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- Eklund, Caroline, 1983-
(författare)
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Development and evaluation of a web application for stress management : Supporting behaviour change in persons with work related stress
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Stress is the most common reason for sick leave in Sweden. Stress can lead to health-related problems such as burnout syndrome, depression, sleep disorders, cardiovascular disease and pain. It is important to handle stress at an early stage before it could lead to health-related problems. The web enables to reach many persons at a low cost. Web-applications have proven to be effective regarding several health-related problems. However, adherence is often low and many of the available stress management-programs have not been based on evidence. The overall aim of the thesis was to develop and evaluate a fully automated, evidence-based web-application for stress management for persons experiencing work related stress. The thesis compiles of four studies. Study I contained the systematic development of the program in three phases. Phase one included the development of the program's theoretical framework and content, and phase two consisted of structuring the content and developing the platform to deliver the content from. The third phase consisted of coding the behaviour change supporting content, validation of the program among experts and testing it with one possible end-user. The result was an interactive web-application tailored to the individual's need for stress management supporting behaviour change in several ways; My Stress Control (MSC). In study I, MSC was also tested regarding how to proceed through the program. The results showed that the participants had trouble to reach the program’s end. In study II the feasibility of the coming RCT study procedure was investigated as well as how feasible MSC, the web-application, was to be applied in a larger study. 14 persons participated in study II. The findings proved the scientific study procedure feasible with minor changes, but some changes were required for the web-application to increase the chance for success in a larger, more costly study. In study III nine of the 14 persons that participated in study II were interviewed. The interviews aimed for a better understanding of how the participants experienced the program to further develop it. One theme was identified: Struggling with what I need when stress management is about me. It described an understanding for that stress management takes time and is complex but that it was difficult to find the time for working with it. In study IV, a randomized controlled trial, MSC was evaluated regarding its effect on stress. One group with access to MSC was compared to a wait-list group. 92 persons participated in study IV. The results showed that there were no significant between- or within group differences on perceived stress. A small effect size of MSC on perceived stress was shown between intervention- and wait-list groups, but adherence to the program was low.These studies support that a web-application based on the evidence within multiple fields may have effect on perceived stress. However, to handle stress on one’s own is complex and the paradox in having one more thing to do when already stressed contribute to a conflict on how to handle the task. How to facilitate adherence to the fully automated program should be further investigated in future studies.
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| 2. |
- Fondell, Elinor, et al.
(författare)
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Physical Activity, Stress, and Self-Reported Upper Respiratory Tract Infection
- 2011
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Ingår i: Medicine & Science in Sports & Exercise. - : LIPPINCOTT WILLIAMS & WILKINS. - 0195-9131 .- 1530-0315. ; 43:2, s. 272-279
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Upper respiratory tract infection (URTI) is the most common reason for seeking primary care in many countries. Still, little is known about potential strategies to reduce susceptibility. We investigated the relationships between physical activity level, perceived stress, and incidence of self-reported URTI. Methods: We conducted a population-based prospective cohort study of 1509 Swedish men and women aged 20-60 yr with a follow-up period of 4 months. We used a Web-based questionnaire to assess disease status and lifestyle factors at the start of the study. We assessed physical activity and inactivity as total MET-hours (MET task) per day and perceived stress by the 14-item Perceived Stress Scale. Participants were contacted every 3 wk via e-mail to assess incidence of URTI. They reported a total of 1181 occurrences of URTI. We used Poisson regression models to control for age, sex, and other potential confounding factors. Results: We found that high levels of physical activity (>= 55 MET.h.d(-1)) were associated with an 18% reduced risk (incidence rate ratio (IRR) = 0.82, 95% confidence interval (CI) = 0.69-0.98) of self-reporting URTI compared with low levels of physical activity (< 45 MET.h.d(-1)). This association was stronger among those reporting high levels of stress (IRR = 0.58, 95% CI = 0.43-0.78), especially among men (IRR = 0.37, 95% CI = 0.24-0.59), but absent in the group with low levels of stress. Conclusions: We found that high physical activity was associated with a lower risk of contracting URTI for both men and women. In addition, we found that highly stressed people, particularly men, appear to benefit more from physical activity than those with lower stress levels.
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| 3. |
- Fondell, Elinor, et al.
(författare)
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Short natural sleep is associated with higher T cell and lower NK cell activities
- 2011
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Ingår i: Brain, behavior, and immunity. - : Elsevier BV. - 0889-1591 .- 1090-2139. ; 25:7, s. 1367-1375
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Tidskriftsartikel (refereegranskat)abstract
- Short sleep duration increases the risk of several diseases, possibly involving compromised immune function. However, most previous studies are based on experimentally induced sleep deprivation, and only a few have studied natural variations in sleep duration. Thus our aim was to study how natural variations in sleep duration affect immune function. In total, 36 healthy men and women, aged 20-54, donated blood; 29 on three consecutive mornings, and seven on one morning. Each morning, participants self-reported sleep duration the night prior to blood draw. General sleep patterns, physical activity and stress were also assessed. A flow-cytometric assay was used to measure natural killer cell activity (NKCA), T cell function (in response to PHA, influenza, and SEA+B), and B cell function (in response to PWM) per volume whole blood. Short sleep duration prior to blood draw (<7h) was associated with 49% higher PHA-induced T cell function (95% CI 7/109%) and 30% lower NKCA compared with normal prior sleep (7-9h) (95% CI -46/-8%). In addition, high perceived stress was associated with 39% higher PHA-induced T cell function (95% CI 0/94%). High general physical activity was associated with 47% increased numbers of B cells and 28% increased numbers of T cells, but not with immune function. Our results suggest strong relationships between short sleep duration and T- and NK-cell functions. The stability of the findings as well as the clinical consequences of the link between short sleep and immune function should be explored in future studies.
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