Norwegian pre-service teacher students' and public health nursing students' views on health - a qualitative study of students' perceptions

PURPOSE

In 2020, the Norwegian school curriculum was revised, introducing a new cross-curricular subject, Public Health, and Life Skills. The curriculum emphasizes collaboration between teachers and the school health service. Subsequently, a research project, Literacies for Health and Life Skills, was initiated at Oslo Metropolitan University. The aim was to develop a new approach to the subject. A part of the research was to explore perceptions about good and poor health among teacher students and public health nursing students.

METHODS

This study has a qualitative design using auto-photography, group discussions and photo-elicitation interviews as methods to explore the students' views on health.

RESULTS

A analysis revealed three themes about good health in both student groups: Relaxation and tranquillity, belonging and relations, and enjoyment as important to health. Three themes about poor health emerged in both student groups: The ideal body and self-perception, you are as healthy as you feel, and the best in life is also the worst. The students' statements were characterized by underlying assumptions about health in society, with a focus on "healthism". No major differences between the student groups were found.

CONCLUSION

This study serves as a step towards increased understanding of health perceptions among future professionals working with children and adolescents.

Health literacy and musculoskeletal disorders in adolescents: a scoping review

OBJECTIVES

Health literacy (HL) related to musculoskeletal disorders (MSDs) in adolescents is a field with limited previous evidence. This study aimed to review and synthesise studies on MSDs and HL as well as various dimensions of HL in adolescents.

DESIGN

Scoping review in accordance with Arksey and O'Malleys framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.

SEARCH STRATEGY

The search strategy was performed in the following databases in November 2021 (initial search) and December 2022 (updated search); Medline, EMBASE, PsychINFO, Cochrane, CINAHL, ERIC, Web of Science and Google Scholar. Eligible studies involving MSDs and HL or either of the HL dimensions related to finding, understanding, appraising or applying health information in adolescents were considered. Any dimension of HL studied, the outcome measure(s) used to assess HL and the type of MSD examined were charted, reviewed and synthesised. A directed content analysis was used for the subjective interpretation of text data.

RESULTS

A total of 16 841 studies were identified and 33 were eligible for inclusion. Ten articles presented HL with a definition or description in the theoretical background. The remaining 23 studies involved finding, understanding, appraising or applying health information, without using the term 'health literacy'. Most of the studies addressed how adolescents understand (n=32), and apply (n=23) health information, while few studies focused on how they find (n=11) and appraise (n=7) musculoskeletal health information.

CONCLUSION

Few studies have addressed HL and MSDs in adolescents explicitly, while most studies have considered dimensions of HL. Our findings suggest that there is important work to be done to align conceptual understandings with the measurement of HL in adolescents and that further research should be carried out to explore how HL is distributed among adolescents with MSDs and how adolescents living with MSDs report their HL.

The imperative to develop health literacy: An ethical evaluation of HealthLit4Kids

An imperative exists to promote health literacy (HL) development in today's young people. Included in curricula worldwide, health literacy has been recognised as a social determinant in its own right, which has the potential to redress inequity and positively impact health and educational outcomes. While it has been shown that schools provide an ideal setting to support HL development, available evidence suggests that health may be undertaught in primary schools, and further resources are required to support educators' inclusion of HL in their lessons. The aims of this paper were to (1) highlight the ethical imperative to promote HL through schools and (2) provide an ethical evaluation of an existing HL intervention. Spike's (2018) four principles for public health ethics were employed as a framework for evaluating a program's ethical status and suitability in the school setting. In this paper, one program, HealthLit4Kids, is evaluated according to Spike's framework, and shown to be an ethically acceptable approach to foster HL in young people. These results model how other HL programs may be evaluated and offer critical insights concerning how HL could be promoted in an ethically acceptable manner in the classroom.

Oral Health Literacy, Sense of Coherence and Associations With Poor School Performance

BACKGROUND

This study aimed to investigate the associations of oral health literacy (OHL), sense of coherence (SOC) and other covariates with self-reported school performance (SRSP) in adolescents enrolled in public schools in Brazil.

