Sveikatos priežiūros darbuotojų ir gyventojų įtraukimo bei dalyvavimo e. sveikatos sistemoje mastas ir tendencijos Lietuvoje

Mokslo studijoje atskleistas suinteresuotųjų pusių įtraukimo į e. sveikatos plėtros procesą mastas ir tendencijos Lietuvoje. Remiantis e. sveikatos kūrėjų, diegėjų ir naudotojų sociologinių kiekybinių tyrimų analize, įvertintas sveikatos priežiūros įstaigų personalo, sveikatos priežiūros įstaigų vadovų bei gyventojų informuotumas apie e. sveikatos informacines technologijas, naudojimasis technologijomis, e. sveikatos technologijų vertinimas Lietuvoje ir atitinkamoje sveikatos priežiūros įstaigoje, atskleisti e. sveikatos technologijų diegimo proceso ypatumai bei problemos. Apibendrinus tyrimo rezultatus pateiktos pasitenkinimo e. sveikatos būkle išvados ir, vadovaujantis poreikių e. sveikatos srityje analize, suformuluoti pasiūlymai informuotumui ir e. sveikatos diegimo procesui gerinti

E. sveikatos plėtros integruotos transformacijos: suinteresuotųjų pusių tinklo perspektyva

E. sveikata yra vertintina kaip svarbiausia sveikatos sistemos valdymo inovacija, todėl susiduriama ne tik su techninėmis, bet ir su įvairiomis žmogiškojo faktoriaus problemomis, kurios būdingos diegiant naujoves. Monografijoje atskleidžiamas e. sveikatos plėtros mastas ir tendencijos iš suinteresuotųjų pusių tinklinės perspektyvos siekiant inovatyvumo ir tvaros sveikatos sistemoje. Pristatoma sukurta e. sveikatos suinteresuotųjų bendradarbiavimo platforma, kurioje sveikatos valdymo inovacijos ir socialinių technologijų galimybės sinergijoje su politinių, organizacinių ir vadybinių priemonių dinaminiu rinkiniu pateikia ir atnaujina politines organizacines ir vadybines priemones esamuoju laiku

Relationships between exercise motivation, exercise dependence and risk of eating disorders in leisure time exercisers

