The present dissertation investigated adolescents’ overall stress and perceived stressors, the effectiveness of a universal psychoeducational program about stress, the Stress Lessons, and... Show moreThe present dissertation investigated adolescents’ overall stress and perceived stressors, the effectiveness of a universal psychoeducational program about stress, the Stress Lessons, and adolescents’ self-referral to a targeted school-based intervention. Another aim was to examine whether adolescents from different demographic groupings vary in their experience of stressors and the effect of psychoeducation. A large and heterogeneous sample was recruited from schools with variation in educational tracks and self-perceived ethnic backgrounds. The sample consisted of 1613 predominantly young adolescents with an average age of 13 years old. Most adolescents have to maneuver through a world of stressors, mostly related to the school environment, their health, and future uncertainty, while adolescents experience less stress from social pressure and financial pressure. Furthermore, our results indicate that the Stress Lessons were effective regarding improving adolescents’ knowledge about stress, but not in terms of stress levels. Finally, we found that adolescents who reported higher levels of test anxiety were generally more likely to show interest in an intervention targeting reduction of performance anxiety after the Stress Lessons. However, we did not find that adolescents with lower levels of social skills were more interested in an intervention targeting improvement of social skills. Show less
Improving survival rates in children and adolescents with malignant bone tumours, paved the way to the application of new surgical extremity-salvage techniques. For the surgical treatment of... Show moreImproving survival rates in children and adolescents with malignant bone tumours, paved the way to the application of new surgical extremity-salvage techniques. For the surgical treatment of malignant bone tumours of the lower extremity, there are a number of resection options (amputation, limb sparing, and rotationplasty) available. Each option has its own indication and after the surgery different advantages and disadvantages. The debate is whether limb-salvage or ablative surgery is advantageous for the individual patient. Purpose of the studies presented in this thesis are evaluate and compare QoL, functional ability and physical activity levels among children and young adults in the first years after bone cancer surgery of the leg. A cross sectional and a prospective study were conducted in the Dutch university bone cancer centres. The results of the cross-sectional study show that outcomes are equivalent for those undergoing limb salvage or ablative surgery. The results of the prospective study showed that; survivors improve in the two years following resection of the bone tumour and the resulting limb-sparing or ablative surgery at all domains evaluated, with the exception of the mental QoL domains. These improvements were most pronounced over the first year after surgery. Show less
Cross-cultural research shows that cultural frameworks provide guidance on what to feel and when, and how to express emotions from a young age. These cultural variations can cause misinterpretation... Show moreCross-cultural research shows that cultural frameworks provide guidance on what to feel and when, and how to express emotions from a young age. These cultural variations can cause misinterpretation and misunderstanding and are especially relevant for ethnic minority groups, who may be described as living ‘in between’ cultures. This thesis examines the extent to which Moroccan-Dutch adolescents’ emotional functioning can be considered in between cultures. Their emotion awareness, acknowledgment of social emotions, anger regulation, and anger communication was compared with those of their Dutch peers and with those of their peers living in Morocco. The thesis also addresses the adaptiveness of these aspects of emotional functioning in terms of psychological functioning. The results reveal that, overall, Moroccan-Dutch adolescents’ emotional functioning shows more similarities with that of their Dutch than their Moroccan peers. Although these ‘Dutch’ emotion patterns do not always seem adaptive for Moroccan-Dutch adolescents’ psychological wellbeing, the findings suggest that their emotional functioning in peer situations is a product of the Dutch culture. Show less