A qualitative study on the role of cultural background in patients perspectives on rehabilitation

Background Low back pain (LBP) is one of the major concerns in health care. In Switzerland, musculoskeletal problems represent the third largest illness group with 9.4 million consultations per year. The return to work rate is increased by an active treatment program and saves societal costs. However, results after rehabilitation are generally poorer in patients with a Southeast European cultural background than in other patients. This qualitative research about the rehabilitation of patients with LBP and a Southeast European cultural background, therefore, explores possible barriers to successful rehabilitation. Methods We used a triangulation of methods combining three qualitative methods of data collection: 13 semi-structured in-depth interviews with patients who have a Southeast European cultural background and live in Switzerland, five semi-structured in-depth interviews and two focus groups with health professionals, and a literature review. Between June and December 2008, we recruited participants at a Rehabilitation Centre in the German-speaking part of Switzerland. Results To cope with pain, patients prefer passive strategies, which are not in line with recommended coping strategies. Moreover, the families of patients tend to support passive behaviour and reduce the autonomy of patients. Health professionals and researchers propagate active strategies including activity in the presence of pain, yet patients do not consider psychological factors contributing to LBP. The views of physicians and health professionals are in line with research evidence demonstrating the importance of psychosocial factors for LBP. Treatment goals focusing on increasing daily activities and return to work are not well understood by patients partly due to communication problems, which is something that patients and health professionals are aware of. Additional barriers to returning to work are caused by poor job satisfaction and other work-related factors. Conclusions LBP rehabilitation can be improved by addressing the following points. Early management of LBP should be activity-centred instead of pain-centred. It is mandatory to implement return to work management early, including return to adapted work, to improve rehabilitation for patients. Rehabilitation has to start when patients have been off work for three months. Using interpreters more frequently would improve communication between health professionals and patients, and reduce misunderstandings about treatment procedures. Special emphasis must be put on the process of goal-formulation by spending more time with patients in order to identify barriers to goal attainment. Information on the return to work process should also include the financial aspects of unemployment and disability.

Does culture really matter in sports participation? The impact of socio-cultural factors on sports behaviour in Switzerland

The physical activity of the Swiss population differs considerably depending on the linguistic region. German speakers are more often physically active than people living in the French or Italian-speaking part of Switzerland (Stamm & Lamprecht, 2011). This study analyses how socio-cultural factors correlate with sports participation for adolescents and young adults. In order to analyse this research question, Bourdieu’s concept of habitus (1984) has been adapted and used as a theoretical background. This sport-related concept of habitus considers culturally determined values, the attribution of meaning and patterns of action such as the understanding of sports, the importance of sports, body, health or leisure. On this basis, the sport-related habitus and the practical relevance of sports participation has been empirically reconstructed for adolescents and young adults aged 15 to 25 through a qualitative study including guideline-based interviews with German (n=6) and French (n=4) speaking adolescents and young adults, as well as a quantitative survey in a German (n=106) and a French (n=99) speaking commune of Switzerland. Initial findings reveal that young German speakers associate sports with self-discipline (χ²(1, N=205)= 8.223, p<.005, V=.200) and fitness (χ²(1, N=205)= 21.989, p<.005, V=.328) whereas young French speakers are more likely to relate health (χ²(1, N=205)= 9.455, p<.005, V=.215), effort and perspiration (χ²(1, N=205)= 18.835, p<.005, V=.303) to sports. Similarly, the understanding of body and health as well as the attitude towards leisure differs between the German and French speaking parts of Switzerland. This study illustrates that the concept of sports habitus is culturally shaped and therefore may be fruitful in further analyses. Bourdieu, P. (1984). Distinction. A Social Critique of the Judgement of Taste. Cambridge: Harvard University Press. Stamm, H. & Lamprecht, M. (2008). Swiss sports participation in an international perspective. European Journal for Sport and Society, 8 (1+2), 15-29.

The impact of structural conditions in communes on physical activity and sports behaviour of adolescents and young adults in Switzerland

Introduction The physical activity of the Swiss population differs considerably depending on the linguistic region. German speakers are more often physically active than people living in the French- or Italian-speaking part of Switzerland (Stamm & Lamprecht, 2008). This study analyses how differing structural conditions in communes (e.g. sport facilities, significance of the municipal promotion of sport) across different linguistic regions of Switzerland correlate with physical activity and sports participation for adolescents and young adults. Methodological approach Based on the theory of social action (Coleman, 1990), it is assumed that individual behaviour is not only determined by individual but also by structural and socio-cultural factors in which a person is socially embedded. In two case studies, multilevel data was gathered analysing possible influences of structural factors on sports behaviour. Using an online survey, 15 to 25 year old inhabitants (N = 205) living in a German- and French-speaking commune were questioned about their sports participation in and outside of their commune, as well as their perception of sport-related structural characteristics in their commune. To collect information about communes’ sport facilities, the sport providers (N = 23) were interviewed. Sport-related characteristics of the communes were also collected through two interviews with representatives of the municipal administration. Results and discussion Physical activity is significantly higher (Chi2 (1, N = 183) = 4.78, p < .05) and sport participation is significantly lower in the French speaking commune (Chi2 (1, N = 205) = 3.84, p < .05). Adolescents and young adults in the French speaking commune (M = 3.15, SD = 1.23) are less satisfied with the opportunities to be physically active in the environment than their counterparts living in the German speaking commune (p < .001, Mann-Whitney U – test). These first findings show the impact of structural conditions in communes on physical activity and sport participation of adolescents and young people. However, it must be noted that this study is explorative and further communes would need to be examined in order to generalize the results. References Coleman J S (1990). Foundations of social theory. Belknap, Cambridge, MA. Stamm H, Lamprecht M (2008). EJSS, 8(1+2), 15-29.

