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This review articulates current understanding of the aesthetic, artistic and creative contributions that Dance makes to Health and Wellbeing across the lifecourse within publications 2000–2019, an under-researched area. Review Questions: What are the aesthetic, artistic and creative contributions that Dance makes to Health and Wellbeing across the lifecourse? And what methodologies are appropriate for investigating these contributions? A database keyword search identified 769 articles and 91 evaluations. 109 documents were identified for further in-depth analysis and rating, resulting in 24 papers (11 articles, 3 PhD studies, 10 evaluation reports), which were thematically analysed. Findings offer seven interrelated contributions that Dance makes to Health and Wellbeing: embodiment, identity, belonging, self-worth, aesthetics, affective responses and creativity. There was less insight regarding different methodologies, and discussions focused on quantitative data's limitations. There were insights into inclusion of embodied voices, subjective accounts, and lived experiences. Whilst acknowledging challenges, this paper illuminates the key contributions of dance to arts and health. It provides a future conceptual research agenda (prioritizing identity and creativity) and associated methodological developments. It recommends expanding geographical/lifecourse research, better defining terms, fuller epistemological critiques to open space for new methodologies, and continued attendance to appropriate rigour criteria. [ABSTRACT FROM AUTHOR]

Purpose: This paper presents qualitative research findings from the evaluation of a Parkinson's Dance well-being venture in the UK. Methods: Qualitative data was gathered to see how bespoke dancing sessions helped people with Parkinson's (PwP) to manage their conditions and improve their lives and prospects. Principles of a participatory approach were incorporated and methods included semi-structured interviewing, researchers participant observation and an elicitation-based activity. Nineteen PwP, six carers, four dance artists and seven helpers participated in the study. Results: Participating in Parkinson's Dance sessions meant that PwP could experience the possibilities to dance, develop a "can do" attitude, experience fun, enjoyment, social connection, exercise, movement to music, improvement and/or maintenance of their balance, suppleness, coordination and confidence with movement, symptoms being pushed back and ability to learn new things. Conclusions: Our findings add to the evidence-base about the benefits of dance for people experiencing Parkinson's and through novel application of the Life-world based well-being framework of K. T. Galvin and Todres (2011) we propose a theoretical basis for Parkinson's Dance as a resource for well-being. There is scope to consider application of the well-being framework to other arts activities and as the basis of an arts and well-being evaluation tool. [ABSTRACT FROM AUTHOR]

Recovery-oriented mental health care approach is gaining acceptance in Asian countries, including Singapore. Following Western countries, Singapore started hiring peer support specialists (PSS) as part of mental healthcare services. The aim of this paper was to explore and understand how individual peer support specialists in Singapore perceive and make sense of their role given their unique perspective as both recipients and providers of mental healthcare treatment. Six PSS in Singapore were interviewed utilizing a semi-structured interview schedule. Interviews were transcribed verbatim and analysed using interpretative phenomenological analysis. Four superordinate themes were generated illustrating how PSS viewed their role: embracing and embodying recovery, balancing on a bridge, impossible without support, and helping to end stigma. Findings also illustrated participants' awareness of the nature of the job and the role of PSS as still in the infancy stage. They embraced a recovery-oriented mindset despite experiencing stigma from professionals and/or their social support. The need to understand familial attitudes towards the PSS role is discussed. The limitations, contributions to the research, and several areas for future research are also outlined. [ABSTRACT FROM AUTHOR]

Purpose: Despite increased focus on parenting support internationally, there is a lack of agreement in what constitutes parenting support. This paper explores the experiences of parenting support activities from the perspective of stakeholders in Norwegian basic schools. Methods: Five focus group interviews were conducted with representatives from the schools' parent work committee, class teachers, health nurses, and social workers from nine schools. The data were interpreted using an inductive thematic analysis. Results: Three main themes emerged from the data: (1) A community for the best of the child, (2) uniting through relations, and (3) sharing knowledge and language. Parenting support was experienced as universal, relational, and multidimensional. It was related to everyday life interactions between the home, school, and the parenting community with the best interest of the child as a goal. Conclusion: To avoid reducing parents to passive recipients of expert advice, parenting support activities should be an integral part of everyday school-home-parenting community collaborations. Abbreviation: EU-The European Union; UN-The Unition Nations; CoE-The Council of Europe; NSD-The Norwegian Centre for Research Data; CTP-Class teachers in primary school; CTJS-Class teachers in junior secondary school; P-Parents; H-Health nurses; SW-Social workers [ABSTRACT FROM AUTHOR]

Purpose: Understanding the nature of wellbeing as multidimensional and complex provides a policy window to generate a strengths-based policy orientation to promote wellbeing in education settings. The purpose of this exploratory paper is to map how wellbeing is interpreted across public education policy documents in Aotearoa New Zealand. Method: To explore the narrative that this group of documents weave, we draw on models of holistic wellbeing, ecological systems and appreciative inquiry. Policy documents were analysed using text mining software to track notions of wellbeing; their occurrence and co-occurrence with related concepts. Results: Key findings include the predominance of wellbeing, the interrelatedness of wellbeing with relationships, and the predominance of student wellbeing over the wellbeing of other stakeholders, highlighting that current education policy does not interpret wellbeing as relational, complex or contextual. Conclusion: We argue that interpreting such documents through a wellbeing lens demonstrates the complexity and disparity of the conceptualization and contextualization. We assert that it is critical to explore possibilities for deliberate and ecological wellbeing connections within educational policy and practice for the good of all stakeholders. [ABSTRACT FROM AUTHOR]

Purpose: Self-reliance and social participation are strongly promoted by social policy. Both concepts are linked to the concept of vulnerability, for people who do not meet these standards are labelled "vulnerable people". In this paper, the insider's perspective takes central stage by seeking to explore what it means to be labelled a "vulnerable person", and through this to further our insight into the meaning of the concept of vulnerability. Method: Thirty-three in-depth interviews were conducted with 16 allegedly vulnerable people. The data were subjected to thematic content analysis. Results: Our analysis revealed three main dimensions and eight sub-dimensions of perceived vulnerability, outlining an insider's concept of vulnerability. This concept includes manifestations of vulnerability, feelings coexisting with vulnerability, and the image of vulnerable people. Conclusion: The perception of vulnerability changes when interacting with others in society, especially with social policy implementers. In this interaction, the perceived vulnerability increases and becomes societal vulnerability. It concerns a dependency situation in which one's strength and self-determination are not recognized, and the help needed is not provided. By acknowledging the insider's perspective, social policy can fulfil a more empowering role towards "vulnerable people" and contribute to people's well-being. [ABSTRACT FROM AUTHOR]

