| 1. |
- Armannsdóttir, Brynja, et al.
(författare)
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Cumulative incidence of sickness absence and disease burden among the newly sick-listed, a cross-sectional population-based study.
- 2013
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Ingår i: BMC public health. - : Springer Science and Business Media LLC. - 1471-2458. ; 13:1
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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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| 2. |
- Holmgren, Kristina, 1955, et al.
(författare)
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The prevalence of work-related stress, and its association with self-perceived health and sick-leave, in a population of employed Swedish women.
- 2009
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Ingår i: BMC public health. - : Springer Science and Business Media LLC. - 1471-2458. ; 9:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Women report more occupational ill-health and are more sick-listed than men. Exploration of women's working conditions would therefore seem to be valuable. In this study we investigated the prevalence of work-related stress and its association with self-perceived health and sick-leave in a population of employed, working Swedish women. METHODS: This cross-sectional population study comprised 424 employed, working women who answered questionnaires on work-related stress, self-perceived health and sick-leave. The odds ratio (OR) with 95% confidence interval (CI) was calculated in order to analyse the association between the exposure variables of work-related stress and outcome variables of ill-health symptoms, self-rated health and sick-leave. RESULTS: Ten percent of the group reported high perceived stress owing to indistinct organisation and conflicts, and 25% high perceived stress owing to individual demands and commitment. Twenty-two percent reported low influence at work and 33% reported work interference with leisure time. All categories of overall work-related stress were significantly associated with increased odds of high level of illness symptoms, with the highest OR for high perceived stress owing to indistinct organisation and conflicts and high perceived stress owing to individual demands and commitment with an OR of 3.17 (CI = 1.51-6.62) and 4.53 (CI = 2.71-7.56) respectively. High perceived stress owing to indistinct organisation and conflicts and low influence at work were significantly associated with sick-leave with an OR of 3.85 (CI = 1.59-9.30) and 2.54 (CI = 1.17-5.48) respectively. CONCLUSION: This study showed an association between, on the one hand, work-related stress, and on the other hand, illness symptoms and sick-leave. Distinguishing between the occurrence of negative work characteristics, and the immediate perception of stress because of these, resulted in a broad view of women's working conditions and expanded knowledge of work-related stress in women.
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| 3. |
- Löve, Jesper, 1974, et al.
(författare)
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Can work ability explain the social gradient in sickness absence: a study of a general population in Sweden.
- 2012
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Ingår i: BMC public health. - : Springer Science and Business Media LLC. - 1471-2458. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: Background: Understanding the reasons for the social gradient in sickness absence might provide an opportunity to reduce the general rates of sickness absence. The complete explanation for this social gradient still remains unclear and there is a need for studies using randomized working population samples. The main aim of the present study was to investigate if self-reported work ability could explain the association between low socioeconomic position and belonging to a sample of new cases of sick-listed employees. Methods: The two study samples consisted of a randomized working population (n = 2,763) and a sample of new cases of sick-listed employees (n = 3,044), 19-64 years old. Both samples were drawn from the same randomized general population. Socioeconomic status was measured with occupational position and physical and mental work ability was measured with two items extracted from the work ability index. Results: There was an association between lower socioeconomic status and belonging to the sick-listed sample among both women and men. In men the crude Odds ratios increased for each downwards step in socioeconomic status, OR 1.32 (95% CI 0.98-1.78), OR 1.53 (1.05-2.24), OR 2.80 (2.11-3.72), and OR 2.98 (2.27-3.90). Among women this gradient was not as pronounced. Physical work ability constituted the strongest explanatory factor explaining the total association between socioeconomic status and being sick-listed in women. However, among men, the association between skilled non-manual, OR 2.07 (1.54-2.78), and non-skilled manual, OR 2.03 (1.53-2.71) positions in relation to being sick-listed remained. The explanatory effect of mental work ability was small. Surprisingly, even in the sick-listed sample most respondents had high mental and physical work ability. Conclusions: These results suggest that physical work ability may be an important key in explaining the social gradient in sickness absence, particularly in women. Hence, it is possible that the factors associated with the social gradient in sickness absence may differ, to some extent, between women and men.
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| 4. |
- Löve, Jesper, 1974, et al.
