| 1. |
- Alexanderson, Kristina, et al.
(författare)
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Rehabkoordinatorer inom psykiatrin:erfarenheter från läkare : Resultat från Region Stockholm
- 2021
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I denna rapport presenteras resultat från två enkäter som skickades till läkare verksamma inom psykiatrin i Stockholms län år 2018 respektive år 2020. Enkäterna innehöll frågor om läkares arbete med sjukskrivningar. Syftet var att få kunskap om läkares erfarenheter av arbete med sjukskrivning av patienter inom psykiatrin och om detta förändrades när den nya funktionen rehabiliteringskoordination(1-3) infördes vid psykiatriska enheter. Enkäterna baserades på enkäter använda i tidigare studier(4, 5).
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| 2. |
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| 3. |
- Berglund, Erik, et al.
(författare)
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Coordination and Perceived Support for Return to Work : A Cross-Sectional Study among Patients in Swedish Healthcare
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:7
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Tidskriftsartikel (refereegranskat)abstract
- Background: Receiving support from a return-to-work (RTW) coordinator (RTWC) may be beneficial for people on long-term sick leave. The aim of this study was to investigate whether the number of contacts with an RTWC and their involvement in designing rehabilitation plans for the patients were associated with perceiving support for RTW, emotional response to the RTWC, and healthcare utilization. Methods: In this cross-sectional study, 274 patients who had recently been in contact with an RTWC in Swedish primary or psychiatric care answered questions regarding their interaction with an RTWC, perceived support for RTW, and emotional response to the RTWC. Results: Having more contact with an RTWC was associated with perceiving more support in the RTW process (adjusted OR 4.14, 95% CI 1.49-11.47). RTWC involvement in designing a rehabilitation plan for the patient was associated with perceiving more support in the RTW process from an RTWC and having a more positive emotional response to the RTWC. Conclusions: From the patient's perspective, this study indicates that the involvement of an RTWC and receiving a rehabilitation plan that an RTWC has helped to design might be perceived as important in the RTW process.
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| 4. |
- Berglund, Erik, et al.
(författare)
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Physicians' experience of and collaboration with return-to-work coordinators in healthcare : a cross-sectional study in Sweden
- 2023
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Ingår i: Disability and Rehabilitation. - : Taylor & Francis. - 0963-8288 .- 1464-5165.
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Tidskriftsartikel (refereegranskat)abstract
- PurposeReturn-to-work coordinators (RTWCs) give people on sick leave individualized support and coordinate between different stakeholders, including physicians. The aim of this study was to explore physicians’ experience of RTWCs and investigate factors that influence how much physicians collaborate with RTWCs, or refer patients to them, in primary, orthopaedic, and psychiatric care clinics.Materials and methodsOf the 1229 physicians responding to a questionnaire, 629 physicians who had access to a RTWC in their clinic answered to questions about collaborating with RTWCs.ResultsAmong physicians who had access to a RTWC, 29.0% collaborated with a RTWC at least once a week. Physicians with a more favourable experience of RTWCs reported more frequent collaboration (adjusted OR 2.92, 95% CI 2.06–4.15). Physicians also collaborated more often with RTWCs if they reported to often deal with problematic sick-leave cases, patients with multiple diagnoses affecting work ability, and conflicts with patients over sickness certification.ConclusionsPhysicians who had more problematic sick-leave cases to handle and a favourable experience of RTWCs, also reported collaborating more often with RTWCs. The results indicate that RTWCs’ facilitation of contacts with RTW stakeholders and improvements in the sickness certification process may be of importance for physicians.Implications for RehabilitationThis study of physicians’ experience of collaborating with return-to-work coordinators (RTWCs) observes that physicians reported more collaboration with or referrals to coordinators if they had a favourable experience of coordinators.The results indicate that physicians report more collaboration with or referrals to RTWCs if they had more problematic sick-leave cases to handle in the clinic.These findings imply that it might be possible to increase the collaboration between physicians and RTWCs in clinical settings by managing factors of importance.
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| 5. |
- Bergsten, Eva L., 1969-, et al.
