Are environmental characteristics in the municipal eldercare, more closely associated with frequent short sick leave spells among employees than with total sick leave: a cross-sectional study

Background: It has been suggested that frequent-, short-term sick leave is associated with work environment factors, whereas long-term sick leave is associated mainly with health factors. However, studies of the hypothesis of an association between a poor working environment and frequent short spells of sick leave are few and results are inconsistent. Therefore, we aimed to explore associations between self-reported psychosocial work factors and workplace-registered frequency and length of sick leave in the eldercare sector. Methods: Employees from the municipal eldercare in Aarhus (N = 2,534) were included. In 2005, they responded to a work environment questionnaire. Sick leave records from 2005 were dichotomised into total sick leave days (0–14 and above 14 days) and into spell patterns (0–2 short, 3–9 short, and mixed spells and 1–3 long spells). Logistic regression models were used to analyse associations; adjusted for age, gender, occupation, and number of spells or sick leave length. Results: The response rate was 76%; 96% of the respondents were women. Unfavourable mean scores in work pace, demands for hiding emotions, poor quality of leadership and bullying were best indicated by more than 14 sick leave days compared with 0–14 sick leave days. For work pace, the best indicator was a long-term sick leave pattern compared with a non-frequent short-term pattern. A frequent short-term sick leave pattern was a better indicator of emotional demands (1.62; 95% CI: 1.1-2.5) and role conflict (1.50; 95% CI: 1.2-1.9) than a short-term non-frequent pattern. Age (= 40 years) statistically significantly modified the association between the 1–3 long-term sick leave spell pattern and commitment to the workplace compared with the 3–9 frequent short-term pattern. Conclusions: Total sick leave length and a long-term sick leave spell pattern were just as good or even better indicators of unfavourable work factor scores than a frequent short-term sick leave pattern. Scores in commitment to the workplace and quality of leadership varied with sick leave pattern and age. Thus, different sick leave measures seem to be associated with different work environment factors. Further studies on these associations may inform interventions to improve occupational health care

Attitudes towards sickness absence and sickness presenteeism in health and care sectors in Norway and Denmark: a qualitative study.

BACKGROUND: In the health and care sector, sickness absence and sickness presenteeism are frequent phenomena and constitute a field in need of exploration. Attitudes towards sickness absence involve also attitudes towards sickness presenteeism, i.e. going to work while sick, confirmed by previous studies. Sickness behavior, reflecting attitudes on work absence, could differ between countries and influence absence rates. But little is known about attitudes towards sickness absence and sickness presenteeism in the health and care sectors in Norway and Denmark. The aim of the present paper is therefore to explore attitudes towards sickness absence and sickness presenteeism among nursing home employees in both countries. METHODS: Eight focus group discussions (FGDs) were conducted using a semi-structured interview guide, the main attention of which was attitudes towards sickness absence and sickness presenteeism. FGDs were conducted in two nursing homes in Norway and two in Denmark, with different geographic locations: one in a rural area and one in an urban area in each country. FGDs were recorded, transcribed and analyzed using framework analysis to identify major themes and explanatory patterns. RESULTS: Four major significant themes were identified from the FGDs: a) sickness absence and sickness presenteeism, b) acceptable causes of sickness absence, c) job identity, and d) organization of work and physical aspects of the workplace. Our analyses showed that social commitment and loyalty to residents and colleagues was important for sickness absence and sickness presenteeism, as were perceived acceptable and non-acceptable reasons for sickness absence. Organization of work and physical aspects of the workplace were also found to have an influence on attitudes towards sickness absence. CONCLUSIONS: The general interpretation of the findings was that attitudes towards sickness absence and sickness presenteeism among nursing home employees were embedded in situational patterns of moral relationships and were connected to a specific job identity. These patterns were constituted by the perception of colleagues, the social commitment to residents, and they influence on what was deemed as acceptable and non-acceptable reasons for sickness absence. In other words, attitudes towards sickness absence and sickness presenteeism were socially and morally determined at personal levels by an overall concept of work, independent of country

Comparisons of sickness absence patterns, trends and attitudes in the health and care sectors in two municipalities in Norway and Denmark.

