1.
Tinnfält, Agneta
(författare)
Adolescents' perspective on mental health and health-promoting dialogues
2007
Licentiatavhandling (övrigt vetenskapligt/konstnärligt) abstract
Young people in Sweden are satisfied with most things in their lives. But they are not satisfied with school and not with their opportunities for personal influence. The Convention on the Rights of the Child emphasizes the right for children to express their views freely and that their views should be given due weight. In the present academic essay adolescents, 13, 15 and 16 years old, have been interviewed about matters concerning mental health. The overall aim of the study is to increase our knowledge of adolescents´ perceptions, of mental health and of school nurses´ mental health-promoting dialogue. Focus groups were used in the data collection in study I, as well as in study II. In study II these were combined with individual interviews. Altogether 26 adolescents in study I and 48 in study II were interviewed. Content analysis was used in the analysis in study I, and in study II a phenomenographical approach was used in the analysis. The findings in study I include what issues to discuss and where the school nurse’s mental health-promoting dialogue should take place. The findings show that adolescents emphasize as most important what the school nurse is like as a person in the health-promoting dialogue, and that trust, attentiveness, respectfulness, authenticity, accessibility during school hours and continuity are established. In study II, the findings show that adolescents find mental health to be an emotional experience where positive and negative health is part of the concept. Family is perceived as the most important determinant for young people’s health, closely followed by friends and thereafter school. The girls and the boys in study II did not feel that there were large differences in mental health between girls and boys, but they saw differences in the way they act; girls are talkative and emotional, and boys are silent and tough. Age differences seem to be more important than gender in the adolescents’ perception of mental health. The findings are discussed in relation to gender and previous research. Furthermore, the voice of young people and ethical issues in interviewing young people are discussed. The findings are thereafter placed in an ecological model.
2.
Olsson, Ulf
(författare)
OM FRISKVÅRDSPEDAGOGIK I ARBETSLIVET. : EN O/RÄTTVIS BETRAKTELSE.
1993
Licentiatavhandling (övrigt vetenskapligt/konstnärligt) abstract
I fokus för detta arbete står friskvård inom arbetslivet som pedagogisk praktik med hälsoprofilsbedömning, en metod för undersökning och påverkan av människors hälsostatus och hälsovanor, som konkret exempel. En bakgrund till detta är framväxten av insatser för folkhälsa och den ökade betoning av friskvård inom arbetslivet som skett inom såväl privat som offentlig sektor. Friskvård handlar om människors levnadsvanor när det gäller kost, motion, stress, alkohol, tobak m.m.Hälsoprofilsbedömning och friskvårdspedagogik inom arbetslivet ses här ur två olika perspektiv. Ur det ena perspektivet behandlas verksamheten på dess egna villkor - som en metod att inom ramen för arbetslivet få till stånd ner hälsosamma livsstilar genom kontrakt mellan självständiga parter. Det andra perspektivet kan ses som kritiskt granskande. Här ifrågasätts premissema för hälsoprofilsbedömningen utifrån begrepp som makt och disciplinering. En inspirationskälla har därvid bland annat Michel Foucaults arbeten varit. Som empiriskt material för analysen används två avhandlingar som presenterar hälsoprofilbedömningen som metod.Ur dessa båda perspektiv erhålles två olika betraktelser om hälsoprofilsbedömning och friskvårdspedagogik inom arbetslivet - en rättvis och en orättvis. På basis av en kritisk pragmatisk ansats diskuteras möjligheten till ett samtal baserad på relationen mellan de båda betrakelserna.
3.
Cakici, Baki, 1984-
(författare)
Disease surveillance systems
2011
Licentiatavhandling (övrigt vetenskapligt/konstnärligt) abstract
Recent advances in information and communication technologies have made the development and operation of complex disease surveillance systems technically feasible, and many systems have been proposed to interpret diverse data sources for health-related signals. Implementing these systems for daily use and efficiently interpreting their output, however, remains a technical challenge. This thesis presents a method for understanding disease surveillance systems structurally, examines four existing systems, and discusses the implications of developing such systems. The discussion is followed by two papers. The first paper describes the design of a national outbreak detection system for daily disease surveillance. It is currently in use at the Swedish Institute for Communicable Disease Control. The source code has been licenced under GNU v3 and is freely available. The second paper discusses methodological issues in computational epidemiology, and presents the lessons learned from a software development project in which a spatially explicit micro-meso-macro model for the entire Swedish population was built based on registry data.
4.
