Parkinson disease(PD) is a degenerative neurological disorder that impacts a great number of individuals in the United States and often results in significant changes to speech and voice, as well as increased reliance on informal caregivers. Relevant literature has shown that caring for a person with PD can have a negative impact on caregivers but has not explored the relationship between perceived impact of life events or relationship satisfaction and caregiver quality of life(CGQOL), or the impact that therapy delivery paradigm can have on these psychosocial factors and on caregivers of people with PD. The current study examined the psychosocial factors associated with caring for someone who has PD and the effect of therapy delivery paradigm on these factors through regression and mediation analyses. Results indicated that caregiver burden, caregiver depression, and perceived impact of life events (PILES), were significantly associated with CGQOL post-treatment, but quality of life pre-treatment and treatment modality were not significant. Although no evidence of mediation was found in this study, change in PILES scores from pre-to post-treatment was significantly associated with caregivers’ ratings of patient self-efficacy for communication post-treatment, while caregiver burden pre-treatment and self-efficacy for people with disabilities pre-treatment were significantly associated with caregivers’ rating of self-efficacy for people with disabilities post-treatment. Collectively, results from this study suggest that focusing on the psychosocial impact of caregiving is an integral part of the treatment process for any provider working with people with PD. Ensuring that caregivers receive the support and education needed to effectively manage the psychosocial factors associated with caregiving will lead to higher quality of care for the patient, as well as better patient outcomes in therapy, and in their daily lives.

The purpose of this study was to utilize the Student Readiness InventoryTM to profile retention and academic success rates for College of Agriculture freshmen. The Student Readiness Inventory (SRI) has been developed to help measure psychosocial issues related to academic achievement and college student retention. This information, combined with high school grade point average and admission test scores from American College Testing (ACT, Inc.), will help advisors and administrators in the College of Agriculture identify potential at-risk students during their first year of college. From SRI test results, a model for intervention will be built to meet the students' specific psychosocial needs, encouraging their persistence in obtaining a degree, and enhancing their college experience. Fifty-five incoming freshmen completed the SRI survey. Overall mean scores indicated that the students scored lower in psychosocial skills including social activity, study skills, academic self-confidence, and communication skills. Student SRI summary profile information will be provided to advisors and administrators to identify and help students who may be "at-risk" for dropping out of school before completing their degrees. The SRI information can help advisors and administrators in designing intervention programs or activities to assist students with improving abilities where they may be deficient. Further utilization of the SRI program may provide data on student trends with regard to retention and academic success for students in the College of Agriculture at Utah State University.

Abstract Background: Musculoskeletal discomfort is common among professional orchestra musicians and according to the literature some anatomical areas, such as the neck, upper back and upper extremities, seem to be more frequently affected than others. There are also suggestions made that general joint hypermobility could be a potential risk factor for musculoskeletal discomfort among musicians. Furthermore, there seems to be a higher perceived feeling of psychosocial demands and stress among musicians in comparison to the general workforce. Aim: Investigate the prevalence of, and associations between, musculoskeletal discomfort, general joint hypermobility, psychosocial factors and stress among Swedish big band musicians. A further aim was to investigate associations between musculoskeletal discomfort, general joint hypermobility, psychosocial factors and stress, respectively. Method & Material: This study was part of a larger national survey on professional orchestra musicians in Sweden. This study focused on professional jazz musicians and included data from all three professional big bands in Sweden. The study presents the prevalence of musculoskeletal discomfort, general joint hypermobility, psychosocial factors and stress among professional Swedish big band musicians. 32 musicians completed the survey. Results: The study showed a high prevalence of musculoskeletal discomfort and general joint hypermobility. There were no statistically significant relationships between musculoskeletal discomfort and general joint hypermobility but between psychosocial demands and musculoskeletal discomfort in the anatomical subgroup low back/hip, and between negative stress and musculoskeletal discomfort in the anatomical subgroup low back/hip. Conclusion: In accordance with existing studies on classical orchestra musicians, this study found a high prevalence of musculoskeletal discomfort and general joint hypermobility among Swedish big band musicians. There was a statistically significant association with the relationship between psychosocial demands and musculoskeletal discomfort in the anatomical subgroup low back/hip and between negative stress and musculoskeletal discomfort in the anatomical subgroup low back/hip. Key words: big band musicians, musculoskeletal discomfort, general joint hypermobility, psychosocial factors, stress.

