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Empowerment and health promotion in working life
Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: In ‘workplace health promotion’, empowerment is assumed to promote health. Nevertheless, few studies have examined the relationship between empowerment in working life, and health.

Aim: To study the impact of empowerment in working life on health, with special focus on gender differences.

Material and methods: Paper I is a review of the scientific literature, examining instruments intended to measure empowerment in working life. The second study (paper II) was a cross-sectional survey, assessing the relationship between psychological empowerment, and self-rated health and burnout among employees. Papers III and IV encompass a two-year longitudinal survey study of the gender-specific relationships between baseline levels of psychological empowerment, and the combination of psychological support and social support, and self-rated health and burnout two years later among employees. Study five (paper V) is a qualitative study, using focus-group interviews and phenomenography to evaluate a theory-based intervention method, problem-based learning, for workplace health promotion with regard to possible facilitation of empowerment processes.

Results: In paper I, nine questionnaires were found and analysed. Most of the questionnaires focused on intra-individual issues, while a smaller number dealt with the interaction between individual and organisation. Control and competence were frequently used dimensions. The Psychological Empowerment Instrument had undergone the most comprehensive investigation, showing satisfactory validity and reliability. In paper II, men reported a greater degree of psychological empowerment than women in terms of self-determination and impact. Associations were found between psychological empowerment, and self-rated health and burnout (p<0.05). Men and women with higher levels of empowerment reported significantly better health, compared with those who had lower levels of empowerment. Papers III and IV show that for women, increasing levels of psychological empowerment at work at baseline were associated with better self-rated health as measured by the SF-36 scales physical role function, bodily pain, and mental health at the 2-year follow-up (p<0.05). Also for women, a combination of high psychological empowerment and high social support at the workplace was associated (p<0.05) with better self-rated health (bodily pain, general health, vitality, social functioning, emotional role, mental health, EQ-5D VAS, and EQ-5D index) and lower levels of work-related burnout at the 2-year follow-up. For men, psychological empowerment at baseline, and a combination of psychological empowerment and social support at the workplace, were associated with self-rated health at follow-up as measured by the EQ-5D VAS (p<0.05). Combinations of psychological empowerment and social support were associated with work-related burnout at the two-year follow-up for women only (p=0.002). The differences between men and women were confirmed in the gender×empowerment and social support interaction analysis for the measures bodily pain, social function, and work-related burnout (p<0.05). The phenomenographic analysis in paper V resulted in six descriptive categories: reflection, awareness and insight, self-direction and self-management, group coherence, social support and action. The results correspond to established theories on components of empowerment processes. The method “problem-based learning” initiated processes of change at organisational, workplace and individual levels. Social support and group coherence were expressed as essential in order to transform challenging strategies into action and goal realisation.

Conclusions: This thesis demonstrates that psychological empowerment is associated with self-rated health and burnout. Psychological empowerment also impacts mental and somatic health after two years. The impact on health becomes more extensive when psychological empowerment is combined with social support at the workplace. Empowerment and social support are crucial core characteristics in ‘workplace health promotion’, but effects may differ for men and women. Empowerment processes can be facilitated by implementation of the participative intervention method known as “problem-based learning”. Practitioners and researchers who are active in health enhancement in working life should gain from implementing these findings, whether the focus is on health promotion, disease prevention, or rehabilitation back to work.

Place, publisher, year, edition, pages
Linköping: Institutionen för hälsa och samhälle , 2006. , 90 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 934
Keyword [en]
Health promotion, Workplace, Social support, self-rated health, burnout
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:liu:diva-7436ISBN: 91-85497-69-X (print)OAI: oai:DiVA.org:liu-7436DiVA: diva2:22436
Public defence
2006-02-10, Aulan, Hälsans hus, Campus US, Linköpings Universitet, Linköping, 13:00 (English)
Opponent
Available from: 2006-09-27 Created: 2006-09-27 Last updated: 2012-10-23Bibliographically approved
List of papers
1. Measuring empowerment in working life: a review
Open this publication in new window or tab >>Measuring empowerment in working life: a review
2006 (English)In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 26, no 1, 37-46 p.Article in journal (Refereed) Published
Abstract [en]

This study identifies and describes questionnaires that measure empowerment in working life. Theoretical bases and empirical examination of the questionnaires are also reported. Nine questionnaires emerged from a database search including AMED, CINAHL, ERIC, MEDLINE and PSYCINFO. The main target groups were employees in general. Most authors share the same theoretical basis. Most of the questionnaires focus on intra- individual issues, while a smaller number deal with the interaction between individual and organization. Control and competence are frequently used dimensions. Cronbach's alpha for complete questionnaires ranged between 0.62 and 0.96. No comparisons with outcome of health were reported. Spreitzer's questionnaire [54] has undergone the most comprehensive investigation. Research is required to achieve better understanding of the interplay between conditions at work and empowerment and health.