Miedema, Elke, 1985
(författare)
HEALTH PROMOTION AND HEALTHCARE ARCHITECTURE - Conceptualizations of Health Promotion in relation to Healthcare Building Design
2017
Licentiatavhandling (övrigt vetenskapligt/konstnärligt) abstract
Background: Today's healthcare system is under development and reorienting and adapting to embrace a person centred and holistic perspective on health, including a focus on health promotion. This reorientation results in changes in the healthcare models, processes as well as it sets new requirements for healthcare building design. A vast majority of research has been devoted to the relation between inpatient healthcare building design and individual health, e.g. how our hospitals affects treatments and patient outcomes. Less attention has been paid to the relation between outpatient healthcare building design and public or population health and wellbeing, e.g. healthcare in the community to lessen the load on large hospitals. At the same time as the aforementioned development is happening there is a growing body of research emphasizing the importance of the built environment for public health. Objective: This licentiate thesis aim to explore conceptualizations of health promotion in the context of outpatient healthcare building design, the aim is to enable a broader platform to enable incorporation of several health promotion perspectives into future healthcare building design. The main research question is: How is health promotion conceptualized in the context of outpatient healthcare building design? In addition, several other questions emerged in the research process: What aspects of building design result in health-promoting building design? How is health-promoting building design conceptualized in the literature and in practice? What tools and outcomes are referred to when evaluating health-promoting building design? Methods: The research included two studies with an explorative approach: a scoping review and a content analysis of interviews. Results: The results present different conceptualizations of health promotion in the context of healthcare building design. In addition, the results provide an interpretation of health-promoting building design. The results also relate to health promotion strategies, perspectives on health-promoting building design and some aspects of building design that can contribute to, or prevent, health promotion. Discussion: The discussion emphasizes challenges related to developing health-promoting building design, such as vague and contradicting definitions and interpretations of core concepts as health promotion and itís interpretation in the built environment. In addition, the discussion highlights the challenges associated with evaluating health-promoting building design. Conclusions: Health promotion perspectives, have been shown to influence healthcare building design through altered implications for the built environment. As shown, healthcare building design thus seems to have the opportunity to promote the health and wellbeing of patients, staff, visitors and the community. However, the vocabulary used to address health promotion, the different perspectives and health-promotion is weak and inconsistent. The thesis therefore proposed definitions for health promotion and health-promoting building design, that might guide future research and discussions on health promotion vocabulary. Future research should focus on developing the health-promoting building design vocabulary, collecting examples of health-promoting building design, relating health promotion theory to existing architecture theory, and methods and outcomes to evaluate health-promotion building design.
5.
6.
Erichsén, Eva, 1959-
(författare)
Constipation in palliative care : Prevalence, definitions, symptom distress and risk-factors
2015
Licentiatavhandling (övrigt vetenskapligt/konstnärligt) abstract
Background and aims: Constipation for patients in palliative care is common and described with variations in prevalence. Side -effects from opioid- treatment, is considered to be one of the main factors leading to constipation. The overall aim of the thesis was to study constipation among patients admitted to specialized palliative care- settings in Sweden. The specific aims of the thesis were 1) To describe and explore the prevalence, definition and symptom distress of constipation by applying different definitions of constipation, in patients admitted to specialized palliative care settings in Sweden. 2) To identify factors related to constipation in patients in specialized palliative care and comparing these factors for patients with different types of constipation to patients without constipation.Methods: A literature- search were conducted where prevalence of- and factors related to constipation was explored and included in a questionnaire, developed for this thesis. Data was collected in a cross- sectional design with a response rate of 50% and analysed with logistic regression.Results: A total of 485 patients from 38 specialized palliative care- units in Sweden participated. Prevalence of constipation for patients in specialized palliative care varied between 7- 43 % depending on definition used. Two different constipation- groups were identified: Medical constipation- group 23% (MCG) and Perceived constipation- group 35% (PCG). Three sub- groups was also identified: patients with i) only ≤ 3 defecations/week, 7%, ii) only perception of being constipated, 19%, and iii) patients with both ≤ 3 defecations/ week and perception of being constipated,16%. Several factors were found to be related to constipation as hospitalisation, absence of laxative- treatment, haemorrhoids, poor appetite, hard stool form and opioids.Conclusions: Prevalence of constipation may differ depending on definitions used. Distress from constipation and other factors related to constipation, than opioids, needs to be incorporated into the clinical constipation- assessment. Validated constipation assessment tool needs to be developed.
7.
