Charles University in Prague Faculty of Pharmacy in Hradec Králové Department of Biological and Medical Sciences Candidate: Lucie Ambrožová Supervisor: Doc. MUDr. Josef Herink, DrSc. Title of diploma thesis: Intestinal microbiota and mood disorders The intestinal microbiom is composed mainly of two dominated strains - Bacteroidetes and Firmicutes. The other strains are just not numerous like the previous ones. The specimens have the invariable core of microbiom which doesn't change in time. Nevertheless they have also the transient gut bacteria, which change during their life. Intestinal microbiom is influenced by many factors. Between them we can categorize for example the way of the childbirth, the breast - feeding, the alimentation, the state of health, and the medicaments. Every specimen has own specific microbiom. It was found that human population is possible to divide into three intestinal groups or enterotypes. To each enterotype dominates different bacterial strain. It was proved that intestinal microbiom communicates with the brain and it works also vice versa. This communication system is called "brain - intestine" and takes several ways in several body systems (such as nervous, endocrine, metabolic, and immune). To normal development of the brain is needed the right colonisation of non...

Objetivos. Tendo em vista o caráter bidimensional dos fatores psicossociais relacionados ao estresse (CASSEL, 1974), este trabalho teve por objetivos: identificar a interação de fatores psicossociais negativos (estressores) e benéficos (protetores) presente na situação de trabalho de um grupo de operadores de telemarketing, e verificar o potencial do humor como \'recurso psicossocial\' frente ao estresse, como estratégia de coping (dimensão psicológica) e comportamento comunicativo favorecedor do apoio social (dimensão sociológica). Método. Foi realizado um estudo de caso em uma central de tele-atendimento de empresa administradora de planos de saúde pertencente a uma instituição pública, envolvendo doze entrevistas individuais e uma coletiva, semi-estruturadas, observação participante e aplicação de questionário, respondido por 124 operadores de telemarketing de diferentes turnos de trabalho. O questionário, auto-aplicável, constou de dados sócio-demográficos, questões sobre condições de trabalho, estresse no trabalho (KOMPIER & LEVI, 1995), fatores de incômodo e fadiga e satisfação, queixas de saúde e uso do humor. Os dados foram analisados com base no modelo Demanda-Controle (BAKER & KARASEK, 2000; KARASEK & THEORELL, 1990), tendo incluído: análise temática do conteúdo das entrevistas (MINAYO, 1982) e análise descritiva das freqüências obtidas através do questionário. Resultados. A população estudada era predominantemente feminina (72,6 por cento ), jovem (idade média 28 anos), com escolaridade secundária (48,4 por cento ) ou universitária (51,6 por cento ) e salário médio de R$ 600.00. 25,8 por cento eram estudantes. Entre outros, foram identificados fatores psicossociais negativos relacionados: ao ambiente físico; à estrutura temporal (pressão da fila; ritmo elevado externamente imposto; poucas pausas); à latitude decisória: a) falta de controle sobre a tarefa (rigidez da organização do trabalho; fraseologia padrão; falta de oportunidade de tomar decisões individuais, falta de participação); b) baixo grau de arbítrio da habilidade (grande volume de informações a processar, treinamento insuficiente; presença de terminologia médica); interface conteúdo, significado do trabalho e relacionamento com clientes provocando sofrimento emocional via empatia. O relacionamento com os clientes, um dos principais estressores do trabalho dos operadores, por freqüentemente envolver destrato, revelou-se importante fonte de satisfação quando envolve manifestação de reconhecimento. As referências aos fatores de incômodo e ix fadiga e de satisfação foram consistentes, respectivamente, com os fatores psicossociais estressores e benéficos, mostrando-se bons sinalizadores para a identificação daqueles aspectos. Entre os principais fatores de satisfação estavam a jornada de trabalho de seis horas e o relacionamento apoiador e brincalhão entre colegas e com os médicos auditores (apoio social). Quanto às queixas de saúde, 77,4 por cento dos sujeitos referiram sintomas osteomusculares; principais sintomas relacionados ao estresse referidos foram ansiedade (76,6 por cento ) e irritabilidade (66,1 por cento ). O uso do humor como coping foi referido por 78,2 por cento . Quanto a quem ri com quem, os dados indicam que brincadeiras são trocadas durante o trabalho entre os operadores, para 97,6 por cento ; dirigidas pelos operadores aos médicos, para 82,2 por cento ; dirigidas pelos médicos aos operadores, para 66,3 por cento ; pelos operadores aos supervisores, para 59,6 por cento , e pelos supervisores aos operadores, para 58,9 por cento . Conclusões. A situação de trabalho analisada