Sickness absence is of great concern in most Western societies and has huge economic and social consequences. The Scandinavian countries, especially Norway, have high sickness absence rates. In both Norway and Denmark, the highest sickness absence rates are found in the health and care sector. The aims of this doctoral thesis are to compare the sickness absence patterns of municipal employees in the health and care sector in two comparable countries, Norway and Denmark, and to explore attitudes towards sickness absence and sickness presenteeism in nursing homes in Norway and Denmark. The thesis consists of three papers. Papers I and II are based on data from the personnel registers of the municipalities of Kristiansand, Norway and Aarhus, Denmark. These registers contain information on sickness absence for employees in the health and care sector. Paper III is based on data from focus group discussions among nursing homes employees in the same two municipalities. Paper I compares sickness absence patterns, measured as rate and number of sick leave episodes, between employees in the health and care sector of the municipality of Kristiansand, Norway and Aarhus, Denmark. We found higher sickness absence rates in Norway compared to Denmark, and employees in Denmark had more frequent, but shorter sick leave episodes compared to Norway. This may indicate that more frequent sick leave episodes prevent higher sick leave rates. In Paper II we investigated sickness absence patterns and time trends of municipal employees in the health and care sector in Kristiansand, Norway and Aarhus, Denmark. We found an overall increase in the sickness absence rate in Denmark, while the largest overall increase in number of sick leave episodes was found in Norway. The largest increase in sickness absence rates and number of sick leave episodes were observed among young employees in both countries. The results indicate that sickness absence, measured as rate and number of sick leave episodes, converged in the two countries between 2004 and 2008. In Paper III we explored attitudes towards sickness absence and sickness presenteeism among municipal employees in nursing homes in Kristiansand, Norway and Aarhus, Denmark. We found that attitudes towards sickness absence and presenteeism were socially and morally determined at the individual level by an overall perception of work, independent of country. The results from these studies indicated that the overall sickness absence rates in Denmark increased between 2004 and 2008, whereas they were stable in Norway. Sickness absence patterns, measured as rate and number of sick leave episodes, converged during the study period and the sickness absence rates in young employees increased significantly in both countries. Attitudes towards sickness absence and sickness presenteeism seemed similar, independent of country

Risikovurdering og optimalisering av pasientsikkerhet ved ekstubasjon - en systematisk litteraturoversikt

Master i spesialsykepleie - Nord universitet 202

Utvidet egenmelding : en vei mot riktigere sykefravær?

<p><strong><em>Bakgrunn: </em></strong>Kunnskapen om hvilken betydning rett til bruk av egenmelding har for sykefravær og sykefraværsmønster er svært begrenset. Denne studien undersøker effekten på korttidsfraværet av en utvidet egenmeldingsordning.</p><p><strong><em>Materiale og metode: </em></strong>Kristiansand kommune med 5700 ansatte (4300 årsverk) innførte 1. april 2002 rett for sine ansatte til å selv dokumentere sykefravær på inntil 50 dager fordelt på 1-10 perioder som et kontrollert intervensjonsforsøk. Dialog med arbeidsplassen var forutsatt for både egenmeldt og legemeldt fravær når fraværet hadde vart i 5 dager.</p><p><strong><em>Resultat: </em></strong>Forsøket viste at egenmelding i stor grad erstattet legemelding for fravær med inntil en ukes varighet. Gjennomsnittslengden av sykefraværet i arbeidsgiverperioden på 16 dager ble forkortet med 0,8 dager. Kurven for tilbakevending til arbeid tilsvarte forventet tilfriskningskurve uten de karakteristiske toppene ved fem, syv og 14 dager som en ser ved legemeldt fravær. Både antall korte sykefravær og andel av ansatte med korttidsfravær økte, men til tross for en forventet registreringseffekt økte ikke sykefraværet som prosent av mulige arbeidsdager i arbeidsgiverperioden.</p><p><strong><em>Konklusjon: </em></strong>Utvidet egenmeldingsrettigheter med strukturert oppfølging fra arbeidsplassen resulterte i et endret mønster for korttidsfravær som kan indikere at dagens ordninger for egenmeldt fravær ikke er tilpasset arbeidstakernes behov.</p><p> </p><p>Fleten N, Krane L, Johnsen R. <strong>Extended self-certification - a step towards more appropriate </strong><strong>sickness absence? </strong><em>Nor J Epidemiol </em>2009; <strong>19 </strong>(2): 223-228.</p><p> </p><p><strong>E</strong><strong>NGLISH SUMMARY</strong></p><p><strong><em>Background: </em></strong>Knowledge on the consequences of extended self-certification for sickness absence is sparse. This study examines changes in short term sickness absence due to comprehensive extension in the selfcertification scheme.</p><p><strong><em>Aim: </em></strong>To explore any effect on short term sick leave by introducing generous self-certification entitlements combined with structured workplace follow-up.</p><p><strong><em>Method: </em></strong>Kristiansand Municipality with 5700 employees, introduced as a two years trial in April 2002 the right to self certificate sickness absence for until 50 days per year, divided on 1 until 10 periods. Arendal was control municipality. When the sickness absence had lasted for 5 days a structured dialog with the working place was scheduled, regardless self-certification or any medical certificate issued by a physician.</p><p><strong><em>Results: </em></strong>The study indicates that extended self-certification halved medical certificates issued by a physician for sickness spells less than a week. The average length of sickness absence limited to the employerfinanced period on 16 days was reduced with 0.8 days. The curve for returning to work corresponded to the expected getting-well curve, i.e. without the typical peaks at 5, 7 and 14 days seen for physician certified sickness spells. Both the numbers of short term sick leave and the portion of employees with short term sick leave increased. Still the sickness absence, as percent of possible workdays during the employerfinanced period, was stable.</p><p><strong><em>Conclusion: </em></strong>The results from the study indicate that extended self-certification reduces the length of the short term sickness absences. This effect on short term sickness absence, proposes that extended selfcertification might be a step towards a more need-adjusted sickness absence pattern.</p

