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1.
  • Ejlertsson, Lina, 1988-, et al. (author)
  • Salutogena arbetsfaktorer för friska medarbetare : en enkätstudie inom primärvården
  • 2014
  • Reports (other academic/artistic)abstract
    • Bakgrund: En fungerande primärvård är viktig för invånarnas hälsa. Hälso- och sjukvården i Sverige är under stor press och sjukvårdspersonalens välbefinnande är ett omdiskuterat ämne. Många studier i primärvården lyfter fram stress och ohälsa bland personalen, medan s.k. salutogena studier, dvs. sådana som lyfter fram resurser och möjligheter, i princip saknas. Det övergripande syftet med denna studie var att belysa goda arbetsförhållanden i primärvården ur ett salutogent perspektiv.Metod: En enkätstudie genomfördes vid samtliga 26 vårdcentraler, 18 offentliga och åtta privata, i sex kommuner i nordöstra Skåne. Enkäten riktade sig till alla anställda inom primärvården (n = 599). Frågorna omfattade olika dimensioner av arbetsförhållanden och hälsa. Som bas användes två salutogent inriktade mätinstrument: SHIS (Salutogenic Health Indicator Scale), som mäter indikatorer på hälsa, och WEMS (Work Experience Measurement Scale), med frågor om upplevelsen av arbetet och arbetssituationen. Dessa frågor kompletterades med nyskapade frågor. Dels gjordes en inledande intervjustudie, som resulterade i frågor av särskild relevans för primärvården, dels inkluderades frågor inspirerade av befintliga frågeinstrument. Index bildades utifrån de olika områdena, vilka skapades genom att frågor med logiskt samband slogs samman. Samtliga index presenteras i den här rapporten.Resultat: Den totala svarsfrekvensen var 84 procent. Det fanns stora individuella variationer mellan de olika vårdcentralerna. Hälsotillståndet hos de anställda var i första hand associerat med återhämtning, följt av balans mellan arbete och privatliv samt individuella inre arbetsupplevelser, som t.ex. att kunna gå till jobbet med glädje och att uppleva arbetet som meningsfullt och utmanande. Egenskaper som präglar arbetsplatsen hade det tydligaste förhållandet till upplevelsen av energi på arbetet, och det mest signifikanta sambandet med feed-back var att ha en tillgänglig chef. Det fanns en positiv trend för den yngre åldersgruppen (<35 år) i upplevelsen av hälsa (SHIS). Samma grupp hade inom flera andra områden signifikant högre värden än resterande åldersgrupper, bl.a. gällande individuella inre upplevelser samt upplevelsen av feedback och arbetet som energigivare. Bland yrkesgrupperna var SHIS högt bland sköterskorna liksom upplevelsen av arbetet som energigivare. Den paramedicinska personalen upplevde självbestämmande såväl som möjlighet till reflektion på arbetet i störst utsträckning, medan den administrativa personalen tillsammans med läkarna upplevde högst grad av feedback på arbetet.Slutsats: Studien ger en grund för arbetsrelaterade insatser i syfte att stärka de funna salutogena faktorerna, samt för att öka de anställdas deltagande i framtida hälsofrämjande arbete. Varje vårdcentral har genom studien goda möjligheter att arbeta vidare med de egna resultaten.
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2.
  • Sollerhed, Ann-Christin, 1954-, et al. (author)
  • Physical benefits of expanded physical education in primary school : findings from a 3-year intervention study in Sweden
  • 2008
  • In: Scandinavian Journal of Medicine and Science in Sports. - : Wiley-Blackwell. - 0905-7188 .- 1600-0838. ; 18:1, s. 102-107
  • Journal article (peer-reviewed)abstract
    • The aim of this study was to assess whether a school-based program with expanded physical education lessons was effective in increasing children's physical capacity and in preventing excessive weight gain in children. The study performed in 2000-2003 comprised 132 children, 73 boys and 59 girls at baseline 6-9 years and in follow-up 9-12 years, attending two different schools with a similar size, appearance and structure in a rural area. The norm school (N-school) followed the stipulated curricular time, one to two physical education lessons a week, while the intervention school (I-school) increased it to four lessons. More positive changes in physical index (the sum of the age-standardized results in 11 physical tests) were found among children in the I-school than in the N-school. The number of children who increased body mass index (BMI) increased in both schools, but a lower increase in BMI could be seen in the I-school. Expanded physical education lessons could increase physical status among both overweight and normal-weight children, in particular aerobic fitness. The weekly dose of physical activity must be higher than 40 min a day and must start earlier in children's life to be more effective in combating BMI increase.
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3.
