Are social pressure, bullying and low social support associated with depressive symptoms, self-harm and self-directed violence among adolescents? A cross-sectional study using a structural equation modeling approach.

BACKGROUND: More in-depth evidence about the complex relationships between different risk factors and mental health among adolescents has been warranted. Thus, the aim of the study was to examine the direct and indirect effects of experiencing social pressure, bullying, and low social support on mental health problems in adolescence. METHODS: A school-based cross-sectional study was conducted in 2022 among 15 823 Norwegian adolescents, aged 13-19 years. Structural Equation Modelling was used to assess the relationships between socioeconomic status, social pressure, bullying, social support, depressive symptoms, self-harm and suicide thoughts. RESULTS: Poor family economy and low parental education were associated with high pressure, low parental support and depressive symptoms in males and females. Moreover, poor family economy was associated with bullying perpetration and bullying victimization among males and females, and cyberbullying victimization among females, but not males. Low parental education was associated with bullying victimization among males, but not females. Further, high social pressure was associated with depressive symptoms among males and females, whereas high social pressure was linked to self-harm and suicide thoughts among females, but not males. Bullying victimization and cyberbullying victimization were associated with depressive symptoms, self-harm, and suicide thoughts among males and females. Bullying victimization was associated with depressive symptoms among males, but not females, whereas bullying perpetration was linked to self-harm and suicide thoughts among females, but not males. Low parental support was associated with bullying perpetration, bullying victimization, depressive symptoms, self-harm and suicide thoughts among males and females, whereas low parental support was associated with high social pressure among females, but not males. Low teacher support was associated with high social pressure and depressive symptoms. Low support from friends was associated with bullying victimization, depressive symptoms and suicide thoughts among males and females, whereas low support from friends was linked to self-harm among males, but not females. Finally, results showed that depressive symptoms were associated with self-harm and suicide thoughts among males and females. CONCLUSION: Low socioeconomic status, social pressure, bullying and low social support were directly and indirectly associated with depressive symptoms and self-directed violence among Norwegian adolescents.

Differences in Approaches to Learning Between Occupational Therapy Students in the USA and Norway.

Students approach learning in different ways, and this study aimed to examine and understand differences in learning approaches between occupational therapy students in Norway and the USA. A total of 321 students, from two universities in the USA and six higher education institutions in Norway, completed the short version of the Approaches and Study Skills Inventory for Students. The data were analyzed with linear regression analyses. U.S. students had substantially higher scores on the strategic approach and higher scores on the deep approach, compared to the Norwegian students. Differences may be due to different national regulations and levels of education required for entering the programs, or personal factors such as predisposition for learning.

Community-Working Occupational Therapists' Involvement in Research and Development Projects in Norway.

The aim of this study was to explore community-working occupational therapists' involvement in research and development projects. A cross-sectional survey of occupational therapists working in community-based services in Norway (n = 617) was conducted. In all, 117 of the 617 participants responded that they were involved in research and development projects. Greater likelihood of participation in research and development work were found for occupational therapists who had completed further education. Current and prioritized research topics were professional development and the development of interprofessional and professional service designs for occupational therapy. Service and quality development, rehabilitation and technology were areas where more knowledge was considered needed. To increase the growth and success of occupational therapy research and development, it is important that more occupational therapists in the municipality continue to complete further education. High-quality occupational therapy practice should be based on research and development projects in the municipalities.

Occupational Therapy students' Concepts of Learning: Cross-Sectional and Longitudinal Associations With Deep, Strategic, and Surface Study Approaches.

This study aimed to gain knowledge about the cross-sectional and longitudinal associations between learning concepts and approaches to studying among occupational therapy students. A repeated cross-sectional design was combined with a longitudinal study design. Self-report questionnaires assessed sociodemographic variables, learning concepts, and approaches to studying (deep/strategic/surface). Linear regression analyses (n ranging between 109 and 193 in the analyses) showed that higher transforming concept ratings were consistently associated with higher ratings on the deep study approach, both cross-sectionally and longitudinally. Higher reproducing concept ratings were positively associated with higher strategic approach ratings in the second and third study years. In view of the results, students' understanding of what learning is impacts on their study attitudes and behaviors, which in turn is likely to influence learning outcomes and academic performance.

