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  • 1.
    Jonker, Dirk
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Rolander, Bo
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Balogh, I
    Lund University, Sweden .
    Sandsjo, L
    University of Boras, Sweden .
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Winkel, J
    Technical University of Denmark, Denmark .
    Rationalisation in public dental care - impact on clinical work tasks and mechanical exposure for dentists - a prospective study2013In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 56, no 2, p. 303-313Article in journal (Refereed)
    Abstract [en]

    Swedish dentistry has been exposed to frequent rationalisation initiatives during the last half century. Previous research has shown that rationalisation often results in increased risk of developing work-related musculoskeletal disorders, thus reducing sustainability in the production system. In this prospective study, we assessed mechanical exposures among Swedish dentists in relation to specific rationalisations of clinical dental work during a six-year period. Body postures and movements of 12 dentists were assessed by inclinometry synchronised to video recordings of their work. No rationalisation effects could be shown in terms of a reduction in non-value-adding work (waste), and at job level, no major differences in mechanical exposure could be shown between baseline and follow-up. Conclusion: The present rationalisation measures in dentistry do not seem to result in rationalisation at job level, but may potentially be more successful at the overall dental system level. Practitioner summary: In contrast to many previous investigations of the mechanical exposure implications of rationalisation, the present rationalisation measures did not increase the level of risk for dentists. It is highlighted that all occupations involved in the production system should be investigated to assess production system sustainability.

  • 2.
    Jonker, Dirk
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Rolander, Bo
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Balogh, I.
    Department of Occupational and Environmental Medicine, Lund University, Lund, Sweden.
    Sandsjö, I.
    MedTech West/School of Engineering, University of Borås, Borås, Sweden.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Winkel, J.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Rationalisation in public dental care - impact on clinical work tasksand biomechanical exposure for dentists: a prospective studyManuscript (preprint) (Other academic)
    Abstract [en]

    Comprehensive rationalisations in Swedish dentistry suggest contribute to increase risk for MSDs among dentists. This prospective study focused on assessing changes in degree of rationalisation of clinical dental work by dentists during a six years period, with particular emphasis on time aspects and mechanical exposure. Twelve dentists were followed up by the means 45 minute’s video recordings and synchronised inclinometry measurements. The video recordings were analyzed by a loss analysis technique.

    The results shows that non-VAW time proportion (waste) at the follow up was not reduced, but rather showed a trend towards an increase. Mechanical exposures during non-VAW and VAW were essentially not changed during the follow up time. The risk for MSDs for dentists due to mechanical exposure is unchanged. The used loss analysis technique has a lot to contribute in health care settings but the used concept applied needs further elaboration in the future.

  • 3.
    Jonker, Dirk
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Rolander, Bo
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Balogh, Istvan
    Department of Occupational and Environmental Medicine, Lund University, Sweden.
    Relation between perceived and measured workload obtained by long-term inclinometry among dentists2009In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 40, no 3, p. 309-315Article in journal (Refereed)
    Abstract [en]

    Dentists reported high perceived physical work conditions. Working postures and movements of the head and upper extremities during dental work were registered with inclinometry measurements during four hours. The aim was to clarify the relationship between measured working postures/movements and perceived physical work conditions. Dentists worked with elevated arms and a rather steep forward inclination of the head. Correlations (r = -0.52 to -0.66) between inclination velocity and perceived workload on VAS scales were found, but there were only weak correlations between observed working postures. The different tasks involved in dental work provide limited variation in work movements and postures, measured by inclinometry. By alternating between sitting and standing, it might be possible to achieve variation in physical workload during dental work.

  • 4.
    Jonker, Dirk
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Rolander, Bo
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Balogh, Istvan
    Department of Occupational and Environmental Medicine, Lund University, Sweden.
    Sandsjö, Leif
    Occupational and Environmental Medicine, Dept of Public Health and Community Medicine, The Sahlgrenska Academy at University of Gothenburg, Sweden.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Winkel, Jörgen
    National Research Centre for the Working Environment, Copenhagen, Denmark/Department of Work Science, University of Gothenburg, Sweden.
    Mechanical exposure among general practice dentists in Sweden and possible implications of rationalization.2011In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 54, no 10, p. 953-560Article in journal (Refereed)
    Abstract [en]

    The present study investigates dental work in terms of time distribution and mechanical exposure in value-added and non-value-added tasks. Further rationalization of dental work would typically involve an increase in the proportion of value-added tasks. Information on mechanical exposure within classes of value-added and non-value-added tasks can be used to predict possible implications of rationalization.

