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Helgesson M, Gustafsson K, Leineweber C. Psychosocial and organisational work factors as predictors of sickness absence among professionally active adults with common mental disorders. BMC Psychiatry 2023; 23:543. [PMID: 37495944 PMCID: PMC10373327 DOI: 10.1186/s12888-023-05020-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/11/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND The incidence of sickness absence (SA) due to common mental disorders (CMDs) has increased in recent decades. It is hence important to elucidate how individuals with CMDs can maintain work. The aim was to analyse the relationship between psychosocial and organisational workplace factors and a spell of > 14 days of SA among persons with CMDs. METHODS Included were respondents of the Swedish Work Environment Survey (SWES) 1993-2013, diagnosed with a CMD up to five years before the interview in the SWES (n = 3,795). Relative Risk (RR) regression models with 95% Confidence Intervals (CIs) analysed associations between psychosocial-, and organisational workplace factors and a subsequent spell of SA > 14 days. RESULTS Low control over work (RR:1.16; CI:1.01-1.35), job strain (RR:1.25; CI:1.04-1.49), no flexible working hours (RR:1.25; CI:1.08-1.45) or no possibility to work from home (RR:1.37; CI:1.13-1.66) were significantly related to an increased risk of SA. Persons diagnosed with depression experiencing job strain had the highest increased risk of SA (RR:1.55; CI: 1.07-2.25). CONCLUSIONS A sustainable work-life among working individuals with CMDs can be provided by reducing job strain, and if possible, by increasing flexibility regarding workplace and working hours. This may prevent spells of SA, and hereby increase productivity.
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Affiliation(s)
- Magnus Helgesson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SE-17177, Sweden.
- Department of Public Health and Caring Sciences, Health Equity and Working Life, Uppsala University, Uppsala, SE-75237, Sweden.
| | - Klas Gustafsson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SE-17177, Sweden
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Durand MJ, Sylvain C, Paquette MA. Return to Work for People with Common Mental Disorders: Insights into the Implementation of a Collaborative Program in a Specialized Mental Health Hospital. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:362-374. [PMID: 36329284 DOI: 10.1007/s10926-022-10079-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/14/2022] [Indexed: 05/12/2023]
Abstract
Purpose Common mental disorders (CMDs) are a major cause of sick leave. Return-to-work (RTW) interventions providing mechanisms that support the participation and collaboration of the different stakeholders appear promising in these circumstances. The Therapeutic Return-to-Work (TRW) Program offers such mechanisms designed to enable affected workers to fully reintegrate into their jobs on a sustainable basis. This study evaluated the feasibility of implementing this program for workers with CMDs, within a specialized mental health hospital. Methods The study was conducted using a multiple case design and three main data sources: (1) the worker's medical file, (2) the log completed by the clinicians, and (3) individual interviews with stakeholders. Data were analyzed using a qualitative approach. Results Twelve workers between 32 and 60 years old, mostly women with complex mental health profiles working in large enterprises, participated in this study. Three main observations were made regarding the TRW Program implementation: (1) eight cases were characterized by complete or virtually complete implementation; (2) no explanatory factor could be identified for the different implementation levels; (3) eight cases achieved RTW success (RTW to the original job or another job), which appears partially attributable to the high level of program implementation. Conclusions: The TRW Program seems highly promising for supporting the return to work of workers with CMDs. However, studies identifying the factors likely to influence the implementation process in different health service contexts and specifying the scope and nature of the program's actual impact on RTW outcomes should be conducted before larger-scale implementation takes place.