The importance of socio-cultural factors on sports behaviour of adolescents and young adults in Switzerland – a conceptualisation on the basis of the habitus-approach

Sport participation has often been the topic in sports science and it could be shown that in Europe the population of northern and western countries are more often physically active than southern and eastern countries (European Commission, 2014). In Switzerland the physical activity of the Swiss population also differs between the linguistic regions. The German speaking population is more often physically active than the French or Italian speaking part (Stamm & Lamprecht, 2008). To explain the differences in sport participation structural and cultural factors have been discussed. Because within a country homogenous structural conditions can be assumed, the aim of this study is to analyse how socio-cultural factors correlate with sport participation of adolescents and young adults. In order to analyse this research question, Bourdieu’s concept of habitus (1984) has been used as theoretical background. This sport-related concept of habitus considers cultural determined values, the attribution of meaning and patterns of action which is socially determined and have an influence on individual actions and therefore also on the sport practise. On this basis, a qualitative study including guideline-based interviews with German (n=5) and French (n=3) speaking adolescents and young adults at the age of 16 to 24 (M=21.4) were held in two different linguistic regions of Switzerland. To analyse the interviews the documentary method was applied (Bohnsack, 2010). Initial findings reveal that there are different sport related values, attributions of meanings and patterns of action also called framework of orientations concerning topics like body, health and leisure which correlate with the habitual sports practise in the two different linguistic regions. This study illustrates that the habitus is culturally shaped and that it could help to understand the meaning of socio-cultural factors for sport participation.

The Interaction Between Forest Fires and Human Activity in Southern Switzerland

The impact of human activities on the fire regime in southern Switzerland was studied using (pre)historical charcoal and pollen data from lake sediments and statistical data from the 20th century. The cultural impact on forest fire was established by correlating charcoal-influx data with pollen percentages of anthropogenic indicators such as Plantago lanceolata, the Cerealia (sum of Avena t., Triticum t. and Hordeum t.) and Secale. During the 20th century, fire frequency was correlated with precipitation, dry and very dry periods and landscape management indicators. The effects of human activity on the fire regime are clearly recognisable since at least the Neolithic period. Using palaeoecological or statistical data, the variations in fire regime originating from anthropogenic actions may be differentiated from those due to climatic changes if they are sufficiently conspicuous.

Otium et negotium. Reading processes and their cultural backgrounds in early Italian and German humanism

Reading and reading habits have radically changed in the digital age. Readers are no longer physically bound to textual objects and libraries, they deal with texts by copying, altering, and annotating them, and they mix established textual forms with other semiotic systems such as pictograms, icons and images. These circumstances also provoke a renewed research interest in the history of reading. In this talk, I will concentrate on reading processes as to how they were enacted and practised in early Italian and German humanism. I will start with some paradigmatic scenes described in Petrarch’s letters (among others the famous visit of the Mont Ventoux, where Petrarch, after having enjoyed a spectacular panorama, withdraws into the contemplative reading of St-Augustine). The transmission of Petrarch’s writings in humanist circles of Southern Germany (e.g. with the Schedel and Gossembrot families in Nurnberg, Augsburg and Strasburg) will then lead to specific reading practices documented in manuscripts that once belonged to coherent libraries and are nowadays spread all over Europe. In the case of the former tradesman and mayor Sigismund Gossembrot, complex habits of textual annotating and cross-referencing can be observed. The dichotomy of the Latin terms otium (‘rest’ and ‘leisure’) and negotium (‘activity’, but also ‘practice’, ‘negotiation’, ‘circulation of social energy’ in the sense of New Historicism) will be used as an ideal-type outline to describe the occurring processes of reading.

Otium et negotium. Reading processes and their cultural backgrounds in early Italian and German humanism

Reading and reading habits have radically changed in the digital age. Readers are no longer physically bound to textual objects and libraries, they deal with texts by copying, altering, and annotating them, and they mix established textual forms with other semiotic systems such as pictograms, icons and images. These circumstances also provoke a renewed research interest in the history of reading. In this talk, I will concentrate on reading processes as to how they were enacted and practised in early Italian and German humanism. I will start with some paradigmatic scenes described in Petrarch’s letters (among others the famous visit of the Mont Ventoux, where Petrarch, after having enjoyed a spectacular panorama, withdraws into the contemplative reading of St-Augustine). The transmission of Petrarch’s writings in humanist circles of Southern Germany (e.g. with the Schedel and Gossembrot families in Nurnberg, Augsburg and Strasburg) will then lead to specific reading practices documented in manuscripts that once belonged to coherent libraries and are nowadays spread all over Europe. In the case of the former tradesman and mayor Sigismund Gossembrot, complex habits of textual annotating and cross-referencing can be observed. The dichotomy of the Latin terms otium (‘rest’ and ‘leisure’) and negotium (‘activity’, but also ‘practice’, ‘negotiation’, ‘circulation of social energy’ in the sense of New Historicism) will be used as an ideal-type outline to describe the occurring processes of reading.