  • Abrahamsson, Agneta, et al. (author)
  • A salutogenic perspective could be of practical relevance for the prevention of smoking amongst pregnant women
  • 2002
  • In: Midwifery. - 0266-6138 .- 1532-3099. ; 18:4, s. 323-331
  • Journal article (peer-reviewed)abstract
    • OBJECTIVE: to use empirical data to assess the theoretical relevance of using a salutogenic, instead of a pathogenic, perspective to prevent smoking during pregnancy. DESIGN: quantitative study, a questionnaire was completed during the first trimester of pregnancy and an interview was conducted after the baby was born. SETTING: a geographically defined area in the south-east of Sweden. PARTICIPANTS: all 395 women in the study area who were pregnant during the study period 1994-1995. FINDINGS: the women were categorised according to their smoking habits. A significant difference in the sense of coherence (SOC) score was shown between smoking and non-smoking women in indicators of bad health. Women who relapsed to smoking showed a lower level of SOC, particularly in the manageability component, than others. The SOC score was higher in the whole study group than in other comparable, non-pregnant populations. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: a salutogenic perspective could be used in antenatal care as a basis for encouraging pregnant women to stop smoking. This could enhance the SOC by making smoking more understandable for the woman, by discussing smoking as a way of coping, and by encouraging the woman's own capacity and motivation to stop smoking. Starting a dialogue about smoking from the woman's point of view could do this, with the midwife and the woman exploring together the woman's thoughts about the smoking problem.
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4.
  • Abrahamsson, Agneta, et al. (author)
  • Smoking patterns during pregnancy : differences in socio-economic and health-related varaiables
  • 2000
  • In: European Journal of Public Health. - 1101-1262 .- 1464-360X. ; 10:3, s. 208-213
  • Journal article (peer-reviewed)abstract
    • Background: The objective of this study was to assess different smoking patterns during and after pregnancy and relate these patterns to socioeconomic conditions and different health issues such as symptoms, drug consumption and health care use. Methods: The study group included 337 pregnant women from a district in south Sweden. A questionnaire was filled in during the first part of pregnancy and an interview was conducted after the baby was born. The women were categorised according to their smoking habits. Results: The categories defined were continuers, relapsers, decreasers, quitters and non-smokers. Among relapsers three symptoms, difficulty in relaxing (OR 4.48), restlessness (OR 9.59) and dysphoria (OR 3.98), were more common than among non-smokers. All three musculoskeletal symptoms were most common among continuers. Among quitters the OR for backache was 2.05, for numbness In the arms and legs 2.76 and for tearfulness 2.92. Educational level was relatively high among quitters and few had a smoking partner. Among smokers (decreasers, relapsers and continuers) 24% used drugs regularly, compared to 5% among non-smokers. Conclusions: To prevent smoking during pregnancy awareness of the relations between different smoking categories and symptoms could make it easier for hearth personnel to individualise support. A possible starting point is to discuss how to cope with different symptoms occurring during smoking cessation. Women with predictors for continued smoking during pregnancy, such as low education, unemployment, a smoking partner and multiparous, should be focused on more intensively and preventive strategies suitable for their special needs should be developed.
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6.
  • Andersson, H. Ingemar, 1950-, et al. (author)
  • Chronic pain in a geographically defined general population : studies of differences in age, gender, social class, and pain localization.
  • 1993
  • In: The Clinical Journal of Pain. - 0749-8047 .- 1536-5409. ; 9:3, s. 174-182
  • Journal article (peer-reviewed)abstract
    • OBJECTIVE: To establish basic epidemiological data on chronic pain (duration > 3 months) in a defined population. Relationships between age, gender, and social class were tested. DESIGN: A survey of pain symptoms, including location, intensity, duration, and functional capacity, was conducted by means of a mail questionnaire. SETTING: General populations in two Swedish primary health care districts. Medical care was provided in a state health system. SUBJECTS: A random sample (from the population register) of 15% of the population aged 25-74 (n = 1,806). The response rate was 90%. OUTCOME MEASURES: Descriptive epidemiologic data in relation to objectives of the study. RESULTS: Without sex differences, 55% (95% confidence interval, 53-58%) of the population had perceived persistent pain for 3 months and 49% for 6 months. Among individuals with chronic pain, 90% localized their pain to the musculoskeletal system to a variable extent. Women experienced more multiple localizations of pain and had pain in the neck, shoulder, arm, and thigh to a greater extent than men. Prevalence of pain increased by age up to 50-59 years for both genders and then slowly decreased. The neck-shoulder area was the most common site of pain (30.2%), followed by the lower back (23.2%). Even in the youngest age groups more than one of four reported chronic pain. Blue-collar workers and employers (including farmers) reported chronic pain to a greater extent than other groups. In 13% of the population, manifest pain problems were associated with reduced functional capacity. CONCLUSION: Chronic pain symptoms are common but unevenly distributed in a general population. The results may influence planning and consultation in primary health care as well as warranting selective prevention activities.
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7.
  • Andersson, H. Ingemar, 1950-, et al. (author)
  • Folkhälsovetenskap : perspektiv och framtid
  • 2009
  • In: Folkhälsa som tvärvetenskap. - Lund : Studentlitteratur. - 9789144040097 ; , s. 367-375
  • Book chapter (other academic/artistic)
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8.