    Twenty-four dentists were investigated. Using a data logger, postures and movements were continuously recorded for each subject during four hours of work, which included 45 minutes of video recording. Time distribution and mechanical exposure for each work activity were calculated from the video recordings, using a loss analysis technique. Value-added tasks, which comprised 57% of the total working time, generally implied significantly more constrained mechanical exposures as compared with non-value-added tasks.

    The results indicate that future rationalization of dental work, involving a reduction of nonvalue-added tasks, may increase the risk of developing musculoskeletal disorders.

  • 5.
    Jonker, Dirk
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Rolander, Bo
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Balogh, Istvan
    Department of Occupational and Environmental Medicine, Lund University, Sweden.
    Sandsjö, Leif
    Occupational and Environmental Medicine, Dept of Public Health and Community Medicine, The Sahlgrenska Academy at University of Gothenburg, Sweden.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Winkel, Jörgen
    National Research Centre for the Working Environment, Copenhagen, Denmark/Department of Work Science, University of Gothenburg, Sweden.
    Mechanical exposure levels and duration of value-adding versus non-value-adding tasks among general practice dentists in Sweden.2008Conference paper (Refereed)
  • 6.
    Jonker, Dirk
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Rolander, Bo
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Balogh, Istvan
    Department of Occupational and Environmental Medicine, Lund University, Sweden.
    Sandsjö, Leif
    Occupational and Environmental Medicine, Dept of Public Health and Community Medicine, The Sahlgrenska Academy at University of Gothenburg, Sweden.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Winkel, Jörgen
    National Research Centre for the Working Environment, Copenhagen, Denmark/Department of Work Science, University of Gothenburg, Sweden.
    Rationalization in public dental care and impact on biomechanical exposures for dentists - a prospective study. Oral presentation.2010Conference paper (Refereed)
  • 7.
    Rolander, Bo
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Evaluation of muscular activity, local muscular fatigue, and muscular rest patterns among dentists2005In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 63, no 4, p. 189-195Article in journal (Refereed)
    Abstract [en]

    In a previous study, dentists reported very high scores for perceived physical workload, but only low to moderate scores for the musculoskeletal system. This is difficult to explain when other occupational groups in the dental services are compared, and is the main reason why the present study was performed. To measure muscular activity, a surface electromyography (sEMG) study was done, and included the subjects who reported neck and shoulder complaints in the previous study. A portable sEMG system (MyoGuard) was used to collect a myoelectric signal on-line and analysis of the myoelectric signal in a computer. sEMG was recorded from both trapezius muscles for approximately 4 h during an ordinary working day. Twentyseven dentists participated in the study. The results show accumulated rest% fairly close to that of female cashiers and supermarket employees and increased average rectified value percent (ARV%) during work that could contribute to the very high workload perceived by dentists.

  • 8. Order onlineBuy this publication >>
    Rolander, Bo
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Work conditions, musculoskeletal disorders and productivity of dentists in public dental care in Sweden: Are dentists working smarter instead of harder?2010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Introduction: During the last 20 years, Sweden and other countries have been adjusting their models of welfare to a changed economic environment. Rationalization, influenced by New Public Management, has been implemented in public dentistry in order to improve efficiency and to streamline activities. This has involved transferring some of dentists’ tasks to dental hygienists and dental nurses. The goal is to achieve a more efficient mix of skills and more interaction between professional groups, in order to utilize all skills better in a more efficient work organization. Organizational changes may have an effect on the work environment both with regard to physical and to psychosocial work conditions and affect health and well-being. In many cases these changes have a profound negative effect on musculoskeletal and mental health, and corresponding risk factors, by reducing the number of natural breaks and thus reducing the efficacy of targeted ergonomic interventions. Dentists in Jönköping County in Sweden perceive high precision demands and poor working postures in their work. The five studies in this thesis describe organizational changes and analyse the risk of illness among dentists in the public sector in Jönköping County.

    Aim: The main aim is to study dentists’ physical and psychosocial work conditions and investigate associations with musculoskeletal disorders, work ability and sick leave during a period of extensive rationalizations; secondly, to assess the risk of illness as a basis for recommending preventive measures.

