1.
2.
Andersson, H. Ingemar, 1950-
(author)
Chronic pain : epidemiological studies in a general population
1998
Doctoral thesis (other academic/artistic) abstract
The aim was to study the epidemiology of chronic pain (> 3 months duration) and factors associated to pain prevalence, prognosis, health care and medication in a general population. A cross-sectional mailed survey to a random population sample (n = 1806) was followed by a clinical examination and a prospective study of three selected groups. Pain related diagnoses from primary health care was monitored and compared with pain prevalence. The most important findings were: - a high total prevalence of chronic pain, 55.2%, without gender difference but varying by age and socioeconomic level. About one fourth (12.8%) reported high pain intensity and functional impairments. Women experienced pain at more locations and with higher intensity. - in a multivariate analysis increasing age, female gender, low education, high work strain, depression and insomnia were associated with chronic pain. - widespread pain showed a worse 2- year prognosis compared with neck shoulder pain. - musculoskeletal location of pain dominated, myalgia and myofascial pain being the most common symptom descriptions. - co-morbidity with chronic pain was common. More hypertensives and an increased level of serum uric acid associated to widepread pain indicated possible metabolic connections to pain. - smoking (current and previous) was associated with low-back and widespread pain. - chronic pain had a substantial influence of primary health care-seeking and medication; high pain intensity being the most important predictor of care and medication. - pain related diagnoses in primary health care increased between 1987 and 1996. Chronic pain, mainly with musculoskeletal location, is a community health problem. A multi-factorial approach in prevention and treatment on the basis of present knowledge is necessary.
3.
Björklund, Margereth, 1950-
(author)
Living with head and neck cancer : a health promotion perspective - a qualitative study
2010
Doctoral thesis (other academic/artistic) abstract
Background and aim: In society there is a growing awareness that a vital factor for patientswith chronic diseases, such as head and neck cancer (HNC), is how well they are able to function in their every day lives – a common, but often overlooked, public health issue. The overall aim of this thesis is to reach a deeper understanding of living with HNC and to identify the experiences that patients felt promoted their health and well-being. It also explores the patients' experiences of contact and care from health professionals and whether these encounters could increase their feelings of health and well-being; salutogenic approach.Methods: This thesis engages a qualitative data design. On three occasions, 35 purposivelyselected patients were interviewed (31 from Sweden and one from Denmark, Finland, Island, and Norway). The first study was conducted in the Nordic counties (I), and the remainingstudies were conducted in Sweden (II, III, IV). Interviews were performed on a single basis(I, II, III) and then repeated (IV). The individual, semi-structured qualitative interviews usedopen-ended questions (n=53). Three different forms of analyses were used: critical incident technique (I), thematic content analysis (II), latent content analysis (III), and interpretativedescriptive analysis (paper IV).Findings: Living with head and neck cancer was expressed as living in captivity, in the sensethat patients' sometimes life-threatening symptoms were constant reminders of the disease. The patients experienced a threat against identity and existence. Patients struggled to find power and control over everyday life, and if successful this appeared to offer them better health and well-being along with spiritual growth. The general understanding was that these patients had strong beliefs in the future despite living on a virtual rollercoaster. The patients went through a process of interplay of internal and external enabling that helped them acquire strength and feelings of better health and well-being. Consequently, they found power and control from inner strength and other health resources, e.g. social networks, nature, hobbies, activity, and health professionals. However, the findings also revealed the opposite; that some patients were more vulnerable and felt powerless and faced everyday life with emotional and existential loneliness. They were dependent on next of kin and health professionals. Having good interpersonal relationships and emotional support 24 hours a day from next of kin were crucial, as were health promoting contacts and care from health professionals. This health promoting contact and care built on working relationships with competent health professionals that were available, engaged, respectful, validating, and, above all experienced in the treatment phase. But many patients experienced not health promoting contact and care – and a sense of not being respected, or even believed. Added were the patients' experiences of inadequate coordination between phases of their lengthy illness trajectory. They felt lost and abandoned by health services, especially before and after treatment.Conclusions: Inner strength, good relationships with next of kin, nature, hobbies, andactivities could create strength and a sense of better health and well-being. Patients experienced a mutual working relationship during dialoguing and sensed co-operation and equality in encounters with competent health professionals. This could lead to enhanced power and control i.e. empowerment in a patient's everyday life. The findings highlight psychosocial rehabilitation in a patient-centred organisation when health professionals supportpatients' inner strength and health resources , and also offer long-term support to next of kin.Finally, this research suggests that if health professionals could gain a deeper understanding of the psychosocial, existential, social, and economic questions on patients' minds, they could better sense how patients feel and would be better equipped not only to offer greater support, but to raise their voices to improve health policy and health care for these patients.
