| 1. |
- Jonker, Dirk, 1956-
(författare)
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Self-assessed and direct measured physical workload among dentists in public dental clinics in Sweden during a period of rationalizations
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Much research has been done on interventions to reduce work-related musculoskeletal disorders (WMSDs) at the workplace. However, this problem is still a major concern in working life. The economic cost for WMSDs corresponds to between 0.5% and 2% of the gross national product in some European countries, and in 2007, 8.6% of workers in the EU had experienced work-related health problems during the previous 12 months. In Sweden, one in five of all employees have rated occurrence of WMSDs during the previous 12 months.In spite of comprehensive ergonomic improvements of workplace and tool design in dentistry the prevalence of musculoskeletal disorders in neck, upper arms and back is reported to be between 64% and 93%.The present thesis investigates if the perceived high exertion during work corresponds to actual physical exposures. Further, it is investigated if risk full physical exposures may be generated due to rationalisations. Specifically, changes in physical exposures are investigated prospectively during a period of rationalisations. Empirical data on production system performance, individual measured physical workload, and self-rated physical workload are provided.High estimates of self-rated workload were found. These high scores for perceived workload were associated with high measured muscular workload in the upper trapezius muscles. Also, negative correlations were found between low angular velocities in the head, neck and upper extremities on the one hand, and estimates for perceived workload on the other. Both measured muscular workload and mechanical exposure among dentists indicate a higher risk of developing WMSDs than in occupational groups with more varied work content. Value-Adding Work (VAW) comprised about 57% of the total working time and compared to industrial work an increase with about 20 percent units is hypothesised. Furthermore, VAW compared to non-VAW (“waste”) implies more awkward postures and especially low angular velocities interpreted as constrained postures.Consequently, when increasing the proportion of time spent in VAW due to rationalisations, work intensification is expected. However, at follow up, we did not find such work intensification.Previous research indicates that rationalisation in working life may be a key factor in the development of WMSD. The present thesis suggests that ergonomics may then be considered proactively as part of the rationalisation process.
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| 2. |
- Rolander, Bo
(författare)
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Work conditions, musculoskeletal disorders and productivity of dentists in public dental care in Sweden : Are dentists working smarter instead of harder?
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: During the last 20 years, Sweden and other countries have been adjusting their models of welfare to a changed economic environment. Rationalization, influenced by New Public Management, has been implemented in public dentistry in order to improve efficiency and to streamline activities. This has involved transferring some of dentists’ tasks to dental hygienists and dental nurses. The goal is to achieve a more efficient mix of skills and more interaction between professional groups, in order to utilize all skills better in a more efficient work organization. Organizational changes may have an effect on the work environment both with regard to physical and to psychosocial work conditions and affect health and well-being. In many cases these changes have a profound negative effect on musculoskeletal and mental health, and corresponding risk factors, by reducing the number of natural breaks and thus reducing the efficacy of targeted ergonomic interventions. Dentists in Jönköping County in Sweden perceive high precision demands and poor working postures in their work. The five studies in this thesis describe organizational changes and analyse the risk of illness among dentists in the public sector in Jönköping County.Aim: The main aim is to study dentists’ physical and psychosocial work conditions and investigate associations with musculoskeletal disorders, work ability and sick leave during a period of extensive rationalizations; secondly, to assess the risk of illness as a basis for recommending preventive measures.Methods: The present thesis was designed with four cross-sectional studies (Paper I-IV) and one prospective longitudinal study (Paper V). In Paper I, a questionnaire concerning physical and psychosocial work conditions and health was sent out to all employees working in public dental care in Jönköping County in Sweden. To obtain more information on the difficult physical work situation for dentists (Paper I), an observation study with Portable Ergonomic Observation (Paper II) and an sEMG study (Paper III) was then conducted. Paper IV deals with psychosocial issues (using the same survey as in Paper I) and questions in the Eysenk Personality Questionnaire (EPQ) and the Marlowe-Crown scale SD (MCSD), to analyse their impact on perceived physical load. In Paper V, data about physical and psychosocial