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Wåhlin-Norgren, Charlotte
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Publications (10 of 17) Show all publications
Arapovic-Johansson, B., Wåhlin-Norgren, C., Hagberg, J., Kwak, L., Björklund, C. & Jensen, I. (2018). Participatory work place intervention for stress prevention in primary health care. A randomized controlled trial. European Journal of Work and Organizational Psychology, 27(2), 219-234
Open this publication in new window or tab >>Participatory work place intervention for stress prevention in primary health care. A randomized controlled trial
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2018 (English)In: European Journal of Work and Organizational Psychology, ISSN 1359-432X, E-ISSN 1464-0643, Vol. 27, no 2, p. 219-234Article in journal (Refereed) Published
Abstract [en]

The aim of this study is to explore whether a participatory, organizational intervention can reduce work-related risk factors, and thereby prevent stress-related ill health. We build on the job demand-control and effort-reward imbalance models of stress. It is a two-armed randomized trial, with one primary health care unit receiving the intervention and a two-unit control group. Validated questionnaires for the assessment of psychosocial work environment and health were administered, at the baseline and at 6 and 12-month follow up. The primary outcome was job strain. Secondary outcomes were effort-reward imbalance, exhaustion, sleep, and recovery. Group-level objective data on workload and data about relevant processes during the study were continuously collected. The changes in the intervention group with regard to job strain, effort-reward imbalance, exhaustion, sleep and recovery were not statistically different from changes in the control group. For the non-exhausted employees though, reward was significantly higher at follow up compared to baseline, but only in the intervention group. An important piece of information is that the objective workload was statistically significantly higher in the intervention group throughout the study. Not all the components of the intervention were implemented as intended. Context and process information, such as objective data and implementation fidelity are necessary for a valid interpretation of the results.

Place, publisher, year, edition, pages
Routledge, 2018
Keywords
Stress prevention; randomized controlled trial; demand-control; effort-reward; ProMES
National Category
Applied Psychology
Identifiers
urn:nbn:se:liu:diva-147452 (URN)10.1080/1359432X.2018.1431883 (DOI)000428813000005 ()2-s2.0-85041190720 (Scopus ID)
Note

Funding Agencies|AFA Insurance; Swedish Research Council for Health, Working Life and Wellfare

Available from: 2018-05-16 Created: 2018-05-16 Last updated: 2018-05-24Bibliographically approved
Flodin, U., Rolander, B., Lofgren, H., Krapi, B., Nyqvist, F. & Wåhlin-Norgren, C. (2018). Risk factors for neck pain among forklift truck operators: a retrospective cohort study. BMC Musculoskeletal Disorders, 19, Article ID 44.
Open this publication in new window or tab >>Risk factors for neck pain among forklift truck operators: a retrospective cohort study
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2018 (English)In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 19, article id 44Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background

No previous research has been performed into neck pain among forklift operators. This is a common complaint among these workers, who number around 150,000 in Sweden and six million in Europe. The aim of the study was to examine long-term exposure to unnatural neck positions among forklift operators as a risk factor for neck pain.

Methods

A retrospective cohort study was conducted of all eligible employees at a high-level warehouse. Forklift operators and office workers answered an 18-page questionnaire comprising questions about joint pain, work tasks, work postures and year of start for all items. By using person years in the exposed and less-exposed groups before start of neck pain we were able to calculate Incident Rate ratios for various exposures.

Results

Forty nine percent of the forklift operators reported having experienced neck pain compared to 30 % of office workers. Being a forklift operator was associated with an increased risk of neck pain (OR = 5.1, 95% CI 1.4–18.2). Holding the head in an unnatural position resulted in significantly increased risks for neck pain, irrespective of type of position. The risks for neck pain remained after taking other ergonomic exposures and psychosocial aspects into consideration.

Conclusions

This is the first published study showing that forklift operators have an increased risk of neck pain. The results are therefore of significance for improving work schedules, the adjustment of work tasks for these workers and the design of the vehicles.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
Forklift operators; Neck pain; Ergonomics; Work postures; Retrospective cohort study; Occupational medicine
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:liu:diva-145452 (URN)10.1186/s12891-018-1956-3 (DOI)000424785700001 ()29426319 (PubMedID)2-s2.0-85041929368 (Scopus ID)
Note

