This study, which is part of a research project conducted to explore the experiences of quality of life of older people living in a residential facility, focuses specifically on the psychosocial needs of these residents. Psychosocial needs refer to the innate psychological nutriments that prompt older people to take purposeful, self-directed action in an attempt to satisfy these needs and ultimately foster well-being. These may include needs for mastery, acknowledgement, social interaction and care. In this study the term “older people” refers to individuals aged 60 years and older. The group of older people who participated in this study all live in a residential facility for older people. “Residential facility” refers to premises or a building where older people are provided with accommodation and access to 24-hour care. Previous research concerning the needs of older people focused mainly on their physical care, in the context of deteriorating health. Considering that many older people are leading healthy, vigorous lifestyles, however, it is also important to explore the psychosocial needs of the more functional older people in residential facilities. Psychosocial needs were initially described by Maslow, within a hierarchical system, whereby psychosocial needs emerge only when biological needs have been satisfied. In view of the exceptions described in the literature of older people who overcome the inevitable physical strains that accompany ageing, Maslow’s bottom-up approach is seen as restrictive in its view of older people. In the present study self-determination theory (SDT) has been found to be applicable in exploring psychosocial needs, because of its holistic and adaptive view of people possessing the potential to address their needs within a social environment. SDT views people as motivated to gratify their needs for competence, autonomy and relatedness. A qualitative approach was used to describe the psychosocial needs of the older people studied. The research was conducted in a residential facility for older people in Johannesburg, Gauteng. The older participants comprised 16 residents, including 3 males and 13 females, aged 65 and older. Data-gathering was conducted by using the Mmogo-method®. This required each participant to use a lump of clay, sticks and beads to make something that represents their experiences of life in the residential facility. Prompting questions were asked and each participant was given an opportunity to describe his or her visual presentation. Group discussions allowing for confirmation or revision of perspectives of experiences followed. Data were analysed by means of secondary, thematic and visual analysis. Trustworthiness was ensured by carefully applying specific guidelines which were produced by considering different models aimed at ensuring rigour in qualitative research. These guidelines included clear and coherent writing; conceptual coherence; ensuring a trustworthy procedure through member-checking, multiple perspectives and clarification, as well as the researcher’s attentiveness to her own biases. The research was approved by the ethical committee of North-West University. The researcher applied ethical guidelines as prescribed by the Health Professions Council of South Africa while the research was conducted, and afterwards. Findings revealed four psychosocial needs, namely a need for autonomy, interpersonal interaction within a specific context, a sense of safety, and transcendental needs. The need for autonomy included freedom of personal preference, independent living and active participation. On the interpersonal level, there was a need for general relationships, in which sharing, acknowledgement and caring were present (both instrumental and emotional), as well as close family and friendship relationships. The need for safety covers both physical and organisational safety. On the transcendental level, there is a need for space and opportunities to express and address spiritual needs. These findings may be used to facilitate the development of policies and programmes which aim to address the psychosocial needs of older people in residential facilities as well as in other living arrangements. / MSc (Clinical Psychology), North-West University, Potchefstroom Campus, 2015

Syfte: Denna studie har som syfte att beskriva och jämföra den psykosociala arbetsmiljön hos två olika yrkeskategorier, sjuksköterska på vårdavdelning och personer anställda inom kundsupport och samband med upplevd hälsa. Bakgrund: Sjuksköterskor och personer anställda inom kundsupport arbetar i verksamheter där kraven ofta är höga. Stor arbetsbelastning i kombination med  tidspress kan leda leda till att personalen drabbas av ohälsa. Metod: En jämförande tvärsnittsstudie genomfördes våren 2013. Frågeformulär användes för insamlande av data.  Deltagarna bestod av 50 sjuksköterskor från 4 olika vårdavdelningar samt 48 personer anställda inom kundsupport från 2 företag. Data analyserades med statistikprogrammet SPSS version 20.0. Analyser som gjordes var frekvensberäkning, independent T-test (för medelvärden, standardavvikelser och p-värden) samt Pearsons korrelation för sambandsanalys. Resultat: Studien visade skillnader i upplevelse av psykosociala arbetmiljöområden  mellan de båda yrkeskategorierna. Samband mellan psykosocial arbetsmiljö och hälsa fanns i områdena Kontroll i arbetet, Skicklighet i arbetet, Social interaktion, Ledarskap, Organisationskultur-och klimat samt Grupparbete. Sambanden var tydligare för personer anställda inom kundsupport. Slutsats: Det kan finnas samband mellan hälsa och den  psykosocial arbetsmiljö.