Workplace bullying and medically certified sickness absence: Direction of associations and the moderating role of leader behavior

The aim of this study was to determine (1) associations between workplace bullying and subsequent risk and duration of medically certified sickness absence, (2) whether employees’ perceptions of supportive, fair, and empowering leader behavior moderate the association between bullying and absence, and (3) whether prior sickness absence increases the risk of being a new victim of bullying. Altogether, 10,691 employees were recruited from 96 Norwegian organizations in the period 2004–2014. The study design was prospective with workplace bullying and leader behavior measured at baseline and then linked to official registry data on medically certified sickness absence for the year following the survey assessment. For analyses of reverse associations, exposure to bullying was reassessed in a follow-up survey after 24 months. The findings showed that workplace bullying was significantly associated with risk (risk ratio = 1.23; 95% CI = 1.13–1.34), but not duration (incidence rate ratio = 1.05; 95% CI = 0.89–1.25) of medically certified sickness absence after adjusting for age, gender, and supportive, fair, and empowering leader behavior. None of the indicators of leader behavior moderated the association between bullying and sickness absence (both risk and duration). Adjusting for baseline bullying, age, and gender, prior long-term sickness absence (>21 days) was associated with increased risk of being a new victim of bullying at follow-up (odds ratio = 1.86; 95% CI = 1.28–2.72). Effective interventions toward workplace bullying may be beneficial with regard to reducing sickness absence rates. Organizations should be aware that long-term sickness absence might be a social stigma as sick-listed employees have an increased risk of being bullied when they return to work

Sick leave patterns as predictors of disability pension or long-term sick leave: A 6.75-year follow-up study in municipal eldercare workers

OBJECTIVES: The aim was to study whether a workplace-registered frequent short-term sick leave spell pattern was an early indicator of future disability pension or future long-term sick leave among municipal eldercare workers. SETTING: The municipal healthcare sector in the city of Aarhus, which is the second largest city in Denmark. PARTICIPANTS: All elder care employees who worked the entire year of 2004 in the municipality of Aarhus, Denmark (N=2774). The employees’ sick leave days during 2004 were categorised into: 0–2 and 3–17 short (1–7 days) spells, 2–13 mixed short and long (8+ days) spells and long spells only. Student workers (n=180), employees who were absent due to maternal/paternal leave (n=536) and employees who did not work the entire year of 2004 (n=1218) were not included. PRIMARY OUTCOME: Disability pension and long-term sick leave (≥8 weeks) were subsequently identified in a National register. The cumulative incidence proportion as a function of follow-up weeks was estimated using the Kaplan-Meier curve. The relative cumulative incidence (RR) of experiencing events within 352 weeks was analysed in a generalised linear regression model using the pseudo values method adjusted for age, occupation, unfavourable work factors and sick leave length. RESULTS: A frequent short-term and a mixed sick leave pattern showed RRs of being granted a disability pension of 2.08 (95% CI 1.00 to 4.35) and 2.61 (95% CI 1.33 to 5.12) compared with 0–2 short spells. The risk of long-term sick leave was significantly increased for all sick leave patterns compared with 0–2 short spells. Adding sick leave length to the models attenuated all RRs and they became non-significant. CONCLUSIONS: Sick leave length was a better indicator of future workability than spell frequency. Preventive actions should target employees engaged in homecare. The more sick leave days the greater the preventive potential seems, irrespective of spell frequency