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  • 1.
    Dahlkvist, Eva
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Health and Medicine, Örebro University, Örebro, Sweden.
    Hartig, Terry
    Department of Psychology, Uppsala university, Uppsala, Sweden; Institute for Housing and Urban Research,Uppsala university, Uppsala, Sweden.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Skovdahl, Kirsti
    Faculty of Health Sciences, Buskerud and Vestfold university, Norway.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Garden greenery and the health of older people in residential care facilities: A multi-level cross-sectional study2016In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 9, p. 2065-2076Article in journal (Refereed)
    Abstract [en]

    AIMS:

    To test the relationship between greenery in gardens at residential facilities for older people and the self-perceived health of residents, mediated by experiences of being away and fascination when in the garden and the frequency of visitation there. To examine how these indirect effects vary with the number of physical barriers to visiting the garden.

    BACKGROUND:

    Many older people in residential facilities suffer from complex health problems. Access to a green outdoor environment may enable psychological distance, engage effortless attention, encourage more frequent visitation and promote resident health.

    DESIGN:

    A multi-level, cross-sectional, correlational design.

    METHODS:

    Questionnaires were administered June-August, 2011 to convenience samples of residents at 72 facilities for older people with complex healthcare needs. One to 10 eligible residents were sampled during self-motivated garden visits at each facility (n = 290). They reported on their garden experiences and health. Facility staff reported on objective garden characteristics and barriers to access. A serial mediation model was tested with multiple linear regression analysis.

    RESULTS:

    The total indirect effect of greenery on self-perceived health was positive and significant. Garden greenery appears to affect health by enhancing a sense of being away, affording possibilities to experience the outdoor environment as interesting and encouraging visitation. Among residents in homes with multiple barriers, only fascination mediated the relationship between greenery and self-perceived health.

    CONCLUSION:

    Ample greenery in outdoor space at residential facilities for older people appears to promote experiences of being away and fascination, more frequent visitation and better health.

  • 2.
    Engström, Maria
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala universitet; Lishui universitet.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Strömberg, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Hagerman, Heidi
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Skytt, Bernice
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala universitet.
    Staff working life and older persons' satisfaction with care: a multilevel, correlational design2021In: Journal of Nursing Care Quality, ISSN 1057-3631, E-ISSN 1550-5065, Vol. 36, no 1, p. 7-13Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The importance of staff working life for staff well-being has been demonstrated in several studies; less research has focused on staff working life and older persons' satisfaction with care.

    PURPOSE: The study aim was to study relationships between 1) staff assessments of their structural conditions/empowerment in elderly care, psychological empowerment, and job satisfaction and (2) older persons' satisfaction with care.

    METHODS: A multilevel, cross-sectional, and correlational design was applied using questionnaire data on working life (1021 staff members) and unit-level data (40 elderly care units) on older persons' satisfaction with care.

    RESULTS: Statistically significant relationships were found between all 3 working life variables and older persons' satisfaction with care. Furthermore, the results revealed an indirect/mediating effect of job satisfaction between structural empowerment and satisfaction with care, but not for psychological empowerment.

    CONCLUSIONS: Staff structural empowerment, psychological empowerment, and job satisfaction are linked to older persons' satisfaction with care.

  • 3.
    Essner, Ann
    et al.
    Uppsala universitet; Evidensia Gävle.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Zetterberg, Lena
    Uppsala universitet.
    Hellström, Karin
    Uppsala universitet.
    Sjöström, Rita
    Region Jämtland Härjedalen; Umeå universitet.
    Gustås, Pia
    SLU.
    Investigating the Probability of Response Bias in Owner-Perceived Pain Assessment in Dogs With Osteoarthritis2020In: Topics in Companion Animal Medicine, ISSN 1938-9736, Vol. 39, article id 100407Article in journal (Refereed)
    Abstract [en]

    Owners’ ability to recognize signs of chronic pain in dogs undergoing pharmacologic and nonpharmacologic pain interventions during a period of physical rehabilitation is not known. This study aimed to compare dogs with and without chronic pain, and to assess the relationship between explanatory factors, including the probability of owners’ response bias induced by pharmacologic and nonpharmacologic pain intervention, and chronic pain in dogs with osteoarthritis (OA). Seventy-one dogs with OA were included in this observational study. Owner-perceived pain interference was measured by Canine Brief Pain Inventory (CBPI) and owner-perceived pain behavior was assessed using Helsinki Chronic Pain Index. A dichotomous variable of Helsinki Chronic Pain Index was used in regression analysis to investigate the association between chronic pain and explanatory factors (body condition, anti-inflammatory medication, animal physiotherapy consultation once or more and owners’ perception of pain interfering). Seventy-five percent of the dogs had ongoing anti-inflammatory medication, 51% of were overweight and 45% had a physiotherapy consultation. Higher levels of overt pain behaviors were reported in items addressing activities. Body condition, physiotherapy consultation and medication were not associated with chronic pain. Odds ratio (OR) and 95% confidence intervals of OR for the CBPI were 1.74 (1.23-2.47) and significantly associated with chronic pain. The adjusted OR of the CBPI did not differ from the crude OR. Owner-perceived pain behavior was not confounded by the dogs’ medication. Results indicated that CBPI was not mediated by the medication. The CBPI pain interference score was not associated with response bias and may be used as clinical outcome measure of chronic pain and pain-related disability in dogs with OA along a period of physical rehabilitation comprising pharmacologic and nonpharmacologic pain interventions.

