Recovery at work as a health-promoting process

The purpose of this thesis was to deepen the understanding of recovery during the workday and its importance for employee health. Workplace intervention as a tool to promote employees’ experience of recovery was also evauated.The studies were carried out in a primary health care setting in one health care district in Sweden between 2013 and 2019, together with the employees working at the 26 participating centres. Both quantitative and qualitative methods were applied during the process. Two separate questionnaires were used and analysed with multivariate linear or logistic regression analyses. Also, focus group interviews were conducted for two different data collections, bothanalysed inspired by systematic text condensation.The findings indicate that experiencing recovery is the most significant predictor of self-rated health. The results also identified three factors of importance for perceived recovery during the workday: variation, companionship, andmanageability. Since these factors appeared to be prerequisites for recovery, they became the basis for planning and implementing a workplace intervention with various recovery activities addressed to primary health care employees.Consideration was also given to each workplace’s own abilities, needs, and wishes. An evaluation after intervention ending showed a significant increase in experienced recovery during the workday among the participating employees,which was mainly explained by the possibility for reflection. When exploring the intervention process further, four promoting factors for the successful outcome emerged: support, legitimacy, customization, and simplicity. Also, three areas were positively affected by the intervention. These upward spirals were work climate, employee well-being, and recovery awareness.The results of this thesis contribute to work recovery research by establishing that recovery is essential for self-rated health, and that interventions can be used to enhance employees’ experience of recovery during the workday. Otherimportant areas, like work climate and employee well-being, can also be positively affected. For intervention success, special consideration should be given to strengthening workplace relationships, with key factors such ascompanionship, reflection, and support

Flow situations during everyday practice in a medical hospital ward. Results from a study based on experience sampling method

Nursing is a constant balance between strain and stimulation and work and health research with a positive reference point has been recommended. A health-promoting circumstance for subjective experience is flow, which is a psychological state, when individuals concurrently experience happiness, motivation and cognitive efficiency. Flow situations can be identified through individuals' estimates of perceived challenge and skills. There is, to the best of our knowledge, no published study of flow among health care staff. The aim of this study was to identify flow-situations and study work-related activities and individual factors associated with flow situations, during everyday practice at a medical emergency ward in Sweden, in order to increase the knowledge on salutogenic health-promoting factors.The respondents consisted of 17 assistant nurses and 14 registered nurses, who randomly and repeatedly answered a small questionnaire, through an experience sampling method, during everyday nursing practice. The study resulted in 497 observations. Flow situations were defined as an exact match between a high challenge and skill estimation and logistic regression models were used to study different variables association to flow situations.The health care staff spent most of its working time in individual nursing care and administrative and communicative duties. The assistant nurses were more often occupied in individual nursing care, while the registered nurses were more involved in medical care and administrative and communicative duties. The study resulted in 11.5% observations of flow situations but the relative number of flow situations varied between none to 55% among the participants. Flow situations were positively related to medical care activities and individual cognitive resources. Taking a break was also positively associated with flow situations among the assistant nurses.The result showed opportunities for work-related interventions, with an adherent increase in flow situations, opportunity for experience of flow and work-related health among the nursing staff in general and among the assistant nurses in particular

Patients report improvements in continuity of care when quality of life assessments are used routinely in oncology practice: Secondary outcomes of a randomised controlled trial.

INTRODUCTION AND AIM: In a randomised trial investigating the effects of regular use of health-related quality of life (HRQOL) in oncology practice, we previously reported an improvement in communication (objective analysis of recorded encounters) and patient well-being. The secondary aims of the trial were to measure any impact on patient satisfaction and patients' perspectives on continuity and coordination of their care. METHODS: In a prospective trial involving 28 oncologists, 286 cancer patients were randomised to: (1) intervention arm: regular touch-screen completion of HRQOL with feedback to physicians; (2) attention-control arm: completion of HRQOL without feedback; and (3) control arm: no HRQOL assessment. Secondary outcomes were patients' experience of continuity of care (Medical Care Questionnaire, MCQ) including 'Communication', 'Coordination' and 'Preferences to see usual doctor' subscales, patients' satisfaction, and patients' and physicians' evaluation of the intervention. Analysis employed mixed-effects modelling, multiple regression and descriptive statistics. RESULTS: Patients in the intervention arm rated their continuity of care as better than the control group for 'Communication' subscale (p=0.03). No significant effects were found for 'Coordination' or 'Preferences to see usual doctor'. Patients' evaluation of the intervention was positive. More patients in the intervention group rated the HRQOL assessment as useful compared to the attention-control group (86% versus 29%), and reported their doctors considered daily activities, emotions and quality of life. CONCLUSION: Regular use of HRQOL measures in oncology practice brought changes to doctor-patient communication of sufficient magnitude and importance to be reported by patients. HRQOL data may improve care through facilitating rapport and building inter-personal relationships

