2012 m. rugsėjo, spalio ir lapkričio mėnesiais buvo atlikta trijų Kauno m. vidurinių mokyklų 6, 7, 8, 9 ir 10 klasių moksleivių anoniminė anketinė apklausa, kurios metu buvo apklausti 446 moksleiviai (230 mergaičių ir 216 berniukų). Klausimynas buvo sudarytas iš klausimų, susijusių su patiriamu priekabiavimu mokykloje, taip pat tyrėme ar moksleiviai turi sveikatos nusiskundimų: galvos skausmą, skrandžio ir pilvo skausmą, liūdesį, nerimą, blogą nuotaiką, nemigą, nervinę įtampą ir t.t. Moksleivių psichologinei būsenai įvertinti buvo įtraukta jau aprobuota A. Antanovsky vidinės darnos sutrumpinta 13 teiginių skalės versija. Potrauminio streso simptomai buvo vertinami Įvykio poveikio skale. Taip pat tyrėme moksleivių suvartojamų, kai kurių maisto produktų dažnį, buvome įtraukę tokius maisto produktus: alkoholiniai, energetiniai ir saldūs gazuoti gėrimai, bulvių traškučiai, saldainiai, šokoladai, picos, mėsainiai, šaldyti pusfabrikačiai, švieži vaisiai ir daržovės, košės, natūralios vaisių sultys, mėsa, žuvis ir t.t. Statistinė duomenų analizė atlikta naudojant kompiuterinį SPSS 15.0 for Windows versijos statistinį duomenų analizės paketą ir Microsoft Office Excel. / In 2012. September, October and November have been carried out an anonymous questionnaire in three high school between 6, 7, 8, 9 and 10th grade student; there was questioned 446 students (230 girls and 216 boys). The questionnaire consisted of questions related to school bullying also investigated whether students have health complaints: headaches, stomach and abdominal pain, sadness, anxiety, low mood, insomnia, nervous tension, etc. To evaluate psychological state of pupils was used an approved A. Antonovsky Sense of Coherence condensed statements 13 scale version. Post-traumatic stress symptoms were rated by using Event scale. Also it was investigated frequency of students' usage of some food; there were added these foods: alcohol, energy and sweet fizzy drinks, crisps, sweets, chocolates, pizzas, burgers, frozen semi-finished goods, fresh fruits and vegetables, cereals, natural fruit juices meat, fish, etc. Statistical analysis was performed by using a computer SPSS for Windows version 15.0 statistical package and Microsoft Office Excel.

nÃo hà / Esta dissertaÃÃo objetivou avaliar os riscos psicossociais presentes no contexto de trabalho de uma instituiÃÃo pÃblico-privada do estado do Cearà que possam influenciar no processo saÃde/doenÃa dos seus trabalhadores efetivos e terceirizados. Identificaram-se os fenÃmenos psicossociais existentes nas relaÃÃes de trabalho, analisando processos de subjetivaÃÃo e contribuindo para a compreensÃo dos efeitos adversos da heterogeneidade de vÃnculos laborais sobre a saÃde do trabalhador, a partir da perspectiva psicossociolÃgica, bem como do campo da SaÃde do Trabalhador. Para tanto, iniciou-se o delineamento a parte da seguinte pergunta: quais os riscos psicossociais para a saÃde do trabalhador presentes no ambiente de trabalho de uma instituiÃÃo pÃblico-privado? Foram considerados mÃtodos quantitativos e qualitativos e a pesquisa caracterizada como um estudo de caso. Utilizou-se trÃs escalas do InventÃrio de Trabalho e Riscos de Adoecimento â ITRA, questionÃrio biosociodemogrÃfico e entrevistas semiestruturadas. Contou-se com o suporte do programa estatÃstico SPSS e do mÃtodo de AnÃlise SociolÃgica do Discurso como recurso de tratamento dos dados. Responderam ao questionÃrio 312 participantes e, posteriormente, entrevistaram-se 10 trabalhadores (4 efetivos e 6 terceirizados). Os resultados mais significativos do questionÃrio indicaram nÃveis de avaliaÃÃo crÃticos para os fatores âorganizaÃÃo do trabalhoâ (70,2%; M = 3,11) e grave para âcusto cognitivoâ (46,8%; M = 3,48); e satisfatÃrios para âRealizaÃÃo Profissionalâ (54,5%; M = 3,98), âLiberdade de ExpressÃoâ (59%; M = 4,19), âCusto FÃsicoâ (74,7%; M = 1,87) e âFalta de Reconhecimentoâ (58,7%; M = 1,84). Os resultados estatÃsticos do teste t indicaram diferenÃa significativa entre trabalhadores efetivos e terceirizados apenas para os fatores âorganizaÃÃo do trabalhoâ, ârelaÃÃes socioprofissionaisâ e âcusto fÃsicoâ. A partir da integraÃÃo dos dados, evidencia-se os seguintes aspectos potencializadores de adoecimento e fontes de desgaste: ingerÃncias polÃticas, cobranÃa por resultados, burocratizaÃÃo de procedimentos e falta de treinamento para formaÃÃo de gestores. No quesito de promoÃÃo de saÃde, destaca-se a prÃtica de atividade fÃsica, a religiÃo e o forte vÃnculo afetivo estabelecido com a organizaÃÃo e com os colegas de trabalho. Foi possÃvel apreender e melhor compreender o contexto desses trabalhadores a partir da sua prÃpria perspectiva, assim como corroborar achados, apontados pela literatura, de vulnerabilidade e precarizaÃÃo dos indivÃduos prestadores de serviÃos terceirizados. / This dissertation aimed to evaluate the psychosocial risks in the work environment of a public-private organization in the state of CearÃ, Brazil, and to understand how those risks can impact the health/disease process of its associate and outsourced workers. The existing