  • 4.
    Essner, Ann
    et al.
    Department of Neuroscience, Faculty of Physiotherapy, Uppsala University, Uppsala, Sweden; Evidensia Djurkliniken Gefle, Gävle, Sweden.
    Zetterberg, Lena
    Department of Neuroscience, Faculty of Physiotherapy, Uppsala University, Uppsala, Sweden.
    Hellström, Karin
    Department of Neuroscience, Faculty of Physiotherapy, Uppsala University, Uppsala, Sweden.
    Gustås, Pia
    Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Husbandry, Swedish University of Agricultural Sciences, Uppsala, Sweden.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Sjöström, Rita
    Unit of Research Education and Development, Region Jämtland Härjedalen, Östersund, Sweden; Department of Community Medicine and Rehabilitation, Faculty of Physiotherapy, Umeå University, Umeå, Sweden.
    Psychometric evaluation of the canine brief pain inventory in a Swedish sample of dogs with pain related to osteoarthritis2017In: Acta Veterinaria Scandinavica, ISSN 0044-605X, E-ISSN 1751-0147, Vol. 59, no 1, article id 44Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: To evaluate intervention, implement evidence-based practice and enhance the welfare of dogs with naturally occurring osteoarthritis (OA), access to valid, reliable and clinically relevant outcome measures is crucial for researchers, veterinarians and rehabilitation practitioners. The objectives of the present study were to translate and evaluate psychometric properties, in terms of internal consistency and construct validity, of the owner-reported measure canine brief pain inventory (CBPI) in a Swedish sample of dogs with pain related to OA.

    RESULTS: Twenty-one owners of clinically sound dogs and 58 owners of dogs with pain related to OA were included in this observational and cross-sectional study. After being translated according to the guidelines for patient-reported outcome measures, the CBPI was completed by the canine owners. Construct validity was assessed by confirmatory factor analysis, by repeating the principal component analysis and by assessing for differences between clinically sound dogs and dogs with pain related to OA. Internal consistency was estimated by Cronbach's α. Confirmatory factor analysis was not able to confirm the factor-structure models tested in our sample. Principal component analysis showed a two-component structure, pain severity and pain interference of function. Two components accounted for 76.8% of the total variance, suggesting an acceptable fit of a two-component structure. The ratings from the clinically sound dogs differed from OA dogs and showed significantly lower CBPI total sum. Cronbach's α was 0.94 for the total CBPI, 0.91 for the pain severity and 0.91 for the pain interference of function.

    CONCLUSIONS: The results indicate that the translated version of the CBPI is valid for use in the Swedish language. The findings suggest satisfying psychometric properties in terms of high internal consistencies and ability to discriminate clinically sound dogs from OA dogs. However, based on the confirmatory factor analysis, the original factor structure in the CBPI is not ideally suited to measure pain related to OA in our sample and the hypothesis of the presented two-factor structure was rejected. Further research needs to be conducted to determine whether the original psychometric results from CBPI can be replicated across different target groups and particularly with larger sample size.

  • 5.
    Essner, Ann
    et al.
    Department of Neuroscience, Uppsala University, Uppsala, Sweden; Evidensia Djurkliniken Gefle, Gävle, Sweden.
    Zetterberg, Lena
    Evidensia Djurkliniken Gefle, Gävle, Sweden.
    Hellström, Karin
    Evidensia Djurkliniken Gefle, Gävle, Sweden.
    Gustås, Pia
    Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Sjöström, Rita
    Region Jämtland Härjedalen, Unit of Research Education & Development, Östersund, Sweden.
    Validation of a translated version of the Canine Brief Pain Inventory for the measure of pain severity and functional movements in canine osteoarthritis2016In: Journal of Small Animal Practice, ISSN 0022-4510, E-ISSN 1748-5827, Vol. 57, no Suppl. 2, p. 8-9Article in journal (Refereed)
    Abstract [en]

    Reasons for performing study: The Canine Brief Pain Inventory (CBPI) is a caregiver-reported questionnaire designed to assess pain severity and the impact of pain on activities, such as functional movements, in canine osteoarthritis (OA). The English version of CBPI has displayed satisfactory psychometric properties, in canine OA. To be used in another language the CBPI has to be properly translated and tested.

    Objectives: To report some psychometric properties of a translated version of the CBPI (CBPI-S), in a group of dogs diagnosed with OA.

    Study design: Observational, cross-sectional.

