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  • 1.
    Andersen, Åsa
    et al.
    Uppsala University, Sweden.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Anderzen, Ingrid
    Uppsala University, Sweden.
    Kristiansson, Per
    Uppsala University, Sweden.
    Larsson, Kjerstin
    Uppsala University, Sweden.
    Positive experiences of a vocational rehabilitation intervention for individuals on long-term sick leave, the Dirigo project: a qualitative study2017In: BMC Public Health, E-ISSN 1471-2458, Vol. 17, article id 790Article in journal (Refereed)
    Abstract [en]

    Background: The process of returning to work after long-term sick leave can sometimes be complex. Many factors, (e.g. cooperation between different authorities and the individual as well as individual factors such as health, emotional well-being and self-efficacy) may have an impact on an individuals ability to work. The aim of this study was to investigate clients experiences with an individually tailored vocational rehabilitation, the Dirigo project, and encounters with professionals working on it. The Dirigo project was based on collaboration between rehabilitation authorities, individually tailored interventions and a motivational interviewing approach. Methods: A descriptive qualitative design was used with data collected through interviews. Fourteen individuals on long-term sick leave took part in individual semi-structured interviews. The interviews were analysed using content analysis. Results: The analysis showed overall positive experience of methods and encounters with professionals in a vocational rehabilitation project. The positive experiences were based on four key factors: 1. Opportunities for receiving various dimensions of support. 2. Good overall treatment by the professionals. 3. Satisfaction with the working methods of the project, and 4. Opportunities for personal development. Conclusions: The main result showed that the clients had an overall positive experience of a vocational rehabilitation project and encounters with professionals who used motivational interviewing as a communication method. The overall positive experience indicated that their interactions with the different professionals may have affected their self-efficacy in general and in relation to transition to work. The knowledge is essential for the professionals working in the area of vocational rehabilitation. However, vocational rehabilitation interventions also need a societal approach to be able to offer clients opportunities for job training and real jobs.

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  • 2.
    Back, A.
    et al.
    Karolinska Inst, Sweden; Stockholm Cty Council, Sweden.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    von Thiele Schwarz, U.
    Karolinska Inst, Sweden.
    Richter, A.
    Karolinska Inst, Sweden; Stockholm Cty Council, Sweden.
    Hasson, H.
    Karolinska Inst, Sweden; Stockholm Cty Council, Sweden.
    Correction: Walking the tightrope-perspectives on local politicians role in implementing a national social care policy on evidence-based practice (vol 10, 75, 2016)2021In: International Journal of Mental Health Systems, E-ISSN 1752-4458, Vol. 15, no 1, article id 46Article in journal (Other academic)
    Abstract [en]

    n/a

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  • 3.
    Back, A.
    et al.
    Karolinska Institute, Sweden; Stockholm County Council, Sweden.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    von Thiele Schwarz, U.
    Karolinska Institute, Sweden.
    Richter, A.
    Karolinska Institute, Sweden; Stockholm County Council, Sweden.
    Hasson, H.
    Karolinska Institute, Sweden; Stockholm County Council, Sweden.
    Walking the tightrope-perspectives on local politicians role in implementing a national social care policy on evidence-based practice2016In: International Journal of Mental Health Systems, E-ISSN 1752-4458, Vol. 10, article id 75Article in journal (Refereed)
    Abstract [en]

    Background: Despite national policy recommending evidence-based practice (EBP), its application in social care has been limited. While local politicians can affect the process, little is known about their knowledge, attitudes and roles regarding EBP. The aim here is twofold: to explore the role of local politicians in the implementation of EBP in social care from both their own and a management perspective; and to examine factors politicians perceive as affecting their decisions and actions concerning the implementation of EBP policy. Methods: Local politicians (N = 13) and managers (N = 22) in social care were interviewed. Qualitative thematic analysis with both inductive and deductive codes was used. Results: Politicians were rather uninformed regarding EBP and national policy. The factors limiting their actions were, beside the lack of awareness, lack of ability to question existing working methods, and a need for support in the steering of EBP. Thus, personal interest played a significant part in what role the politicians assumed. This resulted in some politicians taking a more active role in steering EBP while others were not involved. From the managers perspective, a more active steering by politicians was desired. Setting budget and objectives, as well as active follow-up of work processes and outcomes, were identified as means to affect the implementation of EBP. However, the politicians seemed unaware of the facilitating effects of these actions. Conclusions: Local politicians had a possibility to facilitate the implementation of EBP, but their role was unclear. Personal interest played a big part in determining what role was taken. The results imply that social care politicians might need support in the development of their steering of EBP. Moving the responsibility for EBP facilitation upwards in the political structure could be an important step in developing EBP in social care.

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  • 4.
    Boonstra, M. D.
    et al.
    Univ Groningen, Netherlands.
    Abma, F. I
    Univ Groningen, Netherlands; Res Ctr Insurance Med, Netherlands.
    Wilming, L.
    Univ Groningen, Netherlands; Res Ctr Insurance Med, Netherlands.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    Karlsson, Elin
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Brouwer, S.
    Univ Groningen, Netherlands; Res Ctr Insurance Med, Netherlands.
    Social Insurance Literacy of Dutch Workers Receiving Disability Benefits and its Associations with Socio-Economic Characteristics2022In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 32, p. 494-504Article in journal (Refereed)
    Abstract [en]

    Purpose This study explores the concept social insurance literacy (SIL) and corresponding questionnaire (SILQ) among workers receiving disability benefits and the comprehensibility of the social security institute (SSI), and examines associations with socio-economic characteristics. Methods 1753 panel members of the Dutch SSI were approached to complete the SILQ-NL37. This measure was based on the original SILQ. The SILQ-NL37 contains domains for obtaining, understanding and acting upon information for both individual SIL and system comprehensibility. A higher score means better SIL or comprehensibility. Data on age, gender, education, living situation, Dutch skills and time receiving disability benefits were also collected. With k-means clustering, groups with adequate and limited SIL were created. Associations with socio-economic characteristics were examined with independent t-tests and linear regression analyses for both the total scores and within domain scores. Cronbach alpha and Spearman rhos indicated measurement properties were good to acceptable for the SILQ-NL37. Results Thirty-five percent of the 567 participants were in the group with limited SIL. Higher individual SILQ-NL37 scores were associated with having a partner (p = 0.018) and northeastern living region (p = 0.031). Higher scores for obtaining (p = 0.041) and understanding (p = 0.049) information were associated with female sex, and for acting on information with younger age (p = 0.020). People with limited Dutch skills (p = 0.063) and a partner (p = 0.085) rated system comprehensibility higher. Conclusions According to the SILQ-NL37 scores, about 35% of the panel members have limited ability to obtain, understand and act upon social insurance systems information. Limited SIL is associated with several socio-economic factors. Future researches should study the concept in a more representative sample, and in different countries and social insurance contexts.

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  • 5.
    Cassegard, Carl
    et al.
    Univ Gothenburg, Sweden.
    Malmqvist, Karl
    Univ Gothenburg, Sweden.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Toward a resonant society: An interview with Hartmut Rosa2023In: Sociologisk forskning, ISSN 0038-0342, E-ISSN 2002-066X, Vol. 60, no 1, p. 177-195Article in journal (Refereed)
    Abstract [en]

    In this interview, the internationally renowned German sociologist Hartmut Rosa engages in a conversation about resonance, critical theory, politics, and sociology. Rosa discusses populist politics and emotions, and he frames this discussion through his concept of resonance and its implications for politics and democracy. The interview was made in connection with a public lecture Rosa held in Gothenburg in March 2023, titled In search of the prime mover: Can there be a valid conception of social energy?

  • 6.
    Dahlqvist, I
    et al.
    Reg Vastra Gotaland, Sweden.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Severin, J.
    Reg Vastra Gotaland, Sweden; Univ Gothenburg, Sweden.
    Akerstrom, Magnus
    Reg Vastra Gotaland, Sweden; Univ Gothenburg, Sweden; Reg Vastra Gotaland, Sweden.
    Shifting from an individual to an organizational perspective in work environment management - a process evaluation of a six-year intervention program within the Swedish public sector2023In: BMC Public Health, E-ISSN 1471-2458, Vol. 23, no 1, article id 1108Article in journal (Refereed)
    Abstract [en]

    BackgroundWorking systematically with the work environment, particularly the organizational and psychosocial work environment entails several challenges for employers. There is a lack of knowledge on how to best undertake this work. Thus, the aim of this study is to evaluate the process of a six-year organizational-level intervention program where workplaces could apply for additional funds to implement preventive intervention measures, with the intention of improving working conditions and reducing sickness absence within the Swedish public sector.MethodsThe program management process was studied using a mixed-method approach combining qualitative document and content analyses based on process documentation produced between 2017 and 2022 (n = 135), interviews with internal occupational health services professionals in 2021 (n = 9) and quantitative descriptive analyses of submitted applications with decisions from 2017 to 2022 (n = 621).ResultsQualitative analyses of the process documentation revealed concerns from the project group regarding access to sufficient competence and resources among stakeholders and participating workplaces, and role conflicts and ambiguities between the program and everyday operations. To address these challenges, the application process was developed over time using the knowledge gained from previous years. A change in the mental models in work environment management, from an individual to an organizational perspective, was seen among the project group and the internal occupational health services responsible for implementing most of the granted intervention measures. In addition, the proportion of granted intervention measures on an organizational level increased throughout the years from 39% in 2017 to 89% in 2022. The changes in the application process were believed to be the main contributor to the change among the applying workplaces.ConclusionsResults indicate that a long-term organizational-level workplace intervention program may be used, by the employer, as a tool for shifting from an individual- to an organizational perspective in the work environment management. However, additional measures on multiple levels need to be implemented to secure a sustainable shift in perspective within the organization.