Keyword
Empowerment; Health promotion; Measurement; Working life; Workplace health promotion
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-21811 (URN)16373978 (PubMedID)
Available from: 2009-10-05 Created: 2009-10-05 Last updated: 2017-12-13Bibliographically approved
2. Psychological empowerment and self-rated health and burnout in a sample of Swedish employees
Open this publication in new window or tab >>Psychological empowerment and self-rated health and burnout in a sample of Swedish employees
(English)Manuscript (preprint) (Other academic)
Abstract [en]

PURPOSE: To explore the gender-specific association between psychological empowerment and self-rated health and burnout in a working population.

MATERIAL AND METHOD: A cross-sectional survey was carried out among 1,243 employees (response rate 81% (n=1007), 65 % females). Psychological empowerment was measured by the Spreitzer questionnaire, developed for a working life context. The questionnaire includes the subscales: meaning, competence, self-determination and impact. Self-rated health was evaluated with EQ-5D and SF-36 and the Copenhagen Burnout Inventory was used to measure burnout.

RESULTS: Men reported a greater degree of empowerment than women in terms of self-determination and impact. Significant associations (p<0.05) were found between psychological empowerment and self-rated health and burnout. Men and women with higher levels of empowerment reported significantly better health compared to those with lower levels of empowerment. In multivitriate analyses, all four subscales of empowerment were associated with burnout among both men and women. The most pronounced association with self-rated health was seen for the subscale impact. These associations were particularly strong among women.

CONCLUSION: Psychological empowerment in working life is associated with self-rated health and burnout. Interventions aiming to promote health at work or aiming to prevent burnout may therefore benefit if they comprise empowerment in terms of impact, self-determination, meaning and competence. Also, workplace health promotion that includes empowerment processes should be gender conscious.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-84813 (URN)
Available from: 2012-10-23 Created: 2012-10-23 Last updated: 2013-09-03Bibliographically approved
3. Psychological empowerment, social support at the workplace and self-rated health and burnout: a 2-year longitudinal analysis in a sample of Swedish employees
Open this publication in new window or tab >>Psychological empowerment, social support at the workplace and self-rated health and burnout: a 2-year longitudinal analysis in a sample of Swedish employees
(English)Manuscript (preprint) (Other academic)
Abstract [en]

PURPOSE: To explore the gender-specific longitudinal association between a combination of psychological empowerment and social support at the workplace and self-rated health and burnout in a working population.

MATERIAL AND METHOD: The participants were employees working in the public service sector in central Sweden. The baseline survey in two cohorts was carried out in 2001 and the follow-up in 2003. The questionnaire was answered by 715 respondents at both points in time (overall response rate 67%). Measures used were the Psychological Empowerment Instrument by Spreitzer, the social support dimension in the Demand-Control-Support Questionnaire, the SF-36, the EQ-5D, and the Copenhagen Burnout Inventory. Based on empirical medians, psychological empowerment and social support at baseline were combined into four categories. Mlltivariate comparisons adjusted for age, education, study cohort and SRH and burnout at baseline were performed using multiple linear regression analysis. The genderxempowerment and social support interaction effect was assessed in the multiple linear regression analysis. All analyses were performed for men and women separately.

RESULTS: For women, a combination of high psychological empowerment and high social support at the workplace, in comparison with a combination of low psychological empowerment and low social support, is strongly associated with better SRH (bodily pain, general health, vitality, social functioning, emotional role, mental health, the EQ-5D VAS, and EQ-5D index) and lower levels of work-related burnout at the 2-year follow-up after adjusting for demographics and baseline SRH and burnout. For men, there are univariate associations with burnout and some associations with SRH. After adjustments for demographics and baseline SRH and burnout, psychological empowerment and social support is associated with SRH as measured by the EQ-5D VAS for men. The gender x empowerment and social support interaction analyses confirm gender differences regarding bodily pain, social function, and work-related burnout.