    Methods: Twenty-one caregivers of clinically sound dogs and 61 caregivers of dogs with OA were prospectively included in this study. After being translated, according to recommendations for patient-reported outcome measures, the CBPI-S was completed by the caregivers. Construct validity (the ability to measure what it is supposed to measure) was assessed by repeating the principal component analysis and by assessing for differences between sound dogs and dogs with OA using Mann–Whitney U test. Internal consistency (the correlation among items) was estimated by Cronbach's α.

    Results: Principal component analysis showed a two-component structure (pain severity and impact of pain). Two components accounted for 76 · 8% of the total variance, suggesting an acceptable fit of a two-component structure. Inter-item correlations were good (overall > 0 · 39) and mean inter-item correlation was 0 · 79 for severity items and 0 · 62 for impact items. Clinically sound dogs differed from OA dogs and showed significantly lower CBPI-S total score. Cronbach's α was 0 · 94 for the total CBPI-S, 0 · 91 for the pain severity and 0 · 91 for the impact of pain.

    Conclusion: Our results supplement the knowledge with the CBPI by verifying the easy to use utility. Also, by repeating satisfying construct validity and high internal consistency of CBPI-S our results indicate that the translated version seems valid for use in another language.

    Ethical animal research: The study was approved by the Local Animal Ethics Committee in Uppsala. Informed client consent was obtained for all animals used in the study.

    Sources of funding: This study was funded by Evidensia Djursjukvård, Svelands Stiftelse, Jan Skogsborgs Stiftelse and Agria & Svenska Kennelklubbens Forskningsfond.

  • 6.
    Hagerman, Heidi
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Skytt, Bernice
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Wadensten, Barbro
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Nursing Department, Medicine and Health College, Lishui University, Lishui, China.
    Empowerment and performance of managers and subordinates in elderly care: a longitudinal and multilevel study2017In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 25, no 8, p. 647-656Article in journal (Refereed)
    Abstract [en]

    AIM: To investigate relationships between first-line managers' ratings of structural and psychological empowerment, and the subordinates' ratings of structural empowerment, as well as their ratings of the managers' leadership-management performance.

    BACKGROUND: Work situations in elderly care are complex. To date, few studies have used a longitudinal, correlational and multilevel design to study the working life of subordinates and managers.

    METHOD: In five Swedish municipalities, questionnaires were answered twice during 2010-12 by 56 first-line managers and 769 subordinates working in nursing homes or home-help services.

    RESULTS: First-line managers' empowerment at Time 1 partially predicted subordinate's structural empowerment and ratings of their managers' leadership-management performance at Time 2. Changes over time partially revealed that the more access managers had to structural empowerment, i.e. increase over time, the higher the ratings were for structural empowerment and managerial leadership-management performance among subordinates.

    CONCLUSIONS: Findings strengthen research and theoretical suggestions linking first-line managers' structural empowerment to their subordinates' structural empowerment and ratings of their manager's leadership-management performance.

    IMPLICATIONS FOR NURSING MANAGEMENT: Managers with high access to structural empowerment are more likely to provide subordinates access to structural empowerment.

  • 7.
    Kaltenbrunner, Monica
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Bengtsson, Lars
    University of Gävle, Faculty of Engineering and Sustainable Development, Department of Industrial Management, Industrial Design and Mechanical Engineering, Industrial Management. University of Gävle, Center for Logistics and Innovative Production.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Associations between lean maturity in primary care and musculoskeletal complaints among staff. A longitudinal study2023In: BMJ Open, E-ISSN 2044-6055, Vol. 13, article id e067753Article in journal (Refereed)
    Abstract [en]

    Objective. We had two aims: 1) to determine the prevalence of musculoskeletal complaints among staff in primary care 2) to determine to what extent Lean maturity of the primary care unit can predict musculoskeletal complaints one year later. 

    Design. Descriptive, correlational, and longitudinal design.

    Setting. Primary care units in mid-Sweden.

    Participants. In 2015, staff members responded to a web survey addressing Lean maturity and musculoskeletal complaints. The survey was completed by 481 staff members (response rate 46%) at 48 units; 260 staff members at 46 units also completed the survey in 2016. 

    Outcome measures. Associations with musculoskeletal complaints were determined both for Lean maturity in total, and for four Lean domains entered separately in a multivariate model, i.e., Philosophy, Processes, People and partners, and Problem-solving.     

    Results. The shoulders (12-month prevalence 58%), neck (54%), and low back (50%) were the most common sites of 12-months retrospective musculoskeletal complaints at baseline. Shoulders, neck, and low back also showed the most complaints for the preceding 7 days (37%, 33%, and 25%, respectively). The prevalence of complaints was similar at the 1-year follow-up. Total lean maturity in 2015 was not associated with musculoskeletal complaints, neither cross-sectionally nor one year later, for shoulders (one-year β: -0.002, 95% CI -.03 to .02), neck (β: 0.006, 95% CI -.01 to .03), low back (β: 0.004, 95% CI -.02 to .03) and upper back (β: 0.002, 95% CI -.02; .02). 