apresentou grande predomínio de fatores psicossociais estressores em relação a \'protetores\' ou \'atenuantes\', representando combinação de intensidade e poucas chances de recuperação psicofisiológica ou, segundo o modelo Demanda-Controle, uma combinação de baixa latitude decisória com altas exigências (pressões psicológicas). O humor constitui um recurso psicossocial potencialmente \'protetor\' (CASSEL, 1974) ou \'modificador\' (BAKER & KARASEK, 2000) do processo de estresse, como estratégia de \'coping\' individual: por favorecer o distanciamento cognitivo; proporcionar alívio de tensão e expressão da subjetividade. Como comportamento comunicativo, o humor pode favorecer o apoio social (por convidar à proximidade; reduzir a distância entre níveis hierárquicos; permitir a expressão de críticas de forma socialmente menos arriscada); mas, acima de tudo, as trocas de humor refletem a dinâmica e a natureza das relações interpessoais, como indica a análise de quem ri com quem, uma das contribuições originais da pesquisa. Esta análise refletiu a presença de forte apoio social entre os operadores e entre estes e os médicos auditores. As brincadeiras \'relâmpago\' que irrompem durante o trabalho são percebidas como fontes de prazer, descarga de tensão e micro-espaços de reequilíbrio psicofisiológico. O humor integra o domínio da liberdade e é fortemente influenciado pelos valores. Se imposto aos trabalhadores, pode ser percebido como um constrangimento psicológico ou moral / Aim. Taking into account the two-dimensional nature of stress-related psychosocial factors (CASSEL, 1974), the study aimed at identifying the interrelation of negative (stressors) and protecting (beneficial) such factors in the work of a group of telemarketing operators, and the potential of humor as a \'psychosocial resource\' in face of stress at work, as a coping strategy (psychological dimension) and communicative behavior favoring social support (sociological dimension). Method. A case study was developed at a call center of the managed care unit of a public institution in São Paulo, Brazil. Data collection involved semi-structured interviews (twelve individual and one collective interview), participatory observation, and an inquiry responded by 124 operators from different work shifts. The inquiry included socio-demographic data, as well as questions on working conditions, factors of discomfort and fatigue and of work satisfaction, stress at work (KOMPIER & LEVI, 1995), health complaints and use of humor. Data analysis was based on the Demand/Control model (BAKER & KARASEK, 2000; KARASEK & THEORELL, 1990), and included content analysis of interviews (MINAYO, 1982), of data gathered through participatory observation, and descriptive analysis of inquiry frequencies. Results. The population studied was predominantly feminine (72.6 per cent ), young (average age 28 years), with high school (48.4 per cent ) or college education (51.6 per cent ) and average monthly wage around US$200.00. 25.8 per cent were students. Among others, negative psychosocial factors identified included: physical environment; time structure (pressure from the queue; high and externally imposed rhythm; few rest breaks); low decision latitude: a) low task control (strict work organization; script; lack of opportunity for individual decision making; lack of participation); and b) low skill discretion (great volume of information to be processed; insufficient training; presence of medical terminology); interrelation of work content, work meaning, and relationship with customers leading to emotional suffering through empathy. The relationship with customers, viewed as an important work-related stressor for often involving rude treatment, is perceived as an important source of satisfaction when involving recognition. Data on factors of discomfort and fatigue showed to be consistent with references to psychosocial stressors and protectors identified. Among protecting factors identified were the 6-hour working period and the supportive relationship among co-workers and with the medical auditors, often involving humor exchanges. Main health complaints were xi musculoskeletal (77.4 per cent ) and stress-related symptoms: anxiety (76.6 per cent ) and irritability (66.1 per cent ). Humor used as coping was referred by 78.2 per cent . Data on who laughs with who indicate that humorous/playful comments are often directed by operators to co-workers, for 97.6 per cent ; by operators to doctors, for 82.2 per cent ; by doctors to operators, for 66.3 per cent ; by operators to supervisors, for 59.6 per cent , and by supervisors to operators, for 58.9 per cent . Conclusions. The work situation of telemarketing operators studied involved a negative balance between psychosocial stressors and beneficial or mitigating factors: a combination of high work intensity and few chances of psycho-physiological recovery or, according to the Demand-Control