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  • 101.
    Nilsson, Staffan
    et al.
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Arts and Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences. Linköping University, HELIX Vinn Excellence Centre.
    Employability and work ability: returning to the labour market after long-term absence2013In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 44, no 4, p. 449-457Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of this study was to analyse how people who return to the labour market after long-term sickness absenteeism and subsequent job loss differ in employability, work ability, health, educational level, age, and gender, compared to those who do not.

    PARTICIPANTS: The cohort consisted of 191 individuals, 20 men and 171 women, whose employment was terminated because they had not been able to return to their regular work after taking a long-term sick leave and rehabilitation measures.

    METHODS: This study is based on a postal questionnaire sent out to a cohort of previous employees in a Swedish municipality in 2008.

    RESULTS: At the time of the survey, 39% of the respondents had returned to the labour market and the remaining 61% had not. Return to the labour market after a long-term sick leave was positively associated with male gender, young age, and work ability, i.e. the ability to work with respect to health and work-related demands. Employability, educational level, and health were not significantly associated with a return to the labour market.

    CONCLUSIONS: In the discourse on employability, work ability is often neglected even though it is a central aspect of an individual's ability to obtain new employment.

  • 102.
    Nordlund, Anders
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation .
    Ekberg, Kerstin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation .
    Self reported musculoskeletal symptoms in the neck/shoulders and/or arms and general health (SF-36): eight year follow up of a case-control study2004In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 61, no 3Article in journal (Refereed)
    Abstract [en]

    Aims: To explore and compare the prevalence after eight years of self reported musculoskeletal symptoms and general health (SF-36) for groups with initially different degrees of severity of symptoms in the neck/shoulders and/or arms. Methods: A case-control study was performed in 1989 comprising 129 clinically examined cases and 655 survey controls. The study population was followed up in 1997 with a postal survey. The controls, none of which were clinically examined at baseline (1989), were divided into groups according to degree of severity of self reported symptoms in the neck/shoulders and/or arms at baseline: no symptoms, light symptoms, and severe symptoms. Cases were clinically diagnosed with a musculoskeletal disorder of the neck/shoulders and/or arms at baseline. Results: At the 1997 follow up, there was a trend of increasing prevalence of musculoskeletal symptoms, as well as decreasing health status as rated in the SF-36 over the three severity groups among controls. Only small differences were seen between the cases and the controls reporting severe musculoskeletal symptoms or the neck/shoulders and/or arms. Conclusion: The degree of questionnaire based self reported musculoskeletal symptoms of the neck/shoulders and/or arms clearly indicate different degrees of future health problems (both in terms of self reported musculoskeletal problems and health in general as captured by the SF-36). Therefore, there is a need for improved intervention and health promotion strategies. Such effort should be implemented before musculoskeletal symptoms have developed to clinical cases, particularly in the realm of the workplace.

  • 103.
    Nordlund, Anders
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Ekberg, Kerstin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Kristenson, Margareta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Östergötlands Läns Landsting, Centre for Public Health Sciences, Centre for Public Health Sciences.
    Group: med:, Linquest
    Ståhlbom, Bengt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine. Östergötlands Läns Landsting, Pain and Occupational Centre, Occupational and Environmental Medicine Centre.
    Tondel, Martin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine. Östergötlands Läns Landsting, Pain and Occupational Centre, Occupational and Environmental Medicine Centre.
    EQ-5D in a general population survey - A description of the most commonly reported EQ-5D health states using the SF-362005In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 14, no 4, p. 1099-1109Article in journal (Refereed)
    Abstract [en]

    The importance of studying health-related quality of life in the general population has increasingly been emphasized. From a public health perspective, this benefits the identification of population inequalities in health status. One of the currently most popular instruments is the EQ-5D. Evaluations of the EQ-5D generally focus on the overall preference-based index. As this index has a built-in value, exploration of the information from the underlying health states is also important. In this study, the ten most commonly reported EQ-5D health states are described using the SF-36. Data collected in 1999 by questionnaires mailed to a random sample aged 20-74 in south-eastern Sweden were used (n = 9489). Almost 43% reported the best possible EQ-5D health state and 78% were accounted for by three EQ-5D health states. The EQ-5D health state classification was largely reflected by the SF-36, with the EQ-5D items mobility, usual activities, pain/discomfort and anxiety/depression tapping most clearly on the SF-36 scales physical functioning, role limitations due to physical health problems, bodily pain, and mental health, respectively. However, within the same level of EQ-5D (i.e., moderate problems) there was a rather large variation of SF-36 scale scores, particularly regarding the EQ-5D item pain/discomfort and the SF-36 scale BP. © Springer 2005.

  • 104.
    Nordström, Karin
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Hemmingsson, Tomas
    Arbets- och miljömedicin, Institutionen för folkhälsovetenskap, Karolinska Institutet.
    Johansson, Gun
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Rörlighet på arbetsmarknaden och återgång i arbete. Posterpresentation.2011Conference paper (Refereed)
  • 105.
    Nordström, Karin
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Hemmingsson, Tomas
    Arbets- och miljömedicin, Institutionen för folkhälsovetenskap, Karolinska Institutet.
    Johansson, Gun
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Sick leave and the impact of job-to-job mobility on future vocational situation.2012Conference paper (Other academic)
  • 106.
    Nordström, Karin
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Linköping University, HELIX Vinn Excellence Centre.
    Hemmingsson, Tomas
    Arbets- och miljömedicin, Institutionen för folkhälsovetenskap, Karolinska Institutet.
    Johansson, Gun
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Sick leave and the impact of job-to-job mobility on the future vocational situation2014In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 305Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 107.
    Nordström, Karin
    et al.
    Karolinska Institute, Sweden.
    Hemmingsson, Tomas
    Karolinska Institute, Sweden; Stockholm University, Sweden.
    Ekberg, Kerstin
    Linköping University, HELIX Vinn Excellence Centre. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Johansson, Gun
    Karolinska Institute, Sweden.
    SICKNESS ABSENCE IN WORKPLACES: DOES IT REFLECT A HEALTHY HIRE EFFECT?2016In: International Journal of Occupational Medicine and Environmental Health, ISSN 1232-1087, E-ISSN 1896-494X, Vol. 29, no 2, p. 315-330Article in journal (Refereed)
    Abstract [en]