(författare)
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Fall and collision related injuries among pedestrians, sickness absence and associations with accident type and occupation
- 2023
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Ingår i: Journal of Safety Research. - : Elsevier. - 0022-4375 .- 1879-1247. ; 86, s. 357-363
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: This study explores pedestrian fall accidents and collisions with other road users in the Swedish road transport system, and sickness absence (SA) in relation to accident type, injury, and occupation. Further, it studies the associations between accident type, occupation, and duration of SA. Methods: Data from several national registers were used that included 15,359 working age pedestrians (20–64 years) receiving healthcare after a fall or collision throughout 2014–2016. Individual characteristics, accident type, injury, and occupation were presented and related to SA. Logistic regression was used to estimate odds ratios (OR), with 95% confidence intervals, for associations between accident type, occupation, and SA duration. Results: About 11,000 pedestrians (72%) were involved in fall accidents in the road traffic environment and well over 4,000 in collisions with another road user; 22% of all injured pedestrians had a new SA. The population had a higher proportion of women and individuals in older age groups (≥45). Of the falls, 31% were due to snow or ice, and these were associated with a higher OR for both short SA (<90 days) 1.76 (95% CI 1.56–1.98) and long SA (≥90 days) 1.81 (95% CI 1.51–2.18), compared to the group slipping, tripping, and stumbling. The working sectors health & social care, and construction had the highest ORs for SA. A higher OR was found for health & social care, short SA 1.58 (95% CI 1.38–1.81), long SA 1.79 (95% CI 1.45–2.20) and for construction, short SA 1.56 (95% CI 1.24–1.96), long SA 1.75 (95% CI 1.26–2.44), compared to the sector finance, communication, & cultural service. Conclusions: The OR for having short and long SA was higher in falls due to snow or ice and differed between occupational sectors. Practical implications: This information contributes to the knowledge base for planning a safe road transport system for pedestrians.
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| 6. |
- Bergsten, Eva L., 1969-, et al.
(författare)
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Fall and collision related injuries among pedestrians, sickness absence and associations with accident type and occupation
- 2023
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Ingår i: Journal of Safety Research. - : Elsevier. - 0022-4375 .- 1879-1247. ; 86, s. 357-363
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: This study explores pedestrian fall accidents and collisions with other road users in the Swedish road transport system, and sickness absence (SA) in relation to accident type, injury, and occupation. Further, it studies the associations between accident type, occupation, and duration of SA.METHODS: Data from several national registers were used that included 15,359 working age pedestrians (20-64 years) receiving healthcare after a fall or collision throughout 2014-2016. Individual characteristics, accident type, injury, and occupation were presented and related to SA. Logistic regression was used to estimate odds ratios (OR), with 95% confidence intervals, for associations between accident type, occupation, and SA duration.RESULTS: About 11,000 pedestrians (72%) were involved in fall accidents in the road traffic environment and well over 4,000 in collisions with another road user; 22% of all injured pedestrians had a new SA. The population had a higher proportion of women and individuals in older age groups (≥45). Of the falls, 31% were due to snow or ice, and these were associated with a higher OR for both short SA (<90 days) 1.76 (95% CI 1.56-1.98) and long SA (≥90 days) 1.81 (95% CI 1.51-2.18), compared to the group slipping, tripping, and stumbling. The working sectors health & social care, and construction had the highest ORs for SA. A higher OR was found for health & social care, short SA 1.58 (95% CI 1.38-1.81), long SA 1.79 (95% CI 1.45-2.20) and for construction, short SA 1.56 (95% CI 1.24-1.96), long SA 1.75 (95% CI 1.26-2.44), compared to the sector finance, communication, & cultural service.CONCLUSIONS: The OR for having short and long SA was higher in falls due to snow or ice and differed between occupational sectors.PRACTICAL IMPLICATIONS: This information contributes to the knowledge base for planning a safe road transport system for pedestrians.
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| 7. |
- Dervish, Jessica, et al.
