| 1. |
- Azad, Azadé, 1983-, et al.
(författare)
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Conducting In-Depth Interviews via Mobile Phone with Persons with Common Mental Disorders and Multimorbidity : The Challenges and Advantages as Experienced by Participants and Researchers
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:22
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Tidskriftsartikel (refereegranskat)abstract
- Qualitative interviews are generally conducted in person. As the coronavirus pandemic (COVID-19) prevents in-person interviews, methodological studies which investigate the use of the telephone for persons with different illness experiences are needed. The aim was to explore experiences of the use of telephone during semi-structured research interviews, from the perspective of participants and researchers. Data were collected from mobile phone interviews with 32 individuals who had common mental disorders or multimorbidity which were analyzed thematically, as well as field notes reflecting researchers' experiences. The findings reveal several advantages of conducting interviews using mobile phones: flexibility, balanced anonymity and power relations, as well as a positive effect on self-disclosure and emotional display (leading to less emotional work and social responsibility). Challenges included the loss of human encounter, intense listening, and worries about technology, as well as sounds or disturbances in the environment. However, the positive aspects of not seeing each other were regarded as more important. In addition, we present some strategies before, during, and after conducting telephone interviews. Telephone interviews can be a valuable first option for data collection, allowing more individuals to be given a fair opportunity to share their experiences.
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| 2. |
- Holmlund, Lisa, et al.
(författare)
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Are psychosocial work factors and work-home interference associated with time to first full return-to-work after sick leave due to common mental disorders?
- 2023
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer. - 0340-0131 .- 1432-1246. ; 96, s. 747-755
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo (1) examine the time to first full return-to-work (RTW), and (2) investigate whether psychosocial work factors and work-home interference are associated with time to first full RTW after sick leave due to common mental disorders (CMDs).MethodsThe cohort study comprised 162 employees on sick leave due to CMDs participating in a two-armed cluster-randomised controlled trial in Sweden. Baseline data consisted of a web-based questionnaire and follow-up data of repeated text messages every fourth week for 12 months. The time to first full RTW was estimated using the Kaplan–Meier Estimator. Parametric Weibull survival models with interval-censored outcomes were used to determine associations between psychosocial work factors and work-home interference with time to first full RTW. In a post hoc analysis, time-interval differences in associations for 0– ≤ 6- versus > 6–12 months were tested.ResultsDuring the 12-month follow-up, n = 131 (80.9%) reported a first full RTW. The median time to this RTW was 16 weeks (95% CI 12; 20). High psychological job demands, high emotional job demands, high work-to-home interference (WHI), and low social job support were independently associated with a longer time to first full RTW. Time-interval differences were found for job control and emotional job demands.ConclusionsPsychosocial work demands and WHI are associated with a longer time to RTW after sick leave due to CMDs. Work organisations and rehabilitation practices should include accommodations for high psychological and emotional job demands during RTW, as well as pay attention to the risk of spill-over of high job demands into employees’ private lives.
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| 3. |
- Holmlund, Lisa, et al.
(författare)
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Ethical aspects of the coordination of return-to-work among employees on sick leave due to common mental disorders : a qualitative study
- 2023
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Ingår i: Disability and Rehabilitation. - : Taylor & Francis. - 0963-8288 .- 1464-5165. ; 45:13, s. 2118-2127
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Tidskriftsartikel (refereegranskat)abstract
- PurposeIdentify ethical issues that arise in the coordination of return-to-work (RTW) among employees on sick leave due to common mental disorders (CMDs).Material and methods41 semi-structured individual interviews and one focus group interview with stakeholders (n = 46) involved in RTW: employees on sick leave due to CMDs, coordinators and physicians at primary health care centres, managers, representatives of the Swedish social insurance agency and occupational health services. A six-step thematic analysis focused on the ethical values and norms related to autonomy, privacy, resources and organization, and professional values.ResultsFive themes were identified: (1) autonomous decision-making versus the risk of taking over, (2) employee rights versus restrictions to self-determination, (3) respect for employee privacy versus stakeholders’ interests, (4) risk of unequal inclusion due to insufficient organizational structure and resources, (5) risk of unequal support due to unclear professional roles and responsibilities.ConclusionThe main ethical issues are the risks of unequal access to and unequal support for the coordination of RTW. For the fair and equal provision of coordination, it is necessary to be transparent on how to prioritize the coordination of RTW for different patient groups, provide clarity about the coordinator’s professional role, and facilitate ongoing boundary work between stakeholders.
