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Sökning: WFRF:(Hensing Gunnel 1956)

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1.
  • Dale, Richard Allan, 1965, et al. (författare)
  • YOUNG ADULTS' EXPERIENCES WITH NEAR-INJURY SITUATIONS: A CRITICAL INCIDENT STUDY IN SWEDEN
  • 2017
  • Ingår i: International Journal of Child Youth & Family Studies. - : University of Victoria Libraries. - 1920-7298. ; 8:1, s. 97-111
  • Tidskriftsartikel (refereegranskat)abstract
    • As injuries are the main health threat for young adults (18-29 years) in industrial countries, a better understanding of injury risk is needed for this population. Using the Critical Incident Technique, this study explores how young people experience situations that have the potential to cause physical injury (i.e., near-injury situations). Clearly, understanding how and why near-injury situations arise can be used to develop strategies to help prevent severe injury. Content analysis was used to categorize the characteristics of the experiences into unexpected risk in ordinary tasks, duty first, and price for learning. Young adults' exposures to new or unusual environmental conditions, especially in unexpected risk in ordinary tasks, should be considered when planning injury prevention strategies. A combination of individual, social, and contextual demands and expectations was identified in both work-and sports-related experiences with near-injury situations. The price for learning, which arises from the added risk involved in learning situations, is another condition that was identified and requires further attention. The Critical Incident Technique proved to be a useful method for identifying near-injury situations that might otherwise have been difficult to recall. Young adults' efforts to display their ability to handle difficult situations at work and in their everyday lives was identified as a major contributor to near-injury situations.
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4.
  • Sverker, Annette, 1958, et al. (författare)
  • Sharing life with a gluten-intolerant person--the perspective of close relatives.
  • 2007
  • Ingår i: Journal of human nutrition and dietetics : the official journal of the British Dietetic Association. - 0952-3871 .- 1365-277X. ; 20:5, s. 412-22
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Several studies indicate the importance of social support in the case of chronic disease. AIM: The aim was to explore dilemmas experienced by close relatives living with a person suffering from coeliac disease, and to describe the strategies they used to deal with these dilemmas. METHODS: Twenty-three informants were interviewed. A systematic inductive qualitative method, the critical incident technique was used. RESULTS: Disease-related worries included having bad conscience about not being affected by the disease, experiencing anxiety and witnessing the vulnerability of the affected relative in social situations. Dilemmas related to manage daily life were connected with increased domestic work, restricted freedom of action and the diseased person's preferential right of interpretation of health risks associated with the coeliac disease and deviations from the diet restrictions. Dilemmas related to disturbances in social life, concerned lack of information, knowledge and understanding. Different strategies were described to manage daily life. CONCLUSIONS: Close relatives experienced a variety of dilemmas that affected the situation of the whole family. The role of relatives in handling the coeliac disease with the diseased person in the everyday life might be underestimated, and to provide relatives with better knowledge regarding the disease might improve the situation also for patients.
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5.
  • Östlund, Gunnel, 1956-, et al. (författare)
  • Developing a typology of the 'duty to work', as experienced by lay persons with musculoskeletal disorders
  • 2002
  • Ingår i: International Journal of Social Welfare. - : Wiley. - 1369-6866 .- 1468-2397. ; 11:2, s. 150-158
  • Tidskriftsartikel (refereegranskat)abstract
    • Musculoskeletal diagnoses account for the majority of cases of reduced work capacity. This article investigates lay persons' strategies in relation to work and musculoskeletal disorders. Twenty interviews were conducted and analysed using grounded theory. A typology of self-presentations was developed. The interviewees' self-presentations revealed a strong sense of a 'duty to work'. This sense of duty took four different forms, leading us to categorise persons expressing particular forms as workaholics, work manics, workhorses or relaxed workers. Relaxed workers seem to have the best prognosis for recovery as they had a confident self-agency and worked to fulfil their own needs rather than those of others. This was in contrast to work manics, with an uncertain self-agency and driven to work by others' needs. In conclusion, awareness of such linguistic forms as self-attributions and idiomatic phrases provides an opportunity to identify and talk about individual's self-agency and driving forces in the recovery process.
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  • Östlund, Gunnel, 1956-, et al. (författare)
  • Domestic strain : a hindrance in rehabilitation?
  • 2004
  • Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 18:1, s. 49-56
  • Tidskriftsartikel (refereegranskat)
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7.
  • Bertilsson, Monica, et al. (författare)
  • Capacity to work while depressed and anxious - a phenomenological study
  • 2013
  • Ingår i: Disability and Rehabilitation. - : Informa Healthcare. - 0963-8288 .- 1464-5165. ; 35:20, s. 1705-1711
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: The aim was to explore experiences of capacity to work in persons working while depressed and anxious in order to identify the essence of the phenomenon capacity to work. Method: Four focus groups were conducted with 17 participants employed within the regular job market. Illness experiences ranged from symptoms to clinical diagnoses. A phenomenological approach was employed. Results: The phenomenon of capacity to work was distinguished by nine constituents related to task, time, context and social interactions. The phenomenon encompassed a lost familiarity with ones ordinary work performance, the use of a working facade and adoption of new time-consuming work practices. Feelings of exposure in interpersonal encounters, disruption of work place order, lost "refueling and a trade-off of between work capacity and leisure-time activities was also identified. The reduced capacity was pointed out as invisible, this invisibility was considered troublesome. Conclusions: A complex and comprehensive concept emerged, not earlier described in work capacity studies. Rehabilitation processes would benefit from deeper knowledge of the individuals capacity to work in order to make efficient adjustments at work. Results can have particular relevance both in clinical and occupational health practice, as well as in the workplaces, in supporting re-entering workers after sickness absence.
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  • Hadžibajramović, Emina, 1977, et al. (författare)
  • Burnout among midwives—the factorial structure of the burnout assessment tool and an assessment of burnout levels in a Swedish national sample
  • 2022
  • Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 22:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Many workplaces, within the healthcare sector, experience high rates of mental health problems such as burnout, anxiety, and depression, due to poor psychosocial working conditions and midwives are not an exception. To develop preventive interventions, epidemiologic surveillance of burnout levels, and their relation to professional specific working conditions is needed. Aims of this study is to assess the construct validity of the Burnout Assessment Tool (BAT) in the context of Swedish midwives, to evaluate whether the item responses can be combined into a single score and differential item functioning regarding age. Another aim was to assess the burnout levels of Swedish midwives. Methods: Data come from a national cohort of Swedish midwives (n = 1664). The construct validity was evaluated using Rasch analysis. Burnout levels were presented by median and first (Q1) and third (Q3) quartiles for the BAT total score and the four subscales (exhaustion, mental distance, cognitive and emotional impairment). Results: In the analysis including all 23 items the fit to the Rasch model was not obtained. Items within each subscale clustered together in a residual correlation matrix in a pattern consistent with the underlying conceptualization of the BAT, indicating multidimensionality. The Rasch analysis was re-run using the four testlets as input variables which resulted in a good fit. The median burnout level was 2.0 (Q1 = 1.6, Q3 = 2.4). The four subscales differentiated the picture (elevated levels on exhaustion and low levels on the other three subscales). Conclusions: The construct validity of the BAT for use in the context of Swedish midwives was confirmed. The results indicated a strong general factor, meaning that the responses can be combined into a single burnout score. The scale works invariantly for different age groups. The results of this study secure access to a validated instrument to be used for accurate assessment of the burnout levels among midwives in Sweden.