Validation of a short version of the Lee fatigue scale in adults living in Norway: a cross-sectional population survey.

BACKGROUND: Due to the nature of fatigue, a brief reliable measure of fatigue severity is needed. Thus, the aim of our study was to evaluate a short version of the Lee Fatigue Scale (LFS) in the Norwegian general population. METHODS: This cross-sectional survey consists of a representative sample from the Norwegian population drawn by The National Population Register in Norway. The study is part of a larger study (NORPOP) aimed at collecting normative data from several questionnaires focused on health in adults living in Norway. Registered citizens between 18 and 94 years of age were randomly selected stratified by age, sex and geographic region. Of the 4971 respondents eligible for the study, 1792 (36%) responded to the survey. In addition to age and sex, we collected responses on a 5-item version of the LFS measuring current fatige severity. The psychometric properties focusing on internal structure and precision of the LFS items were analyzed by a Rasch rating scale model. RESULTS: Complete LFS scores for analyses were available for 1767 adults. Women had higher LFS-scores than men, and adults < 55 years old had higher scores than older respondents. Our analysis of the LFS showed that the average category on each item advanced monotonically. Two of the five items demonstrated misfit, while the three other items demonstrated goodness-of-fit to the model and uni-dimensionality. Items #1 and #4 (tired and fatigue respectively) showed differential item functioning (DIF) by sex, but no items showed DIFs in relation to age. The separation index of the LFS 3-item scale showed that the sample could be separated into three different groups according to the respondents' fatigue levels. The LFS-3 raw scores correlated strongly with the Rasch measure from the three items. The core dimensions in these individual items were very similarly expressed in the Norwegian language version and this may be a threat to the cultural-related or language validity of a short version of the LFS using these particular items. CONCLUSIONS: The study provides validation of a short LFS 3-item version for estimating fatigue in the general population.

Psychological responses and associated factors during the initial lockdown due to the corona disease epidemic (COVID-19) among Norwegian citizens.

BACKGROUND: Ongoing COVID-19 studies pay little attention to the risk or protective factors related to psychological stress. AIMS: This study aims to estimate the prevalence of anxiety, depression and insomnia during the initial phase of the COVID-19 outbreak, and explore factors that might be associated with these outcomes. METHODS: A population-based cross-sectional survey was conducted using snowball-sampling strategy. Participants from 18 years or older filled out an anonymous online questionnaire. RESULTS: A total of 4527 citizens filled out the questionnaire. Prevalence rates were; insomnia 31.8%, anxiety 17.1% and depression 12.5%. Risk factors associated with anxiety, depression and insomnia were being single (OR = 0.75, OR = 0.57, OR = 0.59), unemployed (OR = 0.47, OR = 0.53, OR = 0.73), financial concerns (OR = 1.66, OR = 2.09, OR = 1.80) at risk for complication from COVID-19 (OR = 1.63, OR = 1.68, OR = 1.60), and being generally worried due to the COVID-19 (OR 0 3.06, OR = 1.41, OR = 1.74). CONCLUSION: Being single, unemployed, at risk of health complications, or having concerns because of financial or other consequences of the pandemic are associated with mental health adversities such as anxiety, depression and insomnia during a pandemic lockdown.

Intrinsic Relationships between Learning Conceptions, Preferences for Teaching and Approaches to Studying among Occupational Therapy Students in the United States.

The aim of this study was to examine the associations between occupational therapy students' learning conceptions, preferences for teaching, and approaches to studying. The deep learning concept was associated with deep and strategic approaches to learning. The student preference for the teaching-style "transmitting information" was associated with a surface approach to learning. Understanding the interrelationships between students' learning concepts, teaching preferences, and study approaches may provide incentive for faculty members to think about novel approaches to teaching. While occupational therapy faculty members should encourage a deep learning concept and stimulate students' linking of ideas, they may need to modify their teaching style to accommodate surface-oriented students' needs.

Do health professionals' attitudes towards alcohol use matter for alcohol prevention efforts? Results from the WIRUS-OHS study.