model, a combination of high demands (psychological pressure) and low decision latitude. Humor is potentially a \'psychosocial resource\' (CASSEL, 1974) or \'modifying factor\' (BAKER & KARASEK, 2000) to the stress process, as an individual coping strategy, for favoring cognitive distancing/re-framing; relief from strain; expression of subjectivity. As a communicative behavior, humor may favor social support (for inviting to proximity; reducing social distance between different hierarchic levels, and permitting the expression of criticisms in less risky ways); but above all, humor as communicative behavior reflects interpersonal relationships dynamics and nature, as it was shown by the analysis of who laughs with who, an original contribution of this research that highlighted the presence of strong social support among operators and between them and the medical doctors. Brief humor events irrupting during work are perceived as a source of pleasure, and micro-spaces of psychophysiological recovery. Humor integrates the domain of freedom and is heavily influenced by cultural values. If it is imposed to workers, it may be perceived as a psychological or moral constraint

Objetivos. Tendo em vista o caráter bidimensional dos fatores psicossociais relacionados ao estresse (CASSEL, 1974), este trabalho teve por objetivos: identificar a interação de fatores psicossociais negativos (estressores) e benéficos (protetores) presente na situação de trabalho de um grupo de operadores de telemarketing, e verificar o potencial do humor como \'recurso psicossocial\' frente ao estresse, como estratégia de coping (dimensão psicológica) e comportamento comunicativo favorecedor do apoio social (dimensão sociológica). Método. Foi realizado um estudo de caso em uma central de tele-atendimento de empresa administradora de planos de saúde pertencente a uma instituição pública, envolvendo doze entrevistas individuais e uma coletiva, semi-estruturadas, observação participante e aplicação de questionário, respondido por 124 operadores de telemarketing de diferentes turnos de trabalho. O questionário, auto-aplicável, constou de dados sócio-demográficos, questões sobre condições de trabalho, estresse no trabalho (KOMPIER & LEVI, 1995), fatores de incômodo e fadiga e satisfação, queixas de saúde e uso do humor. Os dados foram analisados com base no modelo Demanda-Controle (BAKER & KARASEK, 2000; KARASEK & THEORELL, 1990), tendo incluído: análise temática do conteúdo das entrevistas (MINAYO, 1982) e análise descritiva das freqüências obtidas através do questionário. Resultados. A população estudada era predominantemente feminina (72,6 por cento ), jovem (idade média 28 anos), com escolaridade secundária (48,4 por cento ) ou universitária (51,6 por cento ) e salário médio de R$ 600.00. 25,8 por cento eram estudantes. Entre outros, foram identificados fatores psicossociais negativos relacionados: ao ambiente físico; à estrutura temporal (pressão da fila; ritmo elevado externamente imposto; poucas pausas); à latitude decisória: a) falta de controle sobre a tarefa (rigidez da organização do trabalho; fraseologia padrão; falta de oportunidade de tomar decisões individuais, falta de participação); b) baixo grau de arbítrio da habilidade (grande volume de informações a processar, treinamento insuficiente; presença de terminologia médica); interface conteúdo, significado do trabalho e relacionamento com clientes provocando sofrimento emocional via empatia. O relacionamento com os clientes, um dos principais estressores do trabalho dos operadores, por freqüentemente envolver destrato, revelou-se importante fonte de satisfação quando envolve manifestação de reconhecimento. As referências aos fatores de incômodo e ix fadiga e de satisfação foram consistentes, respectivamente, com os fatores psicossociais estressores e benéficos, mostrando-se bons sinalizadores para a identificação daqueles aspectos. Entre os principais fatores de satisfação estavam a jornada de trabalho de seis horas e o relacionamento apoiador e brincalhão entre colegas e com os médicos auditores (apoio social). Quanto às queixas de saúde, 77,4 por cento dos sujeitos referiram sintomas osteomusculares; principais sintomas relacionados ao estresse referidos foram ansiedade (76,6 por cento ) e irritabilidade (66,1 por cento ). O uso do humor como coping foi referido por 78,2 por cento . Quanto a quem ri com quem, os dados indicam que brincadeiras são trocadas durante o trabalho entre os operadores, para 97,6 por cento ; dirigidas pelos operadores aos médicos, para 82,2 por cento ; dirigidas pelos médicos aos operadores, para 66,3 por cento ; pelos operadores aos supervisores, para 59,6 por cento , e pelos supervisores aos operadores, para 58,9 por cento . Conclusões. A situação de trabalho analisada apresentou grande predomínio de fatores psicossociais estressores em relação a \'protetores\' ou \'atenuantes\', representando