Purpose: Women's experiences of pregnancy, labour and birth are for some pregnant women negative and they develop a fear of childbirth, which can have consequences for their wellbeing and health. The aim was to synthesize qualitative literature to deepen the understanding of women's experiences of fear of childbirth. Methods: A systematic literature search and a meta-synthesis that included 14 qualitative papers. Results: The main results demonstrate a deepened understanding of women's experiences of fear of childbirth interpreted through the metaphor "being at a point of no return". Being at this point meant that the women thought there was no turning back from their situation, further described in the three themes: To suffer consequences from traumatic births, To lack warranty and understanding, and To face the fear. Conclusions: Women with fear of childbirth are need of support that can meet their existential issues about being at this point of no return, allowing them to express and integrate their feelings, experiences and expectations during pregnancy, childbirth and after birth. Women with fear after birth, i.e., after an earlier negative birth experience, need support that enables them to regain trust in maternity care professionals and their willingness to provide them with good care that offers the support that individual women require. Women pregnant for the first time require similar support to reassure them that other's experiences will not happen to them. [ABSTRACT FROM AUTHOR]

A recent paper has made the case for a ''fifth wave'' of public health action. The paper articulated the first four waves as focusing on civil engineering, the germ theory of disease, welfare reforms and lifestyle issues. This article will focus on wellbeing and will expand on the authors' articulation of a current need to ''discover a new image of what it is to be human'' to begin to address the challenges of promoting well-being. This article will consider an alternative way of viewing human beings within a ''caring'' context and how this alternative view may aid this potential fifth wave of public health action. This alternative view has emerged from the work of Husserl who suggested that any human view of the world without subjectivity has excluded its basic foundation. The phenomenological understanding of ''lifeworld'' is articulated through five elements, temporality, spaciality, intersubjectivity, embodiment and mood that are all discussed here in detail. A world of colours, sparkling stars, memories, happiness, joy, anger and sadness. It is this ''lifeworld' that when health care or as argued in this article as public health becomes overly focused on decontextualized goals, and measuring quality superficially can be neglected. [ABSTRACT FROM AUTHOR]

Purpose: This is a study on a sport-based intervention, with a focus on physical activity, social relations, and learning, to promote health and well-being in the workplace lived space. Lived space is situated and associated with social and cultural conventions which affect the quality of the perceived space at work. The aim of the paper is to elucidate the participant's experiences of the intervention and how health and well-being were affected. Methods: The intervention was conducted with employees from the warehouse of a company within the retail sector. The design consisted of one initial workshop as a baseline, a sport-based intervention, three group interviews, and a final workshop. A hermeneutic phenomenological analysis focused on experiences of the intervention and the meaning of the workplace as the lived space. Results: Three themes emerged in the analysis; Expressing positive individual effects, Expressing improved work environment and The meaning of the workplace as lived space. The themes are discussed in relation to three basic health foci: physical activity, social relations and learning. Conclusion: The workplace as a lived space offers a valuable opportunity for sport-based interventions that improve health and well-being through physical activity, social relations, and learning. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study was to explore and describe experiences of daily life after having experienced an avalanche three decades ago. Method: This paper presents a qualitative study of 12 male survivors of an avalanche during their military service, interviewed 30 years post-disaster. Findings: A comprehensive understanding of the categories led to the latent theme "Finding my own way of managing and dealing with life". Findings revealed three categories describing experiences of daily living: (i) A comfortable life; (ii) A challenging, yet accomplished life; (iii) A demanding life. The first category represents a greater degree of using adaptive coping strategies for managing everyday life compared to the other two categories. The third category represents the group having the most challenging consequences. Among the three, the latter category conveys the most maladaptive coping strategies. Conclusions:The participants had different experiences with regards to their health and how they coped with their everyday life after the avalanche disaster. Insights into coping strategies may provide a guide for appropriate interventions for survivors dealing with traumatic events. [ABSTRACT FROM AUTHOR]

Well-being in the workplace is considered by many authors to be the outcome of the interaction between individual characteristics and those of the working and organizational environment. This study aims to understand the significance attributed to the concept of well-being in the workplace by employees, its influencing factors, and, among those, the role of individual psychological characteristics. The research was conducted on a sample of 72 employees using a qualitative approach based on focus groups and individual interviews. Data analysis was performed by a paper and pencil technique. The focus groups and interviews collected 628 statements, which were divided into three main areas: meaning of well-being in the workplace (248), any kind factors that affect well-being in the workplace (158), and individual characteristics that affect well-being in the workplace (222). The individual characteristics identified by the participants as capable of influencing well-being in the workplace include being positive, communication, management of difficulties and conflicts, socio-emotional skills, and values. The research was limited by the participants involved and by the sole use of the paper and pencil technique of data analysis. Results highlight that well-being in the workplace does not depend exclusively on external conditions in terms of the working and organizational environment within which the individual operates: so, it could be promoted not only from above, through actions by management, but also from below, influencing individual traits and behaviours. Results would be useful for developing training, workplace counselling, and organizational development activities aimed to support small groups, leaders, and other strategic players in the construction of the subsystems of wellbeing in the workplace. [ABSTRACT FROM AUTHOR]

Purpose This study aims to contribute to the development of a theoretical model that is useful for enhancing well-being/positive mental health with pedagogical resources that enable the acquisition of skills and knowledge, particularly during Emerging Adulthood. Methods This paper enquires into the role of well-being promotion in higher education following the dual-factor model of mental health difficulties and wellbeing. The study narratively reviews the main well-being models and presents a compared theoretical synthesis examining the dimensions that promote or facilitate the presence of well-being using a promotion approach. Results The study identifies 14 dimensions involved in wellbeing—emotional, psychological and social factors—that can be potentially improved through learning processes. Drawing on empirical and theoretical studies on emerging adult population, a factorial model is proposed. Preliminary factor interactions are examined paying close attention to the cognitive processes that explain or affect their relationship with well-being, the possible correlations between them and particularities of emerging adults. Conclusion Wellbeing factors can be particularly targeted by educational promotion, as they can be developed through learning processes. An integrative model that provides a broad perspective can assist in pedagogical design and defining educational goals for these learning processes involved in wellbeing promotion.