CONCLUSION: A combination of psychological empowerment and social support in working life strongly affects SRH and work-related burnout two years later for women, but only in part for men.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-84817 (URN)
Available from: 2012-10-23 Created: 2012-10-23 Last updated: 2013-09-03Bibliographically approved
4. Psychiological empowerment at the workplace and self-rated health and burnout: a 2-yeah longitudinal analysis in a sample of Swedish employees
Open this publication in new window or tab >>Psychiological empowerment at the workplace and self-rated health and burnout: a 2-yeah longitudinal analysis in a sample of Swedish employees
(English)Manuscript (preprint) (Other academic)
Abstract [en]

PURPOSE: To explore the gender-specific longitudinal association between psychological empowerment at the workplace and self-rated health and burnout in a working population.

MATERIAL AND METHOD: The participants were employees working in the public service sector in central Sweden. The baseline survey was carried out in 2001 and the follow-up in 2003. The questionnaire was answered by 715 respondents at both points in time (overall response rate 67%). Measures used were Psychological Empowerment Instrument by Spreitzer, the SF-36, the EQ-5D, and the Copenhagen Burnout Inventory. Gender specific differences in average score for self-rated health and burnout at follow-up were assessed using multiple linear regression adjusted for age, education, study cohort and self-rated health and burnout at baseline. An analysis on interactional effects due to gender was also performed.

RESULTS: For women, increasing levels of psychological empowerment at work at baseline are associated with less bodily pain, better physical role function and mental health in the multivariate analysis at follow-up two years later. For men, increased psychological empowerment at baseline is significantly associated with better self-rated health as measured by the EQ-5D VAS at follow-up in the multivariatc analysis. Higher levels of psychological empowerment at baseline show a statistically significant association with a lower degree of burnout at follow-up in the univariate analysis for men and women. However, the associations diminished after adjustments in the multivariate analyses. No significant gender x empowerment interaction appeared.

CONCLUSION: Psychological empowerment in working life was associated with somatic and mental aspects of SRH two years later for women. Men seem to be less affected by psychological empowerment, yet an association with the EQ-5D V AS appeared. Psychological empowerment did not predict burnout two years later for either men or women.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-84815 (URN)
Available from: 2012-10-23 Created: 2012-10-23 Last updated: 2013-09-03Bibliographically approved
5. Evaluation of empowerment processes in a workplace health promotion intervention based on learning in Sweden
Open this publication in new window or tab >>Evaluation of empowerment processes in a workplace health promotion intervention based on learning in Sweden
2005 (English)In: Health Promotion International, ISSN 0957-4824, E-ISSN 1460-2245, Vol. 20, no 4, 351-359 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to evaluate a theory-based method for workplace health promotion (WHP) with regard to possible facilitation of empowerment processes. The intervention tool was the pedagogic method known as problem-based learning (PBL). The aim of the intervention was to promote empowerment and health among the employees. The intervention was implemented in three organizations within the public sector in Sweden, in a bottom-up approach. All employees, including management, in each organization, were offered the opportunity to participate (n = 113) and 87% (n = 97) participated. The intervention was implemented in 13 groups of six to eight participants who met once a week over a period of 4 months. The predetermined overall goal of the intervention was to promote employee health within the organizational setting. A facilitator in each group and a group-specific mutual agreement guided the intervention, as did the problem solving process. The participants set goals and developed strategies to reach their goals between the meetings. Thirty informants were interviewed in seven focus groups after the intervention about the intervention method and the process, following a semi-structured theme guide. The phenomenographic analysis resulted in six descriptive categories: reflection, awareness and insight, self-direction and self-management, group coherence, social support and actions. The results correspond to established theories of components of empowerment processes. The method initiated processes of change at organizational, workplace and individual levels as the participants examined their work situation, determined problems and initiated solutions. Social support and group coherence were expressed as essential in order to transform challenging strategies into action and goal realization. The findings indicate that systematic improvements of social support and group coherence among employees ought to be facilitated by the organization as a health-promoting arena. PBL appears to be a profitable and powerful instrument with the potential to enable empowerment.

Keyword
Empowerment, Problem-based learning, Workplace health promotion
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-50354 (URN)10.1093/heapro/dai023 (DOI)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-12Bibliographically approved

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