No description available.

This study explored the view of a small-scale group of upper secondary school seniors on school-related stress during their last school year in comparison to previous years. A qualitative research method was used and five students partook in semi-structured interviews with open-end questions. The study derived from the perspectives of two theoretical models that were selected due to their relevance; firstly, the Demand-Control Support model, and secondly, the Transactional Model of Stress and Coping. The results show that these upper secondary school seniors describe themselves as less stress than they perceived themselves to be in their second year. Regarding the stress-related effects experienced by these students, it was found that sleep deprivation and anger were the most problematic ones along with their tendencies to compare themselves to others. It was also found that the five participants perceived the school health servieces' work as insufficient in many ways. One of the most recurring suggestions, by the students, on how to improve it was to discuss stress and the availability of the school health services more openly.

Psykisk ohälsa är idag den vanligaste orsaken till långtidssjukskrivningar i Sverige och stressrelaterade diagnoser står för 49 procent där kvinnor är överrepresenterade. Konsekvenserna av stressrelaterad ohälsa leder till stora problem i vardagen. Där den subjektiva upplevelsen av inkongruens mellan krav och förmåga i aktivitetsutförande samt en obalans i aktivitetsmönster är centrala. Inom arbetsterapi anses ett balanserat aktivitetsmönster och kongruens i aktivitetsutförande vara en förutsättning för delaktighet och hälsa. Syftet med studien var att undersöka förekomsten av arbetsterapeutiska interventioner för kvinnor med stressrelaterad ohälsa och deras självskattade upplevelser av interventionerna. Metoden som användes var en kvantitativ tvärsnittsstudie där data från 188 kvinnor insamlades via en egenkonstruerad webbenkät på sociala nätverket Facebook. Enkäten berörde demografisk data samt förekomst och självskattad upplevelse av sju arbetsterapeutiska interventioner. Resultatet visade att 37 procent av respondenterna erhållit någon form av arbetsterapeutisk intervention och i snitt 2.5 interventioner per respondent. Inga statistiska regionala skillnader kunde urskiljas i förekomst av arbetsterapeutiska interventioner. Den mest förekommande interventionen var Tips och råd för att hantera stressiga situationer (31%). Anpassningar på arbetsplatsen, miljö och utförande var den intervention som skattades högst då 13 av de 14 kvinnor (93%) som deltagit i interventionen skattade Mycket bra/Ganska bra. Totalt skattade kvinnorna samtliga arbetsterapeutiska interventioner Mycket bra/Ganska bra (80%). Slutsats: Resultatet visade att arbetsterapeutiska interventioner förekom endast bland cirka en tredjedel av de kvinnor som sökt vård relaterat till stressrelaterad ohälsa. Dock ansåg majoriteten att deras upplevelser av interventionerna var positiva vilket indikerar att arbetsterapeutiska interventioner kan vara ett stöd i rehabiliteringen för kvinnor med stressrelaterad ohälsa. / Mental ill-health is today the most common cause of long-term sick leave in Sweden and stress-related diagnoses account for 49 percent where women are over-represented. The consequences of stress-related ill-health leads to difficulties in everyday life. Where a subjective experience of incongruence between requirements and ability in occupational performance and an imbalance in activity patterns are crucial. Having a balanced activity pattern and experiencing congruence in occupational performance are considered to be essential for experiencing participation and health in occupational therapy theory. The purpose of this study was to explore the incidence of occupational therapy interventions for women with stress-related disorders and their self-rated experiences of the interventions. The method used was a quantitative cross-sectional study where data from 188 women were collected using a self-designed web survey on the social network Facebook. The questionnaire concerned demographic data and the incidence and self-rated experience of seven occupational therapy interventions. The result showed that 37 percent of the respondents had received some form of occupational therapy intervention and on average 2.5 interventions per respondent. There were no statistical regional differences in the incidence of occupational therapy interventions. The most common intervention was Strategies for managing stressful situations (31%). The intervention Workplace adjustments of performance and environment rated highest where 13 out of 14 women (93%) rated Very good/Fairly good. Overall the occupational therapy interventions where rated as Very good/Fairly good (80%). Conclusion: The overall result showed that occupational therapy interventions occurred only among approximately one-third of the women who sought care related to stress-related disorder. However, the majority considered that their experience of the interventions were positive, which indicates that occupational therapy interventions can be a support in the rehabilitation of women with stress-related disorders.

