Mental well-being among the oldest old: revisiting the model of healthy ageing in a Finnish context

Purpose: This study aimed to examine how participants aged 80 years old or over describe their mental well-being-exploring the suitability of the model of healthy ageing when outlining the mental well-being concept.Methods: Six structured focus group interviews with 28 participants were conducted in Western Finland in 2017. Qualitative content analysis was performed, where both manifest and latent content was considered in a process involving meaning condensation and coding, followed by categorization.Results: The healthy ageing model constituted a useful framework for the conceptualization of mental well-being, illustrating the links between these two constructs. The analysis resulted in a four-dimensional model of mental well-being in oldest old age, the key components being: Activities-enjoyment and fulfilment; Capability-functioning and independence; Orientation-awareness, shifted perspectives and values; and Connectedness-sense of belonging.Conclusions: Although functional status plays an important role for well-being in general, it is not the principal component of self-reported mental well-being within the heterogeneous group of the oldest old. Further, many persons in this age group do not view themselves as passive or dependent, on the contrary, they underline the importance of empowering attitudes, a positive mindset and actively creating circumstances which support their mental well-being

Comprehending socio-relational factors of mental wellbeing in the oldest old within Nordic and Mediterranean countries

Socio-relational aspects are essential for mental wellbeing (MWB), especially in the oldest old age. Our study aims to explore the socio-relational aspects related to MWB in accord ance with the experiences of the oldest old of four European countries; and to examine how these differ between Mediterranean and Nordic people. A total of 117 participants aged 80+ years old were recruited, and 23 focus groups were performed. Qualitative con tent analysis identified five main themes. Family seemed to be the most important driver of the MWB of the oldest old, followed by relationships with close friends. Participants felt better when they had a sense of being needed, cared for, and connected. Loneliness and isolation negatively affected MWB, although solitude was appreciated. Differences appeared between Mediterranean and Nordic regions. Initiatives to promote positive interactions with family and friends, as well as social activities within the community, may contribute to strengthening MWB in the oldest ol

Western Finland Mental Health Survey 2011 : Survey methods

Pohjanmaa- ja Pohjalaiset masennustalkoot -hankkee

Discrimination in the workplace, reported by people with major depressive disorder:A cross-sectional study in 35 countries

Objective: Whereas employment has been shown to be beneficial for people with Major Depressive Disorder (MDD) across different cultures, employers' attitudes have been shown to be negative towards workers with MDD. This may form an important barrier to work participation. Today, little is known about how stigma and discrimination affect work participation of workers with MDD, especially from their own perspective. We aimed to assess, in a working age population including respondents with MDD from 35 countries: (1) if people with MDD anticipate and experience discrimination when trying to find or keep paid employment; (2) if participants in high, middle and lower developed countries differ in these respects; and (3) if discrimination experiences are related to actual employment status (ie, having a paid job or not). Method: Participants in this cross-sectional study (N=834) had a diagnosis of MDD in the previous 12 months. They were interviewed using the Discrimination and Stigma Scale (DISC-12). Analysis of variance and generalised linear mixed models were used to analyse the data. Results: Overall, 62.5% had anticipated and/or experienced discrimination in the work setting. In very high developed countries, almost 60% of respondents had stopped themselves from applying for work, education or training because of anticipated discrimination. Having experienced workplace discrimination was independently related to unemployment. Conclusions: Across different countries and cultures, people with MDD very frequently reported discrimination in the work setting. Effective interventions are needed to enhance work participation in people with MDD, focusing simultaneously on decreasing stigma in the work environment and on decreasing self-discrimination by empowering workers with MDD.</p

Problem gambling in a Nordic context : Moving from social factors to a psychosocial perspective

