| 1. |
- Cedstrand, Emma, et al.
(författare)
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A Participatory Intervention to Improve the Psychosocial Work Environment and Mental Health in Human Service Organisations. A Mixed Methods Evaluation Study
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 18:7
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Tidskriftsartikel (refereegranskat)abstract
- Work-related stress is a global problem causing suffering and economic costs. In Sweden, employees in human service occupations are overrepresented among persons on sick leave due to mental health problems such as stress-related disorders. The psychosocial work environment is one contributing factor for this problem, making it urgent to identify effective methods to decrease stress at the workplace. The aim of the study is to evaluate a participatory intervention to improve the psychosocial work environment and mental health using an embedded mixed methods design. The study is a controlled trial with a parallel process evaluation exploring fidelity and participants' reactions to the intervention activities, experiences of learning and changes in behaviours and work routines. We collected data through documentation, interviews and three waves of questionnaires. Our results show small changes in behaviours and work routines and no positive effects of the intervention on the psychosocial work environment nor health outcomes. One explanation is end-users' perceived lack of involvement over the process causing the intervention to be seen as a burden. Another explanation is that the intervention activities were perceived targeting the wrong organisational level. A representative participation over both content and process can be an effective strategy to change psychosocial working conditions and mental health.
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| 2. |
- Cedstrand, Emma, et al.
(författare)
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Co-Creating an Occupational Health Intervention within the Construction Industry in Sweden : Stakeholder Perceptions of the Process and Output
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 18:24
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Tidskriftsartikel (refereegranskat)abstract
- One way to prevent work-related stress, is to implement primary occupational health interventions aimed at improving the psychosocial work environment. However, such interventions have shown a limited effect, often due to implementation failure and poor contextual fit. Co-creation, where researchers, together with end-users and other relevant stakeholders, develop the intervention is increasingly encouraged. However, few studies have evaluated the effects of co-created interventions, and participants' experience of the co-creation process. This is one of the first studies evaluating stakeholder perceptions of co-creating an occupational health intervention. We applied a thematic analysis, with data from 12 semi-structured interviews with stakeholders involved in the co-creation. Our results show that the respondents, in general, were satisfied with engaging in the co-creation, and they reported an increased awareness regarding risk factors of stress and how these should be handled. Additionally, the respondents described trust in the intervention activities and a good fit into the context. The study indicates that co-creating occupational health interventions can enhance the implementation and the contextual fit.
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| 3. |
- Cedstrand, Emma, et al.
(författare)
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Effects of a co-created occupational health intervention on stress and psychosocial working conditions within the construction industry : a controlled trial
- 2022
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Ingår i: Frontiers In Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Background Work-related stress problems, i.e., burnout, depression, and anxiety, is a rising global health challenge. Poor mental health also appears to be a challenge for the construction industry, even though the occupational health focus has traditionally been on the physical work environment and musculoskeletal disorders. Yet, studies targeting the organisational level (i.e., work environment, policy) to enhance mental health within the construction industry are scant. Therefore, our first objective was to evaluate the effectiveness of a co-created occupational health intervention on stress and psychosocial working conditions within the construction industry in Sweden. The second objective was to evaluate whether the intervention was implemented as intended, i.e., implementation fidelity. The trial is registered in the ISRCTN clinical trial registry (ISRCTN16548039, ). Methods This is a controlled trial with one intervention and one matched control group. We co-created the program logic with stakeholders from the intervention group. The essence of the chosen intervention components, duties clarification, and structured roundmaking was enhanced planning and role clarification. We assessed adherence to the intervention and dose delivered (i.e., fidelity). We collected data on the outcomes (role clarity, team effectiveness, planning, staffing, quantitative demands, and the psychosocial safety climate) with online questionnaires at baseline, 12, and 24 months. Marginal means models adjusting for missing data patterns were applied to estimate potential differences in outcomes between groups over time. Results Fidelity was considered reasonably high. Yet, we found no intervention effects on the primary outcome stress. All outcomes, except role clarity deteriorated during the trial in the intervention and control group. However, the results indicate a positive effect of the intervention components on professionals' role clarity. The pandemic appears to have negatively affected stress and psychosocial working conditions. Conclusion The study's results suggest that co-creating occupational health interventions could be one solution for improved implementation fidelity. More studies are needed to evaluate these intervention components. Also, we recommend researchers of future intervention studies consider using missing not at random, sensitivity analysis.
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| 4. |
- Cedstrand, Emma, et al.
(författare)
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Study protocol of a co-created primary organizational-level intervention with the aim to improve organizational and social working conditions and decrease stress within the construction industry : a controlled trial
- 2020
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Within construction industry, physical work exposures have long been recognized as possible determinants for musculoskeletal disorders, but less attention has been given the increasing organizational and social work hazards and stress within this industry. There is to date a lack of knowledge about how to improve organizational and social working conditions and decrease stress within the construction industry.Methods: This paper outlines the design of a controlled trial to evaluate the effectiveness of a co-created organizational-level intervention with the aim to improve role clarity, quantitative demands, staffing, planning, team effectiveness, psychosocial safety climate and stress. Two regions (> 700 employees) within one large construction company in Sweden will participate as intervention and control group. Further we present the design of the process evaluation assessing fidelity, support from managers, readiness for change and contextual factors. We will utilize questionnaires, semi-structured interviews, observations and documentation as means for data collection, hence a mixed methods approach is applied.Discussion: The study is expected to contribute to the understanding of how adverse organizational and social working conditions and stress can be improved within the construction industry. By applying co-creation we wish to develop an intervention and implementation strategies that fit to the context, are in line with the needs of end-users and are supported by all management levels - all of which are highlighted features in successful workplace interventions.