    Conclusion. The prevalence of musculoskeletal complaints among primary care staff was high and did not change within a year. The extent of Lean maturity at the care unit was not associated with complaints among staff, neither in cross-sectional analyses nor in a one-year predictive analysis

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  • 8.
    Kaltenbrunner Nykvist, Monica
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Bengtsson, Lars
    University of Gävle, Faculty of Engineering and Sustainable Development, Department of Industrial Management, Industrial Design and Mechanical Engineering, Industrial Management. University of Gävle, Center for Logistics and Innovative Production.
    Mathiassen, Svend Erik
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Staff perception of Lean, care-giving, thriving and exhaustion: a longitudinal study in primary care2019In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 19, no 1, article id 652Article in journal (Refereed)
    Abstract [en]

    Background

    Lean is commonly adopted in healthcare to increase quality of care and efficiency. Few studies of Lean involve staff-related outcomes, and few have a longitudinal design. Thus, the aim was to examine the extent to which changes over time in Lean maturity are associated with changes over time in care-giving, thriving and exhaustion, as perceived by staff, with a particular emphasis on the extent to which job demands and job resources, as perceived by staff, have a moderated mediation effect.

    Method

    A longitudinal study with a correlational design was used. In total, 260 staff at 46 primary care units responded to a web survey in 2015 and 2016. All variables in the study were measured using staff ratings. Ratings of Lean maturity reflect participants’ judgements regarding the entire unit; ratings of care-giving, thriving, exhaustion and job demands and resources reflect participants’ judgements regarding their own situation.

    Results

    First, over time, increased Lean maturity was associated with increased staff satisfaction with their care-giving and increased thriving, mediated by increased job resources. Second, over time, increased Lean maturity was associated with decreased staff exhaustion, mediated by decreased job demands. No evidence was found showing that job demands and job resources had a moderated mediation effect.

    Conclusion

    The results indicate that primary care staff may benefit from working in organizations characterized by high levels of Lean maturity and that caregiving may also be improved as perceived by staff.

  • 9.
    Koyi, Hirsh
    et al.
    Department of Respiratory Medicine, Gävle Hospital, Gävle, Sweden; Karolinska Institutet, Stockholm, Sweden; Centre for Research and Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden.
    Hillerdal, Gunnar
    Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Solna, Stockholm, Sweden.
    Andersson, Olov
    Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Solna, Stockholm, Sweden.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Brandén, Eva
    Department of Respiratory Medicine, Gävle Hospital, Gävle, Sweden; Karolinska Institutet, Stockholm, Sweden; Centre for Research and Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden.
    Lung cancer among native and foreign-born Swedes: histopathology, treatment, and survival2016In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 55, no 11, p. 1344-1348Article in journal (Refereed)
    Abstract [en]

    Background: Lung cancer (LC) is the leading cause of cancer-related death worldwide, including Sweden. Several studies have shown that socioeconomic status affects the risk, treatment, and survival of LC. Due to immigration after Second World War, foreign-born people constitute 12.5% of the Swedish population. We wanted to investigate if there were any differences in LC management, treatment and survival among the foreign-born Swedes (FBS) compared to the native Swedish population (NatS) in Stockholm. Material and methods: A retrospective analysis of all patients diagnosed with non-small cell lung cancer (NSCLC) at the Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Solna from 1 January 2003 to 31 December 2008 was made. In all, 2041 cases of LC were diagnosed, thereof 1803 with NSCLC. Of these, 211 (11.7%) were FBS. Results: The mean age of NatS and FBS patients was 69.9 years, median 70 (range 26–96) and 66.0 years, median 66 (range 38–94), respectively (p < 0.001). In all, 89.8% of NatS and 90.0% of FBS were either smokers or former smokers. Adenocarcinoma was the most common subtype in both groups (NatS 54.7%, FBS 48.3%). In 140 (8.8%) of the NatS and 17 (8.1%) of the FBS the diagnosis was clinical only. There were no significant differences in stage at diagnosis, nor in performance status (PS) or different therapies between the groups. The median overall survival time for the NatS was 272 days and for FBS 328 days, again no significant difference. However, the median overall survival time for female NatS was 318 days and for female FBS 681 days (p = 0.002). Conclusion: FBS patients were significantly younger than NatS at diagnosis, and female FBS lived longer than female NatS, but otherwise there were no significant differences between NatS and FBS patients with LC regarding diagnosis, treatment, and survival. 

