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  • 1.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Institutionalizing suspicion: Tracing the decline of the Swedish sickness insurance system in the 2000's2024In: International Journal of Sociology, ISSN 0020-7659, E-ISSN 1557-9336Article in journal (Refereed)
    Abstract [en]

    This article presents an analysis of Swedish sickness insurance in the 2000's, outlining cultural and structural shifts in political and institutional design. The study is based on analytic dualism and Margaret S. Archer's morphogenetic model, which is used to create an analytical narrative focusing on political and institutional developments. The narrative identifies two distinct phases: one period of rapid cultural and structural change (morphogenesis), and one of institutionalization of the new structure (morphostasis). The narrative describes how a key element of the Swedish welfare state, sickness insurance, underwent a transition from an encompassing and generous to a strict and suspicious system, and how this was effectively solidified politically and organizationally. This is related both to a broader shift toward neoliberal and workfare policies, and to the specific socio-cultural and social interactions between agents to reform the system. The analysis provides a contribution to the literature by providing an internationally relevant empirical case of how an encompassing system has undergone a period of substantial decline, and by presenting a coherent long-term narrative which temporalizes this development into specific timepoints and phases.

  • 2.
    Lundqvist, Daniel
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Reineholm, Cathrine
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Hellgren, Mattias
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Occupational health and safety management: managers’ organizational conditions and effect on employee well-being2024In: International Journal of Workplace Health Management, ISSN 1753-8351, E-ISSN 1753-836XArticle in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 3.
    Karlsson, Elin
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Hellgren, Mattias
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Sandqvist, Jan
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Seing, Ida
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Social Insurance Literacy Among the Sick-listed-A Study of Clients' Comprehension and Self-Rated System Comprehensibility of the Sickness Insurance System2024In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688Article in journal (Refereed)
    Abstract [en]

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

  • 4.
    Persson, Marcus
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Sociologiska samtal behövs!2024In: Sociologisk forskning, ISSN 0038-0342, E-ISSN 2002-066X, Vol. 61, no 1, p. 3-5Article in journal (Other academic)
  • 5.
    Reineholm, Cathrine
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    Lundqvist, Daniel
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    Bringing risk back in: managers prioritization of the work environment during the pandemic2023In: International Journal of Workplace Health Management, ISSN 1753-8351, E-ISSN 1753-836X, Vol. 16, no 1, p. 4-19Article in journal (Refereed)
    Abstract [en]

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

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  • 6.
    Ladegaard, Yun
    et al.
    Univ Copenhagen, Denmark; Fdn Mental Hlth, Denmark.
    Skakon, Janne
    Univ Copenhagen, Denmark.
    Dalgaard, Vita Ligaya
    Aarhus Univ, Denmark.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    Thomsen, Soren Therkil Slot
    Ascent Consulting Grp, Denmark.
    Netterstrom, Bo
    Bispebjerg Hosp, Denmark.
    Employees with mental disorders seeking support from the workers compensation system - experiences from Denmark2023In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 75, no 4, p. 1361-1377Article in journal (Refereed)
    Abstract [en]

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

  • 7.
    Ståhl, Christian
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Persson, Marcus
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Klimatfrågan är sociologisk2023In: Sociologisk forskning, ISSN 0038-0342, E-ISSN 2002-066X, Vol. 60, no 3-4, p. 215-217Article in journal (Other academic)
  • 8.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Samhällskontrakt2023 (ed. 1)Book (Refereed)
  • 9.
    Dahlqvist, I
    et al.
    Reg Vastra Gotaland, Sweden.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Severin, J.
    Reg Vastra Gotaland, Sweden; Univ Gothenburg, Sweden.
    Akerstrom, Magnus
    Reg Vastra Gotaland, Sweden; Univ Gothenburg, Sweden; Reg Vastra Gotaland, Sweden.
    Shifting from an individual to an organizational perspective in work environment management - a process evaluation of a six-year intervention program within the Swedish public sector2023In: BMC Public Health, E-ISSN 1471-2458, Vol. 23, no 1, article id 1108Article in journal (Refereed)
    Abstract [en]

