Daily challenges and use of resistance resources among younger adults with serious mental illness: A qualitative study from a salutogenic health promotion perspective

The main objective of this qualitative study was to explore the challenges young adults with serious mental illness experience in everyday life, the factors that can promote or prevent health and well-being and how they cope with these challenges. This doctoral thesis aligns with the phenomenological-hermeneutic tradition and understanding. It involves the analysis and interpretation of nine in-depth interviews guided by the theory of salutogenesis. The thesis comprises three articles that delve into and discuss the experiences of everyday challenges and the cultivation of salutogenic coping abilities. Moreover, the thesis considers the interaction experience between an individual and their social environment and its potential impact on health and well-being. It also examines and discusses experiences related to physical activity and how these might influence health and well-being. Overall, this study illustrates the need for more tolerant, health-promoting public attitudes where people with serious mental illness feel that they are included and accepted as valued and integral members of the community. The study demonstrates that receiving social support and being included in the community is crucial for bolstering self-identity and combating stigma, thereby fostering a sense of coherence, health, and well-being. Additionally, it indicates that enhancing the capacity to recognize and utilize appropriate resistance resources is vital for cultivating a proactive and positive self and developing health-promoting coping skills, subsequently leading to improved health and well-being. Furthermore, it is essential to understand that the development of salutogenic coping skills must be personalised to cultural contexts and society and supported by local communities, families and services. Additionally, the study shows that adapted physical activity is a crucial resistance resource to increase self-identity, health and well-being by providing a sense of mastery, meaningfulness, and social engagement, thus contributing to an improved ability to manage stressors. Furthermore, the findings also reveal that individuals need to choose a physical activity based on personal interest and meaning to engage in physical activity and promote sustainable life changes. The findings of the present study are important in that they contribute to increased expertise in mental health care and an increased focus on treatments that emphasise active participation, salutogenic coping and strengthening the person's sense of coherence to promote positive health and well-being.Hovedmålet med denne kvalitative studien var å utforske ulike utfordringer unge voksne med alvorlig psykisk lidelse opplever i hverdagen, hvilke faktorer som kan fremme eller forhindre helse og velvære og hvordan disse utfordringene håndteres. Studien benytter teorien om salutogenese som et teoretisk rammeverk og avhandlingens tre artikler drøfter resultatene i lys av denne teorien. Artiklene utforsker og diskuterer hvordan ulike livserfaringer kan påvirke utviklingen av salutogene mestringsevner, helse og velvære. Avhandlingen kan plasseres innenfor en fenomenologisk-hermeneutisk tradisjon og forståelse, og hvor de ni dybdeintervjuene ble analysert og forstått i lys av teorien om salutogenese. Samlet sett illustrerer denne studien behovet for mer tolerante og helsefremmende offentlige holdninger slik at mennesker med alvorlige psykiske lidelser kan oppleve at de er inkludert og akseptert som verdsatte og viktige medlemmer av fellesskapet. Studien viser at det å oppleve sosial støtte og inklusjon i fellesskapet er essensielt for å styrke selvidentiteten og kunne bekjempe stigma, og dermed fremme en økt opplevelse av sammenheng, helse og velvære. Studien viser også at det er viktig å styrke evnen til å kunne identifisere og bruke hensiktsmessige motstandsressurser for å fremme utviklingen av en handlekraftig og positiv selv-identitet og salutogene mestringsevner og dermed oppleve økt helse og velvære. Videre at det vesentlig å forstå at utviklingen av salutogene mestringsevner må tilpasses kulturelle kontekster og samfunnet, samt støttes av lokalsamfunn, familier og helsetjenester. Studien viser også at tilpasset fysisk aktivitet er en viktig motstandsressurs som kan fremme en sterkere selvidentitet, gi økt psykisk velvære, og sterkere sosialt engasjement og tilknytning, og dermed bidra til en forbedret evne til å håndtere stressfaktorer. Videre viser funnene at for å engasjere seg i fysisk aktivitet og fremme bærekraftige endringer i livet er det vesentlig å velge en fysisk aktivitet som er basert på personlig interesse og oppleves meningsfull. Funnene i denne studien har betydning ved at de kan bidra til økt kompetanse innen psykisk helsevern og gi økt søkelys på behandlinger som vektlegger aktiv deltakelse, salutogen mestring, og styrking av personens opplevelse av sammenheng for å fremme positiv helse og velvære.publishedVersio

