Välbefinnande – en överblick

Välbefinnande – en överblick

Jesper Eriksson

Avdelningen för Samhällsmedicin och folkhälsa

Värde i sig?

Välbefinnande och hälsa?

Välbefinnande och funktionsförmåga?

Vad är välbefinnande?

Går det att mäta?

Hur man blir lycklig

Värde i sig?

Individnivå

Gruppnivå

Samhällsnivå

Välbefinnande och hälsa?

Välbefinnande

Hälsa

WHOs definition av hälsa:

"a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity…"

WHO Constitution 1948

Sveriges folkhälsomål:

“Skapa samhälleliga förutsättningar för en god hälsa på lika villkor för hela

befolkningen”

Folkhälsoinstitutet 2007

Hälsa = livslängd

Livslängd

Livslängd

Större yta

Livskv

alité

Livskv

alité

Både inom psykologi och medicin har kritiken ökat mot ett alltför stort fokus på

de negativa aspekterna av hälsobegreppet

Hälsa = frånvaro av symptom…?

Greater optimism is associated with greater longevity and lowered rates of non-fatal heart attacks (Kubzansky et al., 2001)

Pleasant emotion expressed at age 22 as women entered a catholic convent predicted their longevity after age 75 (Danner, Snowdon, & Friesen, 2001)

Low life satisfaction predicted fatal accidents (Koivumaa-Honkanen et al., 2002)

Preoperative well-being predicted better recovery from surgery (Kopp et al., 2003)

Well-being of patient entering whiplash rehabilitation predicted whether going back to work after 2 years (Heikkilä, Heikkilä, & Eisenmann, 1998)

Patients with end-state renal failure were more likely to survive for 4 years if they were happy than if they were not (Devins, Mann, Mandin, & Leonard, 1990)

People high in well-being have easier to cope with pain than people low in well-being (Keefe et al., 2001)

People put into a positive mood showed lower blood pressure reactivity to a stressor than controls (Smith, Ruiz, & Uchino, 2001)

People reporting high levels of positive emotions were at reduced risk of developing symptoms when exposed to cold viruses (Cohen et al., 2003)

•Välbefinnande och mortalitet

•Välbefinnande och minskad sårbarhet

•Välbefinnande- snabbare rehabilitering

•Sambandet mellan välbefinnande och hälsa påverkas också av hälsorelaterat beteende som träning, rökning, alkohol, diet

Samband mellan välbefinnande och hälsa

Forskningsmässiga effekter av att vi bortser

från välbefinnande?Fokusbias: Well-being distinct from ill-being. 2 biomarkörer stödde spegelhypotesen, 7 stödde hypotesen att well-being och ill-being representerar olika aspekter av hälsa (Ryff et al. 2006)

Distinct or mirrored?

Determinants

Outcomes/effects

Validitetsbias: Individer som upplevde subjektivt välbefinnande samtidigt som de inte hade ”depression” (completely healthy) hade en lägre prevalens av CVD än de som endast hade ”frånvaro av depression”. Detta indikerar att tidigare forskning kan ha underestimerat risken för exempelvis CVD eftersom risken är jämförd med en väldigt heterogen grupp av ”icke-depressiva” (Keyes, 2004).

Välbefinnande och funktion

•Robust consistency showing that happiness also precede success. Review of 225 cross-sectional, longitudinal, and experimental studies, 275.000 participants (Lyubomirsky, King, & Diener, 2005)•Clear correlation between employee engagement, well-being, and business outcomes (i.e. profit & turnover). Meta analyses of the Gallup studies, hundreds of work units around the world (Harter, Schmidt, & Keyes, 2002)

•Induced positive affect

•Widens the scope of attention (Fredrickson & Branigan, 2005)

•Broadens behavioral repertoire (Fredrickson & Branigan, 2005)

•Increases creativity (Isen, Daubman, & Nowicki, 1987)

•Clear association between well-being and rehabilitation (Kopp et al., 2003, Heikkilä, Heikkilä, & Eisenmann, 1998)

•Success gives happiness…

Vad är välbefinnande?

Well-being

Quality of life

Overall life satisfaction

Psychological well-being Hedonic well-

being

Positive health

Happiness

Subjective well-being

Domain life satisfaction

Homeostasis

Health

Eudaimonic well-being

Set-point

Objective well-being

Complete health

Presence of positive affect

Absence from negative affect

Joy

FlowSense of meaning

Mood

Contentment

Relaxation

Positive psychology

Går välbefinnande att mäta?

Diener & Seligman, 2004

QoL

OWB

SWB

Affection

Cognition

PA

NA

Domain

Overall

Intensity, frequency, duration?

“…the sum

of its parts?”

Quality of Life

+

+-

-

Affect & cognition?

Vardagens ”ups & downs” har inte nödvändigtvis ett starkt

samband med ”overall life-satisfaction”

Current state or enduring

trait?

Top-down

Bottom-up

Homeostasis

Set-point

Ny set-point

Set-point

Set-point

Major life event

Psychological well-being

As a measure of eudaimonic well-being

1. Autonomy – independence and self-determination

2. Environmental mastery – the ability to manage one’s life

3. Personal growth – being open to new experiences

4. Positive relations with others– having satisfying high quality relationships

5. Purpose in life – believing that one’s life is meaningful

6. Self-acceptance – a positive attitude towards oneself and one’s past life. Ryff

2004

Realize that enduring happiness doesn't come from financial success. People adapt to changing circumstances—even to wealth or a disability.

Take control of your time. Happy people feel in control of their lives, often aided by mastering their use of time.

Act happy. We can sometimes act ourselves into a frame of mind. Manipulated into a smiling expression, people feel better; when they scowl, the whole world seems to scowl back. So put on a happy face.

Seek work and leisure that engages your skills. Happy people often are in a zone called "flow"—absorbed in a task that challenges them without overwhelming them.

Join the "movement" movement. An avalanche of research reveals that aerobic exercise not only promotes health and energy, it also is an antidote for mild depression and anxiety.

Give your body the sleep it wants. Happy people live active vigorous lives yet reserve time for renewing sleep and solitude.

Give priority to close relationships. Intimate friendships with those who care deeply about you can help you weather difficult times.

Focus beyond self. Reach out to those in need. Doing good also makes one feel good.

Be grateful. People who pause each day to reflect on some positive aspect of their lives experience heightened well-being.

Nurture your spiritual self. For many people, faith provides a support community.

Nedkortat från David G. Myers, The Pursuit of Happiness (Avon Books)

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Tack…

Avdelningen för Samhällsmedicin och folkhälsa