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

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  • 10.
    Persson, Marcus
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Sociologisk Forskning ger ut sin 60:e årgång!2023In: Sociologisk forskning, ISSN 0038-0342, E-ISSN 2002-066X, Vol. 60, no 2, p. 121-123Article in journal (Other academic)
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  • 11.
    Ståhl, Christian
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Karlsson, Elin
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Wenemark, Marika
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Enheten för folkhälsa.
    Sandqvist, Jan
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Arestedt, Kristofer
    Linnaeus Univ, Sweden; Dept Res, Sweden.
    The Social Insurance Literacy Questionnaire (SILQ): Development and Psychometric Evaluation2023In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688Article in journal (Refereed)
    Abstract [en]

    PurposeFor clients to understand social insurance decisions and processes, information from authorities needs to be comprehensible, and clients need sufficient individual abilities. These dimensions are captured by the concept social insurance literacy, which has been operationalized into a measure, the Social Insurance Literacy Questionnaire (SILQ). The aim of this study was to describe the development of the SILQ and evaluate its psychometric properties using Rasch measurement theory.MethodsThe development of the SILQ included a Delphi study and cognitive interviews. A preliminary version, divided on four scales corresponding to the domains of the concept (obtaining information, understanding information, acting on information, and system comprehensibility) was psychometrically evaluated according to Rasch measurement theory, in a survey to a stratified random sample of people on sick leave (n = 1151) sent out in the fall of 2020.ResultsOverall, the items in the final version of the SILQ demonstrated good fit to the Rasch model, and the response scale worked as intended. Unidimensionality was supported for all scales, but minor problems with local dependency was detected for three items. The person separation was 0.80 for the Obtain scale, 0.82 for the Understand scale, 0.68 for the Act scale, and 0.81 for the System scale. Corresponding ordinal alpha values were 0.91, 0.91, 0.86, and 0.91, respectively.ConclusionThis study is a first step toward exploring literacy in the social insurance field. The SILQ covers individual abilities and systems' comprehensibility, and the results show that it has acceptable psychometric properties.

  • 12.
    Ståhl, Christian
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    De Wispelaere, Jurgen
    Stockholm Sch Econ Riga, Latvia; Tampere Univ, Finland.
    MacEachen, Ellen
    Univ Waterloo, Canada.
    The work disability trap: manifestations, causes and consequences of a policy paradox2023In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 45, no 11, p. 1916-1922Article in journal (Refereed)
    Abstract [en]

    Purpose This article focuses on the risk that work disability policies lock people into work disability rather than promote durable health and return to work. We outline the concept of a work disability trap as a heuristic device to explore this policy paradox inherent in the design of most social insurance systems. Materials and methods This is a conceptual paper drawing on examples from existing research. Results We identify three manifestations of the disability trap: not overcoming disability; underperforming; and returning to work prematurely. The causes of these manifestations are identified as structural rather than based on malingering clients, while negative consequences are identified both on client and system levels. Conclusion We emphasize the need for systems built on trust and reasonable expectations, and the need for providing rehabilitation support independently of economic compensation. Universal basic income is introduced as a potential tool to ameliorate some of the consequences of the disability trap.

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  • 13.
    Cassegard, Carl
    et al.
    Univ Gothenburg, Sweden.
    Malmqvist, Karl
    Univ Gothenburg, Sweden.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Toward a resonant society: An interview with Hartmut Rosa2023In: Sociologisk forskning, ISSN 0038-0342, E-ISSN 2002-066X, Vol. 60, no 1, p. 177-195Article in journal (Refereed)
    Abstract [en]

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

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

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

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  • 15.
    MacEachen, Ellen
    et al.
    Univ Waterloo, Canada.
    de Rijk, Angelique
    Maastricht Univ, Netherlands.
    Dyreborg, Johnny
    Natl Res Ctr Working Environm, Denmark.
    Fassier, Jean-Baptiste
    Hosp Civils Lyon, France; Univ Sherbrooke, Canada.
    Fletcher, Michael
    Victoria Univ Wellington, New Zealand.
    Hopwood, Pamela
    Univ Waterloo, Canada.
    Koivusalo, Meri
    Tampere Univ, Finland.
    Majowicz, Shannon
    Univ Waterloo, Canada.
    Meyer, Samantha
    Univ Waterloo, Canada.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    Welti, Felix
    Univ Kassel, Germany.
    Laws, Policies, and Collective Agreements Protecting Low-wage and Digital Platform Workers During the COVID-19 Pandemic2022In: NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy, ISSN 1048-2911, E-ISSN 1541-3772, Vol. 32, no 3, p. 201-212Article in journal (Refereed)
    Abstract [en]