Socialsekreterare är en yrkesgrupp inom vilken det förekommer ett stort antal sjukskrivningar på grund av stressrelaterad psykisk ohälsa. Det framkommer att arbetsmiljön samt ledarskapet har en stor påverkan på de anställdas psykiska hälsa. Syftet med studien var att genom en kvalitativ metod undersöka hur enhetschefer inom socialtjänsten arbetar för att förebygga stressrelaterad psykisk ohälsa bland sina anställda. Vidare undersöktes också huruvida ett rumsligt nära ledarskap har någon påverkan på det förebyggande arbetet. Intervjuer genomfördes med fyra enhetschefer anställda inom socialtjänsten. Som hjälp vid intervjuerna användes en halvstrukturerad intervjuguide med öppna frågor. Analysen utgick från innehållsanalys samt krav, kontroll och stödmodellen. I resultatet framkom att ett rumsligt nära ledarskap är av stor vikt för enhetschefer när det gäller det förebyggande arbetet. Närhet gör att enhetschefer lättare kan följa med i det dagliga arbete, se när arbetsbelastningen på de anställda ökar samt se hur de anställda mår. Det framkommer också att stöd från chef och kollegor är viktigt för att förebygga stress, då man som anställd behöver känna att man inte står ensam med arbetet. Tydlighet i socialsekreterarens yrkesroll framgår också som en viktig faktor, vilket kan påverkas av god introduktion samt mentorskap vid nyanställning. Handledning, regelbundna teammöten, samtal samt mätning och reglering av arbetsbelastning framkommer också som viktiga rutiner i det förebyggande arbetet. / Social workers are a professional group where there are a large number of sick leaves related to stress-related mental illness. It appears that the working environment and leadership have a great impact on the employees´mental health. The aim of the study was to find out through a qualitative method how unit managers within the social services work to prevent stress-related mental illness among their employees. Furthermore, we also looked into whether a spatially close leadership has any impact on the preventive work. Interviews were made with four unit managers within the social services. At the interviews a semi-structured interview guide with open questions was used as a guideline. The analysis was based on content analysis and the demand, control and support model. As a result of the analysis we came to the conclusion that a spatially close leadership is of a great importance to the unit managers regarding the preventive work. To be near the employees makes it easier for the unit managers to follow the daily work, to discover when the employees´ workload increases and to see the well-being of the employees. It also appears that support from the unit manager and the colleagues is important in order to prevent stress, as employees need to feel that they don´t stand alone in their work. Clarity in the professional role also appears as an important factor, which can be influenced by a proper introduction as well as mentoring for newly employed. Guidance, regular team-meetings, conversations as well as measurement and regulation of the workload also appear to be important routines in the preventive work.

No description available.

Mental health problems among young people, girls and young women in particular, are a serious public health problem. Gendered patterns of mental illness are seen in conjunction with stress-related problems such as anxiety, depression, and psychosomatic complaints. Intervention models tailored to the health care situation are therefore in need of development and evaluation. The overall aim of this thesis is to develop knowledge and understanding for young women’s mental health, stress-related, and bodily problems from a psychosomatic and gender theory perspective, and to evaluate a gender sensitive physiotherapeutic intervention model consisting of a stress management course for young women with stress-related problems. The thesis consists of four studies. The overall research design combines qualitative and quantitative methods in which questionnaires and interviews were used to explore participant experiences and symptoms linked to perceived stress before and after the intervention. Data consisted of a cumulative sample of 65 young women, 16 to 25 years of age, who attended the youth-friendly health center because of stress-related problems. In paper I, multiple symptom areas of mental health and somatic problems, self-image and aspects of body perception were measured before the course. Participants were 47 of the young women. The results were compared with published normative and clinical reference groups. In paper II, the young women’s experiences of living stressful femininity were analysed with a qualitative content analysis using gender theoretical and phenomenological perspectives as an interpretative frame. The study was based on interviews with 25 of the women. In paper III, follow-up interviews were done with 32 of the women after completion of the course. Data was using qualitative content analysis to illuminate experiences of participating in the course. In paper IV, the course was evaluated by measuring changes in multiple symptom areas using the Adult Self Report (ASR), Social Analysis of Social Behaviour (SASB), and Body Perception Questionnaire (BPQ). Participants were 54 of the women who completed measurements finishing the course. Young women present complex symptomatology of stress-related problems. The total burden of symptoms plus the narrated experiences highlight how renegotiations of gender constructions and handling of normative and stressful femininity constrain access to bodily resources. After the stress management course, their measured and narrated experiences show positive changes and release of mental health and stress problems, including a more positive self-image and sense of enhanced confidence in their bodies. Experiences of the course as a safe and explorative space for gendered collective understanding and embodied empowerment indicate the need to develop gender-sensitive interventions. The thesis contributes to youth and gender theoretical perspectives with integration of psychosomatic and psychiatric physiotherapy. A broader awareness of how gender constructions and sociocultural aspects are significant in the understanding of psychosomatic expressions of mental ill health and young femininity is valuable in development of theory and interventions in physiotherapy, as well as into other fields.

