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  • 1.
    Aboagye, Emmanuel
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden.
    Björklund, Christina
    Gustafsson, Klas
    Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden. .
    Hagberg, Jan
    Aronsson, Gunnar
    Department of Psychology, Stockholm University.
    Marklund, Staffan
    Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet.
    Leineweber, Constanze
    Stress Research Institute, Stockholm University.
    Bergström, Gunnar
    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. Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet.
    Exhaustion and impaired work performance in the workplace: Associations with presenteeism and absenteeism2019In: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948, Vol. 61, no 11, p. e438-e444Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of this study was to investigate the association between presenteeism and absenteeism during the previous year and the current levels of exhaustion and impaired work performance in a Swedish university setting.

    METHODS: In a study of 3525 employees, an ordinal logistic regression and general linear model was used to examine the association between presenteeism and absenteeism during the previous year and the current exhaustion and impaired work performance, respectively.

    RESULTS: Presenteeism, but not absenteeism, during the previous year independently increased the risk of having moderate or severe exhaustion. Presenteeism, absenteeism, and exhaustion remained positively associated with impaired work performance when health status and other confounders had been adjusted for.

    CONCLUSIONS: Presenteeism, but not absenteeism, was associated with exhaustion. Both presenteeism and absenteeism were the salient correlates of impaired work performance.

  • 2.
    Aboagye, Emmanuel
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. Karolinska institutet.
    Gustafsson, Klas
    Karolinska institutet.
    Jensen, Irene
    Karolinska institutet.
    Hagberg, Jan
    Karolinska institutet.
    Aronsson, Gunnar
    Stockholms universitet.
    Marklund, Staffan
    Karolinska institutet.
    Leineweber, Constanze
    Karolinska institutet.
    Bergström, Gunnar
    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. Karolinska institutet.
    What is number of days in number of times? Associations between, and responsiveness of, two sickness presenteeism measures.2020In: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948, Vol. 62, no 5, p. 180-185Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To examine the associations between SP reported as number of days with SP reported as number of times and to evaluate their responsiveness.

    METHODS: The study population (n = 454) consisted of employed individuals, at risk of long-term sickness absence. Correlation analyses were performed to examine associations between the two SP measures and external constructs such as work performance, general health and registered sick leave. Both SP constructs were measured several times to examine responsiveness.

    RESULTS: The SP measures are moderately correlated. They moderately correlated with work performance and health status measures. SP reported as number of times seem to be more sensitive than number of days in detecting changes after rehabilitation.

    CONCLUSIONS: Numerical or categorical constructs are valid sources of data on SP. However, categorized SP seem to be more responsive.

  • 3.
    Aboagye, Emmanuel
    et al.
    Karolinska institutet.
    Jensen, Irene
    Karolinska institutet.
    Bergström, Gunnar
    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. Karolinska institutet.
    Björk Brämberg, Elisabeth
    Karolinska institutet.
    Pico-Espinosa, Oscar Javier
    Karolinska institutet.
    Björklund, Christina
    Karolinska institutet.
    Investigating the association between publication performance and the work environment of university research academics: a systematic review2021In: Scientometrics, ISSN 0138-9130, E-ISSN 1588-2861, Vol. 126, no 4, p. 3283-3301Article, review/survey (Refereed)
    Abstract [en]

    The purpose of this review was to investigate the association between publication performance and the organizational and psychosocial work environment of academics in a university setting. In 2018 we conducted database searches in Web of Science, Medline and other key journals (hand-searched) from 1990 to 2017 based on population, exposure and outcome framework. We examined reference lists, and after a title and abstract scan and full-text reading we identified studies that were original research and fulfilled our inclusion criteria. Articles were evaluated as having a low, moderate or high risk of bias using a quality assessment form. From the studies (n = 32) identified and synthesized, work-environment characteristics could explain the quality and quantity aspects of publication performance of academics. Management practices, leadership and psychosocial characteristics are influential factors that affect academics’ publication productivity. Most of the reviewed studies were judged to be of moderate quality because of issues of bias, related to the measuring of publication outcome. The findings in the studies reviewed suggest that highly productive research academics and departments significantly tend to be influenced by the organizational and psychosocial characteristics of their working environment. The practical relevance of this review is that it highlights where academics’ performance needs support and how the work environment can be improved to bolster publication productivity.

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  • 4.
    Ahmadi, Elena
    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.
    Lundqvist, Daniel
    Department of Behavioural Sciences and Learning, Division of Education and Sociology, Linköping University, Linköping, Sweden.
    Bergström, Gunnar
    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.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science.
    A qualitative study of factors that managers in small companies consider important for their wellbeing2023In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 18, no 1, article id 2286669Article in journal (Refereed)
    Abstract [en]

    Purpose

    Given the importance of small businesses for society, and the significance of managers’ wellbeing for employee health, leadership, and business performance, more knowledge is needed on the sources of managers’ wellbeing. This study explored factors within the small business context that were perceived by managers to hinder or enable their wellbeing.

    Methods

    Data were collected through qualitative semi-structured interviews with 20 managers from 12 small companies, and analysed with content analysis.

    Results

    The factors that these managers in small businesses experienced as enhancing or hindering their personal wellbeing covered five categories: demands and resources in the daily managerial work, achievement of results, social factors, organizational factors, and individual factors.

    Conclusions

    The specific context of managerial work in small companies encompasses unique factors. For instance, the small company managers’ wellbeing was affected by vulnerability due to the smallness of the business and the absence of available resources. Simultaneously, a small company context provided a strong social climate and close relationships with employees and customers that strengthened the managers’ wellbeing. The findings suggest that the availability of financial, personnel, and organizational resources varies between small companies of different size, which may have implications for small business managers’ work and wellbeing.

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  • 5.
    Ahmadi, Elena
    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.
    Lundqvist, Daniel
    Linköpings universitet.
    Bergström, Gunnar
    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. Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Public Health and Sport Science, Public Health Science. EPIUnit–Instituto de Saude Publica, Universidade do Porto, Porto, Portugal.
    Managers’ and employees’ experiences of how managers’ wellbeing impacts their leadership behaviours in Swedish small businesses2023In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 75, no 1, p. 97-112Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:There is a growing interest in managers’ wellbeing due to the observed associations between their wellbeing and leadership behaviours, and between leadership behaviours and employees’ wellbeing. However, it is still unclear how managers’ wellbeing influences their practiced leadership across different workplace contexts, which specific behaviours are affected, and how this varies across time.

    OBJECTIVE:The purpose of this study was therefore to explore managers’ and employees’ experiences and perceptions regarding the consequences of managers’ wellbeing for their leadership behaviours in small businesses.

    METHODS:Semi-structured interviews were conducted with 37 participants (19 managers and 18 employees) working at 12 Swedish small firms, and analysed using content analysis.

    RESULTS:The findings show that managers were more constructive when they felt well, and more passively destructive when unwell. Variations in managers’ wellbeing influenced their mood, energy level, and performance, as well as the company’s working climate. However, these destructive leadership variations did not have a substantial impact, because several protective factors were present.

    CONCLUSION:This study shows that the wellbeing of managers in small businesses has perceptible consequences for their leadership behaviours. The study also shows that sustained leadership behaviours may coexist with temporary variations of these behaviours on a constructive-destructive continuum depending on the leader’s wellbeing. Overall, the findings contribute to a more nuanced and dynamic understanding of how the interaction between managers’ wellbeing and their behaviours unfolds in the particular context of small companies.

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  • 6.
    Ahmadi, Elena
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Psychology, Sports Science and Occupational Health Sciences, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Lundqvist, Daniel
    Bergström, Gunnar
    University of Gävle, Faculty of Health and Occupational Studies, Department of Psychology, Sports Science and Occupational Health Sciences, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work, Criminology and Public Health Sciences, Public Health Science.
    Managers in the context of small business growth: a qualitative study of working conditions and wellbeingManuscript (preprint) (Other academic)
  • 7.
    Aronsson, G
    et al.
    Stockholm University.
    Hagberg, J
    Karolinska Institutet.
    Björklund, C
    Karolinska Institutet.
    Aboagye, Emmanuel
    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. Karolinska Institutet.
    Marklund, S
    Karolinska Institutet.
    Leineweber, C
    Stockholm University.
    Bergström, Gunnar
    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. Karolinska Institutet.
    Health and motivation as mediators of the effects of job demands, job control, job support, and role conflicts at work and home on sickness presenteeism and absenteeism2021In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 94, p. 409-418Article in journal (Refereed)
    Abstract [en]

    Purpose: The first objective was to contribute to a better understanding of the contrasting and paradoxical results in studies of work environment factors and sickness presence and sickness absence. A second objective was to examine if, and under what conditions, employees choose to replace sickness absence with sickness presence, i.e., so-called substitution.

    Methods: The study utilizes a large body of cross-sectional questionnaire data (n = 130,161) gathered in Sweden from 2002 to 2007 in connection with a comprehensive health promotion initiative. Health and motivation were analyzed as mediators of the effects of five job factors, job control, job support, job demand, role conflict and "work to family conflict" on sickness presence and absence.

    Results: The results concerning job demands indicate substitution in that increased job demands are associated with increased presenteeism and reduced absenteeism. The direct effect of higher job support was increased absenteeism, but via the health and motivation paths, the total effect of more social support was health-promoting and associated with a reduction in sickness absence and sickness presence. High job control emerged as the most pronounced health-promoting factor, reducing sickness presenteeism as well as absenteeism. More role conflicts and work-to-family conflicts were directly and indirectly associated with decreased health and increased absenteeism as well as presenteeism. earlier research.

    Conclusion: The mediation analyzes shed light on some of the paradoxes in research on sickness presenteeism and sickness absenteeism, especially regarding job demands and job support. The substitution effect is important for workplace policy and occupational health practice.

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  • 8.
    Axén, Iben
    et al.
    Karolinska Institutet.
    Björk Brämberg, Elisabeth
    Sahlgrenska Academy, University of Gothenburg; Karolinska Institutet.
    Vaez, Marjan
    Karolinska Institutet.
    Lundin, Andreas
    Karolinska Institutet.
    Bergström, Gunnar
    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. Karolinska Institutet.
    Interventions for common mental disorders in the occupational health service: a systematic review with a narrative synthesis2020In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 93, no 7, p. 823-838Article, review/survey (Refereed)
    Abstract [en]

    Introduction

    Common mental disorders (CMD) are leading causes of decreased workability in Sweden and worldwide. Effective interventions to prevent or treat such disorders are important for public health.

    Objective

    To synthesize the research literature regarding occupational health service (OHS) interventions targeting prevention or reduction of CMD among employees. The effect on workability (sickness absence, return-to-work and self-reported workability) and on CMD symptoms was evaluated in a narrative analysis.

    Data sources

    The literature search was performed in four electronic databases in two searches, in 2014 and in 2017.

    Eligibility criteria (using PICO)

    Population: studies investigating employees at risk or diagnosed with CMD, as well as preventive workplace intervention targeting mental health. Intervention: studies where the recruitment or the intervention was delivered by the OHS or OHS personnel were included. Control: individuals or groups who did not receive the target intervention. Outcome: all types of outcomes concerning sickness absence and psychological health were included.

    Study quality was assessed using a Swedish AMSTAR-based checklist, and results from studies with low or medium risk of bias were narratively synthesized based on effect or absence thereof.