    Methods: The present thesis was designed with four cross-sectional studies (Paper I-IV) and one prospective longitudinal study (Paper V). In Paper I, a questionnaire concerning physical and psychosocial work conditions and health was sent out to all employees working in public dental care in Jönköping County in Sweden. To obtain more information on the difficult physical work situation for dentists (Paper I), an observation study with Portable Ergonomic Observation (Paper II) and an sEMG study (Paper III) was then conducted. Paper IV deals with psychosocial issues (using the same survey as in Paper I) and questions in the Eysenk Personality Questionnaire (EPQ) and the Marlowe-Crown scale SD (MCSD), to analyse their impact on perceived physical load. In Paper V, data about physical and psychosocial conditions and health from a survey, as well as production data (number of adult treatments per year per dentist) from computerized patient records (T4), are analysed with regard to changes and associations during a period of extensive rationalizations (2003 – 2008).

    Results: In Paper I, dentists reported the poorest physical work conditions of all occupational groups and high prevalence of musculoskeletal disorders. However, relatively low intensity of pain was reported and only a small proportion thought that work was affected. Paper II and Paper III confirmed that dentists’ work is physically demanding, with sitting postures and head bent forward, as well as prolonged low muscle loading. Paper IV shows that physical load is mainly influenced by psychosocial demands and to some extent by loss of work control. The results in Paper V show that during the period of extensive rationalizations between 2003 and 2008, dentists perceive improved precision demands and fewer uncomfortable work postures, but still a high level of physical load. The number of adults treated per dentist also improved, but there was a slight deterioration in work control and leadership.

    Conclusions: The results in this thesis show a consistent picture of high perceived physical load due to high precision demands and uncomfortable work postures, supported by observation of body movements (Portable Ergonomic Observation) and sEMG signs during psychosocially demanding circumstances. The rationalizations implemented in Jönköping County during the period 2003-2008 have not resulted in a deterioration of the physical environment, in spite of the fact that dentists produce more treatments of adult patients than before. This result may indicate that rationalizations do not always lead to increased health risks; it depends how they are implemented. Dentists may have changed the way they work for the better, and due to task delegation and SMS reminders a smoother patient flow has probably resulting in a reduction of workload and perceived stress regarding financial loss.

    List of papers
    1. Experience of musculo-skeletal disorders,intensity of pain, and general conditions in work: The case of employees in non-private dental clinics in a county in southern Sweden.
    Open this publication in new window or tab >>Experience of musculo-skeletal disorders,intensity of pain, and general conditions in work: The case of employees in non-private dental clinics in a county in southern Sweden.
    2001 (English)In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 17, p. 65-73Article in journal (Refereed) Published
    Abstract [en]

    Objectives: (1) To identify perceived musculo-skeletal disorders and intensity of pain among the employees in the nonprivate dental clinics; (2) To assess perceived psychosocial and physical work conditions on the localization and intensity of musculo-skeletal disorders and pain. Study design: A questionnaire, comprising four sections (demographic, self-reported psychosocial and physical work conditions, self-reported disorders from the musculo-skeletal system, self-reported intensity of pain on nine different localization on the body) was mailed to 391 employees. Of these, 338 reported musculo-skeletal disorders. In this latter group, 239 reported work as the cause. These employees completed the questionnaire. Results: The greatest amount of pain was reported for the cervico-brachial region. Among all participants, a response pattern was found where the physical work demands were very high, the psychosocial work demands fairly high, the work climate supportive, and the control over work moderate. At an occupational group level, theoretical inconsistencies were identified in terms of a lack of anticipated relationships, especially for the dentist groups. Conclusions: For a scientific and social purpose, more research, which identifies relationships between workrelated musculo-skeletal pain and dos-response [8], effortreward [16], and demand-control [12] aspects of the working conditions, is clearly needed.