conditions and health from a survey, as well as production data (number of adult treatments per year per dentist) from computerized patient records (T4), are analysed with regard to changes and associations during a period of extensive rationalizations (2003 – 2008).Results: In Paper I, dentists reported the poorest physical work conditions of all occupational groups and high prevalence of musculoskeletal disorders. However, relatively low intensity of pain was reported and only a small proportion thought that work was affected. Paper II and Paper III confirmed that dentists’ work is physically demanding, with sitting postures and head bent forward, as well as prolonged low muscle loading. Paper IV shows that physical load is mainly influenced by psychosocial demands and to some extent by loss of work control. The results in Paper V show that during the period of extensive rationalizations between 2003 and 2008, dentists perceive improved precision demands and fewer uncomfortable work postures, but still a high level of physical load. The number of adults treated per dentist also improved, but there was a slight deterioration in work control and leadership.Conclusions: The results in this thesis show a consistent picture of high perceived physical load due to high precision demands and uncomfortable work postures, supported by observation of body movements (Portable Ergonomic Observation) and sEMG signs during psychosocially demanding circumstances. The rationalizations implemented in Jönköping County during the period 2003-2008 have not resulted in a deterioration of the physical environment, in spite of the fact that dentists produce more treatments of adult patients than before. This result may indicate that rationalizations do not always lead to increased health risks; it depends how they are implemented. Dentists may have changed the way they work for the better, and due to task delegation and SMS reminders a smoother patient flow has probably resulting in a reduction of workload and perceived stress regarding financial loss.
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| 3. |
- Fagerlind Ståhl, Anna-Carin, 1982-
(författare)
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Live long and prosper : Health-promoting conditions at work
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis is to contribute with knowledge concerning health-promoting conditions at work, and to investigate how individual, workplace and organisational conditions are interrelated. In the thesis, work-related flow, i.e. an experience of motivation, absorption and work enjoyment, is used as a holistic notion of occupational health. In Paper I, work-related flow is investigated in relation to decision latitude, social capital and an innovative learning climate at work. Paper II investigates whether the use of tools inspired by lean production, such as standardisation and value stream mapping, is positively associated with conditions for innovative learning in organisations. The aim of Paper III is to identify conditions for health and performance in organisation and at work; further, to investigate the association between work-related flow and performance. Paper IV reports on a longitudinal investigation of workrelated flow in relation to lean tool use and conditions at the workplace. The empirical material is based on data from 10 organisations, including 4442 employees. Papers I-III are cross-sectional, whereas Paper IV is longitudinal. Papers II-IV utilise multilevel analyses.The results show that decision latitude, social capital and an innovative learning climate are associated with an increase in work-related flow (Papers I, III & IV), and with performance (Paper III). Individuals’ decision latitude enables an increased benefit from the social capital and innovative learning climate at work (Paper I). The effect of tools inspired by lean production on work-related flow (Papers III & IV), and on conditions for innovative learning (Paper II) differs, depending on which tools are used, and on workplace conditions. These tools enable innovative learning mainly where decision latitude is low (Paper II), and it is primarily the lean tool value stream mapping which has the potential to create an arena for innovative learning (Paper II) and work-related flow (Paper IV).It is concluded that the individual is embedded in a social work context that has the potential to strengthen the ability to act with motivation, absorption and enjoyment. In order to utilise collective healthpromoting conditions at work, individuals need to have authority to make their own decisions and use their skills. The effect of tools inspired by lean production depends on the specific tools that are used, and on individuals’ decision latitude at work. Their potential to enable innovative learning is most evident for employees who have few opportunities for autonomous decision-making and skill use in their work. For those with a high degree of decision latitude, the use of lean tools has a smaller effect. Work-related flow may in itself serve as a resource that improves performance and increases engagement in health-promoting work conditions. In order to promote health as well as performance, work needsto be organised so that employees have opportunities to decide over their own work, and utilise their skills, individually and collectively within the workgroup.
