| 1. |
- Ahlstrom, Linda
(författare)
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Improving Work Ability and Return to Work among Women on Long-term Sick Leave
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to gain new knowledge of factors and interventions that improve work ability and return to work (RTW) among women on long-term sick leave from human service organizations (HSOs). The specific aims of the studies were: to evaluate the associations between the self-rated Work Ability Index (WAI) and Work Ability Score (WAS), and the relationship with prospective sick leave, symptoms, and health (Paper I); to investigate whether intervention with myofeedback training or intensive muscular strength training could decrease pain and increase work ability among women with neck pain (Paper II); to examine the associations between workplace rehabilitation and the combination of supportive conditions at work with work ability and RTW over time (Paper III); and to explore experiences, views, and strategies in the rehabilitation process for RTW (Paper IV). This thesis is based on a prospective cohort study (n=324) and a randomized controlled study (RCT) (n=60, participants with neck pain). Both quantitative and qualitative methods were used. The data collection consisted of questionnaires, laboratory-observed data, register-based data, and interviews. The results showed a very strong association between WAI and WAS, and results predicted future sick leave degree, health-related quality of life, vitality, neck pain, self-rated general health, self-rated mental health, behavioral stress, and current stress (Paper I). In the RCT (Paper II), individuals in the myofeedback intervention group increased their vitality and work ability over time and individuals in the intensive musculoskeletal strength training group increased their WAI, WAS, and mental health over time. WAI, WAS, and RTW increased over time among individuals provided with workplace rehabilitation and supportive conditions at work (Paper III) such as a sense of feeling welcome back at work, influence at work, possibilities for development, degree of freedom at work, meaning of work, quality of leadership, social support, sense of community, and work satisfaction. Women described (Paper IV) how they were striving to work and how they had different views, strategies, and approaches in the rehabilitation process for RTW. They expressed a desire to work, their goals for work, and their wishes for work. In the rehabilitation process for RTW they described their interaction with stakeholders as either controlling the interaction or struggling in the interaction. They described strategies to cope with RTW in terms of yo-yo (fluctuating) working: yo-yo working as a strategy or yo-yo working as a consequence. This thesis identifies factors of importance in improving work ability and RTW among women on long-term sick leave from HSOs. For women with neck pain, the intervention study showed feasibility of the intervention and demonstrated improved work ability and decreased pain (Paper II). The intensive muscular strength training program, which is easy for the individual to learn and perform at home, was associated with increased work ability. The results regarding rehabilitation highlight the importance of integrating workplace rehabilitation with supportive conditions at work to increase work ability and improve RTW (Paper III). Women expressed that they were striving to work and that they wanted to work (Paper IV). These women were “going in and out” of work participation (yo-yo working) as a way to handle the rehabilitation process. For assessing the status and progress of work ability among women on long-term sick leave, the single-question WAS may be used as a compliment to the full WAI as a simple indicator (Paper I).
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| 2. |
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| 3. |
- Ahlstrom, Linda, et al.
(författare)
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Return to work from long-term sick leave : a five-year prospective study of the importance of adjustment latitudes at work and home
- 2014
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundAdjustment latitude among employees, i.e. adjusting work to individual’s health capacity, has been associated with successful return to work (RTW) in cross-sectional studies. The aim is to investigate the long-term importance of adjustment latitude at the workplace and at home, as well as attitudes (own and colleagues) for increased work ability (WA), working degree (WD) and health-related quality of life (HRQoL) among female human service workers (HSW) on long-term sick leave in Sweden.MethodsA cohort of female HSW (n=324) on long-term sick leave (>60 day) received a questionnaire at four times (0, 6, 12, 60 months). Prevalence ratios (PR) were used to examine possible relationships between explanatory factors and outcomes. Linear mixed models were used for longitudinal analysis of the repeated measurements of WA Score (0-10), WD (0-100%) and HRQoL (0-100). Analyses were performed with different models; the explanatory variables for each model were adjustment latitude, attitudes towards breaks at work, shared or single household and amount of household work.ResultHaving more adjustment latitude at work was associated with both increased WA and RTW compared to having few adjustment latitude opportunities. Adjustments related to working-pace were strongly associated with increased WD (PR 3.29(95%CI=1.71-6.26)), as were adjustments to working-place. Having opportunities to take short breaks at work, and a general acceptance at work to take short breaks was associated with increased WA. At home, a higher responsibility for household work (PR 1.98(95%CI=1.33-2.95)) was related to increased WA and RTW. Individuals with possibilities for adjustment latitude, especially pace and place, at work, and an acceptance to take breaks at work, increased in WA score significantly more over time and had higher WA score compared with individuals not having such opportunities at work. These prospective results were similar for the outcome WD and HRQoL.ConclusionsThe results highlight the importance of possibilities for adjustment latitude at work and at home, as well as accepting attitudes to take short breaks to increase WA and RTW among female human service workers previously on long-term sick leave.