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| 5. |
- Cerdas, Sara, et al.
(författare)
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Development of job demands, decision authority and social support in industries with different gender composition - Sweden, 1991-2013
- 2019
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThis study aims to explore the development of job demands, decision authority and social support within and between industries with different gender composition in Sweden between 1991 and 2013.MethodsCross-sectional data from 12 waves of the Swedish Work Environment Surveys (1991 to 2013), comprising in total 109,698 respondents, were used. Industries were classified in 7 categories according to its gender composition and main activity, comprising two female-dominated, three gender-mixed and two male-dominated industries. Proportions of workers reporting high job demands, low decision authority and poor social support between 1991 and 2013 were calculated. Logistic regression analyses were performed to estimate variation across time, using 1991 as the reference category, and between industries, using knowledge intensive services as the reference category. Estimates for high job demands, low decision authority and poor social support were presented as average marginal effects (AMEs).ResultsThe probabilities of reporting low decision authority were higher in education and health and social care during the whole study period, for both genders, compared with the reference category of knowledge intensive services. The probability of having high job demands were higher for men and women in education, and women in health and social care, compared with the reference category. Men in the male dominated industries had increased job demands over time, compared to the beginning of the study period (1991). The probability of reporting poor social support was higher in the later than in the earliest time period for women in the female-dominated industry health and social care as well as in the gender-mixed labour intensive services industry.ConclusionsThere has been a negative development of job demands and decision authority in the female-dominated industries education and health and social care in Sweden, whereas social support has developed more negatively for women in health and social care and in labour intensive services.
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| 6. |
- Cerdas, Sara, et al.
(författare)
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Development of Organisational and Psychosocial Work Factors Across Industries with Different Gender Composition in Sweden, 2003-2013
- 2018
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Ingår i: Book of proceedings: 13th Conference of the European Academy of Occupational Health Psychology. - Nottingham : European Academy of Occupational Health Psychology. - 9780992878641 ; , s. 34-35
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Konferensbidrag (refereegranskat)abstract
- Background: In Sweden, the development of mental ill-health and sickness absence has been poorer in female-dominated industries compared to others. One possible explanation is the different developments of psychosocial working conditions across industries. Men and women appear to react similarly to the same psychosocial exposures at work, but differences in exposure patterns may prevail. There is to date a lack of studies on the extent to which psychosocial work exposures are associated with the gender segregation on the Swedish labour market at the industry level. This study aims to investigate how organisational and psychosocial work factors have developed over time across industries with different gender composition in Sweden from 2003 to 2013, and to what extent these factors differ between industries.Methods: The present study is based on repeated cross-sectional data from the Swedish Work Environment Survey (SWES). SWES is conducted biennially by Statistics Sweden (SCB) and includes Swedish workers aged 16-64 years. Six waves from 2003 to 2013, comprising a study sample of 45,631 subjects, were analysed, Industries were categorised according to gender composition and divided into seven categories: 1) Goods and energy production; 2) Machine handling; 3) Manual services; 4) Public administration; 5) Knowledge intensive services; 6) Education; 7) Health and social care. Proportions of men and women in each industry who were exposed to adverse or positive organisational and psychosocial work factors were calculated for each of the six waves. Logistic regression analyses, adjusted for age, educational level and year of response to SWES were performed on the full sample (all six waves), in order to estimate the odds of being exposed to organisational and psychosocial work factors in each industry using the knowledge intensive service industry as the reference category.Results: Preliminary results show that in female dominated industries (Education and Health and social care), many organisational and psychosocial work factors developed poorly over the study period. Higher odds of exposure to adverse or positive organisational and psychosocial work factors were found for several industries when using the industry of Knowledge intensive services as the reference category.Conclusion: This study is one of the first of its kind analysing the development of organisational and psychosocial work factors, as well as differences in these factors between industries with different gender compositions in Sweden.
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| 7. |
- Nyberg, Anna, et al.
(författare)
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Does Exposure to High Job Demands, Low Decision Authority, or Workplace Violence Mediate the Association between Employment in the Health and Social Care Industry and Register-Based Sickness Absence? : A Longitudinal Study of a Swedish Cohort
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this paper was to investigate if job demands, decision authority, and workplace violence mediate the association between employment in the health and social care industry and register-based sickness absence.Methods: Participants from the Swedish Longitudinal Occupational Survey of Health who responded to questionnaires in 2006-2016 (n = 3951) were included. Multilevel autoregressive cross-lagged mediation models were fitted to the data. Employment in the health and social care industry at one time point was used as the predictor variable and register-based sickness absence >14 days as the outcome variable. Self-reported levels of job demands, decision authority, and exposure to workplace violence from the first time point were used as mediating variables.Results: The direct path between employment in the health and social care industry and sickness absence >14 days was, while adjusting for the reverse path, 0.032, p = 0.002. The indirect effect mediated by low decision authority was 0.002, p = 0.006 and the one mediated by exposure to workplace violence was 0.008, p = 0.002. High job demands were not found to mediate the association.Conclusion: Workplace violence and low decision authority may, to a small extent, mediate the association between employment in the health and social care industry and sickness absence.
