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Lindberg, M., Skytt, B., Lindberg, M., Wijk, K. & Strömberg, A. (2023). A complex challenge with unclear improvement: the need for involvement, contextualization and facilitation when managers implement a leadership model. Leadership in Health Services, 36(2), 236-246
Open this publication in new window or tab >>A complex challenge with unclear improvement: the need for involvement, contextualization and facilitation when managers implement a leadership model
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2023 (English)In: Leadership in Health Services, ISSN 1751-1879, E-ISSN 1751-1887, Vol. 36, no 2, p. 236-246Article in journal (Refereed) Published
Abstract [en]

Purpose

Management and leadership in health care are described as complex and challenging, and the span of control is known to be a key component in the manager’s job demands. The implementation of change can be a challenge in health care, and managers often have roles as implementation leaders. Little attention has been given to how managers perceive the process of implementation. Thus, this study aims to explore second-line managers’ perceptions of, prerequisites for and experiences from the implementation of changes in their manager’s work conditions.

Design/methodology/approach

A grounded theory–based qualitative design was used. Data were collected from a purposive sample of nine second-line managers by individual semi-structured interviews. The three stages of initial coding, focus codes and axial coding were used in data analysis.

Findings

Three thematic areas were identified: engagement, facilitation and achievement. The second-line managers’ descriptions suggest that the change work entails a complex challenge with an unclear result. Involvement, consideration for the context and facilitation are needed to be able to conduct a cohesive implementation process.

Originality/value

This study findings outline that to succeed when implementing change in complex organizations, it is crucial that managers at different levels are involved in the entire process, and that there are prerequisites established for the facilitation and achievement of goals during the planning, implementation and follow-up.

Place, publisher, year, edition, pages
Emerald, 2023
Keywords
Change management; Health services; Implementation; Leadership; Organisation and administration; Qualitative research
National Category
Health Sciences
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-40080 (URN)10.1108/lhs-05-2022-0055 (DOI)000863665800001 ()36193881 (PubMedID)2-s2.0-85139172682 (Scopus ID)
Available from: 2022-10-07 Created: 2022-10-07 Last updated: 2023-04-25Bibliographically approved
Wijk, K., Bergsten, E. L., Mathiassen, S. E. & Hallman, D. (2023). Individual determinants of satisfaction with the work environment after relocation to activity-based workplaces: a prospective study. PLOS ONE, 18(3), Article ID e0281771.
Open this publication in new window or tab >>Individual determinants of satisfaction with the work environment after relocation to activity-based workplaces: a prospective study
2023 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 3, article id e0281771Article in journal (Refereed) Published
Abstract [en]

Relocation to activity-based workplaces influences work environment satisfaction, but individual determinants of changes in satisfaction remain unknown. The aim of the present study was to determine whether age, gender, education, occupational position, or office type before relocation can predict work environment satisfaction among employees and managers relocated to activity-based offices. Respondents (n=422) rated work environment satisfaction three months before and nine months after relocation. The findings indicate that, on average, satisfaction decreased after relocation, while for some workers it increased. Occupational position and office type at baseline predicted changes in satisfaction with the work environment; specifically, managers and those working in open-plan offices before relocation reported a smaller decline in satisfaction after relocation, compared to those relocating from private offices. Participants with no university education were more satisfied with the physical and psychosocial work environment in activity-based workplaces than those with a university degree. 

Place, publisher, year, edition, pages
PLOS, 2023
National Category
Occupational Health and Environmental Health
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-40615 (URN)10.1371/journal.pone.0281771 (DOI)000967546000012 ()37000789 (PubMedID)2-s2.0-85151350085 (Scopus ID)
Funder
Swedish Transport Administration
Available from: 2022-12-19 Created: 2022-12-19 Last updated: 2023-06-16Bibliographically approved
Macassa, G., Wijk, K., Rashid, M., Hiswåls, A.-S., Daca, C. & Soares, J. (2023). Interpersonal violence is associated with self-reported stress, anxiety and depression among men in east-central Sweden: Results of a population-based survey. Medicina, 59(2), Article ID 235.
Open this publication in new window or tab >>Interpersonal violence is associated with self-reported stress, anxiety and depression among men in east-central Sweden: Results of a population-based survey
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2023 (English)In: Medicina, ISSN 1010-660X, E-ISSN 1648-9144, Vol. 59, no 2, article id 235Article in journal (Refereed) Published
Abstract [en]