    Objectives: Sickness absence in workplaces may reflect working conditions. It may also reflect a "healthy hire effect," i.e., that workplaces recruit individuals with experience of sickness absence differently. The purpose of the study was to determine if a history of sickness absence among recruits is associated with the average level of sickness absence in workplaces. Material and Methods: In a register-based follow-up study, Swedish workplaces with at least 5 employees in 2006 were selected (approximately 127 000 workplaces with 3.9 million employees). The workplaces were categorized according to the average workplace sickness absence in 2006 and the recruits were categorized according to the individual sickness absence in 2005. The workplaces with a high average level of sickness absence were more likely than those with a low level to hire employees with high sickness absence in the year preceding employment: men - odds ratio (OR) = 7.2, 95% confidence interval (CI): 6.6-7.8, women OR = 7.5, 95% CI: 6.9-8.1. Results: The results show that there is a greater likelihood of employing individuals with high levels of sickness absence in the workplaces with many days of the average sickness absence than in the workplaces with few days of the average sickness absence. Conclusions: The results suggest that sickness absence in workplaces may reflect a healthy hire effect.

  • 108.
    Persson, Jan
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
    Bernfort, Lars
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences. Region Östergötland, Heart and Medicine Center, Allergy Center.
    Wåhlin, Charlotte
    Region Östergötland, Heart and Medicine Center, Occupational and Environmental Medicine Center. Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Institutet, Sweden.
    Öberg, Birgitta
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Costs of production loss and primary health care interventions for return-to-work of sick-listed workers in Sweden2015In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, no 9, p. 771-776Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study was to investigate, from the perspective of society, the costs of sick leave and rehabilitation of recently sick-listed workers with musculoskeletal disorders (MSD) or mental disorders (MD). Methods: In a prospective cohort study, 812 sick-listed workers with MSD (518) or MD (294) were included. Data on consumption of health care and production loss were collected over six months from an administrative casebook system of the health care provider. Production loss was estimated based on the number of sick-leave days. Societal costs were based on the human capital approach. Results: The mean costs of production loss per person were EUR 5978 (MSD) and EUR 6381 (MD). Health care interventions accounted for 9.3% (MSD) and 8.2% (MD) of the costs of production loss. Corresponding figures for rehabilitation activities were 3.7% (MSD) and 3.1% (MD). Health care interventions were received by about 95% in both diagnostic groups. For nearly half of the cohort, no rehabilitation intervention at all was provided. Conclusions: Costs associated with sick leave were dominated by production loss. Resources invested in rehabilitation were small. By increasing investment in early rehabilitation, costs to society and the individual might be reduced. Implications for Rehabilitation Resources invested in rehabilitation for sick-listed with musculoskeletal and mental disorders in Sweden are very small in comparison with the costs of production loss. For policy makers, there may be much to gain through investments into improved rehabilitation processes for return to work. Health care professionals need to develop rehabilitative activities aiming for return to work, rather than symptoms treatment only.

  • 109.
    Persson, Jan
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
    Bernfort, Lars
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Wåhlin, Charlotte
    Institute of Environmental Medicine, Karolinska Institutet.
    Öberg, Birgitta
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Costs to society related to sickness absence due to musculoskeletal or mental disorders in Sweden - results from a cohort study2013Conference paper (Refereed)
  • 110.
    Pransky, Glenn S.
    et al.
    Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, USA; University of Massachusetts Medical School, Worcester, USA.
    Fassier, Jean-Baptise
    Claude Bernard University Lyon 1, Lyon, France.
    Besen, Elyssa
    Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, USA.
    Blanck, Peter
    Burton Blatt Institute, Syracuse University, Syracuse, NY, USA.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Feuerstein, Michael
    Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
    Munir, Fehmidah
    University of Loughborough, Leicester, UK.
    Sustaining Work Participation Across the Life Course.2016In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 26, no 4, p. 465-479Article in journal (Refereed)
    Abstract [en]

    Introduction Many disability prevention strategies are focused on acute injuries and brief illness episodes, but there will be growing challenges for employers to manage circumstances of recurrent, chronic, or fluctuating symptoms in an aging workforce. The goal of this article is to summarize existing peer-review research in this area, compare this with employer discourse in the grey literature, and recommend future research priorities. Methods The authors participated in a year-long sponsored collaboration that ultimately led to an invited 3-day conference, "Improving Research of Employer Practices to Prevent Disability", held October 14-16, 2015, in Hopkinton, Massachusetts, USA. The collaboration included a topical review of the scientific and industry literature, group discussion to identify key areas and challenges, drafting of initial documents, and feedback from peer researchers and a special panel of experts with employer experience. Results Cancer and mental illness were chosen as examples of chronic or recurring conditions that might challenge conventional workplace return-to-work practices. Workplace problems identified in the literature included fatigue, emotional exhaustion, poor supervisor and co-worker support, stigma, discrimination, and difficulties finding appropriate accommodations. Workplace intervention research is generally lacking, but there is preliminary support for improving workplace self-management strategies, collaborative problem-solving, and providing checklists and other tools for job accommodation, ideas echoed in the literature directed toward employers. Research might be improved by following workers from an earlier stage of developing workplace concerns. Conclusions Future research of work disability should focus on earlier identification of at-risk workers with chronic conditions, the use of more innovative and flexible accommodation strategies matched to specific functional losses, stronger integration of the workplace into on-going rehabilitation efforts, and a better understanding of stigma and other social factors at work.