    Results

    Thirty-three studies were included and assessed for risk of bias. Twenty-one studies had low or medium risk of bias. In 18 studies, rehabilitation interventions were evaluated, 11 studies concerned interventions targeting employees at risk for developing CMD and four studies investigated preventive interventions. Work-focused cognitive behavioral therapy and problem-solving skill interventions decreased time to first return-to-work among employees on sick leave for CMD in comparison with treatment-as-usual. However, effect on return to full-time work was not consistent, and these interventions did not consistently improve CMD symptoms. Selective interventions targeting employees at risk of CMD and preventive interventions for employees were heterogeneous, so replication of these studies is necessary to evaluate effect.

    Limitations

    Other workplace interventions outside the OHS may have been missed by our search. There was considerable heterogeneity in the included studies, and most studies were investigating measures targeting the individual worker. Interventions at the workplace/organizational level were less common.

    Conclusions and implication of key findings

    Return-to-work and improvement of CMD symptoms are poorly correlated and should be addressed simultaneously in future interventions. Further, interventions for CMD administered through the occupational health service require further study. Rehabilitative and preventive strategies should be evaluated with scientifically robust methods, to examine the effectiveness of such interventions.

  • 9.
    Bergström, Gunnar
    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. Karolinska institutet.
    Gustafsson, Klas
    Karolinska institutet.
    Aboagye, Emmanuel
    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.
    Marklund, Staffan
    Karolinska institutet.
    Aronsson, Gunnar
    Stockholms universitet.
    Björklund, Christina
    Karolinska institutet.
    Leineweber, Constanze
    Stockholms universitet.
    A resourceful work environment moderates the relationship between presenteeism and health. A study using repeated measures in the Swedish working population2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 13, article id 4711Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to investigate if the psychosocial work environment moderates the proposed negative impact of presenteeism on future general health. We expect that the negative impact of presenteeism on general health is weaker if the psychosocial work environment is resourceful, and more pronounced if the environment is stressful. Data were derived from the 2008–2018 biennial waves of the Swedish Longitudinal Occupational Survey of Health (SLOSH). The final analytic sample consisted of n = 15,779 individuals. We applied repeated measures regression analyses through generalized estimating equations (GEE). Results from the autoregressive GEE models showed statistically significant interaction terms between presenteeism and all four investigated moderators, i.e., job demands, job control, job support and job strain. The results indicate that the psychosocial work environment moderates the negative association between presenteeism and general health and illustrates a buffering effect of the psychosocial work environment. A possible explanation for these results may be that psychosocially resourceful work environments give room for adjustments in the work situation and facilitate recovery. The results also indicate that by investing the psychosocial work environment employers may be able to promote worker health as well as prevent reduced job performance due to presenteeism.

  • 10.
    Berthelsen, Hanne
    et al.
    Malmö University.
    Muhonen, Tuija
    Malmö University.
    Bergström, Gunnar
    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. Karolinska institutet.
    Westerlund, Hugo
    Stockholm University.
    Dollard, Maureen F.
    University of South Australia.
    Benchmarks for Evidence-Based Risk Assessment with the Swedish Version of the 4-Item Psychosocial Safety Climate Scale2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 22, article id 8675Article in journal (Refereed)
    Abstract [en]

    The purpose of the present study was to validate the short version of The Psychosocial Safety Climate questionnaire (PSC-4, Dollard, 2019) and to establish benchmarks indicating risk levels for use in Sweden. Cross-sectional data from (1) a random sample of employees in Sweden aged 25–65 years (n = 2847) and (2) a convenience sample of non-managerial employees from 94 workplaces (n = 3066) were analyzed. Benchmarks for three PSC risk levels were developed using organizational compliance with Occupational Safety and Health (OSH) regulations as criterion. The results support the validity and usefulness of the Swedish PSC-4 as an instrument to indicate good, fair, and poor OSH practices. The recommended benchmark for indicating good OSH practices is an average score of >12.0, while the proposed cutoff for poor OSH practices is a score of ≤8.0 on the PSC-4. Scores between these benchmarks indicate fair OSH practices. Furthermore, aggregated data on PSC-4 supported its reliability as a workplace level construct and its association with quantitative demands, quality of leadership, commitment to the workplace, work engagement, job satisfaction, as well as stress and burnout. Thus, the Swedish version of PSC-4 can be regarded as a valid and reliable measure for both research and practical use for risk assessment at workplaces.

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  • 11.
    Berthelsen, Hanne
    et al.
    Malmö universitet.
    Westerlund, Hugo
    Stockholms universitet.
    Bergström, Gunnar
    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. Karolinska institutet.
    Burr, Hermann
    Federal Institute of Occupational Safety and Health (BAuA), 10317 Berlin, Germany.
    Validation of the Copenhagen Psychosocial Questionnaire Version III and Establishment of Benchmarks for Psychosocial Risk Management in Sweden.2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 9, article id E3179Article in journal (Refereed)
    Abstract [en]

    This study presents the Swedish standard version of the Copenhagen Psychosocial Questionnaire, COPSOQ III, and investigates its reliability and validity at individual and workplace levels with the aim of establishing benchmarks for the psychosocial work environment. Cross-sectional data from (1) a random sample of employees in Sweden aged 25-65 years (N = 2847) and (2) a convenience sample of non-managerial employees at 51 workplaces (N = 1818) were analysed. Internal consistency reliability was evaluated as well as the effects of sex, work sector and blue/white-collar work. Population benchmarks and mean scores for major occupational groups were computed based on weighted data. ICC(1) and ICC(2) estimates were computed to evaluate aggregation to the workplace level and Pearson inter-correlations to evaluate construct validity at individual and aggregated levels. The reliability and scale characteristics were satisfactory, with few exceptions, at both individual and workplace levels. The strength and direction of correlations supported the construct validity of the dimensions and the amount of variance explained by workplace justified aggregation to the workplace level. The present study thus supports the use of COPSOQ III for measurement at the workplace level and presents benchmarks for risk management as well as for research purposes.

  • 12.
    Björk Brämberg, E
    et al.
    Karolinska institutet.
    Arapovic-Johansson, B
    Karolinska institutet.
    Bültmann, U
    University of Groningen, The Netherlands.
    Svedberg, P
    Karolinska institutet.
    Bergström, Gunnar
    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. Karolinska institutet.
    Prevention of sick leave at the workplace: design of a cluster-randomized controlled trial of a problem-solving intervention among employees with common mental disorders2021In: BMC Public Health, E-ISSN 1471-2458, Vol. 21, article id 1756Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Common mental disorders are highly prevalent in the working population, affecting about 1 in 5 persons in the Organisation for Economic Co-operation and Development countries. About 30% of those affected have a first period of sick leave. Despite several attempts to reduce the risk of sick leave among employees with common mental disorders, there is a lack of knowledge about effective, preventive interventions which aim to reduce such risks. This protocol describes the design of a study to evaluate the effectiveness of a problem-solving intervention delivered by first-line managers to employees with common mental disorders on the prevention of sick leave during the 12-month follow-up.

    METHODS/DESIGN: The study applies a two-armed cluster-randomized trial design of a problem-solving intervention conducted in private-sector companies. First-line managers are randomized into intervention- or control groups by computer-generated random numbers, allocation ratio 1:1. Employees are eligible if at risk for future sick leave due to common mental disorders. These are identified by self-reported psychological health measured by the General Health Questionnaire 12-item, cut-off ≥3, or a positive answer to risk of sick leave. The intervention is based on problem-solving principles. It involves the training of the first-line managers who then deliver the intervention to employees identified at risk of sick leave. First-line managers in the control group receives a lecture. Primary outcome is number of registered days of sick leave due to common mental disorders during the 12-month follow-up. Secondary outcomes are general health, psychological symptoms, work performance, work ability and psychosocial work environment. A process evaluation will examine the intervention's reach, fidelity, dose delivered, dose received, satisfaction and context. Research assistants managing the screening procedure, outcome assessors and employees are blinded to randomization and allocation.

    DISCUSSION: The study includes analyses of the intervention's effectiveness and an alongside process evaluation. Methodological strengths and limitations, for example the risk of selection bias, attrition and risk of contamination are discussed.

    TRIAL REGISTRATION: Clinicaltrials.gov NCT04975750 Date of registration: 08/16/2021.

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  • 13.
    Björk Brämberg, Elisabeth
    et al.
    Institutet för Miljömedicin, Enheten för interventions och implementeringsforskning inom arbetshälsa, Karolinska Institutet, Stockholm; Institutionen för medicin, Enheten för allmänmedicin, Göteborgs universitet .
    Axén, Iben
    Institutet för Miljömedicin, Enheten för interventions och implementeringsforskning inom arbetshälsa, Karolinska Institutet, Stockholm .
    Strömberg, Carl
    Institutet för Miljömedicin, Enheten för interventions och implementeringsforskning inom arbetshälsa, Karolinska Institutet, Stockholm Institutet för Miljömedicin, Enheten för interventions och implementeringsforskning inom arbetshälsa, Karolinska Institutet, Stockholm Institutet för Miljömedicin, Enheten för interventions och implementeringsforskning inom arbetshälsa, Karolinska Institutet, Stockholm .
    Bergström, Gunnar
    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. Institutet för Miljömedicin, Enheten för interventions och implementeringsforskning inom arbetshälsa, Karolinska Institutet, Stockholm; Centrum för Arbets - och Miljömedicin, Stockholms läns landsting, Stockholm.
    Insatser via företagshälsan för att minska eller förebygga psykisk ohälsa: En kartläggning av forskningen - uppdatering 20182018In: FALF KONFERENS 2018 Arbetet - problem eller potential för en hållbar livsmiljö? Gävle 10-12 juni 2018: Program och Abstracts / [ed] Per Lindberg, Gävle: Gävle University Press , 2018, p. 71-72Conference paper (Refereed)
    Abstract [sv]

    Bakgrund

    Psykisk ohälsa är en vanlig orsak till lidande och försämrad arbetsförmåga både i Sverige och internationellt. Effektiva insatser för att förebygga eller minska psykisk ohälsa är därför av stor betydelse för både folkhälsa och arbetshälsa. Företagshälsovården (FHV) är en viktig aktör på svenska arbetsplatser då majoriteten av alla anställda har tillgång till denna tjänst. Kunskapen är dock begränsad vad gäller effekter av de förebyggande eller rehabiliterande insatser som ges av FHV kring psykisk ohälsa. Denna litteratur-genomgång publicerades först 2015 och har nu uppdaterats med studier publicerade fram t.o.m. maj 2017.

    Syfte

    Att genomföra en systematisk kartläggning av nationell och internationell forskning där insatserna getts av företagshälsovården för att förebygga eller minska psykisk ohälsa i arbetslivet.

    Metod

    Litteratursökningar gjordes i fyra databaser och det vetenskapliga underlaget kom att utgöras av 33 studier varav 12 är nytillkomna i denna uppdatering. Prospektiva studier med eller utan jämförelsegrupp inkluderades. Urval av studier och kvalitetsgranskning gjordes av två oberoende forskare.