The aim is to identify facilitators and barriers for physical activity (PA) experienced by morbidly obese adults in the Western world. Inactivity and a sedentary lifestyle have become a major challenge for health and well-being, particularly among persons with morbid obesity. Lifestyle changes may lead to long-term changes in activity level, if facilitators and barriers are approached in a holistic way by professionals. To develop lifestyle interventions, the perspective and experiences of this group of patients are essential for success. The methodology of the systematic review followed the seven-step procedure of the Joanna Briggs Institute and was published in a protocol. Six databases were searched using keywords and index terms. Manual searches were performed in reference lists and in cited citations up until March 2015. The selected studies underwent quality appraisal in the Joanna Briggs-Qualitative Assessment and Review Instrument. Data from primary studies were extracted and were subjected to a hermeneutic text interpretation and a data-driven coding in a five-step procedure focusing on meaning and constant targeted comparison through which they were categorized and subjected into a meta-synthesis. Eight papers were included for the systematic review, representing the experiences of PA among 212 participants. One main theme developed from the meta-data analysis: "Identity" with the three subthemes: "considering weight," "being able to," and "belonging with others." The theme and subthemes were merged into a meta-synthesis: "Homecoming: a change in identity." The experiences of either suffering or well-being during PA affected the identity of adults with morbid obesity either by challenging or motivating them. A change in identity may be needed to feel a sense of "homecoming" when active. [ABSTRACT FROM AUTHOR]

Objective: Subjective experience of people living with bipolar disorder is gaining attention in the field of research. Improving well-being could be as important as symptom remission, but this constitutes a vague concept. This study aimed at exploring the boundaries and the determinants of the well-being of people living with bipolar disorder in a French context. Methods: Individual semi-structured interviews were conducted with 16 patients by three professionals. Interviews were transcribed and analysed using the thematic analysis method. Results: Various dimensions emerged as contributing to well-being: daily routines, connectedness, regaining a positive identity, and self-awareness for self-management. Conclusions: In addition to those common to the general population, this study highlighted specific determinants of well-being: the construction of a positive identity through acceptance of the diagnosis, the importance of self-awareness and self-management. They are highly intertwined with those of personal recovery and could help caregivers design interventions that directly target these goals. This study aimed to identify specific components of well-being for people living with bipolar disorder. Understanding the determinants of wellbeing enable caregivers to design tailored interventions that directly target quality of life and help improve bipolar disorder outcomes. [ABSTRACT FROM AUTHOR]

Purpose: In 2017, international students contributed almost $32 billion to Australia's economy, more than half of which was attributable to students from China. Despite its historical popularity as a study destination, research suggests that these students confront numerous obstacles in pursuing their studies within Australia. In this study, the perspectives of these students were explored. The dominant issues raised by these students related to mental health and emotional wellbeing. Methods: Nineteen students in one Australian university participated in one-on-one in-depth semi-structured interviews. Data were analysed using grounded theory approaches. Three broad themes were generated in the study: psychological stress (which was linked to language barriers, shifts in pedagogy, and changes in lifestyle); perceived safety (which was linked to lack of security, safety and perceived racial discrimination); and social isolation (linked to reduced sense of belonging; lacking close personal connections; and feelings of loneliness and homesickness). Conclusions: Results suggested that a tripartite model of interactive risk factors may be appropriate for exploring how international students fare emotionally with their new environments. [ABSTRACT FROM AUTHOR]

South Asians are the largest and fastest-growing racialized group in Canada, yet there are limited data on various aspects of health and well-being within this population. This includes the South Asian older adults' ethnoculturally informed perceptions of ageing. The study aimed to understand how social and cultural forces impact the meaning assigned to healthy ageing amongst older South Asians in Canada. We recruited with purposeful and snowball sampling strategies in Southern Ontario. We conducted in-depth focus group and individual interviews (n = 19) in five South Asian languages, employing a multilingual and cross-cultural qualitative approach. In our analysis, we identified three central themes: (a) taking care of body (b) taking care of mind and heart and (c) healthy ageing through the integration of mind and body. Our study demonstrates that older immigrants are a diverse and heterogeneous population and that their conception of healthy ageing is strongly influenced by their country of origin. This study also demonstrates how racialized foreign-born older adults might provide distinctive perspectives on the ageing process and on social theories of ageing due to their simultaneous immersion in and belonging to global majority and global minority cultures. This research also adds to the limited body of literature on the theories of ageing, despite migration trends, still has a white-centric lens. [ABSTRACT FROM AUTHOR]

Purpose: Despite suboptimal HIV outcomes among female sex workers (FSW), limited research has been conducted on factors that impact viral suppression among this population. Examining narratives of HIV management, we examined how experiences of diagnosis, treatment initiation, and ongoing care behaviours shaped viral suppression outcomes over time. Methods: We conducted 20 in-depth interviews with FSW in Santo Domingo, Dominican Republic. Using narrative and thematic qualitative approaches, we developed analytic summaries and matrices to compare trajectories of managing HIV between suppressed and unsuppressed participants. Results: Regardless of suppression status, participants described similar narratives of overcoming initial challenges to HIV management through personal resilience and social support. Unsuppressed participants identified more delays in initiating antiretroviral therapy and more lapses in adherence due to less active acceptance of their HIV status and more persistent experiences of economic hardship and HIV stigma. Conclusions: We found that individual, interpersonal and structural factors, including stigma and economic precarity, differentiated trajectories towards viral suppression among FSW indicating the importance of multilevel interventions. Improved access to mental health services and social support could promote greater early acceptance of HIV status and progress towards viral suppression among FSW. [ABSTRACT FROM AUTHOR]

Purpose: The invaluable, yet challenging role of pastors in the community signifies the need to understand and care for their well-being. Well-being, conceptualized in the multidimensional construct of flourishing, does not explicitly include spiritual well-being, yet, it is the foundation of pastors' well-being. In this article we aim to describe pastors' spiritual wellbeing and in so doing, highlight its fundamental importance in pastors' flourishing in the ministry. Methods: Positioned in the interpretive pragmatic paradigm, data were gathered and analysed from three focus groups with 18 pastors in the Dutch Reformed Church and the Uniting Reformed Church of South Africa. Interactive qualitative analysis was applied, and results were conceptually refined through narrative synthesis. Results: Four themes were constructed to describe pastors' spiritual well-being namely: i) an altruistic calling; ii) discipleship iii) seasons of the ministry; and iv) ethics. Conclusion: The findings highlight the importance and essence of the spiritual aspects predominant to pastors' well-being. Attending to spiritual well-being will enhance their resilience and constructive coping and is integral to their way of flourishing at work. This proposes an extension of the flourishing framework to include spiritual well-being as an explicitly conceptualized sub-dimension for application to the study's Christian pastoral context. [ABSTRACT FROM AUTHOR]