  • 111.
    Reineholm, Cathrine
    et al.
    Linköping University, HELIX Vinn Excellence Centre. Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Gustavsson, Maria
    Linköping University, HELIX Vinn Excellence Centre. Linköping University, Department of Behavioural Sciences and Learning, Learning in Working Life and Educational Settings. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Work and Working Life.
    Ekberg, Kerstin
    Linköping University, HELIX Vinn Excellence Centre. Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Evaluation of job stress models for predicting health at work2011In: WORK: A Journal of Prevention, Assessment and Rehabilitation, ISSN 1051-9815, Vol. 40, no 2, p. 229-237Article in journal (Refereed)
    Abstract [en]

    Objectives: Few workplace health promotion (WHP) interventions are designed to improve work conditions. Methods for measurement of work conditions are often developed from a risk factor perspective rather than a WHP perspective. More knowledge is needed on the work conditions that promote health in order to develop a good work environment. The purpose of the present study was to investigate if the Demand Control Support model, the Effort Reward Imbalance model and the Job Characteristic Inventory are correlated, if the subscales predict health and to analyze which combination of subscales is the most useful predictor of health longitudinally. <br> <br>Participants: The study used questionnaire data from 662 civil servants at baseline and at follow-up 2 years later. <br> <br>Method: The data were analysed by multiple regressions. <br> <br>Results: A new model; effort, reward, and variety, was found having a higher predictive power to predict health than the original models. <br> <br>Conclusions: To promote health at work, social relations and health-mediating work conditions are important because these conditions may buffer health. Health can be assumed to be a resource that is created in everyday activities and interactions in workplaces, and there is a need to develop health measure instruments based on holistic health theories.

  • 112.
    Reineholm, Cathrine
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Gustavsson, Maria
    Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Learning in Working Life and Educational Settings.
    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.
    Evaluation of Job Stress Models for Predicting Health at Work. Oral presentation.2010Conference paper (Refereed)
  • 113.
    Reineholm, Cathrine
    et al.
    Linköping University, HELIX Vinn Excellence Centre. Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Gustavsson, Maria
    Linköping University, HELIX Vinn Excellence Centre. Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Karlsson, Nadine
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Work ability and performance: associations with clarity of work and work conditions: A multilevel studyManuscript (preprint) (Other academic)
    Abstract [en]

    Today’s flexible working life has resulted in loose structures, less predictability and increased uncertainty for employees. Uncertainty regarding what work tasks to carry out may result in low job satisfaction and high tension, but also in reduced performance and effectiveness. Conversely, organizations with clear goals and strategies provide better opportunities for employees to understand what is expected and how to perform the work. This paper explores associations with clarity of work, work conditions and work ability, and secondly if work ability affects performance, given the organizational and work conditions. The study was based on questionnaire data from 4442 subordinates in 10 organizations in different sectors. The data were analysed by multilevel logistic regressions. High clarity of work, high control and high social capital were associated with higher work ability and better performance. High demands were associated with lower work ability and lower performance. High work ability was associated with better performance. The results imply that good work ability is an important factor for employees’ performance, affected by socio-demographic factors, but mostly with organizational and work conditions. Organizations with clear goals creates more favorable work conditions that support employees’ control, their ability to cope with working life and their performance.

  • 114.
    Reineholm, Cathrine
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Gustavsson, Maria
    Linköping University, Department of Behavioural Sciences and Learning, Learning in Working Life and Educational Settings. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Arts and Sciences.
    Liljegren, Mats
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    The importance of work conditions and health for voluntary job mobility: a two-year follow-up2012In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 12, no 682Article in journal (Refereed)
    Abstract [en]

    Background

    Changing jobs is part of modern working life. Within occupational health, job mobility   has mainly been studied in terms of employees' intentions to leave their jobs. In contrast to actual turnover, turnover intentions are not definite and only reflect the probability that an individual will change job. The aim of this study was to determine what work conditions predict voluntary job mobility and to examine if good health or burnout predicts voluntary job mobility.

    Methods

    The study was based on questionnaire data from 792 civil servants. The data were analysed   using logistic regressions.

    Results

    Low variety and high autonomy were associated with increased voluntary job mobility.   However, the associations between health and voluntary job mobility did not reach   significance. Possible explanations for the null results may be that the population   was homogeneous, and that the instruments for measuring global health are too coarse   for a healthy, working population.

    Conclusions

    Voluntary job mobility may be predicted by high autonomy and low variety. The former may reflect that individuals with high autonomy have stronger career development motives; the latter may reflect the fact that low variety leads to job dissatisfaction. In contrast to our results on job content, global health measurements are not strong   predictors of voluntary job mobility. This may be because good health affects job mobility through several offsetting channels, involving the resources and ability to seek a new job. Future work should use more detailed measurements of health or   examine other work settings so that we may learn more about which of the offsetting effects of health dominate in different contexts.

