| 1. |
- Bergman, Caroline, et al.
(author)
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Employees’ Conceptions of Coworkership in a Swedish Health Care Organization
- 2017
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In: Nordic Journal of Working Life Studies. - : Det Kgl. Bibliotek/Royal Danish Library. - 2245-0157. ; 7:4, s. 91-107
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Journal article (peer-reviewed)abstract
- The concept of coworkership is widely established as a top-down communication strategy within organizations. However, interpretations may differ between organizational levels, and the employees’ point of view is still largely unexplored. The aim of this study was to explore and describe conceptions of coworkership among employees with different professions in a Swedish health care organization. Twelve focus group interviews were conducted with 68 employees, and the data were analyzed using phenomenography. Coworkership was experienced as a collective process, which included colleagues but not explicitly managers. Five categories emerged, representing different conceptions of coworkership: group coherence and striving toward a common goal, cooperation over professional and organizational boundaries, work experience and trusting each other’s competence, social climate and sense of community, and participation and influence. The collective process in terms of cooperation is closely related to team climate, which in turn influences the quality of patient care and a health-promoting work environment.
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| 2. |
- Bertilsson, Monica, et al.
(author)
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Health care professionals´ experience-based understanding of individuals´ capacity to work while depressed and anxious
- 2015
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In: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 22:2, s. 126-136
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Journal article (peer-reviewed)abstract
- Aim. The meaning of capacity to work while depressed and anxious is not well comprehended. The aim of this study was to explore and describe health care professionals’ experience-based understanding of capacity to work in individuals with depression and/or anxiety disorders. Method. An exploratory qualitative design was used. Four focus groups were conducted with 21 professionals from psychiatric, occupational, and primary health care. Data were analysed using inductive content analysis. Results. Capacity to work while depressed and anxious was understood as a change from the familiar to a no longer recognizable performance at work. Managing time, daily work demands, and emotions was described as difficult for the patients, and capacity to work could be fragmented by anxiety attacks. Patients were perceived as continuing to work while life outside work crumbled. Capacity to work was described as part of a greater whole, the work community, and the patient’s participation in the work community was considered problematic. Conclusions. The findings provide a deeper understanding of the reduced capacity to work compared with theoretical or medico-administrative descriptions. Applied to patient encounters it could promote fitness-for-work dialogues, rehabilitation, and tailor-made work interventions.
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| 3. |
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| 4. |
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| 5. |
- Bertilsson, Monica, et al.
(author)
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The capacity to work puzzle: a qualitative study of physicians' assessments for patients with common mental disorders
- 2018
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In: Bmc Family Practice. - : Springer Science and Business Media LLC. - 1471-2296. ; 19
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Journal article (peer-reviewed)abstract
- Background: Entitlement to sickness benefits is a legal process requiring health-related reduced work capacity confirmed by a physician via a sickness certificate. However, there is a knowledge gap concerning physicians' clinical practice of work capacity assessments for patients with common mental disorders (CMD). Physicians claim more knowledge and skills in how to actually do the assessments. The aim of this study was to explore physicians' tacit knowledge of performing assessments of capacity to work and the need for sickness absence in patients with depression and anxiety disorders. Methods: We performed a qualitative study with open-ended interviews and a short video vignette of a physician and a patient with depression as stimuli. Participating physicians (n = 24) were specialized in general practice, occupational health or psychiatry and experienced in treating patients with depression and anxiety. Interviews were audio-recorded and transcribed verbatim. Inductive content analysis was used as the analytical tool. Results: Five categories were identified. Category 1 identified work capacity assessment as doing a jigsaw puzzle without any master model. The physicians both identified and created the pieces of the puzzle, mainly by facilitating strategies to make the patient a better supplier of essential information. The finished puzzle made up a highly individualized comprehensive picture required for adequate assessment. Categories 2-4 identified the particular essential pieces of information the participants used, relating to the patient's disorder, capacity in the work place and contextual everyday life. For the sickness absence assessment, apart from decreased work capacity, the physicians also took particulars of the work place into account; e.g. could the work place handle an employee with reduced capacity. Conclusions: Physicians' tacit knowledge of assessing work capacity and the need for sickness absence for patients with CMD was identified as doing a jigsaw puzzle. The physicians became identifiers and creators of the pieces of the puzzle using a broad palette of essential information. Our findings contribute to the knowledge gap on clinical assessment and can be used as an educational tool. Because they are based on the professions' tacit knowledge, acceptance of the model can be expected to be high.
