In the past two years, six National Football League players have died by suicide. Investigations into most of the deaths revealed that the players suffered from brain damage likely caused by repeated concussions. As is the case with many health issues, tragedy often precedes action; the suicides of these high profile football stars have catalyzed action on concussion policy and practice, as well as opened up the conversation about the overall mental health of athletes. This thesis joins the conversation around mental health and athletes, specifically Canadian varsity football players. Mental health problems and illnesses are presented as especially common, affecting about 1 in 5 Canadians. That is not to underestimate the severity of mental illnesses, which can deteriorate an individual’s quality of life, significantly impact friends and family and, in the most severe cases, also lead to death by suicide. That said, this thesis adopts a theoretical perspective that focuses on the promotion and protection of good mental health. This thesis is primarily concerned with investigating the social, political, and external factors that negatively impact how football players conceptualize mental health and mental illness, and also the recommended behaviour to seek professional help if needed. The growing body of research concerning the negative impact of mental illness stigma is compelling and leaves no doubt that stigma is a significant barrier to recovery. This thesis explores the stigma process as well as its social function in groups. Next, it investigates how the already powerful stigma around mental illness is further exacerbated by gender and more specifically, how traditional masculine ideology (i.e. men should be strong and powerful) conflicts with stereotypical beliefs about mentally ill people (i.e. weak and/or incompetent). Gender and health are further linked in terms of behaviour. In other words, rejecting health behaviours becomes a strategy some men utilize to project their masculinity, paradoxically contributing to the creation or worsening of many health problems. A health behaviour that is explored in detail is psychological help-seeking, and the psychosocial processes of help-seeking, which are also mainly regulated by masculinity. An overview of the most common mental health problems and illnesses found in male varsity athletes is provided. All of the above components are then applied to the unique context of varsity football players. The thesis draws on the literature as well as qualitative interview data that explores the experiences of 8 varsity football players at the University of Ottawa. Regarding mental health promotion, the findings show that football players may require adapted communication approaches. To that end, the thesis transitions into an early-stage health communication plan supported by the literature and the primary data. The plan proposes overall outcomes, short term/intermediate objectives, a communication strategy, and a tactical approach. Next, a web-based health resource is suggested as a primary communication vehicle and is outlined in detail. The plan then suggests potential partnerships for extending the strategic communication plan’s reach and credibility. This is followed by suggestions for evaluating both the short term/intermediate objectives as well as the strategic communication plan’s overall impact. This thesis concludes with a chapter exploring the contributions lifted from the eight qualitative interviews, as well as suggested directions for research, policy and practice.

