Organizational Hindrances to the Retention of Older Healthcare Workers

The Swedish healthcare sector is currently experiencing recruitment difficulties combined with increasing demand for healthcare services. This study accordingly seeks knowledge of the obstacles to and opportunities for retaining older employees in the Swedish healthcare sector. Results of interviews with line managers and human resource (HR) partners indicate that the informants have positive attitudes toward older healthcare workers in general, particularly acknowledging their contributions based on long experience and skill. However, line managers’ high workload, the absence of age-management strategies, and universal HR policies not conducive to older workers’ individual needs are considered obstacles to retention on an organizational level. To retain older healthcare workers and maintain their ability and motivation, the healthcare sector and especially HR strategies need to be more proactive in addressing these issues, and formalized policies are required in order to benefit from the potential labor reserve that older employees constitute

Working technique during computer work Associations with biomechanical and psychological strain, neck and upper extremity musculoskeletal symptoms

About 35 % of the working population in Sweden report that computer use accounts for 50% or more of their total working hours. Among this population approximately 40% of the women and 25% of the men experienced symptoms in the neck and/or upper extremities at least once a week during the preceding 3 month. The overall aim of the studies underlying this thesis was to explore possible associations between working technique and perceived exertion, comfort, biomechanical and psychosocial strain as well as neck and upper extremity symptoms among computer users. Specific research questions addressed were a) Whether working technique was associated with muscle activity, wrist positions and forces applied to the computer mouse, respectively? b) Whether working technique was associated with psychological demands, emotional stress and perceived muscle tension, respectively? c) Whether there were associations between self-rated perceived comfort and observations of workplace layout and between self-rated perceived exertion and working postures. d) Whether working technique perceived exertion and comfort was associated with neck and upper extremity symptoms. The results showed that subjects classified as having a good working technique worked with less muscular load in the forearm (p=0.03) and in the trapezius muscle on the mouse operating side (p=0.02) compared to subjects classified as having a poor working technique. Subjects who reported high psychological demands and perceived muscular tension, respectively, used poorer working technique than subjects who did not perceive this conditions (demands, p=0.03, muscular tension, p=0.02). Moreover, the concordance between ratings of comfort and observations of workplace layout was reasonably good concerning the working chair and the keyboard and good regarding the computer screen and the input device. The concordance between ratings of perceived exertion and observations of working postures indicated good agreement for all measured body locations. This applies to the group that rated poor comfort and high exertion. Regarding the group that rated good comfort and low exertion ratings must be supplemented with observations. Furthermore, the results revealed that high perceived exertion and low comfort were related to an increased incidence of neck, and upper extremity symptoms, while poor working technique was not associated with such a risk. It is concluded that working technique is associated with both biomechanical and psychological strain while no associations could be seen between working technique and the incidence of neck and upper extremity symptoms. Furthermore, high perceived exertion and low comfort are associated with a higher incidence of neck and upper extremity symptoms

Associations between working techniques, physical and psychosocial loads during VDU work

