| 1. |
- Ahlstedt, Carina, 1969-, et al.
(författare)
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Do illegitimate tasks matter for registered nurses' work motivation? : A cross-sectional study based on a nationally representative sample of Swedish nurses
- 2023
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Ingår i: International Journal of Nursing Studies Advances. - : Elsevier. - 2666-142X. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Background: A challenge in Western countries is the growing need for registered nurses (RNs') in hospitals, primary care and home healthcare. Decreasing illegitimate tasks and strengthening RNs' work motivation are some strategies to address this challenge.Objective: Our overall aim was to explore the association between RNs' experiences of illegitimate tasks and work motivation operationalised as four dimensions: work engagement, opportunities to provide high-quality care, employer satisfaction and intention to remain at the workplace. To address this aim, three specific research questions were asked: (1) Is there an association between illegitimate tasks and work motivation? (2) Do the levels of reported illegitimate tasks differ between RNs working in hospitals and those working in primary care or home healthcare settings? (3) Do associations between illegitimate work tasks and work motivation differ with type of workplace?Design: A cross-sectional design.Methods: We used responses from a stratified population of RNs in Sweden, n = 2,333, working either in hospitals, primary care or home healthcare. Calibrating weights were applied in all analyses to ascertain the generalisability of the findings. Illegitimate tasks were measured with the Bern Illegitimate Tasks Scale. Data were analysed using chi-squared tests and linear or logistic regression analysis. Interaction was measured on the multiplicative scale by adding an interaction term to the fully adjusted models.Results: Overall, approximately 25 % of RNs reported frequently experiencing illegitimate tasks. There were statistically significant associations between higher perceptions of illegitimate tasks and lower ratings in the four dimensions of work motivation: work engagement [beta coefficient [beta] = -0.14, confidence interval [CI] 95 % = -0.18; -0.10], opportunities to provide highquality care [beta = -0.46, CI 95 % = -0.51; -40] and employer satisfaction [beta = -0.60, CI 95 % = -0.67; -0.54]. Experiencing higher levels of illegitimate tasks also related to a decreased intention to remain at the workplace [illegitimate tasks: odds ratio = 0.32, CI 95 % = 0.27; 0.29]. RNs who worked in home healthcare reported higher levels of illegitimate tasks than RNs who worked in hospitals.Conclusions: Reducing the amount of illegitimate tasks may contribute to counteracting the shortage of RNs by increasing work motivation and willingness to remain at the workplace.
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| 2. |
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| 3. |
- Brulin, Emma, et al.
(författare)
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An impaired learning environment : Resident physicians’ experience of the transition to pandemic care during the first wave of the COVID-19 pandemic in Sweden
- 2023
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Ingår i: Frontiers in Psychology. - : Frontiers Media SA. - 1664-1078. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Extensive studies regarding the COVID-19 pandemic have shown negative effects on physicians-in-training. Besides a high workload, their learning environment has been affected. A quality learning environment is vital for residents’ physician’s clinical development and also their health. Nevertheless, few studies have explored this. The aim of this study was to explore resident physicians’ experiences of transition to pandemic care during the first wave of the COVID-19 pandemic in Sweden. Method: In this qualitative study, 12 Swedish resident physicians were interviewed using a semi-structured interview guide. They were interviewed between June and October of 2020 and asked to reflect on the pandemic and, more specifically, the first wave. The empirical material was analysed using qualitative content analysis. The analysis resulted in one theme and four categories. Results: The theme identified was An impaired learning environment which signifies the disruptions the resident physicians experienced during the first wave of the pandemic. The four categories, Professional role insecurity, High expectations but little influence, Stagnant clinical development, and Professional growth through experience, describe in what way the learning environment was impacted.
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| 4. |
- Brulin, Emma, 1980-, et al.