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

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  • 16.
    Ståhl, Christian
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    Karlsson, Elin
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Misstro och kamp: Sjukskrivnas erfarenheter av kontakter med Försäkringskassan2022In: Socialmedicinsk Tidskrift, ISSN 0037-833X, no 4, p. 601-611Article in journal (Refereed)
  • 17.
    Ståhl, Christian
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    Norvell Gustavsson, Isa
    Linköping University, Department of Culture and Society, Division of Social Work. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Jonsdottir, Ingibjorg H.
    Reg Vastra Gotaland, Sweden; Univ Gothenburg, Sweden.
    Akerstrom, Magnus
    Reg Vastra Gotaland, Sweden; Univ Gothenburg, Sweden.
    Multilevel, risk group-oriented strategies to decrease sickness absence in the public sector: evaluation of interventions in two regions in Sweden2022In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 95, p. 1415-1427Article in journal (Refereed)
    Abstract [en]

    Purpose Sickness absence has been identified as needing to be addressed through multilevel interventions, but knowledge regarding optimal design and implementation of such interventions is scarce. The aim of this study was to evaluate the implementation and effects of a large-scale multilevel intervention in the public sector in Sweden. Methods The overall effect of the intervention was assessed using mixed-effect models. Sickness absence data (before, and 6 or 12 months after the intervention) for 90 intervention groups and 378 reference groups was retrieved from administrative personnel systems from the two participating regional councils. The implementation processes were evaluated using qualitative content analysis of qualitative interviews conducted at two timepoints. Results The results show that the vast majority of implemented measures were on an individual level and the integration of the intervention differed between the two regions. The reception and perception of the intervention activities seem to have been influenced by the implementation process, and how well the interventions were communicated and integrated, both regarding the integration of the different interventions and their integration into the discrete context and existing routines. No short-term overall effects on sickness absence were found. Conclusions The results point to the many challenges in implementing complex interventions, especially where organizational measures are involved-including adequate participation by, and communication between, the involved actors, as well as sufficient resources. The results indicate potential learning effects regarding the awareness of organizational factors in sick leave, after implementing and integrating multilevel strategies.

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  • 18.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Sjukförsäkringsutopier2022In: Bortom systemskiftet: mot en ny gemenskap / [ed] Niklas Altermark, Magnus Dahlstedt, Stockholm: Verbal förlag , 2022, p. 121-140Chapter in book (Other (popular science, discussion, etc.))
    Abstract [sv]

    Den svenska sjukförsäkringen bygger på att den som tillfälligtvis är svag får stöd från det gemensamma till denna åter är i skick att stå på egna ben. Det är, i korthet, systemets syfte och mål. Men bakom detta finns olika idéer om det goda samhället samt på vilket sätt detta kan åstadkommas genom politik och genom offentliga institutioner. Varje idé m ett gott samhälle rymmer också ett slags utopi om det ideala, det vi kanske aldrig når, men som fungerar som en kompass för vår politiska strävan.

  • 19.
    Boonstra, M. D.
    et al.
    Univ Groningen, Netherlands.
    Abma, F. I
    Univ Groningen, Netherlands; Res Ctr Insurance Med, Netherlands.
    Wilming, L.
    Univ Groningen, Netherlands; Res Ctr Insurance Med, Netherlands.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    Karlsson, Elin
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Brouwer, S.
    Univ Groningen, Netherlands; Res Ctr Insurance Med, Netherlands.
    Social Insurance Literacy of Dutch Workers Receiving Disability Benefits and its Associations with Socio-Economic Characteristics2022In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 32, p. 494-504Article in journal (Refereed)
    Abstract [en]

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

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  • 20.
    Tengelin, Ellinor
    et al.
    Univ West, Sweden.
    Hensing, Gunnel
    Univ Gothenburg, Sweden.
    Holmgren, Kristina
    Univ Gothenburg, Sweden.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    Bertilsson, Monica
    Univ Gothenburg, Sweden.
    Swedish managers experience-based understanding of the Capacity to work in employees with Common Mental Disorders: a Focus Group Study2022In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 32, p. 685-696Article in journal (Refereed)
    Abstract [en]

