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'Girls need to strengthen each other as a group': experiences from a gender-sensitive stress management intervention by youth-friendly Swedish health services: a qualitative study
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). (Stress and Health in Youth (Umeå SHY))
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. (Stress and Health in Youth (Umeå SHY))
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). (Stress and Health in Youth (Umeå SHY))
2013 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13, no 907, 1-17 p.Article in journal (Refereed) Published
Abstract [en]

Mental health problems among young people, and girls and young women in particular, are a well-known health problem. Such gendered mental health patterns are also seen in conjunction with stress-related problems, such as anxiety and depression and psychosomatic complaints. Thus, intervention models tailored to the health care situation experienced by young women within a gendered and sociocultural context are needed. This qualitative study aims to illuminate young women's experiences of participating in a body-based, gender-sensitive stress management group intervention by youth-friendly health services in northern Sweden.

A physiotherapeutic body-based, health-promoting, gender-sensitive stress management intervention was created by youth-friendly Swedish health services. The stress management courses (n = 7) consisted of eight sessions, each lasting about two hours, and were led by the physiotherapist at the youth centre. The content in the intervention had a gender-sensitive approach, combining reflective discussions; short general lectures on, for example, stress and pressures related to body ideals; and physiotherapeutic methods, including body awareness and relaxation. Follow-up interviews were carried out with 32 young women (17--25 years of age) after they had completed the intervention. The data were analysed with qualitative content analysis.

The overall results of our interview analysis suggest that the stress management course we evaluated facilitated 'a space for gendered and embodied empowerment in a hectic life', implying that it both contributed to a sense of individual growth and allowed participants to unburden themselves of stress problems within a trustful and supportive context. Participants' narrated experiences of 'finding a social oasis to challenge gendered expectations', 'being bodily empowered', and 'altering gendered positions and stance to life' point to empowering processes of change that allowed them to cope with distress, despite sometimes continuously stressful life situations. This intervention also decreased stress-related symptoms such as anxiousness, restlessness, muscle tension, aches and pains, fatigue, and impaired sleep.

The participants' experiences of the intervention as a safe and exploratory space for gendered collective understanding and embodied empowerment further indicates the need to develop gender-sensitive interventions to reduce individualisation of health problems and instead encourage spaces for collective support, action, and change.

Place, publisher, year, edition, pages
BioMed Central, 2013. Vol. 13, no 907, 1-17 p.
Keyword [en]
Stress, Mental health, Psychiatry, Physiotherapy, Gender, Gender-sensitive intervention, stress management, group intervention, young women, adolescents, girls, qualitative method, interviews
Keyword [sv]
Stress, Psykisk hälsa, Genus, genusmedveten intervention, stresshantering, gruppintervention, sjukgymnastik, psykiatri, unga kvinnor tonårsflickor, kvalitativ metod, intervjuer
National Category
Physiotherapy Gender Studies Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public health; Physiotherapy; Psychiatry; hälso- och sjukvårdsforskning
Identifiers
URN: urn:nbn:se:umu:diva-81141DOI: 10.1186/1471-2458-13-907ISI: 000325199700001OAI: oai:DiVA.org:umu-81141DiVA: diva2:653010
Projects
Stress and Health in Youth (Umeå SHY)
Funder
Swedish Research Council, 521-2005-4848Forte, Swedish Research Council for Health, Working Life and Welfare, 2006–1512
Available from: 2013-10-02 Created: 2013-10-02 Last updated: 2017-12-06Bibliographically approved
In thesis
1. Skapa rum. Ung femininitet, kroppslighet och psykisk ohälsa: genusmedveten hälsofrämjande intervention.
Open this publication in new window or tab >>Skapa rum. Ung femininitet, kroppslighet och psykisk ohälsa: genusmedveten hälsofrämjande intervention.
2014 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[en]
Create space. Young femininity, body and mental health : a gender sensitive and health promoting intervention.
Abstract [en]

Mental health problems among young people, girls and young women in particular, are a serious public health problem. Gendered patterns of mental illness are seen in conjunction with stress-related problems such as anxiety, depression, and psychosomatic complaints. Intervention models tailored to the health care situation are therefore in need of development and evaluation. The overall aim of this thesis is to develop knowledge and understanding for young women’s mental health, stress-related, and bodily problems from a psychosomatic and gender theory perspective, and to evaluate a gender sensitive physiotherapeutic intervention model consisting of a stress management course for young women with stress-related problems.

The thesis consists of four studies. The overall research design combines qualitative and quantitative methods in which questionnaires and interviews were used to explore participant experiences and symptoms linked to perceived stress before and after the intervention. Data consisted of a cumulative sample of 65 young women, 16 to 25 years of age, who attended the youth-friendly health center because of stress-related problems. In paper I, multiple symptom areas of mental health and somatic problems, self-image and aspects of body perception were measured before the course. Participants were 47 of the young women. The results were compared with published normative and clinical reference groups. In paper II, the young women’s experiences of living stressful femininity were analysed with a qualitative content analysis using gender theoretical and phenomenological perspectives as an interpretative frame. The study was based on interviews with 25 of the women. In paper III, follow-up interviews were done with 32 of the women after completion of the course. Data was using qualitative content analysis to illuminate experiences of participating in the course. In paper IV, the course was evaluated by measuring changes in multiple symptom areas using the Adult Self Report (ASR), Social Analysis of Social Behaviour (SASB), and Body Perception Questionnaire (BPQ). Participants were 54 of the women who completed measurements finishing the course.

Young women present complex symptomatology of stress-related problems. The total burden of symptoms plus the narrated experiences highlight how renegotiations of gender constructions and handling of normative and stressful femininity constrain access to bodily resources. After the stress management course, their measured and narrated experiences show positive changes and release of mental health and stress problems, including a more positive self-image and sense of enhanced confidence in their bodies. Experiences of the course as a safe and explorative space for gendered collective understanding and embodied empowerment indicate the need to develop gender-sensitive interventions. The thesis contributes to youth and gender theoretical perspectives with integration of psychosomatic and psychiatric physiotherapy. A broader awareness of how gender constructions and sociocultural aspects are significant in the understanding of psychosomatic expressions of mental ill health and young femininity is valuable in development of theory and interventions in physiotherapy, as well as into other fields. 

Place, publisher, year, edition, pages
Umeå: Umeå Universitet, 2014. 70 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1655
Keyword
mental health, stress-related health, young women, femininity, physiotherapy, psychosomatics, psychiatry, gender theory, phenomenology, corporeality, embodiment, empowerment, intervention
National Category
Physiotherapy Psychiatry Gender Studies
Research subject
Physiotherapy; Psychiatry; genusvetenskap
Identifiers
urn:nbn:se:umu:diva-88767 (URN)978-91-7601-081-5 (ISBN)
Public defence
2014-06-13, Aulan, Vårdvetarhuset, Umeå, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2014-05-22 Created: 2014-05-14 Last updated: 2014-06-03Bibliographically approved

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