  • Andersson, H. Ingemar, 1950-, et al. (author)
  • Impact of chronic pain on health care seeking, self care, and medication : results from a population-based Swedish study
  • 1999
  • In: Journal of Epidemiology and Community Health. - 0143-005X .- 1470-2738. ; 53:8, s. 503-509
  • Journal article (peer-reviewed)abstract
    • STUDY OBJECTIVE: To explore individual and social factors that could predict health care utilisation and medication among people with chronic pain in an unselected population. DESIGN: A mailed survey with questions about pain and mental symptoms, disability, self care action, visits to health care providers, and medication. SETTING: General populations in two Swedish primary health care (PHC) districts. Medical care was given in a state health system. PARTICIPANTS: A random sample (from the population register) of 15% of the population aged 25-74 (n = 1806). MAIN RESULTS: Among people reporting chronic pain 45.7% (compared with 29.8 of non-chronic pain persons, p < 0.05) consulted a physician and 7.2% (compared with 1.2%, p < 0.05) a physiotherapist during three months. Primary health care was the most frequent care provider. High pain intensity, aging, depression, ethnicity, and socioeconomic level had the greatest impact on physician consultations. Alternative care, used by 5.9%, was associated with high pain intensity and self care. Use of self care was influenced by high pain intensity, regular physical activity, and ethnicity. Alternative care and self care did not imply lower use of conventional health care. Women reporting chronic pain consumed more analgesics and sedatives than corresponding men. Besides female gender, high pain intensity, insomnia, physician consultation, social network, and self care action helped to explain medication with analgesics. Use of herbal remedies and ointments correlated to self care action, visit to an alternative therapist, high pain intensity, and socioeconomic level. CONCLUSIONS: The presence of chronic pain has an impressive impact on primary health care and medication. Various therapeutic actions are common and are partly overlapping. The use of health care among people with chronic pain depends above all on pain perception and intensity of pain but is also affected by ethnicity, age, socioeconomic level, and depressive symptoms. Among people with chronic pain use of analgesics is common in contrast with other types of pain relief (acupuncture, physiotherapy) suitable for treating chronic pain symptoms.
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9.
  • Andersson, H. Ingemar, 1950-, et al. (author)
  • Musculoskeletal chronic pain in general practice : studies of health care utilisation in comparison with pain prevalence
  • 1999
  • In: Scandinavian Journal of Primary Health Care. - 0281-3432 .- 1502-7724. ; 17:2, s. 87-92
  • Journal article (peer-reviewed)abstract
    • OBJECTIVE: To study the relations between population prevalence of chronic pain and pain-related diagnoses (musculoskeletal and headaches) in primary health care (PHC) and to examine longitudinal variations in these diagnoses. DESIGN: A population-based mailed survey to catch prevalence data and continuous computerised diagnosis registration in PHC. SETTING: General population in a well-defined Swedish PHC district. SUBJECTS: A random sample of 15% of the population aged 25-74, n = 1101. Annual visitors to district physicians at the health centre. MAIN OUTCOME MEASURES: Rates of pain-related diagnoses in PHC in relation to population prevalence of chronic pain. Comparisons of the number of individuals (annual visiting rates) with pain-related diagnoses 1987-1996. RESULTS: Population pain prevalence and pain-related diagnoses in PHC corresponded as regards the magnitude and distribution of chronic pain by age and partly by pain location. Compared to low-back and widespread pain, neck-shoulder pain and headaches were less frequent in PHC in relation to reported prevalence. From 1987 to 1996 we found an increasing number of individuals seeking primary care with pain-related diagnoses. The increase was mainly assigned to the groups of fibrositis/myalgia and headache. CONCLUSION: Pain-related diagnoses in PHC reflect partly the occurrence of self-reported chronic pain symptoms in the population. The observed increase in visits with pain-related diagnoses in the last 10 years is due to an increased number of individuals with soft-tissue rheumatism and headaches. Future studies will have to elucidate whether these findings are due to an increase in morbidity or changes in care-seeking and social conditions.
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  • Andersson, H. Ingemar, 1950-, et al. (author)
  • Salutogenetic and pathogenetic factors of equal importance to predict mortality in a Swedish general population
  • 2008
  • In: European Journal of Public Health, 18(Suppl. 1). ; , s. 193-194
  • Conference paper (other academic/artistic)abstract
    • Social support and physical exercise seem to be salutogenetic factors of importance for longterm survival to balance traditional risk factors such as smoking and defined diseases. The results support health promotion initiatives focused on salutogenetic factors and not only prevention in relation to traditional risk factors and diseases.
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13.