  • 115.
    Reineholm, Cathrine
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Liljegren, Mats
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Gustavsson, Maria
    Linköping University, Department of Behavioural Sciences and Learning, Learning in Working Life and Educational Settings. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Arts and Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Hälsans betydelse för rörlighet. Posterpresentation.2011Conference paper (Refereed)
  • 116.
    Rolander, Bo
    et al.
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Jonker, Dirk
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Balogh, I.
    Department of Occupational and Environmental Medicine, Lund University, Sweden.
    Sandsjö, L.
    MedTech West/School of Engineering, University of Borås, Borås, Sweden..
    Winkel, J.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Svensson, Eva-Chris
    Linköping University, Department of Computer and Information Science. Linköping University, Faculty of Arts and Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Working conditions, health and productivity among dentists: a prospective study during rationalization in public dental careManuscript (preprint) (Other academic)
    Abstract [en]

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

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

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

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

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

  • 117.
    Rolander, Bo
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Jonker, Dirk
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Balogh, Istvan
    Department of Occupational and Environmental Medicine, Lund University, Sweden.
    Sandsjö, Leif
    Occupational and Environmental Medicine, Dept of Public Health and Community Medicine, The Sahlgrenska Academy at University of Gothenburg, Sweden.
    Winkel, Jörgen
    National Research Centre for the Working Environment, Copenhagen, Denmark/Department of Work Science, University of Gothenburg, Sweden.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Physical demands and reported illness among dentists - A longitudinal approach.2008Conference paper (Refereed)
  • 118.
    Rolander, Bo
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Jonker, Dirk
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Balogh, Istvan
    Lund University, Sweden.
    Sandsjö, Leif
    Sahlgrenska Academy at University of Gothenburg, Sweden.
    Winkel, Jörgen
    National Research Centre for the Working Environment, Copenhagen, Denmark/Department of Work Science, University of Gothenburg, Sweden.
    Svensson, E.
    Ekberg, Kerstin
    Linköping University, HELIX Vinn Excellence Centre. Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Impact on working conditions, productivity and health of dentists – a prospective study during rationalizations in public dental care2010Conference paper (Other academic)
  • 119.
    Rolander, Bo
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Jonker, Dirk
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Balogh, Istvan
    Department of Occupational and Environmental Medicine, Lund University, Sweden.
    Sandsjö, Leif
    Occupational and Environmental Medicine, Dept of Public Health and Community Medicine, The Sahlgrenska Academy at University of Gothenburg, Sweden.
    Winkel, Jörgen
    National Research Centre for the Working Environment, Copenhagen, Denmark/Department of Work Science, University of Gothenburg, Sweden.
    Svensson, E.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Rationalization in public dental care and its impact on working conditions, productivity and health of dentists - a prospective study.Manuscript (preprint) (Other academic)
  • 120.
    Rolander, Bo
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Jonker, Dirk
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Winkel, J
    University of Gothenburg, Sweden.
    Sandsjo, L
    University of Borås, Sweden.
    Balogh, I
    Lund University, Sweden.
    Svensson, Erland
    Linköping University, Department of Computer and Information Science. Linköping University, The Institute of Technology.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Working conditions, health and productivity among dentists in Swedish public dental care - a prospective study during a 5-year period of rationalisation2013In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 56, no 9, p. 1376-1386Article in journal (Refereed)
    Abstract [en]

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

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

  • 121.
    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.

  • 122.
    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.
  • 123.
    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.

  • 124.
    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)
  • 125.
    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.

  • 126.
    Strindlund, Lena
    et al.
    Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Långtidssjukskrivna inom Landstinget i Östergötland 2002: Diagnoser, arbetsförhållanden och rehabiliteringsbehov2004Report (Other academic)
    Abstract [sv]

    Studien ingår som en del i projektet ”Arbetsplatsen, arbetsledaren och den sjukskrivne - förutsättningar för samverkan med FK i arbetslivsinriktad rehabilitering”. Projektet är en del i samverkansavtalet mellan försäkringskassan och landstinget i Östergötland och syftar på sikt till att identifiera hinder och goda lösningar för framgångsrik rehabilitering tillbaka till arbete av sjukskrivna inom landstinget.

    Studien bygger på det enkätmaterial som landstinget skickade till samtliga 392 långtidssjukskrivna (>6 månader) medarbetare hösten 2002. Totalt 79% besvarade enkäten.

    En dryg tredjedel var sjukskrivna på grund av en kombination av psykiska och somatiska besvär, en fjärdedel på grund av psykiska besvär enbart och en femtedel på grund av besvär i rörelseorganen enbart. Andelen med psykiska besvär var högst bland yrkesgrupper med hög kvalifikationsnivå, medan besvär i rörelseorganen var vanligare i gruppen med låg kvalifikationsnivå. Mer än hälften hade varit sjukskrivna i mer än 1.5 år. Den självskattade hälsan, mätt med SF-36, var mycket låg bland de långtidssjuka, i detta avseende fanns inga större skillnader mellan hög- och lågkvalificerade grupper.

    Två tredjedelar av de långtidssjuka anger att arbetet helt eller delvis är orsaken till sjukskrivningen, i gruppen med psykiska besvär uppger 90% att arbetet är orsaken. Analys av svaren i en öppen fråga om vilka förhållanden i arbetet som bidragit till sjukskrivningen angavs en hög arbetsbelastning som hänför sig till bemanningsproblematik och små möjligheter till återhämtning som viktiga orsaksfaktorer. Många av de långtidssjuka uppger brister i ledarskapet som en starkt bidragande faktor till ohälsa. Brister i organisation av arbetet skapar oklarheter, som i sin tur leder till stress och hög arbetsbelastning.