(författare)
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Gendered Associations of Flexible Work Arrangement and Perceived Flexibility with Work–Life Interference : A Cross-Sectional Mediation Analysis on Office Workers in Sweden
- 2023
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Ingår i: Social Indicators Research. - : Springer Nature. - 0303-8300 .- 1573-0921. ; 167:1-3, s. 571-588
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Tidskriftsartikel (refereegranskat)abstract
- Flexible work arrangements (FWA) may be beneficial for increasing perceived flexibility (i.e. control over when, where and how to work) and reducing interference between work and private-life, but knowledge of gendered patterns of these relationships is sparse. Drawing on gender theory, the aim of this study was to conduct gender-differentiated analyses of the associations between FWA (non-regulated work or flex-time) and work–life interference using perceived flexibility as a mediator. Survey data were collected in 2016 from a sample of 2614 employees in the Swedish Transport Administration (response rate 67%). The sample included 39.6% women and 60.4% men, 71.7% had non-regulated work and 28.3% flex-time. Associations were determined using linear mixed models and mediation analysis. Results indicated a beneficial effect of non-regulated work (referencing flex-time) on work–life interference through an increase in perceived flexibility. The indirect effect of FWA was pronounced and statistically significant in the total sample, as well as in men and women. However, in men, non-regulated work was associated with a statistically significant increase in interference (competitive mediation). Gender did not interact significantly with work arrangement nor with perceived flexibility. In conclusion, the type of FWA can result in different perceptions of flexibility which in turn may affect experiences of work–life interference. Furthermore, it should be acknowledged that both FWAs and flexibility may be experienced differently for men and women regarding interference. Thus, employers seeking to reduce employee interference should consider gender norms and individual needs.
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| 5. |
- Brulin, Emma, et al.
(författare)
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Money talks : performance-based reimbursement systems impact on perceived work, health and patient care for physicians in Sweden
- 2023
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Ingår i: Frontiers in Psychology. - : Frontiers Media S.A.. - 1664-1078. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The study aimed to investigate in which way performance-based reimbursement (PBR) systems in Swedish healthcare services (1) subjectively impacted physicians’ work and patient care and (2) were associated with the occurrence of stress-induced exhaustion disorders among physicians.Method: The study applied a mixed-method design. Data were collected from a representative sample of Swedish physicians. In the questionnaire, respondents were asked to answer an open-ended question regarding their reflections on PBR. The answers to the open-ended question were analysed using thematic analysis. Respondents were also asked to rate the impact of PBR on their work. The association between PBR and self-rated stress-induced exhaustion disease was analysed with logistic regressions. Stress-induced exhaustion disorder was measured using the Burnout Assessment Scale.Results: Thematic analysis resulted in four themes: (1) Money talks, (2) Patients are affected, (3) Medical morals are challenged, and (4) PBR increase the quantity of illegitimate tasks. Logistic regressions showed that physicians who experienced PBR had an impact on their work and had a two-fold higher risk of stress-induced exhaustion disorder.Discussion: Our findings suggest that current reimbursement systems in Sweden play an essential role in Swedish healthcare and negatively influence physicians’ work and health. Also, current PBR impact patients negatively. No previous study has explored the potentially harmful impact of PBR on how physicians perceive work, health and patient care. Results indicate that policymakers should be encouraged to deeply review PBR systems and focus on ways that they can limit the negative impact on physicians’ work and health while meeting future challenges.
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| 6. |
- Brulin, Emma, 1980-, et al.
(författare)
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Work–Life Enrichment and Interference Among Swedish Workers : Trends From 2016 Until the COVID-19 Pandemic
- 2022
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Ingår i: Frontiers in Psychology. - : Frontiers Media SA. - 1664-1078. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- The COVID-19 pandemic has altered workers' possibilities to combine work and private life. Work and private life could either interfere with each other, that is, when conflicting demands arise, or enrich, that is, when the two roles are beneficial to one another. Analyzing data from the Swedish Longitudinal Occupational Survey of Health through individual growth models, we investigated time trends of interference and enrichment between work and private life from 2016 through March to September 2020, which is during the first wave of the pandemic. The sample included workers who had remained in the same workplace throughout the study period and worked at least 30% of full time, reaching 5,465 individuals. In addition, we examined trends in level of interference and enrichment across gender and industries. Results showed that Life-to-work interference increased over time in the Swedish working population, but neither did work-to-life interference nor enrichment. We observed only marginal differences across gender. Also, in the industries of fine manufacturing and real-estate activities, a decrease in interference, work-to-life interference, and life-to-work interference, respectively, was observed. In the human health and social care industry, an increase in interference and life-to-work interference was seen. Our conclusion is that overall changes to the possibilities to balance work and private life have occurred for workers in Sweden during the first period of the pandemic. Further studies are needed to study development time trends throughout the pandemic and across different occupations.
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| 7. |
- de Lange, Annet H., et al.