Traduit en français en 2017, l’ouvrage séminal de la sociologue Arlie Russell Hochschild, The Managed Heart (1983), approfondit le « travail émotionnel », un concept ensuite repris dans plusieurs champs disciplinaires et contextes d’étude, et qui est au coeur des exigences émotionnelles identifiées par Gollac & Bodier (2010) comme un des facteurs de risques psychosociaux (RPS). Haut lieu d’émotions, où l’« extra-ordinaire » (la maladie, la souffrance, la mort) fait partie du quotidien, l’hôpital est un environnement particulier pour effectuer le travail émotionnel. Ce dernier suppose (1) de gérer ses propres émotions, (2) d’afficher ou d’exprimer certaines émotions pour agir sur celles du patient, (3) en se conformant à certaines « règles émotionnelles », (4) dans un cadre pétri d’une charge émotionnelle variable. Cette thèse vise l’approfondissement du concept de travail émotionnel à l’hôpital : sa caractérisation, sa définition ainsi que les leviers d’action organisationnels susceptibles de faciliter sa réalisation et d’agir sur ses conséquences. Le travail de terrain a été mené dans un CHU auprès de médecins, d’infirmières et d’aides-soignantes dans des services de soins, relevant de différentes spécialités médicales (urgences, gériatrie, rééducation, neurologie), et accueillant des patients vulnérables ou dépendants. Il repose sur une production de données combinant entretiens, observation directe / observation participante et analyse de documents internes. Les résultats émergeant du travail empirique éclairent le travail émotionnel hospitalier dans un cadre français, son importance pour le professionnel de santé et pour le patient. Ils mettent en avant plusieurs éléments : la nature des « règles émotionnelles » dominantes, la modulation de leur appropriation par les professionnels de santé, les différences de charge émotionnelle entre services, la « pénibilité émotionnelle », des indices de fatigue de compassion (un concept qui diffère de l’épuisement émotionnel), le rôle du travail émotionnel dans la prise en charge du patient. Les leviers d’action organisationnels soulignés sont multiples. Il s’agit (1) d’assurer un socle commun de connaissances/compétences par des formations ciblées et/ou transversales, de faciliter les possibilités de self-care et (2) d’encourager les pratiques « vertueuses » que sont les dynamiques de soutien social, l’aménagement de moments de coupure, l’instauration des conditions temporelles et matérielles d’une régulation émotionnelle collective et la réaffirmation de la place du patient dans le service. / Translated into French in 2017, sociologist Arlie Russell Hochschild’s seminal work, The Managed Heart (1983), elaborated the concept of “emotional labor” which has subsequently given rise to studies in several disciplinary fields and contexts and which is central to the emotional demands identified by Gollac & Bodier (2010) as one psychosocial risk factor. As a place rich in emotions where the “extra-ordinary” (illness, suffering and death) is an everyday experience, the hospital is a particular environment for the performance of emotional labor, which involves (1) the management of one’s own emotions, (2) showing or expressing certain emotions in order to influence those of the patient, (3) by following “emotional rules”, all (4) within a context marked by a weight of emotions. This thesis endeavors to offer an in-depth examination of hospital emotional labor: characterizing and defining the concept, as well as discussing the organizational levers that could improve how it might be performed and control its consequences. The fieldwork was carried out in a teaching hospital and concerned doctors, nurses, orderlies / nursing assistants working in departments belonging to different medical specialisations (accident and emergency, geriatrics, rehabilitation, neurology) treating vulnerable or dependent patients. Data production was based on interviews, direct and participant observation and analysis of internal documents. The results of this empirical work shed light on hospital emotional labor in France and its importance for the health professional and the patient. They highlight several elements: the nature of the prevailing “emotional rules”, how (far) they are appropriated by health professionals, how the emotional burden differs between departments, the “emotionally onerous nature of the work”, signs of compassion fatigue (not the same concept as burnout) and the role of emotional labor in patient care. A substantial number of organizational levers are outlined: (1) ensuring common knowledge and skills through targeted or broad-based training, facilitating the opportunities for self-care, (2) encouraging “virtuous” practices consisting in social support dynamics, work breaks, making time and space for collective emotional regulation and reaffirming the place of the patient within the care context.

In this thesis, two qualitative methods based on phenomenology are introduced at the theoretical level - the Method of Explication (EM) and the Descriptive Phenomenological-Psychological Method (DFPM). EM assists the researcher in obtaining qualitative data, while DFPM is adapted to process it. The integration of these methods thus seems to be a way to overcome the incompleteness and limitations of solely EM or DFPM application. The next section, therefore, introduces the Attention-Description-Ideation-Application method (ADIA) based on the integration of EM and DFPM. The most important contribution of the new ADIA method is the detailed practical guidance that a researcher can follow to explore their own direct experience with the world - the researcher can become the subject of their own psychological research. The emerging method was used from the outset to examine the author's own experience of basic military training (BMT), leading to a constant review of the theoretical and methodological conclusions about 3PA and to improvements in its structure. The results of this research are presented at the end of this thesis which has a dual focus and potentially two benefits: on the one hand, it suggests a relatively comprehensive 3PA method designed for direct experience research, while secondly...