Le tempérament de l'enfant et la qualité des comportements maternels ont souvent été identifiés comme étant des éléments déterminants du développement social et cognitif ultérieur de l'enfant (Janson et Mathiesen, 2008; Madigan, Moran, Schuengel, Pederson et Roy, 2007; Lemelin, Tarabulsy et Provost, 2006). Par ailleurs, plusieurs études font état du fait que le tempérament de l'enfant et la qualité du comportement maternel sont souvent en relation (Lemelin et al., 2006; Hemphill et Sanson, 2001). Cependant, actuellement, les auteurs n'arrivent pas à un consensus quant à la direction des effets entre le tempérament de l'enfant et la qualité des comportements maternels. En effet, certaines études montrent que le tempérament influence la qualité des comportements maternels, d'autres montrent l'inverse alors que certaines d'entre elles suggèrent plutôt la présence d'une relation bidirectionnelle entre ces variables. Ces différences peuvent être dues, en partie, aux différences méthodologiques entre les études ou encore aux différentes dimensions tempéramentales considérées. L'objectif de la présente étude est donc d'examiner la direction potentielle des effets entre le tempérament de l'enfant et la sensibilité maternelle entre 15 et 18 mois, tout en considérant cinq dimensions tempéramentales distinctes (niveau d'activité, tendance à exprimer du plaisir, crainte sociale, prédisposition à la colère et intérêt/attention). Plus spécifiquement, elle vise à vérifier si la direction potentielle des effets et la force des relations entre ces deux variables varient en fonction du niveau de risque psychosocial dans lequel se développe l'enfant et en fonction du sexe de ce dernier. Cinquante (50) dyades mère-enfant à faible risque au niveau psychosocial et 98 dyades mère-enfant à haut risque (définit selon le statut de la mère : adulte ou adolescente) ont été évaluées à domicile à deux reprises. À 15 et à 18 mois, les mères devaient compléter le Questionnaire d'évaluation du comportement de l'enfant (QÉCE; Lemelin, Tarabulsy, Provost, Fournier, Robitaille, Hémond et Tessier, 2007), une version canadienne-française du Toddler Behavior Assessment Questionnaire (TBAQ; Goldsmith, 1996) qui permet d'évaluer les cinq dimensions tempéramentales à l'étude et une observatrice devait compléter le Tri-de-cartes des comportements maternels, suite à la visite à domicile (Pederson et Moran, 1995). Les résultats obtenus montrent que la direction des effets et la force de la relation entre le tempérament de l'enfant et la sensibilité maternelle varient en fonction de la dimension tempéramentale prise en compte. En effet, la sensibilité maternelle apparaît comme étant associée aux dimensions généralement considérées comme étant négatives et extériorisées du tempérament, à savoir la prédisposition à la colère et le niveau d'activité. Par ailleurs, la direction des effets ressort aussi comme étant modérée par le niveau de risque psychosocial auquel est exposé l'enfant et par le sexe de celui-ci. Pour les dyades enfant-mère adulte, les résultats soutiennent davantage l'hypothèse selon laquelle le tempérament de l'enfant influence la sensibilité maternelle et ce, tant pour la prédisposition à la colère que pour le niveau d'activité. Par contre, pour les dyades enfant-mère adolescente, la relation entre la prédisposition à la colère et la sensibilité maternelle ressort comme étant bidirectionnelle, alors que pour le niveau d'activité, les résultats supportent l'hypothèse selon laquelle la sensibilité maternelle influence le tempérament de l'enfant. En ce qui concerne la modération par le sexe de l'enfant, pour le groupe de filles, les résultats obtenus soutiennent l'hypothèse de l'influence du tempérament sur la sensibilité maternelle pour la prédisposition à la colère et d'une relation bidirectionnelle pour le niveau d'activité. Cependant, pour le groupe de garçons, l'hypothèse de l'influence de la sensibilité maternelle sur le tempérament est davantage soutenue tant pour la prédisposition à la colère que pour le niveau d'activité. Pris dans leur ensemble, les résultats font état de liens complexes entre le tempérament de l'enfant et la sensibilité maternelle, modérés par le niveau de risque psychosocial auquel est exposé l'enfant et par le sexe de celui-ci, et spécifiques à la dimension tempéramentale prise en compte.