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| 4. |
- Holmlund, Lisa, et al.
(författare)
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Evaluating the feasibility of ReWork-SCI : a person-centred intervention for return-to-work after spinal cord injury
- 2020
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 10:8
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To evaluate the feasibility of: (1) ReWork-SCI with regard to adherence and acceptability and (2) a study design for evaluating ReWork-SCI with regard to recruitment, retention and outcome measures. Design Pre-test and post-test, single group, feasibility study. Setting Spinal cord injury (SCI) unit at a regional rehabilitation centre in Sweden. Participants Two women and five men (n=7). Eligible criteria: (1) sustained traumatic or non-traumatic SCI; (2) completed the first acute care episode in a hospital; (3) between 18 to 65 years of age; (4) assessed by a physician as approachable for participation in the intervention; (5) history of permanent or temporary employment; (6) self-reported desire to return to work; and (7) ability to communicate in English or Swedish. Intervention ReWork-SCI is a person-centred intervention for return-to-work (RTW), developed and evaluated using the Medical Research Council's guidelines. ReWork-SCI follows a person-centred, structured and coordinated intervention process led by a coordinator within a SCI rehabilitation team. Outcome measures The feasibility of ReWork-SCI and a study design was evaluated using a set of outcome measurement tools, vocational data, logbooks and semi-structured interviews. Results All eligible participants accepted enrolment and follow-up. All participants had a plan for RTW after 3 months and four participants had initiated part-time work or work trial 6 months after commencement of intervention. Adherence and acceptability were overall good. Challenges of the intervention related to the person-centred follow-up, staff shortage and rootedness in the SCI team. Conclusions ReWork-SCI was feasible and can contribute to a systematic design of an individualised plan, facilitate decision-making and build trust in the RTW process after SCI. Core features of the intervention was the systematic structure, use of a person-centred approach and dialogue with the employer. For the effectiveness of ReWork-SCI, modifications and considerations of study design are needed.
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| 5. |
- Holmlund, Lisa, et al.
(författare)
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Navigating work and life- a qualitative exploration of managers' and employees' views of return-to-work after sick leave due to common mental disorders
- 2024
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Ingår i: BMC PUBLIC HEALTH. - 1471-2458. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIncorporating multiple perspectives and contexts in knowledge mobilisation for return-to-work after sick leave due to common mental disorders can promote interprofessional and organisational strategies for facilitating the return-to-work process. This study aimed to explore the facilitators of and barriers to return-to-work after common mental disorders. This exploration considered the perspectives of employees and managers and the realms of work and private life.MethodsA qualitative approach was used with data from 27 semi-structured telephone interviews. The strategic sample consisted of employees who returned to work after sick leave due to common mental disorders (n = 17) and managers responsible for their return-to-work process (n = 10). Thematic analysis conducted in a six-step process was used to generate themes in the interview data.ResultsThe analysis generated three main themes with subthemes, illustrating experiences of barriers to and facilitators of return-to-work positioned in the employees' private and work contexts: (1) Getting along: managing personal difficulties in everyday life; (2) Belonging: experiencing social connectedness and support in work and private life; and (3) Organisational support: fostering a supportive work environment. The results contribute to a comprehensive understanding of the return-to-work process, including the challenges individuals face at work and in private life.ConclusionsThe study suggests that return-to-work after sick leave due to CMDs is a dynamic and ongoing process embedded in social, organisational, and societal environments. The results highlight avenues for an interprofessional approach and organisational learning to support employees and managers, including space for the employee to recover during the workday.