(författare)
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Explaining the social gradient in sickness absence: a study of a general working population in Sweden
- 2013
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 13:545
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Tidskriftsartikel (refereegranskat)abstract
- Background Some previous studies have proposed potential explanatory factors for the social gradient in sickness absence. Yet, this research area is still in its infancy and in order to comprise the full range of socioeconomic positions there is a need for studies conducted on random population samples. The main aim of the present study was to investigate if somatic and mental symptoms, mental wellbeing, job strain, and physical work environment could explain the association between low socioeconomic position and belonging to a sample of new cases of sick-listed employees. Methods This study was conducted on one random working population sample (n=2763) and one sample of newly sick-listed cases of employees (n=3044), drawn from the same random general population in western Sweden. Explanatory factors were self-rated 'Somatic and mental symptoms', 'Mental well-being', 'job strain', and 'physical work conditions' (i.e. heavy lifting and awkward work postures). Multiple logistic regression analyses were used. Results Somatic and mental symptoms, mental well-being, and job strain, could not explain the association between socioeconomic position and sickness absence in both women and men. However, physical work conditions explained the total association in women and much of this association in men. In men the gradient between Non-skilled manual OR 1.76 (1.24;2.48) and Skilled manual OR 1.59 (1.10;2.20), both in relation to Higher non-manual, remained unexplained. Conclusions The present study strengthens the scientific evidence that social differences in physical work conditions seem to comprise a key element of the social gradient in sickness absence, particularly in women. Future studies should try to identify further predictors for this gradient in men.
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| 5. |
- Mittendorfer-Rutz, Ellenor, et al.
(författare)
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Determinants in adolescence for adult sickness absence in women and men: a 26-year follow-up of a prospective population based cohort (Northern Swedish cohort).
- 2013
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Ingår i: BMC public health. - : Springer Science and Business Media LLC. - 1471-2458. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background: To date little is known regarding how factors measured in adolescence predict sickness absence in adulthood, and whether different patterns of factors exist for women and men that could contribute to an explanation of adult gender differences in sickness absence. Methods: All pupils in the last year of compulsory school in the municipality of Luleå with complete information from surveys (questionnaires) in 1981 and 1983 (compulsory and upper-secondary schooling; 16 and 18 years of age, N=719) were followed with register data on medically certified sickness absence (1993–2007). Generalised linear models were applied to calculate Risk Ratios with 95% Confidence Intervals (CI) comparing annual mean numbers of sickness absence spells in exposed versus unexposed groups. Results: In the multivariate model, the following factors were found to be predictive of future sickness absence in women: participating in an upper secondary school program in 1983 dominated by women (> 60%): 1.41 (95% CI 1.00 – 1.97); sometimes sickness absence from school in 1981: 1.60 (95% CI 1.18 – 2.17) and low parental socioeconomic status in 1981: 2.20 (95% CI 1.44 – 3.38). In men, low school grades in 1981: 4.36 (95% CI 2.06 – 9.22) and fathers not in gainful employment in 1981: 2.36 (95% CI 1.53 – 3.66) were predictive. Conclusion: The findings suggest that sickness absence in adulthood is predicted by factors measured in adolescence. These predictors may differ for women and men. For women, early life absence and social environmental factors, for men low achievements at school and lack of employment of their father seem to be predictive.
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| 6. |
- Andersson, Christina, 1955, et al.
(författare)
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Capability to make well‑founded decisions: an interview study of people with experience of sickness absence who have common mental disorders
- 2022
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 22:1
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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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| 7. |
- Beno, Anja, et al.
(författare)
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Self-reported changes in work situation – a cross-sectional study of patients 7 years after treatment for stress-related exhaustion
- 2021
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 21:1
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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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| 8. |
- Danielsson, Louise, 1979, et al.
(författare)
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Working in dissonance: experiences of work instability in workers with common mental disorders
- 2017
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Ingår i: Bmc Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: Common mental disorders have a negative impact on work functioning, but less is known about the process when the functioning starts to destabilize. This study explores experiences of work instability in workers with common mental disorders. Methods: A grounded theory study using a theoretical sampling frame, individual in-depth interviews and a constant comparative analysis conducted by a multidisciplinary research team. The sample involved 27 workers with common mental disorders, currently working full or part time, or being on sick leave not more than 6 months. They were women and men of different ages, representing different occupations and illness severity. Results: A general process of work instability was conceptualized by the core category Working in dissonance: captured in a bubble inside the work stream. The workers described that their ordinary fluency at work was disturbed. They distanced themselves from other people at and outside work, which helped them to regain their flow but simultaneously made them feel isolated. Four categories described sub-processes of the dissonance: Working out of rhythm, Working in discomfort, Working disconnected and Working in a no man's land. Conclusions: The experience of work instability in CMDs was conceptualized as "working in dissonance", suggesting a multifaceted dissonance at work, characterized by a sense of being caught up, as if in a bubble. Focusing on how the worker can re-enter their flow at work when experiencing dissonance is a new approach to explore in occupational and clinical settings.