  • Andruškienė, Jurgita, et al. (author)
  • Psychosocial work experiences related to health : a study of Lithuanian hospital employees
  • 2015
  • In: Work. - 1051-9815 .- 1875-9270. ; 53:3, s. 669-677
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Research in the area of workplace health promotion from a salutogenic perspective is lacking in Eastern Europe.OBJECTIVE: To evaluate the relationship between psychosocial work environment and health from a salutogenic perspective among Lithuanian hospital workers.METHODS: Using a cross-sectional design a questionnaire was distributed to staff in a large hospital in Lithuania. Out of 811 employees, 714 completed the survey: 151 physicians, 449 nurses and 114 other staff members (e.g., psychologists, technicians, therapists). A response rate of 88.0% was achieved. The Work Experience Measurement Scale (WEMS) and the Salutogenic Health Indicator Scale (SHIS) were linguistically adapted and used for the first time in a Lithuanian context. Logistic and multiple linear regression models were used for the analyses.RESULTS: Supportive working conditions, positive internal work experiences and time experience contributed the most to good health, defined as a high SHIS index. Having an executive post was significantly related to good work experiences, i.e. a high WEMS score, while being at the age of 40-54 years was associated with a low WEMS score. Physicians had the highest score on supportive working conditions; while nurses had the lowest scores on autonomy.CONCLUSIONS: A salutogenic approach enables an organisation to identify how to improve working conditions for the employees by focusing on possibilities and resources. Individual activities for workplace health promotion among different work groups seem necessary.
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14.
  • Andruskiene, Jurgita, et al. (author)
  • Work experience and school worker's health evaluated by salutogenic health indicators
  • 2011
  • In: Acta Medica Lituanica. - 1392-0138. ; 18:2, s. 86-91
  • Journal article (peer-reviewed)abstract
    • Background. The aim of the study was to establish relations between work experience and health, evaluated by salutogenic health indicators, among school workers.Materials and methods. Teachers (n = 180) and other school workers (n = 154) from randomly selected Panevėžys district schools were questioned using instruments developed by scientists of the Kristianstad University: the Work Experience Measurement Scale (WEMS) and Salutogenic Health Indicator Scale (SHIS). The questionnaire of personal data contained questions about sociodemographic and work-related characteristics.The differences among the mean values were tested by the independent samples t-test and one-way ANOVA. The Cronbach’s alpha coefficient was used to check the internal consistency. The significance level was accepted at p = 0.05.Results. In the teachers’ group, 86.7% were females (75.3% among others), 20.4%were older than 55 years (30.7% in other goups), 18.9% held an executive position(8.5% among others). Teachers, as compared with other school workers, scored higher the domain of internal work experience, (76.9 vs. 62.8, respectively), while other school workers gave higher standardized scores for the time experience domain (71.9 vs. 63.7, p < 0.001 respectively). The SHIS scores among teachers varied from 54.7 (worst experience) to 78.0 (best experience), p < 0.001. In the group of other school workers, the SHIS mean scores varied from 51.9 to 80.0, p < 0.001.Conclusions. Teachers more positively evaluated the domain of internal workingexperience, while other school workers were more satisfied with time experience at the workplace. The established strong correlation between work experience and health, measured by salutogenic health indicators, encouraged the idea to implement workrelated health promotion at school.
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15.
  • Axelsson, Lars, et al. (author)
  • Inequalities of quality of life in unemployed young adults : a population-based questionnaire study
  • 2007
  • In: International Journal for Equity in Health. - 1475-9276 .- 1475-9276. ; 6, s. 1-
  • Journal article (peer-reviewed)abstract
    • Background: It is well known that unemployment is a great problem both to the exposed individual and to the whole society. Unemployment is reported as more common among young people compared to the general level of unemployment. Inequity in health status and lifesatisfaction is related to unemployment. The purpose of this population-based study was to describe QOL among unemployed young people compared to those who are not unemployed, and to analyse variables related to QOL for the respective groups.Methods: The sample consisted of 264 young unemployed individuals and 528 working or studying individuals as a reference group. They all received a questionnaire about civil status, educational level, immigration, employment status, self-reported health, self-esteem, social support, social network, spare time, dwelling, economy and personal characteristics. The response rate was 72%. The significance of differences between proportions was tested by Fisher's exact test or by χ2 test. Multivariate analysis was carried out by means of a logistic regression model.Results: Our results balance the predominant picture of youth unemployment as a principally negative experience. Although the unemployed reported lower levels of QOL than the reference group, a majority of unemployed young adults reported good QOL, and 24% even experienced higher QOL after being unemployed. Positive QOL related not only to good health, but also to high self-esteem, satisfaction with spare time and broad latitude for decision-making.Conclusion: Even if QOL is good among a majority of unemployed young adults, inequalities in QOL were demonstrated. To create more equity in health, individuals who report reduced subjective health, especially anxiety need extra attention and support. Efforts should aim at empowering unemployed young adults by identifying their concerns and resources, and by creating individual programmes in relation not only to education and work, but also to personal development.
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16.