(författare)
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Opportunities and challenges in designing and evaluating complex multilevel, multi-stakeholder occupational health interventions in practice
- 2024
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Ingår i: Work & Stress. - : Routledge. - 0267-8373 .- 1464-5335.
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Tidskriftsartikel (refereegranskat)abstract
- Extant research suggests the effectiveness of Occupational Health Psychology (OHP) interventions depends on their design in the broader organisational context. While the field recognises that pre- and posttest evaluation do not sufficiently capture the complex dynamics around OHP interventions, complex multi-level OHP interventions are still scarce in the literature. As established intervention implementation frameworks suggest, it remains difficult to address this complexity in practice. The present position paper re-evaluates lessons learned from two complex European OHP intervention projects, by applying the Integrated Process Evaluation Framework (IPEF) and related theories to bridge the gap between the theoretically recognised complexity and practical challenges. The re-evaluations emphasise that programme-multilevel theories rooted in OHP-perspectives contribute to adequately hypothesising around systemic factors and mechanisms relevant to OHP interventions. Concretely, middle range theories that outline how an intervention’s mechanisms work within a specific context to produce certain outcomes are crucial. Additionally, strategically and actively involving key stakeholders at all levels of the system and across the different intervention phases improves the embedding of OHP interventions in organisations. We elaborate on these insights with seven concrete recommendations for complex OHP intervention research.
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| 8. |
- de Lange, Annet H., et al.
(författare)
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Opportunities and challenges in designing and evaluating complex multilevel, multi-stakeholder occupational health interventions in practice
- 2024
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Ingår i: WORK AND STRESS. - : Routledge. - 0267-8373 .- 1464-5335.
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Tidskriftsartikel (refereegranskat)abstract
- Extant research suggests the effectiveness of Occupational Health Psychology (OHP) interventions depends on their design in the broader organisational context. While the field recognises that pre- and posttest evaluation do not sufficiently capture the complex dynamics around OHP interventions, complex multi-level OHP interventions are still scarce in the literature. As established intervention implementation frameworks suggest, it remains difficult to address this complexity in practice. The present position paper re-evaluates lessons learned from two complex European OHP intervention projects, by applying the Integrated Process Evaluation Framework (IPEF) and related theories to bridge the gap between the theoretically recognised complexity and practical challenges. The re-evaluations emphasise that programme-multilevel theories rooted in OHP-perspectives contribute to adequately hypothesising around systemic factors and mechanisms relevant to OHP interventions. Concretely, middle range theories that outline how an intervention's mechanisms work within a specific context to produce certain outcomes are crucial. Additionally, strategically and actively involving key stakeholders at all levels of the system and across the different intervention phases improves the embedding of OHP interventions in organisations. We elaborate on these insights with seven concrete recommendations for complex OHP intervention research.
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| 9. |
- Månsson Sandberg, Helena, et al.
(författare)
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COVID-19 related individual work, managerial factors and exhaustion among general practitioners in Sweden : A cross-sectional study
- 2023
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: A Swedish study found that more than 16% of general practitioners (GPs) had exhaustion in spring 2021. A knowledge gap remains about the impact of COVID-19 related individual work and managerial factors on exhaustion among Swedish GPs. This study therefore explores the association between exhaustion and COVID-19 pandemic related individual work and managerial factors among Swedish GPs who managed COVID-19 patients, compared to those GPs who did not. Methods: Cross-sectional data was drawn from the Longitudinal Occupational Health survey in Health Care Sweden study, which included a representative sample of practicing doctors in Sweden. The sample consisted of 6699 doctors with a response rate of 41.2%. This study constitutes a sample of doctors who reported working in primary care facilities at the time of data collection reaching 1013 GPs. The Burnout Assessment Tool was used to assess the level of exhaustion. Questions were also asked about pandemic related, individual work and managerial factors. The data was analysed using descriptive statistics, and multivariate logistic regression.Results: The results showed that moral and emotional distress, excess workload and perceived unsatisfactory management (supportive, work environment and clinical management) increased the risk of GPs who managed COVID-19 patients reporting exhaustion. Furthermore, the results showed that satisfactory management can to some extent protect against the negative effects of moral and emotional distress and excess workload. Conclusions: COVID-19 related individual work and managerial factors had a significant impact on the mental health of GPs who managed COVID-19 patients during the pandemic. In the aftermath of the COVID-19 pandemic and in preparation for future major crises that have a high impact on healthcare, there is a need to investigate the measures that can be taken to enable GPs to carry out their work, while maintaining their health.