4.
Sollerhed, Ann-Christin, 1954-
(author)
Young today - adult tomorrow! : studies on physical status, physical activity, attitudes, and self-perception in children and adolescents
2006
Doctoral thesis (other academic/artistic) abstract
The aim was to gain knowledge of young people's physical status and physical activity, and to further the understanding of the role of school physical education in a salutogenic public health perspective. Two studies were performed in southern Sweden. Study 1 was performed in 1996 among 301 adolescents aged 16-19 in upper secondary school. It comprised three parts: a questionnaire, seven physical tests, anthropometrical measures and information on every student's grades. Study 2, with a longitudinal design and annual measurements, was performed in 2000-2003 (n=205- 275) among children aged 6-12 in two primary schools, one intervention school with expanded physical education lessons, and one norm school which followed the stipulated curricular time. The study comprised a questionnaire, eleven physical tests and anthropometrical measures. In Study 1, students in practical education for occupations such as industrial and building workers, mechanics, assistant nurses and hairdressers, all of which are occupations involving physical effort, had lower physical capacity than students in theoretical education among both boys and girls. A correlation was found between physical capacity and grades. An interrelation between Sense of Coherence (SOC) and attitudes to physical education was found, indicating that past experiences of physical activity and physical education could contribute to the development of SOC, and actual levels of SOC could influence the persistent attitudes to physical education and be important for lifelong physical activity. Study 2 showed high self perceived competence in physical education among children to be associated with high physical performance, male gender, low age, living with both parents, high self perceived physical fitness and enjoying physical education. Children who followed an expanded physical education programme during the three-year follow up showed positive changes in physical performance compared to children in the norm school. The number of children with increasing body mass index (BMI) rose in both schools, but a lower increase in BMI could be seen in the intervention school. In both Study 1 and 2, the highest physical capacity was found among children and adolescents who reported a high level of physical activity in leisure time. This thesis shows it is possible to achieve improvement in physical status among young people with an increase of physical education lessons in school. Differences in physical capacity between prospective blue-collar and white-collar workers already in adolescence during education emphasize the need for early interventions to increase physical activity and capacity in young people. Physical education in the school setting could be seen as an important arena for improving physical capacity, positive self-perceptions and positive attitudes to physical activity, which could be important for public health.
5.
Nilsson, Petra, 1980-
(author)
Enhance your workplace! : a dialogue tool for workplace health promotion with salutogenic approach
2010
Doctoral thesis (other academic/artistic) abstract
The aim of this thesis was to develop and make a quality assessment of a tool, which includes a questionnaire and a dialogue process that could be useful for workplace health promotion from a salutogenic point of view. The studies have been performed within two health care organizations between 2005 and 2009, together with hospital staff. Two questionnaire studies were conducted (n=446 n=505, respectively). A focus group interview study was performed (n=78), and meetings were held in an action research process for applying a questionnaire process at two wards (n=69). The result shows a development process for a multi-dimensional questionnaire, the Work Experience Measurement Scale (WEMS), which can be used to measure work experiences from a salutogenic perspective. WEMS was shown to be a functional workplace health promotion questionnaire with the ability to discriminate between groups. Its psychometric properties support its applicability in health care settings and offer a possibility to measure trends over time regarding employees´ work experiences. A dialogue structure for progress in the questionnaire process is presented. It describes what to precede and how to proceed through a workplace questionnaire process to foster applicability, meaningfulness, and sustainability. Through WEMS, the outcome of work-related Specific Enhancing Resources (SER) may be highlighted and strengthened in workplace activities. When used as a dialogue tool in a continuous questionnaire process, WEMS has the potential of being a useful assessment tool in workplace health promotion. Such a dialogue tool is useful in discussions and tangible for the work of enhancing positive human capabilities and resources (SER) that improve work performance.