METHODS

This was a cross-sectional study conducted with adolescents aged from 14 to 18 years enrolled in 6 public schools in Piracicaba, São Paulo, Brazil. Researchers carried out data collection at schools using a self-administered structured questionnaire. The dependent variable was SRSP. The explanatory factors included were sociodemographic characteristics, OHL, SOC, self-rated oral health, health behaviors, and experience of bullying. Analyses included simple and multiple logistic regression models.

RESULTS

The final sample consisted of 385 adolescents with a mean age of 16 years. Poor school performance was associated (95%CI) with being male, with more than 1 sibling, individual whose last visit to the dentist was due to dental pain, with a lower level of OHL and SOC.

CONCLUSIONS

OHL and SOC were important factors associated with SRSP performance together with other sociodemographic and oral health-related variables in high school students. Our findings reinforce the importance of intersectoral actions between the health and education sectors to promote better school performance among adolescents, including actions to improve OHL and SOC.

The exploration of a ‘model’ for understanding the contribution of emotion regulation to students learning. The role of academic emotions and sense of coherence

The present study is exploring a pathway connecting emotion regulation with academic progress. Specifically, the pattern through which emotion regulation is implicated in learning and academic progress through academic emotions and sense of coherence. This cross-sectional study involves of 406 undergraduate social science students recruited from a university in western Greece. Participants anonymously and voluntarily completed a number of self-report measures. The Emotion Regulation Questionnaire, the Sense of Coherence Scale, the Student Experience of Emotions Inventory and the Approaches to Learning and Studying Inventory, were used to measure emotion regulation, sense of coherence, academic emotional experiences and approaches to learning, respectively. Α four-stage model was tested with structural equation modelling techniques. In particular, the model examined associations between emotion regulation, sense of coherence, academic emotions, approaches to learning and academic progress. The analysis revealed pathways through which these associations appear to be maintained and driven by emotion regulation. Emotion regulation is associated with students’ academic emotions that in turn are linked with approaches to learning and academic progress. Both positive and negative emotions appear to play a role in enabling an adaptive approach to learning. Moreover, sense of coherence may serve as an important meta-cognitive factor enabling students to approach the learning process more effectively. The findings are discussed in the light of the recent literature.

Sense of coherence mediates the relationship between digital health literacy and anxiety about the future in aging population during the COVID-19 pandemic: a path analysis

Objectives: During the COVID-19 pandemic, older adults experience various challenges, including information uncertainties, financial pressure, and visit restrictions, which may lead to anxiety about the future. As a protective factor, sense of coherence (SOC) may play a role to reduce some psychological discomfort. This study aimed to analyze the relationships of SOC with anxiety, digital health literacy (DHL), information, and financial satisfaction among older adults during the outbreak.Methods: This is part of a large-scale DHL study with a cross-sectional survey across 41 countries. This study extracted data from three Asian countries (China, the Philippines, and Singapore) and included people aged ≥60. Structural equation modeling with path analysis was utilized to examine the relationships of SOC with anxiety about the future and other variables.Results: A total of 266 older adults were included, with 43.2% expressed anxiety about the future. DHL (β=-0.13, p < 0.05) and SOC (β=-0.26, p = 0.01) were negatively associated with anxiety, while financial and information satisfaction were not. However, financial satisfaction (β = 0.34, p < 0.01) and DHL (β = 0.32, p = 0.01) were positively associated with SOC. Higher SOC further mediated the negative relationships of DHL (β= -0.11, p = 0.004) and financial satisfaction (β= -0.12, p = 0.004) on anxiety of older adults.Conclusions: SOC had direct negative effect on anxiety and mediated the relationships between anxiety and DHL/financial satisfaction. Strategies should be developed to enhance SOC and DHL among older adults, as these capacities may help to manage anxiety during the pandemic.