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| 4. |
- Seing, Ida, 1982-
(författare)
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Activating the Sick-Listed : Policy and Practice of Return to Work in Swedish Sickness Insurance and Working Life
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- A critical task of social policy in most Western welfare states during recent decades has consisted of reducing the economic burden on society due to sick leave, by stimulating participation in the labour market. Many jurisdictions have introduced activation policies, based on the premise that work “per se” has a therapeutic effect on sick-listed workers. People are expected to be “active”, rather than “passive”, recipients of financial benefits. However, there is limited knowledge of how activation policies focusing on return to work (RTW) are carried out in local practice. Against this background, the overall aim of this thesis is to study the local practice of activation policies by analysing how they are received, implemented and experienced by welfare state organizations, employers and sick-listed workers. The analysis has been influenced by theories concerning organization fields, individualization, street-level bureaucracy and organizational governance.In this thesis, the overall aim is investigated in four interrelated papers. In Paper I, the aim is to analyse the perspectives of stakeholders (i.e. welfare state actors and employers) on work ability by studying multistakeholder meetings. Paper II sheds light on activation policy, focusing on early RTW in the context of modern working conditions; the aim is to analyse RTW practice in local workplace contexts, in relation to Swedish early-RTW policy. The third paper focuses on employers, with the aim of analysing their role and activities regarding RTW, in local workplace practice. In Paper IV, the aim is to analyse sick-listed workers’ experiences of the sickness insurance system in their contact with the Swedish Social Insurance Agency (SSIA) and their front-line staff.The empirical material comprises two empirical studies: 1) audio-recorded multi-stakeholder meetings from regular practice (n=9) and 2) semi-structured interviews with sick-listed workers and their supervisors in 18 workplaces (n=36). The analyses of the material have been performed in accordance with the principles of qualitative content analysis.Main findings of the papers reflect strong organizational boundaries in the implementation process of activation policies. Welfare state actors and employers appear to be governed by their own organizational logics and interests, so the actors involved fail to take a holistic view of sick-listed workers and do not share a common social responsibility for individuals’ RTW. This thesis illustrates how current activation policies focusing on RTW are based on a rather idealized image of the standard workplace. There is an explicit or implicit assumption that employers and work organizations are able to welcome sick-listed workers back to work in a healthy way. However, the intensity of modern working life leaves limited room for accommodating people with reduced work ability, who are not considered to have a business value to the workplace. In several cases, findings indicate that the SSIA’s focus on activation and early RTW clashes with the financially oriented perspective of employers. Economic considerations regarding their business take precedence over legal and ethical considerations, and employers have difficulty taking social responsibility for RTW. Sick-listed workers are encouraged to adjust to new workplace settings and environments to meet the demands of the workplace, and, if RTW is not possible, to the demands of the labour market. The findings also show that sick-listed workers experience that contacts with the SSIA are ‘standardized’; i.e., they perceive that the officials are loyal to demands in their organizations rather than being involved actors who support workers’ individual needs. Sick-listed workers clearly experience that measures in Swedish activation policies have a strong focus on demanding aspects (financial work incentives) and less on enabling aspects (investments in skills).Overall, this thesis illustrates an emerging social climate where sick-listed workers are positioned as active agents who must take responsibility for their sick leave and their RTW process. In a Swedish context, RTW is a matter of activating the sick-listed rather than activating the workplace.