<p>The psychosocial work environment in human service organizations is in many respects rewarding from the aspect of human interaction. However, it has also been described in several research reports as demanding and stressful both physically and mentally, resulting in a negative impact on employee health and a high degree of sickness absence. From a public health perspective it is important to focus on determinants of health in occupational groups that are characterized by caring and human relations. This thesis aims at identifying determinants of individual and organizational health in human service professions from a multifactorial perspective.</p><p>Based on both cross-sectional and longitudinal data, four studies of various aspects of psychosocial work exposures are carried out. Study I, an explorative and qualitative study, examines determinants of the psychosocial work environment in the Church of Sweden. Study II consists of a retrospective, randomized study assessing effects of goal clarity work on organizational well-being in the Church. Study III examines exposures resulting in stress-related sick leave among elderly care employees. Study IV is a longitudinal study that assesses effects of organizational change on health and sickness absence among elderly care employees. </p><p>The results show some positive experiences, despite overall demanding work conditions within both of the studied professions. In the Church (Paper I), experiences of freedom and influence at work and the Christian values tend be factors with modifying effect on health. Four patterns are identified for negative health impact; these include unclear organization, a sense of being different, stressful work and destructive communication style. Effects of goal clarity work (Paper II) indicate an overall positive impact on organizational well-being. In elderly care (Paper III), the results suggest, in general, a positive work climate and high effectiveness. Work related exhaustion was significantly higher among employees with stress related sickness absence. Factors of risk for being absent due to stress are approximately three times higher among employees dissatisfied with both their work and their social situations. Finally, measuring effects of organizational change (Paper IV), the results reveal evidence of unchanged self-rated health (SRH), work satisfaction and work exhaustion after reorganization. However, sickness absence increased across time and there is an indication of impaired levels of the anabolic hormone DHEA-S among those individuals affected by the reorganization. </p><p>The results point to a challenge for further research on the interplay between perceived stressors, resources available, biological stress markers and health in order to find adequate measures for improvements in psychosocial work environment in human service professions.</p>

<p>Today, health problems are likely to have a complex and multifactorial etiology, whereby psychosocial factors interact with behaviour and bodily responses. Women generally report more health problems than men. The present thesis concerns the development of women’s health from a subjective and objective perspective, as related to psychosocial living conditions and physiological stress responses. Both cross-sectional and longitudinal studies were carried out on a representative sample of women. Data analysis was based on a holistic person-oriented approach as well as a variable approach. In Study I, the women’s self-reported symptoms and diseases as well as self-rated general health status were compared to physician-rated health problems and ratings of the general health of the women, based on medical examinations. The findings showed that physicians rated twice as many women as having poor health compared to the ratings of the women themselves. Moreover, the symptom ”a sense of powerlessness” had the highest predictive power for self-rated general health. Study II investigated individual and structural stability in symptom profiles between adolescence and middle-age as related to pubertal timing. There was individual stability in symptom reporting for nearly thirty years, although the effect of pubertal timing on symptom reporting did not extend into middle-age. Study III explored the longitudinal and current influence of socioeconomic and psychosocial factors on women’s self-reported health. Contemporary factors such as job strain, low income, financial worries, and double exposure in terms of high job strain and heavy domestic responsibilities increased the risk for poor self-reported health in middle-aged women. In Study IV, the association between self-reported symptoms and physiological stress responses was investigated. Results revealed that higher levels of medically unexplained symptoms were related to higher levels of cortisol, cholesterol, and heart rate. The empirical findings are discussed in relation to existing models of stress and health, such as the demand-control model, the allostatic load model, the biopsychosocial model, and the multiple role hypothesis. It was concluded that women’s health problems could be reduced if their overall life circumstances were improved. The practical implications of this might include a redesign of the labour market giving women more influence and control over their lives, both at and away from work. </p>

