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- Ahlberg-Hultén, Gunnel, 1952-
(författare)
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Psychological Demands and Decision Latitude Within Health Care Work : Relation to Health and Significance
- 1999
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The general aim of this thesis is to provide a scientific evaluation of the psychosocial work environment for health care personnel. The theoretical basis is the demand-control model developed by Karasek and Theorell. The model consists of the dimensions psychological demands and decision latitude, the latter is a combination of intellectual discretion and authority over decision.The results in study I indicated that there are strong relationships between job strain, high psychological demands and low decision latitude, and blood pressure during work among health care personnel. In study II, symptoms from the low back were associated with all three dimensions psychological demands, skill discretion and decision authority while symptoms from the neck were related to lack of work support. The results in study III indicated that the combination of somatic and psychiatric care could be associated with higher levels of job strain and psychological symptoms.Study IV showed that substantial changes in working conditions had been frequent in the public sector during the period 1988-1996 and that registered nurses and nurse assistants had very different developments. Registered nurses had got a more intense work environment with increased skill utilization but also increased hindrances to perform work. Nurse assistants on the other hand had experienced decreased skill utilization. Temporary employment and part time work, common among health care personnel with low education, were the factors that explained the greatest part of deterioration of skill utilization and possibility to take part in planning of work. These different trends may negatively influence social climate as these two occupational groups often work together.Study V is a qualitative validation of the demand-control model. The findings showed that the model is equally relevant for women as for men and also relevant for health care personnel. Compared to occupational groups working with either "things" or "symbols" health care personnel experienced higher levels of psychological demands and lower levels of decision latitude.It is concluded that the demand-control scale is relevant for use in studies of psychosocial work environment in health care, possibly supplemented with the effort-reward scale. In order to reach a more solid understanding of the psychosocial work environment, questionnaire data should be combined with qualitatively analyzed interviews. The indications of a deteriorated psychosocial work environment for health care personnel in this and other studies calls for radical changes that promote less psychological demands and more decision latitude within this occupational sector.
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| 2. |
- Bergman, Peter N., et al.
(författare)
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Do job demands and job control affect problem-solving?
- 2012
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Ingår i: Work. - : IOS Press. - 1051-9815 .- 1875-9270. ; 42:2, s. 195-203:42, s. 195-203
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The Job Demand Control model presents combinations of working conditions that may facilitate learning, the active learning hypothesis, or have detrimental effects on health, the strain hypothesis. To test the active learning hypothesis, this study analysed the effects of job demands and job control on general problem-solving strategies. Participants: A population-based sample of 4,636 individuals (55% women, 45% men) with the same job characteristics measured at two times with a three year time lag was used. Methods: Main effects of demands, skill discretion, task authority and control, and the combined effects of demands and control were analysed in logistic regressions, on four outcomes representing general problem-solving strategies. Results: Those reporting high on skill discretion, task authority and control, as well as those reporting high demand/high control and low demand/high control job characteristics were more likely to state using problem solving strategies. Conclusions: Results suggest that working conditions including high levels of control may affect how individuals cope with problems and that workplace characteristics may affect behaviour in the non-work domain.
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| 3. |
- Bergman, Peter, et al.
(författare)
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Non-participation in the second wave of the PART study on mental disorder and its effects on risk estimates
- 2010
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Ingår i: International Journal of Social Psychiatry. - : SAGE Publications. - 0020-7640 .- 1741-2854. ; 56:2, s. 119-132
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Tidskriftsartikel (refereegranskat)abstract
- Background: In epidemiological studies, analyses are needed to investigate the consequences of non-response. Aims: To analyse the consequences of attrition in the second wave of the population-based PART study, which was performed three years after the first wave. Methods: Potential determinants for non-participation obtained from population registers and the first wave were analyzed. The relationships between potential determinants and reduced well-being or depressive mood in the first wave questionnaire were investigated separately for participants and non-participants in the second wave. Samples of respondents to the second wave questionnaire with reduced or not reduced well-being were summoned for interview regarding determinants of distress and disorder. The occurrence of potential determinants was compared between participants and non-participants in both groups Results: Low income, low education, non-Nordic origin, not being married and previous psychiatric diagnosis were associated with lower participation rates. These variables were similarly related to depressive mood and low psychological well-being in the first wave among participants and non-participants in the second wave. Potential determinants were not or only weakly related to participation in the interview groups. Conclusion: Although the true prevalence of distress and disorder is underestimated, the true associations between potential determinants and the outcomes seem reasonably well reproduced.