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  • 7.
    Dannapfel, Petra
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Peolsson, Anneli
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Öberg, Birgitta
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Nilsen, Per
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
    Applying self-determination theory for improved understanding of physiotherapists rationale for using research in clinical practice: a qualitative study in Sweden2014In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 30, no 1, p. 20-28Article in journal (Refereed)
    Abstract [en]

    Physiotherapists are generally positive to evidence-based practice (EBP) and the use of research in clinical practice, yet many still base clinical decisions on knowledge obtained during their initial education and/or personal experience. Our aim was to explore motivations behind physiotherapists use of research in clinical practice. Self-Determination Theory was applied to identify the different types of motivation for use of research. This theory posits that all behaviours lie along a continuum of relative autonomy, reflecting the extent to which a person endorses their actions. Eleven focus group interviews were conducted, involving 45 physiotherapists in various settings in Sweden. Data were analysed using qualitative content analysis and the findings compared with Self-Determination Theory using a deductive approach. Motivations underlying physiotherapists use of research in clinical practice were identified. Most physiotherapists expressed autonomous forms of motivation for research use, but some exhibited more controlled motivation. Several implications about how more evidence-based physiotherapy can be achieved are discussed, including the potential to tailor educational programs on EBP to better account for differences in motivation among participants, using autonomously motivated physiotherapists as change agents and creating favourable conditions to encourage autonomous motivation by way of feelings of competence, autonomy and a sense of relatedness.

  • 8.
    Ellen, MacEachen
    et al.
    University of Waterloo, Canada; University of Toronto, Canada; Institute Work and Heatlh, Canada.
    Kosny, A.
    University of Toronto, Canada; Institute Work and Heatlh, Canada; Monash University, Australia.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    OHagan, F.
    Trent University, Canada.
    Redgrift, L.
    Institute Work and Heatlh, Canada; Dalhousie University, Canada.
    Sanford, S.
    Institute Work and Heatlh, Canada.
    Carrasco, C.
    Institute Work and Heatlh, Canada.
    Emile, Tompa
    Institute Work and Heatlh, Canada; McMaster University, Canada.
    Mahood, Q.
    Institute Work and Heatlh, Canada.
    Systematic review of qualitative literature on occupational health and safety legislation and regulatory enforcement planning and implementation2016In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 42, no 1Article, review/survey (Refereed)
    Abstract [en]

    Objective The ability of occupational health and safety (OHS) legislation and regulatory enforcement to prevent workplace injuries and illnesses is contingent on political, economic, and organizational conditions. This systematic review of qualitative research articles considers how OHS legislation and regulatory enforcement are planned and implemented. Methods A comprehensive search of peer-reviewed, English-language articles published between 1990 and 2013 yielded 11 947 articles. We identified 34 qualitative articles as relevant, 18 of which passed our quality assessment and proceeded to meta-ethnographic synthesis. Results The synthesis yielded four main themes: OHS regulation formation, regulation challenges, inspector organization, and worker representation in OHS. It illuminates how OHS legislation can be based on normative suppositions about worker and employer behavior and shaped by economic and political resources of parties. It also shows how implementation of OHS legislation is affected by "general duty" law, agency coordination, resourcing of inspectorates, and ability of workers to participate in the system. Conclusions The review identifies methodological gaps and promising areas for further research in "grey" zones of legislation implementation.

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  • 9.
    Fagerlind, Anna-Carin
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, HELIX Competence Centre.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    Interventioner inspirerade av basinkomst: förutsättningar i lokal välfärdspolitik och förväntade effekter på livskvalitet och arbetsmarknadsdeltagande2021Report (Other academic)
    Abstract [sv]

    Samordningsförbund arbetar för att underlätta processen mot livskvalitet och arbetsmarknadsdeltagande för personer som står långt ifrån arbetsmarknaden genom att samordna insatser från Försäkringskassan, Arbetsförmedlingen, regioner och kommuner. Olika hinder har identifierats i denna process, som bland annat har med villkoren för deltagarnas ekonomiska ersättning att göra.

    Syftet med denna rapport är att undersöka förutsättningar för interventioner inspirerade av basinkomst inom ramen för samordningsförbundens verksamhet, och om detta kan vara ett alternativ för att åstadkomma en mera adekvat process för att öka människors livskvalitet och arbetsmarknadsdeltagande. Rapporten diskuterar resultat från basinkomstexperiment i relation till samordningsförbundens verksamhet med ett fokus på konsekvenser för arbete, hälsa och livskvalitet.

    Basinkomst är en idé om en offentligt finansierad inkomst som betalas regelbundet, individuellt och till alla utan vare sig prövning av behov eller krav på något beteende eller prestation i gengäld. Som sådan utgör den en trygg ekonomisk bas ovanpå vilken löneinkomst eller annan offentlig inkomst kan adderas. Den föreslås ofta ligga på existensminimum. Basinkomst argumenteras bland annat kunna hjälpa behövande ur fattigdom, öka jämlikhet, ge alla ”frihet att säga nej” till destruktiva villkor och reducera den psykiska belastning som ekonomisk oro innebär. Kritiker mot basinkomst argumenterar för att det skulle leda till att personer som väljer att inte lönearbeta tillåts utnyttja de som lönearbetar, att det skulle gå emot arbetslinjen genom att inte kräva någon motprestation, och öka risken för (själv)destruktivt beteende. Argumenten för respektive emot basinkomst baseras såväl på empiriska frågor som kan undersökas i experiment, som på etiska ställningstaganden. För en konstruktiv diskussion krävs en tydlig åtskillnad mellan vilka argument som är av empirisk karaktär, och vilka som bygger på etiska eller ideologiska ståndpunkter.

    Intervjuer med personer som arbetar inom Samordningsförbundet i Centrala Östergötlands insatser visar att fyrkantiga och komplicerade regelsystem, liksom olika villkor för ersättning (t.ex. behovsprövning, ersättningskriterier eller krav på motprestation) ökar deltagarnas oro och stress. Dagens system för bistånd och ersättningar riskerar därför att ge en negativ effekt på rehabilitering samt stå i vägen för kompetenshöjande insatser. Samtidigt ges uttryck för farhågor att ett lösare regelsystem och uteblivna krav på motprestation skulle resultera i att deltagare inte längre deltog i insatser, vilket antas vara negativt både för dem själva och för samhället.

    Experiment och insatser med villkorslös, universell och individuell inkomst har genomförts runt om i världen och utvärderats vetenskapligt, ofta med fokus på hälsa och arbete. Ofta är det personer i utsatt socioekonomisk situation som under en begränsad period har fått basinkomst. Resultaten visar att basinkomst ökar sannolikheten för att kunna lämna dåliga anställningsvillkor och söka sig till bättre samt reducera övertidsarbete. I länder med begränsat inkomstskydd vid exempelvis sjukdom eller föräldraskap och med mindre jämlika möjligheter för att studera används basinkomsten i viss utsträckning till detta. Arbetslösa som får basinkomst söker arbeten och arbetar något mer än personer som inte får basinkomst. Ingenstans finns tecken på att mottagare av basinkomst systematiskt slutar arbeta eller engagerar sig i destruktivt beteende. Inkomsten används snarare för investeringar i anställningsbarhet (transportmöjligheter, utbildning, verktyg) och till nödvändigheter. Mottagare av basinkomst rapporterar stora förbättringar i hälsa, främst psykisk. Detta kan relateras till minskad ekonomisk oro och stress, men också till förbättrade möjligheter att delta i samhället och aktiviteter som uppfattas som meningsfulla, till en ökad upplevelse av tillit och möjlighet att kunna ta kontroll över och planera sin tillvaro, sin tid och sin ekonomi. Resultat har också pekat på minskad kriminalitet, förbättrad skolnärvaro för ungdomar, reducerade olyckor och misshandel, och minskade kostnader för sjukvård.

    Basinkomst kan ses som en såväl aktiverande som rehabiliterande åtgärd. Ekonomiska incitament (lön) och hot om negativa konsekvenser utgör en begränsad och bristfällig källa till motivation att arbeta eller delta i produktiva aktiviteter. Basinkomst kan ses som en resurs som både motiverar och skyddar mot stressrelaterad ohälsa. Behovsprövning och krav på motprestation reducerar individens autonomi medan en villkorslös inkomst gör en aktivitet eller ett arbete till ett fritt val, något som främjar motivation och ökar sannolikheten för upplevelser av meningsfullhet. Villkorslösheten förebygger den stress som orsakas av svårbegripliga ersättningskriterier och behovsprövningar, och som kan uppstå när krav på motprestation överstiger individens resurser eller förmågor och därför inte upplevs som hanterbara. 

    Slutsatsen är att basinkomst med fördel kan utgöra en källa till inspiration för en intervention med syftet att förbättra processen mot livskvalitet och arbete. En intervention inspirerad av basinkomst kan se ut på olika sätt. Det grundläggande är inkomstens villkorslöshet och trygghet där ett ekonomiskt minimum garanteras, liksom en vetenskaplig utvärdering av såväl interventionen som nuvarande insatser och villkor i relation till arbetsmarknadsdeltagande och livskvalitet. En sådan intervention kräver en politisk vilja som i första hand är möjlig och sannolik på lokal, snarare än nationell, nivå. Vi uppmanar alla som är beredda att låta sig inspireras av basinkomst för utformningen av interventioner att vidare utforska de juridiska möjligheter som finns exempelvis inom det lokala tolkningsutrymme som finns i Socialtjänstlagen. Möjligheten att delta i samordningsförbundens insatser skulle vid en sådan intervention utgöra ett värdefullt stöd till deltagarna.

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  • 10.
    Fagerlind Ståhl, Anna-Carin
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Smith, Peter
    Inst Work and Hlth, Canada; Univ Toronto, Canada; Monash Univ, Australia.
    Longitudinal association between psychological demands and burnout for employees experiencing a high versus a low degree of job resources2018In: BMC Public Health, E-ISSN 1471-2458, Vol. 18, article id 915Article in journal (Refereed)
    Abstract [en]

    Background: Exhaustion and burnout are common causes for sickness absence. This study examines the relationship between psychological demands and burnout over time, and if environmental support modifies the longitudinal relationship between psychological demands and burnout at baseline, with burnout measured 2 years subsequently. Methods: A questionnaire was sent to employees in seven Swedish organizations in 2010-2012 with follow-up after 2 years, n = 1722 responded (64%). Linear regressions were used to examine the associations between burnout and psychological demands at baseline and burnout at follow-up. Stratified regression models examined if relationships between burnout and psychological demands at baseline on burnout at follow-up differed for employees in supportive versus unsupportive work environments. Results: Burnout and psychological demands at baseline were associated with burnout at follow-up, after adjustment for study covariates. No significant differences were observed between estimates for psychological demands and burnout among respondents in supportive work environments versus those in unsupportive work environments. Conclusions: This study shows that high demands are associated with greater risk of burnout, regardless of level of other work supports. This has implications for prevention of sick leave due to burnout and for rehabilitation, where demands such as work pace, workload and conflicting demands at work may need to be reduced.

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  • 11.
    Gensby, Ulrik
    et al.
    Team Arbejdsliv.
    Limborg, Hans Jørgen
    Team Arbejdsliv.
    Mahood, Quenby
    Institute for Work and Health.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, HELIX Competence Centre.
    Albertsen, Karin
    Team Arbejdsliv.
    Employer Strategies for Preventing Mental HealthRelated Work Disability: A Scoping Review2019In: Nordic Journal of Working Life Studies, E-ISSN 2245-0157, Vol. 9, no 1, p. 57-101Article in journal (Refereed)
    Abstract [en]

    This study examined Nordic research on psychosocial work environment and disability manage- ment, specifically employer strategies for preventing work disability in common mental disorders (CMDs).A scoping review was performed to identify strategies across several research databases, alongside contact with content experts, hand-searching of non-indexed journals, and internet searches. Identification and selection of relevant studies, charting of data, and collating and sum- marizing of results was done using a six-step framework for conducting scoping reviews. Several key elements and knowledge gaps were identified in current prevention approaches and work- place initiatives across the included studies.We propose a program theory for workplace preven- tion of CMD-related work disability.The program theory may help specify employer strategies, and bridge activities with stakeholders outside the workplace.

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  • 12.
    Hensing, Gunnel
    et al.
    Avdelningen för samhällsmedicin och folkhälsa, Göteborgs universitet.
    Bertilsson, Monica
    Avdelningen för samhällsmedicin och folkhälsa, Göteborgs universitet.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Educational Sciences.
    Chefen – en nyckelperson för medarbetare som har psykiska besvär2021In: Psykisk hälsa i arbetslivet, Studentlitteratur AB, 2021, p. 175-198Chapter in book (Other academic)
  • 13.
    Karlsson, Elin
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Hellgren, Mattias
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Sandqvist, Jan
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Seing, Ida
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Social Insurance Literacy Among the Sick-listed-A Study of Clients' Comprehension and Self-Rated System Comprehensibility of the Sickness Insurance System2024In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688Article in journal (Refereed)
    Abstract [en]

    IntroductionSickness insurance systems and their processes have been studied in terms of transparency, comprehensibility and fairness, highlighting the importance of just procedures that make sense to clients. Related research demonstrates differences between groups of clients, pointing towards a social gradient. The concept of social insurance literacy and the Social Insurance Literacy Questionnaire (SILQ) was recently developed and serves as a measure for client's ability to obtain, understand and act on information in a sickness insurance system, relating to the comprehensibility of the information that the system provides.ObjectiveThe purpose of this study was to investigate social insurance literacy among clients on sick leave and its associations with perceived justice, being granted sickness benefits and background factors.MethodsThis was a questionnaire study with clients on sick leave in Sweden. In the selection process 3993 clients were invited, of which 1173 recently had their sickness benefits withdrawn. Those who answered the SILQ (n = 1152) also answered a perceived justice measure and accepted sharing register data from the Swedish Social Insurance Agency. Data were analyzed through regression analysis.ResultsThe findings demonstrate that clients' perceptions of system comprehensibility and the status of their sick leave case was significantly associated with perceived justice, and being granted sickness benefits, while their individual abilities to obtain, understand, and act on information had lesser influence.ConclusionsThe system's ability to provide understandable information seems more important than clients' abilities to comprehend it. From a client perspective, a just system seems to be related to their experiences of the sick leave process (i,e., whether they had an ongoing or closed case) rather than their skills to obtain the correct information.

  • 14.
    Karlsson, Elin
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Sandqvist, Jan
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Seing, Ida
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Exploring Interactions in the Sickness Insurance System in Terms of Power and Trust2022In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 32, no 3, p. 483-493Article in journal (Refereed)
    Abstract [en]

    Purpose Activation policies and efforts to reduce sick leave rates has influenced sickness insurance systems in Western countries, which has led to social security being more connected with work and attempts to expose malingering among the sickness absent. The aim of this study was to explore how power and trust are expressed by clients and stakeholders within the Swedish sickness insurance system. Methods This was a longitudinal qualitative study based on semi structured interviews and case files from 31 clients on sick leave in Sweden. Data was analyzed using a thematic analysis. Results The main theme Acts of power and distrust illustrates how stakeholders express suspicions towards each other, and how clients need to demonstrate desire and efforts to return to work which other stakeholders verified. Conclusions The clients desire to prove themselves able to contribute to society was prominent in this study and power relations need to be acknowledged, in particular between client and the SIA. Further, to preserve citizens trust in the system, the system needs to demonstrate trust also in the clients.

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  • 15.
    Karlsson, Elin
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Sandqvist, Jan
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Seing, Ida
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Ståhl, Christian
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, HELIX Competence Centre.
    Maktspel och arbetsmoral bland sjukskrivna och andra aktörer - Sjukförsäkringssystemet och moral hazard2021Conference paper (Other academic)
    Abstract [sv]

    Bakgrund: Aktiveringspolicy och teorier om moral hazard har influerat utformningen av sjukförsäkringssystem i flera delar av västvärlden. Detta har lett till att sjukpenning blivit allt svårare att erhålla, mer kopplat till arbete och aktivitet, samt insatser för att genomskåda fusk bland sjukskrivna.

    Syftet med studien var att utforska hur makt och arbetsmoral uttrycks av sjukskrivna och andra aktörer i sjukförsäkringssystemet.

    Metod: Detta var en kvalitativ longitudinell studie baserad på intervjuer och akter från 31 sjukskrivna som varit på en försäkringsmedicinsk utredning. Data analyserades genom tematisk analys.

    Resultat: Resultatet visar hur olika aktörer misstänkliggör varandras agendor och kompetens, samt hur olika maktmedel används för att rättfärdiga deras slutsatser. Det framkom även vissa allianser mellan aktörer där dessa präglas av samsyn och samarbete mot gemensamma mål i sjukskrivningsprocessen. Primärt ses dessa allianser mellan sjukskriven och sjukskrivande läkare, men även i enstaka fall mellan handläggare och sjukskrivande läkare i de fall läkaren förespråkar aktivering. De sjukskrivna personerna uttryckte en stark vilja och försök mot arbete eller aktivitet, och deras arbetsmoral verifierades ofta av andra aktörer.  

    Slutsats: Maktspel förekommer på olika sätt inom sjukförsäkringssystemet och de medel som användes i den här studien gavs olika betydelse beroende på vilken aktör som använde dem (exempelvis tolkningen av en försäkringsmedicinsk utredning). Den här studien kan ifrågasätta vissa antaganden om moral hazard och simulering bland sjukskrivna då personerna ofta presterade över sin förmåga under en försäkringsmedicinsk utredning i förhoppningen om att i någon mån visa sig förmögen att bidra till samhället, vilket även verifierades av andra aktörer.

  • 16.
    Karlsson, Elin
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Sandqvist, Jan
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Seing, Ida
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, HELIX Competence Centre. Linköping University, Faculty of Medicine and Health Sciences.
    Social validitet för försäkringsmedicinska utredningar och påföljande myndighetsbeslut inom sjukförsäkringen2019Report (Other academic)
    Abstract [sv]

    Bakgrund: I det svenska sjukförsäkringssystemet utförs försäkringsmedicinska utredningar av särskilda enheter inom hälso- och sjukvården på uppdrag av Försäkringskassan. Dessa utredningar ligger sedan till grund för handläggares beslut om sjukskrivnas rätt till sjukpenning. Studier av social validitet är ännu ovanliga inom försäkringsmedicin och folkhälsa men kan bidra med kunskap om vad som främjar eller hindrar att metoder uppfattas som godtagbara, begripliga och betydelsefulla.

    Syfte: Att utforska sjukskrivna personers upplevelse av social validitet för försäkringsmedicinska utredningar och påföljande myndighetsbeslut avseende sjukpenning inom sjukförsäkringen.

    Metod: Detta var en kvalitativ longitudinell studie baserad på telefonintervjuer med 30 sjukskrivna som varit på en försäkringsmedicinsk utredning, samt delvis deras akter från Försäkringskassan. En deduktiv innehållsanalys användes.

    Resultat: Sjukskrivnas förståelse för utredningen var beroende av huruvida de specifika testerna var tydligt relaterade till personernas svårigheter eller ej och vilken information de hade fått. De anser att den standardiserade strukturen inte är relevant för alla och att bristen på individanpassning förvårar möjligheten att få en rättvis bild av deras arbetsförmåga. 

    Diskussion: Social validitet utforskades för försäkringsmedicinska utredningar och myndighetsbeslut i termer av godtagbarhet, begriplighet och betydelse. Utredningarna indikerar en låg social validitet i termer av godtagbarhet på grund av bristen på individanpassning, även om vissa delar är mer socialt valida än andra. Vidare varierade utredningarnas begriplighet beroende på deras applicerbarhet och den erhållna informationen, medan dimensionen betydelse indikerar en högre grad av social validitet. Handläggarens påföljande myndighetsbeslut ansågs däremot orelaterat till utredningens resultat, sakna konkreta argument och ibland motsägande andra aktörers rekommendationer, vilket indikerar en låg social validitet i termer av både godtagbarhet, begriplighet och betydelse. 

    Slutsats: Social validitet finns för delar av utredningarna men är låg för det påföljande myndighetsbeslutet.

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  • 17.
    Karlsson, Elin
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Sandqvist, Jan
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Seing, Ida
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, HELIX Competence Centre. Linköping University, Faculty of Arts and Sciences.
    Social validity of work ability evaluations and official decisions within the sickness insurance system: a client perspective2021In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 70, no 1, p. 109-124Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Studies of the social validity of work ability evaluations are rare, although the concept can provide valuable information about the acceptability, comprehensibility and importance of procedures. 

    OBJECTIVE: The aim of this study was to explore clients’ perceptions of social validity of work ability evaluations and the following official decisions concerning sickness benefits within the Swedish sickness insurance system.

    MATERIALS AND METHODS: This was a longitudinal qualitative study based on interviews with 30 clients on sick leave, analyzed through deductive content analysis. 

    RESULTS: Clients’ understanding of the evaluation was dependent on whether the specific tests were perceived as clearly related to the clients’ situation and what information they received. For a fair description of their work ability, clients state that the strict structure in the evaluation is not relevant to everyone. 

    CONCLUSION: The work ability evaluations indicate low acceptability due to lack of individual adaptation, the comprehensibility varied depending on the applicability of the evaluation and information provided, while the dimension ‘importance’ indicated as higher degree of social validity. The official decision about sickness benefits however was considered unrelated to the evaluation results, lacking solid arguments and sometimes contradictory to other stakeholders’ recommendations indicating poor social validity.

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  • 18.
    Karlsson, Elin
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Sandqvist, Jan
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Ståhl, Christian
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine.
    Social validity for work ability assessments and official decisions – clients’ experiences2019In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 29, no Supplement_4, p. 496-497, article id ckz186.306Article in journal (Refereed)
    Abstract [en]

    Background

    Professionals need to be able to express what is at stake during the decision-making process and the discrepancy between formal rules and practical rationality need to be bridgeable and transparent for outsiders. Investigations of social validity for work ability assessments are rare. However, the concept can provide valuable information upon the acceptability and comprehensibility of procedures and how professionals can increase clients’ participation.

    The purpose of this study was to investigate social validity for work ability evaluations within the sickness insurance system and the official decisions they lead to.

    Methods

    This was a longitudinal qualitative study using telephone interviews and files from the Swedish Social Insurance Agency. Clients (n = 30) were interviewed after their participation in a work ability evaluation as well as after receiving an official decision upon eligibility for sickness benefits. Data was analyzed using a deductive content analysis.

    Results

    Preliminary findings show that clients’ comprehensibility of the different tests and their composition were depending on whether the specific tests were perceived as clearly related to the clients’ difficulties and what information they had received. In order to receive a fair description of the client’s work ability, clients state that the work ability evaluation needs to be individually adapted and that the standardized structure is not relevant for all. What is acceptable and fair to one client could be unacceptable to another, depending on what arguments and information case-managers and evaluation professionals provided.

    Conclusions

    Authorities need to express and motivate the reasons for a diverse range of steps during clients sick-leave process, not only regarding official decisions. Social validity for work ability evaluations is depending on the provided information and the applicability to the clients’ situation.

    Key messages

    • Social validity is depending on the provided information and the applicability to the clients’ situation.

    • Authorities need to communicate clearly with clients through the whole sick-leave process.

  • 19.
    Karlsson, Elin
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Seing, Ida
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Sandqvist, Jan
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Ståhl, Christian
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, HELIX Competence Centre.
    Communication Characteristics Between Clients And Stakeholders Within The Swedish Sickness Insurance System – A Document Analysis Of Granted And Withdrawn Sickness Benefit Claims2019Conference paper (Refereed)
    Abstract [en]

    INTRODUCTION: Previous studies show differences regarding which clients receive sickness benefits as well as which clients are questioned or not within the sickness insurance system. There are indications that the characteristics of communication can have an impact on the sick leave process, which motivates this study with the following purpose.

    PURPOSE: The purpose of this study was to investigate how communication within the Swedish sickness insurance system differs between cases of sick leave and how this may affect the clients’ case.

    MATERIALS AND METHODS: This was a document study using thirty client files including the correspondence between clients, their case-manager at the Swedish Social Insurance Agency (SIA) as well as other stakeholders. The clients included had been on a work capacity evaluation during their sick leave spell and were aged 32-64 years. There were twenty women and ten men in this study, with a variety of the degree of sickness absence, disability pension and part time work. The material was analyzed using qualitative document analysis.

    RESULTS: The results show different approaches in communication, characterized by emotional communication, matter-of-fact driven communication and information exchange, which have diverse success in affecting authority decisions. Arguments characterized by emotions such as frustration or desperation are to a larger extent neglected compared to those characterized by a matter-of-fact driven approach and referring to regulations and medical certificates. There are also differences in how information about the client is interpreted by different professionals.

    CONCLUSION: There are differences regarding how clients and stakeholders communicate the clients’ needs and prerequisites, and how this affect the SIA. Further research must be carried out in order to establish social insurance literacy, initially for individuals on sick leave within the sickness insurance, and whether there are differences between diverse groups that could lead to injustice in the system.

  • 20.
    Karlsson, Elin
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Seing, Ida
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Sandqvist, Jan
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Communication characteristics between clients and stakeholders within the Swedish sickness insurance system: a document analysis of granted and withdrawn sickness benefit claims2020In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 42, no 23, p. 3316-3326Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this study was to investigate how communication within the Swedish sickness insurance system differs between cases of sick leave and how this may affect clients’ cases.

    Materials and methods: This was a document study using 30 client files from the Swedish Social Insurance Agency (SIA). The clients included had been on a work ability evaluation during their sick leave spell and were aged 32–64 years. The material was analyzed using qualitative document analysis.

    Results: The results show different approaches to communication, characterized by emotional argumentation, matter-of-fact driven argumentation and information exchange, which have diverse success in affecting official decisions. Arguments characterized by emotions such as frustration or desperation are to a larger extent neglected by the authorities compared to those characterized by a matter-of-fact driven approach and referring to regulations and medical certificates.

    Conclusion: There are differences regarding how clients and stakeholders communicate the clients’ needs and pre-requisites, and how this affects official decisions. Further research must be carried out in order to establish social insurance literacy, initially for individuals on sick leave within the sickness insurance system, and whether there are differences between diverse groups that could lead to injustices.

    • Implications for rehabilitation
    • Within a social insurance context, professionals need to provide clients with adequate and individually adapted information in order for procedures to be perceived as comprehensible and manageable by the clients.

    • The support from stakeholders such as the treating physician and/or employer can affect clients’ sick-leave process.

    • Clients’ treating medical professionals can contribute to ensuring that clients rights are met by communicating the clients’ needs to other stakeholders in a formal way.

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  • 21.
    Klofsten, Magnus
    et al.
    Linköping University, Department of Management and Engineering, Project Innovations and Entrepreneurship. Linköping University, Faculty of Science & Engineering. Linköping University, HELIX Competence Centre.
    MacEachen, Ellen
    University of Waterloo, Ontario, Canada.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    New and small firms in a modern working life: How do we make entrepreneurship healthy?2021In: Small Business Economics, ISSN 0921-898X, E-ISSN 1573-0913, Vol. 57, p. 755-763Article in journal (Refereed)
    Abstract [en]

    The interplay between health, entrepreneurship and small and emerging businesses is a research field receiving growing interest. Studies point to both health-related risks and opportunities, which have implications for the social and economic lives of entrepreneurs and employees in small and new firms. Research has been carried out in different disciplines, which have contributed in different ways to the understanding of this inquiry. As the field is still premature and interdisciplinary in nature, there is a need to establish boundary-crossing avenues for developing new knowledge on the topic. This ambition has led to the development of this special issue. The issue includes results from original research on working life challenges encountered by smaller businesses, approached from a variety of disciplines. In this introduction, we begin by tracing an overarching framework, to which we add brief descriptions of the contributing papers. To conclude, we outline future research goals and discuss how issues around mental health, regulation and work environment inspections, race, disability and gender issues, as well as the growing gig economy will affect the conditions for healthy entrepreneurial work.

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  • 22.
    Ladegaard, Yun
    et al.
    Univ Copenhagen, Denmark; Fdn Mental Hlth, Denmark.
    Skakon, Janne
    Univ Copenhagen, Denmark.
    Dalgaard, Vita Ligaya
    Aarhus Univ, Denmark.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    Thomsen, Soren Therkil Slot
    Ascent Consulting Grp, Denmark.
    Netterstrom, Bo
    Bispebjerg Hosp, Denmark.
    Employees with mental disorders seeking support from the workers compensation system - experiences from Denmark2023In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 75, no 4, p. 1361-1377Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In Europe it is commonly accepted that psychosocial hazards may influence the mental health of employees. However, mental disorders such as depression are generally not acknowledged as an occupational disease covered by the workers compensation system. Studies indicate that workers compensation claim processes may affect employees health negatively due to a demanding case process. If filing a workers compensation claim can harm the employees health, it is highly relevant to pay attention to employees with mental health claims, as they are most likely vulnerable and face a very low chance of compensation. OBJECTIVE: This study investigates how employees with work-related mental disorders experience the process of seeking workers compensation from the Danish Workers Compensation System. METHOD: Interview (N= 13) and questionnaire (N = 436) data from claimants were analysed. RESULTS: Analysis showed that even though many employees wished for the claim to influence the conditions at the workplace, there seemed to be a lack of preventive health and safety initiatives in the workplaces. Central stakeholders such as health and safety representatives were often not involved. Management involvement was often experienced negatively, and the DanishWorking Environment Authority rarely conducted workplace inspections. Employees experienced inadequate information about the workers compensation process and experienced a lack of coordination between stakeholders. CONCLUSION: A more supportive and coordinated approach in the Workers Compensation System is recommendable. The processes in the system could be evaluated using the Social Insurance Literacy concept, to ensure sufficient support of the claimants and reduce potential harmful aspects of the process.

  • 23.
    Lundmark, Åse
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Företagshälsovård mot sjukskrivning?: Företagshälsovårdstjänster i förebyggande och rehabiliterande syften i Norrköpings kommun2019Report (Other academic)
    Abstract [sv]

    Denna rapport beskriver resultat från en studie där Norrköpings kommuns användning av företagshälsovårdens tjänster för sjuk- och friskanmälan undersökts. Syftet med rapporten är att beskriva sjukskrivnas erfarenheter av sjukskrivnings- och rehabiliteringsprocessen, med särskilt fokus på av användningen av företagshälsovård och hur detta hänger samman med kontakten med övriga aktörer. Studien bygger på intervjuer med femton deltagare som arbetar inom vård- och omsorgssektorn i Norrköpings kommun som har analyserats genom kvalitativ innehållsanalys.

    Kontakten med företagshälsovården upplevs generellt som positiv, både i relation till sjuk- och friskanmälan och till olika åtgärder som initierats. Deltagarna uppskattar särskilt att kunna prata med en tredje part. Utformningen av avtal med företagshälsovården tycks dock ha betydelse för vilken typ av insatser som kan sättas in. Några problem med tjänsten för sjuk- och friskanmälan lyftes, exempelvis missvisande rubriceringar av sjukfrånvaroorsak, och upplevelser av onödig kontroll.

    Betydelsen av chefens stöd lyfts av samtliga deltagare. En optimal kontakt med chefen karaktäriseras av en aktiv chef som sätter den sjukskrivne medarbetaren i fokus och i samråd med medarbetaren planerar och lägger upp återgången i arbete. Den ambivalenta chefen initierar anpassningar och åtgärder, men detta sker ibland utan involvering av medarbetaren. För sjukskrivna med en mera passiv chef är kontakt med

    företagshälsovården ibland det enda stöd som initierats för att främja återgång till arbete. Resultatet pekar på att chefens roll och stöd vid sjukskrivning och återgång i arbete inte är utbytbart mot insatser från andra aktörer, såsom företagshälsovården. Kontakten med arbetsplatsen är viktig, och sjukskrivna betonar framför allt betydelsen av chefens kontakt, närvaro, och att denne anpassar kontakten utifrån sjukskrivningsorsak. Dialog mellan chef och medarbetare behövs kring hur kontakten med arbetsplatsen på lämpligast sätt bör läggas upp och på så vis anpassas efter den individuella situationen.

    Företagshälsovården kan användas för att stödja arbetsgivaren i arbetet med att förebygga och hantera sjukfrånvaro, och de insatser som erbjuds upplevs ofta som uppskattade och effektiva. Insatserna från företagshälsovården och arbetsgivaren bör dock initieras i samråd med den sjukskrivne för att öka möjligheterna att insatserna upplevs som hjälpsamma och rättvisa.

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  • 24.
    Lundqvist, Daniel
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Reineholm, Cathrine
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Hellgren, Mattias
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Occupational health and safety management: managers’ organizational conditions and effect on employee well-being2024In: International Journal of Workplace Health Management, ISSN 1753-8351, E-ISSN 1753-836XArticle in journal (Refereed)
    Abstract [en]

    Purpose – Knowledge regarding the importance of the psychosocial work environment for health and wellbeing in the workplace is extensive. However, more knowledge is needed about how the managers’ organizational conditions are related to what occupational health and safety management (OHSM) is actually conducted and how this relates to the work-related health of employees. The aim of this study is therefore to investigate if managers’ organizational conditions are associated with the conducted OHSM, and if the conducted OHSM is associated with the psychosocial work environment and well-being of the employees.

    Design/methodology/approach – An electronic questionnaire was sent to managers and their employees working in 10 different organizations in Sweden, resulting in 1,097 valid responses. Structural equation modeling (SEM) was used to analyze the results.

    Findings – The SEM analysis showed that managers’ conditions were related to employee well-being via OHSM and psychosocial work environment (job demands and job resources).

    Originality/value – This study contributes to the existing literature in the field of OHSM by placing explicit focus on the role of organizational conditions for conducting OHSM. By studying not only the link between work environment and health, but also focus on the underlying organizational structures for OHSM, provides additional possibilities for prevention of the increasing work-related illness. As such, this paper contributes to a more holistic perspective in the field of OHSM.

  • 25.
    Lundqvist, Daniel
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    Reineholm, Cathrine
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    Wallo, Andreas
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    The impact of leadership on employee well-being: on-site compared to working from home2022In: BMC Public Health, E-ISSN 1471-2458, Vol. 22, no 1, article id 2154Article in journal (Refereed)
    Abstract [en]

    Background: The Covid-19 pandemic has brought significant changes to the way people work and there are several reasons to believe that working from home will become more common in the future. Yet more knowledge is needed on whether the effectiveness of leadership differs if the work is performed remotely compared to on-site work.

    Purpose: The aim of this study is to examine the place of work as a moderator for the effectiveness of leadership on employee well-being.Method: A survey was answered by 364 white-collar workers, employed by a larger Swedish municipality, who because of the covid-19-pandemic were offered to work from home.

    Results: The employees working in their regular office perceived having more sufficient work equipment. No other differences were found in the investigated variables. Supportive leadership was associated with all investigated well-being variables in the hypothesised directions. Place of work did not moderate the relationship between Support leadership and the investigated well-being outcomes (Job satisfaction, Stress, General well-being).

    Conclusion: This study shows that there are few differences between employees working from home or working on-site during the Covid-19 pandemic. The supportive leadership of the closest manager seem to be important for well-being regardless of the worksite.

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  • 26.
    MacEachen, Ellen
    et al.
    Univ Waterloo, Canada.
    de Rijk, Angelique
    Maastricht Univ, Netherlands.
    Dyreborg, Johnny
    Natl Res Ctr Working Environm, Denmark.
    Fassier, Jean-Baptiste
    Hosp Civils Lyon, France; Univ Sherbrooke, Canada.
    Fletcher, Michael
    Victoria Univ Wellington, New Zealand.
    Hopwood, Pamela
    Univ Waterloo, Canada.
    Koivusalo, Meri
    Tampere Univ, Finland.
    Majowicz, Shannon
    Univ Waterloo, Canada.
    Meyer, Samantha
    Univ Waterloo, Canada.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    Welti, Felix
    Univ Kassel, Germany.
    Laws, Policies, and Collective Agreements Protecting Low-wage and Digital Platform Workers During the COVID-19 Pandemic2022In: NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy, ISSN 1048-2911, E-ISSN 1541-3772, Vol. 32, no 3, p. 201-212Article in journal (Refereed)
    Abstract [en]

    In the context of the COVID-19 pandemic, this commentary describes and compares shifting employment and occupational health social protections of low-wage workers, including self-employed digital platform workers. Through a focus on eight advanced economy countries, this paper identifies how employment misclassification and definitions of employees were handled in law and policy. Debates about minimum wage and occupational health and safety standards as they relate to worker well-being are considered. Finally, we discuss promising changes introduced during the COVID-19 pandemic that protect the health of low-wage and self-employed workers. Overall, we describe an ongoing "haves" and a "have not" divide, with on the one extreme, traditional job arrangements with good work-and-health social protections and, on the other extreme, low-wage and self-employed digital platform workers who are mostly left out of schemes. However, during the pandemic small and often temporary gains occurred and are discussed.

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  • 27.
    Moldvik, Isa
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Educational Sciences. Linköping University, HELIX Competence Centre.
    Müssener, Ulrika
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Work ethics and societal norms influence sick leave and return to work: tales of transformation2021In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 43, no 21, p. 3031-3040Article in journal (Refereed)
    Abstract [en]

    Purpose: This studys purpose was to explore how people on sick leave manage societal norms and values related to work, and how these influence their perspectives of themselves throughout the rehabilitation process. Materials and methods: This was a longitudinal interview study with a narrative approach, comprising 38 interviews with 11 individuals on long-term sick leave. Data collection was conducted in two phases and analysed iteratively through content analysis. Results: The results suggest that work ethics and societal norms influence individuals views of themselves and the sick leave and rehabilitation process. Conforming ones personal values to the work norm can create internal conflicts and cause feelings of shame for not being able to live up to the established norm. The strong work norm may create unrealistic expectations, which in some cases may result in constraining the return to work process. Conclusion: To transform a sick leave narrative into a positive one, societal norms and their influence on identity needs to be recognised. Stakeholders involved in the process can contribute to a positive transformation by not only supporting return to work, but also to acknowledge and help people manage their self-image as having a disability that limits their ability to work.

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  • 28.
    Müssener, Ulrika
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Söderberg, Elsy
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Does the quality of encounters affect return to work? Lay people describe their experiences of meeting various professionals during their rehabilitation process2015In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 52, no 2, p. 447-455Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Among the many aspects of the rehabilitation process that may be relevant for its outcome, the impact of encounters with various professionals has received little attention. OBJECTIVE: The objective was to gain a deeper understanding of how individuals with experiences of being on sick leave perceive their encounters with professionals, and how such encounters affected their ability to return to work, as well as their attitudes towards the sickness insurance system. METHODS: An inductive qualitative approach was used to analyze data from 20 interviews with men and women, aged 33-59, in Sweden who had experience of being on sick leave for at least 28 days. RESULTS: The study shows how interviewees encounters with professionals affected their self-confidence and perception of their ability to return to work. Professionals treatment of people on sick leave seems to be affected by the structural prerequisites for offering support, where sickness insurance regulations are suggested to have a large impact. CONCLUSIONS: An encouraging and supportive attitude on the part of the professionals is essential for empowering people to handle obstacles during the rehabilitation process; whereas feeling rejected and belittled in the return to work process may lead to disempowerment, and/or delays in measures and longer periods on sick leave.

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  • 29.
    Neher, Margit Saskia
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Nilsen, Per
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Learning opportunities in rheumatology practice: a qualitative study2015In: Journal of Workplace Learning, ISSN 1366-5626, E-ISSN 1758-7859, Vol. 27, no 4, p. 282-297Article in journal (Refereed)
    Abstract [en]

    Purpose

    – This paper aims to explore what opportunities for learning practitioners in rheumatology perceive of in their daily practice, using a typology of workplace learning to categorize these opportunities.

    Design/methodology/approach

    – Thirty-six practitioners from different professions in rheumatology were interviewed. Data were analyzed using conventional qualitative content analysis with a directed approach, and were categorized according to a typology of formal and informal learning.

    Findings

    – The typology was adjusted to fit the categories resulting from the analysis. Further analysis showed that work processes with learning as a by-product in general, and relationships with other people in the workplace in particular, were perceived as important for learning in the workplace. The use of many recognized learning opportunities was lower. Barriers for learning were a perceived low leadership awareness of learning opportunities and factors relating to workload and the organization of work.

    Research limitations/implications

    – The generalizability of results from all qualitative inquiries is limited by nature, and the issue of transferability to other contexts is for the reader to decide. Further studies will need to confirm the results of the study, as well as the proposed enhancement of the typology with which the results were categorized.

    Practical implications

    – The study highlights the importance of relationships in the workplace for informal learning in rheumatology practice. In the clinical context, locally adapted strategies at organizational and individual levels are needed to maximize opportunities for both professional and interprofessional informal learning, taking the importance of personal relationships into account. The findings also suggest a need for increased continuing professional education in the specialty.

    Originality/value

    – The workplace learning typology that was used in the study showed good applicability to empirical health-care study data, but may need further development. The study confirmed that informal workplace learning is an important part of learning in rheumatology. Further studies are needed to clarify how informal and formal learning in the rheumatology clinic may be supported in workplaces with different characteristics.

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  • 30.
    Neher, Margit
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Ellström, Per-Erik
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Nilsen, Per
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Knowledge Sources for Evidence-Based Practice in Rheumatology Nursing.2015In: Clinical Nursing Research, ISSN 1054-7738, E-ISSN 1552-3799, Vol. 24, no 6, p. 661-679Article in journal (Refereed)
    Abstract [en]

    As rheumatology nursing develops and extends, knowledge about current use of knowledge in rheumatology nursing practice may guide discussions about future knowledge needs. To explore what perceptions rheumatology nurses have about their knowledge sources and about what knowledge they use in their practice, 12 nurses working in specialist rheumatology were interviewed using a semi-structured interview guide. The data were analyzed using conventional qualitative content analysis. The analysis yielded four types of knowledge sources in clinical practice: interaction with others in the workplace, contacts outside the workplace, written materials, and previous knowledge and experience. Colleagues, and physicians in particular, were important for informal learning in daily rheumatology practice. Evidence from the medical arena was accessed through medical specialists, while nursing research was used less. Facilitating informal learning and continuing formal education is proposed as a way toward a more evidence-based practice in extended roles.

  • 31.
    Neher, Margit
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Festin, Karin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Nilsen, Per
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Implementation of Evidence-Based Practice in Rheumatology: What Sociodemographic, Social Cognitive and Contextual Factors Influence Health Professionals’ Use of Research in Practice?2016In: Journal of rheumatic diseases and treatment, ISSN 2469-5726, Vol. 2, no 3, p. 1-8Article in journal (Refereed)
    Abstract [en]

    Abstract

    Objective: Research on the use of research in rheumatology practice is largely lacking. This study attempts to fill this knowledge gap by exploring the degree to which evidence-based practice (EBP) is implemented in clinical rheumatology practice and identifying individual and organizational factors that may potentially affect research use in the clinical environment.

    Methods: A web-based questionnaire was distributed to members of health professional groups in clinical rheumatology by way of publicly available e-mail addresses. Data were collected on sociodemographic, social cognitive, and contextual factors deemed to potentially influence the use of research in practice. The outcome measure was the EBP Implementation Scale.

    Results: A complex range of factors was found to influence the outcome. The factors that were most clearly associated with research use were the perception of personal ability to use research knowledge, years of experience in clinical rheumatology, and experience of research activities.

    Conclusions: Our study results suggest a large variation in levels of implementation of EBP across work units and individuals, and although a low general standard is indicated (even if a gold standard does not exist), there was also a great interest in working according to EBP principles. Potential for change is apparent, but it seems necessary to examine the use of research evidence in rheumatology practice at the individual and work unit levels to accommodate local and individual needs and resources. Future studies are needed to examine the influence of contextual influences by other methods.

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  • 32.
    Nilsen, Per
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Roback, Kerstin
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
    Cairney, Paul
    University of Stirling, Scotland.
    Never the twain shall meet? - a comparison of implementation science and policy implementation research2013In: Implementation Science, E-ISSN 1748-5908, Vol. 8Article in journal (Refereed)
    Abstract [en]

    Background

    Many of society’s health problems require research-based knowledge acted on by healthcare practitioners together with implementation of political measures from governmental agencies. However, there has been limited knowledge exchange between implementation science and policy implementation research, which has been conducted since the early 1970s. Based on a narrative review of selective literature on implementation science and policy implementation research, the aim of this paper is to describe the characteristics of policy implementation research, analyze key similarities and differences between this field and implementation science, and discuss how knowledge assembled in policy implementation research could inform implementation science.

    Discussion

    Following a brief overview of policy implementation research, several aspects of the two fields were described and compared: the purpose and origins of the research; the characteristics of the research; the development and use of theory; determinants of change (independent variables); and the impact of implementation (dependent variables). The comparative analysis showed that there are many similarities between the two fields, yet there are also profound differences. Still, important learning may be derived from several aspects of policy implementation research, including issues related to the influence of the context of implementation and the values and norms of the implementers (the healthcare practitioners) on implementation processes. Relevant research on various associated policy topics, including The Advocacy Coalition Framework, Governance Theory, and Institutional Theory, may also contribute to improved understanding of the difficulties of implementing evidence in healthcare. Implementation science is at a relatively early stage of development, and advancement of the field would benefit from accounting for knowledge beyond the parameters of the immediate implementation science literature.

    Summary

    There are many common issues in policy implementation research and implementation science. Research in both fields deals with the challenges of translating intentions into desired changes. Important learning may be derived from several aspects of policy implementation research.

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  • 33.
    Norvell Gustavsson, Isa
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Müssener, Ulrika
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Acting the part: how social and organisational factors shape managers actions towards employees with repeated short-term sickness absence2021In: International Journal of Workplace Health Management, ISSN 1753-8351, E-ISSN 1753-836X, Vol. 14, no 6, p. 634-649Article in journal (Refereed)
    Abstract [en]

    Purpose The aim of the study was to understand the social and organisational factors in the workplace that shape managers actions and attitudes towards workers with repeated short-term sickness absence. Design/methodology/approach This was a qualitative interview study. Semi-structured interviews were conducted with 19 managers at 15 different workplaces. The analysis had an abductive approach, using thematic analysis which focused on the latent content of managers attitudes towards employees with repeated short-term sickness absence. Findings Results indicate that the managers views of people on short-term sick leave shift and move through several phases, which was analysed as they were acts in a play, where their given roles are prescribing which actions to take given the available resources for acting these parts. These acts depict an increasingly controlling attitude, where the sick leave is ultimately seen as an individual problem best managed by repressive tactics. Originality/value Role theory offers the possibility to analyse managers attitudes and behaviours by considering the workplace and the manager-employee relationship as regulated by norms and organisational factors.

  • 34.
    Persson, Marcus
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology.
    Ståhl, Christian
    Den nya redaktionen har ordet2023In: Sociologisk forskning, ISSN 0038-0342, E-ISSN 2002-066X, Vol. 60, no 1, p. 3-4Article in journal (Other academic)
  • 35.
    Persson, Marcus
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Sociologisk Forskning ger ut sin 60:e årgång!2023In: Sociologisk forskning, ISSN 0038-0342, E-ISSN 2002-066X, Vol. 60, no 2, p. 121-123Article in journal (Other academic)
  • 36.
    Reineholm, Cathrine
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    Lundqvist, Daniel
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    Bringing risk back in: managers prioritization of the work environment during the pandemic2023In: International Journal of Workplace Health Management, ISSN 1753-8351, E-ISSN 1753-836X, Vol. 16, no 1, p. 4-19Article in journal (Refereed)
    Abstract [en]

    Purpose The purpose of the paper is to investigate managers experiences of managing work environment and risks during the Covid-19 pandemic and to explore how managers might use these experiences to develop future risk management. Design/methodology/approach Semi-structured interviews were carried out with 18 Swedish managers at different hierarchical levels working in 11 different organizations. A directed content analysis was carried out, informed by theory on risk management. Findings The results point to the pandemic as a societal crisis which workplaces needed to manage through large means of improvisation. Regular work environment routines were put to the test, and several deficiencies in the work environment and risk management were identified. Organizations that handle occupational safety and risks on a daily basis through established routines were less affected and could easier adjust work environment and risk management, compared to organizations prioritizing the social and organizational work environment, which had to re-prioritize and start paying more attention to the physical work environment and to bring risk management into their daily routines. Originality/value The study offers an account of how managers in different labor market sectors in Sweden have acted in the midst of the pandemic by handling real-time crises, how these experiences can be used for engaging in retrospective learning and how this may imply changes to their prospective risk management.

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  • 37.
    Seing, Ida
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    MacEachen, Ellen
    Department of Public Health and Health Systems, Faculty of Applied Public Health, University of Waterloo, Ontario, Canada.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Activation Policies and Sick-Listed Workers’ Experiences and Trust in the Sickness Insurance System in Local Practice2014Manuscript (preprint) (Other academic)
    Abstract [en]

    In recent welfare and labour market reforms in Europe and North America, there is a general trend towards activation, in that people (e.g. those who are sick-listed, unemployed and recipients of social welfare) are expected to be “active”, rather than “passive”, recipients of financial benefits. Meanwhile, street-level bureaucracy in many welfare state organizations has been fundamentally reformed in recent years with the implementation of New Public Management Principles which have come to influence the day-to-day work of front-line staff. The aim of this paper is to analyse sick-listed workers’ experiences of the sickness insurance system in their contact with the SSIA and their front-line staff. The data consists of semistructured interviews with 18 sick-listed workers in Sweden. The material was analysed using qualitative content analysis. The findings illustrate that sick-listed workers experienced contacts with the Social Insurance Agency (SSIA) as “standardized”; that is, they perceived that the officials were loyal to demands in their organizations rather than involved actors that supported workers’ individual needs. The SSIA was described as having a mainly administrative and controlling function during their sick leave, resulting in a distant relationship. It was also clear that sick-listed individuals experienced the activation policy as demanding, and their sick leave was characterized by insecurity and uncertainty. Overall, this paper suggests that activation policies with regulations emphasizing time limits, and enforcement of standardized work processes at the SSIA, challenge sick-listed workers’ trust in the sickness insurance system.

  • 38.
    Seing, Ida
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    MacEachen, Ellen
    Department of Public Health and Health Systems, Faculty of Applied Public Health, University of Waterloo, Ontario, Canada.
    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.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Linköping University, HELIX Vinn Excellence Centre.
    Return to work or job transition?: Employer dilemmas in taking social responsibility for return to work in local workplace practice2015In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, no 18-19, p. 1760-1769Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim was to analyze the role and activities of employers with regard to return to work (RTW), in local workplace practice.

    Method: Semi-structured interviews were conducted with sick-listed workers and their supervisors in 18 workplaces (n  = 36). The analytical approach to study the role of employers in RTW was based on the three-domain model of social corporate responsibility. The model illustrates the linkage between corporations and their social environment, and consists of three areas of corporate responsibility: economic, legal and ethical.

    Results: Employers had difficulties in taking social responsibility for RTW, in that economic considerations regarding their business took precedence over legal and ethical considerations. Employers engaged in either “RTW activities” or “transition activities” that were applied differently depending on how valued sick-listed workers were considered to be to their business, and on the nature of the job (e.g. availability of suitable work adjustments).

    Conclusions: This study suggests that Swedish legislation and policies does not always adequately prompt employers to engage in RTW. There is a need for further attention to the organizational conditions for employers to take social responsibility for RTW in the context of business pressure and work intensification.

    Implications for Rehabilitation

    • Employers may have difficulties in taking social responsibility for RTW when economic considerations regarding their business take precedence over legal and ethical considerations.
    • Rehabilitation professionals should be aware of that outcomes of an RTW process can be influenced by the worker’s value to the employer and the nature of the job (e.g. availability of suitable work adjustments). “Low-value” workers at workplaces with limited possibilities to offer workplace adjustments may run a high risk of dismissal.
    • Swedish legislation and policies may need reforms to put more pressure on employers to promote RTW.
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  • 39.
    Seing, Ida
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    MacEachen, Ellen
    School of Public Health and Health Systems, Faculty of Applied Health Sciences, University of Waterloo, Canada.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Linköping University, HELIX Vinn Excellence Centre.
    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.
    Early-Return-to-Work in the Context of an Intensification of Working Life and Changing Employment Relationships2015In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 25, no 1, p. 74-85Article in journal (Refereed)
    Abstract [en]

    Purpose Many Western welfare states have introduced early-return-to-work policies, in which getting sick-listed people back to work before they have fully recovered is presented as a rather unproblematic approach. This reflects a belief in the ability of employers and the labour market to solve sickness absence. Against this background, the aim of this study was to analyse return-to-work practice in local workplace contexts, in relation to Swedish early-return-to-work policy.

    Methods Semi-structured interviews were conducted with 18 matched pairs of workers and managers. The material, comprising a total of 36 interviews, was analysed using qualitative content analysis.

    Results Three main themes were identified: (1) intensive workplaces and work conditions (2) employer support—a function of worker value and (3) work attachment and resistance to job transition. The results reflected the intensity of modern working life, which challenged return-to-work processes. Managers had different approaches to workers’ return-to-work, depending on how they valued the worker. While managers used the discourse of ‘new opportunities’ and ‘healthy change’ to describe the transition process (e.g. relocation, unemployment and retirement), workers regularly experienced transitions as difficult and unjust.

    Conclusions In the context of early-return-to-work policy and the intensity of modern working life, a great deal of responsibility was placed on workers to be adaptable to workplace demands in order to be able to return and stay at work. Overall, this study illustrates an emerging social climate where sick-listed workers are positioned as active agents who must take responsibility for sick leave and return-to-work process.

  • 40.
    Seing, Ida
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Nordenfelt, Lennart
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Health Sciences.
    Bülow, Pia
    Avdelningen för beteendevetenskap och socialt arbete, Hälsohögskolan, Jönköping.
    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.
    Avstämningsmötet som arena för förhandling om arbetsförmåga.2011In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 88, no 5, p. 408-417Article in journal (Refereed)
  • 41.
    Seing, Ida
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Nordenfelt, Lennart
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Arts and Sciences.
    Bülow, Pia
    Avdelningen för beteendevetenskap och socialt arbete, Hälsohögskolan, Jönköping.
    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.
    Policy and Practice of Work Ability: A Negotiation of Responsibility in Organizing Return to Work2012In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 22, no 4, p. 553-564Article in journal (Refereed)
    Abstract [en]

    Purpose In welfare policy and practical work it is unclear what the concept of work ability involves and assessments may be different among involved actors, partly due to a lack of theoretical research in relation to regulations and practice. Based on theoretical and legal aspects of work ability the aim of the study is to analyze stakeholders’ perspectives on work ability in local practice by studying multi-stakeholder meetings.

    Methods The material comprises nine digitally recorded multi-stakeholder meetings. Apart from the sick-listed individual, representatives from the public Social Insurance Agency, health care, employers, public employment service and the union participated in the meeting. The material was analyzed using qualitative content analysis.

    Results Three perspectives on work ability were identified: a medical perspective, a workplace perspective and a regulatory perspective. The meetings developed into negotiations of responsibility concerning workplace adjustments, rehabilitation efforts and financial support. Medical assessments served as objective expert statements to legitimize stakeholders’ perspectives on work ability and return to work.

    Conclusions Although the formal goal of the status meeting was to facilitate stakeholder collaboration, the results demonstrates an unequal distribution of power among cooperating actors where the employers had the “trump card” due to their possibilities to offer workplace adjustments. The employer perspective often determined whether or not persons could return to work and if they had work ability.

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  • 42.
    Sengers, Johan H.
    et al.
    Univ Groningen, Netherlands; Inst Employee Benefits Schemes UWV, Netherlands; AMC UMCG UWV VUmc, Netherlands.
    Abma, Femke I
    Univ Groningen, Netherlands; AMC UMCG UWV VUmc, Netherlands.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Brouwer, Sandra
    Univ Groningen, Netherlands; AMC UMCG UWV VUmc, Netherlands.
    Work capacity assessments and efforts to achieve a job match for claimants in a social security setting: an international inventory2022In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 44, no 10, p. 1898-1907Article in journal (Refereed)
    Abstract [en]

    Purpose Many high-income countries are witnessing a shift of focus on eligibility for disability benefits towards promotion of work reintegration. However, little is known about how countries assess work capacity, and how a job match is then obtained. The current study aims to compare work capacity assessments and available efforts to achieve a job match in eight high-income OECD countries. Methods A survey was conducted among key stakeholders concerning organization of work capacity assessments in social security settings, and efforts made to obtain a job, across eight OECD countries: Australia, Denmark, Finland, Iceland, Sweden, the Netherlands, the United Kingdom and the United States. Results In most countries, work capacity is assessed at several time points, with variations in moments and in information used for job matching. In countries obtaining information on personal and work levels, the search to find a job match usually begins with the persons who have disabilities. Conclusion Although a shift towards a holistic focus in work capacity assessment has been recognized, medical factors still prevail. Limited emphasis is placed on the implications of functional limitations for the possibilities of work. A holistic approach to assessment needs to be coupled with holistic support measures through provision of coordinated and high quality job matching services.

  • 43.
    Strindlund, Lena
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Abrandt Dahlgren, Madeleine
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, HELIX Competence Centre.
    Employers’ views on disability, employability, and labor market inclusion: A phenomenographic study2019In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 41, no 24, p. 2910-2917Article in journal (Refereed)
    Abstract [en]

    PURPOSE: 

    This study aims to increase our understanding of employers' views on the employability of people with disabilities. Despite employers' significant role in labor market inclusion for people with disabilities, research is scarce on how employers view employability for this group.

    METHODS: 

    This was a qualitative empirical study with a phenomenographic approach using semi-structured interviews with 27 Swedish employers from a variety of settings and with varied experience of working with people with disabilities.

    RESULTS: 

    The characteristics of employers' views on the employability of people with disabilities can be described as multifaceted. Different understandings of the interplay between underlying individual-, workplace-, and authority-related aspects form three qualitatively different views of employability, namely as constrained by disability, independent of disability, and conditional. These views are also characterized on a meta-level through their association with the cross-cutting themes: trust, contribution, and support.

    CONCLUSIONS: 

    The study presents a framework for understanding employers' different views of employability for people with disabilities as a complex internal relationship between conceived individual-, workplace-, and authority-related aspects. Knowledge of the variation in conceptions of employability for people with disability may facilitate for rehabilitation professionals to tailor their support for building trustful partnerships with employers, which may enhance the inclusion of people with disabilities on the labor market. Implications for rehabilitation Employers' views on employing people with disabilities vary with respect to individual-, workplace-, and authority-related aspects in relation to trust, contribution and support. Knowledge of the employers' views on the employability of people with disabilities can support professionals in authorities and in vocational rehabilitation. The findings illustrate the importance of analyzing what type of support employers need as a starting point for building trustful partnerships between authority actors and employers. The findings offer a vocabulary that can be used by professionals in authorities and in vocational rehabilitation in tailoring employer-oriented support to increase labor market inclusion of people with disabilities.

  • 44.
    Strindlund, Lena
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Abrandt Dahlgren, Madeleine
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    When cooperation turns ugly: exploring the dark side of social capital2021In: Qualitative research in organization and management, ISSN 1746-5648, E-ISSN 1746-5656, Vol. 17, no 5, p. 1-18Article in journal (Refereed)
    Abstract [en]

    Purpose

    This article explores theoretical assumptions regarding negative consequences of social capital in the empirical case of a failed cooperation project, and how these consequences are related to processes involving people, structures and environments.

    Design/methodology/approach

    The article is based on a case study of a cooperation project within municipal labor market services. The methodology followed a theorizing process, where data were collected through ethnographical methods and analyzed in relation to existing concepts from theories describing negative effects of social capital and shadow organizing.

    Findings

    The results highlight how the development of negative social capital in the project can be understood through three relational processes, namely the social dynamics of insulation, homogenization and escalating commitment. The authors conclude that the quality of social capital is conditional upon complex interactions within social structures. Moreover, the results highlight the importance of studying organizing practices outside explicit structures, in order to identify the development of non-canonical practices and their consequences.

    Practical implications

    Organizing cooperation projects that aim to bridge professional competencies or organizational boundaries have to be attentive toward informal organizing practices which if remaining unrecognized may grow and threaten the original intentions.

    Originality/value

    The study makes a theoretical contribution by combining a shadow organizing approach with literature on social capital. This combination proves especially useful for analyzing how organizational dynamics can influence the development of social capital into producing negative effects.

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  • 45.
    Strindlund, Lena
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Abrandt Dahlgren, Madeleine
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Zooming in on labour market cooperation: A study of a failed project to support unemployed young people2020In: Social Policy & Administration, ISSN 0144-5596, E-ISSN 1467-9515, Vol. 54, no 3, p. 410-426Article in journal (Refereed)
    Abstract [en]

    Purpose The aim was to study the relational dynamics of interorganizational cooperation over the life of a labor market project supporting unemployed young people. Methods The methodological process followed the practice theory toolkit described by Nicolini (2012). Data were collected by ethnographical methods through the initiation, development and closing down of the project. Data analysis was performed in relation to three focus areas: (a) tensions between creativity and normativity, (b) processes of legitimation and stabilization and (c) interactional order. Results The results visualized how a lack of consensus and the presence of two divergent rationalities, a coordinating rationality and an empowerment rationality, within the project organization had major influences on the initiation, development and closing down of the project. Conclusions The study has, by using a practice theory approach, illuminated the complex dynamics of cooperative projects. The study highlights four central and relative conditions when setting up cooperative projects: (a) to enable open and clear communication, (b) to create an adequate structure for the project and clarify assignments and roles in the project organization, (c) to build trustful relationships within the project organization and towards cooperative actors, and (d) to prioritize steering and monitoring in cooperative projects in order to avoid the project deviating from its purpose.

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  • 46.
    Strindlund, Lena
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Vägen till arbetsgivarna2016Report (Other academic)
    Abstract [sv]

    Syfte: Det övergripande syftet med projektet är att få fördjupad kunskap om vad som påverkar arbetsgivares synsätt på arbetslösa från utsatta grupper, särskilt arbetslösa med funktionsnedsättning, och inställning till arbetsmarknadsinkludering, utifrån målsättningen att förbättra förutsättningarna för en ökad inkluderande arbetsmarknad.

    Metod: Urvalet bestod av 27 arbetsgivare med maximal variation gällande yrkesområde, sektor, storlek och erfarenhet av arbetsmarknadsinkludering av utsatta grupper. Datainsamling skedde genom kvalitativa forskningsintervjuer och materialet analyserades med kvalitativ innehållsanalys.

    Resultat: Arbetsgivarnas inställning till arbetsmarknadsinkludering påverkas av en mängd olika faktorer, av möjliggörande och hindrande karaktär, relaterade till arbetsplats, individ och myndighetsstöd och har samband med arbetsgivarnas olika synsätt på målgruppen; som belastning, resurs och miljörelativt.

    Diskussion: Utifrån framkommen kunskap om de olika faktorerna som påverkar arbetsgivarnas synsätt och inställning till arbetsmarknadsinkludering har en arbetsgivarorienterad modell tagits fram. Arbetssättet utgår ifrån en arbetsgivarkoordinator  som genom sin kännedom om arbetsgivaren och tillgång till adekvata stödinsatser kan möta och anpassa insatsen till arbetsgivarnas olika komplexa behov och förutsättningar.

    Konklusion: Metoden öppnar upp för utveckling av en tillitsfull och professionell samverkan mellan arbetsgivare och myndighetsaktörer vilket skapar ökade möjligheter till arbetsmarknadsinkludering av arbetstagare med funktionsnedsättning, och sannolikt även arbetslösa från andra utsatta grupper.

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    Vägen till arbetsgivarna
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  • 47.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, HELIX Competence Centre.
    Arbetets estetik2019In: Arbetsmarknad & Arbetsliv, ISSN 1400-9692, E-ISSN 2002-343X, Vol. 25, no 2, p. 67-87Article in journal (Refereed)
    Abstract [sv]

    Denna essä undersöker hur arbete har visualiserats och presenterats i bildkonst, musik och litteratur. I texten ges exempel från historien, samtiden och framtiden. Från exemplen kan två teman identifieras. Det första berör hur estetiska uttryck förmedlar bakomliggande kulturella, politiska eller ideologiska idéer om arbete, exempelvis genom propagandakonst eller skildringar av prekära arbetsförhållanden. Det andra berör relationen mellan arbete och resten av livet – här ser vi en sammansmältning av arbete och identitet, illustrerat av influerare och livsstilsbutiker, där arbete endast särskiljs från andra aktiviteter genom dess kommersialisering – och hur detta i sin tur ändrar aktivitetens karaktär.

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    fulltext
  • 48.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Att implementera rehabiliteringssamverkan: en fallstudie2011In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 88, no 5, p. 418-427Article in journal (Refereed)
    Abstract [en]

    Coordination Associations is a structure for cooperation between public actors in the rehabilitation field. In this case study, the implementation processes of two cooperation teams are studied, focusing on strategies for implementation, and how these strategies affected the sustainability of the cooperation. The study illustrate two different strategies with different results; one that tried (but failed) to implement cooperative projects, and one interactive strategy aiming to create a local cooperation structure. The latter strategy resulted in a more successful implementation of the team.

  • 49.
    Ståhl, Christian
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Sociology.
    Beroende och befrielse: En diskussion om beroendeteori, ekologism och befrielseteologi2002Report (Other academic)
    Abstract [sv]

      

  • 50.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Coordinating welfare.2008Conference paper (Other academic)
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