    Resultat

    I 18 av studierna utvärderades rehabiliterande insatser som riktade sig till an-ställda sjuk-skrivna p.g.a. psykisk ohälsa, i elva studier insatser till anställda i risk för psykisk ohälsa och i 4 studier utvärderades förebyggande insatser. Drygt hälften av de inkluderade stud-ierna (17 studier) var från Nederländerna. Tjugoen av 33 studier bedömdes ha medelhög eller hög kvalitet. För rehabiliterande insatser som ges till anställda sjukskrivna för psykisk ohälsa indikerar det vetenskapliga underlaget att problemlösningsbaserad metod och KBT med arbetsplatsinriktning minskar sjukskrivning och/eller påskyndar arbetsåtergång jämfört med sedvanlig insats. Effekten är oklar för övriga rehabiliterande insatser. Kunskapsläget är oklart gällande effekter av förebyggande insatser och effekter av insatser som ges till anställda i risk för psykisk ohälsa. Några av studierna tyder på positiva effekter men insatserna som utvärderats är olika och det är viktigt att försök till replikering görs av dessa utvärderingar. Det finns ett behov av att förebyggande insatser utvärderas med ett forskningsupplägg som ökar möjligheterna att dra slutsatser om effekter. Flera studier indikerar också att det inte finns en tydlig relation mellan omfattning av symtom och arbetsåtergång. Detta understryker vikten av att vid insatser aktualisera arbetsåtergång tidigt i processen och att erbjuda metoder för samtidig symtomhantering och arbetsåtergång.Sammantaget indikerar resultaten att arbetsplatsinriktade insatser med KBT eller problemlösningsbaserad metod som ges via FHV kan förkorta tid till arbetsåtergång bland anställda sjukskrivna för psykisk ohälsa och att särskilt förebyggande insatser behöver utvecklas och utvärderas ytterligare.

  • 14.
    Björk Brämberg, Elisabeth
    et al.
    Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; Närhälsan, Region of Västra Götaland, Hisings-Backa, Sweden .
    Holmgren, Kristina
    Närhälsan, Region of Västra Götaland, Hisings-Backa, Sweden; Department of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden .
    Bültmann, Ute
    Department of Health Sciences, University Medical Center Groningen, Community and Occupational Medicine, Groningen, Netherlands.
    Gyllensten, Hanna
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden .
    Hagberg, Jan
    Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Sandman, Lars
    National Centre for Priorities in Health, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Bergström, Gunnar
    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. Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Increasing return-to-work among people on sick leave due to common mental disorders: Design of a cluster-randomized controlled trial of a problem-solving intervention versus care-as-usual conducted in the Swedish primary health care system (PROSA)2018In: BMC Public Health, E-ISSN 1471-2458, Vol. 18, no 1, article id 889Article in journal (Refereed)
    Abstract [en]

    Background: Common mental disorders affect about one-third of the European working-age population and are one of the leading causes of sick leave in Sweden and other OECD countries. Besides the individual suffering, the costs for society are high. This paper describes the design of a study to evaluate a work-related, problem-solving intervention provided at primary health care centers for employees on sick leave due to common mental disorders. Methods: The study has a two-armed cluster randomized design in which the participating rehabilitation coordinators are randomized into delivering the intervention or providing care-as-usual. Employees on sick leave due to common mental disorders will be recruited by an independent research assistant. The intervention aims to improve the employee's return-to-work process by identifying problems perceived as hindering return-to-work and finding solutions. The rehabilitation coordinator facilitates a participatory approach, in which the employee and the employer together identify obstacles and solutions in relation to the work situation. The primary outcome is total number of sick leave days during the 18-month follow-up after inclusion. A long-term follow-up at 36 months is planned. Secondary outcomes are short-term sick leave (min. 2 weeks and max. 12 weeks), psychological symptoms, work ability, presenteeism and health related quality of life assessed at baseline, 6 and 12-month follow-up. Intervention fidelity, reach, dose delivered and dose received will be examined in a process evaluation. An economic evaluation will put health-related quality of life and sick leave in relation to costs from the perspectives of society and health care services. A parallel ethical evaluation will focus on the interventions consequences for patient autonomy, privacy, equality, fairness and professional ethos and integrity. Discussion: The study is a pragmatic trial which will include analyses of the intervention's effectiveness, and a process evaluation in primary health care settings. Methodological strengths and challenges are discussed, such as the risk of selection bias, contamination and detection bias. If the intervention shows promising results for return-to-work, the prospects are good for implementing the intervention in routine primary health care. Trial registration: ClinicalTrials.gov Identifier: NCT03346395 Registered January, 12 2018. © 2018 The Author(s).

  • 15.
    Boström, Maria
    et al.
    Karolinska institutet.
    Björklund, Christina
    Karolinska institutet.
    Bergström, Gunnar
    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. Karolinska institutet.
    Nybergh, Lotta
    Karolinska institutet.
    Schäfer Elinder, Liselotte
    Karolinska institutet.
    Stigmar, Kjerstin
    Lunds universitet.
    Wåhlin, Charlotte
    Karolinska institutet; Linköpings universitet.
    Jensen, Irene
    Karolinska institutet.
    Kwak, Lydia
    Karolinska institutet.
    Health and work environment among female and male Swedish elementary school teachers - A cross-sectional study2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 1, article id E227Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND OBJECTIVES: Changes in teachers' work situation in Sweden since the 1990s may have contributed to an increase in common mental disorders (CMDs) and burnout. However, there is a lack of research in this field. The aim was to describe how Swedish elementary school teachers experience their health, organizational and social work environment, and the psychosocial safety climate at the workplace, and especially differences and similarities between female and male teachers.

    MATERIALS AND METHODS: Data were collected with the COPSOQ, OLBI, UWES and PSC-12 from 478 elementary teachers, 81.0% of them women, from twenty schools. The response rate was 96.4%.

    RESULTS: Teachers reported relatively good general health but experienced high stress, high work pace and emotional demands, low influence at work and a poor psychosocial safety climate. These factors were especially prominent among female teachers. Both women and men experienced good development possibilities and high work engagement.

    CONCLUSIONS: The results of this study can help us to develop a more sustainable work environment for female and male teachers. A more sustainable work environment might attract more people to the profession and incentivize existing teachers to remain in the profession.

  • 16.
    Brulin, Emma
    et al.
    Stockholms universitet; Karolinska institutet.
    Bjärntoft, Sofie
    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.
    Bergström, Gunnar
    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. Karolinska institutet.
    Hallman, David
    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.
    Gendered associations of flexible work arrangement and perceived flexibility with work–life interference: a cross-sectional mediation analysis on office workers in Sweden2023In: Social Indicators Research, ISSN 0303-8300, E-ISSN 1573-0921, Vol. 167, p. 571-588Article in journal (Refereed)
    Abstract [en]

    Flexible work arrangements (FWA) may be beneficial for increasing perceived flexibility (i.e. control over when, where and how to work) and reducing interference between work and private-life, but knowledge of gendered patterns of these relationships is sparse. Drawing on gender theory, the aim of this study was to conduct gender-differentiated analyses of the associations between FWA (non-regulated work or flex-time) and work–life interference using perceived flexibility as a mediator. Survey data were collected in 2016 from a sample of 2614 employees in the Swedish Transport Administration (response rate 67%). The sample included 39.6% women and 60.4% men, 71.7% had non-regulated work and 28.3% flex-time. Associations were determined using linear mixed models and mediation analysis. Results indicated a beneficial effect of non-regulated work (referencing flex-time) on work–life interference through an increase in perceived flexibility. The indirect effect of FWA was pronounced and statistically significant in the total sample, as well as in men and women. However, in men, non-regulated work was associated with a statistically significant increase in interference (competitive mediation). Gender did not interact significantly with work arrangement nor with perceived flexibility. In conclusion, the type of FWA can result in different perceptions of flexibility which in turn may affect experiences of work–life interference. Furthermore, it should be acknowledged that both FWAs and flexibility may be experienced differently for men and women regarding interference. Thus, employers seeking to reduce employee interference should consider gender norms and individual needs.

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  • 17.
    Casely-Hayford, Jeffrey
    et al.
    Karolinska institutet.
    Björklund, Christina
    Karolinska institutet.
    Bergström, Gunnar
    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. Karolinska institutet.
    Lindqvist, Per
    Linnéuniversitetet.
    Kwak, Lydia
    Karolinska institutet.
    What makes teachers stay? A cross-sectional exploration of the individual and contextual factors associated with teacher retention in Sweden2022In: Teaching and Teacher Education: An International Journal of Research and Studies, ISSN 0742-051X, E-ISSN 1879-2480, Vol. 113, article id 103664Article in journal (Refereed)
    Abstract [en]

    This cross-sectional study aimed to identify individual and contextual factors associated with Swedish teachers' intention to remain in the profession. A sample of 5903 elementary-year teachers completed a questionnaire between 2004 and 2011 assessing their health and perception of individual and contextual factors at work. The findings showed that teachers' intention to remain in the profession is mainly explained by individual factors, predominantly by teachers’ perceived health state, work motivation and collegial support. The main implication is the importance of teachers' perceived health state for their intention to remain, underscoring the importance of a health promoting work environment in schools. 

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  • 18.
    Casely-Hayford, Jeffrey
    et al.
    Karolinska institutet.
    Lindqvist, Per
    Linnéuniversitetet.
    Björklund, Christina
    Karolinska institutet.
    Bergström, Gunnar
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health, Psychology and Sports Sciences, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research. Karolinska institutet.
    Kwak, Lydia
    Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, 171 77 Stockholm, Sweden.
    Enculturating a Protective Professional Community: Processes of Teacher Retention in a Swedish Hard-to-Staff School2024In: Education Sciences, E-ISSN 2227-7102, Vol. 14, no 1, article id 114Article in journal (Refereed)
    Abstract [en]

    This study presented a positive deviant case: a Swedish hard-to-staff school which has had a low rate of teacher turnover over time. In line with the purpose of studying positive deviance in organisations, our exploratory inquiry was geared towards understanding how and why ‘at-risk’ teachers, i.e., teachers who teach in subjects which are known to have high levels of staffing difficulties in Sweden, stayed at this particular school. Using a modified grounded theory approach, our results suggested that teachers remained at the school due to being embedded in a protective professional community that was enculturated by different expressions of collegiality. Finally, these findings are discussed in relation to the theoretical concepts of teachers’ job embeddedness and social capital. 

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  • 19.
    Gustafsson, Klas
    et al.
    Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden.
    Bergström, Gunnar
    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. Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden.
    Marklund, Staffan
    Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden.
    Aboagye, Emmanuel
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden.
    Leineweber, Constanze
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Presenteeism as a predictor of disability pension: A prospective study among nursing professionals and care assistants in Sweden2019In: Journal of Occupational Health, ISSN 1341-9145, E-ISSN 1348-9585, Vol. 61, no 6, p. 453-463Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim of the present study was to examine how presenteeism affects the risk of future disability pension among nursing professionals and care assistants (assistant nurses, hospital ward assistants, home-based personal care workers, and child care assistants). A specific objective was to compare health and social care employees with all other occupations.

    METHODS: The study was based on a representative sample of working women and men (n = 43 682) aged 16-64 years, who had been interviewed between 2001 and 2013 for the Swedish Work Environment Survey conducted every second year since 1989. Information on disability pension was obtained from the Social Insurance Agency's database (2002-2014). The studied predictors were related to disability pension using Cox's proportional hazard regression with hazard ratios (HR) and 95% confidence interval (CI) and selected confounders were controlled for. The follow-up period was 6.7 years (SD 4.2).

    RESULTS: Health and social care employees with frequent presenteeism showed a particularly elevated risk of future disability pension after adjusting for sex, sociodemographic variables, physical and psychosocial working conditions, and self-rated health symptoms. In the amalgamated occupational group of nursing professionals and care assistants, the impact on disability pension of having engaged in presenteeism four times or more during the prior year remained significant (HR = 3.72, 95% CI = 2.43-5.68).