Background and Objectives: Interpersonal violence is a social and public health problem globally, and though it is related to poor health outcomes across all genders, most research has been directed towards violence against women. As a result, the health consequences of men’s victimization may be underreported and unaddressed. The purpose of this study was to assess the relationship between interpersonal violence and the psychological health outcomes of self-reported stress, anxiety, and depression among men. Materials and Methods: The study used data from the male sample (n = 2597) of the 2018 Health on Equal Terms Survey conducted in Gävleborg County in East-Central Sweden. Regression analysis was carried out to study the relationship between interpersonal violence and self-reported stress, anxiety, and depression. Results: The bivariate analysis showed that there was a statistically significant association between interpersonal violence and self-reported stress (OR 2.35; CI 1.45–3.81), anxiety (OR 1.54; CI 1.06–2.25), and depression (OR 2.30; CI 1.48–3.57). Controlling for other variables in the multivariate analysis removed the statistically significant relationship and reduced the odds ratios for stress (OR 1.46; CI 0.57–3.74), anxiety (OR 0.86; 0.40–1.84), and depression (OR 1.40; CI 0.67–3.32) respectively. Conclusions: The study found that interpersonal violence among men was associated with stress, anxiety and depression which was largely explained by demographic, socioeconomic, and health/behavior-related factors. The findings suggest the need for longitudinal studies to assess causal links between male victimization and psychological health outcomes at the county level.

Place, publisher, year, edition, pages
MDPI, 2023
Keywords
interpersonal violence; men; Gävleborg County; Health on Equal Terms Survey; stress; anxiety; depression
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-40938 (URN)10.3390/medicina59020235 (DOI)000940008900001 ()36837437 (PubMedID)2-s2.0-85148906652 (Scopus ID)
Available from: 2023-01-27 Created: 2023-01-27 Last updated: 2023-03-24Bibliographically approved
Macassa, G., McGrath, C., Wijk, K., Rashid, M., Hiswåls, A.-S. & Soares, J. (2023). The association between fear of crime, educational attainment, and health. Epidemiologia, 4(2), 148-162
Open this publication in new window or tab >>The association between fear of crime, educational attainment, and health
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2023 (English)In: Epidemiologia, E-ISSN 2673-3986, Vol. 4, no 2, p. 148-162Article in journal (Refereed) Published
Abstract [en]

Fear of crime is an important public health problem that impacts people’s quality oflife, health, and wellbeing, and causes mental health ailments (e.g., anxiety). This study aimed todetermine whether there was an association between fear of crime, educational attainment, andself-rated health and anxiety among women residing in a county in east-central Sweden. A sample(n = 3002) of women aged 18–84 years surveyed in the Health on Equal Terms survey carried outin 2018 was included in the study. Bivariate and multivariate regression analysis was performedon the relationship between the composite variables fear of crime, educational attainment, andself-rated health and anxiety. Women with primary education or similar who reported fear of crimehad increased odds of poor health (odds ratio (OR) 3.17; 95% confidence interval (CI) 2.40–4.18)compared with women with primary education/similar and no fear of crime (OR 2.90; CI 1.90–3.20).A statistically significant relationship persisted in the multivariate analysis after controlling forother covariates, although the odds were reduced (OR 1.70; CI 1.14–2.53 and 1.73; CI 1.21–2.48,respectively). Similarly, in the bivariate analysis, women who reported fear of crime and whoonly had primary education had statistically significant odds of anxiety (OR 2.12; CI 1.64–2.74); thesignificance was removed, and the odds were reduced (OR 1.30; CI 0.93–1.82) after adjusting fordemographic, socioeconomic, and health-related covariates. Women with only primary educationor similar who reported fear of crime had higher odds of poor health and anxiety compared withthose with university education or similar, with and without fear of crime. Future studies (includinglongitudinal ones) are warranted—on the one hand, to understand possible mechanisms of therelationship between educational attainment and fear of crime and its consequences to health, and onthe other, to explore low-educated women’s own perceptions regarding factors underlining their fearof crime (qualitative studies).