    Mindre än hälften av de långtidssjuka uppger att arbetsledningen genomfört några åtgärder för att främja återgång i arbete. Inte heller försäkringskassan upplevs ha arbetat målinriktat för att främja arbetsåtergång, endast en tredjedel har fått en rehabiliteringsplan.

    För gruppen med psykiska besvär är framför allt minskad stress, ändrade arbetsuppgifter och kortare arbetstid viktiga förutsättningar för återgång i arbete. Gruppen med besvär i rörelseorganen anger att mindre kroppsligt tungt arbete, förändrade arbetsuppgifter och kortare arbetstid är betydelsefullt. Cirka 40% av de långtidssjukskrivna uppger att de skulle kunna arbeta på hel- eller deltid.

    Undersökningsgruppen var sjukskrivna då de besvarade enkäten. Detta kan innebära att man har en ökad benägenhet att tillskriva arbetsplatsen större orsak till ohälsan, än om man varit i arbete. De långtidssjukas upplevelse av arbetsledning och organisation och av hur de fått hjälp och stöd från olika aktörer har emellertid betydelse för hur man ser på sina möjligheter till återgång i arbete. Upplevelser av bristande engagemang och stöd under sjukskrivnings- och rehabiliteringsprocessen kan öka hindren för återgång i arbete.

    Kommentarerna i enkäten gav en bild av vilka förhållanden som är viktiga att utveckla för att etablera en rehabiliteringsprocess som möjliggör för de långtidssjuka att återgå i arbete. Till dessa förhållanden hör:

    • Respekt för ohälsan
    • Arbetsledningens förhållningssätt och agerande
    • Rutiner på arbetsplatsen vid sjukskrivning och rehabilitering
    • Vidgade möjligheter till arbetsträning och omplacering
    • Bättre samverkan mellan rehabiliteringsaktörerna
    • Sociala mötesplatser för långtidssjukskrivna
  • 127.
    Ståhl, Christian
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Multidisciplinary teams as an arena for the decision of work ability2007Conference paper (Refereed)
  • 128.
    Ståhl, Christian
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    Coordination between welfare authorities in promoting return-to-work2008Conference paper (Refereed)
  • 129.
    Ståhl, Christian
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Gustavsson, Maria
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Böhm, Liselotte
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Förutsättningar för implementering och användning av motiverande samtal (MI) inom Försäkringskassan: Slutrapport2015Report (Other academic)
    Abstract [en]

    This is the final report from an evaluation project that has studied implementation and use of Motivational Interviewing (MI) within the Swedish Social Insurance Agency (SSIA). MI was introduced in order to develop and improve methods within social insurance, aiming to promote insurance officials to intervene earlier in the sick leave process. During 2012, dedicated funds were targeted towards developing insurance officials’ competencies, where an education in MI was included.

    An earlier report has been published in the project (Social Insurance Report 2014:16), focusing on the implementation process. It was concluded that both insurance officials and managers were concerned about not being able to sustain and integrate the use of MI into regular practice. In this report, the conditions for use of MI in regular practice are in focus, along with perceived effects of the intervention on the individual and organizational level.

    Specific research questions are:

    • What individual and organizational/practical conditions has facilitated or prevented officials’ continuous use of MI in regular practice?
    • What effects of the intervention can be identified on an individual and an organizational level?

    The report is based on a survey to the insurance officials (n=880), and interviews with 5 managers and 16 insurance officials in four offices. The interviews are follow-ups from a larger data collection that was reported in the first report from the project.

    The results of the study show that many of the officials, some time after the educational intervention, are still committed to the method, and that many claim to use it in meetings with their clients. However, there is a large variation with regard to what parts of the method that are utilized. Most officials have participated in the educational intervention and perceived it as purposeful and interesting. Many officials claim that using the method has improved their meetings with clients.

    Much criticism is directed towards how the SSIA has managed the investment in MI, where officials do not think that the educational intervention has been followed up in any organized way, and that there has been a lack of the necessary training in order to develop and sustain competence in using the method. It is generally perceived that MI has not been a priority in the organization and that managers have not expressed interested in whether the method is used or not. Officials are also critical to their possibilities to use the method related to their current work situation, where heavy caseloads imply little or no time for reflection and learning.

  • 130.
    Ståhl, Christian
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Gustavsson, Maria
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Böhm, Liselotte
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Implementering och användning av motiverande samtal (MI) inom Försäkringskassan2014Report (Other academic)
    Abstract [en]

    In 2012, the Swedish Social Insurance Agency (SSIA) launched an educational intervention where all officials were to be trained in Motivational Interviewing (MI). The purpose of the intervention was to improve the quality of meetings with sickness benefit claimants, and in a long term to strengthen the legitimacy of the SSIA. The intervention comprised off-site education (2+2 days), and workplace coaches to support training and use of MI, through individual and group consultations.

    MI is a client-centered method aimed at facilitating behavior change through focus on motivation and management of ambivalence. The method has been evaluated with convincing results in several areas, e.g. smoking cessation and drug rehabilitation. While it has also been adapted to social work, its effects in such areas are less documented.

    The aim of the study was to elicit how officials, managers and other groups within the SSIA perceived the conditions for using MI, and the implementation process. The study comprises two comprehensive data collections in four insurance offices, comprising interviews with officials, managers, claimants and coaches, and observations at meetings; interviews with managers and coordinators; and a survey to all officials. In this report, data is presented from the first data collection, consisting of observations, and individual interviews with officials, managers, and claimants. A full report will be presented in 2015.