Funding Agencies|Medical Research Council of Southeast Sweden

Available from: 2018-03-23 Created: 2018-03-23 Last updated: 2018-04-13Bibliographically approved
Wagman, P., Lindmark, U., Rolander, B., Wåhlin-Norgren, C. & Håkansson, C. (2017). Occupational balance in health professionals in Sweden.. Scandinavian Journal of Occupational Therapy, 24(1)
Open this publication in new window or tab >>Occupational balance in health professionals in Sweden.
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2017 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 24, no 1Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Health care employees are often women, a group that has high degrees of sick leave and perhaps problems attaining occupational balance. However, people think differently about their everyday activities and it is therefore important to take their perceptions into account but occupational balance has not yet been measured in health professionals. The aim was to describe occupational balance in three different samples of health professionals in Sweden. A further aim was to investigate whether occupational therapists (OTs) rate their occupational balance differently from other health professionals.

MATERIAL AND METHOD: Four hundred and eighty-two health professionals, employees in public dentistry, mental health care and OTs, aged 21-70 years participated. The participants' occupational balance was measured using the occupational balance questionnaire (OBQ).

RESULTS: The ratings of occupational balance were similar to earlier studies and did not differ significantly between the samples. The OTs' occupational balance was also similar to that of the other health professionals.

CONCLUSION: The similarities in occupational balance indicate the same difficulties in attaining it.

SIGNIFICANCE: The result highlights the possibility that working people face similar difficulties in achieving occupational balance. Further research is warranted about how to attain it.

National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-133857 (URN)10.1080/11038128.2016.1203459 (DOI)000392839900003 ()27385582 (PubMedID)
Available from: 2017-01-12 Created: 2017-01-12 Last updated: 2018-05-03
Persson, J., Bernfort, L., Wåhlin, C., Öberg, B. & Ekberg, K. (2015). Costs of production loss and primary health care interventions for return-to-work of sick-listed workers in Sweden. Disability and Rehabilitation, 37(9), 771-776
Open this publication in new window or tab >>Costs of production loss and primary health care interventions for return-to-work of sick-listed workers in Sweden
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2015 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, no 9, p. 771-776Article in journal (Refereed) Published
Abstract [en]

Purpose: The aim of this study was to investigate, from the perspective of society, the costs of sick leave and rehabilitation of recently sick-listed workers with musculoskeletal disorders (MSD) or mental disorders (MD). Methods: In a prospective cohort study, 812 sick-listed workers with MSD (518) or MD (294) were included. Data on consumption of health care and production loss were collected over six months from an administrative casebook system of the health care provider. Production loss was estimated based on the number of sick-leave days. Societal costs were based on the human capital approach. Results: The mean costs of production loss per person were EUR 5978 (MSD) and EUR 6381 (MD). Health care interventions accounted for 9.3% (MSD) and 8.2% (MD) of the costs of production loss. Corresponding figures for rehabilitation activities were 3.7% (MSD) and 3.1% (MD). Health care interventions were received by about 95% in both diagnostic groups. For nearly half of the cohort, no rehabilitation intervention at all was provided. Conclusions: Costs associated with sick leave were dominated by production loss. Resources invested in rehabilitation were small. By increasing investment in early rehabilitation, costs to society and the individual might be reduced. Implications for Rehabilitation Resources invested in rehabilitation for sick-listed with musculoskeletal and mental disorders in Sweden are very small in comparison with the costs of production loss. For policy makers, there may be much to gain through investments into improved rehabilitation processes for return to work. Health care professionals need to develop rehabilitative activities aiming for return to work, rather than symptoms treatment only.

Keywords
Economic analysis; Sweden; mental disorders; musculoskeletal disorders; rehabilitation; sick leave; societal costs
National Category
Basic Medicine
Identifiers
urn:nbn:se:liu:diva-114181 (URN)10.3109/09638288.2014.941021 (DOI)000352139300006 ()25055999 (PubMedID)
Available from: 2015-02-11 Created: 2015-02-11 Last updated: 2018-01-11
Ekberg, K., Wåhlin, C., Persson, J., Bernfort, L. & Öberg, B. (2015). Early and Late Return to Work After Sick Leave: Predictors in a Cohort of Sick-Listed Individuals with Common Mental Disorders. Journal of occupational rehabilitation, 25(3), 627-637
Open this publication in new window or tab >>Early and Late Return to Work After Sick Leave: Predictors in a Cohort of Sick-Listed Individuals with Common Mental Disorders
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2015 (English)In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 25, no 3, p. 627-637Article in journal (Refereed) Published
Abstract [en]