combinação de intensidade e poucas chances de recuperação psicofisiológica ou, segundo o modelo Demanda-Controle, uma combinação de baixa latitude decisória com altas exigências (pressões psicológicas). O humor constitui um recurso psicossocial potencialmente \'protetor\' (CASSEL, 1974) ou \'modificador\' (BAKER & KARASEK, 2000) do processo de estresse, como estratégia de \'coping\' individual: por favorecer o distanciamento cognitivo; proporcionar alívio de tensão e expressão da subjetividade. Como comportamento comunicativo, o humor pode favorecer o apoio social (por convidar à proximidade; reduzir a distância entre níveis hierárquicos; permitir a expressão de críticas de forma socialmente menos arriscada); mas, acima de tudo, as trocas de humor refletem a dinâmica e a natureza das relações interpessoais, como indica a análise de quem ri com quem, uma das contribuições originais da pesquisa. Esta análise refletiu a presença de forte apoio social entre os operadores e entre estes e os médicos auditores. As brincadeiras \'relâmpago\' que irrompem durante o trabalho são percebidas como fontes de prazer, descarga de tensão e micro-espaços de reequilíbrio psicofisiológico. O humor integra o domínio da liberdade e é fortemente influenciado pelos valores. Se imposto aos trabalhadores, pode ser percebido como um constrangimento psicológico ou moral / Aim. Taking into account the two-dimensional nature of stress-related psychosocial factors (CASSEL, 1974), the study aimed at identifying the interrelation of negative (stressors) and protecting (beneficial) such factors in the work of a group of telemarketing operators, and the potential of humor as a \'psychosocial resource\' in face of stress at work, as a coping strategy (psychological dimension) and communicative behavior favoring social support (sociological dimension). Method. A case study was developed at a call center of the managed care unit of a public institution in São Paulo, Brazil. Data collection involved semi-structured interviews (twelve individual and one collective interview), participatory observation, and an inquiry responded by 124 operators from different work shifts. The inquiry included socio-demographic data, as well as questions on working conditions, factors of discomfort and fatigue and of work satisfaction, stress at work (KOMPIER & LEVI, 1995), health complaints and use of humor. Data analysis was based on the Demand/Control model (BAKER & KARASEK, 2000; KARASEK & THEORELL, 1990), and included content analysis of interviews (MINAYO, 1982), of data gathered through participatory observation, and descriptive analysis of inquiry frequencies. Results. The population studied was predominantly feminine (72.6 per cent ), young (average age 28 years), with high school (48.4 per cent ) or college education (51.6 per cent ) and average monthly wage around US$200.00. 25.8 per cent were students. Among others, negative psychosocial factors identified included: physical environment; time structure (pressure from the queue; high and externally imposed rhythm; few rest breaks); low decision latitude: a) low task control (strict work organization; script; lack of opportunity for individual decision making; lack of participation); and b) low skill discretion (great volume of information to be processed; insufficient training; presence of medical terminology); interrelation of work content, work meaning, and relationship with customers leading to emotional suffering through empathy. The relationship with customers, viewed as an important work-related stressor for often involving rude treatment, is perceived as an important source of satisfaction when involving recognition. Data on factors of discomfort and fatigue showed to be consistent with references to psychosocial stressors and protectors identified. Among protecting factors identified were the 6-hour working period and the supportive relationship among co-workers and with the medical auditors, often involving humor exchanges. Main health complaints were xi musculoskeletal (77.4 per cent ) and stress-related symptoms: anxiety (76.6 per cent ) and irritability (66.1 per cent ). Humor used as coping was referred by 78.2 per cent . Data on who laughs with who indicate that humorous/playful comments are often directed by operators to co-workers, for 97.6 per cent ; by operators to doctors, for 82.2 per cent ; by doctors to operators, for 66.3 per cent ; by operators to supervisors, for 59.6 per cent , and by supervisors to operators, for 58.9 per cent . Conclusions. The work situation of telemarketing operators studied involved a negative balance between psychosocial stressors and beneficial or mitigating factors: a combination of high work intensity and few chances of psycho-physiological recovery or, according to the Demand-Control model, a combination of high demands (psychological pressure) and low decision latitude. Humor is potentially a \'psychosocial