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| 4. |
- Alexiou, Eirini, et al.
(författare)
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Worry perception and its association with work conditions among healthcare workers during the first wave of the COVID-19 pandemic: a web-based multimethod survey at a university hospital in Sweden.
- 2024
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Ingår i: BMJ open. - 2044-6055. ; 14:2
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Tidskriftsartikel (refereegranskat)abstract
- In this study, we explored healthcare workers' (HCWs) worry perception and its association with their work situation during the first wave of the COVID-19 pandemic.A web-based multimethods survey including multiple choice and open-ended questions was used.The study was conducted at a university hospital in Sweden.All HCWs who were working during the first wave of the COVID-19 pandemic in March-June 2020 were eligible. HCWs (n=6484, response rate=41%) from 69 departments fulfilled the study inclusion criteria and responded to the survey. Of them, we analysed data from the 3532 participants who replied to the open-ended questions (54% of the respondents).Worry perception and its association with work conditions among HCWs.29% (n=1822) and 35% (n=2235) of the responding HCWs experienced a daily or more than daily strong worry of being infected or infecting others with SARS-CoV-2. This finding could be further confirmed and explored with themes from the qualitative results: 'ambiguity of feeling safe and secure', 'being obliged to adapt to a new reality' and 'into the unknown'. The themes consisted of 6 main categories and 15 subcategories. The findings revealed that the two main drivers of worry perceived by HCWs were lack of personal protective equipment and fear of bringing the virus home to their families and friends.Worries of getting infected are common among HCWs during crises such as the COVID-19 pandemic. Several factors are raised that plausibly could minimise the negative effects of worry among HCWs. Thus, effective preventive work plans should be created, promoted and communicated in order to minimise the effects of such crises and support HCWs. By focusing on effective communication and preparedness, including access to relevant protective equipment and providing general support to HCWs, the work environment and patient care could be sustained during a crisis such as the COVID-19 pandemic.
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| 5. |
- Andreasson, Jörgen
(författare)
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Organizational preconditions and supportive resources for Swedish healthcare managers. : Factors that contribute to or counteract changes
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Swedish Healthcare managers’ organizational preconditions and supportive resources are important for their ability to work with planned change in a sustainable way. This thesis further investigates these factors together with an output measure, healthcare process quality (HPQ).The overall aim was to investigate how healthcare managers’ organizational preconditions and support contribute to or counteract managers’ work with planned change in order to implement process development in a sustainable way. Specific aims were: to improve knowledge of managers’ views of and approaches to increasing their employees’ influence on and engagement in models for improving care processes (study I); to investigate relationships among managers’ organizational preconditions, support, and work to improve quality of care and HPQ over time (study II); to investigate whether managers’ coaching style, preconditions, implementation strategy, appraisal of change, and clinical autonomy are associated with HPQ (study III ); and to assess the influence of support from superiors, colleagues, external sources, subordinates, and private life on managers’ own health (study IV ).The data for Studies I – III came from five hospitals collected over a three-year period. The data were collected by means of interviews (Study I, qualitative analysis) and annual questionnaires (Studies II and III, quantitative and mixed-method analyses). The data for Study IV were based on questionnaires administered to first- and second-line managers in municipal care, twice during a two-year period.The results revealed that the healthcare managers were key actors in implementing planned change, but were dependent on their employees’ engagement in order to succeed. Managers’ appraisal of work with planned change became more positive with strong support from other managers, employees, and the organization as well as with long managerial experience. Support from private life and networks, as well as the managers’ attitudes towards their managerial role, predicted their own health. For new managers or managers with many employees, organizational support predicted their health-related sustainability. Managers practising a more distanced style of coaching (e.g., clearly delegating responsibility for implementation work to employees) were associated with better HPQ outcomes than were managers who were more involved in implementation. In conclusion, implementation of planned change are facilitated by, engaged managers, employees with knowledge of implementation work and of the healthcare system, as well as organizational structures that support the managers. Strong support from various sources as well as managerial experience are important for managers’ appraisal of work with planned change. Strong managerial support and a more delegated leadership style are both important factors related to higher estimated HPQ.