psychosocial phenomena in work relationships were identified by analyzing subjective processes. By doing so, this study contributes to understand how the workerâs health is impacted by the adverse effects of heterogeneous labor links, based on a psychosociological perspective and on the field study of Workerâs Health. In order to do so, the sign research used the following question as starting point: Which psychosocial risks for the workerâs health can be found in the work environment of a public-private institution? This research considered both quantitative and qualitative methods and is characterized as a case study. Three scales from the Inventory of Work and Illness Risks â ITRA, biosociodemographic questionnaire, and semi-structured interviews were used. As for data treatment, this study is supported by the statistical software SPSS and the Sociological Analysis of Speech. The questionnaire was answered by 312 participants and, after that, 10 workers were interviewed (4 associates and 6 outsourced). The most significant results of the questionnaire suggested critical assessment levels for the factors âOrganization of Work Assignmentsâ (70,2%; M = 3,11) and serious levels for âCognitive Burdenâ (46,8%; M = 3,48); the results were satisfactory for the factors âProfessional Fulfillmentâ (54,5%; M = 3,98); âFreedom of Expressionâ (59%; M = 4,19), and âPhysical Burdenâ (74,7%; M = 1,87) and âLack of Recognitionâ (58,7%; M = 1,84). The statistical results for the T-test indicated significant differences between associates and outsourced workers for the factors âorganization of work assignmentsâ, âsocioprofessional relationshipsâ, and âphysical burdenâ factor. The integration of the dathe study emphasizes the following aspects as illness boosters and source of wearness: political interference, pressure for results, bureaucracy of procedures, and lack of management training. As for the heal on of health, the following practices are highlighted: physical activities, religion, and the strong affective link established with the organization and with the co-workers. It was made possible to get a better grasp and understanding of the context of these workers based on own perspective. Additionally, the results of this research support the findings of other studies as pointed out by the literature, such as the vulnerabilization and precarization of people who provide outsourced services.

Workplace discrimination exists in the Swedish work environment. Minority groups (such as immigrants, persons from ethno-racial backgrounds different from the majority population, persons of non-normative sexual orientation, gender, or religious background) may experience discrimination or the fear of possible exposure to discrimination in the workplace. This presents an additional form of stress referred to as ‘minority stress’. Minority Stress is added stress to general stressors experienced by all people that is unique to minority groups. In the workplace, workplace discrimination is a psychosocial risk factor which could lead to minority stress. To address this risk, studies aimed at eliminating health and other disparities requires quality and methodologically sound research on racial/ethnic minorities, yet little guidelines are available. This thesis aims to bridge this gap and adopts ethno-racialization and participatory research frameworks to elicit the views and opinions of eight (8) ethno-racialized minorities in Sweden on how survey items investigating workplace discrimination in Sweden could be designed in a sensitive, non-stigmatizing manner that does not reinforce negative stereotypes. Study participants included five men and three women aged between 18 – 45 years old recruited through opportunistic, snowball sampling technique, with Swedish work experience between1 – 10 years, and working across academia, hospitality, communication, and health sectors. Participants responded to survey questionnaire and were interviewed on four key areas: Demographics; Ethno-racialization questions; Sample of various wordings on discrimination questions and Technology related questions regarding data collection, storage, and access.The result from this study show that “language” used in the wording of survey questions directed at ethno-racialized minorities is an important element if/how they respond and interpret questions. In this regard, using unclear and indirect language that is vague, ambiguous in survey questionnaire could lead to multiple interpretations and impact the validity of data collected. The study also found that ethno-racialized persons are not a homogenous group and as such, how they interpret and respond to survey questions indicate differences and reflect their individual preferences. The study concludes that survey items investigating workplace discrimination among ethno-racialized minorities should be designed using language that is direct and considers the varied opinions and perspectives of members of the group – that is, ethno-racialized minorities come from diverse backgrounds and their views are not homogenous.