Daugelio ekonomiškai išsivysčiusių šalių žmonių fizinis aktyvumas yra nepakankamas ir dedamos milžiniškos pastangos jį didinti. Deja, yra žmonių, kurie žaloja savo sveikatą perdozuodami fizinį aktyvumą, todėl šio tyrimo tikslas buvo nustatyti, kokie ryšiai sieja laisvalaikiu besimankštinančių vyrų ir moterų priklausomybę nuo mankštinimosi, valgymo sutrikimų riziką ir mankštinimosi motyvaciją. Šiame tyrime kėlėme prielaidą, kad priklausomybė nuo mankštinimosi bus reikšmingai susijusi su valgymo sutrikimų rizika ir išorine mankštinimosi motyvacija (mankštinimusi dėl išvaizdos ir fizinės parengties motyvų). Anketinės apklausos būdu buvo nustatyti 256 tiriamųjų (iš jų 81 vyras, imties amžiaus vidurkis 30,8 ± 8,91 metai) demografiniai duomenys, mankštinimosi motyvacija (Motives for Physical Activity Measure - Revised, MPAM‑R, Frederick, Ryan, 1993, klausimynu), valgymo sutrikimų rizika (Eating Attitude Test‑26, Garner, 1982) ir priklausomybė nuo mankštinimosi (Exersice Dependence Scale‑21, Hausenblas, Symons Downs, 2002). Jauniausias tiriamasis buvo 18, vyriausias – 58 metų amžiaus. Pagal nurodomą ūgį ir svorį apskaičiuotas kūno masės indeksas (KMI). Tarp laisvalaikiu besimankštinančių asmenų yra gana paplitusi valgymo sutrikimų rizika (9,1 %) ir priklausomybė nuo mankštinimosi (7,4 %). Į priklausomybės nuo mankštinimosi ir valgymo sutrikimų rizikos grupes pateko daugiau moterų (p < 0,05). Koreliacinė analizė atskleidė, kad moterų valgymo sutrikimų rizika siejasi su mankštinimusi dėl išvaizdos gerinimo, o priklausomybė nuo mankštinimosi – su visais mankštinimosi motyvais, išskyrus fizinę kompetenciją. Vyrų valgymo sutrikimų rizika nėra susijusi su mankštinimosi motyvacija, o priklausomybė nuo mankštinimosi susijusi su mankštinimusi dėl malonumo ir fizinės parengties. Hierarchinė linijinė regresija atskleidė, kad moterų priklausomybę nuo mankštinimosi labiausiai prognozuoja vidinė mankštinimosi motyvacija (mankštinimasis dėl malonumo) ir valgymo sutrikimų rizika. Vyrų priklausomybės nuo mankštinimosi neprognozuoja nė vienas tirtas kintamasis. Gauti duomenys patvirtina teiginius, kad tarp moterų egzistuoja tik antrinė priklausomybė nuo mankštinimosi ir kad priklausomybė nuo mankštinimosi susijusi su vidine mankštinimosi motyvacija.Appropriate regular physical activity is a major component in preventing the growing global burden of chronic diseases. The huge efforts have been put aiming to change habits of sedentary people. Despite of the facts, for some people exercise can become a compulsive and health harmful behaviour. The aim of this study was to examine the relationships between exercise motivation, exercise dependence, and risk of eating disorders in private fitness clubs exercising men and women. Methods. Demographic data, exercise behaviour–related information, overall self-esteem, exercise motivation (Motives for Physical Activity Measure – Revised, MPAM – R, Frederick, Ryan, 1993), exercise dependence (Exersice Dependence Scale – 21, Hausenblas, Symons Downs, 2002) and the risk of eating disorders (Eating Attitude Test - 26, Garner, 1982) were assessed using anonymous selfreport questionnaire in the sample of 256 persons (81 men). Body mass index was determined by self reported weight and height. Results. The prevalence of risk of eating disorders was 9,1%, exercise dependence symptoms – 7,4%. The risk for eating disorders and exercise dependence was more prevalent for women. Correlation analysis revealed that women’ risk for eating disorders was accompanied by exercising for appearance improvement, and exercise dependence – by all exercise motives except of physical competence improvement. Men’s risk for eating disorders was not related to the exercise motivation, and exercise dependence was related to exercising for interest/enjoyment and fitness. Hierarchical regression analysis showed that internal exercise motivation (interest/enjoyment) and eating disorders risk predicted women’s exercise dependence. There were no variables to predict men’s exercise addiction. Conclusions. This data supports presumption that only the secondary exercise dependence exists in women and that exercise addiction is accompanied by internal exercise motivation

Lithuanian physical activity strategy: the culture of the body or the body cult?

The article is devoted to disclosure of the tendencies in the promotion of Lithuanian physical activity. During the Soviet times, Lithuanian sports politics was oriented to elite sport and it is still. The attempts to foster physical activity of the population lie on the movement “Sport for all,” but the results of the movement are not effective enough, because only a small part of the population (approximately 6%) took part in it. No one governmental institution has full and clear responsibility for the results of physical activity promotion. The poor environment of physical activity results in poor possibilities to be physically active in leisure domain. Differently, the huge expansion of the private sport, health, and beauty industries fosters the adoration of the body and overemphasizes the meaning of body image in the society. Physical activity is represented as the measure to achieve ideal body image or good health, but not as the measure of the overall culture of the human or society. Conclusions. The long-lasting, health-related physical activity-oriented national strategy is essential to foster physical activity, health, and quality of life at the national level. The multiplicity of possibilities in the physical activity would foster lifestyle activity instead of adoration of body image and would improve the psychological and physical well-being of the population

Relationship between demographic factors, exercise motives and disordered eating in exercising sample