Improving Physical Activity Levels in Prevocational Students by Student Participation: Protocol for a Cluster Randomized Controlled Trial

BACKGROUND

A consistent finding in the literature is the decline in physical activity during adolescence, resulting in activity levels below the recommended guidelines. Therefore, promotion of physical activity is recommended specifically for prevocational students.

OBJECTIVE

This protocol paper describes the background and design of a physical activity promotion intervention study in which prevocational students are invited to participate in the design and implementation of an intervention mix. The intervention is expected to prevent a decline in physical activity in the target group.

METHODS

The effectiveness of the intervention was evaluated in a two-group cluster randomized controlled trial with assessments at baseline and 2-year follow-up. A simple randomization was applied, allocating 11 schools to the intervention group and 11 schools to the control group, which followed the regular school curriculum. The research population consisted of 3003 prevocational students, aged 13-15 years. The primary outcome measures were self-reported physical activity levels (screen time, active commuting, and physical activity). As a secondary outcome, direct assessment of physical fitness (leg strength, arm strength, hip flexibility, hand speed, abdominal muscle strength, BMI, and body composition) was included. An intervention-control group comparison was presented for the baseline results. The 2-year interventions began by mapping the assets of the prevocational adolescents of each intervention school using motivational interviewing in the structured interview matrix and the photovoice method. In addition, during focus group sessions, students, school employees, and researchers cocreated and implemented an intervention plan that optimally met the students' assets and opportunities in the school context. The degree of student participation was evaluated through interviews and questionnaires.

RESULTS

Data collection of the SALVO (stimulating an active lifestyle in prevocational students) study began in October 2015 and was completed in December 2017. Data analyses will be completed in 2021. Baseline comparisons between the intervention and control groups were not significant for age (P=.12), screen time behavior (P=.53), nonschool active commuting (P=.26), total time spent on sports activities (P=.32), total physical activities (P=.11), hip flexibility (P=.22), maximum handgrip (P=.47), BMI (P=.44), and sum of skinfolds (P=.29). Significant differences between the intervention and control groups were found in ethnicity, gender, active commuting to school (P=.03), standing broad jump (P=.02), bent arm hang (P=.01), 10× 5-m sprint (P=.01), plate tapping (P=.01), sit-ups (P=.01), and 20-m shuttle run (P=.01).

CONCLUSIONS

The SALVO study assesses the effects of a participatory intervention on physical activity and fitness levels in prevocational students. The results of this study may lead to a new understanding of the effectiveness of school-based physical activity interventions when students are invited to participate and cocreate an intervention. This process would provide structured health promotion for future public health.

TRIAL REGISTRATION

ISRCTN Registry ISRCTN35992636; http://www.isrctn.com/ISRCTN35992636.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/28273.

Elucidating the child's perspective in health promotion: children's experiences of child-centred health dialogue in Sweden

Promoting young children’s health through health promotion activities is an investment for the future. In the Child Health Services in the south of Sweden a structured Child-Centred Health Dialogue (CCHD) directed to all 4-year-old children was developed using illustrations based on the most important health messages associated with the promotion of healthy lifestyle in preschool children. The aim of this study was to explore the experiences of children participating in CCHD using 21 non-participant observations during their 4-year health visit and additionally 16 individual interviews 0–7 days after their visit, conducted in the child’s home in the presence of a caregiver. Children participated as social actors when guided to express their views based upon their own understanding was the overall main category generated from the qualitative content analysis. The children showed that they liked to participate actively but could influence their choice to participate. They expressed their views based on their daily life and wanted to understand the meaning of the information with which they interacted. The study revealed that 4-year-old children given the opportunity to speak for themselves—elucidating the child’s perspective—interpreted the health messages in a different way than the intended meaning of the illustrations developed by adults. These findings are important for the improvement of CCHD and underline the utmost importance of including children in research on health promotion. This study supports the view that 4-year-old children can take an active role in their health and are capable of making health information meaningful.