Este trabajo parte del interés que tienen los factores de riesgo psicosocial en el ámbito laboral. Se divide en dos apartados. En el primero, teórico, incluye la conceptualización, clasificación y consecuencias de los factores de riesgo psicosocial en el trabajo; y se analiza el acoso psicológico en el trabajo (mobbing) como un factor que debe ser incluido en la evaluación de los factores de riesgo psicosocial, a continuación, se describen los instrumentos de evaluación que se están utilizando dentro del marco de la prevención, y por último, se describe el sector hortofrutícola. En el segundo, empírico, se exponen los objetivos, el método, los resultados, y la discusión. La muestra está compuesta por 638 trabajadores pertenecientes a cinco empresas del sector hortofrutícola. El resultado de esta investigación es la adaptación de un cuestionario de evaluación de los factores de riesgo psicosocial para el sector hortofrutícola que incluye el mobbing como factor de riesgo. / This study parts of the interest those psychosocial risk factors in the workplace. This work is divided into two sections. In the first, theoretical, including the conceptualization, classification and consequences of psychosocial risk factors at workplace, and discusses the psychological harassment at work (mobbing) as a factor that must be included in the assessment of risk factors psychosocial, then describes the assessment tools being used within the framework of prevention, and finally, describes the horticultural sector. In the second part, empirical, show the objectives, the methodology, the results, and the discussion. A sample of 638 workers from five company the fruit-and-vegetable sector was evaluated. The result of this investigation is the adaptation of a questionnaire for assessing psychosocial risk factors at workplace for the agro furit sector which includes the mobbing as a risk factor.

La investigación parte de la preocupación que existía en la Compañía Go Clean Perú, ubicada en el distrito limeño de Miraflores, donde se presentaban ausencias laborales no justificadas por parte de los operarios, bajo el contrato a plazo fijo y sujeto a la modalidad de servicio específico. El objetivo de la investigación fue identificar la relación entre algún factor de riesgo psicosocial y la ausencia laboral injustificada de los operarios de las generaciones millennials. X y baby boomers de la compañía Go Clean Perú, en el periodo de mayo a octubre del 2019, a fin de proponer un plan de acción para reducir la ausencia no justificada de los operarios de la compañía. El estudio se realizó en varias etapas: selección de la población, análisis de los datos, aplicación del cuestionario SUSESO/ISTAS 21 versión breve y, por último, el análisis de los resultados. Se determinó que las ausencias no justificadas estaban relacionadas con las dimensiones apoyo social y calidad de liderazgo, lo que nos llevó a desarrollar un plan de acción para disminuir el factor de riesgo psicosocial y las ausencias. / The investigation is based on the concern that existed in the Go Clean Peru Company, located in the Lima district of Miraflores, where there were unjustified absences from work on the part of the operators, under the fixed-term contract and subject to the specific service modality. The objective of the research was to identify the relationship between some psychosocial risk factor and the unjustified absence from work of the workers of the millennial generations. X and baby boomers of the company Go Clean Peru, in the period from May to October 2019, in order to propose an action plan to reduce the unjustified absence of the company's workers. The study was carried out in several stages: selection of the population, data analysis, application of the SUSESO / ISTAS 21 questionnaire, short version and, finally, the analysis of the results. It was determined that the unexcused absences were related to the dimensions of social support and quality of leadership, which led us to develop an action plan to reduce the psychosocial risk factor and absences. / Trabajo de investigación