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  • Hansson, Malin, 1975, et al. (författare)
  • Job satisfaction in midwives and its association with organisational and psychosocial factors at work : a nation-wide, cross-sectional study
  • 2022
  • Ingår i: BMC Health Services Research. - London : Springer Science and Business Media LLC. - 1472-6963. ; 22:1, s. 1-10
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundMidwives report a challenging work environment globally, with high levels of burnout, insufficient work resources and low job satisfaction. The primary objective of this study was to identify factors in the organisational and psychosocial work environment associated with midwives’ job satisfaction. A secondary objective was to identify differences in how midwives assess the organisational and psychosocial work environment compared to Swedish benchmarks.MethodsThis nation-wide, cross-sectional web survey study analysed midwives’ assessment of their organisational and psychosocial work environment using the COPSOQ III instrument. A multivariable, bi-directional, stepwise linear regression was used to identify association with job satisfaction (N = 1747, 99.6% women). A conventional minimal important score difference (MID ± 5 as a noticeable difference with clinical importance) were used to compare midwives’ results with Swedish benchmarks.ResultsA multivariable regression model with 13 scales explained the variance in job satisfaction (R2 = .65). Five scales, possibilities for development, quality of work, role conflict, burnout and recognition, explained most of the variance in midwives’ job satisfaction (R2 = .63) and had β values ranging from .23 to .10. Midwives had adverse MID compared to Swedish benchmarks with higher difference in mean values regarding quantitative demands (8.3), work pace (6.0) emotional demand (20.6), role conflicts (7.9) and burnout (8.3). In addition, lower organisational justice (-6.4), self-rated health (-8.8), influence (-13.2) and recognition at work (-5.8). However, variation and meaning of work showed a beneficial difference in mean values with 7.9 and 13.7 respectively.ConclusionsMidwives reported high levels of meaningfulness in their work, and meaningfulness was associated with job satisfaction. However, midwives also reported adversely high demands and a lack of influence and recognition at work and in addition, high role conflict and burnout compared to Swedish benchmarks. The lack of organisational resources are modifiable factors that can be taken into account when structural changes are made regarding organisation of care, management and resource allocation. Midwives are necessary to a high quality sexual, reproductive and perinatal health care. Future studies are needed to investigate if job satisfaction can be improved through professional recognition and development, and if this can reduce turnover in midwives.
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11.
  • Hansson, Malin, 1975, et al. (författare)
  • Professional courage to create a pathway within midwives’ fields of work : a grounded theory study
  • 2021
  • Ingår i: BMC Health Services Research. - London : Springer Science and Business Media LLC. - 1472-6963. ; 21:1
  • Tidskriftsartikel (refereegranskat)abstract
    • The theory of salutogenesis focuses on resources for health and health-promoting processes. In the context of midwives’ work, this is not well described despite the importance for occupational health and the intention to remain in the profession. In order to promote a healthy workplace, it is necessary to consider the facilitating conditions that contribute to a sustainable working life. Therefore, the aim of this study was to explore health-promoting facilitative conditions in the work situation on labour wards according to midwives.
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  • Hansson, Malin, 1975, et al. (författare)
  • Professional courage to create a pathway within midwives’ fields of work
  • 2022
  • Ingår i: https://njfcongress.fi/abstracts-and-posters.
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Background: The theory of salutogenesis focuses on resources for health and health-promoting processes. In the context of midwives’ work, this is not well described despite the importance for occupational health and the intention to remain in the profession. In order to promote a healthy workplace, it is necessary to consider the facilitating conditions that contribute to a sustainable working life. Aim: To explore health-promoting facilitative conditions in the work situation on labour wards according to midwives. Methods: Face-to-face interviews with midwives constituted the empirical material in this classical grounded theory study. Results: The substantive theory of Professional courage to create a pathway within midwives’ fields of work emerged as an explanation of the health-promoting facilitative conditions in midwives’ work situation. The theory consists of a four-stage process with prerequisite contextual conditions: visualising midwifery, organisational resources and a reflective and learning environment, that were needed to fulfil the midwives’ main concern a Feasibility of working as a midwife. This meant being able to work according to best-known midwifery theory and practice in each situation. Positive consequences of a fulfilled main concern were a professional identity and grounded knowledge that enabled the development of the resistant resource professional courage. The courage made it feasible for midwives to move freely on their pathway within the different fields of work extending between normal and medicalised birth and being autonomous and regulated. Conclusions: Professional courage could be seen as a resistance resource, enabling midwives to become resilient when dealing with the unpredictable work situation. The theory can be used to foster health-promoting and sustainable work environments for midwives, which is possible if the organisational preconditions are met, visualising midwifery, having organisational resources and a reflective and learning environment. This could be a key factor in retaining midwives in the profession.
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  • Hansson, Malin, 1975, et al. (författare)
  • Work situation and professional role for midwives at a labour ward pre and post implementation of a midwifery model of care - A mixed method study
  • 2020
  • Ingår i: International journal of qualitative studies on health and well-being. - : Informa UK Limited. - 1748-2631. ; 15:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: To explore and analyse the experience of work situation and professional role for midwives at a labour ward pre and post the implementation of a midwifery model of care (MiMo). Methods: A simultaneous mixed method was used. The qualitative core component departed from three focus group interviews (n=16 midwives). Secondary inductive and deductive content analysis was performed using an unconstrained matrix to make a corresponding comparison of the different time points. The supplemental component was a quantitative survey about the work situation (n=58). Results: The qualitative results pre the implementation showed three categories: Balance between Women and Organization, Midwives-Diverse as both Profession and Person, and Strained Work Situation. Post the intervention they transformed to Balance between Midwifery and Organization, Midwives-An Adaptable Profession, Strained Work Situation, and a new category Ability to concretize midwifery was found. There were no significant differences in the measures of work situation in the quantitative analyses. Conclusions: The synthesized findings based on the qualitative part show that MiMo has a potential to strengthen the professional role and midwifery practice. As such, MiMo has the capability to offer benefits to the labour wards with additional considerations.
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14.
  • Hansson, Malin, 1975, et al. (författare)
  • Work situation and professional role for midwives at a labour ward, pre and post the introduction of a midwifery model of care.
  • 2019
  • Ingår i: NJF Congress Reykjavik 2019.
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Background: The work situation for midwives in different countries is related to high levels of stress, burnout and heavy work load. One aspect of the professional role of midwives is woman-centeredness, theoretically described in midwifery models of care. However, no studies are found about the outcome for midwives work related to midwifery models of care. Therefore, the aim of this study was to explore and analyse the experience of work situation and professional role for midwives at a labour ward, pre and post the introduction of a midwifery model of care (MiMo). Methods: A simultaneous qualitative and quantitative mixed method approach was used in this longitudinal study. The core component comprised of a qualitative inductive secondary content analysis of three focus group interviews with 16 midwives exploring how midwives experienced and described their work situation and professional role pre and post implementation of MiMo. The supplemental component were a quantitative survey analysis of the work situation for midwives (n=58) pre and post the intervention, and the deductive analysis was driven by the qualitative result. Findings: The qualitative core component consisted of the concepts Balance between Women and Organisation, Midwives - Diverse as both Profession and Person and Strained Work Situation pre intervention. Post intervention Balance between Midwifery and Organisation, Midwives - An Adaptable Profession, Strained Work Situation and lastly a new category Ability to concretise midwifery emerged. The quantitative items that had corresponding measures connected to the qualitative categories were analysed. There were no significant differences in any of the quantitative analyses pre and post the introduction of MiMo. Conclusion: Working according to MiMo appears not to have any effect on the strained work situation in midwives, in the context and with the measurements studied here. Although MiMo contributed to raise awareness of the professional role.
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  • Östlund, Gunnel, 1956-, et al. (författare)
  • "It was really nice to have someone : Lay people with musculoskeletal disorders request supportive relationships in rehabilitation.
  • 2001
  • Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 29:4, s. 285-291
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims: To explore the lay person's perspective on the rehabilitation process. Methods: A total of 20 interviews were conducted with women and men who had recent or more distant experience of sickness absence,vith musculoskeletal diagnoses. Grounded theory was used, which includes an inductive approach and theoretical sampling. The interviews focused on the individuals' own stories and experiences of factors that promoted or hindered the rehabilitation process. Results: The interviewees emphasized how and by whom they had been treated rather than what type of rehabilitation programmes they had attended. They focused on the importance of Supportive relationships From the private, occupational, and health care arenas. The relationship with rehabilitation agents (professionals who implemented rehabilitation) was described as having either supportive or non-supportive qualities. Based on the interviewees' descriptions. a model was developed on the socioemotional qualities of the rehabilitation agent. The most promoting factor in the rehabilitation process was to have a professional mentor that is a rehabilitation agent who combines a supportive approach with individually chosen rehabilitation measures and goals. Conclusions: The lay person's perspective gave additional knowledge regarding rehabilitation and recovery from musculoskeletal disorders. The socioemotional qualities of the rehabilitation agents were emphasized by the interviewees and a model regarding these qualities was developed, This model needs to be tested further. A clinical implication of the present study is the need for rehabilitation agents to develop their communication skills further.