Learn, Have Fun and Be Healthy! An Interview Study of Swedish Teenagers' Views of Participation in Club Sport

In Sweden, participation in club sport is a vital part of many children’s lives. Despite this, many stop in their teenage years, raising questions concerning if and in what ways club sport can provide health-promoting activities via longer, sustained participation. The aim of this cross-sectional study is to explore and discuss young people’s views of club sport from a health-promoting perspective. The analysis draws on three sets of qualitative data: results from focus groups interviews conducted in 2007 (n = 14) and in 2016 (n = 8) as well as 18 in-depth interviews conducted 2008. Antonovsy’s salutogenic theory and his sense of coherence (SOC) model inspired the analysis. Teenagers want to be a part of club sport because of a sense of enjoyment, learning, belonging and feeling healthy. Teenagers stop when sport becomes too serious, non-flexible, time-consuming and too competitive. The urge for flexibility and possibilities to make individual decisions were emphasised in 2016. The organisation of club sport, it seems, has not adapted to changes in society and a generation of teenagers’ health interests. Club sport has the potential to be a health-promoting arena, but the focus should be on changing the club sport environment, instead of a focus on changing young people.

Acoustic Comfort as a Salutogenic Resource in Learning Environments—A Proposal for the Design of a System to Improve the Acoustic Quality of Classrooms

This article addresses the topic of environmental comfort from a salutogenic and pedagogical point of view. It begins by presenting a wide framework aimed at describing the complexity and specificity of the acoustic issue and the need to integrate decibel-based metrics with knowledge and reflections which are inherent to non-measurable factors. The article then focuses its attention on educational spaces and presents the results of an investigation carried out in 52 classrooms of 19 primary schools in Florence. From this research and keeping in mind the current Italian legislation, the following results are deduced: (1) the layout of a typical classroom, (2) the average reverberation time and (3) the sound-absorbing surface required to improve the acoustic quality of the typical classroom with polystyrene fibre panels. Subsequently, after having briefly described the more appropriate typology of sound-absorbing solutions, a system for the acoustic correction of classrooms is presented. This system is composed of two parts. The first part is fixed and its realisation is entrusted to specialised personnel; the second, based on the concept of personalisation and transformation of the educational space, is modifiable through time and designed and applied by the students themselves.

Research supervision as a mutual learning process: introducing salutogenesis into supervision using 'The Collegial Model'

Research using salutogenic factors to promote health is extensive. Salutogenesis, and its core concept 'sense of coherence' (SOC), is a resource-oriented theory and framework, applicable in different contexts. Research combining health promotion and doctoral supervision in higher education is scarce. This article places research supervision in a broader context of sustainable working life by focusing on stress management. It is about health promotion in an area of research supervision, a new approach not described earlier. Research on supervision in general is extensive, focusing on co-generative mentoring, counselling and coaching. A new salutogenic model, 'The Collegial Model', is presented as an example of practical application. The aim of the present article is to introduce and discuss how the salutogenic theory and model of health can be applied to research supervision of postgraduate students. Knowledge about how SOC impacts health and learning has benefit from a systematic review on salutogenic research covering published papers from 1992 to 2003 and until today. 'The Collegial Model' examines fundamental characteristics of supervision related to ethics and sense of coherence: relations, communication, processes, reciprocity, reflection, learning, comprehensibility, manageability, meaningfulness and coherence. Principles for carrying out supervision 'the salutogenic way' are suggested. The conclusion is that doctoral supervision involves mutual learning processes between colleagues in the supervisory team. Supervision has to be theory driven, implying that supervisors could benefit from applying a salutogenic way of thinking and working, particularly in development of guidelines for research supervision.