(författare)
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Disclosing or concealing multiple sclerosis in the workplace : two sides of the same coin-insights from a Swedish population-based survey
- 2024
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Ingår i: Frontiers In Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Background: People with multiple sclerosis (PwMS) face health and social challenges of living with a chronic and potentially disabling condition. To disclose or conceal MS at work may critically affect individuals' work situation, career opportunities, and health. PwMS may experience a dilemma when assessing if the possible benefits of disclosing the diagnosis outweigh the possible risks. However, concealing in the long-term may have health implications and prevent opportunities for support and work adjustments. Few studies have examined what drives PwMS to disclose or conceal MS at work and the consequences of these ways of managing MS.Objectives: To explore the reasons PwMS report for disclosing and/or concealing their MS diagnosis in the workplace, as well as the consequences they have experienced.Methods: A web-based survey of PwMS was conducted in 2021. All individuals aged 20-50 listed in the Swedish MS registry were invited to participate. The response rate was 52% and among these participants, 3,810 (86%) completed questions regarding workplace disclosure and/or concealment of MS. Free-text responses on these topics were analyzed using inductive content analysis.Results: It was common to disclose MS in the workplace (85%). Identified drivers for disclosure and concealment related to four categories: Work-related, Social, Personal and Circumstantial. Work-related drivers focused on employment or protecting one's career, and changing one's work situation versus maintaining it. Social drivers included the need for support, addressing or preventing stigma, and being considerate of others. Personal drivers were linked to moral values/personal beliefs and processing of the diagnosis. Circumstantial drivers related to involuntary or unforeseen events, timing factors, one's medical condition and external opinion/advice. Identified consequences for disclosure and concealment related to three categories: Work-life, Social, and Personal. Work-life consequences included work arrangements, and career opportunities. Social consequences were linked to MS awareness, stigma, interactions and social support, as well as dynamics of work relationships. Personal consequences involved levels of disease acceptance, and attitudes toward managing MS.Conclusion: PwMS often described the question of disclosure as challenging and navigated it with caution, as both disclosure and concealment can yield favorable and unfavorable outcomes.
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| 8. |
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| 9. |
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Insatser i vården vid långtidssjukskrivning : En systematisk översikt och utvärdering av medicinska, hälsoekonomiska och etiska aspekter
- 2023
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Rapport (refereegranskat)abstract
- SlutsatserVid psykisk och muskuloskeletal sjukdomUnimodala insatser, multimodala insatser och insatser som involverar arbetsplatskontakt eller koordinering mot arbetsplats har möjligen positiv effekt på återgång i arbete på kort sikt (upp till 12 månader) för personer sjukskrivna på grund av psykisk eller muskuloskeletal sjukdom (låg tillförlitlighet)3. Det går inte att bedöma effektens storlek.Det går inte att bedöma effekten på återgång i arbete av insatser som riktar sig till vårdgivare2.Det går inte att bedöma effekten på återgång i arbete på längre sikt för någon typ av insats.Effekterna på hälsa och funktion går inte att bedöma för någon typ av insats, varken på kort eller lång sikt4.2. Med vårdgivare avses den organisation som bedriver hälso- och sjukvård på en övergripande nivå, inte den enskilda läkaren. De insatser som studerats som riktas till vårdgivare kan förutom till vårdgivaren dock även vara riktade till behandlande personal.3. För noggrannare beskrivning av vilka populationer som slutsatsen gäller, se Tabell 1.4. Slutsatserna gäller för insatser som syftar till att underlätta återgång i arbete.Vid bröstcancerDet går inte att bedöma insatsernas effekt på återgång i arbete eller hälsa och funktion för personer sjukskrivna på grund av bröstcancer5.5. Slutsatserna gäller för insatser som syftar till att underlätta återgång i arbete och inkluderar inte medicinska insatser som har kurativt syfte.KommentarMajoriteten av de inkluderade studierna uppvisar inga statistiskt säkerställda effekter, men resultat från flera studier talar för att vissa insatser kan ha effekter som är betydelsefulla för patienter och samhälle. Det går inte att dra slutsatser om specifika insatser eller om vilka