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  • Östlund, Gunnel, 1956- (författare)
  • Promoting return to work : lay experiences after sickness absence with musculoskeletal diagnoses
  • 2002
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Introduction: Musculoskeletal disorders constitute the greatest cause of sickness absence from work. Despite research and efforts at rehabilitation, sickness absence due to these disorders has not decreased, but has instead increased, particularly in women. Clients’ perceptions of care and rehabilitation, i.e. knowledge generated from a lay perspective, is a neglected area of research. This thesis deals with lay experiences of rehabilitation following sickness absence due to back, neck or shoulder problems, termed musculoskeletal disorders (MSD).Aim: The overall aim was to examine hindering and promoting processes in rehabilitation after sickness absence due to MSD from a lay perspective. Specific aims were to study how lay persons experience rehabilitation agents and rehabilitation activities (paper I), how they describe themselves and their experience in relation to work (paper II), the significance of the private arena regarding return to work (paper III), and how clients who have experienced sickness absence due to MSD perceive contact with rehabilitation agents (paper IV).Method: The study population in the four papers is part of a cohort of persons living in the same municipality and who in 1985 were aged 25-34 years and were sick-listed due to back, neck or shoulder diagnoses for 28 days or  more, n=213. During 1995, 148 persons in the cohort responded to a questionnaire, and in 1997-1998, 20 of these persons were interviewed concerning their experiences with rehabilitation. In papers I, II and III the qualitative method of Grounded Theory was used with a focus on creating an empirically-based theory concerning the area under study. Data collection was strategic and analysis of the tape-recorded interviews was done on a continual basis. How previously sick-listed persons experienced contact with professional rehabilitation agents in t he health care sector and social insurance office was investigated in paper IV. Factor analysis and multiple regression analysis were used to analyse the data in this study.Results: The interview study shed light on lay persons’ experiences with medical, social and work-related measures in rehabilitation, their perceptions of rehabilitation actors and family members in relation to rehabilitation, and their self-presentations. The descriptions of lay persons concerned three arenas, the health care arena, the occupational arena, and the private arena. Dilemmas and difficulties in these arenas were described, such as handling the duty to work, experiencing domestic strain, and the experience of lacking socioemotional support from significant persons during the rehabilitation process. In paper I some ideal types of rehabilitation agents emerged from the interviewees’ descriptions concerning the health care arena, and we called these the routine bureaucrat, the empathic administrator, the distant technician, and the professional mentor. The latter agent was requested and was described as a person who could provide socioemotional support, who had professional competence, and who could function as a unifying link during the rehabilitation process. The results from paper II showed that in their self-presentations, the interviewees expressed having a duty to work and that there were differences in how they handled this sense of duty. The selfpresentations contained descriptions of work as a part of personal identity and could be summarised in the following ideal types: the work manic, the workhorse, the workaholic and the relaxed worker. The latter used a strategy that can be considered to promote rehabilitation in that the individual himself/herself had control over his/her work and worked in accordance with his/her own needs rather than those of others. Paper III focused on the private arena. Different patterns were found in the experiences of men and women. Women related that their responsibility for the home and domestic work seldom left any time for themselves, including any time for rehabilitation. Men more often reported having time for themselves that could be used for leisure activities and rehabilitation. Some of the women said that they lacked socioemotional support from their partner and that they had a great deal of responsibility for housework, which seemed to be a hindrance in returning to work after sickness absence. Furthermore, these women, like most of the men, had little education, which could make finding other work alternatives more difficult. Based on the interviews, a hypothesis was developed regarding domestic strain that is related to the distribution of domestic work, the distribution of responsibility for the home, and the quality of the marital relationship. Paper IV dealt with clients’ perceptions of contact with rehabilitation agents in health care and the social insurance office. Three latent dimensions were found in the respondents’ ratings of these contacts: supportive treatment, distant treatment, and empowering treatment. Sex, disability pension status, mental health and diagnostic group were significantly related to how these dimensionswere rated. Women perceived the treatment from both types of rehabilitation agents as more supportive than men. Contact with the social insurance offices were rated higher by persons with disability pensions than by those who had returned to work. Men rated their contact with rehabilitation agents at social insurance offices high on the dimension of distant treatment. Respondents with mental health problems rated the contact as distant for both types of rehabilitation agents, but contact with health care was also scored low on the supportive dimension. Finally, respondents with neck/shoulder diagnoses rated contact with rehabilitation agents in health care as more empowering than was done by persons with back diagnoses.Conclusions: From a lay perspective rehabilitation following sickness absence due to MSD occured in three arenas, the health care arena, the occupational arena and the private arena, where the quality of relationships both with rehabilitation agents, persons at work and in one’s private life was described as important regarding the rehabilitation process. This thesis also showed that both sex and health were important factors regarding how lay persons’ perceived contacts with rehabilitation agents during the rehabilitation process following sickness absence due to MSD.
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20.
  • Alexanderson, Kristina, et al. (författare)
  • More and better research needed on sickness absence.
  • 2004
  • Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 32:5, s. 321-3
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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  • Alexanderson, Kristina, et al. (författare)
  • Sickness absence with low-back, shoulder, or neck diagnoses: an 11-year follow-up regarding gender differences in sickness absence and disability pension.
  • 2005
  • Ingår i: Work (Reading, Mass.). - 1051-9815 .- 1875-9270. ; 25:2, s. 115-24
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: There is very little knowledge on the long-term outcomes of sickness absence. The aim was to investigate sickness absence and disability pensions over 11 years in a cohort of young persons initially long-term sick listed with back, neck, or shoulder diagnoses. METHOD: A prospective population-based cohort study of all 213 individuals in the Municipality of Linköping, Sweden, who in 1985 were aged 25-34 and had at least one new sick-leave spell > 28 days with such diagnoses. MAIN RESULTS: More women (61%) than men fulfilled the inclusion criteria. In 1996, 22% of the cohort (14% of the men, 26% of the women) had been granted disability pension; 76% of these individuals with musculoskeletal and the rest with psychiatric diagnoses. Partial disability pension was granted to 59% of the women, 17% of the men. Women were more often granted temporary disability pension than men. CONCLUSIONS: This proved to be a high-risk group for disability pension. There were large and somewhat unexpected gender differences regarding incidence and type of disability pension. It has been debated how soon physicians should be concerned about the risk of long-term disability regarding these diagnoses; at four or eight weeks of sickness absence - our results support the former, at least for women.
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23.
  • Andersson, Annika, 1981, et al. (författare)
  • Associations between leisure activities and binge drinking in adults: Findings from a Swedish newly sick-listed sample.
  • 2014
  • Ingår i: Work : A journal of Prevention, Assesment and rehabilitation. - 1051-9815 .- 1875-9270. ; 48:2, s. 143-153
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Leisure activities and drinking patterns are factors that can affect health and ability to return to work after a sick-leave. Associations between participation in leisure activities and binge drinking among sick-listed individuals have been paid little attention in the research literature. Objective: The aim of this study was to examine associations between leisure activities and binge drinking in a sample of newly sick-listed women and men. PARTICIPANTS: The study included 2,888 individuals aged 19-64 years. Methods: Cross-sectional questionnaire data from the Health Assets Project, Sweden, was used. Participation in 18 leisure activities was estimated. Binge drinking was defined as consuming alcohol at least once a month, and typically consuming five or more glasses. RESULTS: Among women aged 19-30 years who regularly went to concerts (OR 2.36) and wrote (OR 2.39) associations were found with binge drinking. Lower OR was found among women aged 31-64 who regularly went to the cinema (OR 0.43), out in the nature (OR 0.46) or participated in sports (OR 0.57). Among men, associations were found between socializing with friends and binge drinking in both age groups (OR 3.83 respectively 1.63). Among younger men who attended sporting events OR was 2.31, and among older men participating in religious communities OR was 0.28. CONCLUSIONS: This study contributes to understanding the interplay between leisure activities and health behavior. In particular, social activities in men were associated with binge drinking while the opposite was true for recreational activities in older women.
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24.
  • Andersson, Annika, 1981, et al. (författare)
  • Participation in leisure activities and binge drinking in adults – findings from a Swedish general population sample.
  • 2012
  • Ingår i: Addiction Research & Theory. - : Informa UK Limited. - 1606-6359 .- 1476-7392. ; 20:2, s. 172-182
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this cross-sectional study was to estimate the associations between participation in different leisure activities and binge drinking in Swedish adults. The study was based on a questionnaire in a general population sample (n=3567) of individuals aged 19–64 years old. Men and women were defined as binge drinkers if they reported that they had consumed alcohol at least once a month, and stated that at a typical drinking occasion they consumed five or more standard glasses (12g of alcohol). Multivariate analyses found associations between binge drinking and socializing with friends among men aged 19–30 years (odds ratio, OR 2.88), in the 31–64 years old age group (OR 1.87). Corresponding results was found in younger women (OR 2.36). A higher OR was also found for younger men who regularly attended sporting events as spectators (OR 1.83), and among respondents in the older age group who regularly played computer or video games (OR 2.11 for women and 1.61 for men). A lower OR for binge drinking was found for men who regularly participated in religious services in both age-groups. Lower prevalence of binge drinking among women was only found in the younger group among those who regularly participated in sports/athletics or other training (OR 0.51). Our findings suggest that prevention strategies could benefit from an everyday life approach, but also that different interventions should be used in relation to specific leisure activities.
