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  • 1.
    Ahlstrom, Linda
    University of Borås, School of Health Science.
    Improving Work Ability and Return to Work among Women on Long-term Sick Leave2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis was to gain new knowledge of factors and interventions that improve work ability and return to work (RTW) among women on long-term sick leave from human service organizations (HSOs). The specific aims of the studies were: to evaluate the associations between the self-rated Work Ability Index (WAI) and Work Ability Score (WAS), and the relationship with prospective sick leave, symptoms, and health (Paper I); to investigate whether intervention with myofeedback training or intensive muscular strength training could decrease pain and increase work ability among women with neck pain (Paper II); to examine the associations between workplace rehabilitation and the combination of supportive conditions at work with work ability and RTW over time (Paper III); and to explore experiences, views, and strategies in the rehabilitation process for RTW (Paper IV). This thesis is based on a prospective cohort study (n=324) and a randomized controlled study (RCT) (n=60, participants with neck pain). Both quantitative and qualitative methods were used. The data collection consisted of questionnaires, laboratory-observed data, register-based data, and interviews. The results showed a very strong association between WAI and WAS, and results predicted future sick leave degree, health-related quality of life, vitality, neck pain, self-rated general health, self-rated mental health, behavioral stress, and current stress (Paper I). In the RCT (Paper II), individuals in the myofeedback intervention group increased their vitality and work ability over time and individuals in the intensive musculoskeletal strength training group increased their WAI, WAS, and mental health over time. WAI, WAS, and RTW increased over time among individuals provided with workplace rehabilitation and supportive conditions at work (Paper III) such as a sense of feeling welcome back at work, influence at work, possibilities for development, degree of freedom at work, meaning of work, quality of leadership, social support, sense of community, and work satisfaction. Women described (Paper IV) how they were striving to work and how they had different views, strategies, and approaches in the rehabilitation process for RTW. They expressed a desire to work, their goals for work, and their wishes for work. In the rehabilitation process for RTW they described their interaction with stakeholders as either controlling the interaction or struggling in the interaction. They described strategies to cope with RTW in terms of yo-yo (fluctuating) working: yo-yo working as a strategy or yo-yo working as a consequence. This thesis identifies factors of importance in improving work ability and RTW among women on long-term sick leave from HSOs. For women with neck pain, the intervention study showed feasibility of the intervention and demonstrated improved work ability and decreased pain (Paper II). The intensive muscular strength training program, which is easy for the individual to learn and perform at home, was associated with increased work ability. The results regarding rehabilitation highlight the importance of integrating workplace rehabilitation with supportive conditions at work to increase work ability and improve RTW (Paper III). Women expressed that they were striving to work and that they wanted to work (Paper IV). These women were “going in and out” of work participation (yo-yo working) as a way to handle the rehabilitation process. For assessing the status and progress of work ability among women on long-term sick leave, the single-question WAS may be used as a compliment to the full WAI as a simple indicator (Paper I).

  • 2.
    Ahlstrom, Linda
    et al.
    University of Borås, School of Health Science.
    Ahlberg, Karin
    Hagberg, Mats
    Dellve, Lotta
    University of Borås, School of Health Science.
    Processen att återgå i arbete efter långtidssjukskrivning: Kvinnor med nacksmärta, arbetandes inom kommunal verksamhet2013Conference paper (Other academic)
    Abstract [sv]

    En kvalitativ studie pågår med syfte att belysa rehabiliteringsprocessen för långtidssjukskrivna kvinnor, med nacksmärta, för att möjliggöra återgång i arbete. Resultaten kan användas för preventivt och promotivt arbete inom ex. primärvården, företagshälsovården, försäkringskassan och arbetsförmedlingen.

  • 3.
    Andreasson, Jörgen
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. 1KTH – Royal Institute of Technology, School of Technology and Health, Stockholm, Sweden.
    Åhlström, Linda
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Eriksson, Andrea
    1KTH – Royal Institute of Technology, School of Technology and Health, Stockholm, Sweden.
    The importance of nurse managers’ preconditions and support resources for their attitude and work with improved quality of care2015Conference paper (Refereed)
  • 4.
    Dalheim Englund, Ann-Charlotte
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Rydström, Ingela
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Dellve, Lotta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Åhlstrom, Linda
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Social support outside work and return to work among women on long-term sick leave working within human service organizations2016In: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 30, no May 2016, p. 187-193Article in journal (Refereed)
    Abstract [en]

    AbstractAim To investigate the relationships between return to work and social support outside work among women on long-term sick leave from human service organizations. Background Work is an important part of life and is, in general, considered to be supportive of health and wellbeing. Few studies have thoroughly investigated the importance of aspects of social support outside work for return to work. Methods A cohort of women on long-term sick leave was followed with questionnaires from 2005 to 2012. Results The availability of social attachment increased the women's work ability, return to work, and vitality significantly more over time. There were positive relationships between return to work and seeking support in terms of emotional support and comfort and expressing unpleasant feelings. Conclusions Important resources to increase return to work can be found in factors outside work, such as close social relationships and support seeking. Thus, it is important to take the woman's whole life situation into account and not focus solely on aspects related to the workplace.

