Public health in restructuring coastal communities : Generational trends in self-rated health following the decline in small-scale fishing. The HUNT study, Norway

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Konsept Kroppskunnskaping som verktøy i helsefremming

Formålet med denne studien studien har vært å få innsikt og forståelse for opplevde erfaringer med å delta i det pedagogiske helsetilbudet Kroppskunnskaping. Dette er et helsefremmende tilbud for mennesker som lever med langvarige helseplager, eller er i risiko for dette. Målet ved helsetilbudet er styrking av mestring og helse gjennom systematisk arbeid med Kroppskunnskaping som verktøy. Problemstillingen for studien er knyttet til hvilke helserelaterte endringer personer som deltar i det pedagogiske helsetilbudet Kroppskunnskaping har opplevd i sine liv og hva som bidro til disse. Utvalget har bestått av 11 deltagere som lever med ulike typer langvarige helseplager og som har gjennomført det pedagogiske helsetilbudet Kroppskunnskaping. Datamaterialet er innsamlet gjennom kvalitativ metode i form av semitrukturert intervju kort tid etter gjennomføringen av programmet. Tre deltok i enkeltvise intervju og åtte deltagere var med i et fokusgruppeintervju. I arbeid med datamaterialet ble fortolkende fenomenologisk analyse (IPA) benyttet som analyseverktøy. Funnene viste at å delta i helsetilbudet Kroppskunnskaping hjalp deltagerne til endring i selvinnsikt, akseptasjon av egen kapasitet og gjenvinning av kontroll i eget liv. Dette førte til mindre opplevde smerter, mindre stress og mer energi til daglige aktiviteter og deltagelse. Enkelte sider ved helsetilbudet bidro i større grad til endringene. Dette var: Regnbuemodellen, gruppetilhørighet og sosial støtte. Det pedagogiske helsetilbudet Kroppskunnskaping beskrives av deltagerne som et annerledes møte med helsevesenet. Nøkkelord: Kroppskunnskaping, helsefremmende arbeid, kronisk sykdom, salutogenese, følelse av sammenheng, kontrollplassering, mestringstro, kvalitativ metode, semistrukturert intervju, fortolkende fenomenologisk analyse

Patients' experiences with changes in perceived control in chronic illness: A pilot study of the outcomes of a new health promotion program in community health care

Among the main challenges accompanying chronic illness are uncertainty and lack of perceived control, both of which put the patient at risk of developing psychological comorbidities. This qualitative study explored patients’ experiences with changes in perceived control while engaging in a new health promotion program in their community. Participants’ bodily knowledge of chronic illness was utilized systematically in the promotion of their health during seven group sessions. Eleven men and women from the eastern part of Norway participated in the pilot implementation. Qualitative interviews were used for data collection and were analyzed according to Interpretative Phenomenological Analysis. The findings were identified as: changes in self-awareness; accepting the limits of one’s capacity; and regaining control. This resulted in patients’ development of a strengthened capacity to handle illness-related strain and individual strategies to prevent psychological deterioration. Keywords: chronic illness, coping, health intervention, perceived control, self-awareness, self-efficacy

Patients' experiences with changes in perceived control in chronic illness: A pilot study of the outcomes of a new health promotion program in community health care

Among the main challenges accompanying chronic illness are uncertainty and lack of perceived control, both of which put the patient at risk of developing psychological comorbidities. This qualitative study explored patients’ experiences with changes in perceived control while engaging in a new health promotion program in their community. Participants’ bodily knowledge of chronic illness was utilized systematically in the promotion of their health during seven group sessions. Eleven men and women from the eastern part of Norway participated in the pilot implementation. Qualitative interviews were used for data collection and were analyzed according to Interpretative Phenomenological Analysis. The findings were identified as: changes in self-awareness; accepting the limits of one’s capacity; and regaining control. This resulted in patients’ development of a strengthened capacity to handle illness-related strain and individual strategies to prevent psychological deterioration. Keywords: chronic illness, coping, health intervention, perceived control, self-awareness, self-efficacy

Public health in restructuring coastal communities: Generational trends in self-rated health following the decline in small-scale fishing. The HUNT study, Norway

Restructuring rural communities can be seen as natural population level experiments of great social epidemiological interest. Following the extensive decline in small-scale fishing in the later decades of the 20th century, many coastal communities have undergone considerable societal restructuring. In Norway, this has entailed a substantial reduction of the fishing workforce, concurrent with new employment opportunities in public sector and aquaculture. The former socialization into fishing from a young age is greatly reduced, with coastal youths now facing other life courses than preceding generations. As restructuring of societies is found to be intertwined with public health, coastal communities can provide valuable insights on public health during times of transitions. In this study, we use repeated cross-sectional population health data from rural Norwegian municipalities to assess the development of self-rated health over four decades in a coastal population who has undergone restructuring of local labour markets. We assess generational differences in health by comparing the prevalence of poor self-rated health at three ages reflecting three generations at each cross section: youths, adults and elderly. We compare results to adjacent geographical areas to assess geographical differences in self-rated health over time. We found a higher predicted prevalence of poor self-rated health in rural coastal adults and elderly compared to other geographical areas across all decades. However, trends revealed improving self-rated health in rural coastal adults and elderly, as well as narrowing health gaps between the rural coastal population and the remaining geographical areas in this Norwegian setting. Our results shed light on public health development in restructuring coastal communities