resource\' (CASSEL, 1974) or \'modifying factor\' (BAKER & KARASEK, 2000) to the stress process, as an individual coping strategy, for favoring cognitive distancing/re-framing; relief from strain; expression of subjectivity. As a communicative behavior, humor may favor social support (for inviting to proximity; reducing social distance between different hierarchic levels, and permitting the expression of criticisms in less risky ways); but above all, humor as communicative behavior reflects interpersonal relationships dynamics and nature, as it was shown by the analysis of who laughs with who, an original contribution of this research that highlighted the presence of strong social support among operators and between them and the medical doctors. Brief humor events irrupting during work are perceived as a source of pleasure, and micro-spaces of psychophysiological recovery. Humor integrates the domain of freedom and is heavily influenced by cultural values. If it is imposed to workers, it may be perceived as a psychological or moral constraint

Syftet med vår studie var att studera trädgårdsterapins roll i människors tillfrisknande från stressrelaterad ohälsa. Studiens frågeställningar var: (1) vilka faktorer beskrivs som stressreducerande i natur och trädgård? (2) på vilket sätt kan personer med stressrelaterad ohälsa bli hjälpta genom trädgårdsterapi? För att besvara våra frågeställningar användes en kvalitativ metod med hjälp av en kunskapsöversikt. Våra analysverktyg har varit KASAM och Coping. Slutsatsen av studien är att trädgård och natur kan stärka återhämtningsprocessen för människor med stressrelaterad ohälsa. Trädgård och natur kan bidra med stressreducerande faktorer som gör att återhämtningen påskyndas och stärks, såsom att hitta lugn, känna trygghet och få utrymme för reflektion. Även samtal och aktiviteter är viktiga delar för återhämtning i trädgårdsterapin. Sökord vi använt oss av är: trädgårdsterapi, terapiträdgårdar, grön rehabilitering, restorativ trädgård och stressrelaterad ohälsa. / The aim of this study was to study the role of horticultural therapy in people´s recovery from stress-related illness. Study questions were: (1) what factors are described as stress-reducing in nature and gardening? (2) in what way can people with stress-related illness be helped by garden therapy? In order to answer our questions, a qualitative methodology using a research synthesis has been made. Our analysis tools were Sense of Coherence and Coping. The study shows that garden and nature can enhance the recovery process for people with stress-related illness. Garden and nature can help with stress-reducing factors that make recovery accelerated and strengthened, such as finding peace, feeling safe and have a space for reflection. Also conversations and activities are important elements for recovery in the horticultural therapy. Keywords we have used are: horticultural therapy, healing gardens, garden therapy, therapeutic gardens, green rehabilitation, restorative garden and stress related illness.

Abstract  Individual psychological factors have been recognized to play an important role in the development of stress-related symptomatology. Despite extensive comorbidity between stress-related ill health and mood disorders, the advances in research on emotion regulation and transdiagnostics, have not been recognized in stress research to any considerable degree. In the current study, using a single subject design with multiple baselines across individuals (n=6), a transdiagnostic treatment intervention targeting maladaptive emotional regulation strategies was implemented on patients suffering from stress-related symptomatology. Results show that symptoms of exhaustion decreased in five of six participants on post-measures, with considerable convergence between measures of depression, anxiety and stress. Further investigation of treatment effects, alongside the processes linking emotion regulation and stress-related symptomatology are needed. / Sammanfattning  Individuella psykologiska faktorer spelar en viktig roll i utvecklingen av stressrelaterade symtom. Trots en omfattande samsjuklighet mellan å ena sidan stressrelaterad ohälsa, å andra sidan depression och ångest, har framsteg inom emotionsforskning och transdiagnostik inte uppmärksammats i någon stor utsträckning inom stressforskningen. I den aktuella studien användes en single subject design med multipla baslinjer mellan individer (n=6), för att implementera en emotionsinriktad transdiagnostisk behandling på patienter som lider av stressrelaterade symtom. Resultaten visar att fem av sex deltagare visade minskade tecken på utmattning efter genomgången behandling, med avsevärd konvergens mellan mått på depression, ångest och stress. För att kunna påvisa behandlingseffekter, samt förklara de processer som förbinder emotionsreglering och stressrelaterade symtom, behövs ytterligare forskning på området.