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| 6. |
- Dellve, Lotta, et al.
(författare)
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Myofeedback training and intensive muscular strength training to improve work ability and decrease pain among female workers on long term sick leave with neck pain : A Randomized Controlled Trial
- 2011
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 84:3, s. 335-346
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Tidskriftsartikel (refereegranskat)abstract
- The theoretical framework is that muscle tension in the neck is related to insufficient muscular rest and is a risk factor for chronic pain and reduced work ability. Promoting muscle strength and muscle rest may increase work ability and reduce neck pain. To test whether myofeedback training or intensive strength training leads to decreased pain and increased work ability in women on long-term sick leave. This is a randomized controlled trial of two 1-month interventions with myofeedback or muscular strength training in the home environment. Female human service organization workers (n = 60) on long-term (> 60 days) sick leave and with chronic neck pain were followed with self-reported and laboratory-observed data of health, pain, muscular activation, and work ability, at baseline, immediately after the intervention and 3 months after baseline. For both intervention groups, pain was lowered over time compared with the control group. Decreased pain and muscular activity was associated with increased self-rated work ability and with laboratory-observed work ability at 3-month follow-up. Decreased pain was also associated with increased self-rated work ability at 1-month follow-up. Muscular strength training was associated with increased self-rated work ability and mental health. Myofeedback was associated with increased observed work ability and self- rated vitality. The two interventions showed positive results, suggesting that they could be developed for use in health care practice to address pain and work ability. The intensive muscular strength training program, which is both easy to conduct at home and easy to coach, was associated with increased work ability.
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| 7. |
- Dellve, Lotta, et al.
(författare)
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Return to work from long-term sick leave : a six-year prospective study of the importance of adjustment latitudes at work and home.
- 2016
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 89:1, s. 171-179
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim was to investigate the long-term importance of adjustment latitude for increased work ability and return to work among female human service workers on long-term sick leave.METHODS: A cohort of female human service workers on long-term sick leave (>60 days) was given a questionnaire four times (0, 6, 12, 60 months). Linear mixed models were used for longitudinal analysis of the repeated measurements of work ability and return to work.RESULTS: Having a higher level of adjustment latitude was associated with both increased work ability and return to work. Adjustments related to work pace were strongly associated with increased work ability, as were adjustments to the work place. Having individual opportunities for taking short breaks and a general acceptance of taking short breaks were associated with increased work ability. At home, a higher level of responsibility for household work was related to increased work ability and return to work. Individuals with possibilities for adjustment latitude, especially pace and place at work, and an acceptance of taking breaks had greater increased work ability over time and a greater work ability compared with individuals who did not have such opportunities.CONCLUSIONS: This study highlights the importance of opportunities for adjustment latitude at work to increase work ability and return to work among female human service workers who have been on long-term sick leave. The results support push and pull theories for individual decision-making on return to work.
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| 8. |
- Fallman, Sara L., et al.
(författare)
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First line nurse managers’ managerial work performance and burnout – a prospective study
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: First line nurse managers have a complex work situation with many competing demands and often low impact on decision-making. This can have impact on their managerial work performance. Nurse managers’ job demands and strain are connected with higher burnout and reduced health.Aim: The aim of this study was to examine the associations between managerial work performance and self-rated health and burnout over time. Method: The study used a prospective design with questionnaire data. Mixed models repeated measures was used to analyze data.Results: A low degree of managerial work performance regarding organization of both daily work and improvement work was associated with a higher degree of burnout as well as self-rated health over time. Low degree of managerial work performance regarding evaluation of daily work was associated with higher degree of burnout over time and lower self-rated health compared to a higher degree of evaluating work, over time.Conclusions: First line nurse managers with low managerial work performance had a higher degree of burnout and lower self-rated health. Thus, it is important to structure support managers with support, training and organizational preconditions.