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| 5. |
- Wåhlin, Charlotte, 1961-
(författare)
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The Rehabilitation Process for Individuals with Musculoskeletal and Mental Disorders : Evaluation of Health, Functioning, Work Ability and Return to Work
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Musculoskeletal disorders (MSD) and mental disorders (MD) are common among working-age individuals, and reduced work ability is often a problem that influences functioning in working life. Having MSD and MD is also a common cause of seeking health care and these conditions account for the majority of sick leave in most western countries. The overall aims of the thesis were to increase knowledge about biopsychosocial assessment of health, functioning and work ability for individuals with MSD and MD seeking care. A further aim was to gain better understanding of praxis behaviour in the rehabilitation process for sick-listed patients by evaluating patient-reported work ability, type of interventions given, usefulness of interventions, and return to work.This thesis comprises four studies based on two different cohorts. A cross-sectional design was used for studies I and II, which included 210 individuals diagnosed with MSD and MD seeking occupational health services. Data collection consisted of questionnaires to patients on self-reported health, functioning, work conditions, work ability and reports of professional assessment of diagnosis, main clinical problem, recommended intervention and sick leave. Studies III (n=699) and IV (n=810) were based on a longitudinal cohort study, ReWESS, with a 3-month follow-up comprising individuals who sought primary health care or occupational health services for MSD or MD and were sick-listed. The data collection included repeated questionnaires to the patients on self-reported health, functioning, work conditions, work ability, type and usefulness of intervention and return to work.There was an association between the professional biopsychosocial assessment and patients’ self-reported measures of health, functioning and work ability in clinical reasoning. Self-reported health and work measures can complement the expert-based diagnosis. Patients who had MSD and MD with co-morbid conditions reported more problems with mental functioning, had higher psychological demands at work and reported poorer work ability compared with those with MSD only. Patients with co-morbid conditions also had worse outcome compared to having mental disorders only. Psychosocial problems and activity limitations concerning social interaction skills were a frequent problem. This can be identified in clinical screening by physiotherapists in dialogue with the patient using the Patient-Specific Functional Scale. Three-quarters of sick-listed individuals with MSD or MD returned to work within 90 days. The treatment approach to sick-listed persons is still very medical and clinically oriented. Access to work-related interventions seems to be limited in the early rehabilitation process and may not be equal in practice. Those who were younger, had higher educational level and reported stronger health resources were favoured. There is a need to strive for access to work-related interventions.Return to work was associated with receiving combined clinical- and work-related interventions for patients with MD, and with better health-related quality of life, positive return to work expectations and better work ability for patients with MSD. Factors associated with return to work can be identified using self-reported measures. Patients with MD who received a combination of work-related and clinical interventions perceived best usefulness and best effect of health care contacts on work ability. Patients with MSD did not report as good usefulness. There seems to be a gap between scientific evidence and praxis behaviour in the early rehabilitation process; unimodal rehabilitation was widely applied, use of a multimodal treatment approach was limited and only one-third received work-related interventions. For patients with MSD, behavioural treatment seems to be underutilized in clinical practice considering the effect it may have on developing coping strategies and reducing symptoms. In order to meet recommendations in guidelines, physical activity needs to increase as a treatment strategy for patients with MD. A clinical implication is that the rehabilitation process needs to adopt a broader perspective for patients with MSD and MD to include patients’ individual health-related needs, aspects of employment and work conditions. Still, it remains a challenge to understand who needs what type of intervention.