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| 6. |
- Haukenes, Inger, et al.
(author)
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Inequity in disability pension: an intersectional analysis of the co-constitution of gender, education and age. The Hordaland Health Study
- 2019
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In: Critical Public Health. - : Informa UK Limited. - 0958-1596 .- 1469-3682. ; 29:3, s. 302-313
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Journal article (peer-reviewed)abstract
- © 2018 Informa UK Limited, trading as Taylor & Francis Group Social position, education, gender and increasing age are all identified as important risk factors for disability pension. This study takes an intersectionality approach and examines their co-constitution, in relation to inequity in disability pension. The population included 22,203 middle-aged men and women participating in the community-based Hordaland Health Study, Western Norway (1997–1999). The participants were categorised in four exposure groups: higher educated men, higher educated women, lower educated men and lower educated women. The outcome was disability pension from 1992 to end of 2007, from a national registry. Using recommendations for intersectionality-informed quantitative research, we estimated the main effects of gender and educational attainment on disability pension, and potential statistical multiplicative interactions between gender and education in relation to cause-specific and all-cause disability pension. For all-cause disability pension, men with higher education had the lowest risk for disability pension (rate per 1000 person-years: 2.01) during the course of working life (from age 35 to 57), followed by higher educated women (rate 3.56), and lower educated men (rate 4.59). Finally, women with lower education had a substantially increased risk already in early middle age (rate 8.39). We found a statistical multiplicative effect of lower education and female gender on all-cause disability pension and disability pension with musculoskeletal disorders compared with men with higher education. The discussion highlights that inequity in disability pension is not only about defining vulnerable groups, but also about understanding how privileges and disadvantages are unequally distributed.
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| 7. |
- Henriksson, Malin, et al.
(author)
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Cause-specific mortality in Swedish males diagnosed with non-psychotic mental disorders in late adolescence: a prospective population-based study.
- 2018
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In: Journal of epidemiology and community health. - : BMJ. - 1470-2738 .- 0143-005X. ; 72:7, s. 582-8
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Journal article (peer-reviewed)abstract
- While risk of premature death is most pronounced among persons with severe mental illness, also milder conditions are associated with increased all-cause mortality. We examined non-psychotic mental (NPM) disorders and specific causes of natural death in a cohort of late adolescent men followed for up to 46 years.Prospective cohort study of Swedish males (n=1 784 626) who took part in structured conscription interviews 1968-2005. 74 525 men were diagnosed with NPM disorders at or prior to conscription. Median follow-up time was 26 years. HRs for cause-specific mortality were calculated using Cox proportional hazards models.Risks in fully adjusted models were particularly elevated for death by infectious diseases (depressive and neurotic/adjustment disorders (HR 2.07; 95%CI 1.60 to 2.67), personality disorders (HR 2.90; 95%CI 1.96 to 4.28) and alcohol-related and other substance use disorders (HR 9.02; 95%CI 6.63 to 12.27)) as well as by gastrointestinal causes (depressive and neurotic/adjustment disorders (HR 1.64; 95%CI 1.42 to 1.89), personality disorders (HR 2.77; 95%CI 2.27 to 3.38) and alcohol-related/substance use disorders (HR 4.41; 95%CI 3.59 to 5.42)).Young men diagnosed with NPM disorders had a long-term increased mortality risk, in particular due to infectious and gastrointestinal conditions. These findings highlight the importance of early preventive actions for adolescents with mental illness.
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| 8. |
- Knapstad, Marit, et al.
(author)
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Registry-based analysis of participator representativeness: A source of concern for sickness absence research?
