| 41. |
- Eriksson, Ann-Kristin Mimmi
(författare)
-
Vid utmattningens gräns. Utmattningssyndrom som existentiellt tillstånd : Vårdtagares och vårdgivares erfarenheter av utmattningssyndrom och rehabilitering med en existentiell ansats i svensk vårdkontext
- 2016
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background and objectives: Stress-related illness is a growing public health problem in Sweden and it is the most common reason for sick leave today. Stress-related illness causes suffering on a number of levels and affects the patient’s health and life in the long term. The stress-related ill health also leads to consequences for society, causing high costs for sick leave and health care as well as lost workforce since people partially or entirely lose their capacity to work. Research on stress-related ill health and rehabilitation often underline work-related conditions as crucial in dealing with the problem. There is also research that points out psychosocial factors in understanding stress-related ill health. What we know little about is the existential perspective of clinical burn-out. Therefore, it is of importance to investigate people’s existential experiences of clinical burn-out and the significance of an existential perspective in rehabilitation.Aim: The overall aim of this thesis is to gain insight into the existential experience of clinical burn-out as well as to highlight the significance of an existential perspective in rehabilitation. In addition, the thesis aims to reach a deeper understanding of clinical burn-out from an existential point of view and contribute to the field with knowledge of the existential dimension of health.Methods: The study, conducted in 2011, is based on qualitative interviews made with an inductive hermeneutic approach. Five patients and seven care givers were interviewed, focusing their existential experiences of clinical burn-out as well as their experiences of rehabilitation with an existential approach. A strategic selection was made of informants in the context of a rehabilitation program with an existential approach for people diagnosed with clinical burn-out. The data was analysed in two steps. In the first step the data was interpreted with an inductive hermeneutic approach. In step two of the analysis, the data was interpreted with a deductive hermeneutic approach, using Karl Jasper’s concept of limit situation as a way of interpreting the existential experience. Aaron Antonovsky’s concept sense of coherence was used as a tool for understanding components that can contribute to restoring health.Results: In this study, the patients describe clinical burn-out as a comprehensive existential experience that can be perceived as being in between life and death, in a shadow world, trapped in a dead end. It’s a situation characterized by being powerless. It creates a need to comprehend one’s situation in order to be able to regain control and manage it. It’s a struggle to make sense of the life situation. When not being met with understanding, the patients lose hope. Existential issues in terms of meaning, existence and life choices become urgent. Working with the existential perspective requires trust, openness from both caregiver and patient, distinctness, a way to communicate it and courage to take on the challenge of dealing with existential issues. The perspective also requires that the existential suffering can be contained. Dealing with existential questions leads to self-knowledge and insights that enables a possibility to make different choices and leave negative behavioural patterns. Also, it can lead to a discovery of spirituality and religion as a resource in life. Besides their personal struggle for meaning, the patients see an existential void in society, leaving people without tools to handle existential needs. This is understood as something that affects people’s ability to handle stressful times in life.The care providers understand burn-out as a manifestation of a way of living that is not sustainable. It is an existential experience embodied in body and mind that can be experienced as being drained of life. It’s an existential challenge, causing grief when realizing one’s limitations as a human being. Also, loss of meaning and sense of existential vulnerability due to an experience of being annihilated is crucial for understanding the deep existential crisis that clinical burn-out can induce. This situation makes the patient ask existential questions about identity, meaning, values and direction. In the burnout-process the patients have distanced themselves from their own self and therefore need to reconnect with themselves. This makes the existential questions central in the rehabilitation as a way to reconnect to inner strength and resources, which are prerequisites for starting a health promoting, sustainable process which is empowering, making it possible to see oneself as a human being who experience meaning, not only as a patient with a diagnosis. Instead of finding meaning in the diagnosis, the patient’s existential questions and the existential experience is a key to moving forward, out of the situation. Meaning-making is therefore important in the rehabilitation.A holistic-existential approach and view of man makes it possible to work with the complexity of the situation. The