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| 6. |
- Reineholm, Cathrine, 1965-
(författare)
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Psychosocial Work Conditions and Aspects of Health
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Today’s working life has led to new requirements and conditions at the workplace, and additional factors may be of importance for employees’ health. Most earlier research has taken place in stable organizations, and has not taken changes in organizations into account. The way in which psychosocial work conditions affect employees’ health and well-being has been the topic of several studies but mental ill health is still one of the most common causes of sick leave in Sweden. Little attention is given to the importance of the workplace and organizational context for employees’ health. The overall aim of this thesis is to investigate how different aspects of health are associated with psychosocial work conditions in today’s working life.This thesis comprises two empirical studies. The first study is a longitudinal study, based on questionnaire data from 1010 employees at the Swedish Labour Market Administration. The second study is designed as a prospective cohort study, based on questionnaire data from 8430 employees in ten organizations, participating in the LOHP project. Linear and logistic regressions were performed to investigate associations between psychosocial work conditions and different aspects of health. Multilevel analysis was performed in one paper.The main findings in Paper I are that traditional job stress models are better for predicting ill health than good health. Different psychosocial work conditions may however, be useful for measuring different aspects of health, depending on whether the purpose is to prevent ill health or to promote health. In Paper II, psychosocial work conditions and symptoms of burnout were found to differ between different hierarchical levels, and different psychosocial work conditions were associated with symptoms of burnout at different hieratical levels. Paper III showed that psychosocial work conditions predict voluntary job mobility, and this may be due to two forces for job mobility: job dissatisfaction and career development. In Paper IV, a strong association between high work ability and better performance was found. Clear goals and expectations may result in improved psychosocial work conditions and work ability, which in turn affects employees’ performance.This thesis has provided knowledge regarding different aspects of health and psychosocial work conditions. Conditions at the organizational and workplace level set the prerequisites for if and how employees use their resources and their ability to act. Access to resources and the capacity to use them may vary depending on the employees’ hierarchal position. Occupational health research needs to focus on differences in psychosocial work conditions at different hierarchical levels. Organizations with clear goals and expectations may create more favourable conditions at work, supporting employees’ room for manoeuver, social capital and their ability to cope with working life, hence promoting health. Health promotion has a holistic approach and considers the work environment, the individual and the interplay between them. However, most health interventions at workplaces are directed to employees’ health behaviour rather than improvements in organizational and work conditions. To develop a good work environment it is necessary to identify conditions at work that promote different aspects of health. These conditions need to be tackled at the organizational, workplace and individual level, as good health is shaped by the interplay between the employee and the conditions for work.
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| 7. |
- Ståhl, Christian, 1980-
(författare)
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In Cooperation We Trust : Interorganizational Cooperation in Return-to-Work and Labour Market Reintegration
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overarching aim of this thesis is to study Coordination Associations (CAs) as a structure for interor-ganizational cooperation in rehabilitation, return-to-work and labour market reintegration. This has been done through empirical studies of two CAs in eastern Sweden.Central questions for the thesis are:How have representatives on different hierarchical levels in the participating organizations experi-enced cooperation within the structure of CAs?What influence do different organizational and/or professional preferences have on interorganiza-tional cooperation?The four studies in this thesis have had different approaches to studying interorganizational cooperation.Study I was concerned with a specific work form, namely interdisciplinary rehabilitation teams, where the analysis concerned how the different professionals in these teams perceived the common work, and how they interpreted the concept of work ability, which is a central concept for determining eligibility for sickness benefits.Study II focused on managers and board members of the CAs in order to determine their motives for and commitment to interorganizational cooperation. The analysis was concerned with the organizational identification and the self-interest of each actor, where the issue of trust between representatives from dif-ferent organizations was specifically targeted in the analysis.Study II focused on managers and board members of the CAs in order to determine their motives for and commitment to interorganizational cooperation. The analysis was concerned with the organizational identification and the self-interest of each actor, where the issue of trust between representatives from dif-ferent organizations was specifically targeted in the analysis.Study III aimed to elucidate the perspectives of officials in different organizations connected to the CAs regarding both the development of cooperation in the CAs, and how the recent changes in sickness insurance regulations will influence future cooperation.Study IV focused on different perspectives regarding the concept of work ability among representa-tives from all participating organizations, since changes in sickness insurance regulations have changed the assessment process and therefore also the demands for interorganizational cooperation.The general methodological approach to the studies in this thesis has been explorative; qualitative methods have been used, involving interviews, focus groups and problem-based group discussions. Inter-views and focus groups have had an open-ended structure, and the material has been analysed through qualitative content analysis.The aim of the Coordination Associations studied in this thesis has been to bridge the gaps between the participating organizations by promoting consensus through common work forms. However, the re-sults from the studies show that such ambitions are troublesome in highly specialized public organizations. Cooperation in the CAs has to a large extent been organized as collaborative work forms rather than as coordination of existing practices. The collaboration has been based on an idea of consensus, where all organizations were expected to participate on equal terms and find common work forms. Although it has been shown that officials from different organizations can work together, the managerial level’s priorities are more determined by their organizational goals and values, which makes them unwilling to finance collaborative work on a longer term.Another theme of the thesis is the lack of cooperation between the public rehabilitation system and the employers. The public actors lack knowledge of working conditions, and since the work principle guides the rehabilitation process, it is necessary to incorporate employers into the cooperation to facilitate sustainable return-to-work and labour market reintegration.A central conclusion of the thesis is that consensus is not a reasonable starting point when designing cooperation structures between public organizations. A sustainable cooperation structure needs to incorpo-rate and coordinate the different actors’ priorities into a long-term cooperation strategy, rather than base the cooperation on vulnerable collaboration projects.