Hermann, Veronica, 1972-
(författare)
Psykisk hälsa, psykisk ohälsa och relaterat stigma : En kvalitativ studie utifrån ungdomars perspektiv
2022
Licentiatavhandling (övrigt vetenskapligt/konstnärligt) abstract
Adolescent mental health problems are a well-recognized and frequently discussed societal problem in Sweden. However, few studies concerning adolescents’ own views on mental health concepts and associated stigma have been conducted. This thesis, including two sub-studies, investigated Swedish adolescents’ views of mental health concepts, mental health problems and perceptions about stigma. A total of 32 adolescents on the Swedish island Gotland were interviewed either in focus groups or individually.In sub-study I on mental health concepts, adolescents described mental well-being as a condition with emotional well-being and good psychological and social function, which they termed to feel well. Mental health problems were described as a spectrum of conditions, caused by several factors. All kinds of mental health problems were termed to feel unwell or to not feel well. Both the presence of mental well-being and symptoms of mental health problems were suggested to be considered when assessing young peoples’ mental health.Sub-study II explored adolescents’ perceptions of the prevalence of mental health problems and related stigma among young people. The adolescents perceived mental health problems as a natural part of their lives and explained the increase by current living condition factors, e.g. pressure related to school or social media and improved openness about mental health problems. Stigmatisation of young people with mental health problems were recognised to be caused by prejudice, triggered by lack of knowledge. The adolescents wished for a future without stereotypic gender norms and stigma of mental health problems.In conclusion, findings of the thesis suggest that adolescents’ descriptions of mental health concepts encompass a broad range of conditions, from normal challenges that can cause distress to severe disabling mental health problems. Furthermore, adolescents acknowledge the simultaneous presence of mental wellbeing and mental health problems, as well as stigma consisting of negative preconceptions, stereotyping and discrimination. The results highlight that adolescents have a complex contextual understanding of mental health problems, but use the terms to feel well or unwell, of which adults need to be aware. Additionally, taking rumour spreading seriously and actively addressing stereotypic gender norms could be important to improve adolescents’ mental health.
8.
9.
Thodelius, Charlotta, 1975
(författare)
Risker och rum. Riskmiljöer och riskfaktorer för barn och ungas skadehändelser i hem- och boendemiljön.
2016
Licentiatavhandling (övrigt vetenskapligt/konstnärligt) abstract
This thesis addresses the concept of risk and the understanding of risks in relation to children’s and adolescents’ injury events in the residential setting. The thesis is based on three main studies, the first study evaluate the register data used in study III, the second study is a literature review and the third study is an empirical study based on register data from the healthcare sector. Study I discuss the methodological and analytical challenges related to work with data collected for another cause. The main data in the statistical analysis in study I is from hospital registration and it is origin designed for epidemiological research and not for a more complex situational or social analysis. To overcome the challenges the empirical analysis in study III was conducted with a mixed method approach, using both quantitative and qualitative data.The aim of study III is to map some of the factors that interplay in injury events in the residential environment, the main focus in the analysis is the relation between the individuals’ position and the physical environment. The two main results in study III are: that age and household income are the two main protective factors, the dwelling type has an effect on some injury events, even after control for other variables (age, gender, household income and ethnicity), but different rooms has different risk profiles. The study also shows the importance of an understanding of the function of the built environment, the physical room has often one primary intention and function but the room also creates an opportunity structure for alternative social praxis. In conclusion, the licentiate thesis has had a focus on the term risk and the understanding of risk from different perspectives. The thesis will be the starting point for the further PhD-project regarding prevention, since the understanding of risks are the foundation of prevention.
10.
Hultman, Barbro
(författare)
Self-rated quality of life among unemployed people and people in work in northern Sweden
2007
Licentiatavhandling (övrigt vetenskapligt/konstnärligt) abstract
Self-assessed quality of life (QoL) is analysed using a QoL questionnaire (Hörnquist’s QLcs)covering the life spheres: somatic health, mental well-being, cognitive ability, social and family life,activity, financial situation, meaning in life and a global score for ‘entire life’. In all, 487unemployed and 2917 employed subjects aged 25-64; and 651 unemployed subjects and 2802 inwork (including employment, studying and military service) in the 18-24 age group, wereinvestigated in a population-based cross-sectional study on life and health in northern Sweden in1997.In line with previous findings, results showed that unemployed people exhibited poorer QoL. Thegreatest difference between unemployed people and those in work was in the financial domain (18-24, 25-64). Unemployed women (aged 25-64) rated the final values of QoL – ‘entire life’ andmeaning in life – higher than unemployed men did. In the young group (aged 18-24), unemployedwomen did not rate any of the domains higher. The young unemployed men rated somatic health andmental well-being higher. Interaction effects were interpreted in the following way: a) unemployedmen (aged 25-64) were worst off in the global domain ‘entire life’; b) employed respondents, havinga university/college education was beneficial for QoL, while for unemployed respondents (25-64) itwas not; c) in the young group (aged 18-24), people in work rated their activity higher thanunemployed people, and the effect was strengthened when they were regularly active during leisure.Close friends and cash reserve were important for all participants, no matter whether they wereemployed or not. The risk of being young and unemployed was greater if the person had a shortereducation, worse economy (according to their own ratings) and was in the upper half of the agegroup (aged 21-24). Finally, the conclusion that QoL is poorer when in unemployment – both for theyoung and those who are older (aged 25-64) – is in line with earlier findings; however, in contrast tothree previous studies, we conclude that psychological well-being is even poorer for young peoplethan for those who are older.Intervention, in terms of steadily improved labour market conditions to counteract the negativeeffects of exclusion from the labour market, is of great importance from a public health perspective.
