Background: About 4 in 10 people in Sweden get cancer during their lifetime, and approximately half of them will be diagnosed during their working life. As cancer survival rates improve, a growing number of individuals face challenges in returning to work following treatment. This increases the demand for effective return-to-work (RTW) strategies. Despite existing rehabilitation frameworks, cancer survivors often encounter barriers to sustainable work reintegration.

Objective: This study aimed to investigate stakeholders' perceptions of facilitators and barriers to RTW among cancer survivors, including factors promoting work-related well-being during the RTW process.

Methods: During the development phase of a work-oriented rehabilitation intervention, semistructured interviews were conducted, with 25 stakeholders involved in the RTW process: health care professionals (n=12), social insurance officers (n=7), employers (n=5), and an employment service agency officer (n=1). Data were analyzed using qualitative content analysis.

Results: Five overarching themes were identified that influenced RTW: collaboration and clear division of responsibilities, balancing individual adaptations, reducing structural barriers through support, views and expectations of the individual regarding RTW, and the emotional significance of work. Key facilitators included flexible work arrangements, individualized adaptations, a strong desire to work, and the emotional value of work. Barriers comprised lack of collaboration among stakeholders, particularly the absence of a clear division of responsibilities, as well as structural barriers, such as sick leave bureaucracy and financial obstacles. The role of rehabilitation coordinators was highlighted as pivotal in bridging gaps between stakeholders and ensuring continuity in care.

Conclusions: RTW for cancer survivors is a complex, multifactorial process requiring coordinated efforts across health care, insurance, and employment sectors. Enhancing collaboration, clarifying stakeholder responsibilities, and implementing flexible, individualized support structures are essential to facilitating cancer survivors' RTW. Additionally, including a designated coordinator in the process is proposed. More support during the early phase of RTW is necessary to reduce the risk of long-term labor market exclusion. To help cancer survivors' RTW, clear role definitions and shared responsibilities among stakeholders are essential. Flexibility in the RTW process helps individuals reintegrate at their own pace, reduces isolation, and promotes social connection. These are key considerations for future policies and support measures.

Background and Aims

More knowledge about perceptions of implementing new ways of working to prevent organism transmission and create safety engagement in health care are needed. This study aimed to explore managers and hygiene representatives', in the role as facilitators, perceptions of safety engagement and factors of importance when implementing measures to reduce healthcare-associated infections.

Methods

Data were collected using both a quantitative and qualitative approach. A total of 24 facilitators were involved in the implementation process (12 managers, and 12 hygiene representatives, all female). The facilitators responded to the Sustainable Safety Engagement Index at three occasions, and 13 of the facilitators participated in open-ended semi-structured interviews.

Results

The results displayed that both internal and external organizational factors affected the implementation process as well as the interactions between individuals within the organization. The Sustainable Safety Engagement Index did not indicate any deviations before and during the implementation process.

Conclusion

To create a patient safety culture and get healthcare personnel engaged, it is important for healthcare managers to be aware of the complexity of healthcare and adapt organizational factors and specific elements in the caring chain. A systematic implementation approach, and reliable measurements along with use of single or multiple strategies is recommended. Furthermore, dedicated facilitators who creates an environment of support and cooperation between different professions and provides inspiration is crucial to maintain the improvement work. Prevailing behaviors should also be considered when planning and implementing patient safety interventions.

Background: Health information technology has developed into a cornerstone of modern healthcare. It has changed workflows and enhanced communication, efficiency, and patient safety. However, technological development has progressed faster than research on its potential effects on care quality and the healthcare work environment. Using the Job Demand-Resources theory, this study investigated the associations between "frustration with technology" and three outcomes: stress, emotional exhaustion, and staff satisfaction with care, holding job resources and the demand workload constant.

Method: A cross-sectional correlational study was conducted between January and April 2022. Healthcare staff from different professions (e.g., physicians, registered nurses, physiotherapists, licensed practical nurses) and workplaces (n = 417, response rate 31%) answered a survey regarding job demands and resources in the workplace, frustration with technology, stress, emotional exhaustion, and satisfaction with care. Data were analyzed with Spearman’s rank correlation coefficient, the Mann–Whitney U test, and the Kruskal–Wallis test, and multiple variables, one for each outcome, were tested with Generalized Estimated Equations models in SPSS.

Results: The bivariate correlation analyses confirmed statistically significant associations between all the independent variables and the outcomes, except for the independent variable high workload. A high workload was associated with stress and emotional exhaustion but not with staff satisfaction with care. In the three GEE models, one for each outcome, higher stress was statistically significantly associated with more frustration with technology and lower scores for the variables participation in decision-making, sense of community at work, and higher workload. Higher emotional exhaustion was associated with more frustration with technology, higher workload, a lower teamwork climate, and lower growth opportunities. Lower staff satisfaction with care was associated with lower scores for the variable participation in decision-making.

Conclusions: Taking other variables into account, technology frustration matters in staff ratings of stress and emotional exhaustion, but not with the satisfaction of given care. Future studies should aim to further investigate what causes technology frustration and how to mitigate it.

Purpose

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

Design/methodology/approach

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

Findings

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

Originality/value

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

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

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

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

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

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

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

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

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

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

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

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

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

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