- 2016
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In: BMJ Open. - : BMJ. - 2044-6055. ; 6
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Journal article (peer-reviewed)abstract
- © BMJ Publishing Group Limited 2016.Objectives: Selective participation can bias results in epidemiological surveys. The importance of health status is often suggested as a possible explanation for non-participation but few empirical studies exist. In a population-based study, explicitly focused on sickness absence, health and work, we examined whether a history of high levels of sickness absence was associated with non-participation. Design: The study is based on data from official sickness absence registers from participants, non-participants and the total target population of the baseline survey of the Health Assets Project (HAP). Setting: HAP is a population-based cohort study in the Västra Götaland region in South Western Sweden. Participants: HAP included a random population cohort (n=7984) and 2 cohorts with recent sickness absence (employees (n=6140) and non-employees (n=990)), extracted from the same overall general working-age population. Primary outcome measures: We examined differences in participation rates between cohorts (2008), and differences in previous sickness absence (2001-2008) between participants (individual-level data) and non-participants or the target population (group-level data) within cohorts. Results: Participants had statistically significant less registered sickness absence in the past than nonparticipants and the target population for some, but not all, of the years analysed. Yet these differences were not of substantial size. Other factors than sickness absence were more important in explaining differences in participation, whereby participants were more likely to be women, older, born in Nordic countries, married and have higher incomes than non-participants. Conclusions: Although specifically addressing sickness absence, having such experience did not add any substantial layer to selective participation in the present survey. Detailed measures are needed to gain a better understanding for health selection in healthrelated surveys such as those addressing sickness absence, for instance in order to discriminate between selection due to ability or motivation for participation.
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| 9. |
- Löve, Jesper, 1974, et al.
(author)
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Future marginalisation and mortality in young Swedish men with non-psychotic psychiatric disorders and the resilience effect of cognitive ability: a prospective, population-based study
- 2016
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In: BMJ Open. - : BMJ. - 2044-6055. ; 6:8
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Journal article (peer-reviewed)abstract
- Objective: Large-scale studies examining future trajectories of marginalisation and health in adolescents with mental illness are scarce. The aim of this study was to examine if non-psychotic psychiatric disorders (NPDs) were associated with future indicators of marginalisation and mortality. We also aimed to determine whether these associations might be mediated by education level and attenuated by high cognitive ability. Design: This is a prospective cohort study with baseline data from the Swedish Conscription register. Setting: The study was carried out in Sweden from 1969 to 2005. Participants: All of the participants were 18-year-old men at mandatory conscription in Sweden between 1969 and 2005 (n=1 609 690). Measures: NPDs were clinically diagnosed at conscription. Cognitive ability was measured by a standardised IQ test at conscription. National register data covered information on welfare support, long-term unemployment, disability pension (DP) and mortality over a period of 1–36 years. Results: NPD at the age of 18 years was a predictor of future welfare support, OR 3.73 (95% CI 3.65 to 3.80); long-term unemployment, OR 1.97 (95% CI 1.94 to 2.01); DP, HR 2.95 (95% CI 2.89 to 3.02); and mortality, HR 2.45 (2.33–2.52). The adjusted models suggested that these associations were not confounded by fathers’ educational level, cognitive ability had only a minor attenuating effect on most associations and the mediating effect of own educational level was small. Conclusions: The present study underlines a higher prevalence of future adversities in young men experiencing NPDs at the age of 18 years. It also indicates that higher cognitive ability may work as a potential resilience factor against future marginalisation and mortality.
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| 10. |
- Löve, Jesper, 1974, et al.