6.
Törnquist Agosti, Madelaine
(author)
Att finna sin egen kraft : hälsopromotion på arbetsplatsen utifrån BELE – ett program för att främja ett salutogent livspussel bland kvinnlig vård-, stöd- och omsorgspersonal
2018
Doctoral thesis (other academic/artistic) abstract
The overall aim of this thesis was threefold; first, to explore resources associated with work-life balance (WLB), with a focus on the work and private lives of human service employees. Second, to develop a workplace health promotion (WHP) intervention with a WLB focus. Third, to explore the participants’ experiences of the developed WHP intervention done in the workplace. A mixed method approach was used to answer the research questions. The thesis is based on two qualitative studies, one quantitative study and one paper that describe the content and development process of the intervention. The qualitative studies were based on individual interviews and focus group interviews (I, IV). Thirteen semi-structured individual interviews and two focus group interviews were conducted with home help service nurses in Sweden (I). Eight focus group interviews and eight semi-structured individual interviews were conducted with participants in the intervention (IV). A qualitative content analysis was used for the analyses in the qualitative studies. The quantitative study was based on a questionnaire survey to a population of two municipality departments (n = 631, response rate 76%) (II). A linear regression model and logistics regressions models were used for the analyses. The planning and development of the intervention was done using an intervention mapping approach (III). The findings showed a complex picture of resources related to WLB. Resources could be found in the work domain, the private domain and the individual domain (I, II). In the work domain, it seems to be important to have a positive time experience and a meaningful job, but also to work part-time and do shift work. In the private domain, a positive time experience and social support was highlighted. Individual resources such as good health, well-being, reflection and satisfaction with one´s life situation were seen as essential to WLB. The development process of the intervention resulted in the “Balance in Everyday Life Empowerment” (BELE) program (III). The findings showed that a majority of the participants taking part in the BELE program experienced a process of change, often enhanced by an increased awareness, support and inner strength, which promoted well-being and balance in their everyday life (IV). In conclusion, it seems important to use a holistic approach where resources in the employees’ overall life situation are included for the enhancement of WLB. The BELE program was an attempt to contribute to WHP with a WLB focus, and the result indicates that the program was effective with regard to promoting employee well-being.
7.