    Purpose Understanding of the capacity to work among employees with common mental disorders (CMDs) is important, but contemporary knowledge on this issue lacks the managers perspective. The aim of this study was to explore and describe managers experience-based understanding of capacity to work in employees with CMD. Methods A qualitative focus group study was designed. Managers with experience in supporting employees with CMD were recruited via organizations and networks. Eight focus group interviews with 31 participants took place. Results The analysis resulted in five categories. (1) Capacity to mentally focus on work tasks decreases or disappears, with negative consequences for work output. (2) Capacity to commit to continuous and coherent task changes, making tasks that span longer periods of time difficult. (3) Capacity to independently adapt to the needs of the situation decreases, and employees need more guidance and instructions than usual. (4) Capacity to keep up professional appearances is reduced, and the employees struggle with the professional role. (5) Ability to interact socially and professionally decreases, which potentially causes conflicts at the workplace. Conclusions This study adds managers perspective to the increasing knowledge on how capacity to work is influenced by CMDs. Managers understand CMDs in employees as changed, reducing the capacities needed for occupational functioning. A deeper understanding of reduced capacity to work is needed to adapt workplaces, and our findings can facilitate work accommodations for employees with CMDs.

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  • 21.
    Lundqvist, Daniel
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    Reineholm, Cathrine
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    Wallo, Andreas
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    The impact of leadership on employee well-being: on-site compared to working from home2022In: BMC Public Health, E-ISSN 1471-2458, Vol. 22, no 1, article id 2154Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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  • 22.
    Sengers, Johan H.
    et al.
    Univ Groningen, Netherlands; Inst Employee Benefits Schemes UWV, Netherlands; AMC UMCG UWV VUmc, Netherlands.
    Abma, Femke I
    Univ Groningen, Netherlands; AMC UMCG UWV VUmc, Netherlands.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Brouwer, Sandra
    Univ Groningen, Netherlands; AMC UMCG UWV VUmc, Netherlands.
    Work capacity assessments and efforts to achieve a job match for claimants in a social security setting: an international inventory2022In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 44, no 10, p. 1898-1907Article in journal (Refereed)
    Abstract [en]

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

  • 23.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, HELIX Competence Centre. Linköping University, Faculty of Arts and Sciences.
    Zygmunt Bauman2022In: Sociologins teoretiker / [ed] Lucas Gottzén, Ulrik Lögdlund, Malmö: Gleerups Utbildning AB, 2022, 2, Vol. Sidorna 267-283, p. 267-283Chapter in book (Other academic)
  • 24.
    Norvell Gustavsson, Isa
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Müssener, Ulrika
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Acting the part: how social and organisational factors shape managers actions towards employees with repeated short-term sickness absence2021In: International Journal of Workplace Health Management, ISSN 1753-8351, E-ISSN 1753-836X, Vol. 14, no 6, p. 634-649Article in journal (Refereed)
    Abstract [en]

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

  • 25.
    Hensing, Gunnel
    et al.
    Avdelningen för samhällsmedicin och folkhälsa, Göteborgs universitet.
    Bertilsson, Monica
    Avdelningen för samhällsmedicin och folkhälsa, Göteborgs universitet.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Educational Sciences.
    Chefen – en nyckelperson för medarbetare som har psykiska besvär2021In: Psykisk hälsa i arbetslivet, Studentlitteratur AB, 2021, p. 175-198Chapter in book (Other academic)
  • 26.
    Back, A.
    et al.
    Karolinska Inst, Sweden; Stockholm Cty Council, Sweden.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    von Thiele Schwarz, U.
    Karolinska Inst, Sweden.
    Richter, A.
    Karolinska Inst, Sweden; Stockholm Cty Council, Sweden.
    Hasson, H.
    Karolinska Inst, Sweden; Stockholm Cty Council, Sweden.
    Correction: Walking the tightrope-perspectives on local politicians role in implementing a national social care policy on evidence-based practice (vol 10, 75, 2016)2021In: International Journal of Mental Health Systems, E-ISSN 1752-4458, Vol. 15, no 1, article id 46Article in journal (Other academic)
    Abstract [en]

    n/a

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  • 27.
    Fagerlind, Anna-Carin
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, HELIX Competence Centre.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    Interventioner inspirerade av basinkomst: förutsättningar i lokal välfärdspolitik och förväntade effekter på livskvalitet och arbetsmarknadsdeltagande2021Report (Other academic)
    Abstract [sv]