Inledning: Stressrelaterad ohälsa är ett växande folkhälsoproblem som skapar lidande för individer och stora kostnader för samhället. Det finns behov av hälsofrämjande och förebyggande metoder för att motverka denna ohälsa. MBSR är en metod som visat lovande effekter på stressreducering och olika dimensioner av stressrelaterad ohälsa.                     Syfte: Syftet med litteraturöversikten var att beskriva effekter av Mindfulness Based Stress Reduction (MBSR) på ohälsosam stress i friska populationer.                                                                                                 Metod: En litteraturöversikt med tio vetenskapliga artiklar som analyserades systematiskt för att identifiera teman i effekter av MBSR-program på stressrelaterad ohälsa.                                                                                                                    Resultat: Samtliga vetenskapliga studier visar hur MBSR-programmet ger positiva effekter på hälsan som ökad mindfulness, reducerad stress samt bättre psykisk och emotionell hälsa. Diskussion: MBSR har i tidigare studier visat sig vara effektiv för ökad livskvalitet och copingförmåga vid kroniska smärttillstånd samt olika fysiska och psykiska diagnoser. Mindre uppmärksamhet har riktats mot möjliga fördelar hos friska populationer. Resultatet av litteraturöversikten visar hur MBSR är en lovande metod för att främja hälsa och förebygga stressrelaterad ohälsa hos friska populationer i det korta perspektivet, vilket stöds av tidigare publicerade studier. / Introduction: Stress-related illness is a growing public health concern which induces suffering for individuals and high costs for society. There is a need for health promotion and prevention methods to counteract this illness. MBSR is a method which demonstrates promising effects on stress reduction and different dimensions of stress-related illness.                                       Aim: The aim of this literature review was to describe the effects of Mindfulness Based Stress Reduction (MBSR) on stress in healthy populations.                                                                                                      Methods: A literature review of ten scientific articles were systematically analyzed to identify themes in effects of MBSR on stress-related ill health.                                       Results: All scientific studies show how MBSR has positive health effects such as increased mindfulness, reduced stress as well as better mental and emotional health.               Discussion: In previous studies MBSR has proven to be effective in enhancing quality of life as well as management of chronic pain conditions and various physical and mental disorders. Less attention has been paid to possible benefits in healthy population. The result of this literature review show how MBSR can be a promising method to promote health and prevent stress-related illness in healthy populations in the short perspective, as confirmed by previous studies.

The aim of this study has been to explore how social workers in a Swedish context, who have been on sick leave due to burnout or other stress-related disorders, perceive their occupational role compared to the time before the disorder. The primary focus has been how the social workers view their occupational role after the experience of being on sick leave due to the disorder and if the experience have taught the social workers things they find valuable in their occupational role. This study is based on six interviews with social workers who have the requested experience and have been back to work for at least six months. The theoretical framework used to analyse the results consists of Sense of Coherence (Antonovsky, 2005) and concepts of coping (Lazarus and Folkman, 1984). This study concludes that the social workers differentiates the view and approach towards the occupational role. The social workers do not perceive that they have a changed view of the occupational role, but their approach to the occupational role seems to be different. The experience have also taught them useful things that they practice in their occupational role and advise other social workers to also practice these wisdoms.