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| 9. |
- Fallman, Sara L.
(författare)
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Organizational flexibility and health among line managers and employees in health care
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Line mangers’ and employees, registered nurses and assistant nurses’, in health care often have a demanding work situation. Sick leave illness and lack of competent staff is a problem. There is a lack of studies on working conditions, such as flexibility and restricted control, from an organizational perspective, (i.e. working conditions formed on a higher level aiming to influence the whole organization) with health care organizations in explicit focus.Aim: The overall aim was to expand knowledge about how working conditions with specific focus on flexibility and restricted control over work, impact on health and work performance among first and second line managers and employees within health care. In Study I the aim was to generate knowledgeabout the importance of adjustment latitude at work and at home for return to work or regaining work ability for female HSO workers on long-term sick leave. In Study II, the aim was to investigate how restricted decision-making autonomy and conflicting demands impact operational managers’ work performance and health. In Study III, the aim was to examine the associations between managerial work performance and self-rated health or burnout among first line nurse managers. In Study IV, the aim was to identify first line managers’ approaches for maintaining low levels of sick leave among healthcare employees.Method: Both qualitative and quantitative methods have been used. Studies I–III employed a quantitative longitudinal design of questionnaire data. In Study I, data from a 6-year study was used. Study II is based on data collected at two points in time, approximately one year apart. The analyses in Study III were performed using data from three points in time, approximately one year apart. Study IV, used a qualitative approach in analyses of interviews with first line managers responsible for units with low sick leave among the employees.Results: The results show the importance of having working conditions that allowed for a flexible work situation and a favorable adjustment latitude among employees. The result showed employee who had more opportunitiesto make adjustment latitudes at work had higher degree of work ability and a higher degree of return to work than those who had fever possibilities for adjustments. First line managers responsible for units with low sick leave among the employees were flexible, and had a holistic approach to meet the employees’ needs for flexible working conditions. Inversely, restricted control in form of top-down control and low control over the own work was associated with lower health, higher degree of burnout and lower ability to perform work.Conclusions: Organizational flexibility from superiors and top management is important for health because it shapes working conditions that support and facilitate individual line managers and employees’ capability to perform theirwork. In specific, higher opportunities for adjustments of pace and place of work are important for employees’ health. Line managers’ work performancemay be supported by higher organizational flexibility in decision-making while restricted control over work conditions were associated with lower health. A holistic approach in relation to the employees’ needs seems to have positive impact on lower sick leave.
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| 10. |
- Gillberg, Nanna, et al.
(författare)
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Resilience Capability and Capacity in Unexpected Crises: Experiences and Lessons Learned in a Healthcare Organisation during the COVID-19 Pandemic
- 2023
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Ingår i: Journal of Nursing Management. - 0966-0429 .- 1365-2834.
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Tidskriftsartikel (refereegranskat)abstract
- Aim. The current article aims to gain insight into (a) what characterises organisational resilience during an unexpected crisis such as COVID-19 and (b) how organisations respond to developments in their environments. Background. In times of societal crises, such as the COVID-19 pandemic, the resilience of the healthcare organisation is tested. Method. This research is based on a case study in a university hospital and a county hospital in Sweden using surveys with both structured and open answers. Results. The result shows ambiguity and “polarised” experiences, emphasising flexibility vs. structure, clear hierarchical information vs. spaces for peer learning through dialogue, and focus on acute care vs. determination to continue with core operations. Conclusion. The article concludes that the pandemic resulted in paradoxes, tensions, and new experiences in organisational processes and interactions. These create opportunities for learning not only during crises but also for improving nursing management in both acute and planned care. Three relations are important in building organisational resilience in crises: resilience capability, resilience capacity, and sustainable resilience practices. Implications for Nursing Management. Organisational resilience under extraordinary circumstances, such as a pandemic, as well as enhancing the previous literature on nursing management that offer a more individually oriented perspective.
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