  • Axelsson, Lars, et al. (author)
  • Self-reported health, self-esteem and social support among young unemployed people : a population-based study
  • 2002
  • In: International Journal of Social Welfare. - 1369-6866 .- 1468-2397. ; 11:2, s. 111-119
  • Journal article (peer-reviewed)abstract
    • A population-based study was performed in southern Sweden in the autumn of 1998. The aim was to study connections between self-reported health, self-esteem and social support among unemployed (≥ three months) young people. The sample consisted of 264 unemployed individuals aged 20–25 years, and 528 individuals of the same age, randomly selected from the population register and not registered as unemployed. The response rate was 72%. Defined by means of factor analysis, mental health consisted of the symptoms tearfulness, dysphoria, sleeping disturbance, restlessness, general fatigue and irritability. The unemployed had more mental health problems than young people who were working or studying. Restlessness and dysphoria were significantly over-represented in the unemployed among both sexes. However, good social support seemed to predict mental health. Support from parents was most important, particularly in males. Those with low self-esteem and poor parental support were especially vulnerable.
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18.
  • Axelsson, Lars, et al. (author)
  • Work ethics and general work attitudes in adolescents are related to quality of life, sense of coherence and subjective health : a Swedish questionnaire study
  • 2005
  • In: BMC Public Health. - 1471-2458 .- 1471-2458. ; 5, s. 103-
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: Working life is an important arena in most people's lives, and the working line concept is important for the development of welfare in a society. For young people, the period before permanent establishment in working life has become longer during the last two decades. Knowledge about attitudes towards work can help us to understand young people's transition to the labour market. Adolescents are the future workforce, so it seems especially important to notice their attitudes towards work, including attitudes towards the welfare system. The aim of this study was to describe and analyse upper secondary school students' work attitudes, and to explore factors related to these attitudes. METHODS: The sample consisted of 606 upper secondary school students. They all received a questionnaire including questions about quality of life (QOL), sense of coherence (SOC), subjective health and attitudes towards work. The response rate was 91%. A factor analysis established two dimensions of work attitudes. Multivariate analyses were carried out by means of logistic regression models. RESULTS: Work ethics (WE) and general work attitudes (GWA) were found to be two separate dimensions of attitudes towards work. Concerning WE the picture was similar regardless of gender or study programme. Males in theoretical programmes appeared to have more unfavourable GWA than others. Multivariate analyses revealed that good QOL, high SOC and good health were significantly related to positive WE, and high SOC was positively related to GWA. Being female was positively connected to WE and GWA, while studying on a practical programme was positively related to GWA only. Among those who received good parental support, GWA seemed more favourable. CONCLUSION: Assuming that attitudes towards work are important to the working line concept, this study points out positive factors of importance for the future welfare of the society. Individual factors such as female gender, good QOL, high SOC and good health as well as support from both parents, positive experience of school and work contacts related positively to attitudes towards work. Further planning and supportive work have to take these factors into account.
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19.
  • Bringsén, Åsa, 1970-, et al. (author)
  • Development and quality analysis of the Salutogenic Health Indicator Scale (SHIS)
  • 2009
  • In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 37:1, s. 13-19
  • Journal article (peer-reviewed)abstract
    • Background: Current health measurement instruments tend to measureaspects of ill-health rather than health in general. There isa need for a salutogenic perspective when describing healthand developing a health measurement instrument. The aim of thisarticle is to present the development process and quality assessmentof a salutogenic health indicator scale. Methods: A descriptionof health, emanating from the concept of health, positive healthand well-being, was used as a basis for the construction ofthe scale. The scale is a semantic differential consisting of12 indicator items covering nine heath-related dimensions. Aprincipal component analysis was performed, and three healthindicator indexes were constructed. Correlation with self-ratedhealth questions was investigated, weighted kappa values werecalculated, and Cronbach's alpha (CA) was used to check internalconsistency. Results: The analysis resulted in a two-factormodel, and the indexes were named intrapersonal characteristics(CA= 0.90) and interactive function (CA= 0.84), summarised intohealth complete (CA= 0.92). Kappa values ranged from 0.44 to0.67, and correlations with self-rated health status were strongerthan those with self-rated sick-leave. Conclusions: Our healthdescription was characterized by complexity, but the instrumentis a short salutogenic health indicator scale. The shortnessincreases the usability. The instrument seems to be able tooffset the current problem of there being a lack of salutogenichealth measurement instruments. The results indicate that furthertesting is justified.
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20.
  • Bringsén, Åsa, 1970-, et al. (author)
  • Flow situations during everyday practice in a medical hospital ward : results from a study based on experience sampling method
  • 2011
  • In: BMC Nursing. - 1472-6955 .- 1472-6955. ; 10, s. 3-3
  • Journal article (peer-reviewed)abstract
    • Nursing is a constant balance between strain and stimulation and work and health research with a positive reference point has been recommended. A health-promoting circumstance for subjective experience is flow, which is a psychological state, when individuals concurrently experience happiness, motivation and cognitive efficiency. Flow situations can be identified through individuals' estimates of perceived challenge and skills. There is, to the best of our knowledge, no published study of flow among health care staff. The aim of this study was to identify flow-situations and study work-related activities and individual factors associated with flow situations, during everyday practice at a medical emergency ward in Sweden, in order to increase the knowledge on salutogenic health-promoting factors.The respondents consisted of 17 assistant nurses and 14 registered nurses, who randomly and repeatedly answered a small questionnaire, through an experience sampling method, during everyday nursing practice. The study resulted in 497 observations. Flow situations were defined as an exact match between a high challenge and skill estimation and logistic regression models were used to study different variables association to flow situations.The health care staff spent most of its working time in individual nursing care and administrative and communicative duties. The assistant nurses were more often occupied in individual nursing care, while the registered nurses were more involved in medical care and administrative and communicative duties. The study resulted in 11.5% observations of flow situations but the relative number of flow situations varied between none to 55% among the participants. Flow situations were positively related to medical care activities and individual cognitive resources. Taking a break was also positively associated with flow situations among the assistant nurses.The result showed opportunities for work-related interventions, with an adherent increase in flow situations, opportunity for experience of flow and work-related health among the nursing staff in general and among the assistant nurses in particular.