komponenter i insatserna som fungerar. Framtida forskning kan bidra med kunskap genom att replikera studier som uppvisat positiva resultat.Det är önskvärt att forskning om insatser som syftar till att främja återgång i arbete i möjligaste mån använder standardiserade mät- och analysmetoder och att forskare utvärderar ett begränsat antal prioriterade utfallsmått på ett vis som gör att dessa kan inkluderas i metaanalyser.De studier som ligger till grund för slutsatserna i denna rapport är i huvudsak genomförda i Nederländerna, Norge, Sverige och Danmark. Projektgruppen bedömer att resultatens överförbarhet till svenska förhållanden är god. Samtidigt kan arbetsmarknad, sjukförsäkringslagstiftning och hälso- och sjukvårdens organisation och arbetssätt ha betydelse för hur insatser genomförs och vilka effekter de har, och dessa faktorer kan dessutom förändras över tid.Ett krav för att en studie skulle inkluderas var att den undersökte insatsens effekt på återgång i arbete. I vissa fall har författarna även undersökt insatsens effekter på hälsa och funktion. Slutsatsen från denna rapport är att det inte går att bedöma insatsernas effekt på hälsa och funktion. Detta ska dock inte tolkas som att det är säkerställt att insatserna saknar effekt på dessa utfall, utan att det skulle behövas ytterligare, välgjorda studier för att kunna bedöma effekten. De sammanvägda resultaten ger inget stöd för att metoderna har negativa effekter, vare sig på återgång i arbete eller hälsa och funktion.Det är svårt att dra slutsatser om kostnadseffektivitet för de olika insatskategorierna som definierats i projektet. Hälsoekonomiska studier har bara identifierats för ett mindre antal av de specifika insatser som omfattas av utvärderingen, och det är oklart om dessa insatser är representativa för kategorierna som helhet. En hälsoekonomisk analys som genomförts i projektet visar att det räcker med en förhållandevis liten effekt på arbetsåtergång för att en insats ska bli kostnadsbesparande i ett samhällsekonomiskt perspektiv.I statistik över långtidssjukskrivning finns ofta könsskillnader. I de inkluderade studierna rapporterades endast undantagsvis separata resultat för kvinnor och män. De inkluderade studierna har inte redovisat effekter utifrån olika yrken eller arbetsmiljöer.Det identifierades inga studier som undersökt insatser till personer sjukskrivna på grund av bipolär sjukdom eller till följd av postinfektiöst tillstånd, inklusive postcovid.Den etiska analysen visar att insatser i vården vid långtidssjukskrivning berör etiska värden som jämlikhet, rättvisa, autonomi och integritet samt kan påverka tredje part vilket ställer höga krav på hur insatser planeras och genomförs i praktiken.
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| 10. |
- Karampampa, Korinna, et al.
(författare)
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Healthcare, Sickness Absence, and Disability Pension Cost Trajectories in the First 5 Years After Diagnosis with Multiple Sclerosis: A Prospective Register-Based Cohort Study in Sweden.
- 2020
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Ingår i: PharmacoEconomics - open. - : Springer Science and Business Media LLC. - 2509-4254 .- 2509-4262. ; 4, s. 91-103
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to longitudinally explore the healthcare, sickness absence (SA), and disability pension (DP) cost trajectories among newly diagnosed people with multiple sclerosis (MS), and investigate whether trajectories differ by year of MS diagnosis, sociodemographics, and multi-morbidity.People with MS in Sweden, aged 25-60years and with a new MS diagnosis in the years 2006, 2007, 2008, or 2009 (four different cohorts) were identified in nationwide registers and followed prospectively for 5years, determining the annual, per patient, direct (inpatient and specialised outpatient healthcare, co-payments, and dispensed drugs) and indirect (SA and DP) costs. Descriptive statistics and group-based trajectories were computed.In total, 3272 people with new MS were identified. In all cohorts, direct costs increased the year after diagnosis and thereafter declined (e.g. from €8261 to €9128, and to €7953, 5years after diagnosis, for the 2006 cohort). SA costs continuously decreased over 5years, while DP costs increased (e.g. from €9795 to €2778 vs. from €7277 to €15,989, respectively, for the 2006 cohort). When pooling all cohorts, four trajectories of direct and indirect costs were identified. A total of 32.1% of people with MS had high direct and indirect costs, which first increased and then decreased; the contrary was seen for trajectories with low direct and indirect costs.There is heterogeneity in the development of MS costs over time after diagnosis; decreasing cost trajectories could be associated with the use of innovative MS therapies, slowing disease progression over time.
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