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- Malmberg Gavelin, Hanna, et al.
(författare)
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Effects of a process-based cognitive training intervention for patients with stress-related exhaustion
- 2015
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Ingår i: Stress. - : Taylor & Francis Group. - 1025-3890 .- 1607-8888. ; 18:5, s. 578-588
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Tidskriftsartikel (refereegranskat)abstract
- Stress-related exhaustion has been linked to a pattern of selective cognitive impairments, mainly affecting executive functioning, attention and episodic memory. Little is known about potential treatments of these cognitive deficits. The purpose of the present study was to evaluate the effects of a process-based cognitive training intervention, designed to target the specific cognitive impairments associated with stress-related exhaustion. To this end, patients diagnosed with exhaustion disorder (ED) were randomized to either a multimodal stress rehabilitation program with the addition of a process-based cognitive training intervention (training group, n = 27) or a treatment-as-usual control condition, consisting of multimodal stress rehabilitation with no additional training (control group, n = 32). Treatment effects were evaluated through an extensive cognitive test battery, assessing both near- and far transfer effects, as well as self-report forms regarding subjective cognitive complaints and burnout levels. Results showed pronounced training-related improvements on the criterion updating task (p < 0.001). Further, evidence was found of selective near transfer effects to updating (p = 0.01) and episodic memory (p = 0.04). Also, the trained group reported less subjective memory complaints (p = 0.02) and levels of burnout decreased for both groups, but more so for the trained group (p = 0.04), following the intervention. These findings suggest that process-based cognitive training may be a viable method to address the cognitive impairments associated with ED.
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- Sonntag-Öström, Elisabet, 1958-, et al.
(författare)
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"Nature's effect on my mind" : patients' qualitative experiences of a forest-based rehabilitation programme
- 2015
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Ingår i: Urban Forestry & Urban Greening. - : Elsevier. - 1618-8667 .- 1610-8167. ; 14:3, s. 607-614
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this study was to investigate the personal experiences and perceived effects on mind from visits to forest environments in a subset of patients with severe exhaustion disorder (ED), who participated in a randomized controlled trial for evaluation of forest-based rehabilitation.Participants: A subsample of 19 patients with diagnosed ED, who completed the three-month forest-based rehabilitation programme in the ForRest project, was interviewed.Method: The forest-based rehabilitation consisted of repeated forest visits with the main objective of spending time in rest and solitude in a chosen forest setting. Semi-structured interviews were carried out and analysed using Grounded Theory.Result: A core category and five subcategories were set up to describe the patients' experiences and development during the forest-based rehabilitation. As patients mostly reported that they strove to achieve peace of mind during the forest visits, Striving for serenity was chosen to be the core category. At first the patients were frustrated when left alone with their own thoughts in an unfamiliar forest environment. They gradually became familiar with the forest environments and also found their favourite places where they experienced peace of mind. They were then able to rest and begin reflective thinking about their life situation, which led to ambitions to change it. The preferred forest environments were characterised by openness, light and a good view, and were felt to be undemanding, peaceful and stimulating.Conclusion: Visits to the forest provided favourite places for rest, were experienced as restorative, seemed to improved reflection and may have contributed to starting the coping process for these patients. However, forest visits, as the only treatment option, are not sufficient as rehabilitation from severe and long-term ED. We suggest that forest visits should be integrated with cognitive behavioural therapy to further improve the recovery and enhance coping in daily life for these patients.
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- Wahlström, Viktoria, 1972-
(författare)
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Interventions for increased physical activity among office workers
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The positive association between physical activity (PA) and health is well established. Technical developments in modern life have created major changes in our societies and working life, and a growing body of research has identified sedentary behavior (SB) as an independent risk factor for type 2 diabetes, cardiovascular disease, and cancer as well as for premature mortality. To promote health, it is important to find ways to decrease SB and incorporate PA in office settings, for example, by using new office designs and behavioral interventions. The aim of this thesis was to evaluate two workplace interventions among office workers to determine if these led to increased PA and reduced SB, and to describe underlying factors behind these results. The thesis is based on two workplace interventions. The first intervention was the Inphact treadmill study, a 13-month randomized controlled trial where treadmill workstations were installed and participants were instructed to use the treadmill for at least one hour per workday. The second intervention was the Active Office Design (AOD) study. This study included a multicomponent PA promoting program, implemented in parallel with an office relocation to either traditional cell offices or to a flex office with activity-based work (ABW). The two groups in the AOD study were followed from 6 months before relocation to 18 months after. Objectively measured data for SB, PA, and body measurements were collected in both studies. In the Inphact treadmill study, body composition, metabolic outcomes, self-reported energy and stress, and depression and anxiety scores were also measured. In the AOD study, measurements of health and lifestyle, musculoskeletal disorders, workload, work tasks, utilization of possibilities to be active at work, and perceptions of the performed PA promoting program were assessed via questionnaires. In addition, interview data were collected via focus groups and individual interviews. Linear mixed models were used for the main statistical analyses of the quantitative data. To explore the factors that influence SB and PA at work we combined factor analysis of mixed data with multiple linear regression.Interview data were analyzed using qualitative content analysis and a deductive approach to a process evaluation model. In both study populations, sitting time was low and standing time was high already at baseline, compared to other studies on office workers. In the Inphact treadmill study, the intervention group showed increased walking time during workdays compared to the control group for all follow-up measurements. At the same time, a decrease in moderate-to-vigorous PA (MVPA) was observed in both the intervention and control groups during leisure time. No intervention effects were seen on body measurements, body composition, metabolic outcomes, stress, or anxiety during the treadmill intervention. In the AOD study, employees relocated to flex offices increased their walking time and MVPA during work hours to a greater extent than those relocated to cell offices, but neither group changed the amount of time spent sitting at work. Contrary to the Inphact treadmill study, no compensatory effects were seen during leisure time. The exploratory analysis resulted in six employee character-types, where the “harmonic and healthy” and “engaged with high workload” tended to sit more and to stand less, while the character type with “high BMI, creative and collaborative work” tended to sit less and stand more. The process evaluation of the intervention revealed a strong culture to encourage PA within the organization and that the intervention was supported by management. The timing of the program was questioned, and activities to support the relocation to the flex office with ABW were requested. Social acceptance for standing and walking at work increased, although the need for the intervention was debated due to the strong culture of facilitating PA at work already in place prior to the study. In conclusion, we showed long-term increases in PA were achieved in office workers, but the changes did not lead to improvements in body measurements and metabolic balance during the follow-up period. The two studies showed conflicting results regarding compensatory effects during leisure. Participants in the Inphact treadmill study decreased their MVPA during leisure, while no compensatory effects were seen in the AOD-study. Our results suggest a possible ceiling effect for the amount sitting time can be reducedin office workers, and that SB and PA in offices is influenced by many factors, such as organizational culture, physical environment, work tasks, work load and physical comfort. Together, the studies in this thesis confirm the importance of carefully tailored worksite interventions for decreasing SB and increasing PA at work.
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