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Affiliation(s)
- Marie-José Durand
- Centre d'action en prévention et réadaptation des incapacités au travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
- Centre de recherche Charles-Le Moyne (CRCLM), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
| | - Chantal Sylvain
- Centre d'action en prévention et réadaptation des incapacités au travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de recherche Charles-Le Moyne (CRCLM), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Marie-Andrée Paquette
- Centre d'action en prévention et réadaptation des incapacités au travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de recherche Charles-Le Moyne (CRCLM), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
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Hedlund Å, Boman E, Kristofferzon ML, Nilsson A. Development and psychometric evaluation of a theory-based questionnaire measuring women's return-to-work beliefs after long-term sick leave for common mental disorders. Work 2023; 76:109-124. [PMID: 36806536 PMCID: PMC10578269 DOI: 10.3233/wor-220301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 11/02/2022] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND Common mental disorders (CMDs) are currently a major cause of long-term sick leave, with women being most affected. OBJECTIVE Using the Theory of Planned Behaviour (TPB), we aimed to describe the development and psychometric evaluation of a new questionnaire to measure women's beliefs about return to work (RTW) after long-term sick leave for CMDs. METHODS Data were collected in central Sweden from women on long-term sick leave (2- 24 months) for CMDs. The questionnaire was developed by conducting an elicitation study with 20 women and included both direct and indirect measures. Subsequently, 282 women participated in a psychometric evaluation and 35 of them in a test-retest procedure. Psychometric properties were evaluated by determining reliability (internal consistency [Cronbach's alpha] and test-retest stability [intraclass correlation coefficient]), construct validity (exploratory factor analysis) and content validity. RESULTS The development resulted in 60 questionnaire items. Content validity assessment showed that the women overall found it easy to complete the questionnaire. Reliability analyses showed satisfactory results for both direct and indirect measures, with a few exceptions. Factor analyses of the indirect scales showed that items were generally in line with the TPB, but that items related to life as a whole/personal life and items related to work were separated into two different factors. CONCLUSION The questionnaire, called the RTW Beliefs Questionnaire, showed promising results and can among women with CMDs be considered useful, especially the scales for direct measures. This questionnaire gives opportunity to identify new potential predictors for RTW.
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Affiliation(s)
- Åsa Hedlund
- Department of Caring Sciences, University of Gävle, Gävle, Sweden
| | - Eva Boman
- Department of Occupational Health Science and Psychology, University of Gävle, Gävle, Sweden
| | | | - Annika Nilsson
- Department of Caring Sciences, University of Gävle, Gävle, Sweden
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Tengelin E, Hensing G, Holmgren K, Ståhl C, Bertilsson M. Swedish managers' experience-based understanding of the Capacity to work in employees with Common Mental Disorders: a Focus Group Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:685-696. [PMID: 35246799 PMCID: PMC9668926 DOI: 10.1007/s10926-022-10029-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/04/2022] [Indexed: 06/14/2023]
Abstract
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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Affiliation(s)
- Ellinor Tengelin
- Department for Health Sciences, University West, SE-461 86, Trollhattan, Sweden.
| | - Gunnel Hensing
- Insurance Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, SE-405 30, Gothenburg, Sweden
| | - Kristina Holmgren
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, SE-405 30, Gothenburg, Sweden
| | - Christian Ståhl
- Department of Behavioural Sciences and Learning, Division of Education and Sociology, Linköping University, SE-581 83, Linköping, Sweden
| | - Monica Bertilsson
- Insurance Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, SE-405 30, Gothenburg, Sweden
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Bertilsson M, Löve J, Martinsson J, Wängnerud L, Hensing G. Association of stigmatizing attitudes with people’s opinion of depression as a valid reason for sickness absence: A Swedish vignette study. Work 2022; 73:495-504. [DOI: 10.3233/wor-205181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Depression is a common cause of sickness absence (SA) and also highly associated with stigma. Few studies have addressed the role of stigma in relation to SA. OBJECTIVE: To investigate if attitudes to depression were associated with the public’s opinion of depression as a valid reason of SA. METHODS: The study population (n = 2413) originated from a web-based panel of citizens. The survey included a short vignette describing a person with symptoms of depression and the person’s work tasks, followed by a question on recommendation of SA. Negative attitudes were measured by the Depression Stigma Scale. Logistic regressions were used to estimate the odds ratios (OR) for the likelihood of not recommending SA, controlling for individual and work-related co-variates. RESULTS: The crude association between negative attitudes and not recommending SA was OR 2.15 (95% CI, 1.76–2.62). In the fully adjusted model the OR was 1.76 (95% CI, 1.40 –2.21) for not recommending SA. CONCLUSIONS: Participants with negative attitudes to depression were more likely to not consider depression as a valid reason of sickness absence. The study supports theories on layered stigma; attitudes from one arena are related to other arenas. Future studies are needed to confirm our findings.