Kiruna, a Swedish community situated 300 km north of the Arctic Circle, has a very high mortality in ischemic heart disease (IHD). Acase-control study was undertaken to find out if the risk factors for IHD or their impact differed from those in other populations. The survey methods comprised questionnaires, physical examinations, laboratory tests, a food diary, ecological studies, and a register study. The study group consisted of 219 men who had suffered an acute myocardial infarction (cases) and 438 men without known ischemic heart disease (controls). The main risk factors were: a family history of IHD, hypertension, hyperlipidemia, diabetes mellitus, and smoking. Also psycho-social risk factors like lack of job support constituted a risk factor. Cholesterol ester and adipose tissue triglyceride fatty acids have a slower turn-over rate than other routinely analysed lipids and lipoproteins and thus reflect dietary habits over a longer period of time. They were measured in a subset of our cohort, showing that the cases, judged from lipid and fatty acid composition, lived on a diet comparable to that of the controls. A prospective diet diary showed few differences between cases and controls and between the whole cohort and a reference cohort in Uppsala in the central part of Sweden. Most notable differences were a low level of y-tocopherol, a low proportion of linoleic acid, and a high proportion of palmitic acid in serum cholesterol esters and adipose tissue triglycerides in the Kiruna cohort. The expected reduced morbidity in ischemic heart disease related to alcohol consumption was not seen in our material. This finding was further examined in an ecological study on a national Swedish level, longitudinally, cross-sectionally, and with time-series methodology. There was an inverse correlation between wine consumption and mortality in IHD for women but no correlation between the consumption of beer and distilled spirits, and mortality in IHD. Heart failure, a common sequela of IHD, has an increasing incidence in a hospital-based population. In spite of improved treatments the prognosis has not improved during the last seven years and is still as bad as or worse than that of many malignant diseases. Male sex and high age implied a worse prognosis. Consumption of acetylsalicylic acid (ASA) for pain relief resulted in a greater risk of developing an acute myocardial infarction in our cohort. This was further examined in an ecological study on anational Swedish level also showing a correlation between ASA consumption and mortality in IHD both in the geographical and the longitudinal analysis for the surveyed years, but not in the time series analysis. / <p>Diss. (sammanfattning) Umeå : Umeå university, 1996, härtill 7 uppsatser.</p> / digitalisering@umu

The aim of this study is to create a deeper understanding of the disease known as eating disorder. The study is based on four autobiographies written by individuals who themselves have been affected by eating disorders. These stories have been studied using a narrative approach. To achieve the purpose, the study is focused on what participants describe as the factors underlying the onset of the disease, the factors that participants describe maintained their eating disorders, as well as what is described to be the factors responsible for their recovery. By my interpretation of the stories, I have been able to identify common factors that all participants describe to be influential in their disease course. The common factors that have been identified are relationships, expectations and emotions. The result shows that it is possible to see a variation in how these factors have influenced the participants' disease course. The variety of how these factors have influenced suggests that each individual's care is unique. The results have been analyzed by using the theory of social construction.

Studiens syfte är att genom en litteraturstudie undersöka psykosociala riskfaktorer till ungdomsbrottslighet. Riskfaktorer som undersöks är individuella attribut, familjeförhållanden, individens egna psykiska förutsättningar, betydelsen av skolgång samt vänner och grupptillhörighet. Då fokus ligger på individen, kommer studien att analyseras utifrån sociala och utvecklingspsykologiska teorier. Forskare i psykologi och kriminologi förklarar att bakomliggande orsaker till att individen begår brott i ung ålder, måste förstås i ett sammanhang med fler faktorer i beaktande, exempelvis individuella egenskaper, men även villkor och erfarenheter i förhållande till dennes miljö. I annan mening krävs det mer än en riskfaktor för att ett brottsligt beteende ska formas, men de betonar däremot att en enda  riskfaktor även kan härleda till en utveckling av fler. Viktigt att belysa är också att sammansättningen av faktorer inte är identiska för varje individ. Ungdomsbrottsligheten kännetecknas av ett reaktivt kriminellt tänkande, vilket innebär att brott i hög utsträckning begås impulsivt och