Existent literature suggests forgiveness could lead to either greater psychological abuse (reinforcement theory), or lower psychological abuse (interpersonal theory). Questionnaires were completed by 291 participants who were dating at least 2 months. More forgiveness-particularly Absence of Negativity-was related to less abuse received from their partner, and this effect was stronger for females than for males. Absence of Negativity (AN) was predictive of health variables (psychosomatic symptoms, mental and physical health), although Presence of Positive forgiveness did not predict health beyond the impact of AN. Abuse-forgiveness and assertiveness-forgiveness interaction terms were not significant predictors of health. Results indicate interpersonal theory describes the link between forgiveness and psychological abuse. Results suggest that focus on AN could be sufficient for mental or physical health change

Syftet med studien var att beskriva hur arbetsterapeuter i primärvården upplever att arbeta med unga vuxna med stressproblematik. Studien utgick ifrån kvalitativ forskningsansats bestående av semistrukturerade intervjuer. Deltagarna rekryterades med avsiktligt urval och snöbollsurval. Totalt deltog tio respondenter, samtliga befann sig på olika vårdcentraler runt om i Sverige. Materialet analyserades och tolkades av författarna och resulterade i tre huvudkategorier: Att ge patienter professionellt och känslomässigt stöd, Att skapa förståelse för aktivitetens betydelse och Att skapa förändring. Resultatet visade att arbetsterapeuter upplever att det ofta finns en obalans i aktiviteterna bland unga vuxna. Unga vuxna uppmuntras av samhällsnormer att ha många bollar i luften och har därför svårt att få återhämtande aktiviteter i sin vardag. Det resulterade i ökad stress och till slut total utmattning. Arbetsterapeuterna upplever att stressen hos unga vuxna växer på grund av obalansen i vardagen, attityder och att de har otillräckligt med strategier för att hantera stressfyllda situationer. Gruppbehandling upplevs som ett bra verktyg att skapa diskussioner kring stress och lyfta bort stigmat från stressproblematiken. Arbetsterapeuterna upplevde svårigheter vid målformuleringen då patienterna formulerade prestationsinriktade mål. Störst förändring upplevdes vara de små förändringarna i vardagen. Detta gjorde skillnad för rehabiliteringen. Slutsatsen var att känslomässigt och professionellt stöd upplevdes som viktigt. Erfarenhet visar att förståelse för aktivitetens betydelse behövs för att skapa förändring. / The aim of this study was to investigate occupational therapists, working in primary health care center, experience and perception of working with young adults with stress related disorders. The study progressed emanated from a qualitative method consisting of semi structured interviews. Participants were recruited from different health care centers, with a purposive sampling and a snowball sampling, totally ten participants participated. The material was analyzed and interpreted and resulted in three main categories: To give the patient professional and emotional support, To create understanding for the significance of activities and To create change. The results show that occupational therapists perceived that the cause of stress was imbalance in the activities of young adults. They are encouraged by societal norms to multitask and to keep busy and they have difficulties to implement recovering activities. This contributed to increased stress and finally led to exhaustion. Group treatment was perceived as a good tool to create discussions about stress and to remove the stigma from stress related disorders. The occupational therapists experienced difficulties in formulating prestige driven goals. The biggest change was perceived to be the small changes in everyday life, this made a difference for the rehabilitation. The conclusion was that emotional and professional support is important. Experience also shows that creating understanding for the significance of activities is needed to make a change.