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Affiliation(s)
- Monica Bertilsson
- Department of Public Health and Community Medicine, the Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Jesper Löve
- Department of Public Health and Community Medicine, the Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Johan Martinsson
- Department of Political Science, University of Gothenburg, Gothenburg, Sweden
| | - Lena Wängnerud
- Department of Political Science, University of Gothenburg, Gothenburg, Sweden
| | - Gunnel Hensing
- Department of Public Health and Community Medicine, the Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
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van Hees SGM, Carlier BE, Blonk RWB, Oomens S. Promoting Factors to Stay at Work Among Employees With Common Mental Health Problems: A Multiple-Stakeholder Concept Mapping Study. Front Psychol 2022; 13:815604. [PMID: 35619783 PMCID: PMC9128844 DOI: 10.3389/fpsyg.2022.815604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 04/08/2022] [Indexed: 11/17/2022] Open
Abstract
Most individuals affected by common mental health problems are employed and actually working. To promote stay at work by workplace interventions, it is crucial to understand the factors perceived by various workplace stakeholders, and its relative importance. This concept mapping study therefore explores perspectives of employees with common mental health problems (n = 18), supervisors (n = 17), and occupational health professionals (n = 14). Per stakeholder group, participants were interviewed to generate statements. Next, each participant sorted these statements on relatedness and importance. For each group, a concept map was created, using cluster analysis. Finally, focus group discussions were held to refine the maps. The three concept maps resulted in several clustered ideas that stakeholders had in common, grouped by thematic analysis into the following meta-clusters: (A) Employee’s experience of autonomy in work (employee’s responsibility, freedom to exert control, meaningful work), (B) Supervisor support (being proactive, connected, and involved), (C) Ways to match employee’s capacities to work (job accommodations), (D) Safe social climate in workplace (transparent organizational culture, collective responsibility in teams, collegial support), and (E) professional and organizational support, including collaboration with occupational health professionals. Promoting stay at work is a dynamic process that requires joined efforts by workplace stakeholders, in which more attention is needed to the interpersonal dynamics between employer and employee. Above all, a safe and trustful work environment, in which employee’s autonomy, capacities, and needs are addressed by the supervisor, forms a fundamental base to stay at work.
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Affiliation(s)
- Suzanne G M van Hees
- Occupation and Health Research Group, HAN University of Applied Sciences, Nijmegen, Netherlands.,Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - Bouwine E Carlier
- Occupation and Health Research Group, HAN University of Applied Sciences, Nijmegen, Netherlands
| | - Roland W B Blonk
- Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands.,TNO, Leiden, Netherlands.,Optentia, North West University, Vanderbijlpark, South Africa
| | - Shirley Oomens
- Occupation and Health Research Group, HAN University of Applied Sciences, Nijmegen, Netherlands.,Department of Primary and Community Care, Nijmegen School of Occupational Health, Radboudumc, Nijmegen, Netherlands
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Bertilsson M, Klinkhammer S, Staland-Nyman C, de Rijk A. How Managers Find Out About Common Mental Disorders Among Their Employees. J Occup Environ Med 2021; 63:975-984. [PMID: 34091578 DOI: 10.1097/jom.0000000000002287] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To explore how managers find out about common mental disorders (CMDs) among employees and associations with managers' work- and knowledge-related characteristics and attitude to CMDs. METHODS Data from an online survey in 2017 with Swedish managers (n = 1810) were used. Different ways managers find out about CMDs were measured, and multivariate logistic regression analysis was conducted for associations with manager characteristics. RESULTS Few managers found out about CMDs themselves; another source was more common, for example, employees' self-disclosure. Managers' overseeing fewer subordinates and those with a negative attitude to depression were more likely to find out about CMDs themselves. The significance of mental health training and education could not be established. CONCLUSION Managers' awareness about employees' CMDs mainly came about through employees' self-disclosure. Managers' attitudes and work conditions were related to the way of finding out.