    Keywords
    Physical and psychosocial work conditions, dosresponse model, effort-reward model, demand-control model, musculo-skeletal disorders and pain
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-45095 (URN)79661 (Local ID)79661 (Archive number)79661 (OAI)
    Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
    2. Perceived contra observed physical work load in Swedish dentists.
    Open this publication in new window or tab >>Perceived contra observed physical work load in Swedish dentists.
    Show others...
    2005 (English)In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 25, p. 253-262Article in journal (Refereed) Published
    Abstract [en]

    In an earlier questionnaire study, dentists reported high experienced physical work load in their profession, but low to moderate complaints from their musculoskeletal system. The correlation between reported physical work load and pain from the musculoskeletal system was weak. This discrepancy could not be satisfactorily explained. Therefore, a second study was undertaken, in which the same 27 dentists who reported musculoskeletal problems were video recorded during one hour of clinical work, and the records were later analyzed using PEO (Portable Ergonomic Observation). PEO is a frequency analysis method which allows observation of work in real time using a portable computer or video recordings. PEO can be adjusted for registration of single or multiple work operations. Output data are presented as frequency, duration, and sequence of the various work operations. The aim of the present study was to investigate if there was a relation between observed work load recorded with PEO, and subjectively estimated work load and musculoskeletal complaints recorded with a questionnaire based on Visual Analogue Scales. Sitting and standing postures, and head, trunk and arm movements were analyzed. The PEO observations showed that dentists generally perform their clinical work in a sitting position, with the head bent forward almost half of the time. Only weak to moderate correlations (r = 0.0-0.6) were found between observed physical work load and subjective estimations of experienced physical work load and musculoskeletal complaints. These findings support the results in our previous study, but they do not explain the large difference between the observed low work load and the subjectively experienced high work load. The study will be followed up by EMG measurements and free interviews, where both muscular load and psychosocial factors will be evaluated.

    Keywords
    Ergonomics, muscle fatigue, work load, musculoskeletal complaints, dental clinics, musculoskeletal disorders, physical demands
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-45096 (URN)79662 (Local ID)79662 (Archive number)79662 (OAI)
    Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
    3. Evaluation of muscular activity, local muscular fatigue, and muscular rest patterns among dentists
    Open this publication in new window or tab >>Evaluation of muscular activity, local muscular fatigue, and muscular rest patterns among dentists
    2005 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 63, p. 189-195Article in journal (Refereed) Published
    Abstract [en]

    In a previous study, dentists reported very high scores for perceived physical workload, but only low to moderate scores for the musculoskeletal system. This is difficult to explain when other occupational groups in the dental services are compared, and is the main reason why the present study was performed. To measure muscular activity, a surface electromyography (sEMG) study was done, and included the subjects who reported neck and shoulder complaints in the previous study. A portable sEMG system (MyoGuard) was used to collect a myoelectric signal on-line and analysis of the myoelectric signal in a computer. sEMG was recorded from both trapezius muscles for approximately 4 h during an ordinary working day. Twentyseven dentists participated in the study. The results show accumulated rest% fairly close to that of female cashiers and supermarket employees and increased average rectified value percent (ARV%) during work that could contribute to the very high workload perceived by dentists.

    Keywords
    Dentistry, ergonomics, surface electromyography
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-45097 (URN)10.1080/00016350510019964 (DOI)79663 (Local ID)79663 (Archive number)79663 (OAI)
    Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
    4. Relationships between psychosocial work environmental factors, personality, physical work demands and workload in a group of Swedish dentists
    Open this publication in new window or tab >>Relationships between psychosocial work environmental factors, personality, physical work demands and workload in a group of Swedish dentists
    2008 (English)In: Swedish Dental Journal, ISSN 0347-9994, Vol. 32, no 4, p. 197-204Article in journal (Refereed) Published
    Abstract [en]

    The aim of the study was to investigate, in a group of 77 Swedish dentists (36 males, 41 females) working in dental clinics, possible effects of psychosocial work environmental factors, personality traits, and social desirability tendencies on their reporting of their workload and of the physical demands placed on them.

    Participants were given questionnaires for assessing their workload, the physical and psychosocial demands of their job,their social support at work, and their control over their work situation, using a 10-cm visual analogue scale (V.A.S.). The Eysenck Personality Questionnaire (EPO) was also given to assess neuroticism and extraversion and the Marlowe-Crown SD-scale to measure tendencies to answer questions in a socially desirable manner.

    As in two earlier studies of ours, very high assessments were made of workload, physical work demands and social support. Higher assessments of workload and of physical work demands were found in those assessing the psychosocial work demands placed on them to be higher. Those assessing the work load of their job as higher also considered themselves to have less control over their work situation and were less extraverted.