    CONCLUSIONS: The study suggests that frequent presenteeism contributes to an increased risk of disability pension among nursing professionals and care assistants as well as among all other occupations.

  • 20.
    Gustafsson, Klas
    et al.
    Karolinska Institutet.
    Marklund, Staffan
    Karolinska Institutet.
    Leineweber, Constanze
    Stockholm University.
    Bergström, Gunnar
    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. Karolinska Institutet.
    Aboagye, Emmanuel
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. Karolinska Institutet.
    Helgesson, Magnus
    Karolinska Institutet.
    Presenteeism, psychosocial working conditions and work ability among care workers - a cross-sectional Swedish population-based study2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 7, article id 2419Article in journal (Refereed)
    Abstract [en]

    Presenteeism, attending work while ill, has been examined in different contexts in the last few decades. The aim was to examine whether poor psychosocial working conditions and perceived work ability are associated with increased odds ratios for presenteeism, focusing on nursing professionals and care assistants. A cross-sectional population-based study was conducted. The selected individuals were extracted from representative samples of employees, aged 16–64, who participated in the Swedish Work Environment Surveys between 2001 and 2013 (n = 45,098). Three dimensions of psychosocial working conditions were measured: job demands, job control, and job support. Presenteeism and perceived work ability was measured. Using multiple logistic regression analyses, odds ratios for presenteeism with 95% confidence intervals (CI) were estimated. While nurses (n = 1716) showed the same presenteeism level as all the other occupation groups (n = 37,125), it was more common among care assistants (n = 6257). The odds ratio for presenteeism among those with high job demands (OR = 2.37, 95% CI 2.21–2.53), were higher among women than among men. For nursing professionals and care assistants, the odds ratios for presenteeism were highest among those with the lowest work ability level. The problems of presenteeism and low work ability among many health and care workers may be lessened by a reduction in psychosocial demands.

  • 21.
    Hallman, David
    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.
    Januario, Leticia
    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.
    Heiden, Marina
    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.
    Svensson, Sven
    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.
    Bergström, Gunnar
    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.
    Telework during the COVID-19 outbreak in Sweden: Effects on time spent sitting, standing, moving and sleeping in office workers2021In: Proceedings of the International Ergonomics Association Conference 2021, 2021Conference paper (Refereed)
  • 22.
    Hallman, David
    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.
    Januario, Leticia
    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.
    Heiden, Marina
    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.
    Svensson, Sven
    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.
    Bergström, Gunnar
    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. Karolinska institutet.
    Working from home during the COVID-19 outbreak in Sweden: effects on 24-h time-use in office workers2021In: BMC Public Health, E-ISSN 1471-2458, Vol. 21, article id 528Article in journal (Refereed)
    Abstract [en]

    Background: The COVID-19 pandemic has triggered national recommendations encouraging people to work from home (WFH), but the possible impact of WFH on physical behaviors is unknown. This study aimed to determine the extent to which the 24-h allocation of time to different physical behaviors changes between days working at the office (WAO) and days WFH in office workers during the pandemic.

    Methods: Data were collected on 27 office workers with full-time employment at a Swedish municipal division during the COVID-19 outbreak in May–July 2020. A thigh-worn accelerometer (Axivity) was used to assess physical behavior (sedentary, stand, move) during seven consecutive days. A diary was used to identify periods of work, leisure and sleep. 24-h compositions of sedentary, standing and moving behaviors during work and non-work time were examined using Compositional data analysis (CoDA), and differences between days WAO and days WFH were determined using repeated measures ANOVA.

    Results: Days WFH were associated with more time spent sleeping relative to awake, and the effect size was large (F = 7.4; p = 0.01; ηp2 = 0.22). The increase (34 min) in sleep time during WFH occurred at the expense of a reduction in work and leisure time by 26 min and 7 min, respectively. Sedentary, standing and moving behaviors did not change markedly during days WFH compared to days WAO.

    Conclusion: Days working from home during the COVID-19 pandemic in Sweden were associated with longer duration of sleep than days working at the office. This behavioral change may be beneficial to health.

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  • 23.
    Heiden, Marina
    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.
    Hallman, David
    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.
    Svensson, Malin
    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.
    Svensson, Sven
    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.
    Bergström, Gunnar
    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. Karolinska institutet.
    Mismatch between actual and preferred extent of telework: cross-sectional and prospective associations with well-being and burnout2023In: BMC Public Health, E-ISSN 1471-2458, Vol. 23, article id 1736Article in journal (Refereed)
    Abstract [en]

    Background: This study aimed to determine whether telework mismatch, i.e., lack of fit between actual and preferred extent of telework, is cross-sectionally and prospectively associated with well-being and burnout.

    Methods: A questionnaire was sent to employees in a Swedish manufacturing company in November 2020 (baseline) and September 2021 (follow-up). It contained questions about well-being (WHO-5 Well-Being Index) and burnout (Copenhagen Psychosocial Questionnaire III), as well as the preferred extent of telework and extent of telework performed. Telework mismatch was calculated as the difference between the actual and preferred extent of telework. Change in mismatch over time was categorized as 1) less mismatch at follow-up than at baseline, 2) more mismatch at follow-up, and 3) identical levels of mismatch at baseline and follow-up. Multivariate and univariate analyses of variance were used to determine the effects of mismatch and change in mismatch over time on baseline ratings and changes in ratings of well-being and burnout. All analyses were performed with and without adjustment for age, sex, marital status, children, type of employment, commuting time and extent of telework performed.

    Results: The response rate was 39% at baseline (n=928, 67% men, mean(SD) age: 45(11) years) and 60% at follow-up (n=556, 64% men, mean(SD) age: 46(11) years). A cross-sectional association was found between telework mismatch and well-being, showing that employees who teleworked more than they would like reported worse well-being than those who teleworked less than they would like. No statistically significant association was found between telework mismatch and burnout. The ability of telework mismatch at baseline to predict changes in well-being or burnout over 10 months was small and non-significant. No association was found between change in telework mismatch over the 10-month period and corresponding changes in well-being or burnout.

    Conclusion: Our results suggest that telework should be thoughtfully practiced in companies/organizations to avoid negative consequences for employees who already telework more than they prefer. Studies are needed to determine how long-term changes in match between preferred and actual extent of telework is associated with employee well-being, including how the association is modified by the nature of the job and the work environment.

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  • 24.
    Heiden, Marina
    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.
    Hallman, David
    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.
    Svensson, Sven
    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.
    Bergström, Gunnar
    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.
    Productivity, Well-Being and Work-Family Conflict in Mandatory Telework during the COVID-19 Pandemic2021In: Proceedings of the International Ergonomics Association Conference 2021, 2021Conference paper (Refereed)
    Abstract [en]

    SUMMATIVE STATEMENT  

    Results from an ongoing questionnaire study on telework during the COVID-19 pandemic show that mandatory telework (as opposed to voluntary), but not the extent of telework, is associated with poor well-being and more family-to-work conflict.

    KEYWORDS: Corona, survey, telecommuting

    PROBLEM STATEMENT  

    Most of what is known today about attitudes and preferences regarding telework is based on studies where telework is an available option in certain occupational groups (Allen, et al., 2015). During the COVID-19 pandemic, however, many organizations have implemented telework to an unprecedented extent, with employees being required or strongly recommended to work from home, in order to reduce the spread of the virus and protect people at higher risk of severe illness from COVID-19. This means that more employees are now teleworking, and for long periods of time, not by choice, but by necessity. Some of these employees have previous experience of telework, and some have not.

    When telework is not voluntary, recommendations for how to arrange telework based on previous findings may not apply. Studies of consequences of telework, and whether they differ between voluntary and mandatory telework, may contribute to a better understanding of how recommendations should look, and how they should be implemented.

    RESEARCH OBJECTIVE/QUESTION 

    The aim of this study is to determine the association between telework practice (i.e., extent of telework, previous experience of telework, and whether telework is mandatory or voluntary) and self-reported productivity, well-being and work-family conflict.

    METHODOLOGY 

    In an ongoing survey among employees in private and public organizations, an electronic questionnaire was distributed between June and December 2020 to 2859 employees, of which 1157 responded. The questionnaire addressed the extent of telework performed now, whether it was mandatory or voluntary, previous experience of telework, productivity (Haapakangas, et al., 2018), well-being (Winther Topp, et al., 2015), and work-family conflict (Carlson, et al., 2000). It also included questions about satisfaction with IT tools/support and number of work hours per week (actual hours as well as hours according to the employment contract).

    The questionnaire data have been analyzed using linear regression to determine the association between the extent of telework (in hours/week) and the outcomes productivity, well-being and work-family conflict (i.e., work-to-family conflict and family-to-work conflict). In the regression models, previous experience of telework (≥ 1 year) and whether telework was mandatory were also included as predictors. The analyses were performed with and without adjustment for satisfaction with IT tools/support and actual working hours relative to working hours according to the employment contract.

    RESULTS

    The results showed that the extent of telework had a marginal effect on all outcomes. Employees who had teleworked for less than 1 year reported less work-to-family and family-to-work conflict than employees who had more than 1 year of telework experience. Whether telework was mandatory appeared to have no association with productivity ratings, but mandatory telework was associated with poorer well-being and more family-to-work conflict.

    When the regression models were adjusted for satisfaction with IT tools/support and actual working hours relative to working hours according to the employment contract, associations between telework practice and outcomes remained largely the same. Satisfaction with IT tools/support had a large effect on productivity, well-being and work-to-family conflict. Working longer hours (i.e., working more hours than according to the employment contract) was associated with increased productivity but also more work-to-family conflict. 

    DISCUSSION

    The association between mandatory telework, poor well-being and more family-to-work conflict could possibly be explained by reduced autonomy at work. When it is not possible to decide when to telework and which work tasks to perform during telework, telework may not offer the opportunities to achieve better work-life balance that voluntary telework does. Reasonably, this effect would be stronger among more experienced teleworkers.

    CONCLUSIONS  

    Our findings suggest that the extent of telework performed during the COVID-19 pandemic does not affect self-rated productivity, well-being and work-family conflict. Mandatory telework, however, was associated with poor well-being and more family-to-work conflict, compared to voluntary telework.

     ACKNOWLEDGEMENTS

    The study was conducted within the research program Flexible Work: Opportunity and Challenge funded by the Swedish Research Council for Health, Working Life and Welfare (reg. no. 2019-01257) and AFA Insurance (reg. no. 200244).

     

    REFERENCES

    Allen, T.D., Golden, T.D., & Shockley, K.M. (2015). How effective is telecommuting? Assessing the status of our scientific findings. Psychological Science in the Public Interest, 16(2), 40–68.

    Carlson, D.S., Kacmar, K.M., & Williams, L.J. (2000). Construction and initial validation of a multidimensional measure of work–family conflict. Journal of Vocational Behavior, 56, 249-276.

    Haapakangas, A., Hallman, D.M., Mathiassen, S.E., & Jahncke, H. (2018). Self-rated productivity and employee well-being in activity-based offices: The role of environmental perceptions and workspace use. Building and Environment, 145, 115-124.

    Winther Topp, C., Dinesen Østergaard, S., Søndergaard, S., & Bech, P. (2015). The WHO-5 Well-Being Index: a systematic review of the literature. Psychotherapy and Psychosomatics, 84(3), 167-176.