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| 7. |
- Stoetzer, Ulrich, et al.
(författare)
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Organizational factors related to low levels of sickness absence in a representative set of Swedish companies
- 2014
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Ingår i: Work. - : IOS Press. - 1051-9815 .- 1875-9270. ; 47:2, s. 193-205
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this qualitative study was to identify manageable organizational factors that could explain why some companies have low levels of sickness absence. There may be factors at company level that can be managed to influence levels of sickness absence, and promote health and a prosperous organization. PARTICIPANTS: 38 representative Swedish companies. METHODS: The study included a total of 204 semi-structured interviews at 38 representative Swedish companies. Qualitative thematic analysis was applied to the interviews, primarily with managers, to indicate the organizational factors that characterize companies with low levels of sickness absence. RESULTS: The factors that were found to characterize companies with low levels of sickness absence concerned strategies and procedures for managing leadership, employee development, communication, employee participation and involvement, corporate values and visions, and employee health. CONCLUSIONS: The results may be useful in finding strategies and procedures to reduce levels of sickness absence and promote health. There is research at individual level on the reasons for sickness absence. This study tries to elevate the issue to an organizational level. The findings suggest that explicit strategies for managing certain organizational factors can reduce sickness absence and help companies to develop more health-promoting strategies.
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| 8. |
- Stoetzer, Ulrich, et al.
(författare)
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Problematic interpersonal relationships at work and depression : a Swedish prospective cohort study
- 2009
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Ingår i: Journal of Occupational Health. - 1341-9145 .- 1348-9585. ; 51:2, s. 144-151
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Studies have shown that interpersonal relations at work are important for several health related outcomes. The aim of the present study was to investigate whether low social support, serious conflict, exclusion by superiors or by co-workers at work may be determinants of depression. METHODS: In a representative Swedish cohort study data were obtained in two waves three years apart. 4,040 women and men who did not change their jobs between the waves were chosen for the study. Exposure and confounders were obtained at Time 1 and outcome, depression according to Bech's MDI at Time 2. Previous depression was controlled for by adjusting for depression at Time 1. Data were analyzed using multiple logistic regression analyses. RESULTS: Odds-ratios adjusted for possible confounders and depression at base-line showed significant effects for all four exposures on depression (adjusted OR, low social support 1.5 CI 95% 1.1-2.0, serious conflict 1.4 CI 95% 1.1-1.9, exclusion by superiors 1.6 CI 95% 1.2-2.1 and exclusion by co-workers 1.7 CI 95% 1.2-2.3). CONCLUSIONS: The present results support the conclusion that problematic interpersonal relationships at work can be determinants of depression. These prospective findings may be of relevance for prevention and when rehabilitating depressed patients.
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| 9. |
- Stoetzer, Ulrich, et al.
(författare)
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Working conditions predicting interpersonal relationship problems at work
- 2009
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Ingår i: European Journal of Work and Organizational Psychology. - : Informa UK Limited. - 1359-432X .- 1464-0643. ; 18:4, s. 424-441
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Tidskriftsartikel (refereegranskat)abstract
- Interpersonal relationships have been shown to be an important component of the psychosocial work environment that may affect health, job satisfaction, and productivity. The question whether interpersonal relationships at work are influenced by other psychosocial working conditions such as demands and control has not been studied. The aim of the present study is to investigate if high work demands and aspects of low work control could predict three indicators of detrimental interpersonal relationships at work. In a representative Swedish cohort study, data were obtained in two waves three years apart from 4049 participants, who did not change their jobs between the waves. These data were analysed by multiple logistic regression analyses. Odds ratios adjusted for possible confounders and negative interpersonal relationships at base-line showed that high demands predicted serious conflict and exclusion by co-workers. Low skill discretion predicted exclusion by co-workers. It is argued that these prospective findings are of relevance to interventions targeting troublesome and detrimental interpersonal relationships at work and that the findings can be important in understanding the development of work-related mental ill-health.
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