Background: Stress-Related Exhaustion (SE) has increased in the last 10 years. Examination is key for good care, but research on body examinations for SE is lacking. Clinically, autonomic stress response with affected respiratory patterns can be observed in SE.  Global Body Examination (GBE) can be used to evaluate autonomic stress responses. GBE has a respiratory domain (rGBE) that has been tested for validity, but not for its intra-rater reliability. Moreover, its’ association with SE symptom severity is unknown. Aim: To examine intra-rater reliability of rGBE in SE, and concurrent validity between rGBE and symptom severity in SE, measured with the self-reported outcome measure Shirom-Melamed Burnout Questionnaire (SMBQ). Method: Test-retest and cross-sectional design was used in the study, with a sample of convenience. Intra-rater reliability was analyzed with ICC, standard error of measurement (SEM) and agreement through a Bland-Altman plot. Spearman’s rho was used to analyze correlation between SMBQ and rGBE. Result: Sample size was 25. Intra-rater reliability was very high (ICC: 0.94, 95% CI: 0.86-0.97, p<0.01). Bland-Altman plot revealed no systematic errors. Mean of rGBE: 7.51 (SD2.14) with SEM: 0.56. Correlation between rGBE and SMBQ was low, Spearman’s rho=0.48,95% CI: 0.09-0.74, p=0,02, with 22% shared variance. Conclusion: rGBE shows good intra-rater reliability and seems suitable for examining SE symptoms. However, its use in diagnostic and to determinate symptom severity in SE remains uncertain due to the wide CI. Beyond SE, rGBE might be useful for other disorders affecting the autonomic balance, as well as diseases that affect respiration. / Bakgrund: Utmattningssyndrom har ökat i samhället de senaste 10 åren. Undersökning är viktig för god rehabilitering men forskning gällande kroppsundersökningar saknas på utmattningssyndrom. Kliniskt har bland annat påverkat respirationsmönster observerats, som ett kroppsligt uttryck på autonom uppvarvning. Global Body Examination (GBE) är en undersökningsmetod som kartlägger autonom uppvarvning. GBE har en respirationsdomän (rGBE) som har testats för validitet, men inte för intrabedömarreliabilitet. Om ett samband föreligger mellan rGBE och besvärsgrad vid utmattningssyndrom är också okänt. Syfte: Att undersöka intrabedömarreliabilitet hos rGBE, samt den samtidiga validiteten mellan rGBE och självskattad besvärsgrad enligt Shirom-Melamed Burnout Questionnaire (SMBQ) hos individer med utmattningssyndrom. Metod: Test-retestdesign och tvärsnittsdesign användes i studien. Bekvämlighetsurval utfördes. Intrabedömarreliabilitet analyserades med ICC, standardmätfel och överenstämmelse via en Bland-Altman analys. Korrelationen mellan rGBE och SMBQ analyserades med Spearman’s rho. Resultat: Deltagarantalet blev 25. Intrabedömarreliabiliteten var mycket hög; ICC=0.94, 95% konfidensintervall 0.86-0.97, p<0.01. Bland-Altman analys visade inga systematiska mätfel. Medelvärde av rGBE blev 7.51 (SD 2.14) med standardmätfel på 0.56. Sambandet mellan rGBE och SMBQ var lågt; Spearmans's rho=0.48, 95% konfidensintervall 0.09-0.74, p=0.02. Samvariationen blev 22%. Slutsats: rGBE visar god intrabedömarreliabilitet och kan vara en lämplig undersökningsmetod för att observera utmattningssymtom. Inga säkra slutsatser kan dras gällande rGBEs användbarhet vid diagnostik eller besvärsgradering av utmattningssyndrom då konfidensintervallet blev brett. Utöver utmattningssyndrom kan rGBE troligen vara användbar vid besvär som påverkar den autonoma balansen, såväl som besvär som påverkar respirationen.

Bakgrund: Det finns få studier gjorda av vilka åtgärder en arbetsplats bör genomföra för att få en effektiv och hållbar återgång till arbetet, för personer med stressrelaterad ohälsa. Syfte: Syftet med studien var därför att beskriva hur personer som tidigare varit sjukskrivna för stressrelaterad ohälsa, upplevde stöd från arbetsplatsen vid återgång i arbetet. Metod: Deltagarna bestod av sex personer som varit sjukskrivna under olika tidsperioder de senaste fem åren. Datainsamlingen skedde genom enskilda intervjuer med öppna frågor som gav tolkningsutrymme för deltagarna. Intervjutexterna analyserades därefter enligt en kvalitativ innehållsanalys. Resultat: Analysen mynnade ut i två huvudkategorier: ”Anpassningar av arbetssituationen främjar arbetsåtergången” och ” Den sociala miljön påverkar arbetsåtergången”. Dessa innehöll vardera tre underkategorier. Slutsats: Slutsatsen av studien är att stödet från arbetsplatsen behöver ges efter individens kapacitet i förhållande till arbetsmiljön, såväl som i arbetsuppgifternas krav.