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| 10. |
- Månsson Sandberg, Helena, et al.
(författare)
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COVID-19- related work, managerial factors and exhaustion among general practitioners in Sweden : a cross-sectional study
- 2023
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Ingår i: BMC Primary Care. - : Springer Nature. - 2731-4553. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Introduction A significant number of international studies show that general practitioners (GPs) suffered from burnout when working during the COVID-19 pandemic. A Swedish study found that more than 16% of GPs had exhaustion in spring 2021. Exhaustion can be regarded as an initial stage of burnout. A knowledge gap remains on GPs´ working conditions, the impact of management during the pandemic and how it was associated with exhaustion. This study aims to explore the association between severe symptoms of exhaustion and COVID-19 pandemic-related work and managerial factors among Swedish GPs and whether managerial factors have an impact on the association between exhaustion and COVID-19-related work factors.Methods Cross-sectional data was drawn from the Longitudinal Occupational Health survey in Health Care Sweden (LOHHCS), which included a representative sample of practicing doctors in Sweden. The sample consisted of 6699 doctors with a response rate of 41.2%. This study constitutes a sample of doctors who reported working in primary care facilities at the time of data collection, i.e. 1013 GPs. The Burnout Assessment Tool (BAT) was used to assess severe symptoms of exhaustion. Questions were also asked about pandemic-related work and managerial factors. The data was analysed using descriptive statistics and multivariate logistic regression to identify the association between exhaustion, work and managerial factors.Results The multivariate analysis showed that GPs who managed COVID-19 patients were about twice as likely to report severe symptoms of exhaustion. Further, GPs who reported that management was unsupportive, provided unsatisfactory working conditions and unsatisfactory policies for patient prioritisation were between two and four times more likely to report severe symptoms of exhaustion.Conclusions COVID-19-related work and managerial factors had a significant impact on the mental health of GPs. Furthermore, the potentially protective effect that satisfactory management actions had on mental health was limited. In the aftermath of the COVID-19 pandemic and in preparation for future major crises that have a high impact on healthcare, there is a need to investigate the measures that can be taken to enable GPs to carry out their work, while maintaining their wellbeing.
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| 11. |
- Månsson Sandberg, Helena, et al.
(författare)
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How general practitioners used job crafting strategies during the COVID-19 pandemic in Sweden
- 2024
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Ingår i: Scandinavian Journal of Primary Health Care. - : Taylor & Francis Group. - 0281-3432 .- 1502-7724. ; 42:2, s. 276-286
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Tidskriftsartikel (refereegranskat)abstract
- Objective: General practitioners (GPs) played a crucial role in limiting the impact of the COViD-19 pandemic, and many GPs experienced they did not have the prerequisites to provide adequate care. However, GPs developed approaches that helped them to provide care to patients through various job crafting strategies. The aim of this study is to identify how job crafting strategies were deployed by GPs at the beginning of the COViD-19 pandemic in Sweden and the significance of the strategies on their work situation. Design: A qualitative design with semi-structured interviews. The data was analysed using qualitative content analysis with job crafting as the conceptual framework for the analysis process. Setting: Primary healthcare in five healthcare regions in sweden. Subjects: Fourteen GPs participated in individual interviews. Results: In their endeavours to organise and provide care, GPs shaped the task, relational and cognitive boundaries of their work. GPs felt proud about finding new ways of working when given room to manoeuvre. Intensified collaboration between healthcare professionals made GPs more confident in their clinical work. GPs expressed that they consequently felt stronger in their professional role through what they accomplished in the organisation of care. Conclusions/Implications: The results suggest that the job crafting strategies GPs used were meaningful to them in clinical practice. Knowledge about how GPs’ job crafting strategies were deployed might be useful for healthcare organisations in preparing for future health crises. Taking advantage of GPs’ experiences and strategies is considered important for promoting sustainable working conditions for GPs in the future.
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| 12. |
- Pagard, Sophie, et al.
