Customized interventions improved employees' experience of recovery during the workday.

BACKGROUND: There is a lack of research regarding factors promoting recovery during the workday and effective interventions. OBJECTIVE: To evaluate how different intervention activities may impact employees' experiences of recovery at the workplace. METHODS: Customized intervention activities based on qualitative results and a participatory approach were integrated among the employees at six primary health care centres (PHCCs; n = 166) during one year. Recovery and workplace factors were measured with a questionnaire at the start and end of intervention, and also in a control group (15 PHCCs; n = 328). Group differences were tested (Chi-2) and explanatory factors compared by logistic regression models. RESULTS: The proportion of employees reporting workday recovery increased in the intervention group (19.9%to 29.1%; p = 0.01), whereas the control group showed no significant change. Recovery was explained by self-reflection and reflection with co-workers. After intervention, having influence on work situation, energy-building experience, and opportunity for laughter also contributed significantly to recovery. CONCLUSIONS: The results contribute to work recovery research by confirming that a customized intervention may have an impact on employees' recovery experiences. The study showed that considering the factors of reflection, influence, and companionship can positively impact workplace recovery.

Strengthened workplace relationships facilitate recovery at work - qualitative experiences of an intervention among employees in primary health care.

BACKGROUND: The literature on workplace interventions focusing on recovery is scarce; hence this study intends to expand that knowledge. An intervention was run for one year, aiming at increasing the experience of recovery during the workday among primary health care employees. During the intervention, different forms of recovery activities were integrated into the daily work at six primary health care centres. The aim of this study was to explore the intervention process and its effects. METHODS: After completion of an intervention, 39 employees in seven focus groups were interviewed about their experiences of the intervention. A semi-structured interview guide was used, and the qualitative analysis was conducted by systematic text condensation. RESULTS: Despite different conditions and attitudes when the project was launched, the participants portrayed a positive outcome of the intervention at all six workplaces. Four promoting factors for intervention success were identified: support, legitimacy, customization, and simplicity. Also, three areas of improvement during the intervention period were described: the workplace climate, employee well-being, and recovery awareness, which in turn became promoting factors. CONCLUSIONS: An intervention aiming at increasing workplace recovery can be promoted by support, legitimacy, customization, and simplicity. By using these promoting factors, health care workplaces can implement activity models which could increase employees' experiences of recovery during the workday. Positive effects on workplace climate and employee well-being can also be achieved.

Flow situations during everyday practice in a medical hospital ward. Results from a study based on experience sampling method.

BACKGROUND: Nursing is a constant balance between strain and stimulation and work and health research with a positive reference point has been recommended. A health-promoting circumstance for subjective experience is flow, which is a psychological state, when individuals concurrently experience happiness, motivation and cognitive efficiency. Flow situations can be identified through individuals' estimates of perceived challenge and skills. There is, to the best of our knowledge, no published study of flow among health care staff. The aim of this study was to identify flow-situations and study work-related activities and individual factors associated with flow situations, during everyday practice at a medical emergency ward in Sweden, in order to increase the knowledge on salutogenic health-promoting factors. METHODS: The respondents consisted of 17 assistant nurses and 14 registered nurses, who randomly and repeatedly answered a small questionnaire, through an experience sampling method, during everyday nursing practice. The study resulted in 497 observations. Flow situations were defined as an exact match between a high challenge and skill estimation and logistic regression models were used to study different variables association to flow situations. RESULTS: The health care staff spent most of its working time in individual nursing care and administrative and communicative duties. The assistant nurses were more often occupied in individual nursing care, while the registered nurses were more involved in medical care and administrative and communicative duties. The study resulted in 11.5% observations of flow situations but the relative number of flow situations varied between none to 55% among the participants. Flow situations were positively related to medical care activities and individual cognitive resources. Taking a break was also positively associated with flow situations among the assistant nurses. CONCLUSIONS: The result showed opportunities for work-related interventions, with an adherent increase in flow situations, opportunity for experience of flow and work-related health among the nursing staff in general and among the assistant nurses in particular.

The Locomotor Capabilities Index; validity and reliability of the Swedish version in adults with lower limb amputation.