  • 10.
    Nordlöf, Hasse
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Department of Public Health and Caring Sciences, Uppsala University, Sweden.
    Wiitavaara, Birgitta
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Westerling, Ragnar
    Department of Public Health and Caring Sciences, Uppsala University, Sweden.
    A cross-sectional study of factors influencing occupational health and safety management practices in companies2017In: Safety Science, ISSN 0925-7535, E-ISSN 1879-1042, Vol. 95, p. 92-103Article in journal (Refereed)
    Abstract [en]

    Companies need to ensure a functioning occupational health and safety management (OHSM) system to protect human health and safety during work, but generally there are differences in how successful they are in this endeavor. Earlier research has indicated that factors like company size, safety culture, and different measures of financial performance may be related to the quality of OHSM practices in companies. Therefore, the aim of this study was to investigate whether these factors are associated with OHSM practices in companies. A postal questionnaire was used to collect data from a sample of Swedish manufacturing companies, and complementary data regarding the companies were retrieved from a credit bureau database. The statistical analysis was performed with ordinal regression analysis using generalized estimating equations. Different predictor variables were modeled with OHSM practices as the outcome variable, in order to calculate p-values and to estimate odds ratios. Company size, safety culture, and creditworthiness were found to be associated with better, as well as worse, OHSM practices in companies (depending on directionality). Practical implications for industry and future research are discussed.

  • 11.
    Nordlöf, Hasse
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research. Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, Socialmedicin..
    Wiitavaara, Birgitta
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Westerling, Ragnar
    Institutionen för folkhälso- och vårdvetenskap, Uppsala universitet.
    To measure OHS management practices in manufacturing companies2016Conference paper (Refereed)
    Abstract [en]

    Introduction: Manufacturing companies are bound to manage many different processes in their day-to-day operations. A systematic management of occupational health and safety (OHS) factors is necessary in order to comply with OHS legislation. Work environmental risks should be assessed and controlled, and if not controlled immediately, an action plan should be established and followed up on later. A successful OHS management should reduce hazards in the workplace and protect worker health and safety. But how can we accurately measure how well companies actually comply with OHS legislation? Earlier measures exist, but they often assess the perceptions of the respondent rather than the circumstance of the company. The aim of this study was to develop and utilize a way to measure OHS management practices, by using a self-report-questionnaire distributed to companies.   

    Methods: A questionnaire was developed in several steps. OHS legislation and earlier studies were read in order to identify different relevant indicators for OHS management compliance. These indicators were then compiled, sorted, and narrowed down in order to produce a manageable and relevant list of 13 indicators. A criterion for relevant indicators was that they together should provide appropriate information on whether a company has come far, or not so far, in arranging a systematic OHS management. A yes–no question was formulated for each of the indicators. Three examples of indicators were: whether the company has written routines stating how the OHS management should be carried out or not, whether written risk assessments have been conducted during the last 12 months or not, and whether the company has routines in place for reporting incidents that occur (near-misses and accidents) or not. The indicators and questions were chosen and formulated in order to measure as much of an objective circumstance at the companies as possible. The rationale is that, either the companies have an arrangement for these indicators, or they do not. Questionnaires were sent to a sample of manufacturing companies (n=238) in central Sweden, for one manager and one safety delegate per company to answer.

    Results and discussion: Taken together, the 13 indicators formed an OHS management practices index. A yes-answer for each indicator was counted as 1 and no as 0, and the scores were summed together. Other measures were also collected for this study: companies’ safety culture, overall work environment priority, company profitability, and company size. The OHS management practices index will undergo psychometric testing for validity and reliability, such as test-retest and Cronbach’s alpha test statistic. The development process and usability of the OHS management practices measure will be presented in more detail at the conference. We believe that this novel measure of OHS management practices, as employed in this study, can be of interest for future research within the field of OHS. This approach provides a relatively straightforward way to measure companies’ OHS management practice using questionnaire items.

  • 12.
    Randmaa, Maria
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala university; Lishui university, China.
    Mårtensson, Gunilla
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala university.
    Leo Swenne, Christine
    Uppsala university.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Psychometric properties of an instrument measuring communication within and between the professional groups licensed practical nurses and registered nurses in anaesthetic clinics.2019In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 19, no 1, article id 950Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The most common cause of clinical incidents and adverse events in relation to surgery is communication error. There is a shortage of studies on communication between registered nurses and licenced practical nurses as well as of instruments to measure their perception of communication within and between the professional groups. The aim of the present study was to evaluate the psychometric properties of the Swedish version of the adapted ICU Nurse-Physician Questionnaire, designed to also measure communication within and between two professional groups: licensed practical nurses and registered nurses. Specifically, the aim was to examine the instrument's construct validity using confirmatory factor analysis and its internal consistency using Cronbach's Alpha.

    METHODS: A cross-sectional and correlational design was used. The setting was anaesthetic clinics in two Swedish hospitals. A total of 316 questionnaires were delivered during spring 2011, of which 195 were analysed to evaluate the psychometric properties of the questionnaire. Construct validity was assessed using confirmatory factor analysis and internal consistency using Cronbach's Alpha. To assess items with missing values, we conducted a sensitivity analysis of two sets of data, and to assess the assumption of normally distributed data, we used Bayesian estimation.

    RESULTS: The results support the construct validity and internal consistency of the adapted ICU Nurse-Physician Questionnaire. Model fit indices for the confirmative factor analysis were acceptable, and estimated factor loadings were reasonable. There were no large differences between the estimated factor loadings when comparing the two samples, suggesting that items with missing values did not alter the findings. The estimated factor loadings from Bayesian estimation were very similar to the maximum likelihood results. This indicates that confirmative factor analysis using maximum likelihood produced reliable factor loadings. Regarding internal consistency, alpha values ranged from 0.72 to 0.82.

