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  • 1.
    Andersen, Anders Johan W
    et al.
    University of Agder, Norway .
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Internet-based Mental Health Services in Norway and Sweden: Characteristics and Consequences2013In: Administration and Policy in Mental Health, ISSN 0894-587X, E-ISSN 1573-3289, Vol. 40, no 2, p. 145-153Article in journal (Refereed)
    Abstract [en]

    Internet-based mental health services increase rapidly. However, national surveys are incomplete and the consequences for such services are poorly discussed. This study describes characteristics of 60 Internet-based mental health services in Norway and Sweden and discusses their social consequences. More than half of the services were offered by voluntary organisations and targeted towards young people. Professionals answered service users questions in 60% of the services. Eight major themes were identified. These characteristics may indicate a shift in the delivery of mental health services in both countries, and imply changes in the understanding of mental health.

  • 2. Biong, Stian
    et al.
    Karlsson, Bengt
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    Metaphors of a shifting sense of self in men recovering from substance abuse and suicidal behavior2008In: Journal of Psychosocial Nursing and Mental Health Services, ISSN 0279-3695, E-ISSN 1938-2413, Vol. 46, no 4, p. 35-41Article in journal (Refereed)
    Abstract [en]

    The purpose of this descriptive study was to explore and interpret men's experience of sense of self within the context of recovery from substance abuse and suicidal behavior. A secondary analysis of data from a previous study of four young Norwegian men revealed how a shifting sense of self was constructed through the use of metaphors. The analysis identified three themes related to the participants' sense of self: The Meaning of Being Isolated, The Meaning of Being Close to the Point of No Return, and The Meaning of Still Being on the Edge. By acknowledging metaphorical expressions as a source of important knowledge, this study reflects on how mental health professionals can use metaphors in the recovery process. As part of the treatment alliance and therapeutic communication, we suggest that metaphors may aid the assessment of suicidal ideation, promote a sense of a more active self, and signal acceptance and recognition of subjectivity.

  • 3.
    Biong, Stian
    et al.
    Buskerud University College.
    Svensson, Tommy
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Sociology.
    Bridging the gaps: Experiencing and preventing life-threatening heroin overdoses in men in Oslo2009In: International Journal of Qualitative Studies on Health and Well-Being, ISSN 1748-2623, Vol. 4, no 2, p. 94-105Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to illuminate and interpret the experiences of professionals and men living with life-threatening heroin overdoses in Oslo. A case study design was chosen for data collection. A phenomenological hermeneutic approach and triangulation was used to analyse the data. The na?¨ve reading involved awareness of the perceived sense of social isolation, which had consequences for how life-threatening heroin overdoses were managed, comprehended and motivated by the men. Professionals also experienced isolation, since they had no specific goals or guidelines for cooperation, and relevant political documents did not address the phenomenon of life-threatening heroin overdoses. Non-participant observation revealed different types of isolated interventions, involving very short interventions by several kinds of actors. The structural analysis identified three themes: The meaning of being rescued, the meaning of longing for communion and the meaning of being confused. A comprehensive understanding of the complexity in experiencing and preventing life-threatening heroin overdoses in men in Oslo indicated that the meaning of these social phenomena could be understood as bridging the gaps between barriers to treatment, interaction and motivation.

  • 4. Björklund, Anita
    et al.
    Svensson, Tommy
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Sociology.
    A longitudinal study on the transformation of 15 occupational therapist students'paradigms into occupational therapists' paradigms2006In: Australian Occupational Therapy Journal, ISSN 0045-0766, E-ISSN 1440-1630, Vol. 53, no 2, p. 87-97Article in journal (Refereed)
    Abstract [en]

    Background and Aim: This study describes the transformation of 15 occupational therapist students'paradigms into occupational therapists'paradigms according to Törnebohm's theory of paradigms over a period of 6 years. This research particularly considers the paradigm components world view and field of action view in Törnbohm's sense. Method: Qualitative data were collected using essay questions on three occasions: First week and last semester at the Occupational Therapy Programme at the School of Health Sciences, Jönköping, Sweden, and after 3 years of occupational therapy practice. A content analysis of the collected materials was performed. Conclusion: The transformation of the informants'views could be characterised as comprising three different perspectives: A 'public'view in 1995, a 'theoretical' view in 1998 and an 'experiential/contextual' view in 2001. © 2006 The Authors Journal compilation © 2006 Australian Association of Occupational Therapists.

  • 5. Björklund, Anita
    et al.
    Svensson, Tommy
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Sociology.
    Begreppet hälsa som vägvisare för arbetsterapeuter2005In: Arbetsterapeuten, ISSN 0345-0988, no 9, p. 10-14Article in journal (Other academic)
  • 6. Björklund, Anita
    et al.
    Svensson, Tommy
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Sociology.
    Fokus på hälsa, engagemang och stolthet - En diskussion om teoretiska perspektiv på rehabilitering av sjukskrivna2006In: Vågor på HaVet: tio texter om arbete och funktionshinder / [ed] Bengt Börjeson, Jönköping: Hälsohögskolan , 2006, p. 129-151Chapter in book (Other academic)
    Abstract [sv]

       

  • 7. Björklund, Anita
    et al.
    Svensson, Tommy
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Sociology.
    Read, Sanna
    Holistic and biomedical concepts of health: A study of health notions among Swedish occupational therapists and a suggestion for developing an instrument for comparative studies2006In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 13, no 3, p. 141-150Article in journal (Refereed)
    Abstract [en]

    The objectives of this study were to inquire into notions of health among a group of 439 Swedish occupational therapists and to test a model derived from a qualitative study by Björklund & Svensson with a representative sample of occupational therapists in Sweden. The data were collected through a questionnaire and were analyzed using descriptive statistics, cluster analysis, and confirmatory factor analysis. The means and ranking of the health notions showed that Swedish occupational therapists most frequently hold holistic notions of health, and to a lesser extent biostatistical ones. Most Swedish occupational therapists indicate that being clearly conscious of one's health notions is important both to themselves and to their profession. The test of the model provides a step towards developing an instrument for measuring notions of health that clearly distinguishes between holistic and biomedical ones and that could possibly be used for comparative studies.

  • 8. Bulow, P.
    et al.
    Svensson, Tommy
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Sociology .
    Hansson, J.-H.
    Department of Social Work, Ersta Sköndal University College, Stockholm, Sweden.
    Long-term consequences of the reformation of psychiatric care: A 15-year follow-up study2002In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 56, no 1, p. 15-21Article in journal (Refereed)
    Abstract [en]

    Although there are a great many epidemiological studies of psychiatric diseases and the outcomes of controlled rehabilitation programmes, there is a shortage of studies of routine psychiatric care. This study is a retrospective cohort study of the total number (n = 138) of patients receiving inpatient care at a psychiatric rehabilitation clinic in Jönköping during 1984. The follow-up period is 15 years, 1984-98. The group had a considerable amount of inpatient care, but this decreased dramatically during the time of investigation. Positive indications were that there were no suicides during the last 5 years of the period and that the number of registered crimes showed a marked decrease from 1992. Negative indications were low levels of work and occupation and few social contacts.

  • 9. Bülow, Per
    et al.
    Svensson, Tommy
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Sociology.
    Att vara sin sjukdom: Om psykiskt funktionshinder och åldrande2008In: Att åldras med funktionshinder, Lund: Studentlitteratur , 2008, 1, p. 165-193Chapter in book (Other academic)
    Abstract [sv]

    Vi har hittills haft begränsad kunskap om funktionshindrade människors liv över tid och om innebörden i att leva med funktionshinder under många år. Vad innebär det att åldras med funktionshinder? Hur gestaltar sig "äldreblivandet" om man redan har betydande funktionsnedsättningar sedan tidigare i livet och kanske tvingats lämna arbetslivet långt före gängse pensionsålder? Hur är det att, som en till åren kommen förälder, fortfarande vara den som hjälper sitt vuxna, funtionshindrade barn? Hur ser den formella och informella omsorgssituationen ut? Det är frågor som den här boken belyser och den fyller därmed ett viktigt kunskapsbehov. Boken utgår från ett livsloppsperspektiv. Den centrala frågan är sålunda hur livet idag gestaltar sig för funktionshindrade människor som vuxit upp och levt under vissa historiska villkor. Här ryms även ett anhörigperspektiv där denna fråga studeras på motsvarande sätt. Bokens sex kapitel diskuterar de här frågorna med olika tonvikt och med utgångspunkt från både fysiskt och psykiskt funktionshindrades förhållanden. Samtliga författare bedriver forskning med anknytning till bokens huvudfråga. Att åldras med funktionshinder riktar sig främst till högskolestuderande inom samhälls- och beteendevetenskap, socialt arbete, social omsorg och vård, liksom till yrkesverksamma inom fältet. Den kan också vara värdefull för en intresserad allmänhet.

  • 10. Bülow, Per
    et al.
    Svensson, Tommy
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Sociology.
    Stability of Diagnoses in a Cohort of Long-Term Mentally Ill Patients in sweden2005In: Scandinavian Journal of Disability Research, ISSN 1501-7419, E-ISSN 1745-3011, Vol. 7, no 1, p. 23-40Article in journal (Refereed)
  • 11. Clancy, Anne
    et al.
    Svensson, Tommy
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Sociology .
    'Faced' with responsibility: Levinasian ethics and the challenges of responsibility in Norwegian public health nursing2007In: Nursing Philosophy, ISSN 1466-7681, E-ISSN 1466-769X, Vol. 8, p. 158-166Article in journal (Refereed)
  • 12.
    Clancy, Anne
    et al.
    Harstad University College.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology . Linköping University, Faculty of Arts and Sciences.
    Perceptions of Public Health Nursing Practice by Municipal Health Officials in Norway2009In: PUBLIC HEALTH NURSING, ISSN 0737-1209, Vol. 26, no 5, p. 412-420Article in journal (Refereed)
    Abstract [en]

    Objectives The objective of this study was to describe and analyze municipal decision-makers views on public health nursing and to reflect upon and discuss the relevance of those views to the future of public health nursing in Norway. Design This explorative qualitative study using face-to-face interviews is part of a larger project, comprising 5 studies, that explores perceptions of public health nursing. Sample A purposeful sample of 11 municipal decision-makers was selected for interview during 2006-2007 to reflect variation in community size and perspective. Results Thematic content analysis of the transcribed interviews revealed 4 content categories: contribution, collaboration, challenges, and visibility. The decision-makers expressed satisfaction with the public health nursing services, showed concern about lack of visibility and clear boundaries, and some expressed irritation over lacking collaboration. The interviewees elaborated on their past experiences as the public health nurses coworkers, leaders, collaborators, and service users. Conclusions The respondents recognized public health nursings contribution to public health but they lack sufficient knowledge of its content and tend to take services at local health clinics for granted. Dialogue between nurses and decision-makers is necessary in order to ensure updated evaluation and continued development of public health nursing services.

  • 13.
    Fredrikesen, Sven-Tore
    et al.
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Fra "laert" kropp till "ulaert" kropp: Om overfoering av erfart kunnskap fra intensivsykeplejer till student i klinikske vejledningssituationer2009In: Nordisk tidsskrift for helseforskning, ISSN 1504-3614, E-ISSN 1891-2982, Vol. 5, no 1, p. 13--27Article in journal (Refereed)
    Abstract [no]

    Hensikten med denne studien er å studere hvordan intensivsykepleiere formidler erfart kunnskap i klinisk veiledning av intensivstudenter. Datamaterialet er innsamlet gjennom observasjon og dybdeintervju av seks intensivsykepleiere. Gjennom å anvende fenomenologisk-hermeneutisk analyse fremkommer det at intensivsykepleierne formidler erfart kunnskap til studentene ved sin tilstedeværelse i situasjonen gjennom meningsskapende bevegelser. Denne kunnskapen reflekteres fram gjennom å synliggjøre en oversiktskunnskap slik at studentene forstår inntrykkene i, og av pasientsituasjonen. Videre uttrykkes denne formen for kunnskap gjennom formidling av hva ulike fenomener kan innebære for pasientene. Ved sin tilstedeværelse i pleiesituasjonen formidler sykepleierne også sine kroppslige reaksjoner slik at studentene også får erfare og derfor kjenner slike erfaringer i egen kropp. Meningsskapende bevegelser uttrykkes også når sykepleierne støtter opp om pasientenes livsprosesser og uttrykker disse i situasjonen med studentene. Gjennom samværet med studentene formidles også hvordan sykepleierne møter pasientene på deres kroppslige uttrykk. Denne kunnskapen blir formidlet gjennom reflekterte handlinger, uttrykt gjennom intensivsykepleiernes meningsskapende bevegelser.

  • 14. Fredriksen, Sven-Tore D.
    et al.
    Talseth, Anne Grethe
    Svensson, Tommy
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Sociology.
    Body, strength and movement - Intensive care patients' experience of body2008In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, Vol. 3, no 2, p. 77-88Article in journal (Refereed)
    Abstract [en]

    This study is about intensive care patients' experience of strength, body and movement during critical illness in an intensive care unit. The aim of the study is to inquire and understand the ways the body and its experience appear when the phenomena of strength and movement are altered. The data were collected through in-depth interviews with seven patients and analysed from a phenomenological-hermeneutical point of view. The findings showed a body that refuses to cooperate and is often marginally able to cope with the situation at all. It showed relational bonding between the patients and health personnel and/or significant others where the patients were overlooked and at the same time dependent on the same persons. They were waving between life and death through dimension of existence, which is contrasted to earlier experiences. They showed feeling responsible for the family through a role in to reduce their fears. At the same time, they are in a continuous struggle for life in which they balance between vague hope and a situation so challenging that the only thing left is grim humour. They showed progressing and expectations where the slightest changes in the situation in a positive direction create a hope in them.

  • 15.
    Gustafsson Stolt, Ulrica
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Helgesson, Gert
    Centre for Bioethics at Karolinska Institutet & Uppsala University, Uppsala Science Park, Uppsala, Sweden.
    Liss, Per-Erik
    Linköping University, Department of Department of Health and Society. Linköping University, Faculty of Health Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences. Linköping University, Faculty of Health Sciences.
    Ludvigsson, Johnny
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Information and informed consent in a longitudinal screening involving children: a questionnaire survey2005In: European Journal of Human Genetics, ISSN 1018-4813, E-ISSN 1476-5438, Vol. 13, no 3, p. 376-383Article in journal (Refereed)
    Abstract [en]

    This empirical study explores participants' perceptions of information and understanding of their children's and their own involvement in a longitudinal screening, the ABIS Study. ABIS (All Babies In Southeast Sweden) is a multicentre, longitudinal research screening for Type 1 diabetes and multifactorial diseases involving 17 005 children and their families. For this study, a random selection of mothers was made, using perinatal questionnaire serial numbers from the ABIS study. In total, 293 of these mothers completed an anonymous questionnaire (response rate 73.3%). Our findings from the questionnaire indicate a marked difference between the reported satisfaction with and understanding of the information provided on the one hand and the significant lack of knowledge of some of the aims and methods of the ABIS screening on the other, namely concerning high-risk identification of involved children, potential prevention and future questionnaires. Two questions evoked by our results are: (1) what information is required for participants in longitudinal studies involving children? and (2) how do we ensure and sustain understanding, and thus in a prolonging, informed consent in these studies? This study underlines the importance of an increased understanding of the ethical issues that longitudinal research on children raise and the need to discuss how information and informed consent strategies should be analysed and designed in longitudinal studies.

  • 16.
    Gustafsson Stolt, Ulrica
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Liss, Per-Erik
    Linköping University, Department of Department of Health and Society. Linköping University, Faculty of Health Sciences.
    Ludvigsson, Johnny
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences. Linköping University, Faculty of Health Sciences.
    The problems of obtaining informed consent in screening for Type 1 diabetes involving small childrenManuscript (preprint) (Other academic)
    Abstract [en]

    Purpose As part of a research ethical case study our objective was to explore existing and potential bioethical issues with regard to a research screening for Type 1 involving 17,000 children and their families (present outcome: 78.6%).

    Research design and methods The setting was ABIS (All Babies In Southeast Sweden), a presently ongoing Swedish research screening designed as a multi-centre, longitudinal and geographically located research screening for Type 1 Diabetes in an unselected birth cohort. From the perinatal questionnaire serial numbers we made a random selection of participating mothers. 293 completed the anonymous questionnaire, resulting in a response rate of 73.3%.

    Results The overall majority of respondents reported (1), being satisfied with the information, (2), looking upon the information as sufficient for their decision, (3), having fully understood the information and (4), having made a fully voluntary decision to participate. However, knowledge about the study varied widely and we found several variations of misunderstandings, even regarding basic facts. For example, one in three respondent was unsure (or indeed unaware) with regard to one aim being the identification of children at high risk.

    Condusions We have recorded flaws in research participants understanding of their own and their child's participation in a prospective screening programme, even though attention was paid to distributing information through a variety of methods. This points to the importance of giving information: in a variety of methods and also repeatedly in long-term studies.

  • 17.
    Gustafsson Stolt, Ulrica
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Liss, Per-Erik
    Linköping University, Department of Department of Health and Society. Linköping University, Faculty of Health Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences. Linköping University, Faculty of Arts and Sciences.
    Ludvigsson, Johnny
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Attitudes to bioethical issues: a case study of a screening project2002In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 54, no 9, p. 1333-1344Article in journal (Refereed)
    Abstract [en]

    Commonly expressed in theoretical discussions about ethical problems in the context of epidemiology and screening is the need for more data. A study was carried out involving 21 explorative interviews with participant and nonparticipant mothers in a neonatal research screening project in progress in Sweden, ABIS (All Babies in Southeast Sweden). The respondents were asked, by way of open-ended questions, to give their opinions about certain ethical issues: informed consent; reasons for joining/declining; surrogate decision; the collection, analysis and storage of written and “live” material (biobanks); intervention etc.

    The ethical implications mentioned in the literature mostly concern the risk of creating distress and anxiety (anxiety and possible stigmatisation in respect of positive or false-positive results, worry about material collected and stored, distress caused by blood sampling procedures, etc.). Our results do not support the idea that the risks are substantial. The respondents rather indicate an attitude of benevolence—they are positive both to the current research on children, to the material they contribute (both written material and “biomaterial”), to possible results and intervention plans. On the other hand the participants expressed concern about the storage of material and the right to be informed of any screening/project results. Further studies in this field are needed and would be of help in theoretical discussion, the work of ethical committees and the designing of, for example, screening and research projects.

  • 18.
    Gustafsson Stolt, Ulrica
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Ludvigsson, Johnny
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Liss, Per Erik
    Linköping University, Department of Department of Health and Society. Linköping University, Faculty of Health Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences. Linköping University, Faculty of Health Sciences.
    Bioethical theory and practice in genetic screening for type 1 diabetes2003In: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633, Vol. 6, no 1, p. 45-50Article in journal (Refereed)
    Abstract [en]

    Due to the potential ethical and psychological implications of screening, and especially inregard of screening on children without available and acceptable therapeutic measures, there is a common view that such procedures are not advisable. As part of an independent research- and bioethical case study, our aim was therefore to explore and describe bioethical issues among a representative sample of participant families (n = 17,055 children) in the ABIS (All Babies In South-east Sweden) research screening for Type 1 diabetes (IDDM).The primary aim is the identification of risk factors important for the development of diabetes and other multifactorial immune-mediated diseases. Four hundred, randomly chosen, participant mothers were asked to complete a questionnaire exploring issues of information, informed consent, bio-material, confidentiality and autonomy, and of prevention/intervention. 293 completed the questionnaire, resulting in a response rate of 73.3%. The majority of questions had the form of 6-point Likert-type response scales (1–6).We found that the majority of respondents felt calm in regard of samples and written material, and also concerning the possibility of their child in the future being identified as having high risk of developing Type 1 diabetes. An important finding concerning access and control of mainly biological data was indicated, with the respondents expressing concern for potential future use. We believe our findings indicate that this kind of empirical studies can substantially contribute to our understanding of bioethical issues of medical research involving genetics. Issues, such as safeguards ensuring theethical criteria of autonomy and respect, were emphasised by our respondents. We believe theissues brought up may promote further discussion, and do suggest issues for consideration by, among others, researchers, bioethicists and Institutional Review Boards.

  • 19. Hansson, Jan-Håkan
    et al.
    Svensson, Tommy
    Linköping University, The Tema Institute. Linköping University, Faculty of Arts and Sciences.
    Normalitetsproduktion - teknik eller politik?1998In: Nya kulturer i psykiatrin / [ed] Stefan Sjöström, Lund: Studentlitteratur , 1998, p. 31-44Chapter in book (Other (popular science, discussion, etc.))
  • 20.
    Hillborg, Helene
    et al.
    University of Örebro, Sweden .
    Danermark, Berth
    University of Örebro, Sweden .
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Professionals perceptions of and views about vocational rehabilitation for people with psychiatric disabilities2013In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 44, no 4, p. 471-480Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: One of the challenges agencies and professionals face is to enable people on sick leave to be successful in their vocational rehabilitation. The objective of this study was to explore and analyze some professionals perceptions of and views about vocational rehabilitation among people with psychiatric disabilities. less thanbrgreater than less thanbrgreater thanPARTICIPANTS: Eight professionals from four different agencies (social services, the employment service, the social insurance office, and a psychiatric outpatient setting) working in the area of vocational rehabilitation for people with psychiatric disabilities. less thanbrgreater than less thanbrgreater thanMETHODS: Eight in-depth interviews were conducted. The data collected was analyzed using qualitative content analysis together with an interpretive approach. less thanbrgreater than less thanbrgreater thanRESULTS: The results suggested the respondents were in consensus regarding that which they considered to facilitate or enable successful vocational rehabilitation. Intensive support over a long period of time and a holistic view that takes into account the habits and routines of daily life outside of work as well as the social and psychological aspects of individuals during their rehabilitation processes were considered to be just as crucial to the vocational rehabilitation process as training in the workplace. less thanbrgreater than less thanbrgreater thanCONCLUSIONS: These professionals dealt with a complex vocational rehabilitation system; they felt that their organizations directives and inability to collaborate successfully with other authorities restricted their scope of action and hindered their exercise of good practice.

  • 21.
    Hillborg, Helene
    et al.
    The Swedish Institute for Disability Research, Örebro University.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Danemark, Berth
    Nordic School of Public Health, Göteborg.
    Expectations, visions and sense of empowerment2010In: Scandinavian Journal of Disability Research, ISSN 1501-7419, E-ISSN 1745-3011, Vol. 12, no 2, p. 109-124Article in journal (Refereed)
    Abstract [en]

    The aim of this study is to reveal the meaning some people with psychiatric disabilities assigned to important experiences related to long periods of participation restrictions owing to unemployment and sick leave. The data comprise open-ended interviews with eight informants. A hermeneutic approach together with a comparative analysis was used to analyze the data. The results showed six types of mechanisms important for the outcome of the rehabilitation process: support, understanding, time, control, self-image and vision of the future. Our results indicate that environmental factors such as experience of support and understanding of professionals and time-efficacy seemed to have a great effect on the individuals' attitudes concerning the activities and measures they expected to carry out during their coming rehabilitation. These experiences seemed to affect their belief in their own abilities, their sense of control, and their belief in successful performance. Theories about empowerment closely related to social emotions like pride and shame are also discussed in an attempt to deepen the understanding of the studied phenomena.

  • 22.
    Hillborg, Helene
    et al.
    University of Örebro.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology . Linköping University, Faculty of Arts and Sciences.
    Danermark, Berth
    University of Örebro.
    Towards a working life? Experiences in a rehabilitation process for people with psychiatric disabilities2010In: SCANDINAVIAN JOURNAL OF OCCUPATIONAL THERAPY, ISSN 1103-8128, Vol. 17, no 2, p. 149-161Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to reveal the meaning some people with psychiatric disabilities assigned to important personal experiences in relation to an ongoing rehabilitation process. The data comprises open-ended interviews of eight participants. A hermeneutic approach together with a content analysis was used to analyse the data. The results indicated the importance of not relying on simplified prognoses early in a rehabilitation process when assessing rehabilitation measures and/or work capacity. The phenomenon of rehabilitation seemed to be very complex, diverse, and changed over time depending on different circumstances that arose during the rehabilitation process. These circumstances arose on individual, contextual as well as structural levels and all had an impact on the outcomes. The results also indicated that it seemed to be possible to achieve success, change attitudes, and create a positive image of a future related to a working life if the support was perceived as relevant and the activities undertaken were perceived as contributing to achievement of the individuals goals. Regardless of which path the informants later chose these factors were seen to support an empowerment process and active participation in their own rehabilitation.

  • 23.
    Klanghed Müssener, Ulrika
    et al.
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    Alexandersson, Kristina
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Positive encounters with rehabilitation professionals reported by persons with experience of sickness absence2004In: Work: A Journal of Prevention, Assessment & Rehabilitation, ISSN 1051-9815, Vol. 22, no 3, p. 247-254Article in journal (Refereed)
    Abstract [en]

    More knowledge is needed on different factors that can promote return to work among sick-listed persons. One such factor might be by their interactions with the rehabilitation professionals they encounter. The aim of the present study was to identify and analyze statements about positive encounters with rehabilitation staff, reported by persons who had been absent from work with back, neck, or shoulder diagnoses. A descriptive and explorative qualitative approach was used to analyze data from five focus-group interviews. There were few statements on positive encounters, and they were frequently attributed to sheer luck. Experiences of positive encounters were assigned to two major categories: respectful treatment and supportive treatment. Receiving adequate medical examination or treatment was also mentioned as being positive. Further efforts are needed to study and develop methods for investigating interactions with rehabilitation professionals that laypersons experience as positive and that may contribute to empowerment and influence return to work when sickness absent.

  • 24.
    Kullberg, Agneta
    et al.
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Timpka, Toomas
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Public Health Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    Karlsson, Nadine
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Lindqvist, Kent
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Does the perceived neighborhood reputation contribute to neighborhood differences in social trust and residential wellbeing?2010In: Journal of community psychology (Print), ISSN 0090-4392, E-ISSN 1520-6629, Vol. 38, no 5, p. 591-606Article in journal (Refereed)
    Abstract [en]

    The authors used a mixed methods approach to examine if the reputation of a housing area has bearing on residential wellbeing and social trust in three pairs of socioeconomically contrasting neighborhoods in a Swedish urban municipality. Multilevel logistic regression analyses were performed to examine associations between area reputation and residential wellbeing and social trust, controlling for the random effect of neighborhood and individual level sociodemographic factors. Qualitative data were analyzed to identify mechanisms of how neighborhood reputations were established. The housing area reputation was found to be strongly associated with wellbeing and social trust. The area reputation also seemed to be a determinant of position in the local social structure; residents were found to position themselves in a rank order The results suggest that area reputation is an important and probably underestimated dimension in the development of residential wellbeing and social trust in housing.

  • 25.
    Liss, Per-Erik
    et al.
    Linköping University, Department of Department of Health and Society, Tema Health and Society. Linköping University, Faculty of Arts and Sciences.
    Nordin, Ingemar
    Linköping University, Department of Department of Health and Society, Tema Health and Society. Linköping University, Faculty of Arts and Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences, Sociology. Linköping University, Faculty of Arts and Sciences.
    Målsättningar och verklighet – vård och omsorg i kommunal regi: Del I Mål och prioriteringar2006Report (Other academic)
    Abstract [sv]

    Hur bra är vården och omsorgen i kommunal regi? Det är en vidsträckt fråga där svaren åtminstone delvis måste vara av rent subjektiv karaktär. ”Bra” respektive ”dålig” är inga objektiva egenskaper som saker bara har, utan de är något som vi människor tillskriver dem genom att relatera till våra personliga värderingar. Det blir lite mer lätthanterligt ur vetenskaplig synvinkel om vi istället frågar oss hur vården och omsorgen lever upp till de målsättningar som verksamheten själv ställt upp.

    Att diskutera och utvärdera vården inom landstingen är ju något vi vant oss vid under de senare decennierna. Men idag sker det faktiskt en hel del vård i kommunernas regi. Inom kommunerna har man bland annat ett uppdrag att sköta äldrevården. Hur ser det ut där? Hur bra lever man upp till sina egna ofta mycket ambitiösa målsättningar? I den här rapporten kommer vi inte att kunna ge något uttömmande svar på hur verkligheten stämmer med idealen men den innehåller en hel del intressanta indikationer och ledtrådar.

    När vi – Per-Erik Liss, Tommy Svensson och undertecknad – diskuterade upplägget för det här projektet sade vi oss att det var viktigt att angripa problemet från två håll samtidigt; dels att titta närmare på kommunernas målsättningar, dels att dyka ned i verkligheten och försöka ta reda på hur omsorgen fungerar i praktiken. Uppgiften rörande målsättningarna var först och främst att ta reda på vilka de var och hur de var formulerade. Det var bl a väsentligt att se hur målen var relaterade ”uppåt”, d v s hur de stämmer överens med de mål och prioriteringar som görs på ett nationellt plan. Inte minst borde prioriteringsprinciperna i Hälso- och sjukvårdslagen vara central, inte bara för hur landstingen, utan även kommunerna väljer att fördela sina vårdresurser. I vilken mån spelar exempelvis rättviseprincipen om att fördela efter ”vårdbehov” en roll inom den kommunala sektorn? Och vad utgör ”behov” när det gäller äldre människor? Vad behövs det för hjälp för att vara gammal på ett bra sätt?

    En annan väsentlig fråga är hur de kommunala vård- och omsorgsmålsättningarna relaterar till varandra internt. Vilka är de övergripande målsättningarna och vilka är blott operativa mål eller delmål? Om det exempelvis fastställs ett delmål att hemtjänsten skall vara behjälplig med städning men inte med att sitta ned och prata så har det därmed bestämts att det förra är nödvändigare än det andra för att nå övergripande syften. Det har gjorts en bedömning att den första åtgärden bättre fyller ett väsentligt behov hos de äldre än den andra.

    Men hur har man gått tillväga för att komma fram till denna slutsats? Är det så säkert att de olika delmålen verkligen leder mot de stolta proklamationerna i den övergripande visionen? När vi sedan kontemplerade dykt ner i verkligheten så stod det ganska snart klart att det borde bli en djupdykning snarare än blott ett snorklande vid ytan. Det vill säga, vi skulle kanske inte se så mycket av den övergripande statistiken beträffande budgetar och antal människor under åtgärd. Men för att nå de intressanta skikten där vi kan hoppas på att få syn på enskilda människors, i synnerhet äldre människors, behov av vård, trygghet och värdighet så måste vi dyka på djupet. Vi måste lyssna på enskilda människors berättelser om vilka de är, hur de ser på sina liv och vad som är viktigt för dem. Det är ju först på denna nivå som vi kan börja förstå vilka problem och behov det finns, och hur dessa sedan kan relateras till vårdens och omsorgens målsättningar. Hur betydelsefull är överhuvudtaget den kommunala omsorgsservicen i en människas liv på äldre dagar?

    I detta sammanhang är det också viktigt att beakta det vi kan kalla för ”mellangruppens” erfarenheter, d v s de som har att implementera målen i sin verksamhet; vårdare, biträden och assistenter. Detta är en grupp som ofta hamnar i kläm mellan politiker och allmänhet. I sin dagliga gärning möter de människorna som behöver vård och omsorg. Samtidigt skall deras verksamhet bedrivas i enlighet med de direktiv och riktlinjer som politikerna ställt upp. Går dessa krav ihop? Hur bedömer vårdaren att han/hon kan möta upp mot de dubbla kraven? Deras observationer, erfarenheter och intressen skiljer sig tydligt från de båda andra gruppernas, det utgör ett eget perspektiv.

    När jag, vid slutet av projekttiden, sträckläste först Per-Eriks analytiska diskussion om mål och prioriteringar och sedan Tommys djupintervjuer med hemtjänstens vårdbiträden och gamla, hade jag en stark impuls att vi skulle låta studierna stå helt okommenterade. De utgör alla en del av verkligheten, och jämförelsen inbjuder till många frågor och tankar. Varför inte låta läsaren själv dra sina slutsatser? Hur går dessa vitt skilda bilder ihop?

    Men, trots allt är det här en vetenskaplig rapport och forskare bör kommentera och dra slutsatser. Det hör väl ändå till? Så Per-Erik gör några avslutande kommentarer där han jämför målsättningar med verklighet. Men dessa kommentarer är blott en liten hjälp på traven. Studien om de officiella målsättningarna å ena sidan och studierna av verksamheten bland personal och mottagare å den andra står på egna ben. Att läsa dem tillsammans ger en stark läsupplevelse och mycket att fundera vidare på.

  • 26.
    Ludvigsson, Johnny
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Gustafsson Stolt, Ulrica
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Liss, Per-Erik
    Linköping University, Department of Department of Health and Society. Linköping University, Faculty of Health Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences, Sociology. Linköping University, Faculty of Health Sciences.
    Mothers of children in ABIS, a population-based screening for prediabetes, experience few ethical conflicts and have a positive attitude2002In: Annals of the New York Academy of Sciences, ISSN 0077-8923, E-ISSN 1749-6632, Vol. 958, p. 376-381Article in journal (Refereed)
    Abstract [en]

    Screening is supposed to create less anxiety among first-degree relatives of diabetic patients where the risk of developing diabetes already is well known. It has also been argued that screening of a general child population should never be performed unless identified high-risk individuals can be offered intervention to prevent diabetes. However, the empirical data are scarce, especially regarding what opinions patients or their parents have of these matters/issues themselves. We have therefore tried to evaluate mothers' attitudes to and ethical views on participation in a research screening for prediabetes in an unselected birth cohort. All 21,700 mothers of children in southeast Sweden born between 1 October 1997 and 1 October 1999 were asked to participate in ABIS (All Babies in Southeast Sweden). They were given information about the design of the study and that HLA types and autoantibodies will be determined in order to predict diabetes, but that no prevention of diabetes will be offered unless future studies show effective methods. After informed consent, 78.6% of mothers let their babies participate (17,055 children) despite a quite laborious study protocol. Explorative in-depth semistructured interviews were performed in 21 mothers, of whom 15 were strategically selected to get as many various attitudes as possible and of whom 6 chose not to participate in ABIS. All interviewed mothers were positive to the ABIS project. We conclude that a well-designed screening program to detect individuals in the general population with high risk of developing diabetes does not evoke anxiety nor severe ethical conflicts.

  • 27. Ludvigsson, Mikael
    et al.
    Svensson, Tommy
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Sociology.
    Alexanderson, Kristina
    Begreppet arbetsförmåga - en litteraturgenomgång2006Report (Other academic)
  • 28.
    Müssener, Ulrika
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    Söderberg, Elsy
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Vilken betydelse har positivt bemötande för återgång i arbete?2009In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 86, no 3, p. 238-244Article in journal (Refereed)
  • 29.
    Müssener, Ulrika
    et al.
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences. Linköping University, Faculty of Health Sciences.
    Söderberg, Elsy
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Alexandersson, Kristina
    Personal Injury Prevention, Department of Clinical Neuroscience, Karolinska lnstitutet, Stockholm, Sweden.
    Sickness absentees' experiences of positive encounters by healthcare and sickness insurance professionals: an interview studyManuscript (preprint) (Other academic)
    Abstract [en]

    We need more knowledge on factors that can promote retum to work (RTW) grounded on peoples' own views. One such factor of importance is the way absentees themselves experience their interactions with professionals. The purpose of the study was to identify and analyse sick-listed persons' experiences of positive encounters with professionals.

    An inductive and descriptive-qualitative approach was used to analyse transcripts from 11 semi-structured interviews with persons after or during long-term sickness absence. Being treated with respect, feeling supported, establishing a personal relationship, perceiving demands as well-balanced, and patiicipating in decisions regarding rehabilitation appeared as important qualities. Several interviewees believed that positive encounters might promote RTW.

    Further research is needed to elucidate the aspects of such interactions that enhance empowerment and self-confidence in persons on sick leave, in order to develop professional treatment strategies that facilitates for rehabilitation, and to favour collaborative work between and within group of professionals.

  • 30.
    Müssener, Ulrika
    et al.
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Söderberg, Elsy
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    Alexandersson, Kristina
    Department of Clinical Neuroscience, Personal Injury Prevention, Stockholm, Sweden.
    Encouraging encounters: sick-listed persons’ experiences of interactions with rehabilitation professionals2007In: Social work in health care, ISSN 0098-1389, E-ISSN 1541-034X, Vol. 46, no 2, p. 71-87Article in journal (Refereed)
    Abstract [en]

    Long-term sickness-absence has increased in many countries and more knowledge is warranted on factors that can promote return-to-work (RTW). Interactions with professionals might be one such factor and especially experiences of positive encounters. The purpose of the study was to identify and analyze sick-listed persons' experiences of positive encounters with professionals within social insurance and healthcare. An inductive and descriptive qualitative approach was used to analyze ttanscripts from 11 semi-structured interviews with persons with experience of long-term sickness absence.

    The following five categories of qualities of encounters were found to be of importance: being treated with respect, feeling supported, establishing a personal relationship, perceiving demands as well-balanced, and participating in decisions regarding rehabilitation measures. Several interviewees expressed the opinion that positive encounters with professionals can promote RTW.

    Further research is needed to elucidate the aspects of interactions that enhance empowerment and self-confidence in persons on sick leave, in order to develop professional treatment strategies that facilitate RTW.

  • 31.
    Nordin, Ingemar
    et al.
    Linköping University, Department of Department of Health and Society, Tema Health and Society. Linköping University, Faculty of Arts and Sciences.
    Liss, Per-Erik
    Linköping University, Department of Department of Health and Society, Tema Health and Society. Linköping University, Faculty of Arts and Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences, Sociology. Linköping University, Faculty of Arts and Sciences.
    Målsättningar och verklighet: vård och omsorg i kommunal regi2005Report (Other academic)
  • 32.
    Ståhl, Christian
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. 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.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    Coordination between welfare authorities in promoting return-to-work2008Conference paper (Refereed)
  • 33.
    Ståhl, Christian
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Müssener, Ulrika
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Implementation of standardized time limits in sickness insurance and return-to-work: Experiences of four actors2012In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, no 16, p. 1404-1411Article in journal (Refereed)
    Abstract [en]

    Purpose: In 2008, time limits were introduced in Swedish sickness insurance, comprising a pre-defined schedule for return-to-work. The purpose of this study was to explore experienced consequences of these time limits. Sick-listed persons, physicians, insurance officials and employers were interviewed regarding the process of sick-listing, rehabilitation and return-to-work in relation to the reform.

    Method: The study comprises qualitative interviews with 11 sick-listed persons, 4 insurance officials, 5 employers and 4 physicians (n = 24). Results: Physicians, employers, and sick-listed persons described insurance officials as increasingly passive, and that responsibility for the process was placed on the sick-listed. Several ethical dilemmas were identified, where officials were forced to act against their ethical principles. Insurance officials' principle of care often clashed with the standardization of the process, that is based on principles of egalitarianism and equal treatment.

    Conclusions: The cases reported in this study suggest that a policy for activation and early return-to-work in some cases has had the opposite effect: central actors remain passive and the responsibility is placed on the sick-listed, who lacks the strength and knowledge to understand and navigate through the system. The standardized insurance system here promoted experiences of procedural injustice, for both officials and sick-listed persons.

  • 34.
    Ståhl, Christian
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Müssener, Ulrika
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    Sjukskrivningssystemet och dess aktörer: Efter införandet av rehabiliteringskedjan2011Report (Other academic)
    Abstract [sv]

    Sedan 2008 har ett antal större förändringar gjorts i sjukförsäkringen. Främst har rehabiliteringskedjan, dvs. införandet av fasta tidsgränser för bedömning av arbetsförmåga och rätt till ersättning, stått i fokus för debatten. Med tidsgränserna sattes en slutgräns för hur länge sjukpenning betalas ut, vilket tidigare inte fanns i försäkringen. I denna studie undersöks hur sjukskrivna, arbetsgivare, försäkringskassehandläggare och läkare resonerar kring dessa tidsgränser, arbetsförmågebedömningar, rehabilitering och återgång i arbete.

    Studien omfattar kvalitativa intervjuer med sjukskrivna, arbetsgivare, handläggare på Försäkringskassan samt primärvårds- och företagsläkare. Totalt intervjuades 24 personer.

    Sjukskrivna, arbetsgivare och läkare upplever att Försäkringskassans handläggare blivit mindre tillgängliga, och generellt uppfattas handläggarna som alltmer passiva i rehabiliteringsprocessen. Handläggare på Försäkringskassan menar att de senaste årens regeländringar har medfört en mer administrativ handläggarroll, där mer tid läggs på att hålla tidsgränser än att arbeta med faktisk rehabilitering. Handläggare upplever också att etiska dilemman uppstår när individuella bedömningar kommer i konflikt med tidsgränserna, vilket upplevs som stressande.

    De sjukskrivna upplever att Försäkringskassan borde ta ett större ansvar för att driva sjukskrivnings- och rehabiliteringsprocessen framåt, eftersom de själva har svårt att överblicka och navigera i sjukförsäkringssystemet. Även arbetsgivarna i studien förväntar sig att Försäkringskassan ska ta större ansvar för sjukskrivningsprocessen. Handläggarna på Försäkringskassan har å sin sida blivit alltmer benägna att lägga detta ansvar på de sjukskrivna.

    Studien identifierar också flera brister i samverkan mellan arbetsgivare, sjukvård och Försäkringskassan kring bedömningen av sjukskrivnas arbetsförmåga. Försäkringskassans handläggare lägger stor vikt vid de medicinska underlagen i bedömningarna, och ger uttryck för en tveksamhet inför att använda andra informationskällor (såsom SASSAMkartläggningar), då det upplevs som avsteg från rådande riktlinjer.

    Ett av syftena med rehabiliteringskedjan var att skapa en mer enhetlig och standardiserad sjukskrivningsprocess. Dock upplever såväl handläggare som sjukskrivna att systemet är oflexibelt och inte tar hänsyn till individers olikheter och skilda behov, och att de fasta tidsgränserna därmed medfört en ökad orättvisa för de sjukskrivna. Även om bemötandet från handläggare på Försäkringskassan i många fall upplevs som bra, uppfattas sjukförsäkringssystemet som orättvist; studien ger därmed i första hand exempel på upplevd proceduriell orättvisa, snarare än upplevelser av orättvist bemötande.

    Studien visar på ett ytterligare behov av att studera etik, rättvisa och kvalitet i sjukskrivningsprocessen. 

  • 35.
    Ståhl, Christian
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and 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.
    From Cooperation to Conflict? Swedish Rehabilitation Professionals' Experiences of Interorganizational Cooperation.2011In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 21, no 3, p. 441-448Article in journal (Refereed)
    Abstract [en]

    Purpose This article analyses Swedish rehabilitation professionals' experiences of interorganizational cooperation in return-to-work and labour market reintegration.

    Method Two groups (n = 15) from different organizations met on a regular basis to discuss their practice from a cooperation perspective. The participants had experience of cooperation in the organizational setting of Coordination Associations. The groups worked with a tutor according to a problem-based methodology, to discuss how their practice is influenced by new structures for cooperation. The material was analysed inductively using qualitative content analysis.

    Results Interorganizational cooperation in rehabilitation is generally perceived as promoting coherence and communication. Nevertheless, there are several contradictory factors in the implementation of such work forms, primarily inflexible sickness insurance regulations and inability of managers to implement cooperation in regular practice.

    Conclusions While interorganizational cooperation promotes professional discretion and tailored solutions, the insurance system contradicts such ambitions through increased governance. Ultimately, the contradictory tendencies of cooperative initiatives and the stricter governance of sickness insurance regulations are political matters. If political attempts to promote interorganizational cooperation are to succeed, the increasing sectorization that results from strict governance of sickness insurance regulations needs to be targeted on a system level.

  • 36.
    Ståhl, Christian
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences. Linköping University, HELIX Vinn Excellence Centre.
    Svensson, Tommy
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Sociology.
    Petersson, Gunilla
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and 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.
    A Matter of Trust?: A Study of Coordination of Swedish Stakeholders in Return-to-Work2010In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 20, p. 299-310Article in journal (Refereed)
    Abstract [en]

    Introduction Stakeholder cooperation in return-to-work has been increasingly emphasized over the last years. However, there is a lack of empirical studies on the subject. This study explores different public stakeholders' experiences of participating in Coordination Associations (CAs), a Swedish form of structured cooperation in return-to-work. The aim of the study is to determine the impact of stakeholder interests on the prerequisites for cooperation. Methods Thirty-five representatives from two CAs in eastern Sweden were interviewed regarding the aim, structure and strategies for their common work. Results Stakeholders' actions are to a high degree determined by their institutional preferences and self-interest. In the CAs, the motives for cooperation differ, and although these differences supposedly could be overcome, they are in fact not. One of the stakeholders, the Public Employment Service, limit its interest to coordinating resources, while the other three wishes to engage in elaborated cooperative work forms, implying the crossing of organizational borders. This discrepancy can largely be attributed to the difficulties for representatives from state authorities in changing their priorities in order to make cooperation work. Conclusions Stakeholders' interests have a high impact on the prerequisites for cooperation in return-to-work. By referring to organizational goals, stakeholders engage in non-cooperative behaviour, which threatens to spoil cooperative initiatives and to develop distrust in cooperative work forms. The results of this study expose the complexity of and threats to cooperation, and its conclusions may be used by return-to-work stakeholders in different jurisdictions to improve the possibilities for the development of cooperative structures.

  • 37.
    Ståhl, Christian
    et al.
    Linköping University, HELIX Vinn Excellence Centre. Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    Petersson, Gunilla
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    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.
    Discretion, governance and cooperative learning: Swedish rehabilitation professionals’ experiences of financial cooperation2010Conference paper (Refereed)
  • 38.
    Ståhl, Christian
    et al.
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation . Linköping University, Faculty of Health Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology . Linköping University, Faculty of Arts and Sciences.
    Petersson, Gunilla
    Linköping University, Department of Behavioural Sciences and Learning, Sociology . 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.
    Discretion, governance and cooperative learning: Swedish rehabilitation professionals’ experiences of financial cooperationManuscript (preprint) (Other academic)
    Abstract [en]

    Purpose: This article analyses the experiences of Swedish rehabilitation professionals in interorganizational cooperation in return-to-work and labour marker reintegration.

    Method: Two groups (n=15) from different organizations met recurrently to discuss their practice from a cooperation perspective. The participants had experience of cooperation in the organizational setting of Coordination Associations (CAs). The groups worked with a tutor according to a problem-based methodology to discuss how their practice is influenced by new structures for cooperation. The material was analysed inductively using qualitative content analysis.

    Results: The results show that CAs were successful in creating cooperative work forms at a local level by ensuring financial support for interorganizational work. This experience was considered positive by the participants. However, the different developments in the two CAs (one attained a sustainable cooperation, the other did not) show the importance of local strategies for maintaining the positive effects of cooperation.

    Conclusions: Work forms initiated by Coordination Associations have been perceived and used as learning environments in which the participants use the learning opportunities provided by the formal cooperation structures. However, the level of trust between managers and officials is low, implying that officials have limited support to learn from their cooperation.

  • 39.
    Ståhl, Christian
    et al.
    Linköping University, HELIX Vinn Excellence Centre. Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    Petersson, Gunilla
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    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.
    Swedish Rehabilitation Professionals' Perspectives on Work Ability Assessments in a Changing Sickness Insurance System2010Conference paper (Refereed)
  • 40.
    Ståhl, Christian
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences. Linköping University, HELIX Vinn Excellence Centre.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    Petersson, Gunilla
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and 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.
    Swedish Rehabilitation Professionals’ Perspectives on Work Ability Assessments in a Changing Sickness Insurance System2011In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 33, no 15-16, p. 1373-1382Article in journal (Refereed)
    Abstract [en]

    Purpose: This article analyses Swedish rehabilitation professionals’ perspectives on how changed sickness insurance regulations will affect their practice and cooperation, with a special focus on work ability assessments.

    Method: Two groups of representatives (n=15) from different organizations involved in rehabilitation and return-towork met 7 times to discuss their practice from a cooperation perspective. The groups worked with a tutor according to a problem-based methodology to discuss how their practice is influenced by new structures for cooperation. The material was analysed inductively using qualitative content analysis.

    Results: The results show that work ability assessments are often made without considering work characteristics. Officials at the Social Insurance Agency do not consider themselves competent in assessing work ability. The basis for decisions of eligibility for sickness benefits is thus weak, which is troublesome from a legal perspective. The officials do not cooperate with employers or occupational health services in work ability assessments.

    Conclusions: Recent policy changes calls for comprehensive cooperation between the insurance system, health care, employment services and employers. This study shows that there are flaws in this cooperation. The design of the system is in conflict with the policy ambition of increasing return-to-work, because it disregards employers as cooperation partners.

  • 41.
    Ståhl, Christian
    et al.
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation . Linköping University, Faculty of Health Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology . Linköping University, Faculty of Arts and Sciences.
    Petersson, Gunilla
    Linköping University, Department of Behavioural Sciences and Learning, Sociology . 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.
    The Work Ability Divide: Holistic and Reductionistic Approaches in Swedish Interdisciplinary Rehabilitation Teams2009In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 19, no 3, p. 264-273Article in journal (Refereed)
    Abstract [en]

    Stakeholder cooperation in return to work has been increasingly emphasised in research, while studies on how such cooperation works in practise are scarce. This article investigates the relationship between professionals in Swedish interdisciplinary rehabilitation teams, and the aim of the article is to determine the participants’ definitions and uses of the concept of work ability. Methods The methods chosen were individual interviews with primary health care centre managers and focus groups with twelve interdisciplinary teams including social insurance officers, physicians, physiotherapists, occupational therapists, medical social workers and coordinators. Results The results show that the teams have had problems with reaching a common understanding of their task, due to an inherent tension between the stakeholders. This tension is primarily a result of two factors: divergent perspectives on work ability between the health professionals and the Social Insurance Agency, and different approaches to cooperative work among physicians. Health professionals share a holistic view on work ability, relating it to a variety of factors. Social insurance officers, on the other hand, represent a reductionistic stance, where work ability is reduced to medical status. Assessments of work ability therefore tend to become a negotiation between insurance officers and physicians. Conclusions A suggestion from the study is that the teams, with proper education, could be used as an arena for planning and coordinating return-to-work, which would strengthen their potential in managing the prevention of work disability.

  • 42.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    Målsättningar och verklighet - vård och omsorg i kommunal regi. Del II: Ålderdom, omsorgsberoende och livsperspektiv samt Mål, prioriteringar och omsorgsarbetets vardag2006Report (Other academic)
    Abstract [sv]

    Hur bra är vården och omsorgen i kommunal regi? Det är en vidsträckt fråga där svaren åtminstone delvis måste vara av rent subjektiv karaktär. ”Bra” respektive ”dålig” är inga objektiva egenskaper som saker bara har, utan de är något som vi människor tillskriver dem genom att relatera till våra personliga värderingar. Det blir lite mer lätthanterligt ur vetenskaplig synvinkel om vi istället frågar oss hur vården och omsorgen lever upp till de målsättningar som verksamheten själv ställt upp.

    Att diskutera och utvärdera vården inom landstingen är ju något vi vant oss vid under de senare decennierna. Men idag sker det faktiskt en hel del vård i kommunernas regi. Inom kommunerna har man bland annat ett uppdrag att sköta äldrevården. Hur ser det ut där? Hur bra lever man upp till sina egna ofta mycket ambitiösa målsättningar? I den här rapporten kommer vi inte att kunna ge något uttömmande svar på hur verkligheten stämmer med idealen men den innehåller en hel del intressanta indikationer och ledtrådar.

    När vi – Per-Erik Liss, Tommy Svensson och undertecknad – diskuterade upplägget för det här projektet sade vi oss att det var viktigt att angripa problemet från två håll samtidigt; dels att titta närmare på kommunernas målsättningar, dels att dyka ned i verkligheten och försöka ta reda på hur omsorgen fungerar i praktiken. Uppgiften rörande målsättningarna var först och främst att ta reda på vilka de var och hur de var formulerade. Det var bl a väsentligt att se hur målen var relaterade ”uppåt”, d v s hur de stämmer överens med de mål och prioriteringar som görs på ett nationellt plan. Inte minst borde prioriteringsprinciperna i Hälso- och sjukvårdslagen vara central, inte bara för hur landstingen, utan även kommunerna väljer att fördela sina vårdresurser. I vilken mån spelar exempelvis rättviseprincipen om att fördela efter ”vårdbehov” en roll inom den kommunala sektorn? Och vad utgör ”behov” när det gäller äldre människor? Vad behövs det för hjälp för att vara gammal på ett bra sätt?

    En annan väsentlig fråga är hur de kommunala vård- och omsorgsmålsättningarna relaterar till varandra internt. Vilka är de övergripande målsättningarna och vilka är blott operativa mål eller delmål? Om det exempelvis fastställs ett delmål att hemtjänsten skall vara behjälplig med städning men inte med att sitta ned och prata så har det därmed bestämts att det förra är nödvändigare än det andra för att nå övergripande syften. Det har gjorts en bedömning att den första åtgärden bättre fyller ett väsentligt behov hos de äldre än den andra.

    Men hur har man gått tillväga för att komma fram till denna slutsats? Är det så säkert att de olika delmålen verkligen leder mot de stolta proklamationerna i den övergripande visionen? När vi sedan kontemplerade dykt ner i verkligheten så stod det ganska snart klart att det borde bli en djupdykning snarare än blott ett snorklande vid ytan. Det vill säga, vi skulle kanske inte se så mycket av den övergripande statistiken beträffande budgetar och antal människor under åtgärd. Men för att nå de intressanta skikten där vi kan hoppas på att få syn på enskilda människors, i synnerhet äldre människors, behov av vård, trygghet och värdighet så måste vi dyka på djupet. Vi måste lyssna på enskilda människors berättelser om vilka de är, hur de ser på sina liv och vad som är viktigt för dem. Det är ju först på denna nivå som vi kan börja förstå vilka problem och behov det finns, och hur dessa sedan kan relateras till vårdens och omsorgens målsättningar. Hur betydelsefull är överhuvudtaget den kommunala omsorgsservicen i en människas liv på äldre dagar?

    I detta sammanhang är det också viktigt att beakta det vi kan kalla för ”mellangruppens” erfarenheter, d v s de som har att implementera målen i sin verksamhet; vårdare, biträden och assistenter. Detta är en grupp som ofta hamnar i kläm mellan politiker och allmänhet. I sin dagliga gärning möter de människorna som behöver vård och omsorg. Samtidigt skall deras verksamhet bedrivas i enlighet med de direktiv och riktlinjer som politikerna ställt upp. Går dessa krav ihop? Hur bedömer vårdaren att han/hon kan möta upp mot de dubbla kraven? Deras observationer, erfarenheter och intressen skiljer sig tydligt från de båda andra gruppernas, det utgör ett eget perspektiv.

    När jag, vid slutet av projekttiden, sträckläste först Per-Eriks analytiska diskussion om mål och prioriteringar och sedan Tommys djupintervjuer med hemtjänstens vårdbiträden och gamla, hade jag en stark impuls att vi skulle låta studierna stå helt okommenterade. De utgör alla en del av verkligheten, och jämförelsen inbjuder till många frågor och tankar. Varför inte låta läsaren själv dra sina slutsatser? Hur går dessa vitt skilda bilder ihop?

    Men, trots allt är det här en vetenskaplig rapport och forskare bör kommentera och dra slutsatser. Det hör väl ändå till? Så Per-Erik gör några avslutande kommentarer där han jämför målsättningar med verklighet. Men dessa kommentarer är blott en liten hjälp på traven. Studien om de officiella målsättningarna å ena sidan och studierna av verksamheten bland personal och mottagare å den andra står på egna ben. Att läsa dem tillsammans ger en stark läsupplevelse och mycket att fundera vidare på.

  • 43.
    Svensson, Tommy
    Linköping University, Faculty of Arts and Sciences. Linköping University, The Tema Institute.
    Nya kulturer i psykiatrin1998Other (Other (popular science, discussion, etc.))
  • 44.
    Svensson, Tommy
    Linköping University, The Tema Institute. Linköping University, Faculty of Arts and Sciences.
    On the notion of mental illness: Problematizing the medical-model conception of certain abnormal behaviour and mental afflictions1990Doctoral thesis, monograph (Other academic)
    Abstract [en]

    This study inquires into some polemics concerning the notion of mentalillness or disease. Some central arguments in the debate on psychiatry, of the 1960's and early 70's, are focused on.

    The analysis is performed in two steps. Important theoretical dimensionsof the early debate are analyzed in the context of a discussion of thepolemics surrounding Thomas Szasz's criticism of psychiatry. Then anattempt is made to take the analysis further by taking into account recentdevelopments in the philosophy of medicine. The theoretical line of criticism of the mental-illness notion is tested against two elaborate andarticulate medical models, with regard to their application to abnormal behaviour and mental afflictions.

    The conclusion is that the medical-model conception of so-called mental-illness phenomena appears problematic from theoretical points of view.

    In a final chapter some ideological dimensions of the debate on the notion of mental illness are touched upon.

  • 45.
    Svensson, Tommy
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Sociology.
    Psykiatri eller inte? Radikal psykiatrikritik under 1960- och 1970-talen2005In: Från psykiskt sjuk till psykiskt funktionshindrad / [ed] Lars-Christer Hydén, Lund: Studentlitteratur , 2005, 1, p. 195-216Chapter in book (Other academic)
    Abstract [sv]

    Från psykiskt sjuk till psykiskt funktionshindrad belyser de förändrin gar som ägt rum inom den svenska psykiatrin sedan början av 1990-talet , med speciell tyngdpunkt på psykiatrireformen 1994 och dess konsekven ser. Denna reform har bland annat lett till att den kommunala socialtj änsten fått ett allt större ansvar för omsorgen om personer med långva riga och svåra psykiska funktionshinder. Teman som lyfts fram är försk jutningen från begreppet ?psykisk sjukdom? till ?psykiskt funktionshin der?, vår kunskap kring psykiska funktionshinder och hur drabbade pers oner hanterar dessa i sin vardag. Vidare diskuteras de nya roller som anhöriga och frivilligorganisationer fått efter avvecklingen av de gam la mentalsjukhusen; de krav på delaktighet och inflytande över det egn a livet som psykiskt funktionshindrade ställer, något som också föränd rar villkoren för dem som arbetar med dessa frågor. Boken vänder sig s peciellt till personer som utbildar sig inom vård och omsorg.

  • 46.
    Svensson, Tommy
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Sociology . Linköping University, Faculty of Arts and Sciences.
    Bjorklund, Anita
    School of Health Science, Jönköping, Sweden .
    Focus on health, motivation, and pride: A discussion of three theoretical perspectives on the rehabilitation of sick-listed people2010In: WORK-A JOURNAL OF PREVENTION ASSESSMENT and REHABILITATION, ISSN 1051-9815, Vol. 36, no 3, p. 273-282Article in journal (Refereed)
    Abstract [en]

    Objective/Method: During the last decades sickness absence from work has become a great societal problem. Questions of how rehabilitation processes should become successful and how peoples ability to work can be improved have become of great public interest. In this paper we discuss three well-known theoretical perspectives regarding their usefulness when it comes to research on rehabilitation for return to work. Results: The three perspectives are: Antonovskys salutogenic model of health, Kielhofners model of human occupation and Scheffs sociological theory of "shame and pride". Conclusions: Each of these can be applied to increase understanding and knowledge concerning sickness absence and return to work. We discuss points of affinity among the three perspectives, as well as significant differences, and we propose that a very essential common denominator is the importance of self-experience.

  • 47.
    Svensson, Tommy
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Gottzén, Lucas
    Linköping University, Department of Social and Welfare Studies, Social Work. Linköping University, Faculty of Arts and Sciences.
    Lögdlund, Ulrik
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Introduktion2014In: Sociologins teoretiker / [ed] Lucas Gottzén och Ulrik Lögdlund, Malmö: Gleerups Utbildning AB, 2014, p. 13-21Chapter in book (Other academic)
  • 48.
    Svensson, Tommy
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Karlsson, A
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Alexanderson, Kristina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Nordqvist, Cecilia
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    Shame-inducing encounters. Negative emotional aspects of sickness-absentees' interactions with rehabilitation professionals2003In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 13, no 3, p. 183-195Article in journal (Refereed)
    Abstract [en]

    There is little knowledge on how sickness absentees experience encounters with rehabilitation professionals. This paper explores and describes negative emotions ("shame " in a broad sense) experienced by individuals on sick leave in their interactions with rehabilitation professionals. We performed a qualitative analysis of data from five focus-group interviews. The participants had experience of sickness absence with back diagnoses and discussed factors that facilitate or impede return to work. Reports of demeaning experiences in encounters with rehabilitation workers were frequent and could be divided into two major categories: 1) subjects perceived the behavior of rehabilitation professionals as distanced in a negative way, and felt that they were treated in an indifferent and nonchalant manner or fairly routinely, 2) subjects felt that they were disqualified, which included being discredited or belittled. This explorative study indicates the need for further, more directed investigations of emotional aspects of interactions between sickness absentees and rehabilitation professionals.

  • 49.
    Svensson, Tommy
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    Müssener, Ulrika
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Alexanderson, Kristina
    Karolinska Institute.
    Sickness absence, social relations, and self-esteem: A qualitative study of the importance of relationships with family, workmates, and friends among persons initially long-term sickness absent due to back diagnoses2010In: WORK-A JOURNAL OF PREVENTION ASSESSMENT and REHABILITATION, ISSN 1051-9815, Vol. 37, no 2, p. 187-197Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of the present study was to explore and analyze accounts of social interactions and relationships with family, workmates, and friends supplied by persons with experience of sickness absence due to back, neck, or shoulder diagnoses. The focus was on experiences that seemed to involve positive and negative self-evaluative aspects, and therefore may be important to the self-conception and self-esteem of the absentee, and possibly to return to work. Participants: The interviewees were women and men between 25 to 34 years of age who had been sickness certified due to back, neck, or shoulder diagnosis. Methods: A descriptive and explorative method was used to analyze data from five focus-group interviews. Results: The importance of being supported and encouraged by family members, and the importance of feeling needed at work as well as being part of a social context were aspects stressed by the respondents. Conclusions: Our results indicate that these interactions and relations are important to the absentees self-esteem, and that this should be taken into account when discussing rehabilitation efforts.

  • 50.
    Svensson, Tommy
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    Müssener, Ulrika
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Alexandersson, Kristina
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Pride, empowerment and return to work: On the significance of positive social emotions in the rehabilitation of sickness absentees2006In: Work: A Journal of Prevention, Assessment & Rehabilitation, ISSN 1051-9815, Vol. 27, no 1, p. 57-65Article in journal (Refereed)
    Abstract [en]

    Sickness absence is a great public health problem and there is a lack of knowledge concerning the hows and whys of success or failure in promoting return to work of sick-listed persons. Discussions of and research into social and psychological aspects of this problem area are in need of theoretical contextualisation. In this paper it is suggested that theories of social emotions may be useful, and that the concept of empowerment can be applied provided that it is reasonably well defined. The notions of pride/shame and empowerment are elucidated and discussed, and it is shown that they can be related in the context of research into emotional dimensions of sickness absentees' experiences of the rehabilitation process in a way that may help to guide empirical studies. A simple model of hypothetical relations between pride/shame, empowerment/disempowerment, work ability, health, and return to work is sketched.

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