Aims In the growing field of research on gambling and problem gambling various focal points for prevention efforts are determined. The aim of this thesis is to identify and synthesise the evidence concerning social risk factors in relation to gambling and problem gambling in a Finnish and Nordic context, with a special emphasis on the less studied psychosocial factors. Further, it aims to present an overview of the state-of-the-art of Nordic gambling research. Methods Studies I-II utilized cross-sectional population survey data from the 2011 Western Finland Mental Health Survey (n = 4624, response rate 46.2%), with logistic regression analyses (Odds Ratios, 95% confidence intervals) performed in both studies. Systematic mapping review technique was applied in Study III, encompassing searches in 21 bibliographical e-databases and Google Scholar, covering Nordic gambling-themed articles published between 2000 and 2015. Systematic screening and coding of select variables was performed in line with a specified study protocol. In Study IV, publications from international scientific journals included in Study III were manually screened to identify studies focusing on psychosocial aspects. Search updates for the time period 2016-2019 were also undertaken. Study screening was performed in line with predetermined inclusion and exclusion criteria, and key information coded. Results In Study I, gambling form (online and mixed-mode gambling) as well as psychological distress increased the risk of reporting problem gambling among male past-year gamblers. The socio-demographic variables language and age group were also associated with problem gambling among men. Among female past-year gamblers, gambling form (mixed mode gambling) and reporting problematic alcohol use were associated with experienced problem gambling. In Study II, identical psychosocial factors ̶ higher levels of experienced loneliness and lower levels of experienced trust in people in one’s neighbourhood ̶ were associated with both problem gambling and problematic alcohol use. No structural aspects of social networks were significantly associated with problem gambling. Study III encompassed 382 relevant publications, with 310 of these identified in international and national scientific databases. The majority of the identified studies had first authors with Finnish, Norwegian or Swedish affiliations. The majority of Nordic gambling studies represented prevalence research (38.8%), focusing on gambling activities or problem gambling and various associated factors. Correspondingly, the majority of the studies (39.7%) analyzed population samples/cohorts or other cross-sectional samples, with many of the studies also applying review approaches or presenting case studies (for example the gambling regulation system of a country). The scientific disciplines most frequently represented were social sciences (including media and humanities) and public health sciences. Study IV included 21 original gambling studies applying statistical or interview/narrative methods, with loneliness and social support being the most frequently featured psychosocial phenomena, evidencing mixed results in relation to gambling and problem gambling. Conclusions In this thesis, psychosocial phenomena are identified as relevant factors to consider in relation to gambling and problem gambling in the Nordic context, albeit questions remain regarding the causality and directionality of these complex connections. Results also highlight the significant role of psychosocial factors, compared to structural aspects of social networks, in relation to problem gambling in a Finnish sample. These results support further research on psychosocial experiences not only as harms caused by problem gambling but also as potential determinants of problem gambling. Here, the framework of Wardle and colleagues (2018) is a suitable backdrop for illustrating both harms and determinants in a multi-level socio-ecological framing. The survey study results further highlight inter-level interactions in problem gambling, where for example individual-level socio-demographic factors such as gender can interact with the gambling environment to affect the risk of experiencing problems. The mapping study results highlight the need for a shift in the focus of Nordic gambling research from cross-sectional prevalence studies to increased translation of evidence into prevention and service-focused research initiatives. Gaps concerning for example research applying various qualitative methods and interdisciplinary research also emerged. Few longitudinal projects were identified, although these are now increasing in the Nordic setting. Concerning target groups, less research has focused on older adults and children. While a health science framework has been employed in Nordic gambling research, health science research with a more humanistic perspective such as that of caring science would add valuable contributions to both theory and health and social care practice, alongside the major epidemiological evidence base. ---------- Syfte inom det