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25.
  • Andersson, Christina, 1955, et al. (författare)
  • Capability to make well‑founded decisions: an interview study of people with experience of sickness absence who have common mental disorders
  • 2022
  • Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 22:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Sickness absence and rehabilitation processes can be challenging for an individual. At a time of generally reduced capacity, the individual must comprehend and navigate through several options. The aim of this study was to investigate the prerequisites for support, knowledge and information related to decision making experienced by people on sickness absence due to common mental disorders. Methods A qualitative explorative approach was used. Face-to-face interviews took place with 11 sick-listed individuals with common mental disorders. Patients were recruited from different sources in the western part of Sweden, such as primary health care centres, patient organizations and via social media. Data analysis was performed using manifest content analysis, meaning that the analysis was kept close to the original text, and on a low level of interpretation and abstraction. Results The analysis revealed three themes that described experiences of decision making during the sick leave and rehabilitation process: Ambiguous roles challenge possibilities for moving on; Uncertain knowledge base weakens self-management; and Perceived barriers and enablers for ending sick leave. Conclusions Our findings suggest that alternatives need to be found that address sickness absence and rehabilitation processes from a complex perspective. Collaboration between stakeholders as well as shared decision making should be considered when the time for return to work is discussed with sick-listed individuals. Other factors in the context of the individual must also be considered. Current knowledge on strategies to improve health/well-being while being in the sick leave process need to be elaborated, communicated and adapted to each individuals’ unique situation, including clarifying rights, obligations and opportunities during the sick-leave process.
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27.
  • Andersson, Lena, 1965, et al. (författare)
  • Bright waters, dark moods – explaining regional differences in early retirement with psychiatric disorders
  • 2002
  • Ingår i: European Journal of Public Health. ; 12:Suppl 1
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Social insurance costs have increased dramatically in Sweden and are now higher than the total costs for all health care in the country. Aim The aim of this study was to describe the regional differences in early retirement with psychiatric disorders over the last 20 years and to analyse these differences in relation to the socio demographic distribution of the population in different regions. Method The study was performed as an ecological study comparing the rates of early retirement in Sweden, in the city of Göteborg and the county of Bohuslän, both located on the Swedish west coast. The study population was all sickness insured individuals aged 16–64 years. Data on early retirement was collected from the National Social Insurance register. Population data was collected from Statistics Sweden. Diagnoses were classified according to ICD. Longitudinal data covering the last 20 years was used. Results We found that the regional differences in early retirement with psychiatric disorders were consistent over the studied years. In 1980 the proportion of early retirement with psychiatric disorders was 25% of all early retirements in the city of Göteborg to be compared with 17% in the county of Bohuslän and 15% in Sweden overall. This proportion changed over the years and was in 1998 37% in Göteborg, 25% in Bohuslän and 24% in Sweden. These data also show the large increase of early retirement with psychiatric disorders in relation to other diagnostic groups. Standard mortality ratio 1993 with Sweden as reference was 1.14 in Bohuslän and 2.55 in Göteborg. Corresponding figures for women were 1.30 and 2.29. Conclusion Regional differences remained after controlling for age and sex distribution of the population. From a preliminarily analysis it appears as the high rate in Göteborg cannot be explained as an effect of urbanity. More knowledge is needed to understand why regional differences exist.
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28.
  • Andersson, Lena, 1965, et al. (författare)
  • Can access to psychiatric health care explain regional differences in disability pension with psychiatric disorders?
  • 2007
  • Ingår i: Soc Psychiatry Psychiatr Epidemiol. - : Springer Science and Business Media LLC. - 0933-7954 .- 1433-9285. ; 42:5, s. 366-71
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Psychiatric disorders are a serious public health problem, especially as many psychiatric disorders begin early in life. Disability pension (DP) with psychiatric diagnoses has, since the mid 1990s, increased in several European countries and regional differences within countries have emerged. It is not clear whether these regional differences are associated with differences in access to psychiatric health care. AIM: The aim of this study was to investigate whether regional differences in DP with psychiatric diagnoses in Norway were associated with differences in psychiatric service provision (the number of staff employed and psychiatric beds available). METHOD: The study population consisted of individuals aged 16-67 years living in Norway (n = 4,348,410) and six southern regions. Included cases were individuals who were granted a DP with a psychiatric diagnosis between 1 January and 31 December 1990, 1995 or 2000. Mental retardation was excluded. Data on cases were collected from the National Insurance Administration and data on psychiatric health care staff and beds was collected from Specialist Health Service, Statistics Norway. Regression models were used to calculate incidence rate ratios (IRR) with 95% confidence intervals (CI) using Norway as reference. RESULTS: Staffing levels (per 10,000 inhabitants) did not differ substantially between the regions, with the exception of Oslo that had about 70% higher numbers of staff employed. In regression analyses controlling for numbers of psychiatric staff and beds, regional differences in DP remained. Both men and women in the semi rural regions Aust-Agder and Vest-Agder were significantly more likely to receive a DP with a psychiatric diagnosis, while the IRR for DP was reduced in Ostfold. Different psychiatric staff groups were associated with increased or decreased rates of DP. The adjusted IRR between number of psychiatric staff (man-years of staff per 10,000 inhabitants) and DP with psychiatric diagnoses were: 1.23 (1.18-1.29) for psychologists, 1.13 (1.04-1.23) for physicians, 1.03 (1.00-1.07) for nurses and 0.84 (0.80-0.88) for auxiliary nurses. Furthermore, increased numbers of beds were associated with DP with a psychiatric diagnosis (IRR 2.86 (2.03-4.05) for 100 beds/10,000 population). CONCLUSION: Psychiatric provision (in terms of both staff and beds) was associated with the incidence of DP with psychiatric diagnoses but regional differences in provision did not explain the regional differences in DP with a psychiatric diagnosis. Future work needs to examine whether differences in case detection and case management are associated with regional differences in DP with psychiatric diagnoses.
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29.
  • Andersson, Lena, 1965, et al. (författare)
  • Can avilability to psychiatric care explain regional differences in disability pension due to psychiatric disorders?
  • 2005
  • Ingår i: Europen Journal of Public Health.
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Background In previous studies we have found regional differences in rates of sick leave and disability pension (DP) with psychiatric diagnosis. Age and sex composition of the populations could not explain these differences. The aim of this study was to more closely study associations between availability of psychiatric health care staff and regional differences in DP due to psychiatric disorders in Norway. Methods The study base was all individuals 16-67 years in Norway (n = 2 668 827 in 2000) and six southern regions in 1990, 1995, 2000. As indicators of psychiatric health care we used numbers of psychiatrists, psychologists and psychiatric nurses/10 000 and numbers of in-patient beds, hospitalization days and numbers of discharges/10 000 in each region. A multiple linear regression model was used for the statistical analysis. Results Regional differences in disability pension with psychiatric diagnoses remained after controlling for availability to psychiatric care. In two semi rural regions the relative risk increased while it decreased in the capitol Oslo after control for availability for psychiatric care. There was an association between the frequency of DP:s and number of psychiatrists and other physicians (RR 1,49 (95%CI 1,37-1,61), psychologists (RR 1,29 (95% CI 1,23-1,36) and associated nurses (RR 0,84, 95%CI 0,80-0,88). No association was found between DP frequency and number of psychiatric nurses (RR 1,03 95% CI 1,00-1,06). Conclusions Incidence rates of DP with psychiatric diagnoses in different regions were associated with the number of psychiatric health care staff. Possible explanations to found positive associations can be an improved identification of psychiatric cases but future studies are needed regarding the role of professional psychiatric staff in vocational rehabilitation.
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30.