  • 131.
    Ståhl, Christian
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    From Cooperation to Conflict? Swedish Rehabilitation Professionals' Experiences of Interorganizational Cooperation.2011In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 21, no 3, p. 441-448Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 132.
    Ståhl, Christian
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences. Linköping University, HELIX Vinn Excellence Centre.
    Svensson, Tommy
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Sociology.
    Petersson, Gunilla
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    A Matter of Trust?: A Study of Coordination of Swedish Stakeholders in Return-to-Work2010In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 20, p. 299-310Article in journal (Refereed)
    Abstract [en]

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

  • 133.
    Ståhl, Christian
    et al.
    Linköping University, HELIX Vinn Excellence Centre. Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    Petersson, Gunilla
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    Ekberg, Kerstin
    Linköping University, HELIX Vinn Excellence Centre. Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Discretion, governance and cooperative learning: Swedish rehabilitation professionals’ experiences of financial cooperation2010Conference paper (Refereed)
  • 134.
    Ståhl, Christian
    et al.
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation . Linköping University, Faculty of Health Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology . Linköping University, Faculty of Arts and Sciences.
    Petersson, Gunilla
    Linköping University, Department of Behavioural Sciences and Learning, Sociology . Linköping University, Faculty of Arts and Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation . Linköping University, Faculty of Health Sciences.
    Discretion, governance and cooperative learning: Swedish rehabilitation professionals’ experiences of financial cooperationManuscript (preprint) (Other academic)
    Abstract [en]

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

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

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

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

  • 135.
    Ståhl, Christian
    et al.
    Linköping University, HELIX Vinn Excellence Centre. Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    Petersson, Gunilla
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    Ekberg, Kerstin
    Linköping University, HELIX Vinn Excellence Centre. Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Swedish Rehabilitation Professionals' Perspectives on Work Ability Assessments in a Changing Sickness Insurance System2010Conference paper (Refereed)
  • 136.
    Ståhl, Christian
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences. Linköping University, HELIX Vinn Excellence Centre.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    Petersson, Gunilla
    Linköping University, Department of Behavioural Sciences and Learning, Sociology. Linköping University, Faculty of Arts and Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Swedish Rehabilitation Professionals’ Perspectives on Work Ability Assessments in a Changing Sickness Insurance System2011In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 33, no 15-16, p. 1373-1382Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 137.
    Ståhl, Christian
    et al.
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation . Linköping University, Faculty of Health Sciences.
    Svensson, Tommy
    Linköping University, Department of Behavioural Sciences and Learning, Sociology . Linköping University, Faculty of Arts and Sciences.
    Petersson, Gunilla
    Linköping University, Department of Behavioural Sciences and Learning, Sociology . Linköping University, Faculty of Arts and Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation . Linköping University, Faculty of Health Sciences.
    The Work Ability Divide: Holistic and Reductionistic Approaches in Swedish Interdisciplinary Rehabilitation Teams2009In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 19, no 3, p. 264-273Article in journal (Refereed)
    Abstract [en]

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

  • 138.
    Ståhl, Christian
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Toomingas, Allan
    Karolinska Institute, Sweden.
    Aborg, Carl
    Karolinska Institute, Sweden.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Kjellberg, Katarina
    Karolinska Institute, Sweden.
    Promoting occupational health interventions in early return to work by implementing financial subsidies: a Swedish case study2013In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13Article in journal (Refereed)
    Abstract [en]

    Background

    In 2010, the Swedish government introduced a system of subsidies for occupational health (OH) service interventions, as a part in a general policy promoting early return to work. The aim of this study was to analyse the implementation of these subsidies, regarding how they were used and perceived.

    Methods

    The study was carried out using a mixed-methods approach, and comprises material from six sub-studies: a register study of the use of the subsidies, one survey to OH service providers, one survey to employers, one document analysis of the documentation from interventions, interviews with stakeholders, and case interviews with actors involved in coordinated interventions.

    Results

    The subsidized services were generally perceived as positive but were modestly used. The most extensive subsidy – for coordinated interventions – was rarely used. Employers and OH service providers reported few or no effects on services and contracts. OH service providers explained the modest use in terms of already having less bureaucratic routines in place, where applying for subsidies would involve additional costs. Information about the subsidies was primarily communicated to OH service providers, while employers were not informed.

    Conclusions

    The study highlights the complexity of promoting interventions through financial incentives, since their implementation requires that they are perceived by the stakeholders involved as purposeful, manageable and cost-effective. There are inherent political challenges in influencing stakeholders who act on a free market, in that the impact of policies may be limited, unless they are enforced by law.