oplanerat. Andra konstaterade riskfaktorer är  ungdomens familjeförhållanden. Att leva i en dysfunktionell familj, präglad av konflikter mellan syskon, otydlig hierarki mellan barn- och föräldraroll, våld i hemmet samt föräldrar med beroendeproblematik av olika substanser och psykiska bekymmer, ökar sannolikheten med 86% för ungdomar att begå våldsbrott. Vidare har det konstaterats att egenskaper såsom spänningssökande, impulsivitet, svårhanterlig aggression, brist på motivation till studier och ambitioner för livet, utgör en riskfaktor för att falla i kriminaliteten. Att ha en ADHD diagnos har också visat sig vara en sårbarhet och cirka var femte interner i den svenska kriminalvården har diagnosen. Även en hög skolfrånvaro och misslyckande med studier är förknippat med en individs uppvisande av våldsamt och kriminellt beteende. Faktum är ungdomar redan inom 12 månader utan skolgång uppvisar ett normbrytande beteende. Slutligen är influenser från vänner avgörande när barnet når tonåren. Att umgås med någon som begår brott utgör en stor riskfaktor för att själv hamna i ungdomsbrottsligheten. / The aim of this literature study is to research the psychosocial (risk) factors behind juvenile criminality. Researchers in psychological and criminological fields explain that, the underlying factors that lead an adolescent to criminality, need to be analysed through multidimensional lenses, since there are several factors leading to juvenile criminality. Usually, there is more than one factor that leads to juvenile delinquency, nevertheless, researchers claim that a single risk factor can also lead to the development of other factors, hence, leading young people to commit crime. It is also important to highlight that the combination of factors is not identical to every individual. Juvenile criminality is characterised by reactive criminal thinking, therefore, crimes are largely committed impulsively and unplanned. Moreover, other established risk factors are the family circumstances of the adolescent. The probability of adolescents committing crime, increases by 86% when living in an environment that is characterised by a dysfunctional family, dominated by sibling conflicts and unclear hierarchy between parents and children, violence in the home, and parents with drug addictions and psychological instability. Furthermore, it is proven that characteristics, such as, sensation seeking, impulsiveness, aggression, lack of educational motivation and lack of life ambitions, are also risk factors for falling into crime. Additionally, having an ADHD diagnosis has also been shown to be a vulnerability and about every fifth inmate in the Swedish prison system has the diagnosis. Moreover, school absenteeism and failure to study are also associated with an individual's display of violent and criminal behavior. In fact, adolescents who have been 12 months without schooling, show a norm-breaking behavior. Finally, the influence of friends is crucial when the child reaches adolescence. Hence, spending time with someone who commits a crime is a major risk factor for the individual to fall into juvenile delinquency.

HINTERGRUND: Die Typ-D-Persönlichkeit (von distressed personality) etablierte sich in den letzten Jahren als ein Risikofaktor für den Verlauf kardiovaskulärer Erkrankungen. Die bisherigen Studien waren in den Niederlanden oder Belgien durchgeführt worden. Das Ziel der hier vorliegenden Arbeit war eine unabhängige Überprüfung der Ergebnisse an einer Stichprobe deutscher kardiologischer Patienten. Zusätzlich sollte untersucht werden, ob die Typ-D-Persönlichkeit und ihre Dimensionen der negativen Affektivität (NA) und der sozialen Inhibition (SI) über den Untersuchungszeitraum stabil blieben. METHODEN: Hierzu wurden 1040 stationär oder ambulant kardiologisch behandelte Patienten rekrutiert. Mithilfe der Typ-D-Skala (DS14) und der Hospital Anxiety and Depression Scale (HADS) wurden die Merkmale einer Typ-D-Persönlichkeit sowie Depressivität und Ängstlichkeit erhoben. Zusätzlich wurden klinisch relevante Daten, wie z. B. Geschlecht, Alter und kardiale Vorerkrankungen, erfasst. Endpunkt der Studie war die Gesamtmortalität. Mit Cox-Regressionsanalysen wurde das relative Sterblichkeitsrisiko der Probanden ermittelt. ERGEBNISSE: Hinsichtlich der Stabilität von Typ-D, NA und SI ergaben sich über einen Zeitraum von 5,9 Jahren Re-Test Stabilitäten an der unteren Grenze des Erwarteten. Es gab also eine gewisse Stabilität der Typ-D-Persönlichkeit, diese war aber nicht wesentlich höher als beispielsweise die