holistic-existential approach creates synergies and offers an extra tool both for the caregiver and the patient. Focusing on the patient’s resources and competence makes it possible to see the crisis as a way to learn from it.The existential perspective in health care and rehabilitation is enabled by competence, openness, reliance, empathy and respect when meeting the patient. It also requires courage to take on the challenge of dealing with existential issues. It can be hard for both the patient and the care giver to confront existential suffering. It is the responsibility of the care giver to enable the existential perspective by acknowledging and making the existential perspective possible to communicate and work it through.The care providers understands values in modern society as contributing to people’s experience of feeling alone with existential needs, which intensifies their existential aloneness.The care providers’ experience is that the biomedical paradigm aggravates an existential perspective. The perspective is not associated with the care situation. There is a lack of knowledge about and understanding of the value of the existential perspective, all the way from the decision-making level to the clinical meeting with the patient. In addition, the paradigm affects how the patients express their illness. Also, the perspective requires time. Existential perspectives, therefore, tend to be concealed in the health care context.Applying Karl Jasper’s concept of limit situation, clinical burn-out can be interpreted as a defining existential experience. It can be understood as a limit situation when humans realize their limitations and at the same time get insights that are crucial for their lives. It’s an experience they wish they had not gone through, but on the other hand, it has led to insights they do not want to be without. The meaning-making process is health promoting by recreating meaning, the fundamental part of sense of coherence, which is crucial for a salutogenic direction.Conclusion: The existential state that the clinical burnout patients go through can, using Karl Jasper’s concept, be understood as a limit situation. According to Jasper’s reasoning, the limit situation can be perceived as facing an abyss, making it clear one has limitations as a human being. At the same time, the experience can be perceived as reaching a limit where humans can get insights about human life that can enhance life. Clinical burn-out, using Aaron Antonovsky’s concept, can be understood as a loss of the components that create sense of coherence. Loss of meaning is particularly central for understanding burn-out.Consequently, it is crucial to acknowledge the existential challenge that the patient is facing, as well as the importance of the meaning-making process for facilitating a movement in a health promoting manner. It gives a deeper understanding of the challenges and needs of patients suffering from clinical burn-out.The existential dimension of health has been highlighted in health promotion, but gets little attention in practice. This is especially significant in the health care context. This points out the need for a discussion about how the existential health dimension can be used as a resource in health care and rehabilitation and how this resource for health can be applied in a better way in health promotion and public health.
|
|
| 42. |
- Eriksson, Lina J. K.
(författare)
-
An Exploration of the Behavioral Inhibition System (BIS), Response Inhibition, and Possible Implications in Sports
- 2021
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Large parts of human behaviors are oriented towards achieving a particular goal. Motivational factors in the form of approach and avoidance motivated behavior and executive functions (EFs) such as inhibition are central for goal-directed behavior. There are individual differences in the inhibition of prepotent behavior and the Behavioral Inhibition System (BIS) can be viewed as a neuropsychological system that has been proposed to be a personality trait that explains those individual differences. Inhibition is an EF that is involved in the control of impulses and enable us to choose how to react and behave. Sport is a context in which the cognitive demands can be high and there is a growing body of research trying to pinpoint the cognitive mechanisms behind superior athletic performance. Response inhibition is suggested to be one of the mechanisms that is of importance for performance in sport.The general aim of this thesis was to explore the BIS, response inhibition and the possible implications in sports. A theoretical framework of approach and avoidance motivation, the revised RST (Gray & McNaughton, 2000; McNaughton & Corr, 2004) was combined with a paradigm for assessment of response inhibition; the stop-signal paradigm (Logan & Cowan, 1984). In addition, different instruments for assessment of the BIS was investigated and designs of the stop-signal task for assessment of response inhibition was used. Study I and III aimed to examine the relationship between response inhibition and the BIS. Study I used a sample of non-athletes and Study III used a sample of non-athletes, and athletes from two different interceptive sports, biathlon and alpine skiing. The aim of Study II was to test the factor structure of