Atlikta daugybė tyrimų, atskleidžiančių, kad valgymo sutrikimai labiau paplitę tarp profesionaliai sportuojančių (ypač kultivuojančių estetines sporto šakas) negu bendroje populiacijoje. Naujausi tyrimai atskleidžia, kad asmenys, besimankštinantys sveikatingumo centruose, dažniau kenčia nuo valgymo sutrikimų nei kitur sportuojantys. Nemažai tyrimų atlikta tiriant vaikų, jaunimo ir studentų mankštinimosi motyvacijos, valgymo sutrikimų rizikos ryšius, tačiau mažiau žinoma, kaip demografiniai bei mankštinimosi veiksniai gali būti susiję su besimankštinančių suaugusių asmenų, ypač vyrų, valgymo sutrikimų rizika. Šio tyrimo tikslas – nustatyti, kaip demografiniai (lytis, amžius, išsilavinimas) ir mankštinimosi (motyvacija, stažas) veiksniai susiję su besimankštinančių asmenų valgymo sutrikimų rizika. Tyrimo imtis ir organizavimas. Tyrimas buvo atliekamas 2008 metų pavasarį keliuose Kauno sveikatingumo centruose, taikant apklausos raštu metodą. Iš viso buvo analizuoti 239 tiriamųjų duomenys, iš jų – 81 vyras (amžiaus vidurkis (SD) 30,8 ± 8,9 m.). Tyrimo instrumentas. Anketą sudarė demografinių klausimų blokas. Valgymo sutrikimų rizika nustatyta taikant Požiūrio į valgymą testą (Eating Attitude Test-26, Garner, 1982). Mankštinimosi motyvacija buvo nustatoma remiantis apsisprendimo teorijos pagrindu sukurtu klausimynu (angl. Motives for Physical Activity Measure-Revised; MPAM-R) (Frederick, Ryan, 1993). Rezultatai. Bendras šios imties tiriamųjų valgymo sutrikimų rizikos balų vidurkis buvo 7,67 ± 8 balo. Į valgymo sutrikimų rizikos grupę (surinko 20 ir daugiau balų) pakliuvo 21 (9,1%) tiriamasis, iš jų – 7 (8,64%) vyrai ir 14 (8,86%) moterų. Logistinė regresinė analizė atskleidė, kad mankštinimasis dėl išvaizdos (p 0,05) ir mankštinimosi dažnis buvo susiję su didesne valgymo sutrikimų rizika (p >0,05). Išvados. Valgymo sutrikimų rizika yra paplitęs reiškinys tarp besimankštinančių asmenų. Moteriška lytis, amžius ir aukštesnis išsilavinimas nėra reikšmingai susiję su sveikatingumo centruose besimankštinančių asmenų valgymo sutrikimų rizika. Mankštinimasis dėl išvaizdos gerinimo motyvo yra svarbiausias valgymo sutrikimus prognozuojantis veiksnys (p <0,05). Tyrimas pagrindžia prevencinių programų bei vidinės motyvacijos stiprinimo būtinybę sveikatingumo centruose ir atskleidžia šių programų reikalingumą vyrams.Plethora of research shows that eating disorders are more common among professional athletes, especially aesthetic sports compared to general populations. The research showed that fitness centre exercisers more frequently demonstrated symptoms of disordered eating compared to exercisers of other sports settings. The relationship between eating disorders and exercise – related attitudes and behaviour has been well documented in the young populations, yet less is known how demographic and exercise – related factors are related in populations of adult exercisers at fitness centres. The aim of this study was to assess how demographic (gender, age and education) and exercise – related (motivation, experience, frequency) factors were related to the risk of eating disorders in fitness centres exercisers. Method. The study was carried out in spring of 2008 in several Kaunas health and fitness centres. The data were collected using the method of anonymous questioning. The sample consisted of 239 respondents, 81 of them were men (mean age 30.8 ± 8.9 years). The instrument. The demographic data were collected. The risk of eating disorders was assessed using Eating Attitude Test – 26; EAT - 26, Garner, 1982. Exercise motivation was assessed by Motives for Physical Activity Measure-Revised; MPAM-R (Frederick, Ryan, 1993). Results. The mean score for EAT-26 in the sample was 7.67 ± 8.21 (9.1%) of the sample demonstrated the symptoms of eating disorders (EAT 20), 7 (8.6%) of them were men and 14 (8.9%) women. Logistic regression analysis showed that the strongest significant predictor of disordered eating was exercising due to appearance improvement. The risk of eating disorders was typical of persons exercising in fitness settings. The study showed the necessity to enhance the internal exercise motivation in exercising samples and the need for the body image prevention in fitness settings not only in the young female samples but for the exercising men as well

Links between adolescents body dissatisfaction and self-esteem, health perception, physical activity and eating disorder risks