  • Andersson, Lena, 1965, et al. (författare)
  • Disability pension for psychiatric disorders: Regional differences in Norway 1988-2000
  • 2006
  • Ingår i: Nord J Psychiatry. ; 60:4, s. 255-62
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to describe regional differences in the incidence of disability pensions (DPs) with psychiatric diagnoses, and to determine whether these differences were related to age and/or gender. We compared the incidence rates of new DPs including all diagnoses, with DP with psychiatric diagnoses in Norwegian regions from 1988 to 2000. The population at risk was all individuals aged 16-67 in each year. Individuals already on DP were excluded. Cases were collected from the Norwegian National Insurance Administration. The results showed that the incidence rate ratio (IRR; Norway reference) for DP with psychiatric diagnoses was most elevated for men 1.41 (95% CI 1.27-1.58) and women 1.48 (95% CI 1.34-1.64) living in the most rural region. Men in the urban area had a higher IRR, 1.33 (95% CI 1.26-1.40), than urban women, 1.02 (95% CI 0.96-1.07). The incidence more than doubled in the youngest age group (16-29 years) and decreased in the oldest age group (60-67 years) between 1988 and 2000. The findings conclude that individuals living in semi-rural regions of Norway are more likely to receive a DP with a psychiatric diagnosis than those living in urban areas. Large gender differences were found in the urban area. Further research is needed to investigate the impact of the psychiatric healthcare system and access to rehabilitation on psychiatric disability.
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31.
  • Andersson, Lena, 1965, et al. (författare)
  • General Self-efficacy and Its Relationship to Self-reported Mental Illness and Barriers to Care: A General Population Study
  • 2014
  • Ingår i: Community mental health journal. - : Springer Science and Business Media LLC. - 0010-3853 .- 1573-2789. ; 50:6, s. 721-728
  • Tidskriftsartikel (refereegranskat)abstract
    • Given the prevalence of mental illness worldwide, it is important to better understand the dynamics of mental health help-seeking behavior to improve access to care. The aim of this study was to investigate if general self-efficacy (GSE) was associated with self-reported mental illness and help-seeking behavior and barriers to care in a randomized population. This study utilized a mailed questionnaire completed by 3,981 persons aged 19-64 years who resided in Western Sweden. GSE was measured and logistic regression models calculated, controlling for various sociodemographic variables. Results showed that 25 % of men and 43 % of women reported a lifetime prevalence of mental illness that they felt could have benefitted from treatment. Of those, 37 % of the men and 27 % of the women reported barriers to care. Men and women with low GSE were more likely to suffer from mental illness compared with persons high in GSE, but GSE did not enhance help-seeking behavior or perceived barriers to care. The most prevalent barriers to care for both sexes were beliefs that the illness will pass by itself, doubt whether treatment works, lack of knowledge of where to go and feelings of shame. Overall, GSE scores did not differ among those who experienced various barriers to care with the exception of two barriers only among women.
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32.
  • Andersson, Lena, 1965, et al. (författare)
  • High incidence of disability pension with a psychiatric diagnosis in western Sweden. A population-based study from 1980 to 1998
  • 2006
  • Ingår i: Work. - Amsterdam, Netherlands : IOS Press. - 1051-9815 .- 1875-9270. ; 26:4, s. 343-353
  • Tidskriftsartikel (refereegranskat)abstract
    • Regional differences in Sweden in the prevalence of disability pension with a psychiatric diagnosis are unexplained, in spite of the significant impact on the population's health, rehabilitation systems, and the health care system. The purpose of this study was to describe the pattern of disability pensions with a psychiatric diagnosis and to analyze the impact of age and gender. We examined the incidencerates in one urban and one semi-rural region and compared these to national rates. The study sample was drawn from employed persons between 16-64 years of age who, because of their sickness insurance coverage, would be eligible to access disability pensions should it be necessary. Analysis of annual incidences and standardized morbidity ratios were made for 1980, 1985, 1990, 1995, and 1998. Data ondisability pension cases were collected from the National Social Insurance registers. In the urban region we found that the proportion of men and women clearly outnumbered the national average: approximately twice the number of persons between 16-64 years of age with apsychiatric diagnosis were receiving a disability pension. In the semi-rural region there were fewer men overall on disability pensionswith psychiatric disorders, but in 1980, 1985, and 1995 women clearly outnumbered men. Access to psychiatric care, unemployment, alcohol dependence, and previous sickness absence are suggested as possible factors that might affect the rates of disability pension in different geographical settings. © 2006 IOS Press. All rights reserved.
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33.
  • Andersson, Lena, 1965, et al. (författare)
  • Regional differences in disability pensioning on the basis of psychiatric disorders in Norway
  • 2004
  • Ingår i: Acta Psychiatrica Scandinavica. ; 110:Issue 421
  • Konferensbidrag (refereegranskat)abstract
    • Objective: The incidence of disability pensions granted on the basis of a psychiatric diagnosis presents unexplained regional differences in Norway. The aim of this study was to analyse whether these differences were because of sex and age. Method: In this register-based study we compared in six Norwegian regions the incidence rates of disability pensions granted on the basis of a psychiatric diagnosis between 1988 and 2000. The population at risk comprised all individuals aged 16– 64 years in 1988 (n = 2 571 108) 1990 (n = 2 574 355), 1995 (n = 2 629 038) and 2000 (n = 2 668 827). Individuals already drawing a disability pension were excluded. Cases were those who drew a full- or part-time disability pension on the basis of a psychiatric diagnosis each year. Norway was used as the reference. Results: There were large regional differences, with one region presenting significantly increased SMR during the entire period. Among men the SMR was 1.28 (1.00–1.62 95% CI) in 1988 and 1.41 (1.14–1.71 95% CI) in 2000. Corresponding figures for women were 1.40 (1.14–1.74 95% CI) and 1.37 (1.13–1.67 95% CI). The most accentuated sex differences were found in the urban area Oslo. SMR among men was 1.17 (1.04–1.29 95% CI) in 1988 and 1.50 (1.38–1.63 95% CI) in 2000, while women presented a decreased risk in 1988, 0.87 (0.77–0.97 95% CI) and 1.16 (1.06–1.26 95% CI) in the year 2000. Conclusion: Increased risks remained after controlling for age and sex. Sex differences also varied between regions. Selection mechanisms and unemployment could be possible explanations,as could varying accessibility to the psychiatric health care system.
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34.
  • Armannsdóttir, Brynja, et al. (författare)
  • Cumulative incidence of sickness absence and disease burden among the newly sick-listed, a cross-sectional population-based study.
  • 2013
  • Ingår i: BMC public health. - : Springer Science and Business Media LLC. - 1471-2458. ; 13:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Sickness absence is a public health problem with economic consequences for individuals and society. Although sickness absence and chronic diseases are correlated, few studies exist concerning the role of chronic disease in all-cause sickness absence. The aim was to assess the cumulative incidence of sickness absence and examine the accompanying burden of chronic diseases among the sick-listed. METHODS: A cross-sectional study was performed with data from 2008. Cumulative incidence of all-cause sickness absence (>=14 days) was calculated based on all newly sick-listed individuals (N = 12,543). The newly sick-listed sample and a randomized general population sample (n = 7,984) received a questionnaire (participation rates: 54% and 50%).To assess the burden of self-reported chronic diseases, standardized incidence ratios (SIR) were calculated. RESULTS: Estimated one-year cumulative incidence was 11.3% (95% CI: 11.2--11.3), 14.0% (13.9--14.1) for women and 8.6% (8.5--8.6) for men. Gender differences were consistent across all age groups, with highest cumulative incidence among women aged 51--64 years, 18.2% (18.0--18.5). For women, the burden of chronic disease was significantly higher for nine out of twelve disease groups, corresponding numbers for men were nine out of eleven disease groups (standardized for age and socio-economic status). Neoplastic diseases had the highest SIR with 4.3 (3.4--5.2) for women and 4.2 (2.8--5.6) for men. For psychiatric and rheumatic diseases the respective SIR's were 1.7 for women and 1.8 for men. The remaining disease groups had an elevated risk of 20-60% (SIR 1.2--1.6). The risk of reporting a co-morbidity was increased for women (SIR 1.4 (95% CI 1.4--1.5)) and men (SIR 1.5 (1.4--1.7)) among the sick-listed. CONCLUSIONS: Register data was used to estimate of the cumulative incidence of sickness absence in the general population. A higher burden of chronic disease among the newly sick-listed was found. Targeting long-term health problems may be an important public health strategy for reducing sickness absence.
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35.