The overall aim of this licentiate thesis was to evaluate whether working technique was associated with physical loads and psychosocial loads during VDU work. The thesis is based upon two separate field studies, conducted in two different organisations, one at the editorial department of a daily newspaper, and one at a department for engineering in a telecommunication company. To investigate physical loads two methods were used 1) electromyography for measuring muscular activity and 2) electrogoniometry for measuring wrist postures and movements. Psychological loads (psychological demands, emotional stress and perceived muscle tension) were measured with questionnaires. Observations and evaluations of working technique were made, according to an observation protocol. The results indicated an association between working technique and both physical and psychosocial loads. In study I subjects working with a poor working technique had higher muscle activity in the trapezius muscle on the mouse operating side, and in the forearm muscle. Moreover subjects using a poor working technique worked with more extended wrist than subjects using a good working technique. In study II higher muscular activity (trapezius non mouse side) was associated with emotional stress and perceived muscle tension, respectively. Perception of high muscle tension and high psychological demands, respectively, were associated with poor working technique. In conclusion, the results showed that working technique during VDU work has an impact on physical loads, and moreover, the results indicated an association between working technique and psychosocial loads.Sambandet mellan arbetsteknik, fysiska och psykosociala faktorer vid datorarbete Det övergripande syftet med denna licenciatavhandling var, att undersöka möjliga samband mellan arbetsteknik, fysisk, samt psykosocial belastning vid datorarbete. Licenciat avhandlingen bygger på två separata fältstudier, utförda dels på en redigeringsavdelning på en dagstidning, och dels på en teknisk utvecklingsavdelning på ett telekommunikations företag. För att undersöka fysisk belastning, använde vi oss av två metoder 1) elektromyografi för att mäta muskelaktivitet, samt 2) elektrogoniometer för att mäta handledsvinklar och handledsrörelser. Den psykosociala belastningen mättes med frågeformulär. Arbetsteknik bedömdes med hjälp av ett observationsprotokoll. Resultaten visade på ett samband både mellan arbetsteknik och fysiska faktorer, samt mellan arbetsteknik och psykosociala faktorer. I Studie I fann vi att personer som bedömts arbeta med en dålig arbetsteknik hade högre muskulär belastning i trapeziusmuskulaturen på den sida som hanterade datormusen, samt i underarmsmuskulaturen. Vidare fann vi att personer med dålig arbetsteknik arbetade med större handledsextention än personer med god arbetsteknik. I studie II visade resultaten att hög muskel aktivitet i trapeziusmuskulaturen (icke datormussidan) hade samband med hög emotionell stress och/eller hög grad av upplevd muskelspänning. Dessutom visade resultaten att höga krav och hög muskelspänning, var för sig, var associerade till dålig arbetsteknik. Sammanfattningsvis visar dessa studier att den fysiska belastningen vid datorarbete påverkas av arbetsteknik, samt att psykosociala faktorer (höga krav, upplevelse av hög muskelspänning samt emotionell stress) har samband med arbetsteknik. Nyckelord: datorarbete, muskuloskeletala sjukdomar, arbetsteknik, fysisk belastning, psykosocial belastning

Fysisk träning och stressrelaterad ohälsa

Fysisk träning har diskuterats som en viktig del i förebyggande och till och med behandling av stress och stressrelaterad ohälsa. Det finns sedan en tid tillbaka en mängd evidens för att regelbunden fysisk träning kan påverka utvecklingen av en rad olika sjukdomar som är kopplade till livsstil, inklusive stress. Exempel på sådana är hjärtkärlsjukdomar och typ-2 diabetes. Stressrelaterad mental ohälsa i form av psykisk utmattning, ofta förenad med depression, ångest och minnes- och koncentrationssvårigheter har blivit vanligare och forskningen tyder på att fysisk träning även i sådana fall kan vara effektiv som behandling. De bakomliggande mekanismerna är delvis okända men det finns vetenskapligt stöd för att fysisk träning kan ha liknande effekter på hjärnan som antidepressiv läkemedelsbehandling. Physical exercise has been discussed to be beneficial for prevention and treatment of stress-related diseases. Treatment studies for related diagnoses such as depression exist and exercise has in some cases been shown to have similar effects as pharmeceutical treatment. The underlying mechansims are also suggested to be simila

Perceived work stress, overcommitment, balance in everyday life, individual factors, self-rated health and work ability among women and men in the public sector in Sweden – a longitudinal study

Background: The aim was to investigate whether perceived work stress, overcommiment, balance in everyday life, individual factors and self-rated health in combination predict work ability among women and men in the public sector in Sweden. Methods: A sample was randomly selected from the employee records of the participating public health care organisation in Western Sweden. In total, 2223 employees were included and answered a postal survey twice, at a 2 year interval. The survey included questions about work ability, perceived work stress, overcommitment, balance in everyday life, individual factors and self-rated health. Odds ratios with 95% confidence intervals for work ability were estimated using logistic regression. Results: Imbalance in everyday life and overcommitment predicted reduced work ability in women and imbalance in everyday life and low educational level predicted reduced work ability in men. However, when poor self-rated health was added to the models this was the strongest predictor of work ability for both genders. Conclusion: A combination of poor self-rated health, imbalance in everyday life, and overcommitment predicted reduced work ability. This multifactorial nature of work ability should be taken into account in health promotion programmes

Engaging the missing actor : lessons learned from an age-management intervention targeting line managers and their HR partners