    Despite these dentists perceiving themselves as being faced with a stressful work situation involving a high workload, strong physical and psychosocial demands being placed on them and their having a low degree of control over their work situation, the high degree of social support they experienced may have made their work situation less stressful.

    Keywords
    Workload, physical demands, psychosocial work factors, personality, dentists
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-16403 (URN)
    Available from: 2009-01-23 Created: 2009-01-23 Last updated: 2017-12-14
    5. Working conditions, health and productivity among dentists: a prospective study during rationalization in public dental care
    Open this publication in new window or tab >>Working conditions, health and productivity among dentists: a prospective study during rationalization in public dental care
    Show others...
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Background: Rationalizations comprising technological and organizational changes have been implemented in public dentistry in Sweden during the last decades. The effects on dentists´ work conditions health and production has not been investigated.

    Aim: This study aims to analyze changes and associations in dentists´ working conditions, health/illness and production during a period of rationalizations.

    Material: Sixty-five dentists responded to a questionnaire in 2003 and 2008, measuring work conditions and health. Production was followed in registers.

    Results: During the rationalization period the number of treated adult patients increased. Perceived physical work conditions improved, while work control conditions and perception of the leadership deteriorated. Health/illness was a mediating factor between work conditions and production.

    Conclusions: Rationalizations aiming to increase production must take into account employees' work conditions and effects on health/illness in order to achieve its goal.

    Keywords
    Dentistry; Rationalizations; Physical working conditions; Health, Structural Equation Modeling
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-65427 (URN)
    Available from: 2011-02-07 Created: 2011-02-07 Last updated: 2013-09-03
    Download full text (pdf)
    Work conditions, musculoskeletal disorders and productivity of dentists in public dental care in Sweden : Are dentists working smarter instead of harder?
    Download (pdf)
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  • 9.
    Rolander, Bo
    et al.
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Bellner, Anna-Lena
    University College of Health Sciences.
    Experience of musculo-skeletal disorders,intensity of pain, and general conditions in work: The case of employees in non-private dental clinics in a county in southern Sweden.2001In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 17, p. 65-73Article in journal (Refereed)
    Abstract [en]

    Objectives: (1) To identify perceived musculo-skeletal disorders and intensity of pain among the employees in the nonprivate dental clinics; (2) To assess perceived psychosocial and physical work conditions on the localization and intensity of musculo-skeletal disorders and pain. Study design: A questionnaire, comprising four sections (demographic, self-reported psychosocial and physical work conditions, self-reported disorders from the musculo-skeletal system, self-reported intensity of pain on nine different localization on the body) was mailed to 391 employees. Of these, 338 reported musculo-skeletal disorders. In this latter group, 239 reported work as the cause. These employees completed the questionnaire. Results: The greatest amount of pain was reported for the cervico-brachial region. Among all participants, a response pattern was found where the physical work demands were very high, the psychosocial work demands fairly high, the work climate supportive, and the control over work moderate. At an occupational group level, theoretical inconsistencies were identified in terms of a lack of anticipated relationships, especially for the dentist groups. Conclusions: For a scientific and social purpose, more research, which identifies relationships between workrelated musculo-skeletal pain and dos-response [8], effortreward [16], and demand-control [12] aspects of the working conditions, is clearly needed.

  • 10.
    Rolander, Bo
    et al.
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Jonker, Dirk
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Balogh, I.
    Department of Occupational and Environmental Medicine, Lund University, Sweden.
    Sandsjö, L.
    MedTech West/School of Engineering, University of Borås, Borås, Sweden..
    Winkel, J.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Svensson, Eva-Chris
    Linköping University, Department of Computer and Information Science. Linköping University, Faculty of Arts and Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Working conditions, health and productivity among dentists: a prospective study during rationalization in public dental careManuscript (preprint) (Other academic)
    Abstract [en]

    Background: Rationalizations comprising technological and organizational changes have been implemented in public dentistry in Sweden during the last decades. The effects on dentists´ work conditions health and production has not been investigated.

    Aim: This study aims to analyze changes and associations in dentists´ working conditions, health/illness and production during a period of rationalizations.

    Material: Sixty-five dentists responded to a questionnaire in 2003 and 2008, measuring work conditions and health. Production was followed in registers.

    Results: During the rationalization period the number of treated adult patients increased. Perceived physical work conditions improved, while work control conditions and perception of the leadership deteriorated. Health/illness was a mediating factor between work conditions and production.