  • Axelsson, Malin, et al. (författare)
  • Lived experiences: a focus group pilot study within the MentALLY project of mental healthcare among European users
  • 2020
  • Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 20:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundMental healthcare is an important component in societies' response to mental health problems. Although the World Health Organization highlights availability, accessibility, acceptability and quality of healthcare as important cornerstones, many Europeans lack access to mental healthcare of high quality. Qualitative studies exploring mental healthcare from the perspective of people with lived experiences would add to previous research and knowledge by enabling in-depth understanding of mental healthcare users, which may be of significance for the development of mental healthcare. Therefore, the aim of the current study was to describe experiences of mental healthcare among adult Europeans with mental health problems.MethodIn total, 50 participants with experiences of various mental health problems were recruited for separate focus group interviews in each country. They had experiences from both the private and public sectors, and with in- and outpatient mental healthcare. The focus group interviews (N=7) were audio recorded, transcribed verbatim and analysed through thematic analysis. The analysis yielded five themes and 13 subthemes.ResultsThe theme Seeking and trying to find help contained three subthemes describing personal thresholds for seeking professional help, not knowing where to get help, and the importance of receiving help promptly. The theme Awaiting assessment and treatment contained two subthemes including feelings of being prioritized or not and feelings of being abandoned during the often-lengthy referral process. The theme Treatment: a plan with individual parts contained three subthemes consisting of demands for tailored treatment plans in combination with medications and human resources and agreement on treatment. The theme Continuous and respectful care relationship contained two subthemes describing the importance of continuous care relationships characterised by empathy and respect. The theme Suggestions for improvements contained three subthemes highlighting an urge to facilitate care contacts and to increase awareness of mental health problems and a wish to be seen as an individual with potential.ConclusionFacilitating contacts with mental healthcare, a steady contact during the referral process, tailored treatment and empathy and respect are important aspects in efforts to improve mental healthcare. Recommendations included development of collaborative practices between stakeholders in order to increase general societal awareness of mental health problems.
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36.
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37.
  • Beno, Anja, et al. (författare)
  • Self-reported changes in work situation – a cross-sectional study of patients 7 years after treatment for stress-related exhaustion
  • 2021
  • Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 21:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Exhaustion disorder (ED) is a common cause of sick leave in Sweden, and patients often have long-lasting symptoms and reduced work capacity. The aim of this study was to explore whether patients with ED had made any changes in their work situation from the period of treatment and up to 7 years later. Methods: In this cross-sectional study, patients diagnosed with ED at a specialist outpatient clinic were followed up after 7 years (n = 217). They received questionnaires at baseline covering sex, age, marital status, level of education, and symptoms of burnout, depression, and anxiety measured with the Shirom-Melamed Burnout Questionnaire and the Hospital Anxiety and Depression Scale. After 7 years, they were sent a follow-up questionnaire asking about their work situation and work-related stressors both before they fell sick and at the 7-year follow-up. There were three questions on work situation (change of workplace, change of work tasks, and change of working hours), and 155 patients responded to all three. Results: After 7 years, the majority of the patients (63%; n = 98/155) reported that they had made some kind of change at work. Women were more likely than men to report decreased working hours (p = 0.001), and work-related stressors such as conflicts at work, reorganization, deficient leadership, and general discontent with the work situation were significantly more common at baseline in the group who had made changes at work. Patients who made no changes at work experienced more work-related stress due to quantitative demands in the 7-year follow-up. Conclusion: The majority of the patients with ED made some kind of change in their work situation, and gender differences were found for changes of work tasks and working hours. Work-related stressors might be decisive for making changes at work. © 2021, The Author(s).
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38.
  • Bertilsson, Monica, et al. (författare)
  • A Prospective Study on Self-Assessed Mental Well-Being and Work Capacity as Determinants of All-Cause Sickness Absence
  • 2015
  • Ingår i: Journal of occupational rehabilitation. - : Springer Science and Business Media LLC. - 1053-0487 .- 1573-3688. ; 25:1, s. 52-64
  • Tidskriftsartikel (refereegranskat)abstract
    • Abstract Purpose The aim of the present study was to estimate whether self-assessed mental well-being and work capacity determines future sickness absence. Methods A questionnaire was sent to employed individuals (n=6140), aged 19–64 years, who were registered as sick-listed with a new sick-leave spell in 2008. The response rate was 54%. In this study we included individuals with a single sick-leave spell in 2008 (n=2502). The WHO (Ten) Well-Being Index and four dimensions of self-assessed work capacity (knowledge, mental, collaborative, physical) were used as determinants. Future sickness absence was identified through national register in 2009. Outcome was defined as no sickness benefit compensated days (no SBCD) and at least one sickness benefit compensated day (SBCD). Logistic regression analyses were used to estimate odds ratios (OR) with 95% confidence intervals (CI) for the likelihood of SBCD. Results In 2009, 28% of the women and 22% of the men had SBCD; the median was 59 and 66 benefit days, respectively. Individuals with low mental well-being had higher odds for SBCD with OR 1.29 (95% CI 1.01–1.65) in the fully adjusted model. Participants reporting low work capacity in relation to knowledge (OR 1.55, 95% CI 1.13–2.13), collaborative (OR 1.36, 95% CI 1.03–1.79) and physical (OR 1.50, 95% CI 1.22–1.86) demands at work had higher odds for SBCD after adjustments for all covariates; no relation was demonstrated with mental work capacity (OR 0.99, 95% CI 0.76–1.27). Conclusion Mental well-being and work capacity emerged as determinants of future SA. Screening in health care could facilitate early identification of persons in need of interventions to prevent future SA. Keywords Mental well-being, Self-assessed work capacity, Sickness absence, Insurance medicine
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39.
  • Bertilsson, Monica, et al. (författare)
  • Association of stigmatizing attitudes with people's opinion of depression as a valid reason for sickness absence: A Swedish vignette study
  • 2022
  • Ingår i: WORK-A JOURNAL OF PREVENTION ASSESSMENT & REHABILITATION. - : IOS Press. - 1051-9815. ; 73:2, s. 495-504
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Depression is a common cause of sickness absence (SA) and also highly associated with stigma. Few studies have addressed the role of stigma in relation to SA. OBJECTIVE: To investigate if attitudes to depression were associated with the public's opinion of depression as a valid reason of SA. METHODS: The study population (n = 2413) originated from a web-based panel of citizens. The survey included a short vignette describing a person with symptoms of depression and the person's work tasks, followed by a question on recommendation of SA. Negative attitudes were measured by the Depression Stigma Scale. Logistic regressions were used to estimate the odds ratios (OR) for the likelihood of not recommending SA, controlling for individual and work-related co-variates. RESULTS: The crude association between negative attitudes and not recommending SA was OR 2.15 (95% CI, 1.76-2.62). In the fully adjusted model the OR was 1.76 (95% CI, 1.40 - 2.21) for not recommending SA. CONCLUSIONS: Participants with negative attitudes to depression were more likely to not consider depression as a valid reason of sickness absence. The study supports theories on layered stigma; attitudes from one arena are related to other arenas. Future studies are needed to confirm our findings.
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40.
  • Bertilsson, Monica, et al. (författare)
  • ”Det är den här rädslan att man ska få en stämpel på sig” - om stigmatisering i sjukskrivnings- och rehabiliteringsprocessen med fokus på vanliga psykiska sjukdomar.
  • 2019
  • Ingår i: Socialmedicinsk Tidskrift. - 0037-833X. ; 96:5, s. 702-715
  • Tidskriftsartikel (refereegranskat)abstract
    • Det är väl känt att vanliga psykiska sjukdomar som till exempel depression och ångest omges av stigmatisering och negativa attityder, både i samhället och på arbetsplatser. Vi vet mindre när det gäller om och hur stigmatisering och negativa attityder påverkar i sjukskrivnings- och rehabiliteringsprocessen. Flera litteraturöversikter uppmanar dock både nyckelpersoner och forskare att ta hänsyn till detta när det gäller vanliga psykiska sjukdomar i just sjukskrivnings- och rehabiliteringsprocessen eftersom det kan leda till hinder, till exempel vid arbetsanpassning eller återgång i arbete. Baserat i litteratur och forskning, beskriver denna artikel översiktligt området stigmatisering och vanliga psykiska sjukdomar avgränsat till kontexten för sjukskrivnings- och rehabiliteringsprocessen.
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41.