Health Assets, Vocation and Zest for Healthcare work. A Salutogenic Approach to Active Coping among Certified Nursing Assistant Students

People's health assets (HA) mapping process and design dynamization strategies for it are paramount issues for health promotion. These strategies improve the health heritage of individuals and communities as both the salutogenic model of health (SMH) and health assets model (HAM) defend. Connecting and mobilizing HA and strengthens the 'sense of coherence' (SOC) are both related to enhancing stress active and effective coping strategies. This study aims to describe the HA present in a population of certified nursing assistant students (n = 921) in Spain and then to explore their relationships with the SOC, the motivation to choose healthcare studies and their academic performance. A great variety of HA were identified and mapped. Findings showed that individuals with greater motivation towards self-care and 'caring for others' as internal HA, possessed higher SOC levels and a strong vocation for healthcare work. Differences in HA were identified according to gender, age and employment situation. Consistent connections between the care-relation factor and vocational factor with interpersonal and extrapersonal HA were reported. Evidence and results substantiated the salutogenic and asset-based approach as a proper strategy to strengthen SOC, dynamize their HA map, reinforce the sense of calling and enable Certified Nurse Assistant (CNA) students to buffer against caregiving-related stress and thrive in their profession.

Picturing academic learning: salutogenic and health promoting perspectives on drawings

More than 20 years ago an article about the use of drawings in higher education appeared in a medical journal. After that, other papers explored the possible contribution of drawings in adult education, while only very few in the field of health promotion and education. This article aims to introduce the use of drawing in this field using the salutogenic lens to think, plan and reflect on academic learning. Reflections on what salutogenesis is and what we can consider a clear application of salutogenic principles to the learning process answer a hypothetical question for the reader concerning the relationship between drawings and health promotion theories. They appear as communication tools capable of exploring meaning-making processes, capturing data that is flexible to dynamic systems, power relations, as well as emotional and latent aspects of human experience. This article proposes a connection between salutogenesis and drawings through: a theoretical framework on salutogenic learning and drawings; a teacher practice and its tools focusing the critical point on visual data analysis in a learning environment; a learner case example for knowledge and capacity building through the drawing process; and a health promotion competency-based analysis. Our case example illustrates how drawings were introduced in a post-graduate course in Health Promotion and Education and argues their strengths and weaknesses.

Reorienting Norwegian mental healthcare services: listen to patients' learning appetite

Reorientation of healthcare services towards more efficient health promotion interventions is an urgent matter. Despite policies and guidelines being in place, it is the least developed key action area of the Ottawa charter. User involvement, or the voice of the patient, is missing from the knowledge base of health promotion in the mental healthcare services. The aim of this study was to add experiential knowledge from former patients. We explored the lived experience of 12 former inpatients at a mental healthcare hospital. We describe what they perceive as mental health promoting efforts. A salutogenic theoretical framework and the methodology of interpretative phenomenological analysis were used. The analysis revealed an appetite for learning in order to develop an in depth understanding of their former experiences. This was motivated by a desire to master daily life despite living with an illness and to increase health and well-being. The participants perceived the learning processes within the healthcare setting as mental health promoting. This craving for a better life is compatible with health promotion. It may turn out to be an opportunity to complement the curative activity of healthcare services with health promotion educational activities.

Poverty-related diseases: factors that predict coping in two Cameroonian settings

In this paper, we explore the connection between poverty and health (poverty-related diseases: PRDs) by investigating the factors that play a role in how two groups of people in Cameroon cope with health challenges: workers in a large agro-industrial organization (living in 'camps') and students in two major universities (living on 'campuses'). We investigated factors reported in the literature as being associated with coping, summarized under the 'salutogenic umbrella', as well as demographic, social and environmental factors. A total of 509 respondents from camps and campuses participated in this study. We used a combination of standardized and un-standardized survey instruments to measure coping. We used χ2 and ANOVA tests to investigate bivariate differences and multiple logistic regression analysis to determine which significant survey factors predicted coping. Our results showed expected and unexpected differences between the settings. Individual dispositional factors such as sense of coherence (SOC), self-efficacy (SE), subjective wellbeing and self-rated health differed significantly between the settings. Expected coping resources such as income and SE did not differ between non-copers and copers. Two factors emerged as predictors of coping: living environment (setting) and SOC. Our results highlight the need for a multidimensional perspective on poverty and also the need to apply the salutogenic approach in PRD research. In particular, the emphasis this approach puts on stressors and the capacity to employ a variety of resources to overcome stressors is a fruitful way to better understand PRDs and the importance of location-specific circumstances where poverty, health and diseases are connected.