  • 25.
    Helgadottir, Bjorg
    et al.
    Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, Berze Liusvag 3, S-17177 Stockholm, Sweden..
    Narusyte, Jurgita
    Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, Berze Liusvag 3, S-17177 Stockholm, Sweden..
    Ropponen, Annina
    Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, Berze Liusvag 3, S-17177 Stockholm, Sweden.;Finnish Inst Occupat Hlth, Helsinki, Finland..
    Bergström, Gunnar
    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. Karolinska Inst, Inst Environm Med, Intervent & Implementat Res Worker Hlth Unit, Stockholm, Sweden.;Univ Gavle, Ctr Musculoskeletal Res, Dept Occupat & Publ Hlth Sci, Gavle, Sweden..
    Mather, Lisa
    Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, Berze Liusvag 3, S-17177 Stockholm, Sweden..
    Blom, Victoria
    Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, Berze Liusvag 3, S-17177 Stockholm, Sweden.;Swedish Sch Sport & Hlth Sci, Stockholm, Sweden..
    Svedberg, Pia
    Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, Berze Liusvag 3, S-17177 Stockholm, Sweden..
    The role of occupational class on the association between sickness absence and disability pension: A Swedish register-based twin study2019In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 45, no 6, p. 622-630Article in journal (Refereed)
    Abstract [en]

    Objectives The aim of this study was to examine the association between long-term sickness absence (LTSA) due to mental disorders and musculoskeletal disorders and all-cause disability pension (DP) among blue- and white-collar workers. A secondary objective was to examine the influence of familial factors on the associations. Methods This was a prospective twin cohort study of 42 984 individuals (21-64 years at baseline), 3017 of whom had a new LTSA spell (>14 days) due to mental or musculoskeletal disorders in 2005-2006. Average follow-up time was 5.4 years. Survey data on occupational class and register data on LTSA and DP were used. Cox proportional hazards regression was applied to calculate hazards ratios (HR) with 95% confidence intervals (CI). Results During follow-up, 989 participants went on disability. LTSA due to mental disorders and musculoskeletal disorders led to similar HR for DP among both white- and blue-collar workers when compared to white-collar workers not on LTSA (reference group). LTSA >= 6 months due to musculoskeletal disorders was associated with a higher risk of DP for white-collar (HR 31.50, 95% CI 20.45-48.52) than blue-collar (HR 17.64, 95% CI 13.08-23.78) workers when compared to the reference group. HR were lower in the discordant twin pair models for LTSA due to mental disorders than in the whole cohort. Conclusions White-collar workers on LTSA due to musculoskeletal disorders are especially vulnerable to all-cause DP. This pattern was not present for LTSA due to mental disorders. Familial factors seem to influence the association between LTSA due to mental disorders and all-cause DP.

  • 26.
    Helgadóttir, Björg
    et al.
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Svedberg, Pia
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Mather, Lisa
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Lindfors, Petra
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Bergström, Gunnar
    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. Unit of Intervention and Implementation Research for Worker Health, The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Blom, Victoria
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    The association between part-time and temporary employment and sickness absence: a prospective Swedish twin study2019In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 29, no 1, p. 147-153Article in journal (Refereed)
    Abstract [en]

    Background: Sickness absence (SA) is becoming a major economic problem in many countries. Our aim was to investigate whether type of employment, including temporary employment or part-time employment, is associated with SA while controlling for familial factors (genetic and shared environment). Differences between men and women and across employment sectors were explored.

    Methods: This is a prospective twin study based on 21 105 twins born in Sweden 1959-85. The participants completed a survey in 2005 with follow-up of SA (≥15 days), using register data, until end of 2013. The data were analyzed with logistic regression, with results presented as odds ratios (OR) with 95% confidence intervals (CI).

    Results: Temporary employment involved higher odds of SA (OR=1.21 95% CI=1.04-1.40) compared to full-time employment. Both part-time workers (OR=0.84 95% CI=0.74-0.95) and the self-employed (OR=0.77 95%CI=0.62-0.94) had lower odds of SA. Stratifying by sex showed lower odds for part-timers (OR=0.82 95% CI=0.73-0.94) and self-employed women (OR=0.65 95% CI=0.47-0.90), but higher odds for men in temporary employment (OR=1.33 95% CI=1.03-1.72). Temporary employees in county councils (OR=1.73 95% CI=1.01-2.99) and municipalities (OR=1.41 95% CI=1.02-1.96) had higher odds while part-timers employed in the private sector had lower odds (OR=0.77 95% CI=0.64-0.93). Familial factors did not confound the association between employment type and SA.

    Conclusions: Employment type is associated with SA, with temporary employment involving a higher risk compared to permanent full-time employment while both part-time employment and self-employment involved a lower risk. The associations vary between women and men and across sectors.

  • 27.
    Holmlund, Lisa
    et al.
    Karolinska institutet.
    Bültmann, Ute
    University of Groningen, The Netherlands.
    Bergström, Gunnar
    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. Karolinska institutet.
    Warnqvist, Anna
    Karolinska institutet.
    Björk Brämberg, Elisabeth
    Karolinska institutet.
    Are psychosocial work factors and work-home interference associated with time to first full return-to-work after sick leave due to common mental disorders?2023In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 96, p. 747-755Article in journal (Refereed)
    Abstract [en]

    Objective

    To (1) examine the time to first full return-to-work (RTW), and (2) investigate whether psychosocial work factors and work-home interference are associated with time to first full RTW after sick leave due to common mental disorders (CMDs).

    Methods

    The cohort study comprised 162 employees on sick leave due to CMDs participating in a two-armed cluster-randomised controlled trial in Sweden. Baseline data consisted of a web-based questionnaire and follow-up data of repeated text messages every fourth week for 12 months. The time to first full RTW was estimated using the Kaplan–Meier Estimator. Parametric Weibull survival models with interval-censored outcomes were used to determine associations between psychosocial work factors and work-home interference with time to first full RTW. In a post hoc analysis, time-interval differences in associations for 0– ≤ 6- versus > 6–12 months were tested.

    Results

    During the 12-month follow-up, n = 131 (80.9%) reported a first full RTW. The median time to this RTW was 16 weeks (95% CI 12; 20). High psychological job demands, high emotional job demands, high work-to-home interference (WHI), and low social job support were independently associated with a longer time to first full RTW. Time-interval differences were found for job control and emotional job demands.

    Conclusions

    Psychosocial work demands and WHI are associated with a longer time to RTW after sick leave due to CMDs. Work organisations and rehabilitation practices should include accommodations for high psychological and emotional job demands during RTW, as well as pay attention to the risk of spill-over of high job demands into employees’ private lives.

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  • 28.
    Ida, Karlsson
    et al.
    Karolinska institutet.
    Lydia, Kwak
    Karolinska institutet.
    Iben, Axén
    Karolinska institutet.
    Bergström, Gunnar
    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. Karolinska institutet.
    Ute, Bültmann
    University of Groningen, The Netherlands.
    Kristina, Holmgren
    Göteborgs universitet.
    Elisabeth, Björk Brämberg
    Karolinska institutet.
    Experiences of participating in a problem-solving intervention with workplace involvement in Swedish primary health care: a qualitative study from rehabilitation coordinator's, employee's, and manager's perspectives2023In: BMC Public Health, E-ISSN 1471-2458, Vol. 23, no 1, article id 940Article in journal (Refereed)
    Abstract [en]

    Background

    Work-directed interventions that include problem-solving can reduce the number of sickness absence days. The effect of combining a problem-solving intervention with involvement of the employer is currently being tested in primary care in Sweden for employees on sickness absence due to common mental disorders (PROSA trial). The current study is part of the PROSA trial and has a two-fold aim: 1) to explore the experiences of participating in a problem-solving intervention with workplace involvement aimed at reducing sickness absence in employees with common mental disorders, delivered in Swedish primary health care, and 2) to identify facilitators of and barriers to participate in the intervention. Both aims targeted rehabilitation coordinators, employees on sickness absence, and first-line managers.

    Methods

    Data were collected from semi-structured interviews with participants from the PROSA intervention group; rehabilitation coordinators (n = 8), employees (n = 13), and first-line managers (n = 8). Content analysis was used to analyse the data and the Consolidated Framework for Implementation Research was used to group the data according to four contextual domains. One theme describing the participation experiences was established for each domain. Facilitators and barriers for each domain and stakeholder group were identified.

    Results

    The stakeholders experienced the intervention as supportive in identifying problems and solutions and enabling a dialogue between them. However, the intervention was considered demanding and good relationships between the stakeholders were needed. Facilitating factors were the manual and work sheets which the coordinators were provided with, and the manager being involved early in the return-to-work process. Barriers were the number of on-site meetings, disagreements and conflicts between employees and first-line managers, and symptom severity.

    Conclusions

    Seeing the workplace as an integral part of the intervention by always conducting a three-part meeting enabled a dialogue that can be used to identify and address disagreements, to explain CMD symptoms, and how these can be handled at the workplace. We suggest allocating time towards developing good relationships, provide RCs with training in handling disagreements, and additional knowledge about factors in the employee’s psychosocial work environment that can impair or promote health to increase the RCs ability to support the employee and manager.

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  • 29.
    Januario, Leticia
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science.
    Karstad, Kristina
    National Research Centre for the Working Environment, Copenhagen, Dk.
    Rugulies, Reiner
    National Research Centre for the Working Environment, Copenhagen, Dk.
    Bergström, Gunnar
    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.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Dk.
    Hallman, David
    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.
    Association between psychosocial working conditions and perceived physical exertion among eldercare workers: a cross-sectional multilevel analysis of nursing homes, wards and workers2019In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 19, article id 3610Article in journal (Refereed)
    Abstract [en]

    This cross-sectional multilevel study aims at investigating the associations between psychosocial working conditions of different workplace levels and perceived physical exertion among eldercare workers. Data were obtained from the ‘Danish Observational Study of Eldercare work and musculoskeletal disorderS’ (DOSES) study, including 536 eldercare workers, nested in 126 wards and 20 nursing homes. Psychosocial working conditions were measured by the Copenhagen Psychosocial Questionnaire (COPSOQ). The physical workload was measured with a self-administered scale (0–10) rating perceived physical exertion. Multilevel linear mixed models were used to determine associations of psychosocial conditions between nursing homes, wards, and workers with physical exertion. Most of the variance in the perceived physical exertion was explained by differences between workers (83%), but some variance was explained by wards (11%) and nursing homes (6%). Workers employed in nursing homes with low influence (p = 0.01) and poor leadership (p = 0.02), and in wards with high quantitative demands (p = 0.03), high work pace (p < 0.001), and low justice (p = 0.01) were at increased risk of reporting higher physical exertion. The strongest associations were found for low influence, low quality of leadership, and high work pace at nursing homes and ward levels. In conclusion, improving specific psychosocial working conditions at nursing home and ward levels may be of particular importance to reduce excessive physical workload in eldercare workers

  • 30.
    Januario, Leticia
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health, Psychology and Sports Sciences, 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, Psychology and Sports Sciences, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Bergström, Gunnar
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health, Psychology and Sports Sciences, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Jackson, Jennie
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health, Psychology and Sports Sciences, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Did the COVID-19 pandemic influence inequality in self-reported work environment conditions based on gender and place of birth? A study of a Swedish commercial laundromat2024In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 114, article id 104113Article in journal (Refereed)
    Abstract [en]

    We evaluated differences in work environment conditions and health by gender and place of birth in a commercial laundromat prior to (baseline) and at the end of the first wave of the COVID-19 pandemic (follow-up). Using survey data, including dimensions from the Copenhagen Psychosocial Questionnaire, from forty-one workers, we assessed work environment conditions and health at baseline, follow-up and in change scores between baseline and follow-up. At baseline, men and women reported similar scores, while foreign-born (FB) workers reported better work environment conditions than Swedish-born (SB) workers. During the pandemic, conditions generally declined for all workers, but FB reported smaller declines than SB. A consistent inequality hierarchy across the 4 groups was not clear at baseline, follow-up or in change scores between time points. The study suggests potential cultural differences may exist in how work environment conditions are experienced. This should be considered in future studies and when managing future crises

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  • 31.
    Januario, Leticia
    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.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Bergström, Gunnar
    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.
    Stevens, Matthew L
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Rugulies, Reiner
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Hallman, David
    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.
    Ward-level leadership quality and prospective low-back pain of eldercare workers – do resident handlings mediate the association?2023In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 96, p. 1049-1059Article in journal (Refereed)
    Abstract [en]

    Objective: We investigated the extent to which ward-level leadership quality was associated with prospective low-back pain among eldercare workers, and how this association was mediated by observed resident handlings.