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| 8. |
- Ekberg, Kerstin, 1948-
(författare)
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An epidemiologic approach to disorders in the neck and shoulders
- 1994
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Complaints about pain in the locomotor system represent a commonly occuning health problem among working people all over the world. In this context, a series of studies were employed to determine if work organization and psychosocial conditions at work, in addition to physical work load, contribute to the development of disorders in the neck and shoulders. The potentially health-promoting effect of early and active rehabilitation of those already suffering from disorders in the neck and shoulders was also evaluated.A first psychophysiological study showed that various stress conditions during monotonous work had limited effects on muscle tension. The interindividual variability in muscle reactions to stress was large, but the results indicate that some individuals may react with a sustained, low-level muscle activity that is associated with pain.A cross-sectional study of a sample of a normal working population and a case-control study of patients with disorders in the neck and shoulders revealed a set of work-related core determinants, which appear to be essential component causes for the development of symptoms and signs. Prevalence ratios (PR) were calculated for determinants of early symptoms in the cross-sectional study, and odds ratios (OR) were estimated in the case-control study for determinants of disorders of the neck and shoulders. Repetitive movements demanding precision (PR 1.2 and OR 7.5, respectively), high work pace (PR 1.2 and OR 3.5, respectively), low quality work content (low decision latitude and lqw skill discretion; PR 1.3 and OR 2.6, respectively), and uncertainty about how to perform and-manage the tasks (work-role ambiguity; PR 1.2 and OR 16.5, respectively) were associated with both development of early symptoms, and disorders in the neck and shoulders. The results also show that being a woman (PR 1.3 and OR 11.4, respectively) and I or an immigrant (PR 1.3 and OR 4.9, respectively) imposes a higher risk for developing signs and symptoms in the neck and shoulders, possibly due to selective job-assignment.A controlled, two-year follow-up of cohorts of subjects with early and active rehabilitation versus traditional, less active treatment of neck~shoulder disorders respectively, did not support the hypothesis that active rehabilitation, as compared to traditional treatment methods, promotedbetter health, unless work conditions were changed. People who remained on the same job after rehabilitation, independent of type of treatment, had a less positive prognosis (relative risk 3.6) than those who had a changed work situation.Further analysis of which factors retained people in long-term sick-leave suggested that work conditions are more important than personality and other individual characteristics in determining the amount of time that will elapse before individuals will resume work after a sickleave. There was no gender-difference in this respect.