    Conclusions: Rationalizations aiming to increase production must take into account employees' work conditions and effects on health/illness in order to achieve its goal.

  • 11.
    Rolander, Bo
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Jonker, Dirk
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Balogh, Istvan
    Department of Occupational and Environmental Medicine, Lund University, Sweden.
    Sandsjö, Leif
    Occupational and Environmental Medicine, Dept of Public Health and Community Medicine, The Sahlgrenska Academy at University of Gothenburg, Sweden.
    Winkel, Jörgen
    National Research Centre for the Working Environment, Copenhagen, Denmark/Department of Work Science, University of Gothenburg, Sweden.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Physical demands and reported illness among dentists - A longitudinal approach.2008Conference paper (Refereed)
  • 12.
    Rolander, Bo
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Jonker, Dirk
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Balogh, Istvan
    Lund University, Sweden.
    Sandsjö, Leif
    Sahlgrenska Academy at University of Gothenburg, Sweden.
    Winkel, Jörgen
    National Research Centre for the Working Environment, Copenhagen, Denmark/Department of Work Science, University of Gothenburg, Sweden.
    Svensson, E.
    Ekberg, Kerstin
    Linköping University, HELIX Vinn Excellence Centre. Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Impact on working conditions, productivity and health of dentists – a prospective study during rationalizations in public dental care2010Conference paper (Other academic)
  • 13.
    Rolander, Bo
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Jonker, Dirk
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Balogh, Istvan
    Department of Occupational and Environmental Medicine, Lund University, Sweden.
    Sandsjö, Leif
    Occupational and Environmental Medicine, Dept of Public Health and Community Medicine, The Sahlgrenska Academy at University of Gothenburg, Sweden.
    Winkel, Jörgen
    National Research Centre for the Working Environment, Copenhagen, Denmark/Department of Work Science, University of Gothenburg, Sweden.
    Svensson, E.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Rationalization in public dental care and its impact on working conditions, productivity and health of dentists - a prospective study.Manuscript (preprint) (Other academic)
  • 14.
    Rolander, Bo
    et al.
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Jonker, Dirk
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Karsznia, Alek
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Öberg, Tommy
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Evaluation of muscular activity, local muscular fatigue, and muscular rest patterns among dentists2005In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 63, p. 189-195Article in journal (Refereed)
    Abstract [en]

    In a previous study, dentists reported very high scores for perceived physical workload, but only low to moderate scores for the musculoskeletal system. This is difficult to explain when other occupational groups in the dental services are compared, and is the main reason why the present study was performed. To measure muscular activity, a surface electromyography (sEMG) study was done, and included the subjects who reported neck and shoulder complaints in the previous study. A portable sEMG system (MyoGuard) was used to collect a myoelectric signal on-line and analysis of the myoelectric signal in a computer. sEMG was recorded from both trapezius muscles for approximately 4 h during an ordinary working day. Twentyseven dentists participated in the study. The results show accumulated rest% fairly close to that of female cashiers and supermarket employees and increased average rectified value percent (ARV%) during work that could contribute to the very high workload perceived by dentists.

  • 15.
    Rolander, Bo
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Jonker, Dirk
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Winkel, J
    University of Gothenburg, Sweden.
    Sandsjo, L
    University of Borås, Sweden.
    Balogh, I
    Lund University, Sweden.
    Svensson, Erland
    Linköping University, Department of Computer and Information Science. Linköping University, The Institute of Technology.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Working conditions, health and productivity among dentists in Swedish public dental care - a prospective study during a 5-year period of rationalisation2013In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 56, no 9, p. 1376-1386Article in journal (Refereed)
    Abstract [en]

    In recent decades, comprehensive rationalisations have been implemented in public dentistry in Sweden. How rationalisations affect working conditions, health and production from a long-term perspective has been poorly investigated. This study aims to analyse changes and associations in dentists' working conditions, health and productivity during a 5-year period. In 2003 and 2008, 65 dentists responded to questionnaires measuring work conditions and health. Treatment times for patients and productivity were tracked in electronic registers. Paired t-tests showed that the number of treated adult patients per dentist increased, and perceived physical working conditions improved while perceived work control and leadership deteriorated. Structural equation modelling showed that physical factors were important for health and productivity. When assessing risks in the work environment, there is a need to understand the interaction of effects on working conditions and health due to rationalisations so as to increase the sustainability of production systems.

