Health related behavioural change in context: young people in transition.

Post-modern theorists have highlighted the impacts of rapid social and economic change in lessening structural constraints, arguing that the concepts of "gender" and "social class" are now less useful in understanding people's life chances and choices. While the epochal nature of such changes has been questioned, increasing levels of individualisation and reflexivity have been widely recognised. Agency is prioritised and structural disembeddedness increasingly assumed: people are held to construct their identities and biographies reflexively from a diverse range of experiences and opportunities. When used in relation to understanding health related behaviours this theorising has led to an increasing focus upon the symbolic significance of consumption (and indeed risk) in defining lifestyles and identities. Here we report on the health related behaviours of 106 young people (15/16 yr) during their transition from school to employment, training or further education. This period is arguably central in the process of creating adult identities and accordingly should involve considerable lifestyle choice, reflexivity and symbolic consumption as identities are formed. By drawing on two rounds of data (semi-structured interviews and structured questionnaires) we consider how smoking and drinking behaviours related to the wider social transitions towards adulthood. We provide a situated account of health related behaviours which acknowledges both subjective experience and social location. We argue that the current challenge is to integrate the different levels of structural constraint and individual agency within the context of current rapid social and economic change and suggest that it is only through empirical investigation which embraces an analysis both at the level of structure and individual experience that the conditions of late modernity can be more thoroughly understood.

Mental health: what do we know, how did we find it out and what does it mean for nurses?

In recent years service providers, practitioners and academics have all moved away from the term mental illness in favour of mental health. At the same time nurses have been increasingly asked to go beyond work aimed at the alleviation or reduction of mental illness and to actively promote mental health. Such a perspective acknowledges that those who experience mental illness can equally experience and have the potential for mental health. In this paper we review key works from within psychology and health promotion (including medical sociology) that have shed light on the factors that influence mental health in its positive sense. Throughout the review we are careful to reflect on the role that research methods have played in constructing our current understanding of mental health. The aim of the review is to provide nurses with the knowledge that is necessary to undertake the challenge of promoting mental health in a practical but also reflective way.

Assessing psychological well-being: a holistic investigation of NHS employees.

A substantial body of research has investigated the effects of work on the psychological well-being of employees. However, there has been little assessment of the ways in which workplace factors (such as job demands, working conditions, inter-personal relations and workplace change) interact with personal factors (such as work-life balance, family circumstances, key personality traits or demographic characteristics) to affect psychological health. This article reports findings from a study which aimed to construct and test a comprehensive model of the influences on employee well-being within the UK National Health Service (NHS). The results show that psychological well-being is influenced by a complex array of personal, environmental and work factors. A key finding is that there are clear associations between workplace change and well-being and between work-life (im)balance and well-being. These effects appear to be independent of one another and therefore require separate attention from managers and employers.

Male youth street culture: understanding the context of health-related behaviours.

In the UK growing concerns have been expressed about young people, and particularly young men, who spend large amounts of their leisure time on the streets. Problems such as vandalism, under-age drinking and drug use have all been heavily reported in local and national media. This paper reports on ethnographic (primarily participant observation-based) research which sought to explore the motivations, meanings and behaviours of young people hanging around on the streets during the evening in a Scottish town. The aim is to move beyond previous research which has largely focused on the 'risk' factors associated with health-relevant behaviours, and to provide an understanding of the roles of alcohol, illicit drugs and tobacco within the young people's street culture. The paper therefore provides contextualized accounts of health-relevant behaviours. In conclusion it is argued that, to be effective, health promotion programmes need to locate lifestyle risk behaviours within broader life circumstances and that without a reduction in 'risk conditions' it is unlikely that youth street culture will disappear or that 'risk behaviours' will reduce.

Continuities and changes: teenage smoking and occupational transition.

Rates of cigarette smoking among young people in the U.K. remain high and may be increasing. However, few studies have explored smoking behaviour during the mid- to late teens. This paper reports the third wave of a longitudinal study that followed 106 15-year-olds from their last compulsory year at school for 22 months. Using a mixture of qualitative and quantitative methods, the study shows that this is a period of considerable flux in smoking behaviour. Becoming a regular smoker is not a straightforward progressive process. The role of friendship groups and social context is highlighted. Smoking prevention programmes should be developed to meet the needs of young people in this transitional period.