Place, publisher, year, edition, pages
MDPI, 2023
Keywords
fear of crime; educational attainment; women; self-rated health; anxiety; Gävleborg
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-41714 (URN)10.3390/epidemiologia4020016 (DOI)37218875 (PubMedID)2-s2.0-85165094061 (Scopus ID)
Available from: 2023-04-30 Created: 2023-04-30 Last updated: 2023-08-01Bibliographically approved
Wirkkala, M., Wijk, K., Engström, M. & Larsson, A. C. (2023). Turnover intentions in healthcare staff. In: : . Paper presented at The 23rd Biennial Conference of the International Consortium for Social Development, Gävle, Sweden, August 23-25, 2023.
Open this publication in new window or tab >>Turnover intentions in healthcare staff
2023 (English)Conference paper, Oral presentation only (Other academic)
Abstract [en]

Introduction Turnover intentions (TI) in healthcare staff relate to high workload and high emotional exhaustion. Nurses have higher TI than other healthcare professionals. Few studies have focused on TI in healthcare staff as a group within the Job Demand-Resources (JD-R) theory.

Aim To investigate healthcare staffs’ TI in relation to JD-R theory and relationships with staff wellbeing.

Method A cross-sectional correlational and comparative study using a survey to healthcare staff in Sweden, in 2022. The survey contained questions of work environment, wellbeing and TI. Data were analysed with SPSS.

Results The survey had 416 responders from different professions (response rate 31%). Fourteen percent rated their TI as high. High TI related to high emotional exhaustion. Moderate relationships were seen between high TI and high job demands/low resources. Weak relationships were seen between high TI and high workload and low satisfaction with given care. TI was also related to age, but no differences were seen for gender or level of education. 

Conclusions The results resemble earlier research regarding TI, stress and burnout. The results suggest that high demands and low resources are related to healthcare staffs’ TI. More studies with similar design are needed to confirm and broaden the results.

Keywords
Turnover intentions, healthcare staff, workload, emotional exhaustion, JD-R
National Category
Occupational Health and Environmental Health
Research subject
Health-Promoting Work, Inkluderande arbetsliv
Identifiers
urn:nbn:se:hig:diva-43405 (URN)
Conference
The 23rd Biennial Conference of the International Consortium for Social Development, Gävle, Sweden, August 23-25, 2023
Funder
Region Gavleborg
Available from: 2023-12-06 Created: 2023-12-06 Last updated: 2023-12-08Bibliographically approved
Johansson, N., Sarkadi, A., Feldman, I., Price, A. M. H., Goldfeld, S., Salonen, T., . . . Warner, G. (2022). Ameliorating Child poverty through Connecting Economic Services with child health Services (ACCESS): study protocol for a randomised controlled trial of the healthier wealthier families model in Sweden. BMC Public Health, 22(1), Article ID 2181.
Open this publication in new window or tab >>Ameliorating Child poverty through Connecting Economic Services with child health Services (ACCESS): study protocol for a randomised controlled trial of the healthier wealthier families model in Sweden
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2022 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 22, no 1, article id 2181Article in journal (Refereed) Published
Abstract [en]

Background: Sweden is often held up as an example of a country with low child deprivation; yet, rates of relative deprivation are rising. Every municipality in Sweden is required to provide free, timely and accessible budget and debt counselling under the Social Services Act. The services have been encouraged to perform preventative practice with families; however, this has not been realised. The Healthier Wealthier Families (HWF) model embeds universal screening for economic hardship into child health services and creates a referral pathway to economic support services. Given the universal child health system in Sweden, which is freely available and has excellent coverage of the child population, implementation of the HWF model has potential to support families to access the freely available municipal budget and debt counselling and ultimately improve rates of child deprivation in Sweden.