Benchmarking - Ett verktyg för småföretag?

Syftet med uppsatsen är att studera vilka incitament som eventuellt finns för småföretag att tillämpa benchmarking, samt att ge ett förslag till hur en benchmarkingmetod för småföretag skulle kunna vara utformad. Den teoretiska referensramen har byggts upp kring olika teorier och synsätt som behandlar förberedelser och förutsättningar för benchmarking, benchmarking i 10 steg samt benchlearning. Insamling av primärdata har skett genom intervjuer med tre fallföretag; Into Music AB, Fred Holmberg & Co AB och Stefan Billing Livs AB. Vi har kunnat identifiera fem incitament för småföretag att använda benchmarking. Dessa är följande: att företaget slipper uppfinna hjulet pånytt i jämförelsearbetet, behovet av att förbättra processerna i tillväxt- och mognadsfasen av företagets livscykel, behovet av överblick och kontroll över den platta organisationen, behovet av att förbättras och behålla sin marknadsposition utifrån ett konkurrensperspektiv, vikten av att förstå sin omvärld och kunna identifiera möjligheter och hot på nya och befintliga marknader. Vi har även tagit fram en för småföretag lämplig modell i fem steg med lärandeperspektivet, benchlearning som präglande element. De fem stegen i modellen är Förutsättningar och Förberedelser (FF), Vad förbättra, Informationsinsamling, Position och Målsättning

Patient Experiences of Continuity of Cancer Care: Development of a new Medical Care Questionnaire (MCQ) for Oncology Outpatients

Objectives: To adapt the Components of Primary Care Index (CPCI) to be applicable to oncology outpatients and to assess the reliability and validity of the adapted instrument (renamed the Medical Care Questionnaire (MCQ)). Methods: The development and validation of the MCQ took place in four phases. Phase 1 reviewed the literature and examined existing measures. In Phase 2 the selected instrument (CPCI) was reviewed by a panel of experts using a stepwise consensus procedure. In Phase 3 the adapted 21-item MCQ was administered to 200 outpatients attending oncology appointments. The instrument was refined to 15-items and in Phase 4 it was completed by 477 oncology outpatients. The psychometric properties of the new instrument were assessed using exploratory factor analysis, multi-trait scaling analysis and by comparing MCQ scores between known groups. Results: Exploratory factor analysis of the 15-item MCQ suggested 3 subscales with acceptable to good reliability: “Communication” α=0.69; “Coordination” α=0.84; and “Preferences” α=0.75. Comparing known groups showed that patients who saw fewer doctors during their clinic visits reported stronger “Preferences” to see their usual doctor and rated “Communication” with their doctors as better than patients who saw more doctors during their clinic visits. Conclusion: The MCQ demonstrates good psychometric properties in the target population. It is a brief and simple to use instrument, which provides a valid perspective on patients’ experiences of communicating with doctors and their perceptions of the continuity and coordination of their cancer care. Patient Experiences of Continuity of Cancer Care: Development of a new Medical Care Questionnaire (MCQ) for Oncology Outpatient

Återhämtning under arbetsdagen – : en inspirationsbok för individ och verksamhet

En inspirationsbok med verktyg för att främja återhämtning under arbetsdagen – både för individ och verksamhet

Work ethics and general work attitudes in adolescents are related to quality of life, sense of coherence and subjective health – a Swedish questionnaire study