växande forskningsfältet kring spel om pengar och relaterade problem identifieras fokusområden för preventiva insatser. Avhandlingens syfte är att identifiera och syntetisera evidensen rörande sociala riskfaktorer för spel om pengar och spelproblem i en finländsk och nordisk kontext, med särskilt fokus på mindre beforskade psykosociala faktorer, samt att presentera en översikt av nordisk spelforskning. Metoder Delstudier I och II baserades på data från enkätstudien Enkät om psykisk hälsa i Västra Finland insamlat år 2011 (n = 4624, svarsprocent 46.2%). Logistiska regressionsanalyser utfördes i bägge studier (Oddskvoter, 95% konfidensintervall). Studie III utgjorde en systematisk kartläggningsstudie där sökningar utfördes i 21 bibliografiska databaser samt i Google Scholar, och nordiska publikationer med temat spel om pengar publicerade åren 2000-2015 ingick. Systematisk screening och kodning av förutbestämda variabler utfördes i enlighet med ett specificerat studieprotokoll. I Studie IV utfördes en manuell screening av publikationerna identifierade i internationella vetenskapliga journaler i Studie III för att urskilja studier med ett psykosocialt fokus. Uppdatering av databassökningar för perioden januari 2016-juli 2019 utfördes också. Screening av studier utfördes enligt fastställda inkluderings- och exkluderingskriterier och nyckelinformation kodades. Resultat I Studie I var spelform (spelande både online och offline eller enbart online) och psykisk belastning associerade med en ökad risk för spelproblem bland män som ägnat sig åt spel om pengar under det senaste året. De sociodemografiska faktorerna språk och ålder var också associerade med spelproblem bland män. Bland kvinnor var spelform (spelande både online och offline) och problematisk alkoholanvändning förknippat med en högre risk för spelproblem. I Studie II var identiska psykosociala faktorer ̶ högre nivå av upplevd ensamhet och lägre nivå av tillit till personer i ens grannskap ̶associerade med både spelproblem och problematisk alkoholanvändning. Inga strukturella faktorer kopplade till socialt nätverk var signifikant associerade med spelproblem. Studie III omfattade 382 relevanta publikationer, 310 av dessa identifierades i internationella och nationella vetenskapliga databaser. Majoriteten av identifierade studier hade en första författare med en finländsk, norsk eller svensk institutionstillhörighet. Majoriteten av nordiska spelstudier utgjorde prevalensstudier (38.8%) med fokus på spel om pengar eller spelproblem och associerade faktorer. I linje med detta analyserades befolkningssampel eller andra tvärsnittssampel i majoriteten av studierna (39.7%), medan många studier även tillämpade översiktsmetodik eller presenterade olika fallstudier (rörande exempelvis spelregleringen i ett land). Samhälls- och humanistiska vetenskaper samt folkhälsovetenskap var oftast representerade när det gäller disciplin. I Studie IV inkluderades 21 originalstudier där statistiska metoder eller intervju- eller narrativa metoder tillämpats. Ensamhet och socialt stöd var de psykosociala fenomen som framkom mest frekvent i studierna, och visade på blandade resultat i förhållande till spel om pengar och spelproblem. Konklusioner I avhandlingen identifieras psykosociala fenomen som relevanta faktorer att beakta i förhållande till spel om pengar och spelproblem i den nordiska kontexten, även om frågor kvarstår rörande orsakssamband och riktning i dessa komplexa kopplingar. Resultaten belyser också hur psykosociala faktorer, jämfört med strukturella aspekter av sociala nätverk, spelar en signifikant roll i förhållande till spelproblem i ett finländskt sampel. Resultaten stöder vidare forskning där psykosociala faktorer inte enbart undersöks i egenskap av negativa påföljder av spelproblem, utan också som potentiella determinanter för problematiken. Här fungerar Wardle och kollegors (2018) ramverk som en användbar kuliss för att belysa både negativa effekter av spelproblem men även determinanter utifrån ett socioekologiskt multinivåperspektiv. Enkätstudieresultat belyser även interaktionsaspekter, där exempelvis sociodemografiska faktorer på individnivå såsom kön kan interagera med spelmiljö och därmed påverka risken för att uppleva problem. Resultaten av kartläggningsstudien understryker behovet av ett fokusskifte i nordisk spelforskning från prevalensstudier med tvärsnittsdesign till preventions- och servicefokuserade forskningsinitiativ. Ett behov av mer forskning där kvalitativa forskningsansatser tillämpas samt behov av mer interdisciplinär forskning framkommer också. En brist på longitudinella projekt identifierades men förekomsten av denna typ av projekt och studier ökar nu i Norden. Gällande målgrupper så har mindre forskning fokuserat på äldre personer samt barn. Medan ett hälsovetenskapligt ramverk tillämpats i nordisk spelforskning, så skulle hälsovetenskaplig forskning med ett humanistiskt perspektiv såsom det vårdvetenskapliga erbjuda värdefulla bidrag till både teori samt hälso- och socialvårdspraxis, vid sidan om den omfattande epidemiologiska evidensbasen.Felaktig ISBN i boken