Furenbäck, Ingela, 1963-
(author)
Utveckling av samverkan : ett deltagarorienterat aktionsforskningsprojekt inom hälso- och sjukvård
2012
Doctoral thesis (other academic/artistic) abstract
Syfte: Det övergripande vetenskapliga syftet med denna avhandling att nå en ökad förståelse om samverkansprocesser.Ansats och metoder: Studien har bedrivits genom deltagarorienterad aktionsforskning inom hälso- och sjukvården i Hässleholm. Aktörer på verksamhetsfältet har strävat efter att utveckla samverkan för att tillsammans kunna utveckla närsjukvård. Forskningen har genererat kunskap utifrån lokala omständigheter att tjäna som underlag för beslut om att genomföra praktiska förändringar i verksamheten. En kombination av olika metoder har använts för att generera empiriskt material, där den huvudsakliga metoden har varit deltagande observationer med dialog. Därutöver har intervjuer och granskning av dokument använts samt en forskningscirkel, som är en speciell metod inom deltagarorienterad aktionsforskning. Studien har haft en hermeneutisk ansats och tolkningar har gjorts med stöd av olika teoretiska perspektiv och modeller. Kurt Lewins fältteori har utgjort en övergripande teoretisk ram för studien.Resultat: En ökad förståelse om den studerade samverkansprocessen kunde nås genom att beskriva och tolka skeenden som antogs ha påverkat utvecklingen av samverkan. Processen beskrevs både utifrån vertikal och horisontell integrering inom och mellan organisationer. Beskrivningen innefattade komponenter som fanns både inom arbetsprocesser och sociala processer. Den studerade samverkansprocessen delades in i delprocesser där var och en del innehöll en viss typ av aktivitet som genomfördes för att stödja utvecklingen av samverkan. Två olika strategier för utvecklingen av samverkan identifierades och illustrerades genom olika modeller: den linjära hierarkiska modellen respektive den dynamiska modellen. Den sistnämnda utvecklades genom aktionsforskningen.Slutsatser:I ett första skede bedrev deltagarna på fältet samverkan med stöd av den linjära hierarkiska modellen. Denna modell utgör ett tankeschema där samverkan utvecklas i en linjär hierarkisk process. Politiker fattar beslut, chefer planerar och professionella genomför aktiviteterna. Modellen utgår ifrån ett konsensusteoretiskt perspektiv där konflikter betraktas som störande element. Det innebar i detta fall att aktörer inom olika domäner och organisationer undvek varandras olika föreställningsvärldar varpå samverkansprocessen stötte på hinder i utvecklingen. Aktionsforskningen intervenerade i processen genom arrangera kommunikationsarenor med deltagare från olika domäner och organisationer. Samverkan utvecklades på så sätt utifrån den dynamiska modellen. Denna modell innehåller antaganden om att samverkansprocesser är dynamiska och har sin utgångspunkt i ett konfliktteoretiskt perspektiv där konflikter betraktas som naturliga i processen.
8.
Sollerhed, Ann-Christin
(author)
Young today-adult tomorrow! Studies on physical status, physical activity, attitudes, and self-perception in children and adolescents
2006
Doctoral thesis (other academic/artistic) abstract
The aim was to gain knowledge of young people's physical status and physical activity, and to further the understanding of the role of school physical education in a salutogenic public health perspective. Two studies were performed in southern Sweden. Study 1 was performed in 1996 among 301 adolescents aged 16-19 in upper secondary school. It comprised three parts: a questionnaire, seven physical tests, anthropometrical measures and information on every student's grades. Study 2, with a longitudinal design and annual measurements, was performed in 2000-2003 (n=205- 275) among children aged 6-12 in two primary schools, one intervention school with expanded physical education lessons, and one norm school which followed the stipulated curricular time. The study comprised a questionnaire, eleven physical tests and anthropometrical measures. In Study 1, students in practical education for occupations such as industrial and building workers, mechanics, assistant nurses and hairdressers, all of which are occupations involving physical effort, had lower physical capacity than students in theoretical education among both boys and girls. A correlation was found between physical capacity and grades. An interrelation between Sense of Coherence (SOC) and attitudes to physical education was found, indicating that past experiences of physical activity and physical education could contribute to the development of SOC, and actual levels of SOC could influence the persistent attitudes to physical education and be important for lifelong physical activity. Study 2 showed high self perceived competence in physical education among children to be associated with high physical performance, male gender, low age, living with both parents, high self perceived physical fitness and enjoying physical education. Children who followed an expanded physical education programme during the three-year follow up showed positive changes in physical performance compared to children in the norm school. The number of children with increasing body mass index (BMI) rose in both schools, but a lower increase in BMI could be seen in the intervention school. In both Study 1 and 2, the highest physical capacity was found among children and adolescents who reported a high level of physical activity in leisure time. This thesis shows it is possible to achieve improvement in physical status among young people with an increase of physical education lessons in school. Differences in physical capacity between prospective blue-collar and white-collar workers already in adolescence during education emphasize the need for early interventions to increase physical activity and capacity in young people. Physical education in the school setting could be seen as an important arena for improving physical capacity, positive self-perceptions and positive attitudes to physical activity, which could be important for public health.
