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Health promotion and rehabilitation: a case study
Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0002-8031-7651
2003 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 25, no 16, 908-915 p.Article in journal (Refereed) Published
Abstract [en]

Background: Since the number of people in Sweden on long-term sick leave has rapidly increased since 1996, new non-biomedical models of occupational rehabilitation are at stake. A group of seven women who had finished medical treatment and rehabilitation but were still on sick leave or temporary disability pension for several years, worked in a problem-based rehabilitation group for 6 months. Focus for the group was on a process of change towards health and work ability.

Purpose: The aim of this case study was to improve understanding of effects of a problem-based rehabilitation model (PBR) on health promoting processes amongst a group of women on long-term sick leave. Method: Data source was a focus group interview. The analysis follows the guidelines of qualitative analysis that emerges from grounded theory.

Results: The pedagogical model of PBR enhanced the participant's internal resources such as self-confidence and ability to act in a social setting. External resources such as social support were improved. An individual follow-up was conducted 2 years after the rehabilitation process and four out of seven women had returned to work.

Conclusion: Among this group of women PBR launched health-promoting processes. When the more medically oriented treatment is finished or is not able to contribute further to the individual's recovery, other aspects of the individuals abilities and health resources will be focused upon.

Place, publisher, year, edition, pages
2003. Vol. 25, no 16, 908-915 p.
National Category
Social Sciences
URN: urn:nbn:se:liu:diva-26255DOI: 10.1080/0963828031000122212Local ID: 10761OAI: diva2:246803
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2013-09-03Bibliographically approved
In thesis
1. Stroke among people of working age: from a public health and working life perspective
Open this publication in new window or tab >>Stroke among people of working age: from a public health and working life perspective
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Stroke is a major cause of serious disability and death. In Sweden approximately 30,000 people suffer from stroke each year, and 20% of them are under 65 years of age.

Aim: The aim of this thesis was to study stroke among people aged 30-65 years. Specific aims were: a) to compare the incidence of stroke in Sweden between the periods 1989-1991 and 1998-2000 in persons aged 30-65 years, b) to explore sick leave, disability pension and health-care-seeking behaviour among people 30-65 years of age prior to their stroke in year 2001 in the county of Östergötland, Sweden, c) to explore whether organisational change and work-related stress, as measured by the Job Content Questionnaire, was associated with first-ever stroke among working people aged 30-65, d) to describe the experience of return to work (RTW) after stroke from the patient’s perspective in comparison with experiences of patients on long-term sick leave.

Material and methods: Studies I and II are based on retrospective register data. Study I is based on data from the SHDR and the CDR during 1989-2000, and NSR Östergötland during the period 1989-2000. Study II is based on data from the HCDWÖ and the social insurance office. Study III is a case–control study where the cases are obtained from four hospitals in the south-east of Sweden and the controls come from the base populations at each respective hospital. Studies IV and V are qualitative studies and the informants in study IV are cases from Linköping and Norrköping included in study III. Study V is a case study based upon a focus group interview with 7 women who had undergone a problem-based rehabilitation.

Results: Stroke incidence increased in Sweden for both men and women between 1989 and 2000, especially for women. Future stroke patients showed more sick leave compared with the general population. For men, accumulated sick leave of more than 29 days was associated with an increased risk of later stroke. Frequent health-care-seeking behaviour is not a tool for identifying women who develop stroke, while it may be an indicator for men. We found partial support for an association between organisational change, work-related stress and stroke. The likelihood of stroke was significantly lower for people in active job situations. The individual stroke patient’s capacity and ability to return to work was perceived as enhanced by motivation or ‘will’ and self-efficacy, in combination with external support. Self-efficacy was not only a personal trait or internal factor; it was enhanced and encouraged in interaction with contextual conditions. When the more medically oriented rehabilitation is finished, other aspects of the individual’s abilities should be in focus. There seem to be similarities between the RTW process and processes of health promotion.

Conclusion: Stroke among younger people in regard to work related risk factors and work related rehabilitation is a field where few studies have been carried out, and further research is needed in order to investigate risk factors and planning for prevention, health promotion and rehabilitation. The thesis also indicates the need for gender-specific studies.

Place, publisher, year, edition, pages
Linköping: Institutionen för hälsa och samhälle, 2006. 94 p.
Linköping University Medical Dissertations, ISSN 0345-0082 ; 930
Cerebrovascular accident, epidemiology, Cerebrovascular accident, Health promotion, Rehabilitation, Sick leave
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
urn:nbn:se:liu:diva-7466 (URN)91-85497-70-3 (ISBN)
Public defence
2006-01-13, Aulan, Hälsans hus, Campus US, Linköpings Universitet, Linköping, 13:00 (English)
Available from: 2006-09-28 Created: 2006-09-28 Last updated: 2012-10-23Bibliographically approved

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Medin, JennieBendtsen, PrebenEkberg, Kerstin
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