  • Bertilsson, Monica, et al. (författare)
  • Health care professionals´ experience-based understanding of individuals´ capacity to work while depressed and anxious
  • 2015
  • Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 22:2, s. 126-136
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim. The meaning of capacity to work while depressed and anxious is not well comprehended. The aim of this study was to explore and describe health care professionals’ experience-based understanding of capacity to work in individuals with depression and/or anxiety disorders. Method. An exploratory qualitative design was used. Four focus groups were conducted with 21 professionals from psychiatric, occupational, and primary health care. Data were analysed using inductive content analysis. Results. Capacity to work while depressed and anxious was understood as a change from the familiar to a no longer recognizable performance at work. Managing time, daily work demands, and emotions was described as difficult for the patients, and capacity to work could be fragmented by anxiety attacks. Patients were perceived as continuing to work while life outside work crumbled. Capacity to work was described as part of a greater whole, the work community, and the patient’s participation in the work community was considered problematic. Conclusions. The findings provide a deeper understanding of the reduced capacity to work compared with theoretical or medico-administrative descriptions. Applied to patient encounters it could promote fitness-for-work dialogues, rehabilitation, and tailor-made work interventions.
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42.
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43.
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44.
  • Bertilsson, Monica, et al. (författare)
  • The capacity to work puzzle: a qualitative study of physicians' assessments for patients with common mental disorders
  • 2018
  • Ingår i: Bmc Family Practice. - : Springer Science and Business Media LLC. - 1471-2296. ; 19
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Entitlement to sickness benefits is a legal process requiring health-related reduced work capacity confirmed by a physician via a sickness certificate. However, there is a knowledge gap concerning physicians' clinical practice of work capacity assessments for patients with common mental disorders (CMD). Physicians claim more knowledge and skills in how to actually do the assessments. The aim of this study was to explore physicians' tacit knowledge of performing assessments of capacity to work and the need for sickness absence in patients with depression and anxiety disorders. Methods: We performed a qualitative study with open-ended interviews and a short video vignette of a physician and a patient with depression as stimuli. Participating physicians (n = 24) were specialized in general practice, occupational health or psychiatry and experienced in treating patients with depression and anxiety. Interviews were audio-recorded and transcribed verbatim. Inductive content analysis was used as the analytical tool. Results: Five categories were identified. Category 1 identified work capacity assessment as doing a jigsaw puzzle without any master model. The physicians both identified and created the pieces of the puzzle, mainly by facilitating strategies to make the patient a better supplier of essential information. The finished puzzle made up a highly individualized comprehensive picture required for adequate assessment. Categories 2-4 identified the particular essential pieces of information the participants used, relating to the patient's disorder, capacity in the work place and contextual everyday life. For the sickness absence assessment, apart from decreased work capacity, the physicians also took particulars of the work place into account; e.g. could the work place handle an employee with reduced capacity. Conclusions: Physicians' tacit knowledge of assessing work capacity and the need for sickness absence for patients with CMD was identified as doing a jigsaw puzzle. The physicians became identifiers and creators of the pieces of the puzzle using a broad palette of essential information. Our findings contribute to the knowledge gap on clinical assessment and can be used as an educational tool. Because they are based on the professions' tacit knowledge, acceptance of the model can be expected to be high.
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45.
  • Björkelund, Cecilia, 1948, et al. (författare)
  • Effects of adding early cooperation and a work-place dialogue meeting to primary care management for sick-listed patients with stress-related disorders: CO-WORK-CARE-Stress - a pragmatic cluster randomised controlled trial.
  • 2024
  • Ingår i: Scandinavian journal of primary health care. - 1502-7724. ; , s. 1-15
  • Tidskriftsartikel (refereegranskat)abstract
    • To investigate whether intensified cooperation between general practitioner (GP), care manager and rehabilitation coordinator (RC) for patients sick-listed for stress-related mental disorder, combined with a person-centred dialogue meeting with employer, could reduce sick-leave days compared with usual care manager contact.Pragmatic cluster-randomised controlled trial, randomisation at primary care centre (PCC) level.PCCs in Region Västra Götaland, Sweden, with care manager organisation.Of 30 invited PCCs, 28 (93%) accepted the invitation and recruited 258 patients newly sick-listed due to stress-related mental disorder (n=142 intervention, n=116 control PCCs).Cooperation between GP, care manager and rehabilitation coordinator from start of illness notification plus a person-centred dialogue meeting between patient and employer within 3months. Regular contact with care manager was continued at the control PCCs.12-months net and gross number of sick-leave days. Secondary outcomes: Symptoms of stress, depression, anxiety; work ability and health related quality of life (EQ-5D) over 12months.There were no significant differences between intervention and control groups after 12months: days on sick-leave (12-months net sick-leave days, intervention, mean = 110.7days (95% confidence interval (CI) 82.6-138.8); control, mean = 99.1days (95% CI 73.9-124.3)), stress, depression, or anxiety symptoms, work ability or EQ-5D. There were no significant differences between intervention and control groups concerning proportion on sick-leave after 3, 6, 12months. At 3months 64.8% were on sick-leave in intervention group vs 54.3% in control group; 6months 38% vs 32.8%, and12 months 16.9% vs 15.5%.Increased cooperation at the PCC between GP, care manager and RC for stress-related mental disorder coupled with an early workplace contact in the form of a person-centred dialogue meeting does not reduce days of sick-leave or speed up rehabilitation.Trial registration: ClinicalTrials.gov Identifier: NCT03250026 https://clinicaltrials.gov/study/NCT03250026?tab=results#publicationsCO-WORK-CAREFirst Posted: August 15, 2017. Recruitment of PCCs: September 2017. Inclusion of patients from December 2017.
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46.
  • Björkelund, Cecilia, 1948, et al. (författare)
  • Rehabilitation cooperation and person-centred dialogue meeting for patients sick-listed for common mental disorders: 12 months follow-up of sick leave days, symptoms of depression, anxiety, stress and work ability - a pragmatic cluster randomised controlled trial from the CO-WORK-CARE project.
  • 2023
  • Ingår i: BMJ open. - 2044-6055. ; 13:6
  • Tidskriftsartikel (refereegranskat)abstract
    • To study whether early and enhanced cooperation within the primary care centres (PCC) combined with workplace cooperation via a person-centred employer dialogue meeting can reduce days on sick leave compared with usual care manager contact for patients on sick leave because of common mental disorders (CMD). Secondary aim: to study lapse of CMD symptoms, perceived Work Ability Index (WAI) and quality of life (QoL) during 12 months.Pragmatic cluster randomised controlled trial, randomisation at PCC level.28 PCCs in Region Västra Götaland, Sweden, with care manager organisation.30 PCCs were invited, 28 (93%) accepted invitation (14 intervention, 14 control) and recruited 341 patients newly sick-listed because of CMD (n=185 at intervention, n=156 at control PCCs).Complex intervention consisting of (1) early cooperation among general practitioner (GP), care manager and a rehabilitation coordinator, plus (2) a person-centred dialogue meeting between patient and employer within 3 months.regular contact with care manager.12 months net and gross number of sick leave days at group level.12 months depression, anxiety, stress symptoms, perceived WAI and QoL (EuroQoL-5 Dimensional, EQ-5D).No significant differences were found between intervention and control groups concerning days of sick leave (intervention net days of sick leave mean 102.48 (SE 13.76) vs control 96.29 (SE 12.38) p=0.73), return to work (HR 0.881, 95%CI 0.688 to 1.128), or CMD symptoms, WAI or EQ-5D after 12 months.It is not possible to speed up CMD patients' return to work or to reduce sick leave time by early and enhanced coordination among GP, care manager and a rehabilitation coordinator, combined with early workplace contact over and above what 'usual' care manager contact during 3 months provides.NCT03250026.
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47.
  • Blanck, Per, 1953, et al. (författare)
  • "We do what we think is the best" - a content analysis of experiences of alcohol problem prevention in sweden. A short report.
  • 2007
  • Ingår i: Substance use & misuse. - : Informa UK Limited. - 1082-6084 .- 1532-2491. ; 42:12, s. 2073-83
  • Tidskriftsartikel (refereegranskat)abstract
    • This short report describes an ongoing project whose aim was to explore how respondents from local institutions in a Swedish municipality describe their efforts in preventing alcohol consumption and related problems. Data were collected in focus group interviews, conducted during 2003 with key informants, comprising middle-ranking civil servants from different administrative sectors such as school, social welfare, and the public health office, in four Swedish municipalities: one city district, one town, and two small municipalities. We identified low knowledge of evidence-based methods for prevention of alcohol consumption-related problems and a lack of consistent focus on strategies known to be effective. The main target group for preventive efforts was identified as young people and the most common setting mentioned was the schools. Further, the key informants appeared to regard a wide range of activities as being community* alcohol and drug use prevention. Generally these activities also lacked specification. Increased knowledge of alcohol and drug use prevention methods that are effective at the local level is needed within Swedish municipalities, as is greater understanding of how to implement those methods.