(author)
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Political Ideology and Stigmatizing Attitudes Toward Depression: The Swedish Case
- 2019
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In: International Journal of Health Policy and Management. - : Maad Rayan Publishing Company. - 2322-5939. ; 8:6, s. 365-374
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Journal article (peer-reviewed)abstract
- Stigmatizing attitudes toward persons with mental disorders is a well-established and global phenomenon often leading to discrimination and social exclusion. Although previous research in the United States showed that conservative ideology has been related to stigmatizing attitudes toward mental disorders, there is reason to believe that this mechanism plays a different role in the context of a universal welfare state with a multi-party system such as Sweden. Furthermore, “mental disorders” may signify severe psychotic disorders, which may evoke more negative attitudes. This suggests the importance of specific studies focusing on the more common phenomenon of depression. This paper investigates the relationship between political ideology and stigmatizing attitudes toward depression in Sweden. Methods This study is part of the New Ways research program. Data were collected by the Laboratory of Opinion Research (LORE) at the University of Gothenburg in 2014 (N = 3246). Independent variables were political ideology and party affiliation. The dependent variable was the Depression Stigma Scale (DSS). Data were analyzed with linear regression analyses and analyses of variance. Results More conservative ideology (B = 0.68, standard error [SE] = 0.04, P < .001) and more conservative party affiliation (F(8 2920) = 38.45, P < .001) showed more stigmatizing attitudes toward depression. Item-level analyses revealed a difference where the supporters of the conservative party differed (P < .05) from supporters of the liberal party, with a higher proportion agreeing that “people could snap out of” depression if they wanted to; the populist right-wing party differed from the conservative party with a higher proportion agreeing on items displaying people with depression as “dangerous” and “unpredictable.” Even self-stigma was highest among the populist right-wing party with 22.3% agreeing that “if I had depression I wouldn’t tell….” Conclusion Political ideology was associated with stigmatizing attitudes toward depression in Sweden. The results also confirm the need to distinguish between different forms of conservatism by observing social distance as being a more important driver among voters for the populist right-wing party compared with personal agency and responsibility among voters for the more traditional conservative party.
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| 11. |
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| 12. |
- Lövestad, Solveig, et al.
(author)
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Prevalence of intimate partner violence and its association with symptoms of depression; A cross-sectional study based on a female population sample in Sweden
- 2017
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In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 17:1
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Journal article (peer-reviewed)abstract
- © 2017 The Author(s).Background: Intimate Partner Violence (IPV) is the most common type of violence targeting women. IPV includes acts of physical aggression, sexual coercion, psychological abuse and controlling behaviors and these forms of violence often coexist in the same relationship. Living with IPV is associated with serious mental health outcomes such as depression and depressive symptoms. Few population based studies from Sweden have investigated the relationship between different forms of IPV and women's depressive symptoms and even fewer used controlling behavior as an independent variable in such studies. The aim of this study was therefore to assess the prevalence of exposure to IPV in terms of controlling behavior, sexual, and physical violence and their association with self-reported symptoms of depression in a female population based sample. Methods: The cross-sectional, population based sample contained 573 women aged 18-65 years randomly selected in Sweden. Five self-reported symptoms that define depression in the Diagnostic and Statistical Manual of Mental Disorders were assessed. Physical and sexual violence were inquired about using the World Health Organization's (WHO) Violence Against Women Instrument (VAWI), while controlling behavior was assessed with the Controlling Behavior Scale (CBS). Associations between different forms of IPV and symptoms of depression were estimated by crude and adjusted odds ratio (OR) with 95% confidence intervals (CI). Results: Bivariable associations revealed that women exposed to controlling behavior, had higher OR of depressive symptoms compared to unexposed women (OR 2.43; 95% CI 1.63-3.63). Women exposed to physical and sexual violence had also a higher OR of depressive symptoms (OR 3.78; 95% CI 1.99-7.17 and OR 5.10; 95% CI 1.74-14.91 respectively). After adjusting for socio-demographic and psychosocial covariates, all three forms of IPV showed statistically significant associations with self-reported symptoms of depression. Conclusions: A strength with this study is the analysis of controlling behavior and its association with self-reported symptoms of depression in a female population based sample. Exposure to controlling behavior, physical and sexual violence by an intimate partner were clearly associated with women's self-reported symptoms of depression.
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| 13. |
- Lövestad, Solveig, et al.
(author)
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Suicidal ideation and attempts in population-based samples of women: temporal changes between 1989 and 2015.