Objectives The study aims to identify individual and workplace factors associated with early return to work (RTW)-defined as within 3 months-and factors associated with later RTW-between 3 and 12 months after being sick-listed-in a cohort of newly sick-listed individuals with common mental disorders. Methods In a prospective cohort study, a cross-sectional analysis was performed on baseline measures of patients granted sick leave due to common mental disorders. A total of 533 newly sick-listed individuals fulfilled the inclusion criteria and agreed to participate. A baseline questionnaire was sent by post within 3 weeks of their first day of certified medical sickness; 354 (66 %) responded. Those who were unemployed were excluded, resulting in a study population of 319 individuals. Sick leave was recorded for each individual from the Social Insurance Office during 1 year. Analyses were made with multiple Cox regression analyses. Results Early RTW was associated with lower education, better work ability at baseline, positive expectations of treatment and low perceived interactional justice with the supervisor. RTW after 3 months was associated with a need to reduce demands at work, and turnover intentions. Conclusions Early RTW among sick-listed individuals with common mental disorders seems to be associated with the individuals need to secure her/his employment situation, whereas later RTW is associated with variables reflecting dissatisfaction with work conditions. No health measures were associated with RTW. The study highlights the importance of considering not only health and functioning, but also workplace conditions and relations at the workplace in implementing RTW interventions.

Place, publisher, year, edition, pages
Springer Verlag (Germany), 2015
Keywords
Common mental disorders; Return to work; Work conditions; Sick leave duration
National Category
Basic Medicine Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-121301 (URN)10.1007/s10926-015-9570-9 (DOI)000359948000017 ()25634798 (PubMedID)
Note

Funding Agencies|Swedish Research Council for Health, Working Life and Welfare (FORTE); County Council of Ostergotland, Sweden

Available from: 2015-09-16 Created: 2015-09-14 Last updated: 2018-01-11Bibliographically approved
Öberg, B., Wåhlin, C., Persson, J., Bernfort, L. & Ekberg, K. (2013). A prospective cohort study on newly sick-listed patients with musculoskeletal disorders and sustainable return to work. In: : . Paper presented at Eighth International Conference on Prevention of Work-related Musculoskeletal Disorders (PREMUS 2013), Busan, Korea, July 7-11, 2013 (pp. 312-312).
Open this publication in new window or tab >>A prospective cohort study on newly sick-listed patients with musculoskeletal disorders and sustainable return to work
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2013 (English)Conference paper, Oral presentation with published abstract (Other academic)
Keywords
MSD, Return to work, Prognostic factors
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-96802 (URN)
Conference
Eighth International Conference on Prevention of Work-related Musculoskeletal Disorders (PREMUS 2013), Busan, Korea, July 7-11, 2013
Available from: 2013-08-27 Created: 2013-08-27 Last updated: 2013-09-04
Wåhlin, C., Ekberg, K., Persson, J., Bernfort, L. & Öberg, B. (2013). Evaluation of self-reported work ability and usefulness of interventions among sick-listed patients. Journal of occupational rehabilitation, 23(1), 32-43
Open this publication in new window or tab >>Evaluation of self-reported work ability and usefulness of interventions among sick-listed patients
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2013 (English)In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 23, no 1, p. 32-43Article in journal (Refereed) Published
Abstract [en]

Aim To describe the types of intervention offered, to investigate the relationship between the type of intervention given, patient-reported usefulness of interventions and the effect on self-reported work ability in a cohort of sick-listed patients with musculoskeletal disorders (MSD) or mental disorders (MD).

Methods A prospective cohort study was performed including 810 newly sick-listed patients (MSD 62 % and MD 38 %). The baseline questionnaire included sociodemographic characteristics and measures of work ability. The 3-month follow-up questionnaire included measures of work ability, type of intervention received, and judgment of usefulness.

Results Twenty-five percent received medical intervention modalities (MI) only, 45 % received a combination of medical and rehabilitative intervention modalities (CRI) and 31 % received work-related interventions combined with medical or rehabilitative intervention modalities (WI). Behavioural treatments were more common for patients with MD compared with MSD and exercise therapy were more common for patients with MSD. The most prevalent workplace interventions were adjustment of work tasks or the work environment. Among patients with MD, WI was found to be useful and improved work ability significantly more compared with only MI or CRI. For patients with MSD, no significant differences in improved work ability were found between interventions.