    Practioner Summary: Dentistry in Sweden has undergone considerable change. Questionnaire surveys with dentists, undertaken in 2003 and 2008, found that the present rationalisations resulted in improved perceived physical working conditions. Aspects of the psychosocial working environment had deteriorated, however. This is a concern as health and workability are important for workplace efficiency.

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  • 16.
    Rolander, Bo
    et al.
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Karsznia, Alek
    School of Health Sciences Jönköping university.
    Jonker, Dirk
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation.
    Öberg, Tommy
    School of Health Sciences Jönköping University.
    Bellner, Anna-Lena
    School of Health Sciences Jönköping University.
    Perceived contra observed physical work load in Swedish dentists.2005In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 25, p. 253-262Article in journal (Refereed)
    Abstract [en]

    In an earlier questionnaire study, dentists reported high experienced physical work load in their profession, but low to moderate complaints from their musculoskeletal system. The correlation between reported physical work load and pain from the musculoskeletal system was weak. This discrepancy could not be satisfactorily explained. Therefore, a second study was undertaken, in which the same 27 dentists who reported musculoskeletal problems were video recorded during one hour of clinical work, and the records were later analyzed using PEO (Portable Ergonomic Observation). PEO is a frequency analysis method which allows observation of work in real time using a portable computer or video recordings. PEO can be adjusted for registration of single or multiple work operations. Output data are presented as frequency, duration, and sequence of the various work operations. The aim of the present study was to investigate if there was a relation between observed work load recorded with PEO, and subjectively estimated work load and musculoskeletal complaints recorded with a questionnaire based on Visual Analogue Scales. Sitting and standing postures, and head, trunk and arm movements were analyzed. The PEO observations showed that dentists generally perform their clinical work in a sitting position, with the head bent forward almost half of the time. Only weak to moderate correlations (r = 0.0-0.6) were found between observed physical work load and subjective estimations of experienced physical work load and musculoskeletal complaints. These findings support the results in our previous study, but they do not explain the large difference between the observed low work load and the subjectively experienced high work load. The study will be followed up by EMG measurements and free interviews, where both muscular load and psychosocial factors will be evaluated.

  • 17.
    Rolander, Bo
    et al.
    Occupational Safety and Health Centre, County Hospital Ryhov, Jönköping.
    Karsznia, Alek
    School of Health Sciences, Jönköping University, Jönköping.
    Jonker, Dirk
    Occupational Safety and Health Centre, County Hospital Ryhov, Jönköping.
    Öberg, Tommy
    School of Health Sciences, Jönköping University, Jönköping.
    Bellner, Anna-Lena
    School of Health Sciences, Jönköping University, Jönköping.
    Perceived contra observed physical workload in Swedish dentists.2005In: WORK: A Journal of Prevention, Assessment, & Rehabilitation, ISSN 1051-9815, Vol. 25, p. 253-262Article in journal (Refereed)
    Abstract [en]

    In an earlier questionnaire study, dentists reported high experienced physical work load in their profession, but low to moderate complaints from their musculoskeletal system. The correlation between reported physical work load and pain from the musculoskeletal system was weak. This discrepancy could not be satisfactorily explained. Therefore, a second study was undertaken, in which the same 27 dentists who reported musculoskeletal problems were video recorded during one hour of clinical work, and the records were later analyzed using PEO (Portable Ergonomic Observation). PEO is a frequency analysis method which allows observation of work in real time using a portable computer or video recordings. PEO can be adjusted for registration of single or multiple work operations. Output data are presented as frequency, duration, and sequence of the various work operations. The aim of the present study was to investigate if there was a relation between observed work load recorded with PEO, and subjectively estimated work load and musculoskeletal complaints recorded with a questionnaire based on Visual Analogue Scales. Sitting and standing postures, and head, trunk and arm movements were analyzed. The PEO observations showed that dentists generally perform their clinical work in a sitting position, with the head bent forward almost half of the time. Only weak to moderate correlations (r = 0.0–0.6) were found between observed physical work load and subjective estimations of experienced physical work load and musculoskeletal complaints. These findings support the results in our previous study, but

     

     

    they do not explain the large difference between the observed low work load and the subjectively experienced high work load. The study will be followed up by EMG measurements and free interviews, where both muscular load and psychosocial factors will be evaluated.