BACKGROUND: Use of alcohol is a major public health issue, representing the 7th largest burden of disease in the world. Workplaces offer a unique arena for health initiatives addressing alcohol use, where occupational health services (OHS) personnel play an important role. However, we do not know if the extent of such initiatives may be influenced by personal drinking attitudes among OHS personnel. Thus, the aim of the study was to explore how drinking attitudes among OHS personnel were associated with their frequency of working with alcohol-related cases and with their views on alcohol prevention activities in the OHS. METHODS: The WIRUS project included a cross-sectional survey of attitudes and practices among OHS personnel (n = 325) employed by Norwegian OHS services (n = 69), who informed about sociodemographic and professional characteristics, drinking attitudes, frequency of cases with alcohol-related issues, and perceptions toward the role of the OHS in primary, secondary, and tertiary alcohol prevention activities. Measures of associations were examined with linear and logistic regression models. RESULTS: Drinking attitudes were unrelated to the frequency of working with alcohol-related cases. Physicians, psychologists, and nurses had higher frequency of working with alcohol-related cases, compared to those with other professional backgrounds (ß = 0.46, p = 0.01). Drinking attitudes were also unrelated to attitudes towards primary/secondary/tertiary alcohol prevention activities in the OHS, while female OHS personnel were more positive towards increased primary alcohol prevention activities in the OHS (OR: 1.82, p < 0.05). Only marginal portions (1%-3%) of the variance in attitudes towards alcohol prevention activities in the OHS were accounted for by the models. CONCLUSION: This study did not find evidence of associations between OHS personnel's drinking attitudes and their practices and attitudes towards alcohol prevention activities. The lack of association between OHS personnel's attitudes towards alcohol use and their attitudes and practices relating to alcohol prevention in the workplace might point towards professionalism, as personal attitudes appear not to interfere with their priorities and professional mission. Given the small amount of outcome variance explained by the tested models, other variables should be used in future studies.

Research-based education in undergraduate occupational therapy and physiotherapy education programmes: a scoping review.

BACKGROUND: In a research-based learning environment, students learn how to become critical thinkers and lifelong learners, and to generate discipline-enriching knowledge. Research training is important for all healthcare professionals and the integration of research in education can be one approach to improve evidence-based practice among future professionals. The purpose of this scoping review was to identify studies reporting on research-based education in undergraduate occupational therapy and physiotherapy curricula to document the current state of knowledge and to map factors that reflect and support the implementation of research-based education in undergraduate occupational therapy and physiotherapy programmes. METHODS: A scoping review was used to systematically select and summarize existing literature. The search was conducted using a combination of keywords and MeSH terms in the following databases: EBSCO (Academic Search Elite, CINAHL, ERIC), MEDLINE, Embase, Education Source and grey literature. A thematic analysis identified strategies used to implement and promote research-based education in occupational therapy and physiotherapy bachelor programmes. RESULTS: The database search identified 3068 records. 75 were eligible for full-text assessment and 27 studies were included. The studies were published between 1999 and 2021 and were conducted in Norway, Canada, South Africa, Australia, the United Kingdom, the United States, New Zealand, Ireland, Taiwan, Italy, and Iran. The study designs were mainly quantitative and qualitative, and studies included primarily occupational therapy and physiotherapy students. We identified the following four strategies: 'student engagement in research', 'curriculum improvement regarding EBP', 'EBP teaching' and 'journal club', where 'EBP teaching' was most frequently identified. CONCLUSIONS: Findings from this scoping review suggest that ensuring students' competence in research methods is necessary for students to be able to read and understand research articles, which are important as foundational skills in undergraduate research training. Journal clubs can be a foundation for student engagement with research literature, and students' basic research skills may be facilitated through their involvement in research projects and by conducting systematic reviews. Further, cooperation with clinical practice is important, and the awareness of research-based education should be increased among both faculty members and students.

Perceptions of the academic learning environment among occupational therapy students - changes across a three-year undergraduate study program.