von Angst und Depressivität, und auf Ebene des individuellen Patienten kam es häufig zu Veränderungen. Der Überlebensstatus ließ sich für 977 Studienteilnehmer ermitteln, hiervon waren 172 im Beobachtungszeitraum verstorben. In univariater und multivariater Analyse waren weder Typ-D noch NA oder SI Prädiktionsfaktoren einer höheren Gesamtmortalität. Im Gegensatz zu anderen Studien wies unsere Stichprobe ein heterogenes kardiales Erkrankungsprofil auf. Eine hierdurch bedingte Verschleierung eines Einflusses des Typ-D-Musters konnten wir durch separate Untersuchung der KHK-Patienten ausschließen. SCHLUSSFOLGERUNG: Zusammenfassend lässt sich sagen, dass unsere Studie zu den größten zählt, die bisher zur Evaluation des Einflusses der Typ-D-Persönlichkeit auf die Gesamtmortalität kardiologischer Patienten durch-geführt worden ist. Nach mehr als 5 Jahren Beobachtungszeit, mit 5764 Menschenjahren und 172 beobachteten Todesfällen hat sie suffiziente Ausdruckskraft, relevante Effekte der Typ-D-Persönlichkeit auf die Mortalität aufzudecken. Die klare Abwesenheit dieses Effektes in univariater und multivariater Analyse legt den Schluss nahe, dass die Typ-D-Persönlichkeit und ihre Dimensionen NA und SI bei deutschen kardiologischen Patienten nicht mit einer erhöhten Mortalität assoziiert sind. Die Diskrepanz zwischen unseren Ergebnissen und den Ergebnissen von Denollet und seiner Arbeitsgruppe macht weitere Forschung an anderen Stichproben nötig. Kulturelle Unterschiede in der Verarbeitung negativer Affekte sind als mögliche Ursache unserer abweichenden Ergebnisse zu diskutieren und sollten in zukünftigen Studien weiter untersucht werden.

Il presente lavoro di tesi è stato condotto in ambito psicocardiologico, e riguarda l’indagine delle determinanti psicosociali potenzialmente coinvolte nell’eziopatogenesi, digressione e prognosi delle malattie cardiache. Più studi preliminari sono stati condotti a fini esplorativi, e solo le varabili risultate caratteristiche del campione mantenute in indagini successive. Dopo aver indagato il ruolo del benessere psicologico nell’influenzare la Capacità Funzionale dei pazienti, uno degli indicatori di esito di maggiore importanza in Riabilitazione Cardiologica (RC) (studio 1), si è proceduto a verificare quali tra le variabili cognitive e psicologiche tradizionalmente associate alle malattie cardiache caratterizzasse lo specifico campione, condizionandone Qualità della Vita (QdV) e benessere psicologico (studio 2). Esclusa l’influenza delle variabili cognitive sullo stato emotivo dei soggetti, si è, poi, approfondito il ruolo delle variabili psicologiche nel determinarne la QdV percepita dei degenti (studio 3). Obiettivo del quarto studio è, infine, valutare efficacia ed efficienza dell’aggiunta di tecniche e principi propri del Colloquio Motivazionale (CM) al trattamento psicologico standard (Terapia Breve Strategica, TBS), al di la del solo trattamento breve strategico, nell’incrementare autoefficacia percepita, disponibilità al cambiamento ed aderenza al trattamento riabilitativo nel malati di cuore. Un esempio dell’uso di tale stile comunicativo viene, inoltre, proposto mediante caso clinico (studio 5). / The general aim of this thesis is to seek evidence on how to achieve long-term maintenance of lifestyle changes in a sample of obese inpatients with heart diseases referred to Cardiac Rehabilitation by investigating the influence of selected variables on their physical and psychological status, as well as by examining the efficacy and effectiveness of a motivational-based intervention. Study 1 is aimed at evaluating whether psychological well-being represents an independent predictor of Exercise Capacity. Study 2 focuses on investigating the influence of cognitive abilities and established psychosocial risk factors on the sample’s subjective Quality of life (QoL) and well-being. Since no effect of different levels of cognitive impairments on the expression of psychological distress among the study participants has been identified, in study 3 the effect of emotional impairments on QoL has been further explored. To conclude, the MOTIV-HEART study (study 4) is aimed at testing the incremental efficacy of a brief strategic treatment including motivational components (BST + MI) in improving physical and psychological outcomes over and beyond the stand-alone brief strategic treatment (BST) and whether results will be maintained/increased at 3-month follow-up. An example of this style of communication is also presented through a case study (study 5).