- 2019
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In: BMC public health. - : Springer Science and Business Media LLC. - 1471-2458. ; 19:1
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Journal article (peer-reviewed)abstract
- Little is known about temporal changes in the prevalence of self-reported suicidal ideation and attempts within general populations of women. The aim of this study was to assess the prevalence of self-reported suicidal ideation and attempts over a 26year period (1989-2015) among women from the general population aged 20-49years. A further aim was to investigate associations between sociodemographic factors and lifetime suicidal ideation over this study period.A total of 2072 structured personal interviews were performed with a stratified population-based sample of women between 1989 and 2015. Questions about lifetime suicidal ideation and attempts as well as sociodemographic factors were assessed at four data collection waves. Lifetime prevalence of suicidal ideation and attempts were compared through analysis of differences between two independent proportions and their 95% Confidence Intervals (CI). Associations between sociodemographic factors and lifetime suicidal ideation were estimated by weighted odds ratios (OR).Women aged 20-30years reported higher lifetime prevalence of suicidal ideation in 2013-2015 compared to 1989-1991 (45 and 33% respectively). Rates of lifetime suicide attempts remained similar between these time points (3.5 and 3.1% respectively). Women aged 31-49years reported higher lifetime prevalence of suicidal ideation in 2013-2015 compared to 2000-2002 (35.4 and 23.1% respectively). In this age group, lifetime suicide attempts increased from 0.0% in 2000-2002 to 3.6% in 2013-2015. Women aged 20-30years who were single, unemployed or had low educational attainment had higher OR of lifetime suicidal ideation compared to the reference categories in most of the study waves. In 2013-2015, young students had lower OR of lifetime suicidal ideation (OR 0.34; 95% CI 0.17-0.69) compared to those with employment. Women aged 31-49years, who were single, had higher OR of lifetime suicidal ideation (OR 2.61; 95% CI 1.06-6.44) than married, cohabiting women and this was observed in 2013-2015.The results raise a general concern about an increasing trend in suicidal ideation among young and middle-aged women. The current study expands on previous research by demonstrating that sociodemographic factors may show changing patterns in the associations with lifetime suicidal ideation over time.
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| 14. |
- Priebe, Gunilla, 1965, et al.
(author)
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Kan Hälsostöd främja en positiv utveckling av psykisk hälsa och hälsolitteracitet hos asylsökande och nyanlända? Utvärdering av effekter och processer
- 2019
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Reports (other academic/artistic)abstract
- Sedan 2015 har Sveriges Kommuner och Landsting (SKL) genomfört ett omfattande arbete för att identifiera, sprida och stötta implementeringen av metoder som kan stödja en positiv hälsoutveckling hos asylsökande och nyanlända. I Västra Götalandsregionen (VGR) har HiS spridits utifrån beslut i Hälso-och sjukvårdsstyrelsen september 2016. Som en del av HiS-programmet ges Hälsoinformation vid ett tillfälle och Hälsostödets vid fem gruppträffar. Hälsoinformationen omfattar främst information om det svenska hälso- och sjukvårdssystemet, medan Hälsostödet har ett mer långtgående syfte i att förstärka en positiv utveckling av den psykiska hälsan genom öka begripligheten över den situation gruppdeltagarna befinner sig i, ge dem redskap att i vardagen hantera vissa svårigheter samt också få kunskap om hjälp som finns att få. Föreliggande utvärderings specifika mål har varit (a) att utvärdera effekter på psykisk hälsa och hälsolitteracitet före-och-efter deltagande i HiS-programmets Hälsostöd, samt (b) att utvärdera deltagarnas egen upplevelse av Hälsoinformationens och Hälsostödets genomförande och godtagbarhet. Effektutvärderingen visar på en positiv association mellan deltagande i Hälsostöd och förbättring av nyanländas psykiska hälsa och hälsolitteracitet. Processutvärderingen indikerar att denna kan öka ytterligare efter förbättringar i genomförande. Utvärderingens slutsats är därför att: •satsningen på Hälsostöd fortsätter då den kan anses vara positiv både på individ- och samhällsnivå, för mottagande och integration av asylsökande och nyanlända. Specifikt kan Hälsostöd erbjudas som en dokumenterat fungerande åtgärd för att främja nyanländas psykiska hälsa och hälsolitteracitet. •man överväger om gruppen asylsökande ska erbjudas mer eller annan hjälp. Innehållet och deltagandet i Hälsostöd kan enligt föreliggande utvärdering inte fullt ut hjälpa personer i den mycket påfrestande och utdragna asylprocessen. •åtgärder vidtas för att klargöra prioriteringar mellan uppdragets målsättningar och medel för att nå dessa. •ökade resurser och fokus läggs på att stärka stödjande kultur med syfte att öka projektets effektivitet liksom att motverka hälsorisker för teamledare och Hälsokommunikatörer.