INTRODUCTION: Although the learning environment influences students' motivation, learning outcomes, and satisfaction with the study program, less is known about how these factors change as the students' progress through the study program. AIM: The aim of this study was to examine changes in occupational therapy students' perceptions of the academic learning environment during their three-year study program and to examine factors associated with the students' perceptions of the learning environment. MATERIALS AND METHODS: A longitudinal cohort study was conducted throughout the three-year study program. Data were collected annually using the Course Experience Questionnaire (CEQ). In total, 263 students from six occupational therapy programs participated in at least one data gathering point. The number of participants was 186 in the first year, 168 in the second year and 200 in the third year. Of the 263 students who participated in the study, 87 participated in only one point of data collection, 58 at two points and 118 at all three points of the data collection. Data were analyzed with linear mixed models. RESULTS: The results showed statistically significant temporal changes on the "Emphasis on independence", "Good teaching" and "Generic skills" scales. There was a significant decrease in scores from the first to the second year of study and the scores remained at this level in the third study year on both the "Emphasis on independence" and "Good teaching" scales. In addition, associations were found between study effort and educational institution related to the "Appropriate workload" scale, as well as between age and the "Generic skills" scale. CONCLUSION: The temporal changes of the students' perceptions of the "Emphasis on independence" as well as "Good teaching" scales are noteworthy. Both scales indicated a significant decrease in scores, indicating that the students perceived that they were less independent from first to second and third year, as well as a perceived decline in the quality of teaching from first to second and third year. The results of this study are central when planning to facilitate learning, especially related to independence and perceptions of good teaching for students in occupational therapy programs.

Exploring graduate occupational and physical therapy students' approaches to studying, self-efficacy, and positive mental health.

BACKGROUND: Occupational and physical therapy academic programs are rigorous. Increased rates of student anxiety and depression may impact learning. Data on student study skills, self-efficacy, and mental health is limited. This study explored relationships between students' self-efficacy, mental health factors, and approaches to studying. METHOD: A cross-sectional study was designed. Seventy-three students completed the Approaches and Study Skills Inventory for Students-Short Form, General Self-Efficacy Scale, and Mental Health Continuum-Short Form. Associations between predictors (education program, general self-efficacy and mental health) and ratings on the study approach scales were analyzed with multiple linear regression. RESULTS: Multiple regression models revealed associations between higher self-efficacy and higher ratings on the deep (ß = 0.49, p <  0.01) and strategic (ß = 0.34, p <  0.05) scales, and lower ratings on the surface scale (ß = - 0.29, p <  0.01). Compared to OT students, PT students had higher surface approach ratings (ß = - 0.36, p <  0.001). Poorer mental health scores were associated with higher surface approach ratings (ß = - 0.41, p < 0.001). CONCLUSIONS: To support productive study strategies among occupational and physical therapy students it may be useful to promote their general self-efficacy and positive mental health.

Psychological distress and its associations with psychosocial work environment factors in four professional groups: A cross-sectional study.

This study aimed to explore associations between psychosocial work environment factors and psychological distress in four groups of professionals in Norway. Eight hundred fifty-six professionals participated in this cross-sectional study 6 years after graduation. Data were analyzed with linear and logistic regression analyses. For the sample as a whole, higher psychological distress was associated with higher demands, lower support, lower job satisfaction, more work-home interaction problems, and lower coping in the job. Work-home interaction problems increased the likelihood of having case-level psychological distress. The strength of associations between psychological distress and other factors, such as demands, support, and coping in the job, varied by professional group. In conclusion, problems concerned with work-home interaction were generally associated with higher psychological distress. Between professional groups, other independent variables were differently associated with psychological distress. Work environment factors should receive continued attention in efforts to promote mental health.

Mental health, quality of life, wellbeing, loneliness and use of social media in a time of social distancing during the COVID-19 outbreak. A cross-country comparative study.

BACKGROUND: The COVID-19 outbreak raised questions about how people experience their mental health, quality of life (QoL), wellbeing and loneliness in the context of social distancing, and the use of social media during this time. AIMS: To examine the experience of mental health, QoL, wellbeing and loneliness and use of social media among people living in Norway, USA, UK and Australia. METHODS: A cross-country comparative survey of people living in Norway, USA, UK and Australia. Relevant statistical analyses were used to examine differences between the countries and to explore associations between demographic, mental health and psychosocial variables and use of social media. RESULTS: There were 3810 respondents from four countries, of which 50 - 74% showed a high level of emotional distress. The Norwegian population reported significantly better mental health, QoL and wellbeing and lower levels of loneliness compared to the other countries. High-frequent use of social media after the COVID-19 outbreak was associated with poorer mental- and psychosocial health. CONCLUSIONS: The results suggest that the COVID-19 outbreak took a toll on people's experience of mental health, QoL, wellbeing and experienced loneliness, and high-frequent use of social media was associated with these factors.