BACKGROUND: The Locomotor Capabilities Index (LCI) is a validated measure of lower-limb amputees' ability to perform activities with prosthesis. We have developed the LCI Swedish version and evaluated its validity and reliability. METHODS: Cross-cultural adaptation to Swedish included forward/backward translations and field testing. The Swedish LCI was then administered to 144 amputees (55 women), mean age 74 (40-93) years, attending post-rehabilitation prosthetic training. Construct validity was assessed by examining the relationship between the LCI and Timed "Up-and-Go" (TUG) test and between the LCI and EQ-5D health utility index in 2 subgroups of 40 and 20 amputees, respectively. Discriminative validity was assessed by comparing scores in different age groups and in unilateral and bilateral amputees. Test-retest reliability (1-2 weeks) was evaluated in 20 amputees (14 unilateral). RESULTS: The Swedish LCI showed good construct convergent validity, with high correlation with the TUG (r = -0.75) and the EQ-5D (r = 0.84), and discriminative validity, with significantly worse mean scores for older than younger and for bilateral than unilateral amputees (p < 0.01), and high internal consistency (Cronbach alpha 0.95). In test-retest reliability the intraclass correlation coefficient was 0.91 (95% CI 0.79-0.96) but for the unilateral amputees was 0.83 (95% CI 0.56-0.94). Ceiling effect occurred in 23%. CONCLUSION: The Swedish version of the LCI demonstrated good validity and internal consistency in adult amputees. Test-retest reliability in a small subsample appears to be acceptable. The high ceiling effect of the LCI may imply that it would be most useful in assessing amputees with low to moderate functional abilities.

Inequalities of quality of life in unemployed young adults: a population-based questionnaire study.

BACKGROUND: It is well known that unemployment is a great problem both to the exposed individual and to the whole society. Unemployment is reported as more common among young people compared to the general level of unemployment. Inequity in health status and life-satisfaction is related to unemployment. The purpose of this population-based study was to describe QOL among unemployed young people compared to those who are not unemployed, and to analyse variables related to QOL for the respective groups. METHODS: The sample consisted of 264 young unemployed individuals and 528 working or studying individuals as a reference group. They all received a questionnaire about civil status, educational level, immigration, employment status, self-reported health, self-esteem, social support, social network, spare time, dwelling, economy and personal characteristics. The response rate was 72%. The significance of differences between proportions was tested by Fisher's exact test or by chi2 test. Multivariate analysis was carried out by means of a logistic regression model. RESULTS: Our results balance the predominant picture of youth unemployment as a principally negative experience. Although the unemployed reported lower levels of QOL than the reference group, a majority of unemployed young adults reported good QOL, and 24% even experienced higher QOL after being unemployed. Positive QOL related not only to good health, but also to high self-esteem, satisfaction with spare time and broad latitude for decision-making. CONCLUSION: Even if QOL is good among a majority of unemployed young adults, inequalities in QOL were demonstrated. To create more equity in health, individuals who report reduced subjective health, especially anxiety need extra attention and support. Efforts should aim at empowering unemployed young adults by identifying their concerns and resources, and by creating individual programmes in relation not only to education and work, but also to personal development.

Return to work still possible after several years as a disability pensioner due to musculoskeletal disorders: a population-based study after new legislation in Sweden permitting "resting disability pension".

Different strategies have been used to stimulate a return to work (RTW) among individuals suffering from long-term ailments. In Sweden a new law on "resting disability pension" permits disability pensioners to go back to work without jeopardising their benefits. In this study different variables related to RTW during 2000 by means of this legislation were identified among disability pensioners with musculoskeletal disorders. Individuals in the study group, when compared to a control group, had more often been disability pensioners for several years, had additional education, estimated their previous job to have been physically strenuous to a lesser degree, were more satisfied with the treatment at the social insurance office and had a more positive self-image. This study shows that it may be meaningful to continue/resume rehabilitation efforts and to try to motivate an individual suffering from musculoskeletal disorders to return to work even after several years as a disability pensioner.

Primary care patients with musculoskeletal pain. Value of health-status and sense-of-coherence measures in predicting long-term work disability.

OBJECTIVE: To investigate long-term sick leave among primary care patients with musculoskeletal disorders and the predictive value of health-status and sense-of-coherence measures. METHODS: Patients aged 17 to 64 years who, during seven weeks, attended one of six primary care centers because of non-traumatic musculoskeletal pain and who completed the SF-36 health questionnaire and the sense of coherence (SOC) scale at baseline and after one year. RESULTS: Of 189 patients, 36 (19%) were sicklisted for at least three months before and/or after their visit; the most common diagnoses were non-specific soft-tissue or multiple joint, low back, and shoulder pain. The long-term sicklisted patients had significantly worse baseline SF-36 and SOC scores than the non-sicklisted patients; moderate improvement in the SF-36 bodily pain but no improvement in the physical functioning scores occurred. The duration of sick leave at baseline and the SF-36 bodily pain score were significant predictors of continuos one-year work disability. CONCLUSION: Long-term sick leave was common among primary care patients with musculoskeletal pain. The physical functioning and return-to-work outcomes after one year were poor. The SF-36 bodily pain scale might be helpful in identifying at risk patients.