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| 9. |
- Gunnarsdottir, Hrafnhildur, 1973-, et al.
(författare)
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Associations between parents' subjective time pressure and mental health problems among children in the Nordic countries : a population based study
- 2015
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The home, the family and the parents represent a context of everyday life that is important for child health and development, with parent-child relationships highlighted as crucial for children's mental health. Time pressure is an emerging feature of modern societies and previous studies indicates that parents with children living at home experience time pressure to a greater extent than people with no children living at home. Previous studies of children's mental health in relation to parents' time pressure are lacking. Hence, the purpose of this study was to examine the association between parents' subjective time pressure and mental health problems among children in the Nordic countries as well as potential disparities between boys and girls in different age groups.METHODS: 4592 children, aged 4-16 from Denmark, Finland, Norway and Sweden, participating in the 2011 version of the NordChild study, were included. The Strength and Difficulties Questionnaire was used to measure children's mental health and associations to parents' time pressure were assessed by multiple logistic regression analysis.RESULTS: Among children of parents experiencing time pressure, 18.6% had mental health problems compared to 10.1% among children of parents experiencing time pressure not or sometimes. The odds of mental health problems were higher among both boys (OR 1.80 95% CI 1.32-2.46) and girls (OR 1.95 95% CI 1.42-2.66) if their parents experienced time pressure when adjusted for financial stress. The highest prevalence of mental health problems in the case of parental time pressure was found among girls 13-16 years old (23.6%) and the lowest prevalence was found among boys 13-16 years old (10.7%).CONCLUSIONS: In this study an association between parents' subjective time pressure and increased mental health problems among children was found. Given that time pressure is a growing feature of modern societies, the results might contribute to an explanation as to mental health problems are common among children in the Nordic countries in spite of otherwise favourable conditions. Additional research on the linkage between parents' experienced time pressure and children's and adolescents' mental health problems is needed to confirm the novel findings of this study.
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| 10. |
- Holmgren, Kristina, 1955, et al.
(författare)
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Does early identification of work-related stress, combined with feedback at GP-consultation, prevent sick leave in the following 12 months? a randomized controlled trial in primary health care
- 2019
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- © 2019 The Author(s). Background: Experiencing work-related stress constitutes an obvious risk for becoming sick-listed. In primary health care, no established method to early identify, advise and treat people with work-related stress exists. The aim was to evaluate if the use of the Work Stress Questionnaire (WSQ) brief intervention, including feedback from the general practitioner (GP), had an impact on the level of sickness absence. Method/design: In total 271 (intervention group, n = 132, control group, n = 139) non-sick-listed employed women and men, aged 18 to 64 years, who had mental and physical health complaints and sought care at primary health care centers participated in this two-armed randomized controlled trial. The main outcomes were the number of registered sick leave days and episodes, and time to first sick leave during the 12-months follow-up. The intervention included early identification of work-related stress by the WSQ, GP awareness supported by a brief training session, patients' self-reflection by WSQ completion, GP feedback at consultation, and initiation of preventive measures. Results: The mean days registered for the WSQ intervention group and the control group were 39 and 45 gross days respectively, and 31 and 39 net days respectively (ns). No statistical significant difference for the number of sick leave episodes or time to first day of sick leave episode were found between the groups. Conclusions: The WSQ brief intervention combined with feedback and suggestions of measures at patient-GP-consultation was not proven effective in preventing sick leave in the following 12 months compared to treatment as usual. More research is needed on methods to early identify, advise and treat people with work-related stress in primary health care, and on how and when GPs and other professionals in primary health care can be trained to understand this risk of sick leave due to work-related stress, on how to prevent it, and on how to advise and treat employees at risk. Trial registration: ClinicalTrials.gov. Identifier: NCT02480855. Registered 20 May 2015.
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