休閒活動種類間的差異。 本研究整理國內外有關心流經驗的文獻，編製「休閒心流經驗量表」與「休閒體驗問卷」，並藉由「身心健康量表」以瞭解互相間之關係，採便利取樣方式，對不同產業之541位上班族群進行問卷調查。研究結果發現，休閒心流經驗、休閒體驗與身心健康之間，互相存在顯著正相關。而「一致好」休閒心流經驗組型在休閒體驗的表現上，均顯著高於「高估」與「一致差」組型，且在身心健康上亦顯著高於「一致差」組型；然「一致好」組型在身心健康之「不利健康之因應行為」表現上，卻顯著較「高估」與「一致差」組型差。 此外，研究亦顯示「一致好」休閒心流經驗組型所從事的休閒活動，均屬戶外活動、運動、藝文嗜好與益智類主動式休閒，「一致差」組型則較屬視聽與休憩社交類被動式休閒；而從事戶外活動、運動、藝文嗜好與益智類主動式休閒，在休閒心流經驗與休閒體驗上的表現，較從事視聽與休憩社交類被動式休閒來得好。 最後根據研究分析所得結果，本研究討論其意義，並對後續研究、上班族群與相關實務工作者，提出研究方向及建議。 / This study revised the flow state scale(Jackson & Marsh, 1996) and the description of the quality of experience(Csikszentmihalyi & LeFevre, 1989) as the scale of flow experience in leisure and leisure experience questionnaire, respectively, to understand the relationship of flow experience, leisure experience and mental-physical health in 541 adult workers from different organizations in Taiwan. Results showed that significant positive associations between flow experience and leisure experience, flow experience and mental-physical health, also, leisure experience and mental-physical health. The patterns of flow experience in leisure are found something different on leisure experience and mental- physical health. The congruence/good pattern is significantly better than congruence/poor pattern on leisure experience and mental-physical health; and the congruence/good pattern is also significantly better than over- estimate pattern on leisure experience. Nevertheless, the congruence/good pattern is significantly worse than over-estimate and congruence/poor patterns on harmful coping behaviors subscale. In addition, results also presented that those who are categorized into the congruence/good flow pattern tend to choose active leisure(eg., outdoor activities, physical activities, hobbies, and mental activities); reversely, those who are categorized into the congruence/poor pattern tend to choose passive leisure(eg., television-viewing and shopping). Moreover, those choosing active leisure are better than those choosing passive leisure on flow experience and leisure experience.

Sammanfattning Syfte och frågeställningar Uppsatsen syftade till att undersöka elevers uppfattningar kring begreppet hälsa, ur ett salutogent och patogent perspektiv. De frågor som ställdes var: har eleverna en salutogen eller patogen bild av hälsa, var får eleverna sin uppfattning kring hälsa ifrån samt förmedlar lärare i idrott och hälsa en salutogen eller patogen bild av hälsa enligt eleverna? Metod 10 elever (7 flickor och 3 pojkar) i årskurs 9 från tre skolor i västra och södra delen av Stockholm deltog alla i en halvstrukturerad intervju. Intervjuerna genomfördes på respektive elevs skola i ett avskilt rum. Deras svar kategoriserades och analyserades med utgångspunkt i Antonovskys teorier, och Quennerstedts utvecklingar av dessa, kring salutogent och patogent. Resultat 5 av 10 elever ansågs ha en patogen bild av hälsa, 3 av 10 en salutogen bild medan 2 av 10 ansågs ha en tvetydig/oklar bild av hälsa där både ett salutogent och patogent perspektiv fanns representerat. 9 av 10 elever angav att Undervisning i idrott och hälsa var en källa som de hämtade information kring hälsa från. 8 elever angav Vänner, 6 elever angav Familj. Flest elever uppgav att deras huvudsakliga källa till information kring hälsa var Undervisning i idrott och hälsa. 4 av 10 elever ansågs visa på att deras lärare hade ett patogent synsätt på hälsa och 6 av 10 elever svarade på ett sätt som ledde till bedömningen att deras lärares synsätt på hälsa hade inslag av både salutogent och patogent. Slutsats Både salutogena och patogena inslag förekom i såväl elevernas syn på hälsa som i den bild de förmedlade att deras lärare hade. Dock förföll de patogena perspektiven dominera i bägge fall. Eleverna hämtade i huvudsak sin information kring hälsa från undervisningen i idrott och hälsa, familjen och vänner. Det är därför av relevans för lärare att fundera kring vilken syn på hälsa de förmedlar då det kan ha inverkan på elevers uppfattning kring begreppet hälsa. / Aim The thesis aimed to investigate students perceptions of the concept of health from asalutogenic and pathogenic perspective. The questions asked were: does students have asalutogenic or pathogenic view on health, where do students get their opinion about the healthand does teachers in physical education convey a salutogenic or pathogenic view of health according to the students? Method 10 students (7 girls and 3 boys) in grade 9 from three schools in the western and southern partof Stockholm all participated in a semi-structured interview. The interviews were conducted at each student's school in a secluded room. Their response was categorized and analyzed on the basis of Antonovskys theories, and Quennerstedts developments thereof, around salutogenetic and pathogenic. Results 5 out of 10 students were considered to have a pathogenic view of health, 3 of 10 a salutogenic view while 2 out of 10 were considered to have an ambiguous/unclear view of health in which both salutogenic and pathogenic perspectives were represented. 9 out of 10 students indicated that Teaching in physical education and health was a source that they retrieved information about health from. 8 students answered Friends, 6 students answered Family. Most students stated that their main source of information about health comes from Teaching in physical education and health. 4 out of 10 students were considered to show that their teachers had a pathogenic approach to health and 6 of the 10 students responded in away that led to the assessment that their teachers' approach to health had elements of both salutogenic and pathogenic. Conclusion Both salutogenic and pathogenic element were present in both the students' views on health and in the approach they conveyed that their teachers had on health. However, the pathogenic perspectives dominate in both cases. Students mainly got their information about health from teaching in physical education and health, family and friends. It is of relevance for teachers to reflect on what view on health they convey as it can have an impact on students' perception of the concept of health.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