Associations between learning environment variables and students' approaches to studying: a cross-sectional study.

BACKGROUND: Aspects of the learning environment may be related to students` approaches to studying, but few studies have investigated these relationships in the context of occupational therapy education. OBJECTIVE: To examine associations between occupational therapy students' perceptions of the learning environment and their approaches to studying. METHOD: One hundred eighty-seven first-year occupational therapy students in Norway (response rate 61.3%) participated in this study. Aside from sociodemographic information, the students completed the Course Experience Questionnaire and the Approaches and Study Skills Inventory for Students. Associations between learning environment variables and study approaches were investigated with hierarchical linear regression analyses. RESULTS: Higher scores on Generic skills were associated with higher scores on the deep and strategic approach scales (ß ranging 0.18-0.51), while lower scores were associated with higher surface approach scale scores (ß = - 0.24). Lower scores on Clear goals and standards and Appropriate workload were associated with higher surface approach scores (ß ranging - 0.16 - -0.42). CONCLUSION: By improving aspects of the learning environment, there may be a potential for influencing occupational therapy students' approaches to studying. Based on this study, emphasizing how generic skills developed in the study program may become useful in practising a profession, ensuring clarity of goals and standards, and maintaining an appropriate workload on students appear to be important.

Psychometric properties and associations between subscales of a study approach measure.

The purpose of this study was to (i) confirm the factor structure of the Approaches and Study Skills Inventory for Students (ASSIST) in the current sample of undergraduate occupational therapy students and (ii) explore the pattern of associations between the 13 ASSIST subscales. Occupational therapy students (n = 171) across Norway completed the ASSIST. A three-factor structure was confirmed. Several positive associations were found between the deep and strategic approach subscales, whereas several surface approach subscales were negatively associated with the deep and strategic approach subscales. In conclusion, the study showed that the Norwegian ASSIST has a well-functioning three-factor structure in line with its theoretical underpinnings, and it can therefore readily be adopted as a study process measure in Norwegian occupational therapy education programs. In view of the associations between subscales, there is support for a higher-order concept of "productive" study approaches that encompasses both deep and strategic behaviors. The analysis of associations also suggests that students demonstrating unproductive study behaviors may need guidance and intervention that extends beyond the first detected problematic behavior.

Self-rated global health in the Norwegian general population.

BACKGROUND: Prevalence studies are needed to assess the distribution of diseases. However, in a contrasting health promotion perspective, self-rated health is in itself an important field of study. This study investigated self-rated global health in the general population in Norway. METHODS: As part of a national survey, a two-item measure of global health (score range 0-100) was administered to a general population sample, and 1776 of 4961 eligible participants (response rate 36%) responded. Group comparisons were conducted using independent t-tests and one-way analyses of variance, whereas factors associated with global health was investigated with linear regression analysis. RESULTS: In the adjusted analyses, better global health was associated with higher age (ß = 0.13, p <  0.001), having higher education (ß = 0.10, p <  0.001), being employed (ß = 0.21, p <  0.001), and living with a spouse or partner (ß = 0.05, p <  0.05). CONCLUSIONS: While global health was similar for men and women in the Norwegian general population, other sociodemographic variables were linked with global health. In particular, the link between employment and self-rated global health was strong. The findings are considered representative for the Norwegian population.

General self-efficacy in the Norwegian population: Differences and similarities between sociodemographic groups.