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

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

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

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

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

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

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

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  • 28.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, HELIX Competence Centre. Linköping University, Faculty of Arts and Sciences.
    Making the Familiar Unfamiliar by Zygmunt Bauman2021In: The Sociological Review, ISSN 2754-1371Article, book review (Other academic)
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  • 29.
    Karlsson, Elin
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Sandqvist, Jan
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Seing, Ida
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Ståhl, Christian
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, HELIX Competence Centre.
    Maktspel och arbetsmoral bland sjukskrivna och andra aktörer - Sjukförsäkringssystemet och moral hazard2021Conference paper (Other academic)
    Abstract [sv]

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

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

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

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

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

  • 30.
    Klofsten, Magnus
    et al.
    Linköping University, Department of Management and Engineering, Project Innovations and Entrepreneurship. Linköping University, Faculty of Science & Engineering. Linköping University, HELIX Competence Centre.
    MacEachen, Ellen
    University of Waterloo, Ontario, Canada.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    New and small firms in a modern working life: How do we make entrepreneurship healthy?2021In: Small Business Economics, ISSN 0921-898X, E-ISSN 1573-0913, Vol. 57, p. 755-763Article in journal (Refereed)
    Abstract [en]

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

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  • 31.
    Ståhl, Christian
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Karlsson, Nadine
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Sandqvist, Jan
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    PREDICTIVE VALIDITY OF GENERAL WORK ABILITY ASSESSMENTS IN THE CONTEXT OF SICKNESS INSURANCE2021In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 53, no 4, article id jrm00177Article in journal (Refereed)
    Abstract [en]

    Objective: The activity ability assessment is a Swedish method for assessing general work ability, based on self-reports combined with an examination by specially trained physicians, and, if needed, extended assessments by occupational therapists, physiotherapists and/or psychologists. The aim of this study was to analyse the predictive validity of the activity ability assessment in relation to future sick leave. Design: Analysis of assessments in 300 case files, in relation to register data on sick leave. Subjects: People on sick leave (n =300, 32% men, 68% women; mean age 48 years; assessment at mean sick leave day 249). Methods: Univariate and multivariate statistics. Results: Self-rated work ability was the only factor with predictive value related to future sick leave. Physicians evaluations lacked predictive value, except where the person had a limitation in vision, hearing or speech that was predictive of future decisions by the Social Insurance Agency. No sex differences were identified. Conclusion: The predictive value of the activity ability assessment for future sick leave is limited, and selfrated work ability is more accurate compared with an extensive insurance medical assessment. Self-rated work ability may be more holistic compared with insurance medicine assessments, which may be overly focused on individual factors. A practical implication of this is that the inclusion of contextual factors in assessment procedures needs to be improved.

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  • 32.
    Ståhl, Christian
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Karlsson, Elin
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Sandqvist, Jan
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine.
    Hensing, Gunnel
    Univ Gothenburg, Sweden.
    Brouwer, Sandra
    Univ Groningen, Netherlands.
    Friberg, Emilie
    Karolinska Inst, Sweden.
    MacEachen, Ellen
    Univ Waterloo, Canada.
    Social insurance literacy: a scoping review on how to define and measure it2021In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 43, no 12, p. 1776-1785Article, review/survey (Refereed)
    Abstract [en]

    Purpose: Sickness insurance and workers? compensation systems decide on peoples? eligibility for benefits, and are commonly based on medical certificates and assessments of work ability. Systems differ in the extent to which they preserve clients? dignity and right to fair assessments. In this article, we define a new concept for studying interactions between individuals and systems: social insurance literacy, which concerns how well people understand the different procedures and regulations in social insurance systems, and how well systems communicate with clients in order to help them understand the system. Methods: The concept was defined through a scoping literature review of related concepts, a conceptual re-analysis in relation to the social insurance field, and a following workshop. Results: Five related concepts were reviewed for definitions and operationalizations: health literacy, financial/economic literacy, legal capability/ability, social security literacy, and insurance literacy. Conclusions: Social insurance literacy is defined as the extent to which individuals can obtain, understand and act on information in a social insurance system, related to the comprehensibility of the information provided by the system. This definition is rooted in theories from sociology, social medicine and public health. In the next step, a measure for the concept will be developed based on this review.