  • 5.
    Dellve, Lotta
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. 1KTH – Royal Institute of Technology, School of Technology and Health, Stockholm, Sweden.
    Williamsson, Anna
    1KTH – Royal Institute of Technology, School of Technology and Health, Stockholm, Sweden.
    Strömgren, Marcus
    1KTH – Royal Institute of Technology, School of Technology and Health, Stockholm, Sweden.
    Holden, Richard
    University of Indiana, US.
    Åhlström, Linda
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Andreasson, Jörgen
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. 1KTH – Royal Institute of Technology, School of Technology and Health, Stockholm, Sweden.
    Eriksson, Andrea
    1KTH – Royal Institute of Technology, School of Technology and Health, Stockholm, Sweden.
    The impact of implementation of lean at hospitals for work conditions and health-related conditions among health care professionals: a three year follow-up2015Conference paper (Refereed)
    Abstract [en]

    Introduction The public sector has during the last decades been struggling with the challenge of how to increase the efficiency, the quality of performance, as well as with problems related to work environment and recruitments. Hospitals have struggled with increased focuses on costumer orientation, rationalizations and care processes redesign, and have often used Lean production (LP) as management model.

    Aim to assess the long-term importance of implementing LP in hospitals for the psychosocial work conditions.  Based on earlier research (e.g. Westgaard & Winkel, 2011), the following hypothesis were tested (1) Strategic large scale  implementation of LP is associated with negative impact on mental health; (2) Implementation of LP is associated with weak negative impact on psychosocial work conditions; (3) The association between implementation of LP and psychosocial conditions is moderated by profession and participatory approaches.

    Method  Five hospitals working with improvements of care processes were studied 2012-2014 using questionnaires to employees (T1 n=1303) and interviews at strategic and operative levels. Analyzes with mixed models repeated measurements were performed. The explaining variables for the models were implementation of lean at strategic resp operative level, and time (T1, T2, T3). The outcome variables were work-related health (SRH, work ability, stress-symptoms) and psychosocial work conditions.

    Results  Physical, cognitive and mental stress-related symptoms were only weakly associated with strategic or operative LP initiatives. There were no overall differences in self rated health and work ability with regard to implementation of LP. A higher degree of LP at operative level was associated with decreased work demands. There was, especially initially, more beneficial or improved working conditions in relation to higher degree of LP at operative levels. The long-term follow-up showed that quantitative demands increased and predictability as well as leadership decreased in the non-lean hospitals. There were different patterns with regard to profession and participatory approaches that will be presented.

  • 6.
    Hedén, Lena
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Åhlström, Linda
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Individual response technology to promote active learning within the caring sciences: An experimental research study.2015In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: One major challenge in delivering lectures to large and diverse classes is the maintenance of a high standard of lecturing in order to engage students and increase their participation and involvement. The lecturer's assignment is to arrange and prepare the lecture before teaching, hence enabling students' enhanced learning. Individual response technology could encourage students' active learning and activate higher cognitive levels.

    OBJECTIVES: The aim of this study was to evaluate individual response technology as a complement during lectures for students in higher education, in terms of the students' experiences of participation, engagement, and active learning. Also of interest was whether this technology can be considered a supportive technical system.

    DESIGN: Data were collected through a questionnaire where levels of each condition were reported on a numeric rating scale (0-10) at baseline and after the introduction of individual response technology. To get a broader perspective, two types of lectures (pediatric and statistical) were included, giving a total of four assessment times.

    PARTICIPANTS: The participants comprised 59 students in Bachelor of Nursing program at a Swedish metropolitan university.

    RESULTS: Overall, when individual response technology was used, students reported increased experience of engagement (n=82, mean 6.1 vs. n=65, mean 7.3, p<0.001), participation (n=92, mean 6.1 vs. n=79, mean 7.7, p<0.001), and active learning (n=92, mean 7.3 vs. n=79, mean 8.2 p<0.001). Additionally, the students experienced this technology as a supportive technical system during lectures (mean 6.6 vs. mean 8.1, p<0.001).