“The family is the building block of society. It is a nursery, a school, a hospital, a leisure centre, a place of refuge and rest. It encompasses the whole of society. It fashions our beliefs; it is the preparation for the rest of our life,” Margaret Thatcher (1988). We are all well aware of the important role of family in people’s lives, we know it can affect you, empower you, or break you. Many studies and research has sought to define the role and influence of family in every which way, but truthfully, we can never know enough and we will never know everything. As human beings, we constantly strive for more – more knowledge, more understanding, and more insight. But the family, in essence, is a mystery; a far too complex and unique system that cannot be broken down into simple numbers or words. It is this that inspired me to do this study – although we can never know everything, we can always know more. This study therefore aimed to investigate the psychosocial well-being of a group of families and from the findings obtained, develop a conceptual framework and a model for psychosocial well-being of families from diverse cultures in a South African context. The research method consisted of two stages namely, stage one: a multi-method approach using quantitative and qualitative research for theory generation, and stage two: formulation of a conceptual framework and visual model. The first phase consisted of a quantitative research design with a sample size of 772 participants. The aim of the first phase was to determine the prevalence of psychosocial well-being in families and to identify families who report high, moderate and low levels of psychosocial well-being, using validated psychological instruments. The second aim of the quantitative phase was to propose a measurement model to assess family psychosocial well-being in a South African context. The second phase consisted of a qualitative, explorative research design used to understand and describe aspects that contribute to the psychosocial well-being of families from diverse cultures in a South African context, by analysing the storied (narrative) experiences (N = 23), drawings (N = 14) and family interviews (N = 36) of identified families who reported psychosocial well-being or less thereof, in the first phase of the study (Creswell, 2003). These findings were then utilized to develop a conceptual framework followed and a model for the psychosocial well-being of families in a South African context. The findings from the first, quantitative phase show a rather small group of participants who report high levels of family psychosocial well-being, while the majority falls within the low and moderate ranges, and approximately 64% of the participants are not experiencing optimal psychosocial well-being. The results support a two-factor model of family psychosocial well-being consisting of family functioning and family feelings. Family functioning included family relational patterns, family functioning style and family hardiness while the second factor, family feelings, included family satisfaction and attachment. The findings from the qualitative phase suggest that communication, mutual support, togetherness as a family and spirituality are the most prominent contributing factors, whilst financial difficulties and interpersonal conflicts or arguments are the most prominent hindering factors with regard to family psychosocial well-being in this group of participants. These findings were utilized to develop a conceptual framework and a model for the psychosocial well-being of families from diverse cultures in a South African context that can be used in future research and in the development of programmes to enhance the psychosocial well-being of South African families. / PhD, Psychology, North-West University, Vaal Triangle Campus, 2012

The purpose of this thesis was to investigate overtraining (OT) and burnout (BO) in young athletes. Very little data on the incidence of OT in young athletes is available, hence the purpose of the 1st study was to investigate the prevalence and symptomology of NFOR (non-functional overreaching) and OT in young English athletes practicing different sports and competing across all competitive levels. Data from 376 young athletes (age 15.00 ± 1.97 y) indicated that 29 % had experienced at least one episode of NFOR/OT, and that NFOR/OT was significantly higher at national and international competitive levels (p < 0.01). Presenting symptomology was similar to that reported in adults, with both training and non-training stressors identified as important associates: losses of appetite during periods of hard training, frequent injuries and feelings of a lack of recovery from training, combined with apathy, feeling intimidated by opponents, and being “moody” were the most frequently reported physical and psychological symptoms, respectively. Training load, the commonly believed cause of NFOR/OT, had no significant association with NFOR/OT incidence; however competitive level and gender were significant predictors of NFOR/OT, albeit of a small explained variance (~4%). This study demonstrated that NFOR/OT is evident in young athletes and that the associated factors are multifactorial. The 2nd study monitored prospectively, 4 national-level female swimmers during an 11-month competitive season. Two swimmers (16.00 ± 1.41 y) were diagnosed as OT based on performance decrements (mean decrement of 9 %). One of the OT swimmers (OT2) presented with the classical psychophysiological profile, i.e. high monthly training volumes, low IgA concentration, depressed maximal lactates and high self-reported distress. Conversely the other OT swimmer (OT1) only presented with high Training Distress Scale (TDS) scores. These findings show that both, OT is a complex problem to diagnose and that it’s approach needs to be individualized. The 3rd study investigated the acute psycho-physiological responses to a 6-day training camp in 4 young female swimmers (15.00 ± 1.21 y), of which one was OT and another burnt out (OT1 swimmer from study 2). Both mal-adapted athletes showed performance decrements of ~8 % that lasted for more than 6 months. The OT swimmer, unlike her BO friend, showed a depressed IgA concentration, an unresponsive cortisol, reduced maximal lactate production, and high psychological distress, measured by the TDS. Both swimmers reported slower reaction times on the Stroop test, with the BO swimmer evidencing the worst performance. Finally, the BO swimmer reported very high scores on the Athlete Burnout Questionnaire (ABQ; reduced sense of accomplishment = 4.3; emotional/physical exhaustion = 2.6; sport devaluation = 3.7). This study showed that the psychophysiological profile of an OT swimmer may differ considerably from a BO athlete, with the ABQ being potentially the most efficient tool to diagnose BO. Once more, the individuality of the profiles reinforces the importance of investigating this phenomenon on a case by case basis. The final study used Interpretative Phenomenological Analysis to investigate the psychosocial nature of OT and BO in a 15 year-old female swimmer (OT1 and BO from studies 2 and 3, respectively) and revealed how multiple sources of training and non-training stressors all combined to negatively affect the athlete. The swimmer revealed a past in which she experienced rapid success at an early age and a training mentality of “the more, the better” which was promoted by parents, coaches and herself. Her strong unidimensional identity – centred on swimming – provided few recreational or social opportunities outside the sport. She also reported communication difficulties with her coaches, unwelcome changes in coaching staff, periods of separation from her family, and an over-involved mother. The findings of this thesis suggest that NFOR/OT and BO are issues that many young athletes have to contend with during their sporting careers. The multifactorial nature of these conditions mean that any screening, prevention or recovery interventions must address the problem from a holistic standpoint and as such, Ken Wilber’s (1998) Integral Model is proposed as a suitable framework through which this condition may be investigated in young athletes.