(författare)
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Effects of a participative workplace intervention on work strategies and expectations of availability among office-based employees with flexible work arrangements
- 2024
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Ingår i: IISE Transactions on Occupational Ergonomics and Human Factors. - : Taylor & Francis. - 2472-5838 .- 2472-5846. ; 11:3-4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Flexible work arrangements (FWA) are common, but knowledge on how to organize flexible work to reduce negative consequences and preserve positive aspects is currently sparse, which hampers organizational initiatives. Purpose: This study aimed at determining the extent to which work strategies, work-related ICT use outside regular working hours (i.e., use of laptop, tablet, or smartphone, to handle information and facilitate communication), productivity, expectations of availability, and clarity of expectations about availability, had changed among office-based employees with FWA two and four months after a participative two-step workplace intervention.Methods: An intervention group (n=97) was compared to a control group working as usual (n=70). The intervention, initiated and approved by the top management of the organization, included individual education intended to change work strategies, and workshops developing common rules and routines for FWA within the work group.Results: Participants were satisfied with the intervention and reported larger changes than the control group in work strategies. No statistically significant effects were, however, found on ICT use, productivity, or expectations of availability.Conclusions: This participative workplace intervention was successful in changing employees work strategies but may not be effective in influencing ICT use outside regular working hours, productivity, expectations of availability, and clarity of expectations about availability.
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| 13. |
- Pagard, Sophie, et al.
(författare)
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Improved Work-Life Balance in Flexible Work? Effects of a co-created Workplace Intervention among Office Workers
- 2024
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Tidskriftsartikel (refereegranskat)abstract
- Background Achieving work-life balance in flexible work arrangements is a challenge for both individuals and organizations, but intervention studies are sparse. We aimed to investigate the extent to which work-life balance, work-home interference, and home-work interference changed among office workers with flexible work arrangements after a workplace intervention. Methods Together with a large governmental agency in Sweden, we co-created an intervention with a focus on work strategies and common rules for flexible work in two steps: 1) an education to change individual work strategies and 2) a workshop to develop common rules and routines for flexible work within the workgroup. Two comparable departments participated, with 97 workers in the group receiving the intervention and 70 in a control group. Work-life balance and work-home/home-work interference were measured using questionnaires before the intervention (baseline), after the education (6-month follow-up), and after the workshop (12-month follow-up); and analyzed using linear mixed models with adjustments for covariates. Results We found no marked effects of the intervention on work-life balance, work-home interference, and home-work interference, with statistically non-significant effect estimates at both 6- and 12-months follow-ups. Conclusions Further studies are needed to evaluate whether other initiatives could be more effective in promoting work-life balance among office workers with flexible work arrangements.
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| 14. |
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| 15. |
- Pagard, Sophie
(författare)
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Promoting Work-Life Balance in Flexible Work
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Flexible work arrangements (FWAs), which allows employees to decide when, where, and how to perform the work, is more prevalent than ever in modern working life. However, research about how FWAs can be organized to promote work-life balance (WLB) is sparse. The overall aim of this thesis was to develop, implement, and evaluate a workplace intervention among office-based employees with FWAs. More specifically, the aims wereto: 1) identify demands and resources related to WLB; 2) in co-creation with the investigated organization, identify suggestions for improvements to guide the development of a workplace intervention; and 3) implement and evaluate the effect of an intervention, addressing some of the identified suggestions on proximal (i.e., work strategies, use of work-related information and communication technology (ICT), productivity, and expectations of availability) and distal outcomes (i.e., WLB and interference between work and private life).Methods: Paper I was a cross-sectional study based on a comprehensive questionnaire that examined occupational factors and their associations with WLB. Paper II comprised focus group interviews to collect suggestions for improvements in FWAs at an organizational, work group and individual level. Therefore, while paper I and II informed the design of the intervention, papers III and IV comprised its implementation and evaluation. Paper III examined effects on proximal outcomes and paper IV on distal outcomes.Results: Identified resources related to employees’ WLB in FWAs were boundary management, information about how to organize work, and relation-oriented leadership. Identified demands were over-commitment to work, quantitative job demands, and expectations of availability. Perceived flexibility was a resource for WLB, which interacted with several demands and buffering their negative associations with WLB. Suggestions from the focus groups related to organizational (e.g., common guidelines for FWAs), workgroup (e.g., clarify expectations of availability) and individual-level improvements (e.g., determine own availability), which supported the development and implementation of an intervention addressing work strategies and culture in FWAs. Participants were satisfied with the intervention and reported changes in work strategies. No intervention effects were found on other proximal or distal outcomes.Conclusions: We identified both demands and resources related to employees’ WLB in FWAs. Employees suggested intervention activities mainly focusing on changing work strategies, both as individuals and as a workgroup. The intervention was effective in changing work strategies, but not in improving other proximal and distal outcomes.
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