Aim: This thesis aims to describe perceived overall well-being, coping strategies, experiences of intimacy and sexuality, and global and dimension-specific self-esteem among children and adolescents with mobility impairment. Methods: The study included 141 children and adolescents aged 7–18 years with mobility impairment. Data was gathered by comprehensive semi-structured interviews and the self-report inventories “Children’s Coping Strategies Checklist” (CCSC) and “I Think I am”. Perceived overall well-being was measured by the nine-grade visual “Snoopy scale”. Motor function and pain were measured by the BL motor assessment, and independence or dependence by Katz Index of Independence in Activities of Daily Living. Results: The majority reported a favourable level of perceived overall well-being and positive global and dimension-specific self-esteem. Lower global self-esteem was significantly related to: greater age, being a first-generation immigrant, having an acquired disease or injury and experience of pain, while lower level of perceived overall well-being was significantly related to all of these in addition to not living with both parents. Generally, children and adolescents identified themselves as sexual beings and most expressed future aspirations as living together with partner having children. However, many had limited or no experience of partner-related intimacy and sexual activities, and socio-demographic and disability characteristics had a marginal influence. A history of sexual abuse was reported by 7% in the age cohort 13–18 years. A four-dimensional model of coping strategies including “active coping”, “distraction”, “avoidance” and “support seeking” strategies provided an adequate fit to the CCSC data. Three of the four strategies, all except “avoidance”, were significantly related to several demographic and disability features. Well-being was not significantly related to coping strategies, although the higher the trust in the strategies, the higher the estimation of well-being. Conclusion: The understanding of vulnerability factors as well as identification of coping strategies among children and adolescents with mobility impairment is essential for providing proper care, treatment and support during childhood and adolescence.

The present dissertation includes four empirical studies, each of which focuses on specific aspects of children’s living conditions. Study I analyses the association between young people’s social relations and health complaints using Swedish nationally representative survey data on 10- to 18-year-olds. Both relations with parents and with peers are associated with health complaints. Relational content is more strongly associated with health complaints than is relational structure. With regard to relational content, strained relations are more strongly associated with health complaints than are supportive relations. Study II investigates how effort and reward in school are associated with pupils’ subjective health using data from the Stockholm School Survey. Both effort and reward are shown to be positively associated with subjective health, and in particular pupils who report to put in high effort in school have high levels of subjective health. Contextual variation in health is found for girls but not for boys. Study III is based on Swedish register data and analyses the association between family type and choice of programme in upper secondary school. Children in single-mother households less often choose the natural science/technology (NT) programme compared with children who live with two original parents. Having a resident or a non-resident parent with NT skills is positively associated with choice of the NT programme. Study IV analyses the association between family type and social support, health, and material resources in 24 countries. The data are derived from the international Health Behaviour of School-aged Children (HBSC) survey. In a majority of the countries studied, children in single-mother households report smaller resources compared with children living with two original parents. No clear pattern is found with regard to differences between countries. / At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 2: Submitted. Paper 4: Accepted.

Vilka faktorer som påverkar vår upplevelse av välbefinnande och lycka väcker stort intresse hos människor. Upplevt välbefinnande (subjective well-being) kan definieras som en individs subjektiva uppfattning om sin livstillfredställelse. Grunden för denna uppfattning bygger på hur den enskilda individen skattar och utvärderar sitt liv. Stabilitet i upplevt välbefinnande påverkas av såväl situationsbundna faktorer som personlighet och affekt. Syftet med denna kvantitativa rapport var att utifrån data från forskningsprogrammet IDA undersöka sambandsstrukturen mellan de olika delarna i begreppet upplevt välbefinnande: områdesspecifikt välbefinnande å ena sidan och generellt välbefinnande med allmän livstillfredställelse, positiv affekt och negativ affekt å andra sidan. Samt att hitta eventuella könsskillnader i dessa samband. Resultatet visade på starka samband mellan generellt och områdesspecifikt välbefinnande. Det allra starkaste sambandet konstaterades mellan tillfredställelse med familjeliv och allmän livstillfredställelse. Sambandet mellan yttre villkor för arbetstillfredställelse och generellt välbefinnande var starkare för män än för kvinnor, medan partialsambandet mellan tillfredställelse med partnerrelation och allmän livstillfredställelse var starkare för kvinnor. Diskussion förs kring resultatens överensstämmelse med tidigare forskning.

Happiness research is advancing as an academic discipline as well as on the political agenda. An aspect, largely ignored in the field, is what impact an individual’s construction of the good life has on his or her subjective well-being. The purpose of this paper was to investigate how people in different situations in life and with different backgrounds construct the idea of a good life and the importance these constructions may have in explaining subjective well-being. Despite the differences between themselves, the respondents’ constructions of the good life were shown to have a lot in common. Some factors in the good life were shared by the respondents, such as relations to other people, access to food, water and housing, whereas in other aspects, such as money and time, the constructions of the good life differed quite a lot from one another. When evaluating their own lives the respondents used quite different criteria mostly corresponding to their idea of the good life. If this is a general pattern, possible to replicate in other studies, one may in the future be able to draw the conclusion that the construction of the good life has an effect on our subjective well-being.