9.
Nilsson, Petra S
(author)
ENHANCE YOUR WORKPLACE! A dialogue tool for workplace health promotion with a salutogenic approach
2010
Doctoral thesis (other academic/artistic) abstract
The aim of this thesis was to develop and make a quality assessment of a tool, which includes a questionnaire and a dialogue process that could be useful for workplace health promotion from a salutogenic point of view. The studies have been performed within two health care organizations between 2005 and 2009, together with hospital staff. Two questionnaire studies were conducted (n=446 n=505, respectively). A focus group interview study was performed (n=78), and meetings were held in an action research process for applying a questionnaire process at two wards (n=69). The result shows a development process for a multi-dimensional questionnaire, the Work Experience Measurement Scale (WEMS), which can be used to measure work experiences from a salutogenic perspective. WEMS was shown to be a functional workplace health promotion questionnaire with the ability to discriminate between groups. Its psychometric properties support its applicability in health care settings and offer a possibility to measure trends over time regarding employees´ work experiences. A dialogue structure for progress in the questionnaire process is presented. It describes what to precede and how to proceed through a workplace questionnaire process to foster applicability, meaningfulness, and sustainability. Through WEMS, the outcome of work-related Specific Enhancing Resources (SER) may be highlighted and strengthened in workplace activities. When used as a dialogue tool in a continuous questionnaire process, WEMS has the potential of being a useful assessment tool in workplace health promotion. Such a dialogue tool is useful in discussions and tangible for the work of enhancing positive human capabilities and resources (SER) that improve work performance.
10.
Törnquist Agosti, Madelaine
(author)
Att finna sin egen kraft. Hälsopromotion på arbetsplatsen utifrån BELE- ett program för att främja ett salutogent livspussel bland kvinnlig vård-, stöd- och omsorgspersonal.
2018
Doctoral thesis (other academic/artistic) abstract
AbstractThe overall aim of this thesis was threefold; first, to explore resources associated with work-life balance (WLB), with a focus on the work and private lives of human service employees. Second, to develop a workplace health promotion (WHP) intervention with a WLB focus. Third, to explore the participants’ experiences of the developed WHP intervention done in the workplace. A mixed method approach was used to answer the research questions. The thesis is based on two qualitative studies, one quantitative study and one paper that describe the content and development process of the intervention. The qualitative studies were based on individual interviews and focus group interviews (I, IV). Thirteen semi-structured individual interviews and two focus group interviews were conducted with home help service nurses in Sweden (I). Eight focus group interviews and eight semi-structured individual interviews were conducted with participants in the intervention (IV). A qualitative content analysis was used for the analyses in the qualitative studies. The quantitative study was based on a questionnaire survey to a population of two municipality departments (n = 631, response rate 76%) (II). A linear regression model and logistics regressions models were used for the analyses. The planning and development of the intervention was done using an intervention mapping approach (III). The findings showed a complex picture of resources related to WLB. Resources could be found in the work domain, the private domain and the individual domain (I, II). In the work domain, it seems to be important to have a positive time experience and a meaningful job, but also to work part-time and do shift work. In the private domain, a positive time experience and social support was highlighted. Individual resources such as good health, well-being, reflection and satisfaction with one´s life situation were seen as essential to WLB. The development process of the intervention resulted in the “Balance in Everyday Life Empowerment” (BELE) program (III). The findings showed that a majority of the participants taking part in the BELE program experienced a process of change, often enhanced by an increased awareness, support and inner strength, which promoted well-being and balance in their everyday life (IV). In conclusion, it seems important to use a holistic approach where resources in the employees’ overall life situation are included for the enhancement of WLB. The BELE program was an attempt to contribute to WHP with a WLB focus, and the result indicates that the program was effective with regard to promoting employee well-being.