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  • 33.
    Karlsson, Elin
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Sandqvist, Jan
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Seing, Ida
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, HELIX Competence Centre. Linköping University, Faculty of Arts and Sciences.
    Social validity of work ability evaluations and official decisions within the sickness insurance system: a client perspective2021In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 70, no 1, p. 109-124Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

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  • 34.
    Ståhl, Christian
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    MacEachen, Ellen
    Univ Waterloo, Canada.
    Universal Basic Income as a Policy Response to COVID-19 and Precarious Employment: Potential Impacts on Rehabilitation and Return-to-Work2021In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 31, no 1, p. 3-6Article in journal (Other academic)
    Abstract [en]

    n/a

  • 35.
    Strindlund, Lena
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Abrandt Dahlgren, Madeleine
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.
    When cooperation turns ugly: exploring the dark side of social capital2021In: Qualitative research in organization and management, ISSN 1746-5648, E-ISSN 1746-5656, Vol. 17, no 5, p. 1-18Article in journal (Refereed)
    Abstract [en]

    Purpose

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

    Design/methodology/approach

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

    Findings

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

    Practical implications

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

    Originality/value

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

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  • 36.
    Moldvik, Isa
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Educational Sciences. Linköping University, HELIX Competence Centre.
    Müssener, Ulrika
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Work ethics and societal norms influence sick leave and return to work: tales of transformation2021In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 43, no 21, p. 3031-3040Article in journal (Refereed)
    Abstract [en]

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

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  • 37.
    Karlsson, Elin
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Seing, Ida
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Sandqvist, Jan
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Communication characteristics between clients and stakeholders within the Swedish sickness insurance system: a document analysis of granted and withdrawn sickness benefit claims2020In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 42, no 23, p. 3316-3326Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

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

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

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  • 38.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    En stum värld? [A mute world?]: om resonans, social responsivitet och utbrändhet [on resonance, social responsivity, and burnout]2020In: Sociologisk forskning, ISSN 0038-0342, E-ISSN 2002-066X, Vol. 57, no 3-4, p. 227-247Article in journal (Refereed)
    Abstract [en]

    This article focuses on Hartmut Rosas concept of resonance and Johan Asplunds concept of social responsivity, which are compared theoretically, and with regard to how they are used to describe the phenomenon of burnout. Both concepts describe fundamental human relationships and how we become individuals through interactions with others. The concepts are partly concerned with different analytical levels, where social responsivity is an elementary behaviour, while resonance also includes advanced social behaviours related to the search for meaning in life. In practical use, related to burnout, the concepts have both similarities and differences. Asplund has a narrow perspective on burnout, defined as lost social responsivity, unrelated to exhaustion. Rosa describes burnout as loss of resonance and reciprocity to the world, with exhaustion as a potential cause. Both Rosa and Asplund share a broader sociological analysis of the phenomenon as a consequence of the organization of society. They both express criticism against how it is often managed, where persons with burnout are left to take responsibility for problems outside their control.

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  • 39.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    The Judas kiss: On the work and retrenchment cures and the troubles they bring2020In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 65, no 1, p. 181-186Article in journal (Refereed)
    Abstract [en]

    This Sounding Board article uses a number of societal stereotypes related to work and welfare to problematize the relationship between work and health, and how this relates to the prevention and management of work disability. It outlines current discourses in policy and research around these issues, and discusses some of the ethical implications of these discourses. The article concludes that the current policies on work disability and sickness insurance takes their point of departure in over-simplified account of the relationship between work and health, and that a more critical reading of the evidence is called for. The implications for research are also discussed, where a system-oriented perspective with attention to social gradients and the various working environments is called for.