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| 9. |
- Liljegren, Mats, 1966-
(författare)
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Health at Work : The Relationship between Organizational Justice, Behavioral Responses, and Health
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund: Anställdas hälsa, individuella beteenden i ett organisatoriskt sammanhang och upplevd organisatorisk rättvisa är teoretiskt förenade av social utbytesteori, copingteori och teorier som beskriver konsekvenserna av social ojämlikhet. Empiriskt är förhållandet mer oklart. De få studier som hitintills har granskat relationen mellan organisatoriskt beteende och rättvisa visar på ett samband mellan hög grad av upplevd rättvisa och konstruktiva beteenden och mellan låg grad av upplevd rättvisa och destruktiva beteenden. Flera tidigare studier har visat på ett samband mellan organisatorisk rättvisa och hög hälsa och låg grad av utbrändhet. Relationen mellan organisatoriskt beteende, särskilt rörlighet mellan olika arbetsplatser, och hälsa är överhuvudtaget inte studerat i någon större omfattning och denna relation är i stort sett okänd.Syfte: Det övergripande syftet med föreliggande avhandling är att studera sambandet mellan organisatorisk rättvisa, individuellt organisatorisk beteende och hälsa.Metod: De ingående delstudierna i föreliggande avhandling ingår i en longitudinell panelstudie med tre olika datainsamlingstillfällen. Ett frågeformulär sändes ut till samtliga anställda, även de som hade slutat eller gått i pension under studietiden, i Arbetsmarknadsverket,AMV, i tre mellan svenska län 2001 (N=1010, svarsfrekvens: 78%), 2002 (N=1078, svarsfrekvens 75%) samt 2003 (N=1122, svarsfrekvens 74%).I delstudie I, en tvärsnitts och longitudinell valideringsstudie, användes variansanalys, ”multi-trait/multi-item”, logistisk regressionsanalys samt olika former av faktoranalys för att validera och utvärdera ett instrument (Hagedoorn m fl., 1999) avsett för att skatta individuella beteenden i ett organisatoriskt sammanhang. I delstudie II, en longitudinell panelstudie, användes korrelationsanalys och strukturell ekvationsmodellering, SEM, för att studera den reciproka relationen mellan individuella organisatoriska beteenden och hälsa. I delstudie III, en longitudinell panelstudie, användes faktor-, korrelations- och SEM-analyser för att belysa sambandet mellan upplevd organisatorisk rättvisa, hälsa och utbrändhet. I delstudie IV, en longitudinell panelstudie, användes varians och generell linjär modellering, GLM, ”repeated measures” analyser för att belysa sambandet mellan önskan att byta arbetsplats, faktiskt byte av arbetsplats, hälsa och utbrändhet. I delstudie V, en longitudinell panelstudie, användes varians-, korrelations- och SEM-analyser för att studera det reciproka sambandet mellan hälsa, utbrändhet och byte av arbetsplats.Resultat: Resultatet av delstudie I visade att Hagedoorn m.fl. (1999) instrument kan anses ha godkända psykometriska egenskaper, bortsett från delskalan ”aggressive voice” som uppvisade flera uppenbara svagheter. Delstudie II visade att relationen mellan individuella organisatoriska beteenden och hälsa framförallt är ensidigt: beteendet predicerar hälsan. Typbeteendet ”exit” predicerade sämre hälsa efter två år, medan typbeteendet ”considerate voice” predicerade bättre hälsa efter två år. Slutligen predicerade god fysisk hälsa typbeteendet ”exit” efter två år. Resultatet av Delstudie III visade att upplevd organisatorisk rättvisa är relaterat till god hälsa och låg grad av utbrändhet, både vid en tvärsnitts- och longitudinell jämförelse. De två olika sätten att studera organisatorisk rättvisa, antingen som ett globalt eller tredelat begrepp, bör betraktas som komplementära. I delstudie IV visade sig extern rörlighet, d.v.s. mellan olika arbetsplatser, i jämförelse med icke-rörlighet, har en gynnsam effekt på personlig och arbetsrelaterad utbrändhet. Resultatet visade också att samspelet mellan en önskan att byta arbetsplats och att faktiskt genomföra ett byte snarare är additiv snarare än interaktiv. Slutligen visade resultatet i delstudie V att rörlighet mellan olika arbetsplatser är en mer distinkt prediktor till hälsa och utbrändhet än hälsa och utbrändhet som prediktor till extern rörlighet. Önskan att byta arbetsplats, men inte upplevd organisatorisk rättvisa, visade sig ha effekt på faktiskt byte av arbetsplats.Slutsatser: Föreliggande avhandling har belyst det socialpsykologiska förhållandet mellan organisatorisk rättvisa, beteende och hälsa. Resultatet visar att upplevd organisatorisk rättvisa predicerar hälsa och låg grad av utbrändhet. Resultatet visar också att aktiva individuella organisatoriska beteenden predicerar psykosocial hälsa: ett proorganisatoriskt beteende predicerar psykosocial hälsa medan ett anti-organistoriskt beteende predicerar psykosocial ohälsa. Extern rörlighet har en positiv effekt på utbrändhet och rörlighet är en tydligare prediktor till psykosocial hälsa och utbrändhet än vad hälsa och utbrändhet är till rörlighet.