'What kind of life is this?' Diabetes related notions of wellbeing among adults in eastern Uganda and implications for mitigating future chronic disease risk

Background

Effective prevention and care for type 2 diabetes requires that people link healthy behaviours to chronic disease-related wellbeing. This study explored how people perceive current and future wellbeing, so as to inform lifestyle education.

Methods

Eight focus group discussions and 12 in-depth interviews were conducted in Iganga and Mayuge districts in rural Eastern Uganda among people aged 35–60 years in three risk categories (1) People with diabetes, (2) people at higher risk of diabetes (with hypertension or overweight) and (3) community members without diabetes.

Results

People define wellbeing in three notions: 1) Physical health, 2) Socio-economic status and 3) Aspirational fulfilment. Most people hold the narrower view of wellbeing that focuses on absence of pain. Most overweight participants did not feel their condition as affecting their wellbeing. However, for several people with hypertension, the pains they describe indicate probable serious heart disease. Some people with diabetes expressed deep worry and loss of hope, saying that ‘thoughts are more bothersome than the illness’. Wellbeing among people with diabetes was described in two perspectives: Those who view diabetes as a ‘static’ condition think that they cannot attain wellbeing while those who view it as a ‘dynamic’ condition think that with consistent treatment and healthy lifestyles, they can be well. While many participants perceive future wellbeing as important, people without diabetes are less concerned about it than those with diabetes. Inadequate knowledge about diabetes, drug stock-outs in health facilities, unaffordable healthier food, and contradictory information were cited as barriers to future wellbeing in people with diabetes.

Conclusions

To make type 2 diabetes prevention relevant to healthy people, health education messages should link current lifestyles to future wellbeing. Diabetes patients need counselling support, akin to that in HIV care, to address deep worry and loss of hope.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-6249-0) contains supplementary material, which is available to authorized users.

Preliminary evaluation of an adolescent positive health measurement scale: a salutogenic health promotion approach

Health measurement tools typically assess indicators of poor health by identifying the absence, or presence, of disease and risk factors. This article describes development and validation of the first instrument for measurement of adolescent engagement in positive health promoting actions from a salutogenic approach. This cross-sectional study of 406 youths 14-16 years old tested the validity and reliability of the Salutogenic Wellness Promotion Scale for Adolescents (SWPS-Adol) and examined the extent to which SWPS-Adol positively correlated with and was able to predict perceived health among this population. Findings indicated that SWPS-Adol had good internal consistency (α = 0.84, subscales α = 0.70), a multi-dimensional structure (physical, emotional, social, vocational and spiritual), and was positively correlated with perceived health (r = 0.37, p < 0.001). The SWPS-Adol total score also showed significant positive correlations with the physical (p ≤ 0.001), emotional (p < 0.001), social (p < 0.001) and vocational (p < 0.039) dimensions. The more adolescents engaged in positive behaviors, the better their perceived health. The SWPS-Adol tool provides positive health data to guide adolescent health programs and health curricula, to inform health professionals and policy makers about how positive health actions enhance health and community wellness.

Health promotion in Swedish schools: school managers' views

Schools are recognized worldwide as settings for health promotion, and leadership has a bearing on schools' ability to be health promoting. School managers have a great influence on what is prioritized in school, which in turn affects students' school performance and health. There is lack of research into school managers' views on health promotion, and what they consider to be central to health promotion. The aim was therefore to examine school managers' views about what health promotion in schools include. An explorative design, qualitative content analysis, was performed. In-depth interviews were conducted with all 13 school managers of a middle-sized municipality in central Sweden. The analysis had both manifest and latent content and three categories: 'Organization and Collaboration', 'Optimize the arena' and 'Strengthen the individual', and 10 subcategories emerged. The theme, 'Opportunities for learning and a good life', describes the latent content of these categories. Taking into account the views of school managers are important because these views help form a more complete picture of how school managers work with health promotion and what is needed to enhance health promotion to improve students' opportunities for learning and a good life. The Ottawa Charter for Health promotion is thereby transformed into practice.

