Bakgrund: I Sverige ses en ökning av psykisk ohälsa bland barn och ungdomar vilket leder till ökade vårdköer inom barn- och ungdomspsykiatrisk vård. De vanligaste diagnoserna inom specialistpsykiatrin är idag uppmärksamhets- och hyperaktivitetsstörning (ADHD), autismspektrumtillstånd (AST), ångest samt depression. Specialistsjuksköterskans funktion blir att alltmer följa upp läkemedelsbehandlingar i stället för att fokusera på omvårdnadsåtgärder. Yoga som komplementär behandlingsmetod visar enligt forskning ge lindring av psykiska symtom och har börjat användas på vuxna patienter inom sjukvården. Syfte: Att sammanfatta tidigare forskning om yoga som metod och komplementär behandling vid psykisk ohälsa hos barn och ungdomar. Metod: Integrativ litteraturstudie, med kvantitativ och kvalitativ ansats, av 15 artiklar. Litteratursökningar genomfördes under februari 2023 i tre utvalda databaser. Resultat: Yogainterventioner resulterade i minskad ångest och depressiva symtom, ökad känslohantering, förbättrad sömn, minskad stress och ökat lugn, förbättrad uppmärksamhet, minskad impulsivitet, förbättrad självkänsla och ökad livskvalité. Resultatet presenteras i fyra teman (hanterbarhet av känslor och symtom, avspänning, fokusering och impulskontroll samt välbefinnande) och tillhörande elva subteman. Slutsats: Evidens om positiva fördelar med yoga som komplementär behandlingsmetod för olika psykiska symtom hos barn och ungdomar sammanställdes och bekräftades.

Background: Breast cancer is the most common cancer in the world with approximately 1.7 million new cases diagnosed in 2012. While women with breast cancer are treated with a multitude of different therapies, these treatments can lead to long-term effects that impact quality of life (i.e. fatigue, pain, lymphedema, anxiety, depression, osteoporosis). With more people looking into complementary and alternative medicine (CAM), research on yoga’s effect on quality of life in breast cancer survivors is vital. Methods: This literature synthesis used PsychINFO, MEDLINE, and CINAHL explore current research on yoga’s effects on quality of life in breast cancer survivors. Search terms included: breast cancer, survivor, quality of life, lifestyle, wellbeing, clinical trial, and controlled trial. Literature was excluded if it included men, women under cancer treatment and if yoga was included in a mindfulness intervention. Results: Eleven articles met the inclusion criteria. Yoga was shown to have a positive impact on fatigue, pain, anxiety, depression, and breast cancer survivors’ quality of life. A majority of the studies measured quality of life using the FACT-B and FACT-G scale. Others used similar measurement tools and qualitative journal entries. Specific studies indicated improvements in aromatase-inhibitor associated arthralgia, diurnal salivary cortisol levels, and menopausal symptoms. Conclusions: Yoga appears to be beneficial in improving breast cancer survivor’s quality of life. More research is needed. However, nurses can use this information to educate clients about the benefit of yoga in survivorship. This research may promote further utilization of CAM in improving quality of life.

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While the physical health benefits of exercise are well established, mental health benefits remain unclear. The literature reports reduced stress and improved cognitive function in rodent exercise studies, and improved mood scores in humans. However, though mood disorders are characterized by poor response to treatment, studies rarely evaluate difficult-to-treat patients or functional outcomes. Therefore, we evaluated the impact of 12-week, group-based exercise programs (running or yoga) on mood and functional outcomes including health-related quality of life (HRQOL) and social and cognitive functioning. Methods: Study 1 was a retrospective review of mood and stress outcomes in participants with difficult-to-treat mood disorders. In Study 2, we measured functional outcomes before and after the running program in a subsample from Study 1. Improved friendship and high injury rates in the running group inspired Study 3, a randomized control trial to evaluate mood and functional outcomes in a non-clinical sample using yoga, a low-impact exercise program that included cognitive control. Results: In Study 1 (n=46), depression (p<0.0001) and stress (p=0.01) scores improved over time, and improved friendship levels were predictive of improved mood scores (p<0.04). In Study 2 (n=18), we found improved scores on several HRQOL subscales, including social functioning (p-values<0.01) and weak improvements in working memory and processing speed (p-values<0.04). In Study 3, yoga participants (n=20) had improved stress (p=0.02), loneliness (p=0.002), and HRQOL (p-values<0.03) scores, compared to wait-list controls (n=8). Yoga participants improved on tasks reflecting hippocampal memory (p-values<0.006) and attention and inhibitory control (p=0.03). Regression and mediation analyses suggest that social support mediates the stress-reducing impact of yoga (p-values<0.0005). Discussion: Group-based exercise programs impart benefits across mental health and functional outcomes for participants with and without mood disorders. Exercise may be an effective adjunctive treatment for mood disorders, and more data is needed on how social support impacts clinical outcomes. / Thesis / Doctor of Philosophy (PhD) / This dissertation examines the impact of exercise across multiple indications of mental health and functioning including mood scores, stress, cognitive function, social function and health-related quality of life (HRQOL) in participants with and without mood disorders. Youth and adults engaged in 12-week group-based exercise interventions of running or yoga and completed comprehensive mental health and neurocognitive assessments. Results: Participation in a structured exercise program was associated with improved stress and depression, social functioning, physical and mental HRQOL domains and limited improvements in cognitive function. Results also support therapeutic benefits of structured high- and low-intensity exercise programs across multiple symptoms in patients with difficult-to-treat mood disorders, and further suggest that reduced stress and increased social functioning play key roles in the mental health benefits observed. These results represent a new standard for mood disorders research, to better understand the how lifestyle strategies are effective for the treatment of mental illness.