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  • 40.
    Strindlund, Lena
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Abrandt Dahlgren, Madeleine
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Zooming in on labour market cooperation: A study of a failed project to support unemployed young people2020In: Social Policy & Administration, ISSN 0144-5596, E-ISSN 1467-9515, Vol. 54, no 3, p. 410-426Article in journal (Refereed)
    Abstract [en]

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

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  • 41.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, HELIX Competence Centre.
    Arbetets estetik2019In: Arbetsmarknad & Arbetsliv, ISSN 1400-9692, E-ISSN 2002-343X, Vol. 25, no 2, p. 67-87Article in journal (Refereed)
    Abstract [sv]

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

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  • 42.
    Karlsson, Elin
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Seing, Ida
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Sandqvist, Jan
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Ståhl, Christian
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, HELIX Competence Centre.
    Communication Characteristics Between Clients And Stakeholders Within The Swedish Sickness Insurance System – A Document Analysis Of Granted And Withdrawn Sickness Benefit Claims2019Conference paper (Refereed)
    Abstract [en]

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

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

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

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

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

  • 43.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Educational Sciences. Linköping University, HELIX Competence Centre.
    Det paradoxala arbetsförmågebegreppet [Activation and medicalization in health insurance]: Recensionsessä [The changing meanings of social citizenship]2019In: Sociologisk forskning, ISSN 0038-0342, E-ISSN 2002-066X, Vol. 56, no 2, p. 181-188Article, book review (Other academic)
    Abstract [sv]

    Denna text är en recensionsessä av en nyutkommen bok av Rafael Lindqvist, Aktivering och medikalisering i sjukförsäkringen: Det sociala medborgarskapets förändrade innebörder (2019), och ska läsas som en sidobelysning till de resonemang som förs i boken. Jag kommer att särskilt fokusera på begreppet arbetsförmåga. Arbetsförmåga är ett centralt begrepp i det svenska sjukförsäkringssystemet som många medborgare och professionella behöver använda och förhålla sig till. Det kan dock ha olika innebörd både i begreppslig mening, och i de olika system där det används. Dessa system är ofta politiskt styrda, vilket innebär att begreppet också underordnas de normsystem och sociala kontexter som råder i dessa system; det är i den processen som det används och ges betydelse. Jag kommer att argumentera för att arbetsförmåga är ett paradoxalt begrepp i den svenska sjukförsäkringen, eftersom det samtidigt kan betraktas som såväl avmedikaliserat som strikt biomedicinskt.

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  • 44.
    Gensby, Ulrik
    et al.
    Team Arbejdsliv.
    Limborg, Hans Jørgen
    Team Arbejdsliv.
    Mahood, Quenby
    Institute for Work and Health.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, HELIX Competence Centre.
    Albertsen, Karin
    Team Arbejdsliv.
    Employer Strategies for Preventing Mental HealthRelated Work Disability: A Scoping Review2019In: Nordic Journal of Working Life Studies, E-ISSN 2245-0157, Vol. 9, no 1, p. 57-101Article in journal (Refereed)
    Abstract [en]

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

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  • 45.
    Strindlund, Lena
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Abrandt Dahlgren, Madeleine
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, HELIX Competence Centre.
    Employers’ views on disability, employability, and labor market inclusion: A phenomenographic study2019In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 41, no 24, p. 2910-2917Article in journal (Refereed)
    Abstract [en]

    PURPOSE: 

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

    METHODS: 

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

    RESULTS: 

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

    CONCLUSIONS: 

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

  • 46.
    Ståhl, Christian
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, HELIX Competence Centre.
    Seing, Ida
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Gerdle, Björn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Sandqvist, Jan
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Fair or square? Experiences of introducing a new method for assessing general work ability in a sickness insurance context2019In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 6, p. 656-665Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To study social validity and perceived fairness of a new method for assessing general work ability in a sickness insurance context. Assessments are based on self-reports, combined with examinations by physicians, and, if needed, occupational therapists, physiotherapists and/or psychologists.

    MATERIALS AND METHODS: Interviews with 36 insurance officials, 10 physicians, and 36 sick-listed persons, which were analysed through a qualitative content analysis.

    RESULTS: Insurance officials and physicians considered the method useful and that it facilitated benefit decisions. The experiences of persons who had undergone the assessment differed, where the dialog with insurance officials seemed to have had an influence on experiences of the assessment and the decisions it led to.

    CONCLUSIONS: The perceived fairness and social validity of the assessment depended on how it was carried out; organisational conditions and priorities; communication skills; and decision outcomes. Professionals have an important pedagogical task in explaining the purpose and procedure of the assessment in order for the sick-listed to perceive it as fair rather than square, i.e., too standardised and not considering individual conditions. If the assessment could be used also for rehabilitative purposes, it could possibly be perceived as more acceptable also in cases where it leads to denied benefits. Implications for rehabilitation The perceived fairness of work ability assessments is dependent on procedures for the assessment, communication with the person, and the outcome. What is considered fair differs between assessing professionals and persons being assessed. Professionals may influence the perceptions of fairness through their way of communication. Assessments need to be coupled with rehabilitation measures in order to perceived as relevant and acceptable.

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  • 47.
    Lundmark, Åse
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Företagshälsovård mot sjukskrivning?: Företagshälsovårdstjänster i förebyggande och rehabiliterande syften i Norrköpings kommun2019Report (Other academic)
    Abstract [sv]

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

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

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

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

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

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    Företagshälsovård mot sjukskrivning? Företagshälsovårdstjänster i förebyggande och rehabiliterande syften i Norrköpings kommun
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  • 48.
    Karlsson, Elin
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Sandqvist, Jan
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Seing, Ida
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences.
    Ståhl, Christian
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, HELIX Competence Centre. Linköping University, Faculty of Medicine and Health Sciences.
    Social validitet för försäkringsmedicinska utredningar och påföljande myndighetsbeslut inom sjukförsäkringen2019Report (Other academic)
    Abstract [sv]

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

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

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

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

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

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

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  • 49.
    Karlsson, Elin
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Sandqvist, Jan
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Ståhl, Christian
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine.
    Social validity for work ability assessments and official decisions – clients’ experiences2019In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 29, no Supplement_4, p. 496-497, article id ckz186.306Article in journal (Refereed)
    Abstract [en]

    Background

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

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

    Methods

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

    Results

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

    Conclusions

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

    Key messages

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

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

  • 50.
    Ståhl, Christian
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, HELIX Competence Centre.
    Costa-Black, Katia
    c School of Health Systems and Public Health, Faculty of Health Sciences , University of Pretoria , Pretoria, Republic of South Africa.
    Loisel, Patrick
    d Dalla Lana School of Public Health, University of Toronto , Toronto , Canada; e Canadian Memorial Chiropractic College , Toronto , Canada.
    Applying theories to better understand socio-political challenges in implementing evidence-based work disability prevention strategies2018In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, no 8, p. 952-959Article in journal (Refereed)
    Abstract [en]

    Purpose: This article explores and applies theories for analyzing socio-political aspects of implementation of work disability prevention (WDP) strategies.

    Method: For the analysis, theories from political science are explained and discussed in relation to case examples from three jurisdictions (Sweden, Brazil and Québec).

    Results: Implementation of WDP strategies may be studied through a conceptual framework that targets: (1) the institutional system in which policy-makers and other stakeholders reside; (2) the ambiguity and conflicts regarding what to do and how to do it; (3) the bounded rationality, path dependency and social systems of different stakeholders; and (4) coalitions formed by different stakeholders and power relations between them. In the case examples, the design of social insurance systems, the access to and infrastructure of healthcare systems, labor market policies, employers’ level of responsibility, the regulatory environment, and the general knowledge of WDP issues among stakeholders played different roles in the implementation of policies based on scientific evidence.

    Conclusions: Future research may involve participatory approaches focusing on building coalitions and communities of practice with policy-makers and stakeholders, in order to build trust, facilitate cooperation, and to better promote evidence utilization.

    • Implications for Rehabilitation
    • Implementation of work disability prevention policies are subject to contextual influences from the socio-political setting and from relationships between stakeholders

    • Stakeholders involved in implementing strategies are bound to act based on their interests and previous courses of action

    • To promote research uptake on the policy level, stakeholders and researchers need to engage in collaboration and translational activities

    • Political stakeholders at the government and community levels need to be more directly involved as partners in the production and utilization of evidence

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