Background: Living with chronic obstructive pulmonary disease stage III or IV means living an everyday life, severely restricted by breathlessness. Aim: The aim of this study was to elucidate meanings of feeling well for women with chronic obstructive pulmonary disease stage III or IV. Method: The study has used a phenomenological hermeneutical design. Individual narrative interviews were conducted with 14 women with chronic obstructive pulmonary disease at stages III or IV. Results: The results revealed one theme: striving for moments of easier breathing despite being trapped in breathlessness with four subthemes: acting in rhythm with breathing, taking care of oneself, taking advantage of better moments, and being in togetherness in everyday life. Conclusion: This study shows that women with chronic obstructive pulmonary disease at stages III or IV strived for moments of feeling well despite living with a severe illness. Feeling well meant that when connected to nature, they felt alive, free, and less trapped in breathlessness, which provided a sense of being unconscious of their breathing rhythm. They could do what healthy people tend to take for granted during everyday life. To feel well, the women found it important to receive tailored support from their close relatives. [ABSTRACT FROM AUTHOR]

Purpose: Researchers have observed a rise in mental health issues among university students over the course of the pandemic, in part due to the closure of schools and public spaces for wellness. Thus, the purpose of this study is to explore how students creatively reassemble their self-care practices through different objects and spaces within their homes to care for their mental health. Methods: Photo-elicitation interviews were conducted with ten (10) female university students from the Philippines. Photographs and interview transcripts were analysed through map-making practices and an iterative process of crafting assemblages and their cofunctionings. Results: The work-home assemblage was identified as the site of self-care, delineated by boundary-making and place-making practices and the creation of time spaces. The two major cofunctionings of the work-home assemblage were (a) caring for the self as fostering different relationalities with the self, and (b) caring for the self as copresencing with human and nonhuman others. Conclusion: Findings demonstrate the importance of material and spatial relationalities in facilitating caring relational encounters with the self. Theoretical and practical implications include attuning to the existing material and spatial resources in one's environment and integrating them into one's practices of caring for the self. [ABSTRACT FROM AUTHOR]

Purpose: Postpartum Depression (PPD) --a common health problem for mothers' postpartum increases the risk of negative interaction between mothers and infants as it reduces the former's ability to respond to the latter's needs appropriately. Migrant mothers exhibit a higher prevalence of risk factors for PPD. Hence, this study aimed to investigate migrant mothers' life experiences pertaining to motherhood and PPD. Methods: Qualitative interviews were conducted with 10 immigrant mothers in the south of Sweden during 2021. Results: The qualitative content analysis revealed the following main themes: 1) PPD (two sub themes--psychosomatic symptoms and burden of responsibility due to feelings of loneliness); 2) mistrust of social services (one sub-theme--afraid of losing their children and Swedish social services' lack of understanding); 3) inadequate healthcare (two subthemes-- limited healthcare literacy for migrant mothers and language barrier; 4) women's coping strategy for well-being (two sub-themes--better awareness and understanding of the Swedish system and society, and freedom and independence in the new country). Conclusions: PPD, mistrust of social services, and inadequate healthcare lacking personal continuity were common among immigrant women, thus precipitating discrimination-- including lack of access to services because of limited health literacy, cultural differences, language barriers, and insufficient support. [ABSTRACT FROM AUTHOR]

Purpose: Food delivery platform work is a relatively new phenomenon in Finland and has not been studied widely hence limited knowledge on its work environment. The aim of this study was to explore and understand its psychosocial work environment in the Helsinki region and how it relates to the mental wellbeing of its couriers. Methods: The study draws its findings from 20 semi-structured, in-depth interviews with food delivery platform workers in Helsinki. Data were approached through thematic analysis where the six phases of thematic analysis were meticulously followed. Results: Food delivery platform work provided couriers with income and labour market opportunities. However, its work environment was psychosocially burdening, which posed detrimental challenges to the mental wellbeing of its couriers. Conclusion: Study findings indicated that food delivery platform workers worked in an onerous work environment, which accentuated their occupational mental health. Thus, this study recommends future longitudinal research that would examine the association between food delivery platform work and mental health of couriers working through such platforms. Also, interventions and policies that aim at improving its psychosocial work environment are required for a more decent and healthier work environment that enhances mental health and wellbeing of its couriers. [ABSTRACT FROM AUTHOR]

Purpose: Those travelling overseas for work or leisure including male expatriates, longer-term and frequent travellers (ELoFTs) may be at heightened risk for a range of health and wellbeing issues. Social support may mediate this risk. However, from a public health perspective, little is written about how ELoFTs access health information and support and the role of their social networks in facilitating health and wellbeing outcomes. This research was part of a study examining social network processes of Australian male ELoFTs travelling, living, or working in Southeast Asia (SEA). Methods: Symbolic Interactionism and Grounded Theory were the conceptual framework and methodology supporting semi-structured, in-depth interviews (n = 25) conducted in Australia and Thailand with Australian male ELoFTs to SEA, aged 18 years or older. Results: Findings highlight supports that assist ELoFT transition and adjustment to country of destination or manage their transnational experience. Influential places, people, and points in the migration journey mediated engagement with social support. Conclusions: ELoFT social networks and the support provided within them may provide a mechanism for intervention across a range of public health issues. Findings may support the development of policy and practice across industries charged with supporting successful ELoFT adjustment. [ABSTRACT FROM AUTHOR]

The objective of this study was to understand older adults' perceptions of the connections between an exergame intervention, "I Am Dolphin," and their subjective well-being. Researchers conducted three focus groups with 14 older adults who participated in the exergame feasibility study. The semi-structured focus groups were transcribed, coded, and analysed using deductive and inductive techniques. Three themes were constructed related to playing the exergame and participants' subjective well-being: 1) elevated mood (through scheduled activity, immersion, and socialization), 2) feelings of achievement (especially following frustration and competition), and 3) perceived cognitive or physical changes. These findings will help researchers better understand how exergames may relate to the well-being of older adults. Future investigators could use these findings to create and implement new exergame interventions. [ABSTRACT FROM AUTHOR]