    Methods: 530 Danish eldercare workers, employed in 121 wards, distributed across 20 nursing homes were evaluated. At baseline, leadership quality was measured using the Copenhagen Psychosocial Questionnaire, and resident handlings [handlings per shift, handlings not using assistive devices, handlings done alone, interruptions to handlings, impediments to handlings] were assessed using observations. Frequency and intensity of low-back pain was assessed monthly during the following year. All variables were averaged for each ward. We used ordinary least squares regressions to examine direct effects of leadership on low-back pain and indirect effects through handlings, using PROCESS-macro for SPSS. 

    Results: After adjustments for low-back pain at baseline, type of ward, staff ratio (i.e., number of workers divided by number of residents) and proportion of devices not in place, leadership quality showed no effect on prospective low-back pain frequency (β=0.01 [-0.05:0.07]) and a small beneficial effect on pain intensity (β=-0.02 [-0.04:0.00]). Resident handlings did not mediate the association between leadership quality and frequency or intensity of low-back pain. 

    Conclusions: Good leadership quality was associated with a small decrease in prospective low-back pain intensity, but resident handlings did not seem to play a mediating role, although better ward-level leadership quality contributed to fewer workplace-observed resident handlings without assistance. Potentially, organizational factors such as type of ward and staff ratio, may have a greater influence on handlings and low-back pain than leadership quality per se among eldercare workers.

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  • 32.
    Januario, Leticia
    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.
    Stevens, Matthew
    National Research Centre for the Working Environment, Copenhagen.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen.
    Bergström, Gunnar
    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.
    Hallman, David
    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.
    Resident handlings in eldercare wards: are they associated with the development of musculoskeletal pain among the workers?2021In: Proceedings of the International Ergonomics Association conference 2021, 2021Conference paper (Refereed)
  • 33.
    Januario, Leticia
    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.
    Stevens, Matthew S
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Bergström, Gunnar
    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.
    Rugulies, Reiner
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Karstad, Kristina
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Hallman, David
    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.
    Are resident handlings in eldercare wards associated with musculoskeletal pain and sickness absence among the workers? A prospective study based on onsite observations2021In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 47, no 8, p. 609-618Article in journal (Refereed)
    Abstract [en]

    Objectives We aimed to identify eldercare wards with different types of resident handling characteristics (‘phenotypes’) and determine the prospective association between these characteristics and musculoskeletal pain and sickness absence among workers during a one-year follow-up.

    Methods Our study was based on the DOSES cohort, including 467 workers at 103 eldercare wards. At baseline, resident handlings were assessed using onsite observations. Workers’ self-reported musculoskeletal pain and sickness absence were assessed during the following year using text messages. Observations of the frequency of handlings per shift, use of assistive devices, assistance from others, and barriers (interruptions and impediments) were estimated for each worker, aggregated at ward level, and entered into a latent profile analysis, identifying ward phenotypes. We then used generalized estimating equations to determine associations between ward phenotypes, musculoskeletal pain and sickness absence.

    Results We identified four ward phenotypes: ‘turbulent’ (many handlings with devices and assistance, many barriers), ‘strained’ (many handlings without devices or assistance, some barriers), ‘unpressured’ (few handlings, yet without devices or assistance, few barriers) and ‘balanced’ (some handlings with devices and assistance, some barriers). Compared to workers in balanced wards, workers in turbulent wards had more days with neck-shoulder and low-back pain (LBP); and those working in strained wards had more days with LBP and higher pain intensities.

    Conclusion We found that ward phenotypes based on resident handling characteristics were predictive of musculoskeletal pain and sickness absence over one year. This shows that organizational factors related to resident handling are important determinants of musculoskeletal health among eldercare workers.

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  • 34.
    Keus van de Poll, Marijke
    et al.
    University of Gävle, Faculty of Engineering and Sustainable Development, Department of Building Engineering, Energy Systems and Sustainability Science, Environmental Science. Karolinska institutet.
    Bergström, Gunnar
    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. Karolinska institutet.
    Jensen, Irene
    Karolinska institutet.
    Nybergh, Lotta
    Karolinska institutet.
    Kwak, Lydia
    Karolinska institutet.
    Lornudd, Caroline
    Karolinska institutet.
    Lohela-Karlsson, Malin
    Uppsala University; Centre for Clinical Research, Region Västmanland-Uppsala University.
    Cost-effectiveness of a problem-solving intervention aimed to prevent sickness absence among employees with common mental disorders or occupational stress2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 14, article id 5234Article in journal (Refereed)
    Abstract [en]

    The cost-benefit and cost-effectiveness of a work-directed intervention implemented by the occupational health service (OHS) for employees with common mental disorders (CMD) or stress related problems at work were investigated. The economic evaluation was conducted in a two-armed clustered RCT. Employees received either a problem-solving based intervention (PSI; n = 41) or care as usual (CAU; n = 59). Both were work-directed interventions. Data regarding sickness absence and production loss at work was gathered during a one-year follow-up. Bootstrap techniques were used to conduct a Cost-Benefit Analysis (CBA) and a Cost-Effectiveness Analysis (CEA) from both an employer and societal perspective. Intervention costs were lower for PSI than CAU. Costs for long-term sickness absence were higher for CAU, whereas costs for short-term sickness absence and production loss at work were higher for PSI. Mainly due to these costs, PSI was not cost-effective from the employer's perspective. However, PSI was cost-beneficial from a societal perspective. CEA showed that a one-day reduction of long-term sickness absence costed on average €101 for PSI, a cost that primarily was borne by the employer. PSI reduced the socio-economic burden compared to CAU and could be recommended to policy makers. However, reduced long-term sickness absence, i.e., increased work attendance, was accompanied by employees perceiving higher levels of production loss at work and thus increased the cost for employers. This partly explains why an effective intervention was not cost-effective from the employer's perspective. Hence, additional adjustments and/or support at the workplace might be needed for reducing the loss of production at work.

  • 35.
    Keus van de Poll, Marijke
    et al.
    University of Gävle, Faculty of Engineering and Sustainable Development, Department of Building Engineering, Energy Systems and Sustainability Science, Environmental Science. Karolinska Institutet, Institute of Environmental Medicine, Division of Intervention and Implementation Research in Worker Health.
    Nybergh, L
    Karolinska Institutet, Institute of Environmental Medicine, Division of Intervention and Implementation Research in Worker Health.
    Lornudd, C
    Karolinska Institutet, Department of Learning, Informatics, Management and Ethics (LIME).
    Kwak, L
    Karolinska Institutet, Institute of Environmental Medicine, Division of Intervention and Implementation Research in Worker Health.
    Lohela Karlsson, M
    Uppsala University, Department of Medical Science.
    Hagberg, J
    Karolinska Institutet, Institute of Environmental Medicine, Division of Intervention and Implementation Research in Worker Health.
    Torgén, M
    Uppsala University, Department of Medical Science.
    Jensen, I
    Karolinska Institutet, Institute of Environmental Medicine, Division of Intervention and Implementation Research in Worker Health.
    Bergström, Gunnar
    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. Karolinska Institutet, Institute of Environmental Medicine, Division of Intervention and Implementation Research in Worker Health.
    Preventing sickness absenteeism among employees with common mental disorders or stress-related symptoms at work: A cluster RCT conducted at the occupational health services2019Conference paper (Refereed)
  • 36.
    Keus van de Poll, Marijke
    et al.
    University of Gävle, Faculty of Engineering and Sustainable Development, Department of Building Engineering, Energy Systems and Sustainability Science, Environmental Science. Karolinska Institutet, Institute of Environmental Medicine, Division of Intervention and Implementation Research in Worker Health.
    Nybergh, L
    Karolinska Institutet, Institute of Environmental Medicine, Division of Intervention and Implementation Research in Worker Health.
    Lornudd, C
    Karolinska Institutet, Department of Learning, Informatics, Management and Ethics (LIME).
    Kwak, L
    Karolinska Institutet, Institute of Environmental Medicine, Division of Intervention and Implementation Research in Worker Health.
    Lohela Karlsson, M
    Uppsala University, Department of Medical Science.
    Hagberg, J
    Karolinska Institutet, Institute of Environmental Medicine, Division of Intervention and Implementation Research in Worker Health.
    Torgén, M
    Uppsala University, Department of Medical Science.
    Jensen, I
    Karolinska Institutet, Institute of Environmental Medicine, Division of Intervention and Implementation Research in Worker Health.
    Bergström, Gunnar
    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. Karolinska Institutet, Institute of Environmental Medicine, Division of Intervention and Implementation Research in Worker Health.
    Preventing sickness absenteeism among employees with common mental disorders or stress-related symptoms at work: A cluster RCT conducted at the occupational health services2019Conference paper (Refereed)
  • 37.
    Keus van de Poll, Marijke
    et al.
    University of Gävle, Faculty of Engineering and Sustainable Development, Department of Building Engineering, Energy Systems and Sustainability Science, Environmental Science. Karolinska Institutet.
    Nybergh, Lotta
    Karolinska Institutet.
    Lornudd, Caroline
    Karolinska Institutet.
    Hagberg, Jan
    Karolinska Institutet.
    Bodin, Lennart
    Karolinska Institutet.
    Kwak, Lydia
    Karolinska Institutet.
    Jensen, Irene
    Karolinska Institutet.
    Lohela-Karlsson, Malin
    Uppsala universitet.
    Torgén, Margareta
    Uppsala universitet.
    Bergström, Gunnar
    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. Karolinska Institutet.
    Preventing sickness absence among employees with common mental disorders or stress-related symptoms at work: a cluster randomised controlled trial of a problem-solving-based intervention conducted by the Occupational Health Services2020In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 77, no 7, p. 454-461Article in journal (Refereed)
    Abstract [en]

    Objectives. Common mental disorders (CMDs) are among the main causes of sickness absence and can lead to suffering and high costs for individuals, employers and the society. The occupational health service (OHS) can offer work-directed interventions to support employers and employees. The aim of this study was to evaluate the effect on sickness absence and health of a work-directed intervention given by the OHS to employees with CMDs or stress-related symptoms.

    Methods. Randomisation was conducted at the OHS consultant level and each consultant was allocated into either giving a brief problem-solving intervention (PSI) or care as usual (CAU). The study group consisted of 100 employees with stress symptoms or CMDs. PSI was highly structured and used a participatory approach, involving both the employee and the employee’s manager. CAU was also work-directed but not based on the same theoretical concepts as PSI. Outcomes were assessed at baseline, at 6 and at 12 months. Primary outcome was registered sickness absence during the 1-year follow-up period. Among the secondary outcomes were self-registered sickness absence, return to work (RTW) and mental health.