Cooperative Extension (CE) is a nationwide system that addresses leading concerns for United States residents from agricultural production to healthy youth development. As 80% of Americans are not meeting the Physical Activity Guidelines (PAG), promoting physical activity is a recent addition to CE priority areas. To build capacity of CE to offer physical activity, training on physical activity within the system is needed. Since yoga is a public health intervention growing in popularity due to its link to flourishing and mental well-being, this is a holistic practice that may target physical and mental health in the United States. Due to the variety of yoga practices one could engage with it is important to clarify the link between physical activity and yoga. This dissertation included four studies to promote physical activity and yoga within CE. Study one established the efficacy of a virtual micro-credentialing program for CE professionals (N = 64) that increased their knowledge about physical activity programming and increased their own physical activity levels. The second study was an iterative and pragmatic investigation of wellness initiatives for CE professionals to increase flourishing and physical activity within themselves. The third study explored the degree to which temperature and tempo of yoga classes impacted measured heart rate and rate of perceived exertion. Preliminary evidence suggests that ~30% of the yoga class contributed to moderate-vigorous physical activity, regardless of the temperature and speed. The fourth study was a systematic appraisal of urban and rural yoga studio offerings. The results included that most studios offer 60-minute classes, focused on asana (movement) rather than the other limbs (components) of yoga. This work also resulted in a studio audit form for CE professionals to assess yoga studios for appropriateness to recommend to their participants. Future work includes scaling out the micro-credentialing program and determining the degree to which knowledge of physical activity leads to physical activity program adoption (study 1); ensuring CE professionals have access to wellness initiatives to avoid burn out (study 2); ongoing investigation of the physiological benefits of yoga (study 3); and testing the utility of the studio audit form (study 4). / Doctor of Philosophy / Physical activity is an important part of living a healthy life and can look different for everyone. The Physical Activity Guidelines for Americans recommend for people to get 2 days of full body strength training along with 150 minutes of moderate intensity aerobic activity each week. Aerobic activity is activity that gets your heart rate up. In the first manuscript of this dissertation, Cooperative Extension professionals were trained in how to promote physical activity and physical activity programming. Cooperative Extension is a nationwide program that helps get research knowledge from the universities to the public. The second manuscript looks at how Cooperative Extension professionals were able to incorporate more mindfulness, yoga, and self-care for themselves through employee wellness programs, and which programs worked best in a practical way. The third manuscript looks at if the physical practice of yoga can increase heart rate to moderate to vigorous intensity zones in order to determine if a typical community-based yoga flow could contribute to meeting the aerobic components of the Physical Activity Guidelines. Based on this study, yoga can help participants get into the moderate intensity aerobic activity zone. The fourth manuscript explores the research and development of a yoga studio audit tool. This tool helps assess yoga studios so that public health professionals can recommend the studio that is the right fit for their clients.