Purpose: As cancers increase in Ghana and in many low-and middle-income countries, healthcare utilization has become critical for disease management and patients' wellbeing. There is evidence that medical pluralism is common among cancer patients in Ghana and many other African countries, which results in lack of adherence to and absconding from hospital treatments. The objective of this study was to examine ways in which beliefs in disease causation influence medical pluralism among Akan cancer patients in Ghana. Methods: A qualitative research approach was employed in this study. In-depth interviews were conducted for thirty (30) cancer patients who were purposively recruited from Komfo Anokye Teaching Hospital in Ghana. Thematic content analysis was used in analysing data. Results: Our findings revealed that cancer patients ascribed both physical and spiritual causality to their illness. As such, they combined orthodox treatment with spiritual healing and herbal medicine. Regarding the order of therapeutic search, patients reported to herbal and spiritual centres before going to the hospital, a phenomenon which contributes to the late reporting and diagnosis as well as bad prognosis of cancers in Ghana. Conclusion: The findings of this research elucidate the relationship between culture and health care choices of cancer patients in Ghana. Increased awareness creation is crucial in eradicating myths surrounding cancers in Ghana. [ABSTRACT FROM AUTHOR]

Purpose: This embedded qualitative study explored the acceptability, feasibility, and fidelity of two multi-level RCT interventions among office workers, aiming at improving movement behaviour to enhance mental health and cognition. The interventions addressed the organizational, environmental, and individual level. Methods: Semi-structured interviews and focus group discussions were conducted with 38 stakeholders after completion of the interventions. Data were analysed using reflexive thematic analysis. Results: The interventions were well appreciated, and office workers attributed improvements in movement behaviour and wellbeing to the interventions. Especially the cognitive behavioural therapy (CBT) based counselling and free gym access were appreciated, feasible and delivered as planned. Participants described existing workplace norms as barriers to more activity, particularly for reducing sitting. Support from managers and team support were considered crucial components. However, delivering these components was difficult. Conclusions: The findings support the design of the multi-level interventions for changing movement behaviour. Results highlight the potential of CBT for this target group and the importance of manager and team support. Desired effects of similar multi-level interventions, including CBT, might be achieved in future studies that carefully address the issues with feasibility and acceptability and the resulting low fidelity of some intervention components that were identified in this study. [ABSTRACT FROM AUTHOR]

Purpose: China employed a unique volunteerism system where health care providers outside of Hubei Province, the epicentre, travelled to reverse the devastation wrought by coronavirus disease 2019 (COVID-19) at its global onset. The aim is to study the unique circumstances of Chinese volunteerism in the context of continuing pandemic threats, specifically exploring the experiences of 20 Chinese nurse and physician volunteers fighting COVID-19 during the outbreak. Methods: Interviews were done through video calling. Results: Using content analysis with a hermeneutic perspective, emerging patterns showed the ways in which China's particular manifestation of volunteerism teaches us how to engage global threats of this nature. The overarching lesson, For the Good of the People, was manifested in several dynamic and overlapping themes: 1) Reaching for Professional Standards Even in Crisis; 2) Constantly Caring Through Failures and Successes; and 3) Holding Fast to the Common Good. The devastation was met by the resilience of volunteers, who overcame profound challenges managing patient care. Conclusions: Volunteerism required sacrifice and tremendous support in the form of training and administrative direction, family support, and peer collaboration. Volunteers' physical and psychosocial wellbeing was a priority. Recognizing the representative themes can help societies plan for continuing and future events. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

According to self-determination theory competence is a basic psychological need that is crucial for wellbeing. Social contexts strongly influence whether competence is supported or thwarted. Given that social media is a pervasive social context within adolescents' lives, it can play a crucial role in competence development. Three qualitative methods were used to investigate mid-adolescents' perspectives of how their social media use impacts competence. Participants included 36 students aged 15 years from four Australian schools. All participants completed a rich picture mapping activity and focus group discussions. A sub-sample of 11 students participated in follow-up interviews. Reflexive thematic analysis generated two overarching themes. The first theme cultivating competence includes sub-themes; enhancing social competencies, mastery experiences and goal accomplishment, and social media expertise. The second theme constraining competence includes sub-themes; ineffectance within the social media environment, interfering with sleep, and hindering learning. Findings demonstrated that social media contributes to today's adolescents encountering unique experiences with regards to competence development. Furthermore, adolescents' interactions on social media have broad implications for competence within online and offline realms. This study identifies aspects of social media use that can be targeted to help adolescents engage with social media in ways that cultivate rather than constrain competence. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this scoping review is to compile and examine characteristics and impacts of live music interventions on the health and wellbeing of children, families, and health care professionals in paediatric hospital care. Methods: We searched four scientific databases for peer-reviewed publications of empirical studies of all study designs. The first author screened the publications, with spot-checks for eligibility by the second and third authors. Data extraction and quality assessment were made by the first author with support from the second and third. Additionally, the included studies were screened for quality appraisal. The analysis followed an inductive, interpretive approach for synthesis. Results: Quantitative features were screened and compiled, and qualitative inductive analyses of findings were elaborated into categories connected to research questions. The reported impacts were thematized through emergent features of importance and prerequisites beneficial for successful interventions. Recurrent outcomes present themes of positive affect, copingand reduced hospitalization. Emotional regulation, play and participation, age, session design, adaptivity, and familiarity present benefits, barriers, and facilitators for outcomes. Conclusions: Findings from collected empirical research display philosophy, practice, and relations as keys for characteristics, impacts, and implications of live music interventions in paediatric hospital care. The communicative aspects of music appear at the core of importance. [ABSTRACT FROM AUTHOR]

Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome—Hypermobility Type (JHS/EDS-HT) is a complex and multisystemic condition which significantly impacts on a person’s health and well-being and is challenging for health professionals (HPs) to manage. People with JHS/EDS-HT and HPs recognise the individual nature and the complexities of the condition. There is a requirement to understand the condition within the context of the individual human dimensions of illness and healing. The aim of this paper is to explore the management of this condition using a theoretical model referred to as the Humanisation Framework.  It is suggested that using the philosophical dimensions of this framework will empower HPs and those with JHS/EDS-HT to work together to proactively manage this condition. The eight dimensions of the Humanisation Framework facilitate an experiential understanding of the person within their context and environment, providing a constructive adjunct to the evidence-based management of those with JHS/EDS-HT. The humanisation framework was developed for health and social care and uses the philosophy behind well-being and what makes well-being possible. This paper explores how HPs may use aspects of the framework to understand the condition and empower and motivate those with JHS/EDS-HT to be active participants in their own well-being. [ABSTRACT FROM PUBLISHER]

This paper explores the lived experiences of older surgical patients' (aged 74 years and older) experienced challenges during a brief admission to hospital. Age, gender, polypharmacy, and the severity of illness are also factors known to affect the hospitalization process. For an ethnographic study using participant observation and interviews, surgical cancer patients (n=9, aged 74 years and older) were recruited during admission to a Danish teaching hospital. Using ethnographic strategies of participant observation and interviews, each patient was followed through the course of 1 day during their stay at the hospital. Interviews were carried out with all patients during this time. Three areas of concern were identified as prominent in the patients' experiences and challenges during their short hospital stay: teeth and oral cavity, eating in a hospital setting, and medication during hospitalization. Short-term hospitalization requires focused collaboration between staff and patient concerning individual challenges from their teeth and oral cavity as support of nutritional needs during surgical treatment for cancer. [ABSTRACT FROM AUTHOR]

This article offers a conceptual framework by which different kinds and levels of well-being can be named, and as such, provides a foundation for a resource-oriented approach in situations of illness and vulnerability (rather than a deficitoriented approach). Building on a previous paper that articulated the philosophical foundations of an existential theory of well-being (''Dwelling-mobility''), we show here how the theory can be further developed towards practice-relevant concerns. We introduce 18 kinds of well-being that are intertwined and inter-related, and consider how each emphasis can lead to the formulation of resources that have the potential to give rise to well-being as a felt experience. By focusing on a much wider range of well-being possibilities, practitioners may find new directions for care that are not just literal but also at an existential level. [ABSTRACT FROM AUTHOR]

The aim of this paper is to discuss how everyday life changes for the family in the event of chronic illness or disability. It changes physically due to loss of body function and socially due to time and other constraints related to treatment or lack of mobility. Equally important, there is a psychological impact due to the uncertainty of the future. The article will explore how family participation can help to maintain well-being in everyday life. The family should therefore focus on their own needs as much as on the needs of the family members who are ill. In order to maintain well-being in everyday life, it is crucial for the family to create routines and spend time doing things that they enjoy. By doing this, the family will create a rhythm of well-being regardless of the critical family situation. Family members and professional caregivers also need to come together at the beginning and during the illness or disability event to discuss changes that could be made day-to-day for all those involved, thereby making for an easier transition into care giving. [ABSTRACT FROM AUTHOR]

This paper will explore two contrasting paradigms in mental health care and their relationship to evidence-based practice. The biomedical perspective of pathogenesis and the health perspective of salotogenesis are two major diverse views in mental health care. Positive dimensions of health are traditionally viewed as software not suitable for statistical analysis, while absence of symptoms of disease are regarded as measurable and suitable for statistical analysis and appropriate as a foundation of evidence-based practice. If the main goal of mental health care is to enhance subjectively experienced health among patients, it will not be sufficient to evaluate absence of symptoms of disease as a measure of quality of care. The discussion focuses on the paradox of evidence-based absence of illness and disease versus subjectively experienced health and well-being as criterions of quality of care in mental health care. [ABSTRACT FROM AUTHOR]

Based on in-depth interviews with 15 physicians on long-term sick leave in the north of Sweden, the aim of this paper is to describe and understand what happened before, during and after sick leave. A constructivist grounded theory approach was used to construct a framework inductively from the stories of the physicians. As a result of hierarchical coding procedures in terms of initial, focused and theoretical coding, the circular or helical road back to well-being was constructed. This core category, formed in response to structure and to the culture of the medical profession, is constituted of five categories, including dealing with changing working conditions, resisting sick and patient role, resisting sick leave, spending time on sick leave and, finally, returning to work. Not only were the physicians expected to work very hard, but also they were expected to take charge, and did take charge, of their own treatment and rehabilitation. They reinforced these phenomena, by employing strategies to deal with high workload and to avoid sick leave. None of them later returned to full-time work. Notwithstanding that, some aspects of the culture of the medical profession are destructive; in this case, it promoted a strong will and motivation to return to work. [ABSTRACT FROM AUTHOR]

Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome—Hypermobility Type (JHS/EDS-HT) is a complex and multisystemic condition which significantly impacts on a person’s health and well-being and is challenging for health professionals (HPs) to manage. People with JHS/EDS-HT and HPs recognise the individual nature and the complexities of the condition. There is a requirement to understand the condition within the context of the individual human dimensions of illness and healing. The aim of this paper is to explore the management of this condition using a theoretical model referred to as the Humanisation Framework. It is suggested that using the philosophical dimensions of this framework will empower HPs and those with JHS/EDS-HT to work together to proactively manage this condition. The eight dimensions of the Humanisation Framework facilitate an experiential understanding of the person within their context and environment, providing a constructive adjunct to the evidence-based management of those with JHS/EDS-HT. The humanisation framework was developed for health and social care and uses the philosophy behind well-being and what makes well-being possible. This paper explores how HPs may use aspects of the framework to understand the condition and empower and motivate those with JHS/EDS-HT to be active participants in their own well-being.

A recent paper has made the case for a “fifth wave” of public health action. The paper articulated the first four waves as focusing on civil engineering, the germ theory of disease, welfare reforms and lifestyle issues. This article will focus on well-being and will expand on the authors’ articulation of a current need to “discover a new image of what it is to be human” to begin to address the challenges of promoting well-being. This article will consider an alternative way of viewing human beings within a “caring” context and how this alternative view may aid this potential fifth wave of public health action. This alternative view has emerged from the work of Husserl who suggested that any human view of the world without subjectivity has excluded its basic foundation. The phenomenological understanding of “lifeworld” is articulated through five elements, temporality, spaciality, intersubjectivity, embodiment and mood that are all discussed here in detail. A world of colours, sparkling stars, memories, happiness, joy, anger and sadness. It is this “lifeworld’ that when health care or as argued in this article as public health becomes overly focused on decontextualized goals, and measuring quality superficially can be neglected.