  • 139.
    Tjulin, Åsa
    et al.
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation . Linköping University, Faculty of Health Sciences.
    Edvardsson Stiwne, Elinor
    Linköping University, Department of Behavioural Sciences and Learning, Centre for Teaching and Learning. Linköping University, Faculty of Educational Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation . Linköping University, Faculty of Health Sciences.
    Experience of the Implementation of a Multi-Stakeholder Return-to-Work Programme2009In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 19, no 4, p. 409-418Article in journal (Refereed)
    Abstract [en]

    Introduction Employers can use several strategies to facilitate return-to-work for workers on sick leave, but there seems to be limited knowledge of how workplace-based interventions are actually implemented in organisations. One public Swedish employer initiated a return-to-work programme which incorporated interventions suggested by earlier research, e.g. multi-professional health assessment, case management, educational peer-support groups and adapted workplace training. The overall purpose of the study is to analyse how the programme was implemented and experienced in the organisation, from the perspective of involved stakeholders, i.e. supervisors, occupational health consultants and a project coordinator. The objective of this paper is to identify and analyse how these stakeholders perceived that the programme had been implemented in relation to its intentions. Methods A qualitative method was used, consisting of individual interviews with eight supervisors and the project leader. Two group interviews with five occupational health service consultants were also conducted. Results The study revealed barriers to the implementation of return-to-work interventions. Not all of the intended interventions had been implemented as expected in policy. One explanation is that the key stakeholders expressed a more biomedical, individual view of work ability, while the programme was based on a more holistic, biopsychosocial view. Conclusion Implementation of a return-to-work programme is an ongoing, long-term multi-level strategy, requiring time for reflection, stakeholder participation, openness to change of intervention activities, and continuous communication.

  • 140.
    Tjulin, Åsa
    et al.
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Edvardsson Stiwne, Elinor
    Linköping University, Department of Behavioural Sciences and Learning, Centre for Teaching and Learning. Linköping University, Faculty of Educational Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Rehabilitering i Kommunen. En utvärdering av ReKom-projektet i Norrköpings kommun2007Report (Other academic)
  • 141.
    Tjulin, Åsa
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences. Linköping University, HELIX Vinn Excellence Centre.
    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.
    Edvardsson Stiwne, Elinor
    Linköping University, Department of Behavioural Sciences and Learning, Centre for Teaching and Learning. Linköping University, Faculty of Arts and Sciences.
    Process Evaluation of a Swedish Workplace-based Return-to-Work Program.2008Conference paper (Refereed)
  • 142.
    Tjulin, Åsa
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    MacEachen, Ellen
    The Institute for Work & Health, Toronto, Canada.
    Edvardsson Stiwne, Elinor
    Linköping University, Department of Behavioural Sciences and Learning, Centre for Teaching and Learning. Linköping University, Faculty of Arts and Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    The social interaction of return-to-work explored from co-workers experinces.2011In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 33, no 21-22, p. 1979-1989Article in journal (Refereed)
    Abstract [en]

    Purpose The objective was to explore the role and contribution of co-workers in the return-to-work process. The social interaction of co-workers and supervisors are analysed within the framework of the Swedish national and local employer organisational return-to-work policies.

    Methods An exploratory qualitative method was used, consisting of open-ended interviews with 33 workplace actors across seven work units. Organisational return-towork policies were collected from the three public sector employers.

    Results Three key themes about the return-to-work process emerged during analysis: (1) policies and organizational structure for return to work do not take co-workers into account; (2) return-to-work social demands and expectations interact with broader social interaction and attitudes in the workgroup; (3) supervisory management of return to workis linked to workgroup communication and management.

    Conclusion An examination of the role of co-workers suggests that the social location matters, and highlights how different return-to-work actors interpret the return-to-work situation differently. Employers and workplaces should consider re-integration of sicklisted workers in the light of workgroup social relations and acknowledge social interaction and the heterogeneous experiences of returning workers, supervisors and coworkers.

  • 143.
    Tjulin, Åsa
    et al.
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    MacEachen, Ellen
    The Institute for Work and Health, Toronto, Canada.
    Ekberg, Kerstin
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
    Exploring the meaning of early contact in return-to-work from workplace actors' perspective2011In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 33, no 2, p. 137-145Article in journal (Refereed)
    Abstract [en]

    Purpose. The objective of this article was to explore the meaning of early contact in return-to-work, and how social relational actions and conditions can facilitate or impede early contact among actors in the workplace. Method. An exploratory qualitative method was used, consisting of individual open-ended interviews with 33 workplace actors at seven worksites across three public employers in Sweden. The workplace actors represented in these interviews included re-entering workers, supervisors, co-workers and human resources managers. Organisational policies on return-to-work were collected from the three employers. Results. The analysis indicated that early contact is a complex return-to-work measure with shifting incentives among workplace actors for making contact. For instance, the findings indicated obligation and responsibilities as incentives, incentives through social relations, and the need to acknowledge and balance the individual needs in relation to early contact. Conclusion. The findings strengthen the importance of early contact as a concept with a social relational context that comprises more than just an activity carried out (or not) by the employer, and suggest that early contact with a sick-listed worker is not always the best approach for a return-to-work situation. This study provides a starting point for a more articulated conceptualisation of early contact.

  • 144.
    Tjulin, Åsa
    et al.
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation . Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Arts and Sciences.
    Maceachen, Ellen
    Institute for Work & Health, Toronto, ON, Canada.
    Ekberg, Kerstin
    Linköping University, Department of Medicine and Health Sciences, Work and Rehabilitation . Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Arts and Sciences.
    Exploring Workplace Actors Experiences of the Social Organization of Return-to-Work.2010In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 20, no 3, p. 311-321Article in journal (Refereed)
    Abstract [en]

    Introduction: There is a limited body of research on how the actual social exchange among workplace actors influences the practice of return-to-work. The objective of this study was to explore how workplace actors experience social relations at the workplace and how organizational dynamics in workplace-based return-to-work extends before and beyond the initial return of the sick listed worker to the workplace. Method An exploratory qualitative method approach was used, consisting of individual open-ended interviews with 33 workplace actors at seven worksites that had re-entering workers. The workplace actors represented in these interviews include: re-entering workers, supervisors, co-workers, and human resource managers. Results The analysis identified three distinct phases in the return to work process: while the worker is off work, when the worker returns back to work, and once back at work during the phase of sustainability of work ability. The two prominent themes that emerged across these phases include the theme of invisibility in relation to return-to-work effort and uncertainty, particularly, about how and when to enact return-to-work. Conclusion The findings strengthen the notion that workplace-based return-to-work interventions need to take social relations amongst workplace actors into account. They also highlight the importance and relevance of the varied roles of different workplace actors during two relatively unseen or grey areas, of return-to-work: the pre-return and the post-return sustainability phase. Attention to the invisibility of return-to-work efforts of some actors and uncertainty about how and when to enact return-to-work between workplace actors can promote successful and sustainable work ability for the re-entering worker.