Experiences with physical activity, health and well-being among young adults with serious mental illness

Purpose To explore how young adults with serious mental illness (SMI) experience physical activity and how these experiences influence their perceived health and well-being. Methods Nine young adults with SMI who had participated in an aerobic high-intensity interval training program were interviewed in depth. The interviews were transcribed and subjected to reflexive thematic analysis. Results The results indicated that people with SMI mainly experience physical activity as a meaningful activity that contributes to an increased sense of well-being and better health. However, to overcome various barriers, it is crucial to experience social support and encouragement. The following three main themes were identified through reflexive thematic analysis: (1) positive changes in focus and an increase in well-being occur through physical activity; (2) increased mental strength results from physical activity; and (3) a lack of support and feelings of safety prevent physical activity. Conclusions This study shows that adapted physical activity is an important resistance resource that can promote stronger self-identity, increased mental well-being and social engagement and thus contribute to an improved ability to manage stressors. Furthermore, the findings reveal that to engage in physical activity and promote sustainable life changes, it is important for individuals to choose a physical activity based on personal interest and meaning.publishedVersio

Experiences of the Quality of the Interplay between Home-Living Young Adults with Serious Mental Illness and Their Social Environments

The purpose of this study is to explore the experiences of the interplay between home-living young adults in the community with a serious mental illness (SMI) and their social environment and how this experience influence their mental health and well-being in light of the theory of salutogenesis. In a qualitative study, nine young adults with SMI were interviewed. The interviews were transcribed and subjected to reflexive thematic analysis. The following three overarching themes characterized these young adults’ experiences of such interplay: (1) a sense of shame and feeling less valued in society, (2) challenges in engagement and maintaining relationships, and (3) the significance of social support in one’s family. Accordingly, the young adults experienced both the presence of good, constructive interplay with their social environment and deficits in this reciprocal feedback loop. Overall, this study illuminates the need for more tolerant health-promoting public attitudes to ensure that individuals with a SMI might experience better interplay by feeling that they are valued members of a nurturing society and that they can contribute to their local community. Participation in society should not be limited by one’s illness or expectations of being recovered before one can fully participate in society. Experiencing social support and inclusion in society is essential to strengthen self-identity and fight against stigma, thus promoting a sense of coherence, health and well-being.publishedVersio

Development of salutogenic coping skills: Experiences with daily challenges among young adults suffering from long-term psychosis

Purpose The purpose of this study is to explore experiences with daily challenges and the development of salutogenic copings skills among young adults with serious mental illness. Methods Nine young adults with serious mental illness were interviewed. The interviews were transcribed and subjected to reflexive thematic analysis. Results Two main themes were identified through the analysis: “The influence of symptoms in everyday life and challenges with participating in the community” and “Making the small things matter.” The findings show that different life experiences, or on-going challenges, often can affect or interfere their lives on a daily basis, and that previous experiences with psychosis can contribute to the development of salutogenic coping skills. Conclusions This study shows the importance of increased knowledge and awareness of different life experiences and challenges among people with serious mental illness such as schizophrenia spectrum disorders. It is significant to strengthen the ability to identify and use appropriate resistance resources to promote salutogenic coping skills and thus better health. Furthermore, it is important to be aware that the development of salutogenic coping skills must be personalized to cultural contexts and society as well as supported by local communities, families and services

Development of salutogenic coping skills: Experiences with daily challenges among young adults suffering from long-term psychosis

Purpose The purpose of this study is to explore experiences with daily challenges and the development of salutogenic copings skills among young adults with serious mental illness. Methods Nine young adults with serious mental illness were interviewed. The interviews were transcribed and subjected to reflexive thematic analysis. Results Two main themes were identified through the analysis: “The influence of symptoms in everyday life and challenges with participating in the community” and “Making the small things matter.” The findings show that different life experiences, or on-going challenges, often can affect or interfere their lives on a daily basis, and that previous experiences with psychosis can contribute to the development of salutogenic coping skills. Conclusions This study shows the importance of increased knowledge and awareness of different life experiences and challenges among people with serious mental illness such as schizophrenia spectrum disorders. It is significant to strengthen the ability to identify and use appropriate resistance resources to promote salutogenic coping skills and thus better health. Furthermore, it is important to be aware that the development of salutogenic coping skills must be personalized to cultural contexts and society as well as supported by local communities, families and services.publishedVersio