Background: Nowadays people more often are surviving intensive care, which makes it important to increase the knowledge about the experiences. Illusions, nightmares and unreal experiences are common and often linger for quite some time. Aim: The aim of the study was to illuminate patients' experiences after intensive care. Method: A literature-based study of 16 qualitative studies was conducted Results: A lot of the patients have difficulties moving on, and are haunted by their experience. Memories from the hospital stay are often hazy, and evokes a sense of lacking a part of their life story. There is a need to understand in order to move on. Despite of this, some of the patients manage to find happiness. They find a new meaning in life, and learn to look at things from a brighter side. Conclusion: To process the experience, there seems to be a need of further support. Also, patients need to receive more information about what to expect after discharge.

The purpose of this study was to examine the economic and psychosocial barriers to receiving adequate prenatal care among racial minority women.The respondents for this study were thirty racial minority women. The sixteenAfrican-American and fourteen Hispanic women respondents were all postpartum patients at Grady Memorial Hospital. The content of the study includes an in-depth look at both the economic and psychosocial barriers to receiving adequate use prenatal care, as well as the historical perspective. The related topics of low birthweight and infant mortality are also examined. The Cognitive Theory was examined in an attempt to understand the reasoning behind racial minority women not receiving adequate prenatal care. A Pearson's "r" correlation was conducted between the independent variables and the dependent variable. Both of the null hypotheses were accepted. Therefore, the major findings in this study concluded that there was no statistical significance between economic and psychosocial barriers and receiving adequate prenatal care among racial minority women.

Background: Internalized weight stigma has gained growing interest due to its association with multiple health impairments in individuals with obesity. Especially high internalized weight stigma is reported by individuals undergoing bariatric surgery. For assessing this concept, two different self-report questionnaires are available, but have never been compared: the Weight Self-Stigma Questionnaire (WSSQ) and the Weight Bias Internalization Scale (WBIS). The purpose of the present study was to provide and to compare reliability, convergent validity with and predictive values for psychosocial health outcomes for the WSSQ and WBIS. Methods: The WSSQ and the WBIS were used to assess internalized weight stigma in N = 78 prebariatric surgery patients. Further, body mass index (BMI) was assessed and body image, quality of life, self-esteem, depression, and anxiety were measured by well-established self-report questionnaires. Reliability, correlation, and regression analyses were conducted. Results: Internal consistency of the WSSQ was acceptable, while good internal consistency was found for the WBIS. Both measures were significantly correlated with each other and body image. While only the WSSQ was correlated with overweight preoccupation, only the WBIS was correlated with appearance evaluation. Both measures were not associated with BMI. However, correlation coefficients did not differ between the WSSQ and the WBIS for all associations with validity measures. Further, both measures significantly predicted quality of life, self-esteem, depression, and anxiety, while the WBIS explained significantly more variance than the WSSQ total score for self-esteem.