    CONCLUSIONS: The use of individual response technology during teaching is one way to enhance students' experiences of engagement, participation, and learning within the caring sciences.

  • 7.
    Rydström, Ingela
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Dalheim Englund, Ann-Charlotte
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Dellve, Lotta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Ahlstrom, Linda
    Importance of social capital at the workplace for return to work among women with a history of long-term sick leave: a cohort study.2017In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, ISSN ISSN 1472-6955, Vol. 14, no 16Article in journal (Refereed)
    Abstract [en]

    Background

    The workplace is an essential source of social capital for many people; it provides mutual support and gives meaning to life. However, few prospective studies have thoroughly investigated the importance of aspects of social capital in the workplace. The aim of this study was to investigate the associations between aspects of social capital (social support, sense of community, and quality of leadership) at the workplace, and work ability, working degree, and vitality among women with a history of long-term sick leave from human service organizations.

    Methods

    A longitudinal cohort study was performed among women with a history of long-term sick leave. The study started in 2005, and the women were followed up at 6 months, 1 year, and 6 years using self-reported questionnaires (baseline n = 283). Linear mixed models were used for longitudinal analysis of the repeated measurements of prospective degree of work ability, working degree, and vitality. Analyses were performed with different models; the explanatory variables for each model were social support, sense of community, and quality of leadership and time.

    Results

    Social capital in terms of quality of leadership (being good at solving conflicts and giving high priority to job satisfaction), sense of community (co-operation between colleagues) and social support (help and support from immediate superiors and colleagues) increased the women’s work ability score (WAS) as well as working degree over time. Additionally, social capital in terms of quality of leadership increased the women’s vitality score over time.

    Conclusions

    A sustainable return-to-work process among individuals with a history of long-term sick leave, going in and out of work participation, could be supported with social support, good quality of leadership, and a sense of community at the workplace. The responsibility for the rehabilitation process can not be reduced to an individual problem, but ought to include all stakeholders involved in the process, such as managers, colleagues, health care services, and the social security agency.

  • 8.
    Strömgren, Marcus
    et al.
    1KTH – Royal Institute of Technology, School of Technology and Health, Stockholm, Sweden.
    Åhlström, Linda
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Eriksson, Andrea
    1KTH – Royal Institute of Technology, School of Technology and Health, Stockholm, Sweden.
    Dellve, Lotta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. 1KTH – Royal Institute of Technology, School of Technology and Health, Stockholm, Sweden.
    The importance of Leadership for workplace social capital among healthcare professionals2015Conference paper (Refereed)
    Abstract [en]

    Introduction

    Social capital, operationalized as perceived trust, reciprocity and recognition has in earlier research shown to be important for employees´ job satisfaction and to health care staffs´ engagement in clinical improvements of patient safety and quality of care as well as job satisfaction, health and wellbeing. Since social capital has an impact, it is of interest to investigate which factors that influence workplace social capital. Research findings shows that leadership has great importance to staffs´ health and wellbeing, and affects a number of factors in the work environment factors as job satisfaction and work engagement. If and how leadership is associated with social capital is rarely described in previous research. However the few studies performed indicate that there are associated correlations between leadership and social capital, and leadership quality and social capital. Leadership within healthcare sector has been in focus when working with redesign of care processes and it would be of interest to investigate the role of leadership and the quality of leadership with respect to social capital. The aim was to assess the importance of leadership for workplace social capital in hospital settings.

     

    Materials and methods

    This study was a longitudinal cohort study. Questionnaires to physicians, nurses, assistant nurses at five Swedish midsize hospitals was used to collect data (T0, n=865, T1, n=908). Bivariate, multivariate analyses was used and a mixed model repeated measurement for the longitudinal analyses (n=477) were performed.

     

    Results

    Relationship between staffs perceived quality of leadership and staffs´ social capital was found (R = 0.58, p-value <0.0001). Results of the analysis showed significant differences in levels of social capital between the groups of low, medium and high levels in quality of leadership. The differences between the groups sustained over time where the group with high levels in quality of leadership remained higher in levels of social capital than the other groups. Same pattern were seen in the other groups.

     

    Conclusion

    Leadership quality were related to-, had importance for- and influenced workplace social capital among health care staff.

  • 9.
    Åhlström, Linda
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Dellve, Lotta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. 1KTH – Royal Institute of Technology, School of Technology and Health, Stockholm, Sweden.
    Implementation of lean and the 3-year-trends of sick-leave among health care workers in different hospital care context2015Conference paper (Refereed)
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