a Swedish version of the Reinforcement Sensitivity Theory of Personality Questionnaire (RST – PQ; Corr & Cooper, 2016). The results from Study I indicated that when the ability to inhibit prepotent response and behavioral precision (i.e., accuracy) is central for task performance, higher levels of BIS could be a vulnerability factor when the individual’s inhibitory ability simultaneously is poor. Due to ceiling effects in the variable accuracy, this was not possible to replicate in Study III. The results in Study II suggest that the RST-PQ has considerable promise since it, for example, provides an opportunity to distinguish between the individual differences between fear and anxiety, although there were issues concerning the convergent validity. Study III showed that athletes with experience in interceptive sports do not outperform non-athletes on response inhibition. The implications of these results are that it is possible that other aspects than being an athlete or non-xathlete need to be considered and that individual differences in the BIS could be one of these aspects.Taken together, results from these three studies indicated that that it is possible to combine a theoretical framework of approach and avoidance motivation and a paradigm for the assessment of response inhibition, the stop-signal paradigm, with the purpose of exploring the BIS, response inhibition and possible implications in sport. It has also showed the complexity with using self-report instruments for assessment of neuropsychological systems that, in theory, underlies personality and the difficulties with using SSTs for assessment of an estimated measure (i.e., SSRT) of response inhibition. By exploring the BIS and response inhibition, this thesis offers an approach to view sport expertise and show the value of focusing on individual differences in the personality trait BIS since, at least theoretically, the BIS has the potential to serve as an explanation for variations in response inhibition and the possible association with behavioral precision (i.e., accuracy).
|
|
| 43. |
- Eriksson, Lina J. K., et al.
(författare)
-
Exploring Response Inhibition, the Behavioral Inhibition System and Possible Sex Differences in Athletes and Non-Athletes
- 2023
-
Ingår i: International Journal of Environmental Research and Public Health. - : Multidisciplinary Digital Publishing Institute (MDPI). - 1661-7827 .- 1660-4601. ; 20:14
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The objective of this study was to revisit the question concerning whether athletes are better than non-athletes at fundamental cognitive abilities, such as inhibitory control, in addition to also focusing on motivational dispositions and possible sex differences. Adding the latter could be crucial since both inhibitory control and motivational dispositions, such as approach and avoidance, are central to goal-directed behavior. Methods: This study’s sample was composed of 93 participants (40 males): 29 biathletes; 30 alpine skiers; and 34 non-athletes. A non-sport-specific stop-signal task was used for the assessment of inhibitory control in terms of response inhibition, and the motivational dispositions were assessed with the BIS/BAS scales. Results: The results showed that there were no differences between the two different sports or non-athletes with regard to response inhibition. However, females showed significantly slower response inhibition than males (p = 0.018) and scored significantly higher on the trait variable BIS (p < 0.001). Conclusions: The results from this study suggest that it might be meaningful to explore the contribution of sex differences and motivational dispositions on response inhibition in conjunction with different types of sports.
|
|
| 44. |
- Eriksson, Lina J. K., et al.
(författare)
-
Psychometric properties of a Swedish version of the reinforcement sensitivity theory of personality questionnaire
- 2019
-
Ingår i: Nordic Psychology. - : Informa UK Limited. - 1901-2276 .- 1904-0016. ; 71:2, s. 134-145
-
Tidskriftsartikel (refereegranskat)abstract
- The reinforcement sensitivity theory of personality questionnaire (RST-PQ) is based on a theoretical analysis of the revised reinforcement sensitivity theory. Using a Swedish sample stratified by age and gender, the aim of this study was to test the six-factor structure of a Swedish version of the RST-PQ. Further, we examined the convergent and discriminant validity of the questionnaire. The results of the confirmatory factor analysis showed that the Swedish version did not fully provide support for the six-factor structure. An attempt to improve the model fit resulted in a significantly better model fit for a six-factor structure containing 52 items. Issues concerning the convergent validity were found, as indicated by all six factors having more than 50% of the variance due to error. The discriminant validity was satisfactory for all factors, except for goal-drive persistence and reward interest, which were highly correlated. This indicates a non-independence between these two factors in the model. Nevertheless, the RST-PQ has considerable promise and more emphasis should be put on investigating the convergent validity by using for example broader samples, stratified by country of origin, age, and gender.
|
|
| 45. |
- Eriksson, Lina J. K., et al.