    CONCLUSIONS: The tests of the adapted ICU Nurse-Physician Questionnaire indicate acceptable construct validity and internal consistency, both of which need to be further tested in new settings and samples.

    TRIAL REGISTRATION: Current controlled trials http://www.controlled-trials.com Communication and patient safety in anaesthesia and intensive care. Does implementation of SBAR make any differences? Identifier: ISRCTN37251313, retrospectively registered (assigned 08/11/2012).

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  • 13.
    Randmaa, Maria
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala universitet.
    Leo Swenne, Christine
    Uppsala universitet.
    Mårtensson, Gunilla
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala universitet.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science. Uppsala universitet.
    Implementing situation-background-assessment-recommendation in an anaesthetic clinic and subsequent information retention among receivers: a prospective interventional study of postoperative handovers2016In: European Journal of Anaesthesiology, ISSN 0265-0215, E-ISSN 1365-2346, Vol. 33, no 3, p. 172-178Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Communication errors cause clinical incidents and adverse events in relation to surgery. To ensure proper postoperative patient care, it is essential that personnel remember and recall information given during the handover from the operating theatre to the postanaesthesia care unit. Formalizing the handover may improve communication and aid memory, but research in this area is lacking.

    OBJECTIVE: The objective of this study was to evaluate whether implementing the communication tool Situation-Background-Assessment-Recommendation (SBAR) affects receivers' information retention after postoperative handover.

    DESIGN: A prospective intervention study with an intervention group and comparison nonintervention group, with assessments before and after the intervention.

    SETTING: The postanaesthesia care units of two hospitals in Sweden during 2011 and 2012.

    PARTICIPANTS: Staff involved in the handover between the operating theatre and the postanaesthesia care units within each hospital.

    INTERVENTION: Implementation of the communication tool SBAR in one hospital.

    MAIN OUTCOME MEASURES: The main outcome was the percentage of recalled information sequences among receivers after the handover. Data were collected using both audio-recordings and observations recorded on a study-specific protocol form.

    RESULTS: Preintervention, 73 handovers were observed (intervention group, n = 40; comparison group, n = 33) involving 72 personnel (intervention group, n = 40; comparison group, n = 32). Postintervention, 91 handovers were observed (intervention group, n = 44; comparison group, n = 47) involving 57 personnel (intervention group, n = 31; comparison group, n = 26). In the intervention group, the percentage of recalled information sequences by the receivers increased from 43.4% preintervention to 52.6% postintervention (P = 0.004) and the SBAR structure improved significantly (P = 0.028). In the comparison group, the corresponding figures were 51.3 and 52.6% (P = 0.725) with no difference in SBAR structure. When a linear regression generalised estimating equation model was used to account for confounding influences, we were unable to show a significant difference in the information recalled between the intervention group and the nonintervention group over time.

    CONCLUSION: Compared with the comparison group with no intervention, when SBAR was implemented in an anaesthetic clinic, we were unable to show any improvement in recalled information among receivers following postoperative handover.

    TRIAL REGISTRATION: Current controlled trials http://www.controlled-trials.com Identifier: ISRCTN37251313.

  • 14.
    Richter, Hans
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Domkin, Dmitry
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Elcadi, Guilherme H.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Sports science.
    Anderson, H. W.
    Skogforsk, the forestry research institute of Sweden, Uppsala, Sweden.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Englund, Martin
    Skogforsk, the forestry research institute of Sweden, Uppsala, Sweden.
    A comparison of mental and visual loads resulting from semi-automated and conventional forest harvesting: An experimental machine simulation study2018Conference paper (Other academic)
    Abstract [en]