BACKGROUND: Working life is an important arena in most people's lives, and the working line concept is important for the development of welfare in a society. For young people, the period before permanent establishment in working life has become longer during the last two decades. Knowledge about attitudes towards work can help us to understand young people's transition to the labour market. Adolescents are the future workforce, so it seems especially important to notice their attitudes towards work, including attitudes towards the welfare system. The aim of this study was to describe and analyse upper secondary school students' work attitudes, and to explore factors related to these attitudes. METHODS: The sample consisted of 606 upper secondary school students. They all received a questionnaire including questions about quality of life (QOL), sense of coherence (SOC), subjective health and attitudes towards work. The response rate was 91%. A factor analysis established two dimensions of work attitudes. Multivariate analyses were carried out by means of logistic regression models. RESULTS: Work ethics (WE) and general work attitudes (GWA) were found to be two separate dimensions of attitudes towards work. Concerning WE the picture was similar regardless of gender or study programme. Males in theoretical programmes appeared to have more unfavourable GWA than others. Multivariate analyses revealed that good QOL, high SOC and good health were significantly related to positive WE, and high SOC was positively related to GWA. Being female was positively connected to WE and GWA, while studying on a practical programme was positively related to GWA only. Among those who received good parental support, GWA seemed more favourable. CONCLUSION: Assuming that attitudes towards work are important to the working line concept, this study points out positive factors of importance for the future welfare of the society. Individual factors such as female gender, good QOL, high SOC and good health as well as support from both parents, positive experience of school and work contacts related positively to attitudes towards work. Further planning and supportive work have to take these factors into account

Inequalities of quality of life in unemployed young adults: A population-based questionnaire study

BACKGROUND: It is well known that unemployment is a great problem both to the exposed individual and to the whole society. Unemployment is reported as more common among young people compared to the general level of unemployment. Inequity in health status and life-satisfaction is related to unemployment. The purpose of this population-based study was to describe QOL among unemployed young people compared to those who are not unemployed, and to analyse variables related to QOL for the respective groups. METHODS: The sample consisted of 264 young unemployed individuals and 528 working or studying individuals as a reference group. They all received a questionnaire about civil status, educational level, immigration, employment status, self-reported health, self-esteem, social support, social network, spare time, dwelling, economy and personal characteristics. The response rate was 72%. The significance of differences between proportions was tested by Fisher's exact test or by χ(2 )test. Multivariate analysis was carried out by means of a logistic regression model. RESULTS: Our results balance the predominant picture of youth unemployment as a principally negative experience. Although the unemployed reported lower levels of QOL than the reference group, a majority of unemployed young adults reported good QOL, and 24% even experienced higher QOL after being unemployed. Positive QOL related not only to good health, but also to high self-esteem, satisfaction with spare time and broad latitude for decision-making. CONCLUSION: Even if QOL is good among a majority of unemployed young adults, inequalities in QOL were demonstrated. To create more equity in health, individuals who report reduced subjective health, especially anxiety need extra attention and support. Efforts should aim at empowering unemployed young adults by identifying their concerns and resources, and by creating individual programmes in relation not only to education and work, but also to personal development

Factors related to the practice of breast self examination (BSE) and Pap smear screening among Malaysian women workers in selected electronics factories

BACKGROUND: The Malaysian Ministry of Health promotes breast self-examination (BSE) for all women, and Pap smear screening every three years for all sexually active women ages 20 years and above. The objectives of this paper were to examine the practice of these two screening tests among women production workers in electronics factories, and to identify factors related to practice. METHODS: This was a cross-sectional survey of women production workers from ten electronics factories. Data was collected by a self-administered questionnaire from a total of 1,720 women. The chi-square test, odds ratio and binomial logistic regression were used in bivariate and multivariate analysis. RESULTS: Prevalence rates were 24.4% for BSE once a month, and 18.4% for Pap smear examination within the last three years. Women who were significantly more likely to perform BSE every month were 30 years and older, Malays, with upper secondary education and above, answered the BSE question correctly, and had a Pap smear within the last three years. The proportion of women who had a Pap smear within the last three years were significantly higher among those who were older, married, with young children, on the contraceptive pill or intra-uterine device, had a medical examination within the last five years, answered the Pap smear question correctly, and performed BSE monthly. CONCLUSION: Screening practice rates in this study were low when compared to national rates. Socio-demographic and health care factors significantly associated with screening practice are indicative of barriers which should be further understood so that more effective educational and promotional strategies could be developed