Methods/design: We will conduct a two-arm randomised waitlist-control superiority trial to examine the effectiveness and cost-effectiveness of the HWF model in the Sweden. A longitudinal follow-up with the cohort will explore whether any effects are maintained in the longer-term.

Discussion: HWF is a collaborative and sustainable model that could maximise the effectiveness of current services to address child deprivation in Sweden. The study outlined in this protocol is the first effectiveness evaluation of the HWF model in Sweden and is a crucial step before HWF can be recommended for national implementation within the child health services.

Trial registration: Clinicaltrials.gov; NCT05511961. Prospectively registered on 23 August 2022. https://clinicaltrials.gov/ct2/show/NCT05511961.

Place, publisher, year, edition, pages
BMC, 2022
Keywords
Child health services; Child poverty; Economic services; Healthier wealthier families; Sweden
National Category
Health Sciences Sociology
Identifiers
urn:nbn:se:hig:diva-40549 (URN)10.1186/s12889-022-14424-x (DOI)000888746900016 ()36434580 (PubMedID)2-s2.0-85142468651 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2021-01415
Available from: 2022-12-02 Created: 2022-12-02 Last updated: 2023-08-28Bibliographically approved
Bergsten, E. L., Wijk, K. & Hallman, D. (2022). Implementation of Activity-Based Workplaces (ABW)—The Importance of Participation in Process Activities. International Journal of Environmental Research and Public Health, 19(21), Article ID 14338.
Open this publication in new window or tab >>Implementation of Activity-Based Workplaces (ABW)—The Importance of Participation in Process Activities
2022 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 21, article id 14338Article in journal (Refereed) Published
Abstract [en]

Relocation to new office solutions such as activity-based workplaces (ABW) has increased but satisfaction with the ABW among employees varies, and the importance of participation in the relocation process is unclear. This study aimed to examine the association between employees’ extent of participation in the implementation process activities and satisfaction with the relocation to ABW. Data were collected from 699 employees in a Swedish governmental agency 3-months prior to, 3-months and 9-months after relocation to the ABW. Questionnaires were used to assess participation in process activities and perceived satisfaction with knowledge about working in ABW, office rules, and information and support during the process. Participation in activities was significantly associated with higher overall satisfaction with knowledge, office rules, information and support, and effects were generally more pronounced as the number of attended activities increased. Satisfaction also increased among non-participants, although without reaching the same levels as participants. Our results show the importance to offer and facilitate a high participation in the relocation process activities to obtain satisfaction with a relocation to ABW.

Place, publisher, year, edition, pages
MDPI, 2022
Keywords
activity-based flexible office; office design; relocation; organizational intervention
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:hig:diva-40351 (URN)10.3390/ijerph192114338 (DOI)000883934500001 ()36361224 (PubMedID)2-s2.0-85141593461 (Scopus ID)
Funder
Swedish Transport Administration, 2017/98929
Available from: 2022-11-04 Created: 2022-11-04 Last updated: 2022-12-01Bibliographically approved
Bergsten, E. L., Wijk, K. & Hallman, D. (2022). The important process when relocating to activity-based workplaces. In: : . Paper presented at 51st NES (Nordic Ergonomics and Human Factors Society) Conference, Uppsala, 23-25 October 2022.
Open this publication in new window or tab >>The important process when relocating to activity-based workplaces
2022 (English)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:hig:diva-40352 (URN)
Conference
51st NES (Nordic Ergonomics and Human Factors Society) Conference, Uppsala, 23-25 October 2022
Available from: 2022-11-04 Created: 2022-11-04 Last updated: 2022-12-01Bibliographically approved
Gupta, S. L., Wijk, K., Warner, G. & Sarkadi, A. (2021). Readiness of allied professionals to join the mental health workforce: a qualitative evaluation of trained lay trauma counsellors’ experiences when refugee youth disclose suicidal ideation. International Journal of Environmental Research and Public Health, 18(4), Article ID 1486.
Open this publication in new window or tab >>Readiness of allied professionals to join the mental health workforce: a qualitative evaluation of trained lay trauma counsellors’ experiences when refugee youth disclose suicidal ideation
2021 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 4, article id 1486Article in journal (Refereed) Published
Abstract [en]