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48.
  • Blom, Sara, et al. (författare)
  • How gender and low mental health literacy are related to unmet need for mental healthcare: a cross-sectional population-based study in Sweden
  • 2024
  • Ingår i: ARCHIVES OF PUBLIC HEALTH. - 0778-7367 .- 2049-3258. ; 82:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundMen are more likely to have unmet need for mental healthcare than women. However, an under-investigated aspect of the gender difference is the role of mental health literacy. This study investigated how combinations of gender and mental health literacy were related to two indicators of unmet need: not perceiving a need for mental healthcare despite poor mental health, and refraining from seeking mental healthcare.MethodsThis cross-sectional study was based on a questionnaire sent to a general population sample, aged 16-84 years, in Stockholm County, Sweden, in 2019. Of the 1863 respondents (38%), 1563 were included (>= 18 years). The sample was stratified into four groups, men and women with low or high mental health literacy, using the third quartile of the Mental Health Knowledge Schedule. The likelihood of not perceiving a need for mental healthcare and refraining from seeking mental healthcare, at any time in life, were investigated by calculating odds ratios with 95% confidence intervals.ResultsMen with low mental health literacy were most likely to not perceive a need for mental healthcare, also when adjusting for age, education, and poor mental health (OR 5.3, 95% CI 3.6-7.7), and to refrain from seeking mental healthcare, also when adjusting for age and education (OR 3.3, 95% CI 1.7-6.4), followed by men with high mental health literacy (OR 1.9, 95% CI 1.5-2.4, and OR 1.5, 95% CI 1.0-2.2) and women with low mental health literacy (OR 1.9, 95% CI 1.2-2.9, and OR 2.1, 95% CI 1.1-3.9). Women with high mental health literacy were least likely (reference group).ConclusionThe results show differences in the likelihood of unmet need for mental healthcare based on combinations of gender and mental health literacy level, with men having low mental health literacy being most at risk, and women with high mental health literacy being least at risk. This challenges generalisations of a gender difference in unmet need by showing heterogeneity among men and women based on mental health literacy. Men with low mental health literacy may be particularly in need of targeted interventions to reduce potential individual and societal consequences of their unmet need.
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49.
  • Blomberg, Agneta, et al. (författare)
  • Chefens perspektiv: en saknad pusselbit. En webbaserad enkät om svenska chefers kunskap, erfarenheter och strategier för medarbetare med nedsatt arbetsförmåga på grund av depression och ångest.
  • 2020
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Psykisk ohälsa är det främsta skälet till sjukfrånvaro i Sverige, sjukskrivningar i psykiatriska diagnoser blir också längre jämfört med andra diagnoser och risken för återfall i sjukskrivning är dessutom högre. Perioden innan sjukrivning präglas ofta av en successivt försämrad arbetskapacitet, från att kunna arbeta utan hinder till en känsla av dissonans i förhållande till både arbetsuppgifter och arbetsplats. Preventiva insatser på arbetsplatsen erbjuder möjligheter att förebygga sjukskrivningar och kan eventuellt även bidra till att tidiga besvär inte utvecklas till full sjukdom. Arbetsgivaren har det övergripande ansvaret att ge chefer och arbetsledare förutsättningar att leda det förebyggande arbetet. I och med en ökad kunskap om vilka risk- och skyddsfaktorer som påverkar den psykiska ohälsan är arbetsplatsen en viktig arena för att kunna hantera orsaker till vanlig psykisk sjukdom. Syftet med studien är att undersöka svenska chefers kunskap, erfarenheter och strategier i relation till medarbetare med depressions- och ångestsjukdom. Studien är utformad som en tvärsnittsstudie där datainsamlingen gjordes i form av en webb-enkät. Totalt tillfrågades 5556 personer att delta i studien. Deltagarna rekryterades från Medborgarpanelen hos Laboratory of Opinion Research (LORE) vid Göteborgs universitet och via samarbetspartners till Helix HELIX Competence Centre vid Linköpings Universitet. Efter en kontrollfråga som säkerställde att deltagaren var chef/arbetsledare minskade urvalsramen till 4737 personer och av dessa svarade 3358 personer på enkäten (71 %). Av deltagarna kommer 42 % från offentlig sektor och 58 % från privat sektor och representerar många olika branscher där vård och omsorg, utbildning, IT och tillverknings-industrin är de största. Hälften kommer från företag med mindre än 250 anställda och hälften kommer från större företag/organisationer. En tredjedel är kvinnor och två tredjedelar män. Deltagarna har lång erfarenhet som chef och hälften har varit chef mer än 10 år. Resultatet visar att 64 % av cheferna har erfarenhet av en eller flera medarbetare med depressions- och/eller ångestsjukdom under de senaste två åren. Av dessa uppger 61 % att de fått kännedom genom att medarbetaren själv berättade, resterande svarar att de fått kännedom om medarbetarens sjukdomsbesvär via andra. Vi frågade cheferna om de aktivt uppmanat medarbetare till sjukskrivning på grund av ångest- och depressionssjukdom, vilket 42 % av cheferna hade gjort. I första hand motiverade cheferna sjukskrivning med att medarbetaren behöver tid för återhämtning, och i andra hand för att en sjukskrivning ger möjlighet till läkarkontakt och behandling. Först i tredje hand motiverades sjukskrivningen med nedsatt arbetsförmåga. Vi frågade cheferna hur de uppfattade att sjukdomsbesvären påverkar medarbetarens arbetsförmåga. En majoritet av cheferna rapporterar att medarbetaren har ganska mycket svårare eller mycket svårare att prioritera bland arbetsuppgifter (79 %), att kunna koncentrera sig (77 %) och att upprätthålla arbetstempot (73 %). Av de totalt 1819 chefer som uppger att de har erfarenhet av en eller flera medarbetare med depressions- och ångestbesvär svarade 1777 chefer på frågor om vilka arbetsanpassningar de använder sig av för att stödja sina medarbetare. En stor andel av cheferna svarar att de arbetsanpassar genom att de själva erbjuder mer stöd eller handledning (88 %). Arbetsplatser kan bedriva ett förebyggande arbete för att förhindra uppkomst av psykisk ohälsa. Den vanligaste åtgärden är att erbjuda friskvård (87 %), 49 % erbjuder stressrådgivning och 42 % erbjuder utbildning om stress i arbetslivet, men endast 14 % erbjuder sina medarbetare riktad utbildning om depressions- och ångestsjukdom i arbetslivet. Ett av instrumenten i webb-enkäten undersöker chefers attityder till depression. En majoritet av deltagarna ser inte medicinering som ett hinder för att arbeta. Nästan hälften av deltagarna ger uttryck för att det är svårt med medarbetare med depression och cirka 40 % upplever det som stressande. Vi ser också att en tredjedel av cheferna skulle avstå från att anställa en person som de visste hade haft en depressions- eller ångestsjukdom. Denna studie är idag den största studien i sitt slag både nationellt och internationellt och ger en första inblick i chefers kunskap och strategier när det gäller medarbetare med depressions- och ångestsjukdom.
  •  
50.
  • Borg, Karin, et al. (författare)
  • Prediction of future low levels of sickness absence among young persons sick listed with back, neck, or shoulder diagnoses.
  • 2004
  • Ingår i: Work (Reading, Mass.). - 1051-9815 .- 1875-9270. ; 23:2, s. 159-67
  • Tidskriftsartikel (refereegranskat)abstract
    • In recent years sickness absence has increased in most Western countries. Risk factors for sickness absence and disability pension have been emphasised in studies, while focus on factors predicting low sickness absence is very rare. This paper is an attempt to apply such a perspective in an 11-year prospective cohort study of young persons n = 213) who in 1985 were sick listed > or = 28 days with back, neck, or shoulder diagnoses. Having had no sick-leave spells > 14 days in 1992-1996 was used as the outcome measure. Sixty-nine persons (34%) had no such spells, with an unexpected similar proportion of men and women. Data on prior sick leave and demographic variables were analysed using univariate and multiple logistic regression. Factors that predicted low sickness absence were having prior low sickness absence, being a white-collar worker, and being married. We concluded that individuals with a history of low sickness absence have an increased odds for remaining in the work force after a single long sick-leave spell, and might need less attention in rehabilitation compared to persons with a history of high sickness absence. Focusing on low sickness absence led to different results than those discussed in previous studies on risk factors for disability pension.
  •  
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