    This study is concerned with a new method for partly automating forestry harvesting work. Work-related injuries and constant demands for a higher productivity are two of the many arguments for why forestry work must be improved. Forestry work places great mental demands on the driver because they must continuously evaluate and act on relevant parts in a heavy visual information flow. Against this background the purpose of the present study was to extend the knowledge of functional linkages between visual and mental fatigue, performance, and prefrontal cortex activity, during semi-automated and conventional forestry harvesting work. Eleven healthy participants, range 21–51 years old, with a minimum of 1-year work experience, carried out the task of loading logs along a standardized path in a machine simulator during two counterbalanced 45-min periods: (i) conventional forest harvesting, and; (ii) semi-automated forest harvesting. Equal emphasizes was put on accuracy and speed. During manual forest harvesting the driver controlled the crane arm, used to load logs into the load space of the forest vehicle (“forwarder”), by manually operating the joysticks and so guide the crane to the location of the log and then back to the load space. During semi-automatic forest harvesting the driver moved the crane with the press of a button to a pre-programmed location near the log and then, after another button press, to a pre-programmed location within the load space. The following joystick usage parameters were considered for the statistical analysis: Sequential work cycle number, work phase (1-loading in basket, 2-movement to log, 3-picking up log, 4-movement to load space), number of simultaneously used controls across samples of one phase, number of direction changes of joystick movements per phase. Mental load was assessed by quantification of oxygenated hemoglobin (HbO2) concentration changes over the right dorsolateral prefrontal cortex (dlPFC) via non-invasive functional near infrared spectrometry (fFNIRS: PortaLite mini, Artinis Medical Systems, Zetten, the Netherlands). The frequency and duration of horizontal amplitudes of eye/head/neck angles was assessed continuously with 8 SmartEye cameras and used as a measure of visual load. NASA-TLX and Borg CRS was used to assess perceived mental and physical fatigue. Linear Mixed Model will be used to test and to analyze the effect of the duration of work, joystick usage, work type (manual or semi-automated) and perceived mental and physical effort on the outcome of oxygenated hemoglobin concentration. This study contributes with new knowledge of the consequences of the current increase in automation. The 4th industrial revolution can have tremendous implications on how we perceive and organize work in the future, but little is still known about the impact on human body and brain.

  • 15.
    Richter, Hans
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research. Högskolan i Gävle.
    Domkin, Dmitry
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Elcadi, Guilherme H.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Andersson, H. W.
    Skogforsk, the forestry research institute of Sweden, Uppsala, Sweden.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Englund, Martin
    Skogforsk, the forestry research institute of Sweden, Uppsala, Sweden.
    A Comparison of Mental and Visual Load Resulting from Semi-automated and Conventional Forest Forwarding: An Experimental Machine Simulation Study2019In: Proceedings of the 20th Congress of the International Ergonomics Association (IEA 2018): Volume X: Auditory and Vocal Ergonomics, Visual Ergonomics, Psychophysiology in Ergonomics, Ergonomics in Advanced Imaging / [ed] Bagnara S., Tartaglia R., Albolino S., Alexander T., Fujita Y., Cham, 2019, 827, Vol. X, p. 199-208Conference paper (Refereed)
    Abstract [en]

    The purpose of the present study was to extend the knowledge offunctional linkages between visual and mental load, performance, and prefrontalcortex (PFC) activity, during forestry forwarding work. Eleven healthy participants,range 21–51 years old, with a minimum of 1-year work experience,carried out the task of loading logs along a standardized path in a machinesimulator during two counterbalanced test conditions: (i) conventional cranecontrol, and; (ii) semi-automated crane control. Mental load was assessed byquantification of oxygenated hemoglobin (HbO2) concentration changes overthe right dorsolateral prefrontal cortex (dlPFC) via non-invasive functional nearinfrared spectrometry (fNIRS). Visual, autonomic, and motoric control variableswere measured and analyzed in parallel along with the individual level of performance.Linear Mixed Models (LMM) analysis indicated more mental loadduring conventional crane work. Collectively, our data suggest that fNIRS is aviable tool which can be used in neuroergonomic research to evaluate physiologicalactivity levels in PFC.

  • 16.
    Richter, Hans
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Domkin, Dmitry
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Elcadi, Guilherme H.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Andersson, Helena
    Skogforsk, the forestry research institute of Sweden, Uppsala, Sweden.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Forsman, Mikael
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Englund, Martin
    Skogforsk, the forestry research institute of Sweden, Uppsala, Sweden.
    A comparison of mental and visual loads resulting from semi-automated and conventional forest harvesting: An experimental machine simulation study2018In: FALF Konferens 2018: Arbetet - problem eller potential för en hållbar livsmiljö?: Program och Abstracts / [ed] Per Lindberg, Gävle: Gävle Universtiy Press , 2018, p. 96-Conference paper (Other academic)
    Abstract [en]

    This study is concerned with a new method for partly automating forestry harvesting work. Work-related injuries and constant demands for a higher productivity are two of the many arguments for why forestry work must be improved. Forestry work places great mental demands on the driver because they must continuously evaluate and act on relevant parts in a heavy visual information flow. Against this background the purpose of the present study was to extend the knowledge of functional linkages between visual and mental fatigue, performance, and prefrontal cortex activity, during semi-automated and conventional forestry harvesting work. Eleven healthy participants, range 21–51 years old, with a minimum of 1-year work experience, carried out the task of loading logs along a standardized path in a machine simulator during two counterbalanced 45-min periods: (i) conventional forest harvesting, and; (ii) semi-automated forest harvesting. Equal emphasizes was put on accuracy and speed. During manual forest harvesting the driver controlled the crane arm, used to load logs into the load space of the forest vehicle (“forwarder”), by manually operating the joysticks and so guide the crane to the location of the log and then back to the load space. During semi-automatic forest harvesting the driver moved the crane with the press of a button to a pre-programmed location near the log and then, after another button press, to a pre-programmed location within the load space. The following joystick usage parameters were considered for the statistical analysis: Sequential work cycle number, work phase (1-loading in basket, 2-movement to log, 3-picking up log, 4-movement to load space), number of simultaneously used controls across samples of one phase, number of direction changes of joystick movements per phase. Mental load was assessed by quantification of oxygenated hemoglobin (HbO2) concentration changes over the right dorsolateral prefrontal cortex (dlPFC) via non-invasive functional near infrared spectrometry (fFNIRS: PortaLite mini, Artinis Medical Systems, Zetten, the Netherlands). The frequency and duration of horizontal amplitudes of eye/head/neck angles was assessed continuously with 8 SmartEye cameras and used as a measure of visual load. NASA-TLX and Borg CRS was used to assess perceived mental and physical fatigue. Linear Mixed Model will be used to test and to analyze the effect of the duration of work, joystick usage, work type (manual or semi-automated) and perceived mental and physical effort on the outcome of oxygenated hemoglobin concentration. This study contributes with new knowledge of the consequences of the current increase in automation. The 4th industrial revolution can have tremendous implications on how we perceive and organize work in the future, but little is still known about the impact on human body and brain.