(författare)
-
The interactive effect of the Behavioral Inhibition System (BIS) and response inhibition on accuracy in a modified stop-signal task
- 2016
-
Ingår i: Personality and Individual Differences. - : Elsevier BV. - 0191-8869 .- 1873-3549. ; 97, s. 198-202
-
Tidskriftsartikel (refereegranskat)abstract
- The ability to adjust to a changing environment is an important aspect of every-day life and successful goal directed behavior requires the ability to suppress responses that are no longer appropriate. The main purpose of the present study was to examine if the relationship between inhibitory control (as indexed by stop-signal reaction time, SSRT) and behavioral precision is dependent on levels of Gray and McNaughton's Behavioral Inhibition System (BIS). Additionally, the relationship between BIS and electrodermal activity, and the Behavioral Approach System (BAS) and heart rate activity was investigated. A modified stop-signal task was used. The results showed that there was an interaction effect of BIS and SSRT on accuracy, suggesting that among individuals with higher levels of BIS, longer SSRT (i.e. poorer inhibitory ability) was associated with decreased accuracy. There were no significant correlations between trait variables and physiological variables. The results were discussed in terms of higher levels of BIS being a vulnerability factor when the individual's inhibitory ability simultaneously is poor in situations where the ability to inhibit inappropriate behavioral routines is important for task performance.
|
|
| 46. |
- Eslami, Bahareh, et al.
(författare)
-
Anxiety, depressive and somatic symptoms in adults with congenital heart disease
- 2013
-
Ingår i: Journal of Psychosomatic Research. - : Elsevier BV. - 0022-3999 .- 1879-1360. ; 74:1, s. 49-56
-
Tidskriftsartikel (refereegranskat)abstract
- ObjectiveDespite the improvement in life-expectancy of adults with congenital heart disease, they may experience unique medical and social challenges that could impact on their psychological functioning. The aims of this study were to address the experience of anxiety, depressive and somatic symptoms among adults with congenital heart disease in comparison with that of non-heart diseased persons considering the role of various factors (e.g. socio-economic).MethodsIn cross-sectional case–control study, the participants consisted of 347 patients with congenital heart disease (18–64 years, 52.2% female) and 353 matched (by sex/age) non-heart diseased persons. The participants completed a questionnaire. The data were analyzed with bivariate and multivariate methods.ResultsIn bivariate analyses, scores in anxiety and somatic symptoms were higher among patients than the healthy controls (both at p ≤ 0.001), whereas the groups did not differ in depressive symptoms. Following multiple-linear-regression-analyses, only the association between congenital heart disease and somatic symptoms was confirmed. Among the patients, perceived financial strain was significantly related to anxiety, depressive and somatic symptoms; lower perceived social support to anxiety and depression; and low annual income to somatic symptoms. Additionally, somatic symptoms were associated with anxiety and depressive symptoms, and vice versa. And no medical variables were related to anxiety, depressive and somatic symptoms.ConclusionsCongenital heart disease was only independently associated with somatic symptoms. Financial strain, social support and co-existence of emotional distress with somatic symptoms should be considered in developing appropriate interventions to improve the well-being of patients with congenital heart disease. However, longitudinal research is warranted to clarify causality.
|
|
| 47. |
- Eslami, Bahareh, et al.