The recent refugee crisis presented a huge challenge for the Swedish mental health workforce. Hence, innovative mental health workforce solutions were needed. Unaccompanied refugee minors (URM) are a particularly vulnerable refugee group. Teaching Recovery Techniques (TRT) was introduced as a community-based intervention utilising trained lay counsellors in a stepped model of care for refugee youth experiencing trauma symptoms. Professionals (e.g., teachers, social workers) can deliver the Cognitive Behavioural Therapy-based intervention after a brief training. A point of debate in this workforce solution is the readiness of trained lay counsellors to deal with potentially demanding situations like disclosure of suicidal ideation. This study aimed to explore the TRT trained lay counsellors’ experiences of procedures upon URM’s disclosure of suicidal ideation. Individual semi-structured interviews with TRT trained lay counsellors were conducted, then analysed using systemic text condensation. The analysis revealed four themes: “Importance of safety structures”, “Collaboration is key”, “Let sleeping dogs lie” and “Going the extra mile”. Dealing with suicidal ideation is challenging and feelings of helplessness occur. Adding adequate supervision and specific training on suicidal ideation using role play is recommended. Collaboration between agencies and key stakeholders is essential when targeting refugee mental health in a stepped care model.

Place, publisher, year, edition, pages
MDPI, 2021
Keywords
Cognitive behaviour therapy, Group intervention, Mental health workforce, Stepped care model, Teaching recovery techniques, Trained lay counsellors, Unaccompanied refugee minors, Workforce solution
National Category
Health Sciences Sociology
Identifiers
urn:nbn:se:hig:diva-35248 (URN)10.3390/ijerph18041486 (DOI)000623636300001 ()33557361 (PubMedID)2-s2.0-85100266765 (Scopus ID)
Available from: 2021-02-10 Created: 2021-02-10 Last updated: 2022-09-09Bibliographically approved
Bergsten, E. L., Wijk, K. & Hallman, D. (2021). Relocation to activity-based workplaces (ABW) – importance of the implementation process. International Journal of Environmental Research and Public Health, 18, Article ID 11456.
Open this publication in new window or tab >>Relocation to activity-based workplaces (ABW) – importance of the implementation process
2021 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, article id 11456Article in journal (Refereed) Published
Abstract [en]

Activity-based workplaces (ABW) have been implemented in many organizations to offer office flexibility and decrease facility costs. Evaluations of the ABW implementation process are rare. The study aimed to examine the ABW relocation process of two offices in a Swedish governmental agency and to explore factors that influence the implementation process and satisfaction with it. Qualitative or quantitative data were collected on process variables (context, recruitment, reach, dose delivered, dose received, satisfaction), barriers and facilitators to the process were explored in focus group interviews, and immediate outcomes (perceived knowledge, understanding office rules, satisfying information and support) were measured by questionnaire before and after the relocation. The evaluation showed that recruitment was unsatisfactory and reach insufficient—and participation in activities was thus low for both offices. However, intended changes improved. Unclear aims of ABW, lack of manager support and, lack of communication were some of the reported barriers to participation, while a well-planned process, work groups, and program activities were facilitators. Thus, to increase satisfaction with the relocation, our results suggest that recruitment should be thoroughly planned, taking these factors into account to increase participation. This knowledge may be useful for planning and designing successful ABW relocations and evaluations.

Place, publisher, year, edition, pages
MDPI, 2021
Keywords
activity-based flexible office; organizational intervention; implementation; working environment; office design
National Category
Health Sciences
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-37284 (URN)10.3390/ijerph182111456 (DOI)000726588300001 ()34769974 (PubMedID)2-s2.0-85118217138 (Scopus ID)
Funder
Swedish Transport Administration
Available from: 2021-10-28 Created: 2021-10-28 Last updated: 2022-09-09Bibliographically approved
Projects
The Intervention CAN-Work-S: Facilitating Work Participation among Cancer Survivors During their Entire Professional Career [2021-01546_Forte]; University of Gävle
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-6067-3520

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