Conclusions Patients with MD who received a combination of work-related and clinical interventions reported best usefulness and best improvement in work ability. There was no difference in improvements in work ability between rehabilitation methods in the MSD group. There seems to be a gap between scientific evidence and praxis behaviour in the rehabilitation process. Unimodal rehabilitation was widely applied in the early rehabilitation process, a multimodal treatment approach was rare and only one-third received work-related interventions. It remains a challenge to understand who needs what type of intervention.

Place, publisher, year, edition, pages
Springer Verlag (Germany), 2013
Keywords
Musculoskeletal disorders; Mental disorders; Sick leave; Self-reported; Work ability; Usefulness; Interventions, Sweden
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-76147 (URN)10.1007/s10926-012-9376-y (DOI)000314505200004 ()22760957 (PubMedID)
Funder
FAS, Swedish Council for Working Life and Social Research, 2004-0582
Available from: 2012-03-29 Created: 2012-03-29 Last updated: 2017-12-07Bibliographically approved
Wåhlin, C., Ekberg, K., Persson, J., Bernfort, L. & Öberg, B. (2012). Association between clinical and work-related interventions and return to work for patients with musculoskeletal or mental disorders. Journal of Rehabilitation Medicine, 44(4), 355-362
Open this publication in new window or tab >>Association between clinical and work-related interventions and return to work for patients with musculoskeletal or mental disorders
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2012 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 44, no 4, p. 355-362Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of this study was to explore what characterizes patients receiving clinical interventions vs combined clinical and work-related interventions in a cohort of sick-listed subjects with musculoskeletal or mental disorders. Factors associated with return-to-work were also analysed.

Design: A prospective cohort study.

Methods: A total of 699 newly sick-listed patients responded to a questionnaire on sociodemographics, measures of health, functioning, work ability, self-efficacy, social support, work conditions, and expectations. The 3-month follow-up questionnaire included patients' self-reported measures of return-to-work, work ability and type of interventions. The most frequent International Classification of Diseases-10 diagnoses for patients' musculoskeletal disorders were dorsopathies (M50-54) and soft tissue disorders (M70-79), and for patients with mental disorders, depression (F32-39) and stress reactions (F43).

Results: Patients with mental disorders who received combined interventions returned to work to a higher degree than those who received only clinical intervention. The prevalence of work-related interventions was higher for those who were younger and more highly educated. For patients with musculoskeletal disorders better health, work ability and positive expectations of return-to-work were associated with return-to-work. However, combined interventions did not affect return-to-work in this group.

Conclusion: Receiving combined interventions increased the probability of return-to-work for patients with mental disorders, but not for patients with musculoskeletal disorders. Better health, positive expectations of return-to-work and better work ability were associated with return-to-work for patients with musculoskeletal disorders.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-73425 (URN)10.2340/16501977-0951 (DOI)000303850800010 ()
Funder
FAS, Swedish Council for Working Life and Social Research, 2004-0582
Note

funding agencies|FAS (Swedish Council for Working Life and Social Research)||

Available from: 2012-01-03 Created: 2012-01-03 Last updated: 2017-12-08Bibliographically approved
Wåhlin, C., Ekberg, K. & Öberg, B. (2012). Clinical reasoning in occupational health services for individuals with musculoskeletal and mental disorders. Advances in Physiotherapy, 14(4), 155-165
Open this publication in new window or tab >>Clinical reasoning in occupational health services for individuals with musculoskeletal and mental disorders
2012 (English)In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 14, no 4, p. 155-165Article in journal (Refereed) Published
Abstract [en]

Aims: To investigate whether there are associations between the professional assessment of a patient's main clinical problem and the patient's self-reported health among patients with musculoskeletal disorders and/or mental disorders. To investigate differences in self-reported health and work-related measures in patients who were recommended clinical versus work-related interventions. Method: A cross-sectional study, including a convenience sample of 210 patients, visiting occupational health service. Patients answered a questionnaire on demographic variables, dimensions of health, functioning, work ability and working conditions. Patients’ main clinical problem and type of intervention was classified by physiotherapists. Activity limitations were identified using the Patient-Specific Functional Scale. Findings: The main clinical problems were: medical/organic problems (39%), psychosocial problems (46%) and physical work-related problems (15%). The psychosocial group reported more problems in mental functioning and the medical/organic group had worse physical functioning. There were significant differences for the main clinical problem, educational level, work ability, social interaction skills and mobility in patients who were recommended clinical versus work-related interventions. Conclusions: There are associations between the professional biopsychosocial classification and the patient's self-reported health and functioning. Clinical reasoning may be improved by including systematic biopsychosocial assessment of specific health and working conditions, and activity limitations according to Patient-Specific Functional Scale.