Future challenges for occupational health services can be prevented by proactive collaboration with the companies using the services: a participatory and reflection project

Background

There is clearly a need for research in the field of occupational health service (OHS) for applying new perspectives. Proactive collaboration is needed between the OHSs and the companies. The customers of the companies using the services should be able to safeguard themselves from the health problems caused by the work environment through proactive collaboration with the OHSs.

Objective

The main purpose of this interdisciplinary study was to explore how the stakeholders reflected to create and agree on core values for future challenges in OHS, as seen from the perspectives of OHS professionals and customer companies.

Methodology

An action research process was conducted. This study was divided into three phases. In phase I, the data were collected from interviews and diaries of interdisciplinary occupational health professionals (n=12). A focus group that sampled the eight managers of the customer companies was also included. In phase II, a questionnaire was developed with 24 questions focusing on examining the future challenges for OHS. The questionnaire was sent to customer companies (n=116). In phase III, a scoping review was undertaken.

Results

Three categories emerged from the analysis: “Balancing complex situations” clarified the complexity regarding senior employees; “Working with a proactive approach” indicated the need for working with a new proactive approach supporting sustainable health; and “Collaborate internally and externally” showed good relationships between the customer and the OHS, which is a mutual responsibility to both the partners.

Conclusion

The results outlined that it is necessary to take action to apply new proactive health promotions, with a focus on workplace health promotion. The results also indicated that interventions for senior employees are of importance. This study was done in collaboration with the stakeholders from the occupational health care service center and the managers from the customer companies. The use of a participatory research design, including close collaboration with the participants, allows the researchers to see the challenges.

[Health literacy in childhood and adolescence: An overview and current state of research]

BACKGROUND

Health literacy is multidisciplinary and brings together many concepts, and is of increasing importance for disease protection, health promotion, and prevention, and for health policy within Europe. Although its importance is increasingly recognised, adults are mostly the target audience, whereas children and adolescents, in addition to education and schools, have so far been neglected.

OBJECTIVES

The aim is to give an overview of the state of the art in childhood and adolescence health literacy research, and to identify any existing gaps.

MATERIALS

A literature review has been performed to identify the relevant research data.

RESULTS

Limitations in developmental and age-adjusted conceptual frameworks and a lack of prevalence data, however, significantly impede our understanding of the meaning of health literacy in children and adolescents. School health promotion programmes could serve as a platform for effective health literacy education, beginning in early childhood.

CONCLUSIONS

In addition to compatibility with a broader literacy perspective, the proximity to several theories of health promotion and defined concepts, and the importance of school health promotion and education, it is vital to focus research on current gaps in the understanding of health literacy determinants, health literacy as a determinant of health, and in terms of the design and systematic implementation of intervention programmes.

Health throughout the lifespan: The phenomenon of the inner child reflected in events during childhood experienced by older persons

The aim of this study was to describe and gain more knowledge of the phenomenon of the inner child, reflected in events during childhood experienced by older persons. Thirteen older persons aged 70 to 91 years old were interviewed. A hermeneutical phenomenological analysis of the data revealed two main themes: the inner child becomes visible and the inner child's presence through life. The participants' narratives showed that their understanding of the experiences included both positive and negative feelings, as well as ways to be creative, in which the inner child became visible. The participants' experiences indicated that the inner child was present throughout the lifespan, was found in challenges that occurred in life, and could turn something bad into something good. However, the presence of the inner child could also be a source for development throughout life and could interfere with the person. The findings from this study point to older persons' need to be recognized, acknowledged, and understood as a unique person living his or her own life. In addition, dimensions of well-being such as feeling safe, loved, supported, and creating space for fantasy and possibilities can be compared to the physical, mental, social, and existential dimensions of well-being found in WHO surveys and definitions of health. This calls for a holistic approach when caring for older persons.