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21.
  • Bringsén, Åsa, 1970-, et al. (author)
  • Health care staff's opinions about an individually controlled and flexible working time arrangement
  • 2009
  • Conference paper (peer-reviewed)abstract
    • IntroductionIn the health care sector shift work is common and a variety of flexible working hour arrangements have been implemented and evaluated. High variability of working hours is repeatedly being related to ill health, especially if the variability is company controlled. In order to minimize the harmful effects on health and psychosocial wellbeing individually controlled flexible working time arrangements have been put into practice. AimThe aim of this study was to explore health care staff’s opinions about their individually controlled and flexible working time arrangement. MethodsEight focus group interviews were conducted, between November 2002 and February 2003, at a medical emergency ward in a medium sized Swedish hospital. Sixteen nurses and 19 assistant nurses where mixed in the eight groups. The interviews aimed at being unstructured and the main question emanated from the aim of the study. The analysis was influenced by qualitative content analysis. Five interviews were chosen through a condensation process and these interviews were transcribed verbatim by an external secretary. ResultsTwo patterns of employees’ opinions were revealed. Some of the participants expressed a positive attitude towards their individually controlled and flexible working time arrangement. They enjoyed the possibility to adjust their working schedule to their family situation and leisure activities. The positive ones were also talking about a health promoting possibility for reflection and learning, emanating from frequently working with different co workers, as a result of the flexibility. These participants emphasised an importance of everyone taking part in the planning process and taking turns in adjusting their schedule after the needs of the establishment. Other participants linked the individually controlled and flexible working time arrangement to a negative experience. They talked about a time consuming planning process resulting in less predictable working hours. These participants wanted to have a permanent schedule so that they could adjust their private life after their working hours. The negative ones wanted work to be characterised by predictability and efficiency. They linked this type of work to knowing their co workers well, so that they knew what the other ones were doing without having to communicate while working. The latter group of participants were reluctant to adjusting their schedule after the needs of the establishment. ConclusionsIt seems as if an individually controlled and flexible working time arrangement can result in either positive or negative experiences. Negative feelings form the base for psychological and biological processes that might have a negative impact on health. It is therefore important to reflect on how we implement and organise individually controlled and flexible working time arrangements for employees to have positive experiences with opportunities for sustained or improved health.
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22.
  • Bringsén, Åsa, 1970-, et al. (author)
  • Hälsorelaterade upplevelser av arbetet på en medicinsk vårdavdelning : resultat från en fokusgruppsstudie med sjukvårdspersonal
  • 2009
  • Conference paper (peer-reviewed)abstract
    • ProblembeskrivningAbetsplatser inom sjukvården i Sverige har genomgått många förändringar. De har skett under en period som också präglats av besparings- och rationaliseringsåtgärder. För de anställda karaktäriseras arbetslivet av höga krav, begränsade möjligheter till kontroll, oklart ledarskap, konstanta förändringskrav utan deltagande och en stor mängd sociala relationer och ansvars­områden. Ledarskapet ger inte alltid tillräckligt stöd åt de anställda och rapporteringen av stres­symtom ökar. Traditionellt har folkhälsorelaterad arbetslivsforskning i huvudsak fokuserat på problem och orsaker till ohälsa, medan studier av arbetsplatsrelaterade hälsofaktorer utifrån ett salutogent perspektiv inte varit lika ofta förekommande.Hälsan bland de anställda inom vård och omsorg behöver förbättras och verksamheten behöver göras mer attraktiv för den yngre arbetskraften. Utformningen av strategier för ett framgångsrikt hälsofrämjande arbete har beskrivits som en möjlig insats med positiv påverkan på personalens arbetsförhållanden och hälsa.Mot bakgrund av ovanstående skulle studier om hälsofrämjande arbete på arbetsplatser inom sjukvården vara till stor nytta. Ett hälsorelaterat projekt startades därför 2002 vid en vårdavdelning på ett medelstort sjukhus i södra Sverige. Som del i detta projekt ingick en fokusgruppsstudie med intervjuer av sjukvårdspersonalen som arbetade på avdelningen.SyfteSyftet med fokusgruppsstudien var att undersöka sjukvårdspersonalens upplevelse av sin arbets­situation i relation till deras uppfattningar om en hälsofrämjande arbetsplats.MetodÅtta fokusgruppsintervjuer genomfördes mellan november 2002 och februari 2003. Huvudfrågorna utgick från syftet och moderatorns roll var i huvudsak att stimulera kommunikationen genom att ställa följdfrågor och be om förtydliganden. Tanken var att intervjuerna skulle vara ostrukturerade, så att deltagarnas upplevelser och uppfattningar kunde utvecklas med så lite styrning från moderatorn som möjligt. All sjukvårdspersonal erbjöds att delta i studien och av 39 anställda valde 35 att delta. I grupperna blandades 16 sjuksköterskor och 19 undersköterskor, med fyra till fem deltagare i varje grupp. Intervjuerna spelades in på band, lyssnades igenom och fem intervjuer valdes ut och skrevs ut ordagrant. Dessa fem intervjuer ansågs vara representativa för materialet som helhet då innehållet i de övriga tre intervjuerna också fanns representerat i dessa fem. Analysen genomfördes av moderatorn och inspirerades av beskrivningen om kvalitativ innehållsanalys. ResultatResultatet visade att deltagarna hade både positiva och negativa hälsorelaterade upplevelser av sin arbetsplats. De negativa upplevelserna kopplades i huvudsak ihop med fysisk arbetsmiljö och organisatoriska faktorer, som till exempel den övergripande organiseringen av arbetet på avdelningen, fördelning av