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Evaluation of empowerment processes in a workplace health promotion intervention based on learning in Sweden
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, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0002-8031-7651
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.

Place, publisher, year, edition, pages
2005. Vol. 20, no 4, 351-359 p.
Keyword [en]
Empowerment, Problem-based learning, Workplace health promotion
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-50354DOI: 10.1093/heapro/dai023OAI: oai:DiVA.org:liu-50354DiVA: diva2:271250
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-12Bibliographically approved
In thesis
1. Empowerment and health promotion in working life
Open this publication in new window or tab >>Empowerment and health promotion in working life
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
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:nbn:se:liu:diva-7436 (URN)91-85497-69-X (ISBN)
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

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Arneson, HannaEkberg, Kerstin

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