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| 8. |
- Nyberg, Anna, et al.
(författare)
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Psychosocial Working Conditions for Women and Men in Industries with Different Types of Production and Gender Composition : Sweden, 1991–2017
- 2021
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Ingår i: Gendered Norms at Work. - Cham : Springer Nature. - 2213-0497 .- 2213-0470. - 9783030777333 - 9783030777340 ; , s. 35-61
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Bokkapitel (refereegranskat)abstract
- The chapter aims to contribute to the understanding of increased gender differences in sickness absence and health by applying a structural approach, and by analysing and describing the development of and differences in psychosocial working conditions in differently gendered industries. Some psychosocial work factors are expected to vary by differently gendered industries, and others are expected to vary by differently gendered industries and gender combined. Descriptive and comparative data of psychosocial working conditions for women and men in Sweden from the 1990s and onwards are presented. The results show that job demands and decision authority have developed more negatively in female-gendered industries for both genders since the early 1990s, although more negatively for women. Job demands are furthermore higher and decision authority lower in these industries among both men and women. Gender-based and sexual harassment, on the other hand, show a pattern between gendered industries and gender combined, such that more harassment occurs for men in female-gendered industries and for women in male-gendered industries. The results are discussed in relation to contextual and gender perspectives.
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| 9. |
- Nyberg, Anna, et al.
(författare)
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Status incongruence in human service occupations and implications for mild-to-severe depressive symptoms and register-based sickness absence : A prospective cohort study
- 2020
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Ingår i: Scandinavian Journal of Work, Environment and Health. - Helsinki : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 46:2, s. 209-217
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Tidskriftsartikel (refereegranskat)abstract
- Objective This study aimed to investigate the hypothesis that negative status incongruence may contribute to explain higher risk of mental ill-health and sickness absence in human service occupations (HSO).Methods Participants from the Swedish Longitudinal Occupational Survey of Health who responded to questionnaires in both 2014 and 2016 (N=11 814; 42% men, 58% women) were included. Status incongruence between register-based educational level and subjective social status was assessed. The association between employment in a HSO and status incongruence was estimated in linear regression analyses adjusted for age, income, work hours, sickness absence, childcare, and job qualification match. The prospective associations between status incongruence and mild-to-severe depressive symptoms and register-based sickness absence >= 31 days respectively were estimated with logistic regression analyses in models adjusted for age and outcomes at baseline. All analyses were stratified by gender.Results Employment in a HSO was associated with more negative status incongruence in both genders [standardized coefficient men 0.04, 95% confidence interval (CI) 0.02-0.07; women 0.06, 95% CI 0.04-0.09]. More negative status incongruence was furthermore associated with higher odds of mild-to-severe depressive symptoms (men OR 1.18, 95% CI 1.08-1.29; women OR 1.17, 95% CI 1.09-1.26) and sickness absence >= 31 days (men OR 1.40, 95% CI 1.23-1.59; women OR 1.17, 95% CI 1.07-1.28) two years later.Conclusion Status incongruence is somewhat higher among HSO than other occupations and associated with increased odds of depressive symptoms and sickness absence.
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| 10. |
- Stengård, Johanna, et al.
(författare)
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The role of managerial leadership in sickness absence in health and social care : antecedent or moderator in the association between psychosocial working conditions and register-based sickness absence? A longitudinal study based on a swedish cohort
- 2021
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Ingår i: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe prevalence of sickness absence is particularly high among employees in health and social care, where psychosocial work stressors are pertinent. Managerial leadership is known to affect sickness absence rates, but the role leadership plays in relation to sickness absence is not fully understood; that is, whether poor leadership (i) is associated with sickness absence directly, (ii) is associated with sickness absence indirectly through the establishment of poor psychosocial working conditions, or (iii) whether good leadership rather has a buffering role in the association between work stressors and sickness absence.MethodsFour biennial waves from the Swedish Longitudinal Occupational Survey of Health (SLOSH, 2010–2016, N=2333) were used. Autoregressive cross-lagged analyses within a multilevel structural equation modelling (MSEM) framework were conducted to test hypotheses i)–iii), targeting managerial leadership, register-based sickness absence and psychosocial work stressors (high psychological demands, poor decision authority and exposure to workplace violence).ResultsA direct association was found between poor leadership and sickness absence two years later, but no associations were found between leadership and the psychosocial work stressors. Finally, only in cases of poor leadership was there a statistically significant association between workplace violence and sickness absence.ConclusionsPoor managerial leadership may increase the risk of sickness absence among health and social care workers in two ways: first, directly and, second, by increasing the link between workplace violence and sickness absence.
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