Virginia Cooperative Extension (VCE) agents build local relationships with participants and stakeholders to translate evidence-based information to improve "economic, environmental, and social well-being" of Virginians. However, Extension agents have reported high rates of employee burnout and stress. To mitigate the impacts of agent stress and burn-out, application of mindfulness and yoga through health coaching is emergent, but the impact is yet to be empirically tested. To holistically evaluate the individual-level impacts (i.e., behavior) as well as the system impacts (i.e., costs and sustainability), this project tested the initial feasibility, cost, reach, and efficacy of a virtual health coaching program for VCE agents. The CHAT (Coaching for Health and Togetherness) program consisted of nine weekly, one-hour modules including goal setting, self-reflection, behavior change strategies, group yoga and grounding exercises as well as resources on Ayurveda (an ancient Indian system of medicine and sister science to yoga). The program facilitated group dynamics through relationship building, group goal setting, group distinctiveness, and support. The impacts of the coaching module were measured longitudinally (pre, post, and 3-month follow up) through previously validated scales in flourishing (i.e., complete human well-being), group cohesion, physical activity behaviors, and yoga self-efficacy. Additionally, qualitative data were collected at the 6-month follow up point through semi-structured interviews. Participants in CHAT reported increased flourishing scores from baseline to post-program, t(7)=4.42, p=0.003 with a medium effect size (d=0.53) as well as at the three-month follow-up, t(7)=3.06, p=0.018 with a small effect size (d=0.14). Participants significantly increased aerobic physical activity behaviors from pre-program to post program, X2(1, N=11) =7.21, p=0.007, as well as at the three-month follow up, X2(1, N=11) = 4.95, p=0.026. Participants did not show significant changes in yoga self-efficacy or group cohesion. Future implications of this project include sustainability and scalability of virtual group health coaching programs for behavior change. / Master of Science / Virginia Cooperative Extension (VCE) agents build local relationships with participants and stakeholders to translate evidence-based information to improve "economic, environmental, and social well-being" of Virginians. However, Extension agents have reported high rates of employee burnout and stress. To mitigate the impacts of agent stress and burn-out, application of mindfulness and yoga through health coaching is emergent, but the impact is yet to be empirically tested. To holistically evaluate the individual-level impacts (i.e., behavior) as well as the system impacts (i.e., costs and sustainability), this project tested the feasibility (initial implementation cost, reach) and efficacy of a virtual health coaching program for VCE agents. The CHAT (Coaching for Health and Togetherness) program consisted of nine weekly, one-hour modules including goal setting, self-reflection, behavior change strategies, group yoga and grounding exercises as well as resources on Ayurveda (an ancient Indian system of medicine and sister science to yoga). The program facilitated group dynamics through relationship building, group goal setting, group distinctiveness, and support. The impacts of the coaching module were measured longitudinally (pre, post, and 3-month follow up) through previously validated scales in flourishing (i.e., complete human well-being), group cohesion, physical activity behaviors, and yoga self-efficacy. Additionally, qualitative data were collected at the 6-month follow up point through semi-structured interviews. The results showed significant increases in participants' flourishing from pre-program to post-program as well as at the three-month follow up point, as well as significant changes in aerobic physical activity behaviors. Participants did not show significant changes in yoga self-efficacy, group cohesion from pre-program to post-program or at three-month follow up. Future implications of this project include sustainability and scalability of virtual group health coaching programs for behavior change.

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Dans ce mémoire, le "Connais-toi toi-même" socratique est étudié d'abord pour lui-même, ensuite à la lumière de la philosophie du Yoga telle qu'exprimée dans le Sâmkhya et les Yoga-Sûtra de Patanjali. Le lecteur peu familier avec la philosophie du Yoga y trouvera une présentation du Yoga-Sâmkhya qui lui sera très utile. On y démontre également que le Yoga-Sâmkhya propose une excellente méthode de connaissance de soi. De plus, on y découvre que certaines méthodes de connaissance de soi, populaires de nos jours ont des liens de parenté très évidents avec le Yoga. Les méthodes comparées sont les 12 étapes des Alcooliques Anonymes, les 12 sentiers de Ken Keyes et l'ANDC de Colette Portelance.

The aim of this study was to explore the influence of yoga on learners with ADHD. In order to reach the aim of this study, an initial literature study was executed to describe ADHD and the practice of yoga. Particular aspects such as concentration, anxiety, self-esteem and aggression were highlighted. Semi-structured interviews with parents, teachers, learners and one yoga instructor were used to conduct the empirical study. Valuable data was also collected from the learners using projection tests and self-esteem questionnaires. Assessments were conducted at two points: during the situation analysis and at the outcome of the yoga intervention. Based on the data collected and analysed, findings were made and conclusions were drawn regarding the influence of yoga on learners with ADHD focusing on the aspects of concentration, anxiety, self-esteem and aggression. Recommendations for future research were then proposed. / Psychology of Education / M. Ed. (Guidance and Counselling)