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Affiliation(s)
- Monica Bertilsson
- School of Public Health and Community Medicine, Sahlgrenska Academy University of Gothenburg, Gothenburg, Sweden (Dr Bertilsson, Dr Staland-Nyman); Department of Social Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands (Ms Klinkhammer, Dr de Rijk)
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Hedlund Å, Boman E, Kristofferzon ML, Nilsson A. Beliefs About Return to Work Among Women During/After Long-Term Sick Leave for Common Mental Disorders: A Qualitative Study Based on the Theory of Planned Behaviour. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:604-612. [PMID: 33492634 PMCID: PMC8298344 DOI: 10.1007/s10926-020-09946-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/19/2020] [Indexed: 05/28/2023]
Abstract
PURPOSE Long-term sick leave due to common mental disorders (CMDs) is an increasing problem, especially among women. To help these women return to work (RTW) sustainably, we need to know more about their own beliefs about RTW. One applicable theory is the theory of planned behaviour (TPB). Thus, the present study aimed to describe, based on the TPB, women's beliefs about RTW during or after long-term sick leave for a CMD. METHODS A qualitative approach was used. Twenty women were included during a long-term sick leave period due to a CMD. A deductive content analysis was conducted using predetermined factors from the TPB: behavioural beliefs (advantages-disadvantages of RTW), normative beliefs (supporters and non-supporters of RTW), and control beliefs (facilitators of-barriers to RTW). RESULTS The women believed that RTW would give them meaning and balance in life, but also that it would be challenging to maintain balance after RTW. They believed they had several supporters of RTW, but that the support was sometimes perceived as stressful rather than encouraging. Furthermore, individual adaptation and high demands were the most mentioned facilitator and barrier, respectively. Workplace conditions and personal strategies were thought to be important aspects. CONCLUSIONS By using the TPB, the present study was able to offer new findings on women's beliefs about RTW after long-term sick leave for a CMD. Based on the findings, we suggest that various RTW stakeholders should focus on striving to provide the tasks and work pace women need so they can maintain their professional competence and sense of meaning.
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Affiliation(s)
- Åsa Hedlund
- Department of Caring Sciences, University of Gävle, Kungsbäcksvägen 47, 801 76, Gävle, Sweden.
| | - Eva Boman
- Department of Occupational Health and Psychology, University of Gävle, Kungsbäcksvägen 47, 801 76, Gävle, Sweden
| | | | - Annika Nilsson
- Department of Caring Sciences, University of Gävle, Kungsbäcksvägen 47, 801 76, Gävle, Sweden
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Lyhne CN, Nielsen CV, Kristiansen ST, Bjerrum MB. 'Work is a motivator in life' Strategies in managing work participation among highly educated employees with depression. Work 2021; 69:1063-1073. [PMID: 34219699 DOI: 10.3233/wor-213536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Work participation among employees with depression is hampered due to cognitive impairments. Although studies show higher levels of work disability among people with a lower education, highly educated employees may encounter specific challenges in fulfilling their work role due to the cognitive impairments of depression, as they often perform cognitively demanding jobs. There is little knowledge about their challenges and opportunities with regard to work participation. OBJECTIVE To investigate how highly educated employees with depression manage work participation by focusing on their views on opportunities and challenges in fulfilling their work role. METHODS Eight individual interviews with highly educated employees with depression were conducted. Transcripts were analysed using qualitative content analysis. RESULTS The analysis revealed four categories: struggling with acknowledging depression and disclosure; fear of being stigmatised at work; work is a motivator in life; and striving to fulfil the work role at the expense of private life activities. CONCLUSIONS Highly educated employees with depression need guidance regarding the disclosure of information about health issues and work ability. To successfully manage their work role, they need a clear plan with outlined tasks, demands and goals. Healthcare professionals and workplaces should support them in setting limits with regard to work tasks and working hours.
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Affiliation(s)
- Cecilie N Lyhne
- Research Unit of Nursing and Healthcare, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Claus V Nielsen
- Department of Public Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Central Denmark Region, Denmark.,Regional Hospital West Jutland, Herning, Denmark
| | - Sanne T Kristiansen
- Research Unit of Nursing and Healthcare, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Merete B Bjerrum
- Research Unit of Nursing and Healthcare, Department of Public Health, Aarhus University, Aarhus, Denmark.,The Centre of Clinical Guidelines - Danish National Clearing House, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,The Danish Centre of Systematic Reviews - A JBI Centre of Excellence, The University of Adelaide, Adelaide, South Australia, Australia
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van Hees SGM, Carlier BE, Blonk RWB, Oomens S. Understanding work participation among employees with common mental disorders: What works, for whom, under what circumstances and how? A systematic realist review protocol. Work 2021; 69:827-838. [PMID: 34180455 PMCID: PMC8385521 DOI: 10.3233/wor-213515] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND: Work participation among employees with common mental disorders (CMDs) is an increasingly important, yet highly complex phenomenon. Given the call for preventing instead of reacting to negative work outcomes, there is a need to understand how employees with CMDs can continue working. OBJECTIVES: 1) to provide insights in applying a realist approach to the literature review process and 2) to present a way to develop an explanatory framework on work participation, the related causal mechanisms and the interaction with the work context. METHODS: A systematic realist literature review, using stay at work (SAW) and work performance (WP) as outcomes of work participation. This protocol paper explains the rationale, tools and procedures developed and used for identification, selection, appraisal and synthesis of included studies. RESULTS: The review process entailed six steps to develop so called ‘middle range program theories’. Each step followed a systematic, iterative procedure using context-mechanism-outcome (CMO) configurations. CONCLUSIONS: Conducting a realist review adds on the understanding to promote work participation, by examining the heterogeneity and complexity of intervention- and observational studies. This paper facilitates other researchers within the field of occupational health by demonstrating ways to develop a framework on work participation using realist synthesis.
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Affiliation(s)
- Suzanne G M van Hees
- Occupation and health research group, HAN University of Applied Sciences, Nijmegen, The Netherlands.,Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | - Bouwine E Carlier
- Occupation and health research group, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Roland W B Blonk
- Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands.,Optentia Research Focus Area, North-West University, Vanderbijlpark, South Africa.,TNO, Leiden, The Netherlands
| | - Shirley Oomens
- Occupation and health research group, HAN University of Applied Sciences, Nijmegen, The Netherlands.,Radboudumc, Department of Primary and Community Care, School of Occupational Health, Nijmegen, The Netherlands
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11
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Lyhne CN, Pedersen P, Nielsen CV, Bjerrum MB. Needs for occupational assistance among young adults with ADHD to deal with executive impairments and promote occupational participation - a qualitative study. Nord J Psychiatry 2021; 75:362-369. [PMID: 33380255 DOI: 10.1080/08039488.2020.1862911] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To examine perceived aspects of importance among young adults with ADHD to participate and engage in occupational activities, and to explain how support from occupational specialists can assist them to deal with executive impairments. MATERIALS AND METHODS Individual interviews with eight young adults with attention-deficit/hyperactivity disorder. The interview guide was based on assumptions derived from the literature regarding executive functioning and issues related to participation in occupational activities, alongside the needs for social support. Interview transcripts were analysed using qualitative content analysis. RESULTS Four categories emerged from the analysed interviews: (1) Being involved in an occupational environment fulfils a need for social contact, (2) Occupational activities must be clear and within interest (3) Self-confidence and daily routines are prerequisites for occupational participation (4) Having a lifeline providing continuous support is important. CONCLUSIONS Routines, interest and structure in everyday life are important to engage in occupational activities. There is a need for continuous support from a trusted person to establish and maintain healthy daily routines. Occupational specialists can be a vital resource, as they possess specific knowledge on the possibilities for occupation, and additionally, they can fulfil the young adults' needs for continuous support. There is a need for studies questioning how some young adults with ADHD fulfil their work role despite executive impairments. Focusing on executive functioning can be a valuable supplement to the focus on specific diagnoses in research and practice.
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Affiliation(s)
- Cecilie N Lyhne
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Claus V Nielsen
- Department of Public Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Central Denmark Region, Aarhus, Denmark.,Department of Social Medicine and Rehabilitation, Regional Hospital West Jutland, Central Denmark Region, Herning, Denmark
| | - Merete B Bjerrum
- Department of Public Health, Aarhus University, Aarhus, Denmark.,The Centre of Clinical Guidelines - Danish National Clearing House, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Eskilsson T, Norlund S, Lehti A, Wiklund M. Enhanced Capacity to Act: Managers' Perspectives When Participating in a Dialogue-Based Workplace Intervention for Employee Return to Work. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:263-274. [PMID: 32737671 PMCID: PMC8172407 DOI: 10.1007/s10926-020-09914-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Purpose To explore if and how a dialogue-based workplace intervention with a convergence dialogue meeting can support a return to work process from the managers' perspective. Methods Individual interviews were conducted with 16 managers (10 women and 6 men) who had an employee on sick leave because of stress-induced exhaustion disorder. The manager and employee participated in a dialogue-based workplace intervention with a convergence dialogue meeting that was guided by a healthcare rehabilitation coordinator. The intervention aimed to facilitate dialogue and find concrete solutions to enable return to work. The interviews were analyzed by the Grounded Theory method. Results A theoretical model was developed with the core category enhancing managerial capacity to act in a complex return to work process, where the managers strengthened their agential capacity in three levels (categories). These levels were building competence, making adjustments, and sharing responsibility with the employee. The managers also learned to navigate in multiple systems and by balancing demands, control and support for the employee and themselves. An added value was that the managers began to take preventive measures with other employees. When sick leave was caused only by personal or social issues (not work), workplace actions or interventions were difficult to find. Conclusions From the managers' perspective, dialogue-based workplace interventions with a convergence dialogue meeting and support from a rehabilitation coordinator can strengthen managerial competence and capacity to act in a complex return to work process.