Philosophiae Doctor - PhD / In the decade since first identified, the Acquired Immunodeficiency syndrome (AIDS) has become a serious global disease. The nature of the Human Immunodeficiency Virus (HIV) that causes AIDS, whereby a carrier may be asymptomatic yet remain infectious, has enabled its dramatic spread. The number of AIDS cases is increasing exponentially, averaging a doubling time of between 8-15 months indifferent countries. Of the millions of HIV carriers, it is now estimated that all will eventually go on to develop full-blown AIDS and probably die within 15 years. Unlike other infectious diseases, there is currently no known vaccine or cure. Further, HIV is now virtually completely dependent on volitional sexual behaviours for transmission to occur. It is therefore an entirely preventable disease. However, since the behaviours that contribute to HIV-transmission are influenced by biological, psychological, and social factors, their alteration in line with safer sexual practices has been shown to be considerably complex and difficult. Intervention strategies that have relied on imparting knowledge about the disease have achieved limited success in influencing behaviour change. Unsafe sexual practices, and the risk of HIV-infection, often continue even when knowledge regarding prevention is adequate. It has therefore become apparent that other variables intrude which may mediate between knowledge acquisition, attitude formation, and consequent sexual behaviours. There appear to be no models which adequately explain the complexities in this area, and which enable adequate intervention strategies to be developed. The present study was undertaken to redress this problem, and to explore those variables that mediate in the area. Various psychological and social factors appear to be implicated in influencing sexual attitudes and behaviours. In order to adequately test the impact of psychosocial variables that were found to have significant associations in an exploratory study, a measuring instrument was developed. The AIDS Psychosocial Scale was statistically validated using content, frequency, factor, and reliability analyses and included psychological factors of self concept, defenses of denial, repression, and rationalisation, perceived empowerment in the form of locus of control and self efficacy, and the social factor of peer pressure susceptibility. The impact of these psychosocial variables on indices of knowledge, condom attitude, and sexual practices, and on other epidemiological variables was tested using a sample of students at the University of the Western Cape (n=308). Results indicated a number of correlational and causal links between variables, confirming the mediational role psychosocial factors have in influencing knowledge acquisition, attitude formation, and behaviour outcome. A profile of lower self concept, higher defenses, lower self-efficacy, more external locus of control, and higher peer pressure susceptibility emerged which was associated with poorer knowledge, more negative attitudes, and higher unsafe sex. Based on this study, a model of psychosocial mediation is developed and its implications for intervention strategies discussed.

Introduction: A successful return to sport (RTS) after anterior cruciate ligament reconstruction (ACL-R) demands optimal physical and psychological rehabilitation. Aim: Study the change in psychological readiness to RTS between three- and six-months post ACL-R, to associate psychological readiness to patient-reported knee function and identify factors associated to greater psychological readiness to RTS. The secondary aim was to examine how the Covid-19 pandemic has affected the patients’ rehabilitation. Methods: Prospective cohort study including patients with primary ACL-R recruited from the Swedish Knee Ligament register, age 16-40 and physically active on Tegner>3. Demographics including pre-injury sport participation, psychological readiness reported with the Anterior Cruciate Ligament-Return to Sport After Injury (ACL-RSI) scale, knee function reported with the subjective International Knee Documentation Committee (IKDC) and the impact on rehabilitation by Covid-19 were analyzed at three- and six-months post-surgery. ACL-RSI scores were compared, correlated to IKDC and univariate analysis was used to determine the association between factors and the psychological readiness to RTS. Results: 141 patients were analyzed (56 men, 85 women; median age 24 years), all were recreational or competitive athletes (median Tegner level 8). The psychological readiness progressed through rehabilitation, was correlated to subjective IKDC. No differences could be detected between ACL-RSI scores and included factors at six months post ACL-R. Covid-19 had an impact on 36% (40/112) of the patients’ rehabilitation. Conclusions: Psychological readiness improved after ACL-R and was significantly associated to self-reported knee function at six months post ACL-R. Covid-19 restrictions affected rehabilitation for one in every three participants.