The physical complications of Type 1 diabetes mellitus (T1DM) have been understood as an accelerated ageing process (Morley, 2008). Do people with T1DM also experience accelerated cognitive and brain ageing? Using findings from research of the normal cognitive and brain ageing process and conceptualized in theories of the functional brain changes in cognitive ageing, a combination of cognitive testing and functional magnetic resonance imaging (fMRI) techniques were used to evaluate evidence of accelerated cognitive and brain ageing in middle-aged adults with T1DM. The first part of this thesis comprises a cognitive study of 94 adults (≥ 45 years of age) with long duration (≥ 10 years) of T1DM. Participants completed cognitive assessment and questionnaires on general mood and feelings about living with diabetes. Findings highlighted the importance of microvascular disease (specifically retinopathy) as an independent predictor of cognitive function. The incidence and predictors of mild cognitive impairment (MCI) were then explored. Results indicate a higher percentage of the group met criteria for MCI than expected based on incidence rates in the general population, providing initial evidence of accelerated cognitive ageing. Psychological factors were explored next. The relationship between the measures of well-being, diabetes health, and cognitive function highlighted the need for attention to patient's psychological well-being in diabetes care. Finally, a subgroup of 30 participants between the ages of 45 and 65 who differed on severity of retinopathy were selected to take part in an fMRI study. Blood oxygen level dependent (BOLD) activity was evaluated while participants were engaged in cognitive tasks and during rest. The findings provided evidence that the pattern of BOLD activation and functional connectivity for those with high severity of retinopathy are similar to patterns found in adults over the age of 65. In line with the theories of cognitive ageing, functional brain changes appear to maintain a level of cognitive function. Evidence of accelerated brain ageing in this primarily middle-aged group, emphasizes the importance of treatments and regimens to prevent or minimize microvascular complications.

Bakgrunden till denna studien är baserad på tidigare forskning som har hittat specifika riskfaktorer för att utveckla en förlossningsdepression. En förlossningsdepression klassas som den vanligaste komplikationen av en graviditet och förlossning och påverkar välbefinnandet hos både den drabbade och familjen. Syftet var att belysa nyblivna mammors upplevelser av välbefinnande i relation till föräldraskapet samt att ta reda på hur dessa mammor tycker att ett förebyggande arbete mot nedstämdhet och förlossningsdepression kan se ut. Metoden i studien är en kvalitativ metod i form av två enskilda semistrukturerade intervjuer och tre fokusgruppsintervjuer. Analysmetoden som använts i studien är en kvalitativ innehållsanalys. Resultatet visade tre huvudkategorier som var ”yttre riskfaktorer som påverkar mammans välbefinnande”, ”individuella riskfaktorer som påverkar mammans välbefinnande” och ”förebyggande arbete ur mammans perspektiv”. Dessa visade att förväntningar, bristande socialt stöd och bristande information var tre huvudresultat som bidrog till nedstämdhet hos de nyblivna mammorna i studien. Konklusionen visar att huvudresultaten spelar stor roll för nyblivna mammors välbefinnande och sjukvården har ett stort ansvar i arbetet kring de nyblivna mammornas välbefinnande. Ämnet behöver mer forskning för det fortsatta preventiva arbetet mot nedstämdhet och förlossningsdepressioner bland nyblivna mammor. / The background to this study is based on former research that has found specific risk factors to develop a postpartum depression. A postpartum depression is classified as the most common complication of a pregnancy and birth and affect the well-being of both the mother and her family. The purpose was to investigate the experience of well-being among mothers that recently give birth in relation to parenting and to find out how the mothers think a preventive work against postpartum depression should be. The used method is a qualitative method with two individual semi-structured interviews and three focus group interviews. The analytical method used in the study is a qualitative content analysis. The result three main categories named “external risk factors that affect the mothers’ well-being”, “individual risk factors that affect the mothers’ well-being” and “preventive work from the mothers’ perspective”. These main categories showed that expectations, lack of support and lack of information were the main results that could affect the mothers’ well-being. The conclusion shows that the main results play a major role for the well-being of mothers who recently gave birth and that the healthcare have a major responsibility in the preventive work of the well-being among them. To continue the preventive work against postpartum depression the subject needs further research.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal