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  • 1.
    Bergman, Peter N.
    et al.
    Karolinska Institute, Sweden .
    Ahlberg, Gunnel
    Malardalen University, Sweden .
    Johansson, Gun
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Stoetzer, Ulrich
    Karolinska Institute, Sweden .
    Aborg, Carl
    Karolinska Institute, Sweden .
    Hallsten, Lennart
    Karolinska Institute, Sweden .
    Lundberg, Ingvar
    University of Uppsala Hospital, Sweden .
    Do job demands and job control affect problem-solving?2012In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 42, no 2, p. 195-203Article in journal (Refereed)
    Abstract [en]

    Objective: The Job Demand Control model presents combinations of working conditions that may facilitate learning, the active learning hypothesis, or have detrimental effects on health, the strain hypothesis. To test the active learning hypothesis, this study analysed the effects of job demands and job control on general problem-solving strategies. Participants: A population-based sample of 4,636 individuals (55% women, 45% men) with the same job characteristics measured at two times with a three year time lag was used. Methods: Main effects of demands, skill discretion, task authority and control, and the combined effects of demands and control were analysed in logistic regressions, on four outcomes representing general problem-solving strategies. Results: Those reporting high on skill discretion, task authority and control, as well as those reporting high demand/high control and low demand/high control job characteristics were more likely to state using problem solving strategies. Conclusions: Results suggest that working conditions including high levels of control may affect how individuals cope with problems and that workplace characteristics may affect behaviour in the non-work domain.

  • 2.
    Fagerlind, Anna-Carin
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Gustavsson, Maria
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Johansson, Gun
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Experience of work-related flow: Does high decision latitude enhance benefits gained from job resources?2013In: Journal of Vocational Behavior, ISSN 0001-8791, E-ISSN 1095-9084, Vol. 83, no 2, p. 161-170Article in journal (Refereed)
    Abstract [en]

    Flow is an experience of enjoyment, intrinsic motivation and absorption, which may occur in situations involving high challenges and high skill utilization. This study investigated the likelihood of experiencing work-related flow in relation to the job strain categories of the demand–control model, and to job resources such as social capital and an innovative learning climate. A questionnaire was sent out to employees in nine Swedish organizations (n = 3667, 57% response rate). Binary logistic regression analysis was performed. The results show that active jobs, low-strain jobs, a high degree of social capital and innovative learning climate increased the likelihood of experiencing work-related flow. In jobs with high decision latitude, regardless of demands, there was an increased likelihood to benefit from social capital and an innovative learning climate. The results emphasize the importance of autonomy and skill utilization, to enable the use of additional job resources in order to promote work-related flow and well-being at work.

  • 3.
    Hultin, Hanna
    et al.
    Karolinska Institute, Sweden.
    Hallqvist, Johan
    Uppsala University, Sweden.
    Alexanderson, Kristina
    Karolinska Institute, Sweden.
    Johansson, Gun
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Lindholm, Christina
    Karolinska Institute, Sweden.
    Lundberg, Ingvar
    Uppsala University, Sweden.
    Moller, Jette
    Karolinska Institute, Sweden.
    Lack of Adjustment Latitude at Work as a Trigger of Taking Sick Leave: A Swedish Case-Crossover Study2013In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 8, no 4Article in journal (Refereed)
    Abstract [en]

    Objectives

    Research has shown that individuals reporting a low level of adjustment latitude, defined as having few possibilities to temporarily adjust work demands to illness, have a higher risk of sick leave. To what extent lack of adjustment latitude influences the individual when making the decision to take sick leave is unknown. We hypothesize that ill individuals are more likely to take sick leave on days when they experience a lack of adjustment latitude at work than on days with access to adjustment latitude.

    Methods

    A case-crossover design was applied to 546 sick-leave spells, extracted from a cohort of 1 430 employees at six Swedish workplaces, with a 3–12 month follow-up of all new sick-leave spells. Exposure to lack of adjustment latitude on the first sick-leave day was compared with exposure during several types of control periods sampled from the previous two months for the same individual.

    Results

    Only 35% of the respondents reported variations in access to adjustment latitude, and 19% reported a constant lack of adjustment latitude during the two weeks prior to the sick-leave spell. Among those that did report variation, the risk of sick leave was lower on days with lack of adjustment latitude, than on days with access (Odds Ratio 0.36, 95% Confidence Interval 0.25–0.52).

    Conclusions

    This is the first study to show the influence of adjustment latitude on the decision to take sick leave. Among those with variations in exposure, lack of adjustment latitude was a deterrent of sick leave, which is contrary to the à priori hypothesis. These results indicate that adjustment latitude may not only capture long-lasting effects of a flexible working environment, but also temporary possibilities to adjust work to being absent. Further studies are needed to disentangle the causal mechanisms of adjustment latitude on sick-leave.

  • 4.
    Hultin, Hanna
    et al.
    Karolinska Institutet.
    Hallqvist, Johan
    Karolinska Institutet.
    Alexanderson, Kristina
    Karolinska Institutet.
    Johansson, Gun
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Lindholm, Christina
    Karolinska Institutet.
    Lundberg, Ingvar
    Akademiska Sjukhuset.
    Möller, Jette
    Karolinska Institutet.
    Low level of adjustment latitude--a risk factor for sickness absence2010In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 20, no 6, p. 682-688Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The prerequisite for obtaining sickness benefit is reduced work ability for medical reasons in combination with work demands which cannot be adjusted accordingly. The aim of this study was to investigate if low levels of adjustment latitude, defined as the possibility to temporarily adjust work demands in case of ill health, influence sickness absence.

    METHODS: A prospective cohort study of 1420 employees (47% participation, aged 19-68; 56% women) was conducted at six Swedish workplaces. Exposure to two general and nine specific types of adjustment latitude was ascertained at baseline. Outcome was defined as the first new employer-reported sick-leave spell during a follow-up of 3-12 months. Hazard ratios (HR) of sick leave, with 95% confidence intervals (CI), were estimated by Cox proportional hazards regression.

    RESULTS: The incidence of sickness absence was 2.85/1000 person-days. The self-reported reasons for sick leave were mainly minor complaints such as colds, influenzas and headaches. Employees lacking adjustment latitude had an adjusted HR of sickness absence of 1.51 (95% CI 1.08-2.11). Among specific adjustment latitude types, those not having the possibility to work from home generated an HR of 1.86 (95% CI 1.31-2.64). The effects of lack of adjustment latitude were similar for men and women but seemed to vary between different occupations.

    CONCLUSION: A low level of adjustment latitude at work is a risk factor for sickness absence.

  • 5.
    Hultin, Hanna
    et al.
    Karolinska Institutet, Department of Public Health Sciences.
    Hallqvist, Johan
    Karolinska Institutet, Department of Public Health Sciences.
    Alexandersson, Kristina
    Karolinska Institutet, Department of Clinical Neuroscience.
    Johansson, Gun
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Christina, Lindholm
    Karolinska Institutet, Department of Clinical Neuroscience.
    Lundberg, Ingvar
    Uppsala University, Department of Medical Sciences.
    Möller, Jette
    Karolinska Institutet, Department of Public Health Sciences.
    Work-related psychosocial events as triggers of sickleave – results from a Swedish case-crossover study2011In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 11, no 175Article in journal (Refereed)
    Abstract [en]

    Background

    Although illness is an important cause of sick leave, it has also been suggested that

    non-medical risk factors may influence this association. If such factors impact on the

    period of decision making, they should be considered as triggers. Yet, there is no

    empirical support available.

    The aim was to investigate whether recent exposure to work-related psychosocial

    events can trigger the decision to report sick when ill.

    Methods

    A case-crossover design was applied to 546 sick-leave spells, extracted from a

    Swedish cohort of 1 430 employees with a 3-12 month follow-up of new sick-leave

    spells. Exposure in a case period corresponding to an induction period of one or two

    days was compared with exposure during control periods sampled from workdays

    during a two-week period prior to sick leave for the same individual. This was done

    according to the matched-pair interval and the usual frequency approaches. Results

    are presented as odds ratios (OR) with 95% confidence intervals (CI).

    Results

    Most sick-leave spells happened in relation to acute, minor illnesses that substantially

    reduced work ability. The risk of taking sick leave was increased when individuals

    had recently been exposed to problems in their relationship with a superior (OR 3.63;

    CI 1.44-9.14) or colleagues (OR 4.68; CI 1.43-15.29). Individuals were also more

    inclined to report sick on days when they expected a very stressful work situation than

    on a day when they were not under such stress (OR 2.27; CI 1.40-3.70).

    Conclusions

    Exposure to problems in workplace relationships or a stressful work situation seems

    to be able to trigger reporting sick. Psychosocial work-environmental factors appear

    to have a short-term effect on individuals when deciding to report sick.

  • 6.
    Hultin, Hanna
    et al.
    Karolinska Institute.
    Moller, Jette
    Karolinska Institute.
    Alexanderson, Kristina
    Karolinska Institute.
    Johansson, Gun
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Lindholm, Christina
    Karolinska Institute.
    Lundberg, Ingvar
    Uppsala University.
    Hallqvist, Johan
    Karolinska Institute.
    Low Workload as a Trigger of Sick Leave Results From a Swedish Case-Crossover Study2012In: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948, Vol. 54, no 2, p. 202-209Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate if exposure to an unusually low workload when ill can trigger taking sick leave. Methods: A case-crossover design was applied to 546 sick-leave spells obtained from a cohort of 1430 employees within six Swedish workplaces. New sick-leave spells were reported from the workplaces during 3 to 12 months follow-up. Exposure was assessed in structured participant interviews at sick leave. Case and control periods from the same individual were sampled according to the matched-pair and usual-frequency approaches. Results are presented as odds ratios with surrounding 95% confidence intervals. Results: The odds ratio of sick leave on a day with an unusually low workload was 2.57 (confidence interval, 1.07-6.16). Conclusions: Becoming ill on a day with a lower workload than usual can trigger the decision to take sick leave.

  • 7.
    Johansson, Gun
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Anpassningar av arbetet vid ohälsa2009In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 86, no 3, p. 256-264Article in journal (Refereed)
    Abstract [sv]

    Att anpassa arbete till ohälsa är ett sätt att hantera bristande överensstämmelse mellan arbetets krav och individens kapacitet. En uppdelning kan göras mellan anpassningsmöjligheter, som "naturligt" finns i arbetet, och modifierat arbete, som innebär förändring av arbetssituationen som ett led i rehabilitering. Studier visar att ju fler anpassningsmöjligheter en person har i arbetet ju större är sannolikheten att han eller hon återgår i arbete efter lång sjukskrivning. Starkt stöd finns även för att modifierat arbete ökar sannolikheten att återgå efter lång sjukskrivning. Modifierat arbete kan dock ge upphov till negativa reaktioner bland arbetskamrater och därmed påverka modifieringarna negativt. Arbetsgivare kan även reagera olika på individers återgång i arbete efter sjukskrivning. Möjligheter till ett modifierat arbete kan t.ex. sammanhänga med en välkomnande attityd från arbetsgivaren.

  • 8.
    Johansson, Gun
    Institutionen för folkhälsovetenskap, Avdelningen för arbets- och miljömedicin, Karolinska Institutet.
    Return to work and adjustment latitude among employees on long-term sickness absence2006In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 16, no 2, p. 181-191Article in journal (Refereed)
    Abstract [en]

    Introduction: The aim was to study whether return to work (RTW) after long-term sickness absence is affected by adjustment latitude i.e. opportunities to adjust one's work to one's state of health by e.g. choosing among work tasks and deciding about work pace and working hours. We also studied whether the effect of adjustment latitude differed between those returning full-time and those returning part-time.

    Methods: Differences between men and women were also studied. A questionnaire was sent to 5,590 salaried employees who had been on sick leave for at least 90 days in 2000. The year after, 2001, they received a questionnaire which included questions about work status, working conditions, adjustment latitude and health.

    Results: The questionnaire was returned from 3056 persons. Among women 32% were fully back to work, 34% were partly back and 34% were still on sick leave. Comparable figures for men were 33%, 32% and 36%.

    Conclusion: For both men and women the likelihood to RTW increased with increasing number of opportunities to adjust. Adjustment latitude increased returning to part-time as well as full-time work. The study indicates that work organisation is important for RTW.

  • 9.
    Johansson, Gun
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Ekberg, KerstinLinköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Arbetslivsinriktad rehabilitering2009Conference proceedings (editor) (Refereed)
  • 10.
    Johansson, Gun
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Hultin, Hanna
    Karolinska Institutet, Department of Public Health Sciences.
    Möller, Jette
    Karolinska Institutet, Department of Public Health Sciences.
    Hallqvist, Johan
    Karolinska Institutet, Department of Public Health Sciences.
    Kjellberg, Katarina
    Karolinska Institutet, Department of Public Health Sciences.
    The impact of adjustment latitude on self-assessed work ability in regard to gender and occupational type2012In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 19, no 4, p. 350-359Article in journal (Refereed)
    Abstract [en]

    Objective: Adjustment latitude describes opportunities to change demands at work when ill and may affect work ability. The aim here is to study the association between adjustment latitude and self-assessed work ability among men and women and employees from different occupational sectors.

    Methods: This cross-sectional study used data from a questionnaire sent to 3020 employees in three occupational sectors in Sweden; 1430 responded. Subjects were divided into: full, moderately reduced, and greatly reduced work ability. Presence of nine adjustment opportunities was requested and subjects were divided into three groups. Each specific opportunity was also analyzed in relation to work ability. Multinomial logistic regression was used for analyses.

    Results: Number of opportunities to adjust was associated with work ability among men and employees in health care. "Shortening the working day" was associated with work ability in most groups. For men and industrial employees, "postponing work", "going home and working later", and "working without disturbance" were associated with work ability. "To work from home" was associated with work ability among women and employees in insurance.

    Conclusions: The assumption that adjustment latitude affects work ability is supported. Associations differ with regard to gender and occupational sectors. Further studies with longitudinal design and alternative samples are needed.

  • 11.
    Johansson, Gun
    et al.
    Karolinska Institutet.
    Lundberg, Ingvar
    Karolinska Institutet.
    Adjustment latitude and attendance requirements as determinants of sickness absence or attendance: Empirical tests of the illness flexibility model2004In: Social Science & Medicine, ISSN 0277-9536, Vol. 58, no 10, p. 1857-1868Article in journal (Refereed)
    Abstract [en]

    This study investigates whether the two dimensions of illness flexibility at work, adjustment latitude and attendance requirements are associated to sickness absence and sickness attendance. Adjustment latitude describes the opportunities people have to reduce or in other ways change their work-effort when ill. Such opportunities can be to choose among work tasks or work at a slower pace. Attendance requirements describe negative consequences of being away from work that can affect either the subject, work mates or a third party. In a cross-sectional design data based on self-reports from a questionnaire from 4924 inhabitants in the county of Stockholm were analysed. The results showed that low adjustment latitude, as predicted, increased women's sickness absence. However, it did not show any relation to men's sickness absence and men's and women's sickness attendance. Attendance requirements were strongly associated to both men's and women's sickness absence and sickness attendance in the predicted way. Those more often required to attend were less likely to be absent and more likely to attend work at illness. As this is the first study of how illness flexibility at work affects behaviour at illness, it was concluded that more studies are needed.

  • 12.
    Johansson, Gun
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Lundberg, Ingvar
    Institutionen för medicinska vetenskaper, Arbets- och miljömedicin, Medicinska fakulteten, Uppsala Universitet.
    Components of the Illness Flexibility Model as Explanations of Socioeconomic Differences in Sickness Absence2009In: International Journal of Health Services, ISSN 0020-7314, E-ISSN 1541-4469, Vol. 39, no 1, p. 123-138Article in journal (Refereed)
    Abstract [en]

    The authors studied the social gradient in sickness absence in relation to components of the illness flexibility model, which highlights conditions affecting whether people attend work when they are ill. The conditions studied were: adjustment latitude, attendance requirements at work, stimulating work, and health. The population sample was part of a panel originating in 1994 when 15,154 inhabitants of Stockholm County were randomly selected to receive a questionnaire covering, among other things, health and psychosocial conditions. New questionnaires were sent to the respondents in 1998 and 2002. This article analyzes the 2002 data, for 1,634 women and 1,063 men. These respondents had reported being employed or on leave of absence. In this sample, a social difference was found in sickness absence of 31 days or more per year. For manual workers, women had an odds ratio (OR) of 2.8 and men an OR of 3.4 for such absence compared with nonmanual workers of both sexes in high socioeconomic positions. All single potential confounders decreased these ORs. Adding all characteristics decreased the OR by 78 percent for women and 67 percent for men. The results indicate that the social gradient in sickness absence is due to differences in health and in working conditions when one is ill.

  • 13.
    Nordström, Karin
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    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.
    Hemmingsson, Tomas
    Arbets- och miljömedicin, Institutionen för folkhälsovetenskap, Karolinska Institutet.
    Johansson, Gun
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Rörlighet på arbetsmarknaden och återgång i arbete. Posterpresentation.2011Conference paper (Refereed)
  • 14.
    Nordström, Karin
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    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.
    Hemmingsson, Tomas
    Arbets- och miljömedicin, Institutionen för folkhälsovetenskap, Karolinska Institutet.
    Johansson, Gun
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Sick leave and the impact of job-to-job mobility on future vocational situation.2012Conference paper (Other academic)
  • 15.
    Nordström, Karin
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Linköping University, HELIX Vinn Excellence Centre.
    Hemmingsson, Tomas
    Arbets- och miljömedicin, Institutionen för folkhälsovetenskap, Karolinska Institutet.
    Johansson, Gun
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Sick leave and the impact of job-to-job mobility on the future vocational situation2014In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 305Article in journal (Refereed)
    Abstract [en]

    Background: Change of job could be a strategy in vocational rehabilitation when return to the original job is not possible, but research is very limited concerning the effects of job mobility on the future vocational situation. The aim of the study was to investigate whether job-to-job mobility affects the likelihood of remaining on the labour market over time among persons who are employed and have experienced long-term sick leave.

    Methods: In a longitudinal register study, cohorts from three base years (1994, 1999 and 2004) were created, based on the Swedish population who were 20–60 years old, had sickness allowance insurance, and were employed in the base year and the following year (n > 3,000,000). The likelihood that individuals on long-term sick leave were employed later depending on whether or not they changed workplace during the present or next year of long-term sick leave was analyzed using logistic regression analysis. Age, sector, industry, children, marital status, education, income, rate of sick leave and earlier sick leave and earlier mobility were taken into consideration.

    Results: Women with more than 180 days’ sick leave who changed workplaces were more likely to have a job later compared with those who did not change jobs. For men, the association was statistically significant with 1994 and 2004 as base years, but not in the cohort from 1999.

    Conclusions: The present study indicates that for those on long-term sick leave that changed workplaces, the opportunities to stay on the labour market might increase. However, the study has methodological limitations and the results for men are ambiguous. We do not therefore have enough evidence for recommending job change as a strategy for vocational rehabilitation.

  • 16.
    Peolsson, Anneli
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Landén Ludvigsson, Maria
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Overmeer, Thomas
    Malardalen University, Sweden .
    Dedering, Asa
    Karolinska University Hospital, Sweden .
    Bernfort, Lars
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Allergy Center.
    Johansson, Gun
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Kammerlind, Ann-Sofi
    Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Peterson, Gunnel
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Effects of neck-specific exercise with or without a behavioural approach in addition to prescribed physical activity for individuals with chronic whiplash-associated disorders: a prospective randomised study2013In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 14, no 311Article in journal (Refereed)
    Abstract [en]

    Background: Up to 50% of chronic whiplash associated disorders (WAD) patients experience considerable pain and disability and remain on sick-leave. No evidence supports the use of physiotherapy treatment of chronic WAD, although exercise is recommended. Previous randomised controlled studies did not evaluate the value of adding a behavioural therapy intervention to neck-specific exercises, nor did they compare these treatments to prescription of general physical activity. Few exercise studies focus on patients with chronic WAD, and few have looked at patients ability to return to work and the cost-effectiveness of treatments. Thus, there is a great need to develop successful evidence-based rehabilitation models. The study aim is to investigate whether neck-specific exercise with or without a behavioural approach (facilitated by a single caregiver per patient) improves functioning compared to prescription of general physical activity for individuals with chronic WAD. less thanbrgreater than less thanbrgreater thanMethods/Design: The study is a prospective, randomised, controlled, multi-centre study with a 2-year follow-up that includes 216 patients with chronic WAD (andgt;6 months and andlt;3 years). The patients (aged 18 to 63) must be classified as WAD grade 2 or 3. Eligibility will be determined with a questionnaire, telephone interview and clinical examination. The participants will be randomised into one of three treatments: (A) neck-specific exercise followed by prescription of physical activity; (B) neck-specific exercise with a behavioural approach followed by prescription of physical activity; or (C) prescription of physical activity alone without neck-specific exercises. Treatments will be performed for 3 months. We will examine physical and psychological function, pain intensity, health care consumption, the ability to resume work and economic health benefits. An independent, blinded investigator will perform the measurements at baseline and 3, 6, 12 and 24 months after inclusion. The main study outcome will be improvement in neck-specific disability as measured with the Neck Disability Index. All treatments will be recorded in treatment diaries and medical records. less thanbrgreater than less thanbrgreater thanDiscussion: The study findings will help improve the treatment of patients with chronic WAD.

  • 17.
    Stoetzer, Ulrich
    et al.
    Karolinska Institute, Sweden .
    Aborg, Carl
    Karolinska Institute, Sweden .
    Johansson, Gun
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Svartengren, Magnus
    Karolinska Institute, Sweden .
    Organization, relational justice and absenteeism2014In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 47, no 4, p. 521-529Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: There is a need for more knowledge on how to manage companies towards healthier and more prosperous organizations with low levels of absenteeism. Relational Justice can be a useful concept when managing such organizations. OBJECTIVE: Organizational factors can help to explain why some companies have relatively low absenteeism rates, even though they are equal to other companies in many other aspects. Previous studies suggest that management may be one important factor. Efficient management may depend on good relations between the leaders and the employees. The concept of Relational Justice is designed to capture these relations. Consequently, a Relational Justice framework may be used to understand why some companies have a low incidence of absenteeism. PARTICIPANTS: Managers from a representative body of Swedish companies. METHODS: Interviews were analyzed to explore whether the items representing the concept of Relational Justice can be used to further understand the strategies, procedures and structures that characterize organizations and management in companies with a low incidence of absenteeism. RESULTS: Strategies, procedures or principles related to Relational Justice were common and highlighted in companies with an incidence of absenteeism. The most frequently occurring factors were; to be treated with kindness and consideration, personal viewpoint considered and to be treated impartially. CONCLUSIONS: The results suggested that a Relational Justice framework could be used to increase understanding of the organizational and managerial factors typical for companies with a low incidence of absenteeism. A Relational Justice approach to organizational management may be used to successfully lower absenteeism, change organizations and promote healthy and prosperous companies.