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| 6. |
- Holmlund, Lisa, et al.
(författare)
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Return-to-work : Exploring professionals' experiences of support for persons with spinal cord injury
- 2021
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Taylor & Francis. - 1103-8128 .- 1651-2014. ; 28:7, s. 571-581
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To generate knowledge about how professional stakeholders organise and experience the support of the return-to-work (RTW) process for persons with spinal cord injury (SCI).Methods: Constructivist grounded theory approach. Professional stakeholders (n = 34) involved in the RTW process and representing three Swedish Regions were recruited into seven focus groups. Analysis followed initial, focussed, and theoretical coding.Findings: The core category - mediating intentions to support work and possibilities of working through social, labour market, and societal context - illustrates complexities of when and how to support a person with SCI in the RTW process, and a risk of delayed, unequal, or absent RTW processes. Analysis outlines: (1) Assessment of ability to work - uncertainty of how and when; (2) Planning RTW - divide between dynamic and rule-based perspectives; (3) Work re-entry - unequal paths towards viable solutions.Conclusions: In RTW after SCI, it is critical to acknowledge how the RTW process is situated in relation to the person and context. A possible direction - grounded in an occupational perspective - through early identification of needs and resources and coordination derived from the SCI rehabilitation setting within healthcare is suggested. This can facilitate a time-sensitive and equal RTW process.
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| 7. |
- Holmlund, Lisa
(författare)
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Return to work : exploring paths toward work after spinal cord injury and designing a rehabilitation intervention
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Return to work (RTW) after spinal cord injury (SCI) often involves a complex and extended process for the person, due to consequences of the injury. There is limited evidence on how to support a person with SCI during the RTW process, and employment rates are low in Sweden, as well as internationally. It is important when developing a rehabilitation intervention for RTW after SCI, that the intervention derives from a contextually relevant evidence base, as well as from collaboration with persons with SCI. Aim: The overall aim was to explore and generate knowledge about RTW for adults with SCI, in order to develop and evaluate the design and feasibility of a complex intervention that can serve as a complement to current RTW systems. Methods: This thesis draws on the Medical Research Council’s (MRC) guidance for developing and evaluating complex interventions. Study I was a follow-up study in which narrative interviews and participant observations were used to explore experiences of RTW in the context of everyday life, 7-11 years after SCI. In study II, a participatory approach drawing on photovoice methods was used to explore experiences of barriers and possibilities in RTW among working adults with SCI. In study III, constructive grounded theory and focus group interviews were used to generate knowledge on how professional stakeholders organize and experience the RTW process for the person with SCI. The findings in studies I-III in combination with research in the field and theoretical resources, constituted the evidence base for modelling ReWork-SCI, a person-centred, structured, and coordinated intervention process for RTW after SCI. The feasibility of ReWork-SCI and the study design for evaluating ReWork-SCI, with regard to adherence, acceptability, recruitment, retention, and use of outcome measures, was explored in study IV. Findings: Studies I-III illustrate that the RTW process was experienced as fragmented by the person with SCI and difficult to navigate for the professional stakeholders. Moreover, findings show how the RTW process was situated in a person’s everyday life. Further, tensions between intentions for fair support and possibilities to enable such, meant challenges in when and how a RTW process could be initiated and realized. Study IV shows that ReWork-SCI was feasible although modifications to the intervention, and the study design was necessary prior to a full-scale trial. Conclusion: This thesis adds to the understanding of complexities in the RTW process after SCI. Supporting the person in untangling problematic dimensions of how RTW is situated in everyday life is a critical outset in the process. This thesis shows how a RTW coordinator based in the SCI rehabilitation team can collaborate with the person and provide coordination between stakeholders throughout the RTW process and how ReWork-SCI has the potential to guide when and how a RTW process after SCI can be made possible.
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| 8. |
- Holmlund, Lisa, et al.