Studies in Western countries have shown that body dissatisfaction among adolescents is associated with lower self-esteem, lower levels of exercise, eating disorders (Neumark–Sztainer et al., 2006), and poorer perception of health (Meland, Hougland, Breidablik, 2007). There is a lack of studies in this field in our country and it is unknown whether body dissatisfaction is related to poorer adolescent health assessment. The purpose of this study is to investigate the links between adolescents’ body dissatisfaction and their self-esteem, health perception, physical activity, and eating disorder risk. Methods. The survey was carried out by distributing a written questionnaire to juniors (11th graders) from various secondary schools (n=10) and gymnasiums (n=6) in Kaunas in 2009. The sample of respondents was composed of 805 adolescents. The average respondents’ age (SD) was 17.23 (0.6). 329 (40.9 %) respondents were males and 476 - females (59.1 %). Tools. Body dissatisfaction was determined by the question “Are you essentially satisfied with your body?” Perception of health was determined by the question “How would you evaluate your health?” This question is used in the International Study of Health and Well-being among School-Aged Children, coordinated by WHO (Currie et al., 2002; Zaborskis, Vareikienė, 2008). The Rosenberg Self-Esteem Scale (Rosenberg, 1989) was employed as well. The risk of developing an eating disorder was determined with the Eating Attitudes Test EAT-26 (Garner et al., 1982). Physical activity (PA) was determined by questions from the International Study of Health and Well-being among School-Aged Children, coordinated by WHO (HBSC - Health Behaviour in School-Aged Children). Body mass index (BMI) was calculated according to the weight and age indicated by the respondents. Results. The results demonstrated that 141 (17.4 %) adolescents of the sample were dissatisfied with their bodies. The male respondents dissatisfied with their bodies also revealed a higher risk for developing eating disorders, respectively scoring 14.17 and 4.53 points (U=3155; p=0.001). The female respondents who were dissatisfied with their bodies and who displayed a significantly higher risk of developing eating disorders, respectively scoring 15.23 and 6.93 points (U=9764; p=0.001), had much higher body mass indexes, respectively scoring 21.89 and 19.77 points (U=10734; p=0.001). A correlation analysis of male and female groups revealed that body dissatisfaction was negatively linked to physical activity, self-esteem, and health perception. A logistic regression analysis revealed that dissatisfaction with one’s body and the risk of developing an eating disorder were statistically significant in predicting low health perception scores. Dissatisfaction with one’s body increased poor evaluations of health by a factor of 1.5. Model χ² = 8.76; df= 8; p = 0.36 (Nagerkelke R² = 0.12). Conclusions. Thus, when implementing the general health education program in schools, it is necessary to incorporate activities that would promote critical thinking in adolescents, their self-esteem and their ability to resist negative pressure imposed by media to conform to the body image perpetuated by society

The Relation between the sociocultural attitudes towards appearance and the lifestyle and self-esteem of adolescents

Background. The adolescents seeking to conform to the ideal appearance associate the reduction of weight with smoking and alcohol consumption (Haley, Hedberg, & Leman, 2010) or go on a diet instead of increasing their physical activity (Liechty, 2010). The adolescents dissatisfied with their body have lower self-esteem (Neumark- Sztainer et al., 2006). In this study we assumed that the sociocultural attitudes towards appearance would be associated with adolescents’ harmful lifestyle and lower self-esteem. Research aim was to disclose the relation between the sociocultural attitudes towards appearance of adolescents and their lifestyle and self-esteem. Methods. The research was carried out in Kaunas schools (n=16) using the method of written survey. In total, 805 adolescents were surveyed, 329 (41.1%) out of them were boys. The mean age (SD) of the respondents was 17.23 (0.6) years. Instruments: Sociocultural Attitudes Towards Appearance Questionnaire-3 SATAQ-3-L (Thompson, van den Berg, Roehrig, Guarda, & Heinberg, 2004), Rosenberg Self-Esteem Questionnaire (Rosenberg, 1989). Physical activity (PA) was determined using the questions from the international study Health Behaviour in School-Aged Children. The frequency of dieting and having harmful habits were determined by individual questions. Results. The weight of the majority of adolescents (75.5%) was normal. The numbers of adolescents were as follows: those who smoked (39.8%), consumed alcohol (80.5%), were on diet (36.8%), and had low levels of physical activity (74.4%). The adolescents who smoked, consumed alcohol and were on diet had significantly higher scores in all SATAQ subscales. Physically active adolescents were more striving to meet the Internalization of athletic body image. In the groups of boys and girls, BMI was related to more frequent sociocultural pressures (p<.01) and more frequent dieting (p<.01).In the group of boys, the frequency of smoking was related to lower self-esteem (p<.05). In the group of girls, sociocultural pressures were related to lower self-esteem (p<.05). Conclusion. The sociocultural attitudes towards appearance of adolescents are related to more harmful lifestyle and lower self-esteem. Therefore, health literacy of the adolescents has to be increased by teaching proper attitudes towards their bodies, appropriate diet, and exercising