Intimate Partner Violence (IPV) is one of the most pervasive human rights violation which has negative impacts on the health and well-being of individuals, families and communities. The aim of this study was to explore the perceptions of male civil servants in Ibadan, Nigeria about the perpetration of IPV and to document their suggested measures to prevent IPV in our communities in Nigeria. Four focus group discussions were conducted among 36 male civil servants selected from Oyo State Secretariat, Ibadan using purposive sampling technique. Data were transcribed and analysed using thematic approach. Six major themes were identified; awareness of the forms of IPV, women and men as victims, causes, attitude, consequences as well as the suggested strategies for the prevention of IPV. Physical and psychological abuse were mentioned across the groups. The respondents pointed out that women experience IPV more than men, but that men also experience it. Some respondents stated that physical and psychological abuse against female intimate partners were acceptable in some circumstances according to the societal norms. The negative effects of IPV on physical, mental and social well-being of the individual, families and society were mentioned. Suggested ways of preventing IPV include tolerance and patience which will promote healthy, respectful and non-violent relationships among intimate partners. Considering the perceptions and attitudes of these men to IPV, it is important to reach out to both genders for appropriate preventive and educational intervention in ending IPV among women and men. [ABSTRACT FROM AUTHOR]

People with severe mental ill-health (SMI) experience profound health inequalities. The Optimizing Wellbeing in Self-isolation study (OWLS) explored the effects of the COVID-19 pandemic restrictions on people with SMI, including how and why their physical and mental health may have changed during the pandemic. The OLWS study comprised two surveys and two nested qualitative studies. Of 367 people recruited to the study, 235 expressed interest in taking part in a qualitative interview. In the first qualitative study eighteen interviews were conducted with a purposive sample of participants. We identified six factors which influenced peoples' health, positively and negatively: Staying Physically Active; Maintaining a Balanced and Healthy Diet; Work or Not Working; Daily Routine and Good Sleep; Staying Connected to Family, Friends and the Local Community; and Habits, Addictions and Coping with Anxiety Created by the Pandemic. Different aspects of lifestyle are highly interconnected. For people with SMI, loss of routine and good sleep, poor diet and lack of exercise can compound each other, leading to a decline in physical and mental health. If people are supported to understand what helps them stay well, they can establish their own frameworks to draw on during difficult times. [ABSTRACT FROM AUTHOR]

A growing body of research has been focusing recently on the life and well-being of students with attention-deficit/hyperactivity disorder (ADHD) and also on the well-being of their teachers. However, there is a need for in-depth, qualitative insights into ADHD issues from the teachers' perspectives. Therefore, the main aim of this qualitative study was to use thematic analysis to explore how teachers perceive the relationship with students with ADHD and the factors that influence the quality of this relationship. Sixteen teachers working with adolescent ADHD students were interviewed for this purpose. The results indicate that the quality of the teacher-ADHD student relationship is associated with the ADHD students related behaviours, ambivalent emotions of the teacher, the teacher's beliefs about ADHD and the beliefs about the determinants of the behaviour of the students with ADHD and the teacher's approaches and methods of work in the classroom. Furthermore, the results suggest that increasing the quality of the teachers' well-being is associated with knowledge of ADHD determinants, regulation of ambivalent emotions, empathy, teachers' ability to perceive positive qualities and the potentials of the students with ADHD and their motivation to teach ADHD students. [ABSTRACT FROM AUTHOR]

Common mental health problems are a substantial burden in many western countries. Studies have pointed out that work related factors can both increase and decrease the risk of developing mental health problems. Influence at work is a key factor relating the psychosocial work environment to employees mental health. However, little is known regarding how contemporary employees experience and understand influence at work. The purpose of this study is to explore this in depth. We conducted semi-structured interviews with 59 employees in knowledge and relational work and analysed the data using principles from Interpretative Phenomenological Analysis (IPA). TWe identified three themes each consisting of two interrelated parts, where the second part describes the consequences of the identified type of influence for employees: 1) work tasks and performance, 2) relations and belonging, 3) identity and becoming. The interviewed employees had a multifaceted understanding of influence at work and that influence at work mattered to them in different but important ways. Our hope is that managers, employees and consultants will be inspired by the three themes when designing work tasks, organizations and interventions in order to increase the level of influence and thereby help enhance the mental well-being of employees. [ABSTRACT FROM AUTHOR]

Purpose: This paper examines intergenerational, interdependent and contextual aspects of wellbeing and acculturative stress in refugee families during resettlement. Particular focus is placed on how children influence their parents. Method: The study is based on interviews with and diary notes from Middle Eastern parents and children residing in Sweden. Results: Analyzes of the narratives show how the direct and indirect influence of the child affects the parents in both negative and positive ways. Acculturative stress follows from unexpected and undesired migration outcomes, such as parent-child conflicts and low school achievement. Such strains add to other hardships refugee families face, for instance, unemployment, welfare dependence, poor housing, and insufficient mastery of the majority language. However, acculturative stress can be alleviated by the children's educational success, and reciprocal practices of love and caring including helping out with chores and supporting each other in different ways. Conclusions: Children's agency has significant effects on parents' wellbeing, as wellbeing is accomplished in and through relationships with others. [ABSTRACT FROM AUTHOR]

Purpose: Although social capital influences health-related decisions and behavioural patterns in many developing countries, minimal attention has been paid to the nuances of its effect on healthcare. This paper examines how bonding social capital affects healthcare delivery for inpatients in Ghana. Methods: Semi-structured in-depth interviews were used and thematic analysis method employed to analyse the data. Interviews were conducted with health professionals and relatives and close friends of inpatients in three public health facilities in Ashanti region. Results: Relatives and close friends of inpatients were a critical source of instrumental support such as provision of meals, laundry services, running errands and financial assistance as well as emotional support. These functions—that were both 'expected' and 'encouraged'— reduced the burden on the health facilities, which apparently had limited resources to offer adequate care. However, the relatives of inpatients sometimes inadvertently obstructed efficient healthcare delivery through actions such as extending 'unapproved' alternative care to patients. Moreover, the process of contributing towards health and well-being of the sick exposed the relatives to health risks due to poor living conditions. Conclusion: A well-defined and befitting role must be devised for at least an immediate social relation of inpatients to improve the positive effects of bonding social capital on healthcare delivery. [ABSTRACT FROM AUTHOR]