Background  Female genital mutilation refers to procedures where the external female genitalia are either partially or entirely removed. It is estimated that on a global scale more than 200 million girls and women alive today have undergone some form of genital mutilation. It is a present issue and a violation against women’s rights causing severe health consequences, both physical as well as psychological. There is a lack of knowledge and understanding among nurses regarding the issue. Nurses may encounter these women in any medical setting hence increased awareness regarding the consequences is essential.  Aim The aim was to describe the experiences of women who have undergone female genital mutilation. Method The chosen design for the degree project was a literature review which is used in presenting an overview of current research within a specific topic and can easily be applied to clinical work. Data was collected using the bibliographic databases PubMed, CINAHL and PsychInfo from which 15 scientific articles were analyzed and compiled. Result The result showed that women consequently experienced suffering in various ways due to female genital mutilation. The procedure was described as a traumatic experience causing psychological issues. Pain was experienced either in connection to the circumcision procedure or as a result of it. Other commonly presented issues were consequences related to sexual health. These consequences included, but were not limited to, pain, lack of sexual desire and pleasure. Women seeking health care in western countries expressed mostly negative experiences due to how they were approached by health care providers, making them feel abnormal and embarrassed for example.  Conclusion Women suffer in different forms due to female genital mutilation and are treated with a lack of respect and understanding by health care providers. Increased knowledge and awareness is needed in order for women to be treated in a person-centered way. / Bakgrund  Kvinnlig könsstympning innebär procedurer där det yttre kvinnliga könsorganet helt eller delvis avlägsnas och det beräknas att fler än 200 miljoner flickor och kvinnor runt om i världen har utsatts för könsstympning. Det är ett aktuellt problem då det är en kränkning av kvinnors rättigheter och orsakar allvarliga fysiska och psykiska hälsokonsekvenser. Eftersom sjuksköterskor kan möta dessa kvinnor i många olika sammanhang behövs en ökad kunskap och förståelse kring konsekvenserna.   Syfte Syftet var att beskriva upplevelser hos kvinnor som är könsstympade. Metod Litteraturöversikt valdes som design för arbetet vilket ger en överskådlig blick kring nuvarande forskning inom ett specifikt ämne och som enkelt kan tillämpas på kliniskt arbete. Resultatet sammanställdes av 15 vetenskapliga artiklar som hämtades från databaserna PubMed, CINAHL och PsychInfo.  Resultat Resultatet visade att kvinnlig könsstympning orsakar olika former av lidande. Proceduren beskrevs som en traumatisk upplevelse som resulterade i psykisk ohälsa. Smärta var en vanlig förekommande komplikation som antingen uppstod under själva proceduren eller som en långvarig konsekvens. Ett annat vanligt förekommande problem var sexuell ohälsa som uttrycktes genom exempelvis smärta, nedsatt sexlust och njutning. Kvinnor som sökte sjukvård i västerländska länder beskrev främst negativa upplevelser i hur de blev bemötta av sjukvårdspersonal, vilket orsakade att kvinnorna kände sig generade och onormala.   Slutsats Lidande i olika former är vanligt förekommande hos kvinnor som genomgått könsstympning. Dessa kvinnor blir ofta bemötta på ett respektlöst sätt av sjukvårdpersonal. Ökad kunskap och förståelse för deras situation krävs för att sjukvårdspersonalen ska kunna bemöta dessa kvinnor på ett personcentrerat sätt.

Attitudes and beliefs influence how counselors practice. This study explored four psychosocial factors and their correlation to the attitudes of graduate counseling students' (N = 28) toward lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) individuals. The four main psychosocial factors that were identified in previous research include knowledge level, religiosity, political affiliation, and previous experience with LGBTQ individuals. The hypothesis of this study was there are relationships between attitudes toward LGBTQ individuals and the aforementioned psychosocial factors. Students were invited to participate through emails sent by the Director of the Counseling Education program. The survey used to collect data included a demographics questionnaire and three scales. The findings did not show any significant correlations between knowledge level, religiosity, and political affiliation and attitudes. Personal relationships and attitudes could not be tested due to limitations of the study. These findings were not congruent with previous research.