Psykisk ohälsa är ett problem som ständigt ökar i samhället. Begreppet psykisk ohälsa innefattar en mängd olika psykiska och psykiatriska problem, däribland utmattningssyndromet, vilket är denna studies fokus. Syftet med studien var att undersöka de egna upplevelserna hos personer som själva drabbats av utmattningssyndrom gällande; insjuknandet, symtom, riskfaktorer och konsekvenser till följd av syndromet, samt friskfaktorer. Studien innefattar sex kvalitativa intervjuer med personer som har varit drabbade av utmattningssyndrom, samt kvalitativ data från en enkät som sedan tidigare var utformad tillsammans med en kvantitativ pilotstudie. Resultatet visar att personerna upplevde att vardagen förändrades avsevärt till följd av syndromet, och att en kognitiv och fysisk trötthet upplevdes av samtliga. Resultatet påvisar även att många av intervjupersonerna och enkätdeltagarna upplevde att självuppfattningen förändrades under tiden som sjuk och att bilden över hur en vill vara krockade med den faktiska bilden. Det framkom även att vissa risk- och friskfaktorer bara upplevdes av enskilda eller ett fåtal deltagare, vilket tyder på att syndromet uppkomst och hur det artar sig är en komplex process med en individuell prägel på samtliga aspekter. / Mental illness is a problem that is constantly increasing in society, and burnout syndrome is a relevant part of the mental illness that the society is struggling with. Burnout syndrome is the type of mental illness that this study is focused on. The purpose of this study was to examine people's experience regarding the sickening and diagnostic of burnout syndrome, factors that affect the syndrome negatively and positively but also social and personal consequences that can occur. This study presents six qualitative interviews with people who have been sick with burnout syndrome, together with qualitative survey data that was collected previously. The result of the study shows that the subjects experienced a drastic change of everyday life because of the burnout syndrome. A cognitive and physical fatigue was experienced by all studied subjects. The result also shows that both the interview and survey subjects reported negative changes in the self-perception that affected their mental picture of themselves. The result does also report some affecting factors that are both positive and negative, and a big part of these factors differ between the subjects. This suggests that the burnout syndrome is a complex process that is highly affected by personal and individual factors.

No description available.

The purpose of this study was a deeper understanding of how people with former exhaustion disorder deal with stress later in life, what they consider helped and helps them, and their current stress-related challenges. Seven people who considered themselves recovered were interviewed 3-25 years after illness. The semi-structured interviews were transcribed verbatim and analyzed with inductive content analysis. The result was multifaceted, complex and provides a level of detail that favors understanding and practical application. Five main themes described the participants current stress management: Symptoms of stress, Lessons learned, Challenges, Handling and External perspectives. It emerged among other things, that exhaustion disorder changes the whole life forever. That many symptoms, handling and challenges remain even 3-25 years later. That the afterlife means a constant conscious balancing that when it succeeds means well-being but when it fails brings different degrees of increasing problems. A type of relapse where the body and psyche react faster than before, but the person, through self-development and life design, has acquired a better foundation than before for handling stress and uses different strategies and tools to halt and recover. Strategies and tools that might also help other people. / Studiens mål var en djupare förståelse av hur personer med tidigare utmattningssyndrom senare i livet hanterar stress, vad de anser hjälpt och hjälper samt deras nuvarande stressrelaterade utmaningar. Sju personer som ansåg sig återhämtade intervjuades 3-25 år efter sjukdom. De semistrukturerade intervjuerna transkriberades ordagrant och analyserades med induktiv innehållsanalys.  Resultatet var mångfacetterat, komplext och ger en detaljnivå som gynnar förståelse och praktisk tillämpning. Fem huvudteman beskrev deltagarnas nuvarande stresshantering: Symtom vid stress, Lärdomar, Utmaningar, Hantering och Externa perspektiv. Det framkom bland annat att utmattningssyndrom förändrar hela livet för alltid. Att många symtom, hantering och utmaningar finns kvar även 3-25 år efter. Att livet efter till stor del handlar om en konstant medveten balansering som när den lyckas innebär välmående men då den fallerar ger olika grader av stigande problem. Ett typ av återinsjuknande där kropp och psyke reagerar betydligt snabbare än tidigare men där personen genom egenutveckling och livsdesign skaffat en bättre grund än tidigare för att hantera stressen, samt nyttjar olika strategier och verktyg för att bryta och återhämta sig. Strategier och verktyg som kanske även skulle kunna hjälpa andra människor.