Purpose – This study aims to describe and evaluate the impact of a participatory age-management intervention on the knowledge, awareness and engagement of line managers and their HR partners from six health-care organizations in Sweden.Design/methodology/approach – The learning workshops consisted of lectures, discussions, feedback and exchange of experiences with colleagues and invited experts. A total of 19 participants were interviewed six months after the final workshop, and qualitative thematic analysis was used to analyze the transcribed interviews.Findings – The intervention design produced promising results in improving line managers’ and HR partners’ knowledge and increasing awareness and engagement. On some occasions, the participants also initiated changes inorganizational policies and practices. However, the intervention primarily became a personal learning experience as participants lacked resources and mandates to initiate change in their daily work. To stimulate engagement and change at the organizational level, the authors believe that an intervention must receive support from higher managers, be anchored at the workplace and be aligned with the organization’s goals; moreover, participants must be provided with sufficient resources and mandates to coordinate the implementation of age-management strategies.Practical implications – Prolonged working life policies and skill shortages are affecting organizations and societies, and for many employers, there are strong reasons for developing strategies to attract, recruit and retain older workers.Originality/value – This study offers lessons and guidance for future workplace interventions to attract, recruit and retain older worker

Promoting graded exercise as a part of multimodal treatment in patients diagnosed with stress-related exhaustion

Aims and objectivesThe purpose of this study was to examine, by using patient cohort data, the changes in exercise habits during a 12-month multimodal treatment period, in patients seeking specialist care for stress-related exhaustion. BackgroundRandomised controlled trials have greatly contributed to the fact that both physicians and patients regard regular exercise participation as a highly valuable and effective treatment for mental health disorders. Nevertheless, little is known about the adherence to physical activity recommendations for patients with stress-related mental problems in a clinical setting. Knowledge about what can be achieved within the clinical context, and how current treatments can be improved, is crucial for clinicians, researchers, educators, managers and policy makers involved in nursing practice. DesignLongitudinal analysis of patient cohort data. MethodsThe sample consisted of 169 patients (79% women; mean age=427years) who were referred to a stress clinic due to stress-related exhaustion. All patients received multimodal treatment with similar components. Two different approaches to promote exercise were used in the clinical work (general comprehensive instruction either with or without an 18-week coached exercise programme). The self-reported overall exercise level was assessed at baseline and at three, six and 12months after the first visit. Group by time effects were examined with repeated measures analyses of variance. ResultsThe frequency, duration and intensity of exercise increased substantially during the first three months of multimodal treatment. Although exercise levels tended to decrease thereafter, there was still a significant time effect at the 12-month follow-up showing that follow-up exercise levels were higher than at baseline. ConclusionBoth general exercise instructions and coached exercise were effective in promoting exercise involvement. Relevance to clinical practiceExercise can be successfully promoted as a part of multimodal treatment in patients with stress-related exhaustion

The Role of Physical Activity and Fitness in Prevention and Treatment of Mental Health

Introduction; We have previously shown that self-reported physical activity is inversely related to symptoms of depression, anxiety and burnout and that participation in physical activity dose-dependently lowers the risk of developing mental health problems two years later. We have now extended our findings regarding the relationship between mental health and physical activity by examine if cardiorespiratory fitness and perceived stress are associated with symptoms of occupational burnout and depression, and whether participants’ fitness levels moderate the assumed positive relationships between perceived stress and symptoms of burnout and depression. Methods: The study includes 197 participants (49 % women). The Åstrand bicycle test was used to assess cardorespiratory fitness. Burnout was measured with the Shirom-Melamed Burnout Questionnaire (SMBQ), depressive symptoms with the Hospital Anxiety and Depression Scale (HAD-D). Results: Overall, participants with moderate and high fitness reported fewer symptoms of burnout and depression than participants with low fitness. However, when the participants were divided into high and low stress groups the expected inverse relationship between fitness and symptoms of burnout and depression was only seen in the high stress group, indicating a protective role of fitness in developing mental symptoms among highly stress individuals. Our research program also includes clinical populations with stress-related exhaustion and preliminary data from one of these studies will be presented. Initially inactive patients (n=69) were offered to take part in an 18 months multimodal treatment program (MMT) with a strong exercise component. Changes in mental health symptoms were stronger in those patients who increased their activity levels during the MMT program period compared with patients who did not respond to the exercise component. Thus, patients who managed to integrate weekly episodes of exercise in their ordinary behaviour patterns reported the largest improvements in mental health. This clinical group of patients often report substantial problems with infections such as upper respiratory infections and further studies are needed to explore it increased activity level can influence the burden of infections in this group. Conclusion; Better cardiovascular fitness seems to be associated with decreased symptoms of burnout and depression in highly stressed individuals, thus improving the capacity to cope with stress. Furthermore, regular exercise seems to be an important part in the treatment of patients with stress-related mental health symptoms. Promoting physically active lifestyle to prevent as well as treat stress-related mental health is a worthwhile endeavour