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| 15. |
- Robertson, Josefina, et al.
(author)
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Mental disorders and stress resilience in adolescence and long-term risk of early heart failure among Swedish men.
- 2017
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In: International journal of cardiology. - : Elsevier BV. - 1874-1754 .- 0167-5273. ; 243, s. 326-331
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Journal article (peer-reviewed)abstract
- Recent research suggests that the prevalence of early heart failure may be on the rise. Compromised mental health in adolescence may help to explain this phenomenon. We aimed to investigate whether nonpsychotic mental disorder and low stress resilience in late adolescence were associated with increased risk of early heart failure.A prospective cohort study of 18-year-old men (n=1,784,450) who enlisted 1968-2005. At the conscription examination, 74,522 individuals were diagnosed with nonpsychotic mental disorders. Stress resilience was rated by psychologists; values were trichotomized. The risk of heart failure during the 46-year follow-up was calculated with Cox proportional hazards models. Baseline comorbidities, BMI, blood pressure, fitness, IQ, and parental education were included in the models.Incident cases of heart failure (n=9962) were identified in the National Hospital Register. In fully adjusted models, increased risk of early heart failure was observed in males diagnosed with nonpsychotic mental disorders at conscription (hazard ratio (HR), 1.36; 95% confidence interval (CI), 1.25-1.47). The highest risk was seen among men with the risk factor alcohol/substance use (HR 1.90; 95% CI 1.59-2.28). Conscripts with the risk factor low stress resilience showed increased risk of heart failure compared to those with high scores (HR 1.41; 95% CI 1.30-1.53).Nonpsychotic mental disorder, as well as low stress resilience in late adolescence may be associated with increased risk of early heart failure. Adolescence is potentially an important time for mental health interventions that may reduce both short and long-term consequences.
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| 16. |
- Tabi, E. S. B., et al.
(author)
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Soil-transmitted Helminth infection in the Tiko Health District, South West Region of Cameroon: a post-intervention survey on prevalence and intensity of infection among primary school children
- 2018
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In: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 30
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Journal article (peer-reviewed)abstract
- Introduction: Soil-transmitted helminths (STH) infection remains a public health problem in sub-Saharan Africa with children being most vulnerable. STH infection may result in impairment, permanent disability or death. Annual mass deworming has been implemented in the Tiko Health District (THD), however, no study has assessed the current prevalence of STH infection. This study aimed to determine the prevalence, intensity of STH infections and associated risk factors among school children. Methods: Two months after the school deworming exercise, 400 children were sampled from 10 schools in THD. Stool samples were collected and analyzed using the Kato-katz technique. Data on sociodemographic and behavioral factors were collected using questionnaires. Data were analyzed using SPSS and intensity of infection categorized following WHO recommendations. Descriptive data were calculated with frequencies (n) and proportions (%), prevalence and 95% confidence interval calculated for gender and age respectively. Differences in prevalence for socio-demographic characteristics and behavioral variables were calculated with Chi square (chi(2)). Independent sample t-test was used to compare the means in the number of eggs in feces between male and female school children. Results: The prevalence of STH was 1% (95% CI: 0.02-1.98). Ascaris lumbricoides was the only STH species detected and all cases were of low intensities. The arithmetic mean egg intensity was 3.1egg per gram of faeces. Rates of infection were similar between gender and age. Site of defecation showed an association with STH infection (chi(2)= 13.63, p= 0.03). Conclusion: These findings suggested a low prevalence of STH infection which could be explained by the prior deworming of children, modification in environmental and behavioral factors. Questions on effectiveness of annual mass deworming in achieving STH elimination targets need to be investigated further.
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