arbetsuppgifter, hög arbetsbelastning, dåligt fungerande rutiner, organisering av arbetstider, ledarskapet och genomförandet av förändringsarbete eller omorganisering. När det gällde de positiva hälsorelaterade upplevelserna så dominerade istället psykosociala faktorer som kunde kopplas till antingen arbetskamrater, patienter eller individuella faktorer. Kontakten med arbetskamrater och patienter ansågs fungera som ett hälsofrämjande socialt, emotionellt och instrumentellt stöd, som bidrog till att gör arbetet hanterbart. Skillnaden mellan faktorer som ansågs vara hälsofrämjande respektive ohälsoframkallande var inte helt tydlig. En del faktorer kunde ha både en positiv och en negativ påverkan på deltagarnas hälsa eftersom vissa deltagare hade olika uppfattningar om vad som var hälsofrämjande. Som ett exempel kan nämnas att vissa ansåg att en arbetssituation som karaktäriserades av stabilitet och förutsägbarhet var hälsofrämjande medan andra istället förespråkade en flexibel och variationsrik arbetssituation.SlutsatsResultatet överensstämmer till stor del med tidigare teoribildning men den individuella variabiliteten var dock stor. Då de positiva hälsorelaterade upplevelserna i huvudsak relaterades till psykosociala faktorer, är det svårt att beskriva hälsofrämjande faktorer utifrån struktur och organisation.
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23.
  • Bringsén, Åsa, 1970-, et al. (author)
  • Success factors for visual artists functioning as health promoters at a workplace : results from a Swedish case study
  • 2009
  • Conference paper (peer-reviewed)abstract
    • IntroductionThe interest in relations between arts and workplace related health has increased. The focus has mostly been on the work of arts and health from a disease perspective and to the best of our knowledge the research focusing on relation between the artists and workplace related health from a salutogenic perspective is rare. In 2007 a project called the Contemporary Artists in Contemporary Society (CACS) Scania project was implemented and evaluated. The project consisted of twelve visual artists being positioned at eight workplaces on half time for a period of six months. The idea of the project was that unprejudiced meetings between the artists and the staff could result in workplace related health promoting processes. This study will try to unravel some of the mystery of how artists’ presence can result in workplace related promotion of health.  AimThe aim was to identify success factors for visual artists functioning as health promoters at a workplace. ProcedureThe search for success criterion started with going through the project descriptions and the evaluation reports from the CACS Scania project. This exposition led to the selection of one project that was considered a particularly successful case. Two artists had been placed at the office for management of regional development in Scania. The employees consisted mainly of civil servants and administrators. The evaluation material belonging to this particular project was studied, searching for possible explanations to the success of the project. The material consisted of digital recordings from a focus group interview with five of the participating staff, an interview with the manager, an interview with the two artists as well as stories written by the two artists throughout the project and finally the project description as well as the folder that the two artists produced as a summary of the project. The analysis of the material was influenced by qualitative content analysis and three categories of success factors were found. ResultsThe experience of the participating staffThe result showed that the staff mainly had had positive project related experiences. The staffs’ experiences could be linked to the salutogenic factors comprehensibility, manageability and meaningfulness. The various project related activities were found to be meaningful and the different activities were considered a pleasant reflective break from an everyday routine based and hectic practice. Some of the staff reported having problems managing the openness and indistinctiveness of the project, but the frequent communication with the artists, as well as support from the manager made the indistinctiveness manageable. The presence of the artists and the different project related activities were often found to be amusing, with adherent facilitation of wellbeing among the staff. At other occasions the presence of the artists could be considered disturbing. The artists brought new perspectives into the workplace that sometimes challenged the staffs’ customary way of thinking and acting, opening up possibilities for creativity and reflective processes of work related learning. It seemed as if the positive health related experiences of the staff relied on communication and mutual construction of intellectual fellowship and project related meaning (intersubjectivity). A framework for the work of the artistsFour criteria were considered a useful framework for a description of the artists successful work at the workplace. 1. Presence - The artists were often present at the workplace. 2. Inspiration – The artists were inspired by the workplace. 3. Activity - The artists were constantly presenting things and activated the staff through out the project 4. Communication – The artists communicated with the staff during the development, implementation and completion process of the project. Organisational climateIt seemed as if the organisational climate was suitable for using artists as health promoters. The staff and the manager were for instance describing them as willing to try new and innovative strategies for the development of their work in general and their work related health in particular. ConclusionTo conclude there is a health promoting potential when involving artists as health promoters at a workplace. For this potential to be realised we found three categories of success factors. The experience of the participating staff were considered important since positive experiences, with adherent positive feelings, form the base for psychological and biological processes that generally have a positive impact on health. These experiences are on the other hand dependent on other facilitating factors, that here can be linked to for instance the artists as well as the organisational climate. 