Då befolkningen blir allt äldre ökar andelen personer som drabbas av demenssjukdom. Att drabbas av demens innebär att kognitiva funktioner försämras. Kommunikationsproblem och problem med daglig livsföring, personlighetsförändringar, brister i empatisk förmåga och svårigheter att kontrollera känslor kännetecknar sjukdomsbilden. Det är av betydelse att finna icke-farmakologiska behandlingar då medicinering inte ger önskat resultat. Syftet med denna litteraturstudie var att få ökad kunskap om hur musik påverkar personer med demenssjukdom. Artiklar söktes i databaserna MedLine (via PubMed), Blackwell-synergy samt Cinahl. Detta resulterade i 21 artiklar varav 14 inkluderades efter granskning. Resultatet visade att musik används för att lugna, öka kognitiv förmåga samt öka välbefinnandet hos personer med demenssjukdom. Föreliggande studie påvisade att musik har en positiv inverkan oavsett kognitiv förmåga. Musik är en kostnadseffektiv, icke-farmakologisk behandling som är enkel att implementera. / As the population are getting older the number of people suffering from dementia is increasing. To be diagnosed with dementia means that cognitivie abilities are decreasing. Communication problems, problems with activities in daily living, changes in personality, lack of empathic ability and difficulties in controlling feelings are the characteristics of the disease. There is a need for non-pharmacological treatment when medication does not give the wanted effect. The aim of this literature review was to get an increased knowledge about how music effects elderly persons with dementia. The search of scientific articles was carried out through the databases MedLine (via PubMed), Blackwell-Synergy and Cinahl. The search resulted in 21 articles of which 14 was included in the study result. The result showed that music was used to calm, increase cognitive ability and well-being in persons with dementia. This study showed that music has a positive influence regardless of cognitive ability. It is a costeffective, non-pharmacologic treatment which is easy to implement.

Syftet med litteraturstudien var att genom litteraturen redogöra för cancersjuka ungdomars livskvalitet och hur de hanterar sin sjukdom. Denna studie är en beskrivande litteraturstudie där författarna sökte vetenskapliga artiklar på Medline, Cinahl, SweMed+ och PsykInfo. I resultatet redovisas femton artiklar. Resultatet visade att socialt stöd i form av föräldrar och en speciell vän visade ha stor betydelse för ungdomarnas välmående. Ungdomarna beskrev också att det kändes bra att prata med andra ungdomar i samma situation. Att ha en positiv inställning och humor hjälpte ungdomarna att hantera sin sjukdom. Ett sätt att komma ifrån sjukdomen, och slippa tänka på den för ett tag var att försöka känna sig normal. Detta gjorde de till exempel genom att bära accessoarer, moderna kläder och testa sina gränser. I och med att ungdomarna spenderade så mycket tid på sjukhus blev de isolerade, vilket skapade en utanförkänsla gentemot friska ungdomar. Förändrat utseende, rädsla och utanförskapskänsla är faktorer som påverkade ungdomars livskvalitet negativt. Det visade sig att de cancersjuka ungdomarna hade lägre livskvalitet än friska ungdomar, men desto längre tid det gick efter diagnosen desto högre blev deras livskvalitet. Flickor visade sig generellt ha bättre välbefinnande än pojkar. / The aim of this literature study was to investigate how adolescents with cancer cope with there disease and how it effect their quality of life (QoL). This study was a descriptive literature study were the authors searched for scientific articles in the databases Medline, Cinahl, SweMed+ and PsykInfo. The result is based on fifteen articles. The result showed that social support such as parents and a special friend is important for the adolescents' well-being. The adolescents also described that it felt god to have someone to talk to that was in the same situation. A positive attitude and humour helped the adolescents to cope with their disease. One way to escape from the disease was trying to feel normal, a way of doing that was to wear accessories, modern clothes and pushing their limits. The adolescents spent a lot of time in the hospitals thus made them isolated, which resulted in alienation. Changed body image, fear and alienation are all factors that influence on the adolescents QoL. It was showed that adolescents with cancer had lower QoL than healthy adolescents, but as time pass by their QoL increased. In general the girls hade better QoL than the boys.

Syftet med studien var att undersöka om det fanns skillnader i hur ungdomar mellan 16-18 år i storstäder, städer och landsbygd uppfattade sitt psykiska välbefinnande samt se om resultatet gällde för båda könen. Datamaterialet till studien samlades in av Statistiska Centralbyrån under åren 2000-2003.

Self-regulation capacity allows individuals to manage their thoughts, feelings, and actions to attain personal goals (e.g., well-being and performance), as well as adjust to their changing social and physical environment (Zimmerman, 2000). Self-regulation as a positive adaptive skill and process has not been examined in relation to well-being in the context of medicine. The purpose of the current study was to examine self-regulation with 37 medical students and 25 supervising physicians to determine whether or not it may enhance well-being and performance, and reduce stress and burnout. A mixed-methods design was used to collect and analyze the data, and findings from the quantitative and qualitative phases were presented in two separate articles. Self-regulation capacity appears to be an important skill that may help both physicians and medical students to meet the demands of the medical profession and maintain an adequate level of well-being and performance in their work and daily life.