    Results. A statistical interaction for group × time was found on the primary outcome (p=0.033) and PSI had almost 15 days less sickness absence during follow-up compared with CAU. Concerning the secondary outcomes, PSI showed an earlier partial RTW and the mental health improved in both groups without significant group differences.

    Conclusion. PSI was effective in reducing sickness absence which was the primary outcome in this study.

  • 38.
    Kwak, Lydia
    et al.
    Karolinska Inst, Stockholm, Sweden..
    Bjorklund, Christina
    Karolinska Inst, Stockholm, Sweden..
    Bostrom, Maria
    Karolinska Inst, Stockholm, Sweden..
    Bergström, Gunnar
    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. Karolinska Inst, Stockholm, Sweden.
    Nybergh, Lotta
    Karolinska Inst, Stockholm, Sweden..
    Elinder, Liselotte Schafer
    Karolinska Inst, Stockholm, Sweden..
    Stigmar, Kjerstin
    Lund Univ, Lund, Sweden.;Skane Univ Hosp, Lund, Sweden..
    Wahlin, Charlotte
    Linkoping Univ, Linkoping, Sweden..
    Jensen, Irene
    Karolinska Inst, Stockholm, Sweden..
    Integrating evidence-based approaches for social and organizational risk management in a school setting: A randomized trial on implementation effectiveness2020In: Implementation Science, E-ISSN 1748-5908, Vol. 15Article in journal (Other academic)
  • 39.
    Kwak, Lydia
    et al.
    Karolinska institutet.
    Lornudd, Caroline
    Karolinska institutet.
    Björklund, Christina
    Karolinska institutet.
    Bergström, Gunnar
    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. Karolinska institutet.
    Nybergh, Lotta
    Karolinska institutet.
    Schäfer Elinder, Liselotte
    Karolinska institutet.
    Stigmar, Kjerstin
    Lunds universitet.
    Wåhlin, Charlotte
    Linköpings universitet.
    Jensen, Irene
    Karolinska institutet.
    Implementation of the Swedish Guideline for Prevention of Mental ill-health at the workplace: study protocol of a cluster randomized controlled trial, using multifaceted implementation strategies in schools2019In: BMC Public Health, E-ISSN 1471-2458, Vol. 19, article id 1668Article in journal (Other academic)
    Abstract [en]

    Given today’s high prevalence of common mental disorders and related sick leave among teachers, an urgent need exists for a more systematic approach to the management of social and organizational risk factors within schools. In 2015, we launched the first Swedish occupational health guideline to support a structured prevention of these risks at the workplace. The existence of guidelines does however not guarantee their usage, as studies show that guidelines are often underused. Knowledge is therefore needed on effective implementation strategies that can facilitate the translation of guidelines into practice. The primary aim of the randomized waiting list-controlled trial described in this study protocol is to compare the effectiveness of a multifaceted implementation strategy versus a single implementation strategy for implementing the Guideline for the prevention of mental ill-health at the workplace within schools. The effectiveness will be compared regarding the extent to which the recommendations are implemented (implementation effectiveness) and with regard to social and organisational risk factors for mental ill-health, absenteeism and presenteeism (intervention effectiveness).

  • 40.
    Kwak, Lydia
    et al.
    Karolinska institutet.
    Toropova, Anna
    Karolinska institutet.
    Powell, Byron J.
    Washington University in St. Louis, Missouri, USA.
    Lengnick-Hall, Rebecca
    Washington University in St. Louis, Missouri, USA.
    Jensen, Irene
    Karolinska institutet.
    Bergström, Gunnar
    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. Karolinska institutet.
    Schäfer Elinder, Liselotte
    Karolinska institutet.
    Stigmar, Kjerstin
    Lunds universitet.
    Wåhlin, Charlotte
    Karolinska institutet; Linköpings universitet.
    Björklund, Christina
    Karolinska institutet.
    A randomized controlled trial in schools aimed at exploring mechanisms of change of a multifaceted implementation strategy for promoting mental health at the workplace2022In: Implementation Science, E-ISSN 1748-5908, Vol. 17, no 1, article id 59Article in journal (Refereed)
    Abstract [en]

    Background

    This study will explore implementation mechanisms through which a single implementation strategy and a multifaceted implementation strategy operate to affect the implementation outcome, which is fidelity to the Guideline For The Prevention of Mental Ill Health within schools. The guideline gives recommendations on how workplaces can prevent mental ill health among their personnel by managing social and organizational risks factors in the work environment. Schools are chosen as the setting for the study due to the high prevalence of mental ill health among teachers and other personnel working in schools. The study builds on our previous research, in which we compared the effectiveness of the two strategies on fidelity to the guideline. Small improvements in guideline adherence were observed for the majority of the indicators in the multifaceted strategy group. This study will focus on exploring the underlying mechanisms of change through which the implementation strategies may operate to affect the implementation outcome.

    Methods

    We will conduct a cluster-randomized-controlled trial among public schools (n=55 schools) in Sweden. Schools are randomized (1:1 ratio) to receive a multifaceted strategy (implementation teams, educational meeting, ongoing training, Plan-Do-Study-Act cycles) or a single strategy (implementation teams, educational meeting). The implementation outcome is fidelity to the guideline. Hypothesized mediators originate from the COM-B model. A mixed-method design will be employed, entailing a qualitative study of implementation process embedded within the cluster-randomized controlled trail examining implementation mechanisms. The methods will be used in a complementary manner to get a full understanding of the implementation mechanisms.

    Discussion

    This implementation study will provide valuable knowledge on how implementation strategies work (or fail) to affect implementation outcomes. The knowledge gained will aid the selection of effective implementation strategies that fit specific determinants, which is a priority for the field. Despite recent initiatives to advance the understanding of implementation mechanisms, studies testing these mechanisms are still uncommon.

    Trial registration

    ClinicalTrials.org dr.nr 2020-01214.

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  • 41.
    Marklund, Staffan
    et al.
    Karolinska institutet.
    Gustafsson, Klas
    Karolinska institutet.
    Bergström, Gunnar
    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. Karolinska institutet.
    Leineweber, Constanze
    Stockholms universitet.
    Reasons for presenteeism in different occupational branches in Sweden: a population based cross-sectional study2021In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 94, p. 1385-1395Article in journal (Refereed)
    Abstract [en]

    Objective

    To compare the prevalence and reasons for presenteeism in occupations in three branches defined as employees handling people, handling things or handling symbols.

    Method

    A cross-sectional population-based cohort study was conducted. The study group was drawn from a representative sample (n = 6230) aged 16–64, who had been interviewed in 2015 or in 2017 for the Swedish Work Environment Surveys (SWES). The odds ratios (ORs) stratified by occupational category for reasons of presenteeism, with 95% confidence intervals (CI), were estimated using binomial multiple logistic regression analysis.

    Results

    The study showed that presenteeism was more common among employees handling people (74%), when compared to employees handling things (65%) or handling symbols (70%). The most common reason for presenteeism among employees handling people was “I do not want to burden my colleagues”, while “Because nobody else can carry out my responsibilities” was most common in the other two categories. After control for socio-demography, work environments and health, the differences in reasons mostly remained significant between the three occupational categories.

    Conclusion

    The differences between occupational categories are important for prevalence and reasons for presenteeism. As presenteeism affects the future health of employees and the productivity of the work unit, attempts to reduce presenteeism may be important. Because the reasons vary between occupations, customized preventive measures should be applied in different occupational settings. Among employees handling people, covering up for absence in work team is relevant, while among employees handling symbols and handling things the corresponding focus could be on shared responsibilities for specific tasks.

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  • 42.
    Mather, Lisa
    et al.
    Karolinska Inst, Div Insurance Med, Stockholm, Sweden..
    Narusyte, J.
    Karolinska Inst, Div Insurance Med, Stockholm, Sweden..
    Ropponen, A.
    Karolinska Inst, Div Insurance Med, Stockholm, Sweden..
    Bergström, Gunnar
    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. Karolinska Inst, Inst Environm Med, Stockholm, Sweden.;Univ Gavle, Ctr Musculoskeletal Res, Dept Occupat & Publ Hlth Sci, Gavle, Sweden..
    Blom, V.
    Karolinska Inst, Div Insurance Med, Stockholm, Sweden.;Swedish Sch Sport & Hlth Sci, Stockholm, Sweden..
    Helgadottir, B.
    Karolinska Inst, Div Insurance Med, Stockholm, Sweden..
    Svedberg, P.
    Karolinska Inst, Div Insurance Med, Stockholm, Sweden..
    Adverse outcomes of sick leave due to mental disorders: prospective studies of discordant twin pairs2019In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 29, p. 256-Article in journal (Other academic)
  • 43.
    Mather, Lisa
    et al.
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Narusyte, J.
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Ropponen, A.
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Finnish Institute of Occupational Health, Helsinki, Finland.
    Bergström, Gunnar
    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. Unit of Intervention and Implementation Research for Worker Health, The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Blom, V.
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; The Swedish School of Sport and Health Sciences, Stockholm, Sweden .
    Helgadóttir, B.
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Svedberg, P.
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Sick leave due to mental disorders, morbidity and mortality: a prospective study of discordant twin pairs2020In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 55, p. 25-32Article in journal (Refereed)
    Abstract [en]

    Purpose: To investigate if sick leave due to mental disorders increases the risk of morbidity measured by inpatient and specialized outpatient care, and mortality among women and men, independent of familial factors. Methods: An open cohort study of 4979 twin pairs discordant for sick leave due to mental disorders was conducted in 2005–2013. Twins were followed up in the cause of death and national patient registries until the end of study, emigration, death, and inpatient and specialized outpatient care. Conditional Cox proportional hazard regression, adjusting for the familial factors shared by the twins, was used to calculate hazard ratios (HR) with 95% confidence intervals (CI). In case of non-proportional hazards, time-varying covariates were used. Results: Sick leave due to mental disorders increased the risk for inpatient care among men (HR: 1.90, CI 1.66–2.17) and women (HR: 1.39, CI 1.27–1.51). For men, the risk of outpatient care was higher the first 2 years (HR: 2.08, CI 1.87–2.31), after which it was attenuated (HR: 1.32, CI 1.02–1.70). For women, the HR was 1.57 (CI 1.47–1.68) for the whole study time. There was an increased risk of death among men (HR: 2.91, CI 1.70–4.99), but not among women (HR: 0.84, CI 0.53–1.35). Conclusions: Sick leave due to mental disorders was a risk factor for mortality for men only, and increased the risk of inpatient and specialized outpatient care among both women and men, but the risks were higher for men when stratifying for sex. 

  • 44.
    Mutiganda, Jean Claude
    et al.
    University of Gävle, Faculty of Education and Business Studies, Department of Business and Economic Studies, Business administration. Åbo Akademi University, Turku, Finland.
    Wiitavaara, Birgitta
    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.
    Heiden, Marina
    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.
    Svensson, Sven
    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.
    Fagerström, Arne
    University of Gävle, Faculty of Education and Business Studies, Department of Business and Economic Studies, Business administration.
    Bergström, Gunnar
    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. Karolinska institutet.
    Aboagye, Emmanuel
    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. Karolinska institutet.
    A systematic review of the research on telework and organizational economic performance indicators2022In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 13, article id 1035310Article, review/survey (Refereed)
    Abstract [en]

    Introduction: A systematic review is conducted in the study to investigate the relationship between telework and organizational economic performance indicators such as self-reported employee performance, organizational performance, actual employee turnover rates, or intentions.

