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The main aim of this study was to explore the experiences of interdisciplinary collaboration among staff members, applying cognitive milieu therapy for inpatients with dual diagnosis. The study is based on 33 individual, qualitative interviews. The interdisciplinary approach helped the staff to agree on common aims for the treatment of each patient. The cognitive method was useful and provided the staff with suitable tools in their work with the patients. The staff succeeded in developing a good learning climate, where they cooperated on equal terms with the patients. Collaborative team learning and external supervision facilitated personal learning processes.

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BACKGROUND: Morbid obesity is a progressive, chronic condition associated with failed attempts at change and repeated relapses. AIM: There seems to be little previous research into the understanding of the everyday life of morbidly obese adults. We wanted to gain more knowledge about characteristics of eating habits and body image as well as motivational forces for change. METHODS: A qualitative approach was chosen in order to gain insight into how morbidly obese adults experience everyday life. Qualitative interviews are well suited to provide insight into themes from the interviewee's life story from the subjects' own perspectives. To gain insight into such processes, a narrative approach that allowed the informants to give voice to their ways of doing, thinking and feeling in daily life, was adopted. The informants comprised seven women and four men aged of 26-56 years, recruited from a population of obese individuals who had participated in a weight reduction course. A hermeneutic approach was used where the research question was the basis for a reflective interpretation. RESULTS: The following meaning-units were identified: to be perceived as overweight; and to see oneself as overweight. Ingrained habits: the struggle between knowing and doing; acting without knowing; and eating is soothing. CONCLUSIONS: Seeing oneself as an obese person is a gradual process that implied experiencing oneself as different from significant others, such as (slim) siblings and friends. To experience a gap between knowing and doing concerning food habits in everyday life indicates that informants value they have a choice. This is an important insight to consider when framing interventions to support this vulnerable group.

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PURPOSE: To explore relationships of socio-demographic variables, health behaviours, environmental characteristics and personal factors, with physical and mental health variables in persons with morbid obesity, and to compare their health-related quality of life (HRQoL) scores with scores from the general population. METHODS: A cross-sectional correlation study design was used. Data were collected by self-reported questionnaire from adult patients within the first 2 days of commencement of a mandatory educational course. Of 185 course attendees, 142 (76.8%) volunteered to participate in the study. Valid responses on all items were recorded for 128 participants. HRQoL was measured with the Short Form 12v2 from which physical (PCS) and mental component summary (MCS) scores were computed. Other standardized instruments measured regular physical activity, social support, self-esteem, sense of coherence, self-efficacy and coping style. RESULTS: Respondents scored lower on all the HRQoL sub-domains compared with norms. Linear regression analyses showed that personal factors that included self-esteem, self-efficacy, sense of coherence and coping style explained 3.6% of the variance in PCS scores and 41.6% in MCS scores. CONCLUSION: Personal factors such as self-esteem, sense of coherence and a high approaching coping style are strongly related to mental health in obese persons.

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BACKGROUND: In a collaboration that started in 2001, the Norwegian Nurses' Association and Modum Bad Centre for Mental Health have offered burnout-preventing courses at Modum Bad's resource section for health care professionals, Villa Sana. We have assessed results among the attendees of the first six courses (mean age of 48.3 years, range 35-61) and compared them to results with the same rating scales among 50 breast cancer survivors (mean age 49.3 years, range 31-66). MATERIAL AND METHODS: Informed consent was obtained from 45 attendees (of a total of 47) who filled in self-rating scales assessing level of depression, anxiety and quality of life and a comprehensive questionnaire about their health, work and family situation. The course was assessed on the last day. RESULTS: The majority of attendees had symptoms of depression and anxiety and assessed their quality of life as "average". In comparison, the breast cancer survivors had significantly less psychiatric symptoms and reported higher quality of life. Two thirds of the attendees saw a connection between their problems and work and private life; 33 thought that the course had helped them clarifying important issues in their life. INTERPRETATION: The attendees assessed the course as very useful.

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