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24.
  • Bringsén, Åsa, 1970-, et al. (author)
  • Vårdpersonalens uppfattningar om arbete, glädje, trivsel och hälsa
  • 2004
  • Reports (other academic/artistic)abstract
    • Arbetslivet har en betydelsefull roll när det gäller människans hela livssituation och förändringar på arbetsmarknaden har inneburit att en mindre andel av befolkningen idag tillhör arbetskraften. De som blivit kvar har fått mer att göra med större fysiska och psykiska påfrestningar som följd. Ofta studeras och presenteras arbete som en riskfaktor för ohälsa medan dess eventuella positiva påverkan på anställdas hälsa studerats i betydligt mindre utsträckning.Syftet med denna delstudie var att undersöka personalens upplevelse av sin aktuella arbets­situation i relation till deras bild av en hälsofrämjande arbetsplats.Rapporten redovisar resultatet från en kvalitativ studie med gruppintervjuer (fokusgrupps intervjuer) på två vårdavdelningarna vid sjukhusen i Hässleholm och Kristianstad. Resultat från de två avdelningarna presenteras i ett sammanhang eftersom likheterna är stora men också för att det ger en möjlighet att diskutera eventuella skillnader dem emellan.Resultatet tyder på att intervjudeltagarna uppskattar sina arbeten på de två vårdavdelningarna. Det finns dock utrymme för förbättringar om arbetsplatserna skall leva upp till deltagarnas bild av en hälsofrämjande arbetsplats. Resultatet visar att det är arbetsplatsens stödjande funktioner som ger arbetsglädje och skapar trivsel. Stödet trivseln och arbetsglädjen kan dock förbättras med insatser för en större närhet till chef och läkare samt för bättre fungerande arbets­grupper som helhet. Faktorer som ligger bakom upplevda krav och påfrestningar anses vara orsaker till upplevelsen av negativ stress. Stressen uppges å sin sida vara huvud­anledningen till att arbetsplatserna inte är hälsofrämjande för deltagarna, vilket indikerar ett behov av att reducera kraven på arbetsplatserna. Att intervjudeltagarna inte spontant reflekterade över individuella faktorers betydelse för upplevelsen av trivsel och arbetsglädje kan ses som att det är av underordnad betydelse. Troligt är dock att det även kan bero på många människors förmåga att söka efter orsaker till uppfattningar eller upplevelser i sin omgivning istället för hos sig själva.Intressant är de två olika bilderna av en hälsofrämjande arbetsplats som studiens resultat visar. En ganska stor del av intervjudeltagarna ger uttryck för att en arbetsplats som är stabil i det mesta är hälsofrämjande vilket inte överensstämmer med tidigare arbetsrelaterad forskning. För interventionsprojektet med deltagarbaserat perspektiv är studiens resultat användbart för förståelse för deltagarnas uppfattningar och upplevelser.
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25.
  • Edén, Lena, 1940-, et al. (author)
  • Characteristics of disability pensioners returning to work : an interview study among individuals with musculoskeletal disorders
  • 2007
  • In: Disability and Rehabilitation. - 0963-8288 .- 1464-5165. - 0963-8288 ; 29:22, s. 1720-1726
  • Journal article (peer-reviewed)abstract
    • Purpose. To explore adaptation patterns among disability pensioners with musculoskeletal disorders returning to work by means of the Swedish law on 'resting disability pension'. Method. Qualitative analyses of interviews with 17 individuals going back to work. Results. Three adaptation patterns were identified: The Go- getter, the Realist and the Indifferent. These differed regarding influence factors, own expectations, motive, morals and mentality. Conclusion. Several actors may support a return to work for individuals who received a disability pension due to musculoskeletal disorders. In order to succeed, however, it is essential that the disability pensioner is motivated for a reconstruction of his/ her life.
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