     

     

  • 18.
    Rolander, Bo
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Stenström, Ulf
    Växjö University.
    Jonker, Dirk
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Relationships between psychosocial work environmental factors, personality, physical work demands and workload in a group of Swedish dentists2008In: Swedish Dental Journal, ISSN 0347-9994, Vol. 32, no 4, p. 197-204Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to investigate, in a group of 77 Swedish dentists (36 males, 41 females) working in dental clinics, possible effects of psychosocial work environmental factors, personality traits, and social desirability tendencies on their reporting of their workload and of the physical demands placed on them.

    Participants were given questionnaires for assessing their workload, the physical and psychosocial demands of their job,their social support at work, and their control over their work situation, using a 10-cm visual analogue scale (V.A.S.). The Eysenck Personality Questionnaire (EPO) was also given to assess neuroticism and extraversion and the Marlowe-Crown SD-scale to measure tendencies to answer questions in a socially desirable manner.

    As in two earlier studies of ours, very high assessments were made of workload, physical work demands and social support. Higher assessments of workload and of physical work demands were found in those assessing the psychosocial work demands placed on them to be higher. Those assessing the work load of their job as higher also considered themselves to have less control over their work situation and were less extraverted.

    Despite these dentists perceiving themselves as being faced with a stressful work situation involving a high workload, strong physical and psychosocial demands being placed on them and their having a low degree of control over their work situation, the high degree of social support they experienced may have made their work situation less stressful.

  • 19.
    Rolander, Bo
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Stenström, Urban
    Linnéuniversitetet, Växjö.
    Jonker, Dirk
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Relationships between psychosocial work environmental factors, personality, physical work demands and workload in a group of Swedish dentists2008In: Swedish Dental Journal, ISSN 0347-9994, Vol. 32, p. 197-203Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to investigate, in a group of 77 Swedish dentists (36 males, 41 females) working in dental clinics, possible effects of psychosocial work environmental factors, personality traits, and social desirability tendencies on their reporting of their workload and of the physical demands placed on them. Participants were given questionnaires for assessing their workload, the physical and psychosocial demands of their job, their social support at work, and their control over their work situation, using a 10-cm visual analogue scale (V.A.S.). The Eysenck Personality Questionnaire (EPQ) was also given to assess neuroticism and extraversion and the Marlowe-Crown SD-scale to measure tendencies to answer questions in a socially desirable manner. As in two earlier studies of ours, very high assessments were made of workload, physical work demands and social support. Higher assessments of workload and of physical work demands were found in those assessing the psychosocial work demands placed on them to be higher. Those assessing the work load of their job as higher also considered themselves to have less control over their work situation and were less extraverted. Despite these dentists perceiving themselves as being faced with a stressful work situation involving a high workload, strong physical and psychosocial demands being placed on them and their having a low degree of control over their work situation, the high degree of social support they experienced may have made their work situation less stressful.

  • 20.
    Sjöholm, Hanna
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Rehabilitation Centre, Region Jönköping County, Jönköping, Sweden.
    Hägg, Staffan
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pharmacology. Futurum, Region Jönköping County, Jönköping, Sweden.
    Nyberg, Lars
    Department of Health Sciences, Luleå University of Technology, Luleå, Sweden.
    Rolander, Bo
    Futurum, Region Jönköping County, Jönköping, Sweden.
    Kammerlind, Ann-Sofi
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Futurum, Region Jönköping County, Jönköping, Sweden.
    Correction: The Cone Evasion Walk test: Reliability and validity in acute stroke (vol 24, e1744, 2019)2019In: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, Vol. 24, no 3, article id e1801Article in journal (Other academic)
    Abstract [en]

    n/a

  • 21.
    Sjölander, Catarina
    et al.
    The School of Health Sciences, Jönköping University, Jönköping, The Ryhov County Hospital, Jönköping.
    Rolander, Bo
    The Ryhov County Hospital, Jönköping, Sweden .
    Järhult, Johannes
    The Ryhov County Hospital, Jönköping, Sweden .
    Mårtensson, Jan
    The School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Ahlström, Gerd
    The Swedish Institute for Health Sciences, Lund University, Lund, Sweden.
    Health-related quality of life in family members of patients with an advanced cancer diagnosis: A prospective one-year study2011In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525Article in journal (Refereed)
1 - 21 of 21
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