I urval från Stockholms universitets publikationsdatabas

• Sickness Absence and Sickness Presence Among Health and Care Employees in Sweden-Health Complaints, Health Behavior, and Future Long-Term Sickness Absence

  2021. Magnus Helgesson (et al.). Journal of Occupational and Environmental Medicine 63 (6), 514-520

  Artikel

  Objective: To describe if health complaints relate to health behavior in terms of sickness absence (SA) and sickness presence (SP) and to examine how complaints and health behavior predicts the risk for future long-term sickness absence (LTSA).

  Methods: Data originates from work environment surveys 2001 to 2013 and SA registers 2002 to 2016 of 1838 nurses, 7430 care assistants, and 40,515 individuals in all other occupations. Descriptive and regression analyses were conducted.

  Results: Physical complaints and high SA in combination with high SP increased the risk of LTSA among nurses and care assistants. Nurses' high SP and care assistants' high SA elevated the LTSA risk.

  Conclusions: Strategies to reduce the reasons behind physical health complaints among health care workers are warranted. SP among nurses and SA among care assistants should be considered in the organization of their job demands.

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• Favorable Working Conditions Related to Health Behavior Among Nurses and Care Assistants in Sweden-A Population-Based Cohort Study

  2021. Magnus Helgesson (et al.). Frontiers In Public Health 9

  Artikel

  Objective: To analyze the associations between favorable physical and psychosocial work factors and health behavior among healthcare employees (nurses and care assistants) with health complaints.

  Methods: The study was based on seven iterations (2001-2013) of a biennial Swedish work environment survey linked with data from public registers. In all, 7,180 healthcare employees, aged 16-64 years, who had reported health complaints, were included. Health behavior was operationalized through four combinations of sickness absence (SA) and sickness presence (SP): 'good health behavior' (Low SP/Low SA), 'recovery behavior' (Low SP/High SA), 'risk behavior' (High SP/Low SA), and 'poor health behavior' (High SP/High SA). Odds ratios (OR) were calculated by multinomial logistic regression with 95% confidence intervals (CI).

  Results: After adjusting for socio-demographic factors, those who rarely worked in strenuous postures had an increased probability of having 'good health behavior' (OR range: nurses 1.72-2.02; care assistants 1.46-1.75). Those who rarely experienced high job demands had increased odds for having 'good health behavior' (OR: nurses 1.81; OR range: care assistants 1.67-2.13), while having good job control was found to be related to 'good health behavior' only among care assistants (OR range 1.30-1.68). In the full model, after also considering differences in health, none of the work environment indicators affected 'good health behavior' among nursing professionals. Among care assistants, rarely having heavy physical work and having low psychosocial demands remained significantly associated with 'good health behavior' (OR range: 1.24-1.58) and 'recovery behavior' (OR range: 1.33-1.70). No associations were found between favorable work environment factors and 'risk behavior' among the two groups of employees. However, positive assessments of the work situation were associated with 'good health behavior,' even after controlling for all confounders for both groups (OR range: 1.43-2.69).

  Conclusions: 'Good health behavior' and 'recovery behavior' among care assistants were associated with favorable physical and psychosocial working conditions even when health was considered. This implies that reduced sickness presence and sickness absence among care assistants can be achieved through improved physical and psychosocial working conditions.

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• A Resourceful Work Environment Moderates the Relationship between Presenteeism and Health

  2020. Gunnar Bergström (et al.). International Journal of Environmental Research and Public Health 17 (13)

  Artikel

  The objective of this study was to investigate if the psychosocial work environment moderates the proposed negative impact of presenteeism on future general health. We expect that the negative impact of presenteeism on general health is weaker if the psychosocial work environment is resourceful, and more pronounced if the environment is stressful. Data were derived from the 2008-2018 biennial waves of the Swedish Longitudinal Occupational Survey of Health (SLOSH). The final analytic sample consisted ofn= 15,779 individuals. We applied repeated measures regression analyses through generalized estimating equations (GEE). Results from the autoregressive GEE models showed statistically significant interaction terms between presenteeism and all four investigated moderators, i.e., job demands, job control, job support and job strain. The results indicate that the psychosocial work environment moderates the negative association between presenteeism and general health and illustrates a buffering effect of the psychosocial work environment. A possible explanation for these results may be that psychosocially resourceful work environments give room for adjustments in the work situation and facilitate recovery. The results also indicate that by investing the psychosocial work environment employers may be able to promote worker health as well as prevent reduced job performance due to presenteeism.

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• The changing nature of work - Job strain, job support and sickness absence among care workers and in other occupations in Sweden 1991-2013

  2021. Gunnar Aronsson (et al.). SSM - Population Health 15

  Artikel

  This study examined exposure changes in three psychosocial dimensions - job demands, job control, and social support - and the associations between these dimensions and sickness absence throughout the period 1991-2013. The analyses covered periods of economic ups and downs in Sweden and periods involving major fluctuations in sickness absence. Data on care workers (n = 16,179) and a comparison group of employees in other occupations (n = 82,070) were derived from the biennial Swedish Work Environment Survey and linked to register data on sickness absence. Eight exposure profiles, based on combinations of demands, control, and support, were formed. The proportion of individuals with work profiles involving high demands doubled among care workers (14%-29%) while increasing modestly in the comparison group (17%-21%) 1991-2013. The work profile that isolated high-strain (iso-strain), i.e., high demands, low control, and low social support, was more prevalent among care workers, from 4% in 1991 to 11% in 2013. Individuals with work profiles involving highdemand jobs had the highest number of days on sickness absence during the study period and those with the isostrain work profile had the highest increase in sickness absence, from 15 days per year during 1993-1994, to 42 days during 2000-2002. Employees with a passive work profile (low job demands and low job control) had the lowest rate and the lowest increase in sickness absence. Individuals with active work profiles, where high demands are supposed to be balanced by high job control, had a rather high increase in sickness days around 2000. A conclusion is that there is a long-term trend towards jobs with high demands. This trend is stronger among care workers than among other occupations. These levels of job demands seem to be at such a level that it is difficult to compensate for with higher job control and social support.

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• Can a managerial intervention focusing on job demands, job resources, and personal resources improve the work situation of employees?

  Eva Charlotta Nylén (et al.).

  Knowledge regarding the effects on employees of occupational intervention programs targeting psychosocial factors at work, including job demands, job resources, and personal resources, is limited and existing studies show mixed findings. This study aimed to investigate potential effects on employees’ job demands (i.e., workload, unnecessary tasks, and unreasonable tasks), job resources (i.e., feedback, control, and goal clarity), and personal resources (i.e., signaling and limit-setting strategies) of an intervention targeting managers’ ways of improving the psychosocial work environment among their staff (SWEActManager). Questionnaire data from employees (n=40) of a Swedish municipality, whose managers (n=4) participated in the program, and referents (n=58 employees), were collected before and after the program. The program included four three-hour workshops delivered during a six-week period. Results from 2(group) x 2(time) ANOVAs showed that all three demands increased over time while job control decreased. There were no significant group effects. One interaction effect only was significant: Unnecessary tasks increased more among referents than in the intervention group. The few significant short-term effects probably relate to challenges in designing and implementing organizational interventions targeting managers, and evaluating their effects among subordinates. This study adds to the limited research regarding the effects of organizational psychosocial interventions including managers for their subordinates’ demands and resources in a changing working life.

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