Sense of coherence and associated factors among university students in China: cross-sectional evidence

Background

Sense of Coherence (SOC) is considered as a health-promoting resource; it is mainly developed before the age of 30. The multiple demands university students face, such as study-related stress and financial difficulty, could challenge their SOC development. This study aimed to: 1) investigate the association between SOC, socio-demographic and lifestyle-related characteristics; 2) assess the effect of perceived stress on SOC controlling for other variables among the Chinese university students. Analyses were done to derive a better view on possible strategies to strengthen students’ SOC and with that to promote their health.

Methods

The data used were from a Chinese university student health survey (N = 1,853). Logistic regression analyses were used to explore the effects of varied socio-demographic, lifestyle-related variables on students’ level of SOC, as well as the association between perceived stress and SOC controlling for other variables in the analysis.

Results

Both social support (OR = 2.56 [1.87–3.50]) and better performance compared with peers (OR = 1.64 [1.15–2.34]) were associated with a stronger SOC. Not feeling isolated at university (OR = 1.60 [1.04–2.47]) and satisfaction with the political situation (OR = 2.05 [1.57–2.67]) were also associated with a stronger SOC. This counts also for high health awareness (OR = 1.40 [1.05–1.87]) and nutrition importance (OR = 1.67 [1.04–2.69]). Perceived stress (OR = 0.81 [0.79–0.83]) was negatively associated with a strong SOC when controlling for socio-demographic and lifestyle-related variables.

Conclusion

We suggest integrating stress coping, emotion management training programmes as well as measures promoting social integration for students and teachers at campus, promoting healthy behaviours, and creating a supportive learning environment as strategies for enhancing the SOC level of university students in China.

Nutrition as long-term care as experienced by persons living with inflammatory bowel disease: a qualitative study

This study explored how young adult people living with chronic inflammatory bowel disease (IBD) experienced that knowledge about their body symptoms and their food intake could promote recovery from their diagnosed disease. A hermeneutic approach was used to analyze interviews with patients living with IBD outside hospital. Thirteen young adults 18 to 45 years of age, with IBD, resided in their home environment and were engaged in different study and work activities. Two main themes emerged from the analysis of the interviews: (1) confidence with symptoms of disease as a source to recovery and (2) nutritional recovery in different stages of IBD. The course of the disease may be turned toward regeneration using a balanced diet in a long-term management perspective. Development of a tailored diet will provide energy and act as a catalyst to enhance the adaptive immune system in the body. Embodied knowledge and recovery from IBD within the individual patient requires understanding, clinical support, and the skills of the IBD nurse, dietitian, and doctor in an interdisciplinary team collaboration.

The significance of the sense of coherence for various coping resources in stress situations used by police officers in on-the-beat service

BACKGROUND

Police officers meet many stressors as part of their occupation. The psychological resource "sense of coherence" (SOC) protects against ill-health, but its impact on coping resources for stress situations has not been studied in the population of police officers. Different approaches to investigate the significance of SOC for different outcomes have been identified in literature, leading to some difficulties in the interpretation and generalization of results. The aim was therefore to explore SOC and the coping resources, and to examine the significance of SOC for various coping resources for stress using different models in a sample of Swedish police officers providing on-the-beat service.

MATERIALS AND METHODS

One hundred and one police officers (age: mean = 33 years, SD = 8; 29 females) were included, and the Orientation to Life Questionnaire (SOC-29) and the Coping Resources Inventory (CRI) were used. The dependent variable in each regression analysis was one of the coping resources: cognitive, social, emotional, spiritual/philosophical, physical, and a global resource. Global SOC-29 and/or its components (comprehensibility, manageability, and meaningfulness) were investigated as independent variables.

RESULTS

All CRI and SOC-29 scores except for that of spiritual/philosophical resources were higher than those of reference groups. Manageability was the most important component of SOC for various coping resources in stress situations used by police officers.

CONCLUSION

A deeper study of manageability will give useful information, because this component of SOC is particularly significant in the variation in resources used by police officers to cope with stress. Salutogenesis, the origin of well-being, should be more in focus of future research on workplaces with a high level of occupational stress.