    Methods: The databases Scopus, Business Source Premier, and Web of Science were used to conduct a literature search. Original articles published from 2000 and up to May 2021 were selected. Studies were screened for inclusion independently by review pairs and data were extracted. The Mixed Methods Appraisal Tool (MMAT) was used to evaluate the quality of the studies included.

    Results: Forty-three studies were included with some addressing multiple outcomes. Self-reported performance was higher for teleworking employees compared to those working in the ordinary workplace. The extent of the change in performance was dependent on individual characteristics and the extent of the teleworking practice in the organization. Telework was also associated with increased organizational performance, particularly in homogenous samples with unique work tasks. When telework is voluntary, it appears that both actual employee turnover rates and intentions to leave the organization are lower.

    Discussion: Further research with high-quality prospective designs is necessary to properly understand the contribution of telework to organizational economic performance indicators.

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  • 45.
    Nordlinder, Carolina
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work, Criminology and Public Health Sciences, Social Work.
    Bergström, Gunnar
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health, Psychology and Sports Sciences, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.
    Tham, Pia
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work, Criminology and Public Health Sciences, Social Work.
    Öberg, Peter
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work, Criminology and Public Health Sciences, Social Work.
    Individual, family, job, and organizational factors associated with retirement intentions among older long-term care workers: A systematic review2024In: Geriatric Nursing, ISSN 0197-4572, E-ISSN 1528-3984, Vol. 56, p. 83-93Article, review/survey (Refereed)
    Abstract [en]

    This systematic review synthesized prior quantitative research on individual, family, job, and organizational factors associated with retirement intentions (RI) among older long-term care (LTC) workers. Seven databases were searched for peer-reviewed studies. RI were defined as early (<65 years) or late (>65 years). To assess the methodological quality, we used JBI's checklists. The PRISMA statement guided this review. After duplicates were removed, 4 489 records were identified. A final sample of six articles was selected as eligible for inclusion. Current findings show weak social support, high physical job demands, and type of LTC occupation as important determinants for early RI. Strong social support and good job resources are important determinants fore late RI. In contrast to earlier research on other groups of older workers, this review shows no statistically associations between health nor emotional job demands and early RI for LTC workers. The results are discussed using the JD-R theory.

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  • 46.
    Nybergh, Lotta
    et al.
    Karolinska institutet.
    Bergström, Gunnar
    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. Karolinska institutet.
    Hellman, Therese
    Karolinska institutet; Uppsala university.
    Do work- and home-related demands and resources differ between women and men during return-to-work?: A focus group study among employees with common mental disorders2020In: BMC Public Health, E-ISSN 1471-2458, Vol. 20, article id 1914Article in journal (Refereed)
    Abstract [en]

    Common mental disorders present the main reason for registered sick leave in Sweden today, and women are at a higher risk of such sick leave than men. The aim of our study was to explore how the experiences of work- and home-related demands as well as resources influence return-to-work among employees sick-listed for common mental disorders in Sweden. Specifically, we aimed to explore similarities and differences in patterns of experiences among women and men.

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  • 47.
    Nybergh, Lotta
    et al.
    Karolinska institutet.
    Bergström, Gunnar
    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. Karolinska institutet.
    Jensen, Irene
    Karolinska institutet.
    Hellman, Therese
    Uppsala universitet.
    Experiences of interventions and rehabilitation activities in connection with return-to-work from a gender perspective. A focus group study among employees on sick leave for common mental disorders2021In: PLOS ONE, E-ISSN 1932-6203, Vol. 16, no 6, article id e0253049Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Common mental disorders present the main reason for registered sick leave in Sweden today, and women are at a higher risk of such sick leave than men. The aim of this paper is to explore how employees on sick leave for common mental disorders experience interventions and rehabilitation activities during return-to-work, as well as to explore similarities and differences between the experiences of the interviewed women and men.

    MATERIAL AND METHODS: A qualitative design was applied with semi-structured focus group interviews. Seven focus groups were conducted with a total of 28 participants (13 women and 15 men). The focus group discussions were audiotaped and transcribed verbatim, and data analyzed with conventional content analysis. Similarities and differences in the women's and men's experiences were written down in reflective notes during all steps of the analysis.

    RESULTS: The results comprise of one main category, "To be met with respect and recognition", and subcategories at two levels. Both similarities and differences emerged in how women and men sick-listed because of common mental disorders experienced return-to-work interventions and rehabilitation activities. It was important for both women and men to be met with respect and recognition, which was essential to all forms of help that the participants discussed during the focus group interviews. Women expressed a need for home-related interventions, whereas men expressed a need for organizational interventions to counter feelings of resignation at work. Women could also more easily understand their mental health condition as compared with men.

    CONCLUSION: A key implication of this study is that research on interventions and rehabilitation activities during return-to-work among employees on sick leave for common mental disorders should consider whether the findings are relevant equally to both women and men. Similarly, return-to-work professionals may need to consider possible differences among women and men on sick leave for common mental disorders, and to further customize offered interventions and rehabilitation activities. Doing so may help enhance the effectiveness of such interventions.

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  • 48.
    Ropponen, Annina
    et al.
    Karolinska institutet; Finnish Institute of Occupational Health.
    Narusyte, Jurgita
    Karolinska institutet.
    Wang, Mo
    Karolinska institutet.
    Kärkkäinen, Sanna
    Karolinska institutet; Finnish Institute for Health and Welfare.
    Mather, Lisa
    Karolinska institutet.
    Blom, Victoria
    Karolinska institutet ; Gymnastik- och idrottshögskolan.
    Bergström, Gunnar
    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. Karolinska institutet.
    Svedberg, Pia
    Karolinska institutet.
    Role of social benefits for future long-term sickness absence, disability pension and unemployment among individuals on sickness absence due to mental diagnoses: a competing risk approach2022In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 95, no 4, p. 867-876Article in journal (Refereed)
    Abstract [en]

    Purpose

    To investigate associations between social benefits and disability pension (DP), long-term sickness absence (LTSA, ≥ 90 days), or unemployment among Swedish twins with sickness absence (SA) due to mental diagnoses.

    Methods

    This population-based prospective twin study included register data on first incident SA spell (< 90 days) due to mental diagnoses (ICD 10 codes F00-F99) during the follow-up 2005–2016. SA < 90 days due to other diagnoses than mental diagnoses or any other social insurance benefit was identified for the preceding year of the first incident SA spell due to mental diagnoses (coded yes/no). Comparing those with any previous social benefits vs without, cumulative incidence curve to compare time to an event, and Cox proportional hazards models for cause-specific hazard ratios (HR, 95% confidence intervals, CI) treating first incident DP, LTSA and unemployment as competing risks were modeled.

    Results

    During follow-up, 21 DP, 1619 LTSA, and 808 unemployment events took place. Compared to those without, those with at least one benefit had a higher risk for DP (HR 5.03; 95%CI 1.80, 14.01), LTSA (1.67; 1.50, 1.84) and unemployment (1.24; 1.03, 1.50). The cumulative incidence for DP was very low, < 1%, for LTSA 80% with any previous social benefits vs. 60% without, and for unemployment ≤ 5%.

    Conclusion

    Social benefits received during the preceding year of SA due to mental diagnoses (< 90 days) predict DP, LTSA, and unemployment. Hence, previous social benefits may provide means for early identification of persons at risk for exit from labor market.

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  • 49.
    Svedberg, Pia
    et al.
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Mather, Lisa
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Bergström, Gunnar
    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. Division of Intervention and Implementation Research for Worker Health, The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Lindfors, Petra
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Blom, Victoria
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Psychology, Stockholm University, Stockholm, Sweden; The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    Time pressure and sleep problems due to thoughts about work as risk factors for future sickness absence2018In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 91, no 8, p. 1051-1059Article in journal (Refereed)
    Abstract [en]

    PURPOSE: This study investigated whether time pressure or sleep problems due to thoughts about work are associated with future sickness absence (SA) among women and men employed in different sectors, also when adjusting for confounders including familial factors (genetics and shared environment).

    METHODS: The study sample included 16,127 twin individuals (52% women), aged 19-47 years who in 2005 participated in an online survey including questions regarding time pressure, sleep, work and health. Register data on SA (> 14 days) were obtained from the National Social Insurance Agency and individuals were followed from date of survey response until 12/31/2013. Associations between time pressure, sleep problems due to thoughts about work and future SA were investigated using logistic regression analyses to assess odds ratios (OR) with 95% confidence intervals (CI).

    RESULTS: In total 5723 (35%) individuals had an incident SA spell during follow-up. Sleep problems due to thoughts about work were associated with SA in the fully adjusted model (OR 1.22, CI 1.10-1.36). Stratified by sector, the highest estimate was found for state employees (OR 1.54, CI 1.11-2.13). Familial factors did not seem to influence the associations. We found no statistically significant associations between time pressure and SA. No sex differences were found.

    CONCLUSIONS: Results indicated that sleep problems due to thoughts about work is a risk factor for future SA. This follows previous research showing that sleep length and sleep disturbances, regardless of reason, are associated with SA. But, experiences of work-related time pressure seem to have no effect on SA.

  • 50.
    Svensson, Sven
    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.
    Hallman, David
    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.
    Heiden, Marina
    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.
    Fagerström, Arne
    University of Gävle, Faculty of Education and Business Studies, Department of Business and Economic Studies, Business administration.
    Mutiganda, Jean Claude
    University of Gävle, Faculty of Education and Business Studies, Department of Business and Economic Studies, Business administration.
    Bergström, Gunnar
    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.
    Flexible work: Opportunity and Challenge (FLOC) for individual, social and economic sustainability. Protocol for a prospective cohort study of non-standard employment and flexible work arrangements in Sweden2022In: BMJ Open, E-ISSN 2044-6055, Vol. 12, no 7, article id e057409Article in journal (Refereed)
    Abstract [en]

    Introduction

    Flexibility in working life, including non-standard employment (NSE) and flexible work arrangements (FWAs), offers the organisation a better ability to adapt to changing conditions while also posing considerable challenges for organisations as well as workers. The aim of the Flexible Work: Opportunity and Challenge (FLOC) study is to investigate associations between NSE and FWA on the one hand, and individual, social and economic sustainability on the other.

    Methods and analysis This prospective open cohort study targets approximately 8000 workers 18–65 years old in 8–10 public and private organisations in Sweden. We will use a comprehensive battery of measurement methods addressing financial performance, physical and psychosocial exposures, and physical and mental health, both at the organisational and the individual level. Methods include valid survey questionnaires and register data, and, in subpopulations, technical measurements, interviews and diaries. Main exposures are type of employment and type of work arrangement. Main outcomes are indicators of social and economic sustainability and, at the individual level, health and well-being. Data, collected over 54 months at approximately 18-month intervals, will be analysed using multivariate methods considering main effects as well as potential effect modifiers. The analyses will take into account that respondents are nested in organisations, divisions and/or have specific managers.

    Ethics and dissemination: FLOC is approved by the Swedish Ethical Review Authority (decision numbers 2019–06220, 2020–06094 and 2021–02725). Data will be published in peer-reviewed journals and presented at international conferences, and researchers will assist the organisations in improving policies and routines for employment and organisation of work.

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