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As of 2012, 233,000 Canadians were reported to be living with inflammatory bowel disease (IBD), 2.5% of which were <18 years of age. In Ontario, the incidence of pediatric IBD is ~11.8 per 100,000 population, which is one of the highest rates in the world. Youth with IBD experience numerous health problems secondary to their diagnosis, including poor fitness and lower lean mass. The extent to which youth with IBD can respond to an exercise training program designed to improve fitness remains unknown. The aim of this thesis was to assess the safety, feasibility and physiological efficacy of an exercise training program for youth in remission from IBD. Additionally, we attempted to understand the barriers and facilitators to physical activity in this population. A total of 104 patients were approached to participate in this study, 18 demonstrated interest and 11 consented to participate. Ten youth (nine males, age: 15.4±1.2 years) with IBD completed the study. Participants trained three times per week (2d in lab, 1d at home) for 16 weeks. Training sessions lasted 30 to 60 minutes, and consisted of a customized combination of aerobic and resistance exercises. Fat mass and lean mass were measured via Dual Energy X-ray Absorptiometry. Isometric and isokinetic torque of elbow flexion and knee extension were evaluated using an isokinetic dynamometer system. Peak oxygen consumption (VO2peak) and peak mechanical power (Wpeak) were determined using the McMaster All-Out Continuous cycling test. Barriers and facilitators to physical activity were measured via qualitative interviews pre-training. Body composition, muscle strength and aerobic fitness variables were measured at baseline, after 8 weeks, and after 16 weeks of training. Participants completed 89.1±5.2% of lab training sessions and 55.0±26.5% of home training sessions. There were significant increases in whole body lean mass (p<0.001), isokinetic knee extension strength (p<0.05) and Wpeak (p<0.001) over the course of the training program with small, moderate and large effect sizes respectively. All participants were in remission post-training, demonstrated small deviations in features of disease activity and reported no adverse events with training. Participants described similar barriers and facilitators to physical activity, to those of the general public, such as lack of access to facilities and peer support, respectively. Additionally barriers and facilitators unique to individuals with this condition were identified including the physical burden of disease (e.g., episodic abdominal pain) and creating modifications to activities to facilitate accessibility. Our results demonstrate that exercise training in youth in remission from IBD is safe, feasible and has the capacity to counteract a broad range of secondary symptoms such as deficits in lean mass, muscle weakness and aerobic deconditioning. Youth with IBD should be encouraged to exercise on a regular basis. Results from this study will inform the design of a larger, randomized controlled trial. / Thesis / Master of Science in Kinesiology

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This qualitative study focused on the academic experience of first-year students in Québec universities during the COVID-19 confinement. Transitioning to university studies requires a psychosocial adaptation process, which can facilitate the academic experience. With the rise of COVID-19 in March 2020, confinement was mandatory, leaving students to study from home without any social adaptation, which may result in academic challenges. Following the psychosocial adaptation process to university studies and a phenomenological methodology, this research will study which strategies were used by the ten participants to meet the university academic demands in the COVID-19 confinement context, which coping skills were used, and what worked.

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Chronic pain is one of the most common health conditions, affecting nearly six million Canadian adults. Despite abundant research on chronic pain in general, there is limited knowledge on how racialized immigrant women experience living with chronic pain and how this relates to their broader social circumstances. The purpose of this qualitative, exploratory study is to understand living with chronic disabling pain as situated in and contextualized by the lived experiences of immigrant women residing in Ottawa, Ontario, and to explore the perspectives of the women's care partners as well as physicians providing care for chronic pain. Semi-structured interviews were conducted with 24 participants. The dissertation is guided by the social determinants of health framework and an intersectional lens. Four interconnected themes from the data analysis have been generated: (1) The trajectory and meaning of pain; (2) Reasons for pain and triggering factors; (3) Pain consequences; and (4) Coping and control. Findings indicate that chronic pain is a subjective, complex, biopsychosocial, and multidimensional phenomenon. Pain is a deeply personal experience linked with meaning. Results also highlight an association between the distribution of the social determinants of health during the life course and pain. Furthermore, the pain has profound, multidimensional impacts on the women and their families, and its treatment is a challenging task for health care professionals. In addition, the findings show that pain is often poorly recognized, underestimated, and inadequately managed. Finally, the results illustrate the perseverance and incredible resilience of the women and their carers. The findings provide several implications for policy, research, and practice.

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