(författare)
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Return to work in the context of everyday life 7-11 years after spinal cord injury - a follow-up study
- 2018
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 40:24, s. 2875-2883
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this follow-up study was to explore experiences of return to work in the context of everyday life among adults 7-11 years after spinal cord injury (SCI). Methods: This study used in-depth interviews and observations in a qualitative design with eight persons who had previously been interviewed in 2008. A narrative approach was used during data gathering and analysis. Results: Return to work was experienced as something constantly needing to be negotiated in the context of everyday life. Several years after SCI expectations for work and perceptions of possibilities for meaningful work had changed. Five main themes were identified through the analysis, (1) negotiating the possibilities of working, (2) hope for future work tempered with concern, (3) education as a possible path to employment, (4) paths toward return to work in light of unmet support, and (5) unpaid occupations grounded in interest and competence. Conclusions: Persons who have no higher education or lack viable employment to return to after SCI seem to be vulnerable in return to work. Early and timely interventions tailored to the person's interests and competencies, in which the rehabilitation team has a distinct coordinating role, are thus critical in return to work.
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| 9. |
- Svärd, Veronica, et al.
(författare)
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Collaboration in the return-to-work process after sick leave due to common mental disorders : a qualitative study of stakeholders’ views on goals and roles
- 2024
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Ingår i: BMC Public Health. - : Springer. - 1471-2458. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: This study explores how the goals of collaboration in the return-to-work (RTW) process for people with common mental disorders are described by the stakeholders involved, and how they experience stakeholders’ roles and responsibilities in relation to these goals.Methods: Interviews were conducted with 41 participants from three Swedish regions. Nine of the participants were workers, six employer representatives, four occupational health professionals, four social insurance officers, 18 RTW coordinators and five physicians. Thematic analysis was conducted.Results: Three main themes and overarching goals when collaborating on RTW were identified. In the first theme, ‘creating an informative environment’, all stakeholders emphasised clear roles and responsibilities. The second theme, ‘striving for consensus in an environment of negotiations’, addressed negotiations about when and how to collaborate, on what and with whom, and reveal different views on stakeholders’ goals, roles and responsibilities in collaboration. The third theme identified goals for ‘creating a supportive environment’ for both workers and other stakeholders. Coordinators are found to have an important role in achieving a supportive environment, and in neutralising power imbalances between workers and their employers and social insurance officers.Conclusions: Competing goals and priorities were identified as hindering successful collaboration, contributing to a spectrum of complex versus easy RTW collaboration. This study suggests some basic conditions for achieving a collaborative arena that is neutral in terms of power balance, where all stakeholders can share their views.
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| 10. |
- Svärd, Veronica, et al.
(författare)
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Collaboration in the return-to-work process after sick leave due to common mental disorders : a qualitative study of stakeholders' views on goals and roles
- 2024
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Ingår i: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThis study explores how the goals of collaboration in the return-to-work (RTW) process for people with common mental disorders are described by the stakeholders involved, and how they experience stakeholders’ roles and responsibilities in relation to these goals.MethodsInterviews were conducted with 41 participants from three Swedish regions. Nine of the participants were workers, six employer representatives, four occupational health professionals, four social insurance officers, 18 RTW coordinators and five physicians. Thematic analysis was conducted.ResultsThree main themes and overarching goals when collaborating on RTW were identified. In the first theme, ‘creating an informative environment’, all stakeholders emphasised clear roles and responsibilities. The second theme, ‘striving for consensus in an environment of negotiations’, addressed negotiations about when and how to collaborate, on what and with whom, and reveal different views on stakeholders’ goals, roles and responsibilities in collaboration. The third theme identified goals for ‘creating a supportive environment’ for both workers and other stakeholders. Coordinators are found to have an important role in achieving a supportive environment, and in neutralising power imbalances between workers and their employers and social insurance officers.ConclusionsCompeting goals and priorities were identified as hindering successful collaboration, contributing to a spectrum of complex versus easy RTW collaboration. This study suggests some basic conditions for achieving a collaborative arena that is neutral in terms of power balance, where all stakeholders can share their views.
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