Aims: General self-efficacy (GSE) refers to optimistic self-beliefs of being able to perform and control behaviors, and is linked with various physical and mental health outcomes. Measures of self-efficacy are commonly used in health research with clinical populations, but are less explored in relationship to sociodemographic characteristics in general populations. This study investigated GSE in relation to sociodemographic characteristics in the general population in Norway. Methods: As part of a larger national survey, the GSE scale was administered to a general population sample, and 1787 out of 4961 eligible participants (response rate 36%) completed the scale. Group comparisons were conducted using independent t-tests and one-way analyses of variance. Linear regression analysis was used to examine factors independently associated with GSE. Results: GSE was lower for older compared to younger participants (p < 0.001). It was higher for men compared to women (p < 0.001), higher for those with higher levels of education compared to those with lower levels (p < 0.001) and higher for those in work compared to their counterparts (p < 0.001). Controlling for all variables, male gender and employment were independently associated with higher GSE. Age moderated the associations between gender and employment on one hand, and GSE on the other. The association between being male and having higher GSE was more pronounced in younger age, as was the association between being employed and having higher GSE. Conclusions: Male gender and being employed were related to higher GSE among persons in the general population in Norway, and these associations were stronger among persons of younger age. The findings are considered fairly representative for the Norwegian population.

Factor analysis of the Approaches and Study Skills Inventory for Students in a cross-cultural occupational therapy undergraduate student sample.

BACKGROUND/AIM: The Approaches and Study Skills Inventory for Students (ASSIST) has been used previously to assess the learning approaches among students in higher education, but reports of its use with occupational therapy students are rare. This study investigated the factor structure of the ASSIST in a cross-cultural sample of undergraduate occupational therapy students, and examined whether the factor structure from specific participant groups from different cross-cultural contexts was consistent. METHODS: Occupational therapy students (n = 712) from education programmes in Australia, Norway, Hong Kong and Singapore completed the ASSIST. To assess the factor structure of the instrument, a Principal Components Analysis (PCA) using a confirmatory approach, was completed. Cronbach's coefficient α and inter-item correlations were used to assess the internal consistency of the ASSIST and its subscales. RESULTS: For the whole sample, the PCA confirmed the three primary factors as previously established. Five subscales loaded on the first factor (strategic approach). Four subscales loaded on the second factor (surface approach), whereas the remaining four subscales loaded on the third factor (deep approach). Repeating the analysis for each of the country-specific samples produced slightly diverging factor structures for the samples from Australia and Hong Kong. CONCLUSION: Considering all the data, the ASSIST subscales that emerged from the PCA used with a confirmatory approach in this study revealed a good degree of concordance with the established original factor, scale and subscale structure. The slightly deviating results obtained for the Hong Kong student group indicate that the established factor structure may not be the best fit across all settings, cultural contexts and sample groups.

Involvement in Research and Development Projects Among Community-working Occupational Therapists in Norway.

A cross-sectional descriptive survey was conducted (n = 561). Almost half of the participants took part in research and development projects. Being involved in research and development was associated with lower age, having further education, and higher levels of work experience. The current and prioritized research topics were reablement and assistive technology. The study implies that community-working occupational therapists are largely involved in research and development, or eager to become involved.

Self-diagnosed depression in the Norwegian general population - associations with neuroticism, extraversion, optimism, and general self-efficacy.

BACKGROUND: Multi-item rating scales for depression informs about the level of depression, but does not allow individuals to state by self-evaluation whether they feel depressed or not. The insider perspective on depression is rarely assessed. This study investigated the prevalence of self-diagnosed depression in the Norwegian general population, and associations with sociodemographic and psychological factors. METHODS: As part of a national survey, the General Self-Efficacy Scale, the Life Orientation Test-Revised, a short version of the Eysenck Personality Questionnaire and a one-item measure of self-diagnosed depression was administered to 5.500 persons in the general Norwegian population. Of the 4961 eligible participants ≥ 18 years of age, 1.787 (response rate 36%) participated in the survey, and 1.684 of these had valid scores on the relevant scales. The associations between sociodemographic factors and self-diagnosed depression were examined using univariate and multivariate logistic regression analyses. RESULTS: One hundred and thirty-six participants (8.1%) reported depression during the preceding month. When adjusting for sociodemographic and psychological variables, higher age (OR = 0.82), being in work (OR = 0.57), and higher levels of general self-efficacy (OR = 0.67) and optimism (OR = 0.52) were associated with lower risk of self-diagnosed depression, whereas higher levels of neuroticism (OR = 1.97) was associated with higher risk. CONCLUSIONS: The prevalence of self-diagnosed depression in the adult Norwegian population was higher for women than for men. Higher age, being in work and having higher levels of psychological resources appear to reduce the risk of self-diagnosed depression, whereas neuroticism increases the risk.