Place, publisher, year, edition, pages
London, UK: Informa Healthcare, 2012
Keywords
Musculoskeletal disorders, mental disorders, biopsychosocial model, occupational health services, professional assessment, self-report, work ability, Patient-Specific Functional Scale, intervention.
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-76145 (URN)10.3109/14038196.2012.729609 (DOI)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2004-0582
Available from: 2012-03-29 Created: 2012-03-29 Last updated: 2017-12-07Bibliographically approved
Wåhlin, C. (2012). The Rehabilitation Process for Individuals with Musculoskeletal and Mental Disorders: Evaluation of Health, Functioning, Work Ability and Return to Work. (Doctoral dissertation). Linköping: Linköping University Electronic Press
Open this publication in new window or tab >>The Rehabilitation Process for Individuals with Musculoskeletal and Mental Disorders: Evaluation of Health, Functioning, Work Ability and Return to Work
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Musculoskeletal disorders (MSD) and mental disorders (MD) are common among working-age individuals, and reduced work ability is often a problem that influences functioning in working life. Having MSD and MD is also a common cause of seeking health care and these conditions account for the majority of sick leave in most western countries. The overall aims of the thesis were to increase knowledge about biopsychosocial assessment of health, functioning and work ability for individuals with MSD and MD seeking care. A further aim was to gain better understanding of praxis behaviour in the rehabilitation process for sick-listed patients by evaluating patient-reported work ability, type of interventions given, usefulness of interventions, and return to work.

This thesis comprises four studies based on two different cohorts. A cross-sectional design was used for studies I and II, which included 210 individuals diagnosed with MSD and MD seeking occupational health services. Data collection consisted of questionnaires to patients on self-reported health, functioning, work conditions, work ability and reports of professional assessment of diagnosis, main clinical problem, recommended intervention and sick leave. Studies III (n=699) and IV (n=810) were based on a longitudinal cohort study, ReWESS, with a 3-month follow-up comprising individuals who sought primary health care or occupational health services for MSD or MD and were sick-listed. The data collection included repeated questionnaires to the patients on self-reported health, functioning, work conditions, work ability, type and usefulness of intervention and return to work.

There was an association between the professional biopsychosocial assessment and patients’ self-reported measures of health, functioning and work ability in clinical reasoning. Self-reported health and work measures can complement the expert-based diagnosis. Patients who had MSD and MD with co-morbid conditions reported more problems with mental functioning, had higher psychological demands at work and reported poorer work ability compared with those with MSD only. Patients with co-morbid conditions also had worse outcome compared to having mental disorders only. Psychosocial problems and activity limitations concerning social interaction skills were a frequent problem. This can be identified in clinical screening by physiotherapists in dialogue with the patient using the Patient-Specific Functional Scale. Three-quarters of sick-listed individuals with MSD or MD returned to work within 90 days. The treatment approach to sick-listed persons is still very medical and clinically oriented. Access to work-related interventions seems to be limited in the early rehabilitation process and may not be equal in practice. Those who were younger, had higher educational level and reported stronger health resources were favoured. There is a need to strive for access to work-related interventions.

Return to work was associated with receiving combined clinical- and work-related interventions for patients with MD, and with better health-related quality of life, positive return to work expectations and better work ability for patients with MSD. Factors associated with return to work can be identified using self-reported measures. Patients with MD who received a combination of work-related and clinical interventions perceived best usefulness and best effect of health care contacts on work ability. Patients with MSD did not report as good usefulness. There seems to be a gap between scientific evidence and praxis behaviour in the early rehabilitation process; unimodal rehabilitation was widely applied, use of a multimodal treatment approach was limited and only one-third received work-related interventions. For patients with MSD, behavioural treatment seems to be underutilized in clinical practice considering the effect it may have on developing coping strategies and reducing symptoms. In order to meet recommendations in guidelines, physical activity needs to increase as a treatment strategy for patients with MD. A clinical implication is that the rehabilitation process needs to adopt a broader perspective for patients with MSD and MD to include patients’ individual health-related needs, aspects of employment and work conditions. Still, it remains a challenge to understand who needs what type of intervention.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2012. p. 92
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1290
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-76149 (URN)978-91-7519-976-4 (ISBN)
Public defence
2012-04-20, Berzeliussalen, ingång 64, Campus US, Linköpings universitet, Linköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2012-03-29 Created: 2012-03-29 Last updated: 2013-09-03Bibliographically approved
Organisations

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