Youth involvement in gang-related violence is an ever-growing issue apparent in Stockholm,Sweden. This research places importance on the identification of the central psychosocial factors prevalent in these male youths’ lives, as well as the use of them in intervention construction according to Swedish social workers. Psychosocial factors prevalent in youths’lives are a crucial aspect for social workers to take into account when working with youth involved in gang-related violence. This is highlighted by previous research and by the social workers who participated in this research to be factors such as, poor schooling, low socioeconomic status, peer and family relationships as well as mental health. The research is focused on the region of Stockholm, and explores the expertise and knowledge shared by three social workers. The researchers conducted semi-structured interviews with social workers, while studying previous literature, research and theory surrounding youth, criminality and gang-related violence. The importance of identifying and taking these factors into account during intervention construction for this group on an individual level is signified within this study. The discussion summarizes the identified central psychosocial factors, their known use by the social workers during intervention construction and the significance of doing so according to previous research and literature

Despite high prevalence rates of work-related musculoskeletal disorders (WMSDs), the causes and pathways of WMSD development are not fully understood. Multiple factors (physical, psychosocial, and individual) have been associated with WMSD development, but causal inferences are not available due to lack of experimental designs. Because the responses, validity, and reliability of measured outcomes under multiple-exposure environments are not known, the current work analyzed the effects of multiple WMSD risk factors on several measurement methods. Forty-eight participants completed four trials of simulated manufacturing work at different levels of physical and psychosocial exposure for one psychosocial dimension (job control, job demands, time pressure, or social support). The three independent variables significantly affected outcomes, including muscle activity, heart rate, task performance, discomfort and workload ratings, and psychosocial environment perceptions. Social interaction should take priority over working in isolation, and pressure to achieve high performance should be minimized to reduce WMSD risk. A secondary data analysis determined measurements that could estimate WMSD risk efficiently. Convergent and discriminant validity was assessed to retain methods that provided unique information and minimized overlap between similar methods. For the given manufacturing environment, one muscle activity measure, heart rate mean and variability, one set of workload and discomfort ratings, and a psychosocial questionnaire were the best WMSD risk measurement methods. The third study assessed the test-retest reliability of the outcome measures of an additional trial involving 24 participants. Workload and discomfort appeared reliable under high levels of physical exposure but not under psychosocial manipulations. Physiological measures were reliable for <50% of parameters. The psychosocial questionnaire was reliable under favorable social support but not high physical exposure and favorable job control. The final study determined the number of psychosocial factors experienced through factor analysis on psychosocial questionnaire responses from the main experiment. Participants could distinguish psychosocial dimensions in the work environment, and this questionnaire may be used in experimental settings to measure perceptions of the psychosocial environment. The current research provided a basis for measuring physical and psychosocial exposure simultaneously in occupational settings. Using this knowledge may allow practitioners to focus on interventions and designs that reduce WMSD risk exposure. / Ph. D.

Work-related musculoskeletal disorders (WMSDs) are a major source of lost productivity and revenue in the workplace and disability in workers. There is strong evidence for a relationship between physical risk factors, such as repetitive motions and excessive force, and the development of WMSDs; yet there are unexplained discrepancies in determining which workers are more at risk. Researchers hypothesize that non-physical factors in the workplace, or psychosocial factors, may contribute to the development of WMSDs. The following study examined the effects of two psychosocial factors, mental workload and time pressure, on perceived workload and physiological reactions of the lower arm and wrist during typing activity by measuring muscle activation patterns, wrist posture and movement, key strike forces, and subjective assessments of overall workload. The results indicate that increases in time pressure lead to increases in lower arm muscle activation, key strike forces, and wrist deviations. Key strike forces may increase with higher mental workload levels, but other effects of mental workload were not clear. Perceived overall workload (time load, mental effort load, and stress load) increased with mental workload and time pressure, and typing performance decreased. The evidence from this study suggests that these psychosocial factors (mental workload and time pressure) mediate physical risk factors to increase risk for WMSD development in the upper extremities. The results illustrate the need for those designing jobs and work tasks to consider both physical and psychosocial aspects of the working environment to prevent injuries in employees. / Master of Science