  • 145.
    Tjulin, Åsa
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences. Linköping University, HELIX Vinn Excellence Centre.
    MacEachen, Ellen
    The Institute for Work and Health, Toronto, Canada /Dalla Lana School of Public Health, University of Toronto, Canada.
    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.
    The social challenges of a time scheduled early contact at the workplace in return-to-work. Oral presentation.2010Conference paper (Refereed)
  • 146.
    Tjulin, Åsa
    et al.
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences. Linköping University, HELIX Vinn Excellence Centre.
    MacEachen, Ellen
    The Institute for Work and Health, Toronto, Canada /Dalla Lana School of Public Health, University of Toronto, Canada.
    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.
    The social organization of return-to-work at the workplace. Oral presentation.2010Conference paper (Refereed)
  • 147.
    Vaez, Marjan
    et al.
    Institutionen för klinisk neurovetenskap Karolinska Institutet.
    Ekberg, Kerstin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Laflamme, Lucie
    Institutionen för folkhälsa Karolinska Institutet.
    Abusive Events at Work among Young Working Adults - Magnitude of the Problem and its Effect on Self-Rated Health2004In: Relations Industrielles - Industrial Relations, ISSN 0034-379X, E-ISSN 1703-8138, Vol. 59, no 3, p. 569-584Article in journal (Refereed)
  • 148.
    Vaez, Marjan
    et al.
    Institutionen för klinisk neurovetenskap Karolinska Institutet.
    Ekberg, Kerstin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Laflamme, Lucie
    Institutionen för folkhälsa Karolinska Institutet.
    Ratings of health and quality of life by young working people: Are there occupational or education-based differences?2004In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 23, no 3, p. 193-198Article in journal (Refereed)
    Abstract [en]

    The study examines differences in self-rated health and perceived quality of life (QoL) among young working people according to occupation and education level. Subjects were extracted from a cross-sectional data set, covering questionnaire responses of people aged 20-74 years from the Swedish region of Östergötland, and addressing individual environmental and health conditions. The emphasis was on males and females in paid employment aged 20-34 (n = 863). Differences in self-rated health items and in perceived QoL were subjected to a series of t-tests. Two measures of individual socioeconomic position were considered - occupation and education. No education-based differences were found, and there were few differences based on occupation. Among males, manual workers reported significantly higher scores with regard to pain and physical function than did non-manual workers. Male and female manual workers scored significantly lower on current perceived QoL than non-manual workers. In the case of females, the differences between manual and non-manual workers also applied to former perceived QoL. Yet, after applying the Bonferroni correction, none of the differences observed remained significant. In line with some earlier studies, it appears that - among young working adults - the manners in which health status and QoL are perceived are not strongly conditional on socioeconomic position. © 2004 - IOS Press and the authors. All rights reserved.

  • 149.
    Westlander, Gunnela
    et al.
    Linköping University, The Institute of Technology. Linköping University, Department of Mechanical Engineering, Industrial Ergonomics.
    Ekberg, Kerstin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, National Centre for Work and Rehabilitation.
    Hälsofrämjande interventioner. Del 12005In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 82, no 3, p. 196-266Article in journal (Other academic)
  • 150.
    Wåhlin, Charlotte
    et al.
    Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Persson, Jan
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment. Linköping University, Faculty of Health Sciences.
    Bernfort, Lars
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment. Linköping University, Faculty of Health Sciences.
    Öberg, Birgitta
    Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences.
    Association between clinical and work-related interventions and return to work for patients with musculoskeletal or mental disorders2012In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 44, no 4, p. 355-362Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to explore what characterizes patients receiving clinical interventions vs combined clinical and work-related interventions in a cohort of sick-listed subjects with musculoskeletal or mental disorders. Factors associated with return-to-work were also analysed.

    Design: A prospective cohort study.

    Methods: A total of 699 newly sick-listed patients responded to a questionnaire on sociodemographics, measures of health, functioning, work ability, self-efficacy, social support, work conditions, and expectations. The 3-month follow-up questionnaire included patients' self-reported measures of return-to-work, work ability and type of interventions. The most frequent International Classification of Diseases-10 diagnoses for patients' musculoskeletal disorders were dorsopathies (M50-54) and soft tissue disorders (M70-79), and for patients with mental disorders, depression (F32-39) and stress reactions (F43).

    Results: Patients with mental disorders who received combined interventions returned to work to a higher degree than those who received only clinical intervention. The prevalence of work-related interventions was higher for those who were younger and more highly educated. For patients with musculoskeletal disorders better health, work ability and positive expectations of return-to-work were associated with return-to-work. However, combined interventions did not affect return-to-work in this group.

    Conclusion: Receiving combined interventions increased the probability of return-to-work for patients with mental disorders, but not for patients with musculoskeletal disorders. Better health, positive expectations of return-to-work and better work ability were associated with return-to-work for patients with musculoskeletal disorders.

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