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| 10. |
- Lundqvist, Daniel
(författare)
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Psychosocial Work Conditions, Health, and Leadership of Managers
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Although psychosocial work conditions, health and leadership are concepts that have been studied for a long time, more knowledge is needed on how they are related in managers. Existing research suggests that managers are very influential in their workplaces, but the way in which their workplaces influence them is often overlooked. As a result, the potential reciprocity between managers’ psychosocial work conditions, health and leadership is not in focus. Furthermore, managers have often been studied as a uniform group and little consideration has been given to potential differences between managers at different managerial levels.The overall aim of this thesis is to increase knowledge about the relationships between managers’ psychosocial work conditions, their health, and their leadership; and to elucidate differences between managers at different managerial levels in these relationships. The thesis consists of four separate papers with specific aims. In Paper I, the aim was to compare the differences in work conditions and burnout at three hierarchical levels: subordinates, first-line managers, and middle managers; and to investigate if the association between work conditions and burnout differs for subordinates, first-line managers, and middle managers. In Paper II, the aim was to advance knowledge of workplace antecedents of transformational leadership, by investigating what psychosocial work conditions of first-line managers are associated with their display of transformational leadership; and whether superiors’ leadership is associated with first-line managers’ display of transformational leadership. In Paper III, the aim was to deepen the understanding of how managers’ health and leadership is related by combining two perspectives in previous research. The two specific research questions were: What psychosocial conditions at work affect managers’ health? How does managers’ health influence their leadership? In Paper IV, the aim was to further the understanding of managers’ perceptions of social support, and to increase our understanding of how managers perceive that receiving social support affects their managerial legitimacy.The empirical material is based on three research projects with quantitative and qualitative designs. Papers I and II are based on cross-sectional data from 4096 employees in nine Swedish organizations. Paper III is based on 42 interviews with managers in a Swedish industrial production company, and Paper IV is based on 62 interviews with managers in a Swedish industrial production company and a Swedish municipality. The interviews were analysed using inductive content analysis.The results showed that psychosocial work conditions and symptoms of burnout generally differed between subordinates and managers, and few differences were found between the managerial levels (Paper I). However, in the associations between psychosocial work conditions and symptoms of burnout, similarities were found between subordinates and first-line managers, while middle managers differed. First-line managers’ psychosocial work conditions were also found to be associated with their display of transformational leadership (Paper II). Psychosocial work conditions were perceived to influence managers’ performance and health, and particularly first-line managers described being dependent on favourable work conditions (Paper III). Furthermore, managers’ health was perceived to influence their leadership, and affect both the quality of their work and the quality of their relationships with subordinates. Managers’ social support came from different people within and outside their workplace (Paper IV). Support that concerned their work came from people within the workplace and was perceived to increase their managerial legitimacy, whereas support that concerned personal and sensitive matters was sought from those outside the workplace so that their managerial legitimacy would not be questioned.The results suggest that managers’ psychosocial work conditions, health and leadership are closely related and can be conceptualized as reciprocal spirals. Some resources in the psychosocial work environment, such as social support, may be hard to take advantage of, even if they are available. The psychosocial work conditions of managers at different managerial levels differ to some extent, which has consequences for how the relationship between psychosocial work conditions, health and leadership is expressed. Especially first-line managers seem to be in a vulnerable position because their influence s more restricted, and they are more dependent on favourable psychosocial work conditions.
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