(författare)
-
Gender differences in health conditions and socio-economic status of adults with congenital heart disease in a developing country
- 2013
-
Ingår i: Cardiology in the Young. - 1047-9511 .- 1467-1107. ; 23:02, s. 209-218
-
Tidskriftsartikel (refereegranskat)abstract
- Background Providing appropriate care for adults with congenital heart disease requires the evaluation of their current situation. There is limited research in Iran about these patients, particularly in relation to gender differences in the demographic/socio-economic and lifestyle factors, as well as disease parameters.Materials and methods The sample consisted of 347 congenital heart disease patients in the age group of 18–64 years, including 181 women, assessed by an analytical cross-sectional study. The patients were recruited from the two major heart hospitals in Tehran. Data were collected using questionnaires.Results The mean age of the patients was 33.24 years. Women were more often married and more often had offspring than men (p < 0.001). Educational level and annual income were similar between women and men. Unemployment was higher among women (p < 0.001), but financial strain was higher among men (p < 0.001). Smoking, alcohol, and water-pipe use was higher among men than among women (p < 0.001). Cardiac factors, for example number of cardiac defects, were similar among women and men, except that there were more hospitalisations owing to cardiac problems, for example arrhythmia, among men. Disease was diagnosed mostly at the hospital (57.4%). Most medical care was provided by cardiologists (65.1%). Only 50.1% of patients had knowledge about their type of cardiac defect.Conclusion Gender differences exist in the socio-economic and lifestyle characteristics of adults with congenital heart disease, in some cases related to the disease severity. Our findings also point to the need for interventions to increase patients’ knowledge about, and use of, healthier lifestyle behaviours, irrespective of gender. Furthermore, providing appropriate jobs, vocational training, and career counselling may help patients to be more productive.
|
|
| 48. |
- Eslami, Bahareh, et al.
(författare)
-
Quality of life and life satisfaction among adults with and without congenital heart disease in a developing country
- 2015
-
Ingår i: European Journal of Preventive Cardiology. - : Oxford University Press (OUP). - 2047-4873 .- 2047-4881. ; 22:2, s. 169-179
-
Tidskriftsartikel (refereegranskat)abstract
- Background Life-expectancy of adults with congenital heart disease (CHD) has improved world-wide, but there are limited data on these patients' experiences of quality of life (QoL), life satisfaction (LS), and their determinants (e.g. social support), particularly among patients from developing countries.Design Cross-sectional case-control.Methods A total of 347 CHD patients (18-64 years, 52.2% women) and 353 non-CHD participants, matched by sex/age, were recruited from two heart hospitals in Tehran, Iran. LS and QoL served as dependent variables, and demographic/socioeconomic status, mental-somatic symptoms, social support, and clinical factors (e.g. defect category) served as independent variables in multiple regression analyses once among all participants, and once only among CHD patients.Results The CHD patients had significantly lower scores in LS and all domains of QoL than the control group. However, having CHD was independently negatively associated only with overall QoL, physical health, and life and health satisfaction. Additionally, multivariate analyses among the CHD patients revealed that female sex, younger age, being employed, less emotional distress, and higher social support were significantly associated with higher perceived QoL in most domains, while LS was associated with female sex, being employed, less emotional distress, and better social support. Neither QoL nor LS was associated with cardiac defect severity.Conclusions The adults with CHD had poorer QoL and LS than their non-CHD peers in our developing country. Socio-demographics, emotional health, and social support were important 'determinants' of QoL and LS among the CHD patients. Longitudinal studies are warranted to establish causal links.
|
|
| 49. |
- Eslami, Bahareh, et al.
(författare)
-
Style of Coping and its Determinants in Adults with Congenital Heart Disease in a Developing Country
- 2014
-
Ingår i: Congenital Heart Disease. - : Computers, Materials and Continua (Tech Science Press). - 1747-079X .- 1747-0803. ; 9:4, s. 349-360
-
Tidskriftsartikel (refereegranskat)abstract
- Objective The objective of this study is to compare coping strategies between adults with and without congenital heart disease and to scrutinize the associations between different available resources (e.g., social support) and adoption of certain coping strategies.DesignThe study has a cross-sectional case-control design.SettingThe study was conducted in two university-affilliated heart hospitals in Tehran, Iran.Patients The participants comprised 347 persons (18–64 years) with and 353 individuals without congenital heart disease, matched by gender and age.Outcome Measures Coping strategies, assessed with the Utrecht Coping List-short form, were compared between both groups. Block-wise multiple regression analyses were conducted to scrutinize the associations between different independent variables (e.g., demographic/socioeconomic statuses) and adoption of certain styles of coping (dependent variables) among all participants and separately for each group.Results The styles of coping in the patients were comparable with those of the control group. Multivariate analyses revealed that congenital heart disease per se was not associated with style of coping except for palliative reaction pattern. The active problem-solving coping style was associated with never married marital status, parenthood, unemployment, higher level of anxiety/somatic symptoms, lower level of depressive symptoms, and better social support. The avoidance behavior style was associated with having a low income, whereas the expression of emotion style was associated with higher anxiety symptoms, experience of financial strain, and income. None of the adopted coping strategies was related to the heart disease variables.Conclusions The adults with congenital heart disease coped as well as adults without congenital heart disease. Marital status, parenthood, annual income, financial strain, psychological adjustment, and perceived social support were important explanatory factors in adopting a certain style of coping among adults with congenital heart disease. However, longitudinal studies with repeated measures are warranted.