  • 18.
    Stoetzer, Ulrich
    et al.
    Karolinska Institutet.
    Ahlberg, Gunnel
    Avdelningen för psykologi, Akademin för hållbar samhälls- och teknikutveckling, Mälardalens högskola.
    Johansson, Gun
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Bergman, Peter
    Karolinska Institutet.
    Hallsten, Lennart
    Karolinska Institutet.
    Forsell, Yvonne
    Karolinska Institutet.
    Lundberg, Ingvar
    Institutionen för medicinska vetenskaper, Arbets- och miljömedicin, Medicinska fakulteten, Uppsala Universitet.
    Problematic Interpersonal Relationships at Work and Depression: A Swedish Prospective Cohort Study2009In: Journal of Occupational Health, ISSN 1341-9145, E-ISSN 1348-9585, Vol. 51, no 2, p. 144-151Article in journal (Refereed)
    Abstract [en]

    Problematic Interpersonal Relationships at Work and Depression: A Swedish Prospective Cohort Study: Ulrich STOETZER, et al. Department of Public Health Sciences, Occupational and Environmental Medicine, Karolinska Institutet, Sweden-Objectives: Studies have shown that interpersonal relations at work are important for several health related outcomes. The aim of the present study was to investigate whether low social support, serious conflict, exclusion by superiors or by co-workers at work may be determinants of depression. Methods: In a representative Swedish cohort study data were obtained in two waves three years apart. 4,040 women and men who did not change their jobs between the waves were chosen for the study. Exposure and confounders were obtained at Time 1 and outcome, depression according to Bechs MDI at Time 2. Previous depression was controlled for by adjusting for depression at Time 1. Data were analyzed using multiple logistic regression analyses. Results: Odds-ratios adjusted for possible confounders and depression at base-line showed significant effects for all four exposures on depression (adjusted OR, low social support 1.5 CI 95% 1.1-2.0, serious conflict 1.4 CI 95% 1.1-1.9, exclusion by superiors 1.6 CI 5% 1.2-2.1 and exclusion by co-workers 1.7 CI 95% 1.22.3). Conclusions: The present results support the conclusion that problematic interpersonal relationships at work can be determinants of depression. These prospective findings may be of relevance for prevention and when rehabilitating depressed patients.

  • 19.
    Stoetzer, Ulrich
    et al.
    Karolinska Institute, Sweden .
    Bergman, Peter
    Karolinska Institute, Sweden .
    Aborg, Carl
    Karolinska Institute, Sweden .
    Johansson, Gun
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Ahlberg, Gunnel
    Malardalen University, Sweden .
    Parmsund, Marianne
    Karolinska Institute, Sweden .
    Svartengren, Magnus
    Karolinska Institute, Sweden .
    Organizational factors related to low levels of sickness absence in a representative set of Swedish companies2014In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 47, no 2, p. 193-205Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of this qualitative study was to identify manageable organizational factors that could explain why some companies have low levels of sickness absence. There may be factors at company level that can be managed to influence levels of sickness absence, and promote health and a prosperous organization. PARTICIPANTS: 38 representative Swedish companies. METHODS: The study included a total of 204 semi-structured interviews at 38 representative Swedish companies. Qualitative thematic analysis was applied to the interviews, primarily with managers, to indicate the organizational factors that characterize companies with low levels of sickness absence. RESULTS: The factors that were found to characterize companies with low levels of sickness absence concerned strategies and procedures for managing leadership, employee development, communication, employee participation and involvement, corporate values and visions, and employee health. CONCLUSIONS: The results may be useful in finding strategies and procedures to reduce levels of sickness absence and promote health. There is research at individual level on the reasons for sickness absence. This study tries to elevate the issue to an organizational level. The findings suggest that explicit strategies for managing certain organizational factors can reduce sickness absence and help companies to develop more health-promoting strategies.

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