Purpose: For many people living in low-income countries, poverty implies an increased exposure to conditions that threaten health and wellbeing as well as reduced capacity to maintain health. Despite the challenging conditions caused by poverty, people may consider themselves healthy because they have learned to cope with their situation probably as a result of life experiences which expose people to both challenges and potential solutions. In this paper we present results from studying health and wellbeing challenges and mechanisms to cope with challenges among two different groups of people who are living under conditions of poverty: workers of the Cameroon Development Corporation (CDC) and students of the university of Buea and the university of Yaoundé. Methods: We performed a cross-sectional study, interviewing 21 CDC workers and 21 students. Results Our study reveals context-specific stressors emerging from poor work conditions and study pressure as well as non-context-specific stressors perceived by respondents as living conditions, poor healthcare and financial uncertainty. Respondents devised coping mechanisms to overcome exactly those stressors such as searching for additional money sources, preventive action towards hazardous living conditions and alternative medical support. Conclusion: We conclude that supporting and promoting such avenues is essential for enhanced and continuous coping with stressors. [ABSTRACT FROM AUTHOR]

To assess fibromyalgia patients' experiences and appraisals about a multidisciplinary intervention programme, in Catalonia's primary care, regarding its format and contents, benefits, and health impact in the short and long term. Qualitative interpretative research design through hermeneutic phenomenology perspective. Two focus groups discussions were conducted in February and July 2020. The purposive heterogeneous sample included 19 fibromyalgia patients who attended a multicomponent programme. In addition, thematic analysis on the verbatims was performed. Findings were organized into five main domains with an explanatory theme each. Overall, the informants valued the programme as a positive experience due to its holistic approach, health benefits, suffering relief, group effect, and fibromyalgia legitimacy promotion. Detected improvable aspects focused on extending the timeframe, including family members as beneficiaries, deepening the thematic contents, and getting regular access to this healthcare service. Furthermore, the intervention was considered feasible to be incorporated into usual clinical care. the programme fulfilled users' expectations about results and procedure and showed promise as a treatment strategy to reinforce the usual practice. Our findings suggest a broad perspective on fibromyalgia patients' suffering, which urges us to adjust the intervention programme to their real health needs. [ABSTRACT FROM AUTHOR]

We explore young adults' narrations of life events in association with nonsuicidal self-injury (NSSI) discontinuation, psychological growth, and agency. Transcripts from eleven face-to-face interviews with individuals who quantitatively reported injuring themselves in adolescence (2007–2008) but not in young adulthood (2017) were narratively analysed. We found that at starting points, a period preceding an agentic shift in the narrative, participants endured stressful living conditions and mental illness. During this period, participants perceived no point in trying to initiate change because they did not perceive themselves as having the capacity to do so and nor could they adequately utilize any formal or informal support. After a turning point that enabled agency due to gaining a sense of belongingness, liberation, or perspective, participants underwent a process of attaining psychological well-being. However, narrating psychological growth also required momentum points, encompassing the management of and moving on from stressful contexts, along with the recognition of milestones marking improvement relative to the starting points. NSSI discontinuation was narrated in conjunction with psychological growth when participants also experienced themselves as situated within an agentic context, because agency is understood as necessary to react to and manage current and future life circumstances. [ABSTRACT FROM AUTHOR]

Well-being after spinal cord injury is affected by a range of factors, many of which are within the influence of rehabilitation services. Although improving well-being is a key aim of rehabilitation, the literature does not provide a clear path to service providers who seek to improve well-being. This study aimed to inform service design by identifying the experience and perspective of people with SCI about interventions targeting their well-being. The scoping review of qualitative literature used thematic analysis to identify and categorize themes related to service activities, valued aspects, limitations and perceived outcomes. Thirty-eight studies were selected, related to a range of service types. Most studies did not adopt a well-being conceptual framework to design and evaluate the services. People with SCI particularly valued being treated with dignity, positive expectations, increased autonomy and peer support. Improvements to well-being were reported, including many years post-SCI. However, people with SCI reported limited opportunities to engage in such services. Rehabilitation services can improve well-being across the lifetime of people with SCI, but gaps in service provision are reported. The review identified valued aspects of services that may inform service design, including staff approach and positive expectations, having own skills and worth valued, peer support and interaction, autonomy in valued occupations, and long-term opportunities for gains. [ABSTRACT FROM AUTHOR]

Little is known of the potential of using nature and outdoor activities in relation to community-based health promotion programmes. This study seeks a better understanding of how people with mental or chronic physical health problems experience a local outdoor health promotion or rehabilitation programmes and a better understanding of how these programs contribute to the participant's health and well-being. The study is based on data from the Healthy in Nature project targeting adults with chronic physical health problems and adults with mental health problems. Data was collected using a qualitative multiple case study design involving five selected cases with both qualitative interviews and observation. Data was analysed using Braun et al.'s 6-phase guide to qualitative reflexive thematic analysis, employing Self-Determination Theory as a theoretical framework. Results: Overall, the participants in the two groups experienced increased competence, autonomy, and relatedness, and the participants expressed the importance of both being in a natural environment and doing outdoor activities (friluftsliv). The study makes a valuable contribution to the field of health promotion and rehabilitation pointing to nature and friluftsliv as important elements that offer great potential to community-based health promotion. [ABSTRACT FROM AUTHOR]

Purpose: Many countries around the world are facing an ageing society in which older persons share the fate of carrying a burden in their families, especially in skipped-generation families. This increasing trend has noted over the past several years in Thailand. This is an interpretive phenomenological study that seeks to explore Thai older grandparents' life experience of raising grandchildren in skipped-generation families. Methods: The participants were purposively selected from older grandparents in skipped-generation families in the Northeast of Thailand in 2019. Data were collected by in-depth interviews with 29 participants. Data were analysed using Diekelmann & Allen method. Results: Three major themes emerged regarding the Thai older persons as a breadwinner of a skipped-generation family were as follows. 1) Sacrifice for the family is a value of life. 2) Day by day coping journey of individuals maintains mental well-being. 3) Being grandparents leads to spiritual pride. Conclusion: The older grandparents suffered from a variety of burden and vulnerability beyond their abilities. Social and governmental supporting systems are limited. Creating supporting system strategy is required to increase well-being of grandparents in skipped-generation families. [ABSTRACT FROM AUTHOR]