|
|
| 50. |
- Eslami, Bahareh, 1978-
(författare)
-
The Psychosocial Situation of Adults with Congenital Heart Disease in Iran
- 2013
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background and objectives:Adults with congenital heart disease (CHD) are a new group of patients with a prevalence of 4 per 1000. They have evolved as a result of significant improvements in medical management during the past decades. However, adults with CHD experience various medical and social challenges that may influence their psychosocial functioning. Providing appropriate medical, rehabilitation and social care for adults with CHD, and indeed improving their well-being require the evaluation of their current psychosocial situation. This thesis aims to increase the understanding of the mental health, somatic symptoms, social support, style of coping, quality of life and life satisfaction of adults with CHD and to examine the possible contributing factors in the context of a developing country; issues not addressed in the current literature.Methods:This thesis is based on four studies. Study I recruited 347 consecutive CHD patients (18-64 years) from two heart hospitals in Tehran, Iran. The study iscross-sectional and focused on sex differences in socio-economic status, lifestyle and medical characteristics of adults with CHD. Studies II, III and IV havea cross-sectional case-control design comparing the aforementioned CHD patients with 353 non-CHD participants, matched by sex and age. Outcome variables were anxiety, depressive and somatic symptoms (Study II), styles of coping (Study III), and life satisfaction/quality of life (Study IV). The data were analysed with bivariate and multivariate methods. Multivariate linear regression analyses were performed to scrutinize the association of demographic/socio-economic variables, social support, mental health, and medical variables with the aforementioned outcome variables among adults with CHD (Studies II, III, IV). Results:Study I showed that women with CHD were more often married and had children and were less often employed, but had healthier behaviour compared to men. Even though most of the patients received regular medical viiicare from different typesof medical professionals, half of them had no knowledge about the type of their cardiac defect. Study II showed that CHD patients experienced more anxiety and somatic symptoms than the healthy controls, whereas there were no differences in depressive symptoms. Perceived financial strain, lower social support and low annual income were positively associated with worse outcome in mental health and somatic symptoms. None of the medical variables were related to anxiety, depressive and somatic symptoms. Study III showed that the styles of coping of the CHD patients were comparable to those of the control group and CHD per se was not associated with a certain style of coping, except for palliative reaction pattern. Problem-focused styles of coping were associated with being never married, parenthood, higher level of anxiety and somatic symptoms, lower level of depressive symptoms and higher social support. Emotion-focused styles of coping were associated with annual income and higher level of anxiety. None of theadopted coping strategies were related to the heart disease variables. Study IV showed that adults with CHD had poorer quality of life and lower life satisfaction than the control group. However, CHD was associated only with decreased overall quality of life and its physical health domain, and life and health satisfaction. Among CHD patients, higher quality of life was associated with female sex, younger age, employment status, having less emotional distress and higher social support, while life satisfaction was associated with female sex, being employed, less emotional distress and higher social support. Conclusions:The results support the notion that psychosocial factors contribute to the well-being of adults with CHD.Socio-economic factors, emotional health and social support are significant determinants in nearly all outcomes of interest which need to be considered by health care providers and policy makers in their efforts to improve the health ofadults with CHD. However, longitudinal studies are warranted to establish causal linksand qualitative studies are recommended to deepen the understanding of coping and quality of life.
|
|