Bakgrund: År 2050 beräknas det finnas 100 miljoner personer med demenssjukdom i världen. Att skapa stunder av gemenskap, försöka bevara patientens identitet och göra omvårdnaden personlig är avgörande för en god vård. Patienter med demenssjukdom har ofta kvar sin förmåga att sjunga och känna igen musik även i ett sent stadium av sjukdomen. Syfte: Syftet med examensarbetet var att beskriva vilken inverkan musik kan ha i omvårdnaden av personer med demenssjukdom. Metod: En litteraturöversikt baserad på nio vetenskapliga artiklar genomfördes; sex av studierna var kvantitativa och tre kvalitativa. Nyckelfynd identifierades och sammanställdes för varje artikel. Likheter och skillnader jämfördes och övergripande kategorier skapades som efter ytterligare analys kondenserades till teman och underteman. Resultat: Resultatet visar att olika musikinterventioner ökar välbefinnandet hos personer med demenssjukdom genom minskad ångest, minskad agitation, förbättrad sinnestämning samt uttryck av glädje och lekfullhet. Personernas förmåga till både verbal och icke-verbal kommunikation ökade. Musik visade sig även vara en väg till gemenskap genom ökad social interaktion, bättre samspel och ökat samarbete. Diskussion: Resultatet diskuteras i förhållande till Katie Erikssons teorier om lidande och om lekens betydelse i vårdandet. Att ha en demenssjukdom kan innebära sjukdomslidande, vårdlidande och livslidande. Individuellt anpassad musik kan stärka en persons identitet och skapa en gemenskap som minskar lidandet. I vårdandet är leken central och ett medel för att uppnå hälsa. Leken kan även lindra lidande. / Background: By the year 2050 it is estimated there will be around 100 million dementia sufferers. In order to provide good and adequate care for these people it is paramount to preserve their integrity and their feeling of inclusiveness and to personalise their care. Dementia patients often retain their ability to sing and to recognise music even at an advanced stage of the illness. Aim: The aim of this litterature overview was to describe the impact music have on people with dementia. Methods: A litterature overwiev based on nine scientific articles were conducted; six quantitative and three qualitative. Keyfoundings were identified and put together for each article. Similarities and differences were compared and overall categories were created that after further analysis were condensed to themes and subthemes. Results: The result showed how different musical interventions increased the overall well being of the patients. The reduction of anxiety and agitation were significant and led to an increased level of expression of joy and playfulness. Their ability for both verbal and non-verbal communication increased. Music also led to enhanced social interaction and cooperation. Discussions: The results were discussed in relation to Katie Erikssons´ theories about suffering and the significance of playing in caring. To have dementia may involve suffering on many levels connected to the disease, the care and to life. Indivudually adjusted music may strenghten a persons identity and relieve suffering. Playing is important in the act of caring and a way to attain health. Playing may also relieve suffering.

Background: Self-rated health (SRH) is among the most frequently assessed health perceptions in epidemiological research. While the predominant focus has been the predictive relevance of SRH, there is increasing interest in understanding the nature of SRH. Recently a conceptual interpretation of SRH was proposed. Purpose: To assess the tenability of the recently proposed distinctions of self-rated health, as a spontaneous assessment of overall health, or as an enduring self-concept, or both, and to determine the significance of mental well-being, physical and social health for SRH. Methods: A cohort of individuals undergoing total joint replacement (TJR) for hip or knee osteoarthritis (OA) was followed over 6 months of recovery. Participants (n=449) completed (pre-surgery, 3 and 6 months post-surgery) measures associated with physical health: pain, physical function, sports/recreation, fatigue; mental well-being: anxiety, depression; and social health: social participation, passive/active recreation, community access. Using structural equation modeling, confirmatory factor analyses (CFA) investigated 3 latent health variables, and the responsiveness of SRH to current and changing health status, as well as its predictive significance for future health status was investigated. Results: CFA analyses confirmed relationships between observed health measures and hypothesized latent health dimensions. SRH was responsive to current and changing mental well-being. The effects of physical and social health were mediated through mental well-being. SRH was a strong predictor of future SRH and future health status. Conclusion: SRH displayed features of both an enduring self-concept and spontaneous assessment of health status; evidence is provided that both operate simultaneously. While aspects of physical health have always been perceived as the major determinants of SRH, these findings indicate that mental and social health explain much of the relationship between physical health and SRH. These results are particularly unexpected since this is a sample of individuals undergoing TJR surgery, for which pain and restricted physical function are primary indicators. Since SRH is a significant predictor of health status, TJR outcomes, health care utilization and mortality, this study suggests that health research and care, treatment and management modalities should consider a broad range of health dimensions, not only physical aspects of health, and SRH.