  • 17.
    Skytt, Bernice
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala universitet.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Engström, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala universitet; Lishui University, China.
    An explorative and confirmative factor analysis of the Leadership and Management Inventory-II among staff working in elderly care2024In: Leadership in Health Services, ISSN 1751-1879, E-ISSN 1751-1887, Vol. 37, no 5, p. 66-83Article in journal (Refereed)
    Abstract [en]

    Purpose

    The Purpose of the study was to investigate the construct validity and internal consistency of the LaMI among staff in the context of elderly care in Sweden.

    Design/methodology/approach

    Questionnaire data from a longitudinal study of staff working in elderly care were used. Data were collected using the Leadership and Management Inventory. First data collection was for explorative factor analysis (n = 1,149), and the second collection, one year later, was for confirmatory factor analysis (n = 1,061).

    Findings

    The explorative factor analysis resulted in a two-factor solution that explained 70.2% of the total variance. Different models were tested in the confirmatory factor analysis. The final model, a two-factor solution where three items were omitted, showed acceptable results.

    Originality/value

    The instrument measures both leadership and management performance and can be used to continually measure managers’ performances as perceived by staff to identify areas for development.

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  • 18.
    Svennberg, Lena
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Sports science. The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Who gains?: Sociological parameters for obtaining high grades in physical education2018In: Nordic Journal of Studies in Educational Policy, ISSN 2002-0317, Vol. 4, no 1, p. 48-60Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate factors contributing to higher grades in Swedish physical education (PE) by analysing register data from the Swedish National Agency for Education for all students graduating from compulsory school in 2014 (n = 95,317). The results show that the chances of gaining a high grade in PE are affected by (in decreasing order) migration background, parents? education, attending an independent or a municipally operated school and gender, and that this also holds true after controlling for the other background factors. The results also show that PE grade differences between boys and girls are bigger in the group that moved to Sweden after school start than in the group that had lived in Sweden since school start. In addition, the results point to substantial inequalities between students with a combination of the highest odds and those with a combination of the lowest odds. Bernstein?s concept of the pedagogic device is used to discuss ways of understanding what knowledge becomes valued in PE and which groups have better possibilities to assimilate this valued knowledge.

  • 19.
    Wiitavaara, Birgitta
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Rissén, Dag
    Region Gävleborg.
    Högberg, Hans
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.
    Nilsson, Annika
    University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala universitet.
    Psychometric testing of a short form questionnaire for measurement of health experiences among people with musculoskeletal disorders undergoing multimodal rehabilitation2019In: BMJ Open, E-ISSN 2044-6055, Vol. 9, no 5, article id e025103Article in journal (Refereed)
    Abstract [en]

    Aim

    The aim of present study was to assess if a previously suggested short-form questionnaire tested among women with non-specific neck-shoulder pain is suitable also for use among men and women with non-specific musculoskeletal disorders in any part of the body, by testing its construct validity by a confirmatory factor analysis. If not, the secondary aim was to investigate the evolving factor structure when performing an explorative factor analysis of data in the expanded sample.

    Methods

    Questionnaire data was collected in three different contexts, in primary care via eight different multimodal rehabilitation teams, in specialised care via two different specialist care centres. The sample consisted of 116 participants, male (n=29) and female (n=87) with non-specific musculoskeletal disorders.

    Data was analysed using confirmatory and exploratory factor analysis and a visual comparison between the result of the Principal Component Analysis in present study, and the results attained in a previous study with a similar aim and design.

    Results

    The confirmatory factor analyses did not end up in a model with acceptable measures for validity. Three models were tested, none of them met the criterion for an acceptable model and the goodness-of-fit statistics were not fully acceptable. The exploratory factor analysis had an only partly comparable result, compared to previous study.

    Conclusion

    The results of present study did not prove the suggested short form questionnaire to be suitable for evaluation of symptoms among men and women with non-specific musculoskeletal disorders in any part of the body. Further studies including larger samples are recommended.

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