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Affiliation(s)
- Therese Eskilsson
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden.
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.
| | - Sofia Norlund
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
| | - Arja Lehti
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
- Department of Clinical Sciences, Section of Professional Development, Umeå University, Umeå, Sweden
| | - Maria Wiklund
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
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Hedlund Å. An overlooked concept? Intention to return to work among individuals on sick leave due to common mental disorders: A scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:602-611. [PMID: 33506561 DOI: 10.1111/hsc.13293] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/14/2020] [Accepted: 01/05/2021] [Indexed: 06/12/2023]
Abstract
Intention to return to work (RTW) is an important predictor of actual RTW among individuals on sick leave in general. However, it is not known whether this is also the case for individuals with common mental disorders (CMDs). Because CMDs are a leading cause of disability worldwide, the RTW process is often more complex and sick leave periods are longer than for other diagnoses. Thus, it is important to focus solely on this group. The purpose of this scoping review was to summarise studies targeting individuals' RTW intention and its importance for actual RTW after sick leave due to CMDs. Studies relevant for the aim were identified by a structured searching in three electronic databases (PubMed, CINAHL and PsycINFO) from their inception until the end of June 2020, as well as grey literature and reference lists of included articles. To cover all aspects of "intention", close concepts such as "expectation" and "willingness" were searched for as well. After the selection process, 10 original research papers were included in the review: eight quantitative and two qualitative. Nine of the studies used the concept "expectation" and one "intention". There was also a lack of consistency in measurements across studies. However, they showed that intention (expectation) was a significant predictor of actual RTW. The conclusion is that RTW intention among individuals after sick leave due to CMDs has been narrowly investigated, with a lack of consistency in measurements. Future research should use behavioural-psychological theories to cover the concept "intention" in a more comprehensive and consistent manner.
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Affiliation(s)
- Åsa Hedlund
- Department of Caring Sciences, University of Gävle, Gävle, Sweden
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14
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Standal MI, Foldal VS, Hagen R, Aasdahl L, Johnsen R, Fors EA, Solbjør M. Health, Work, and Family Strain - Psychosocial Experiences at the Early Stages of Long-Term Sickness Absence. Front Psychol 2021; 12:596073. [PMID: 33868075 PMCID: PMC8043853 DOI: 10.3389/fpsyg.2021.596073] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 03/10/2021] [Indexed: 01/12/2023] Open
Abstract
Background Knowledge about the psychosocial experiences of sick-listed workers in the first months of sick leave is sparse even though early interventions are recommended. The aim of this study was to explore psychosocial experiences of being on sick leave and thoughts about returning to work after 8–12 weeks of sickness absence. Methods Sixteen individuals at 9–13 weeks of sick leave participated in semi-structured individual interviews. Data was analyzed through Giorgi’s descriptive phenomenological method. Results Three themes emerged: (1) energy depleted, (2) losing normal life, (3) searching for a solution. A combination of health, work, and family challenges contributed to being drained of energy, which affected both work- and non-work roles. Being on sick leave led to a loss of social arenas and their identity as a contributing member of society. Participants required assistance to find solutions toward returning to work. Conclusion Even in this early stage of long-term sick leave, sick listed workers faced complex challenges in multiple domains. Continuing sick leave was experienced as necessary but may challenge personal identity and social life. Those not finding solutions may benefit from additional early follow-up that examine work-related, social and personal factors that influence return to work.
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Affiliation(s)
- Martin I Standal
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Vegard S Foldal
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Roger Hagen
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway.,Research Institute, Modum Bad, Vikersund, Norway
| | - Lene Aasdahl
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Unicare Helsefort Rehabilitation Centre, Rissa, Norway
| | - Roar Johnsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Egil A Fors
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marit Solbjør
- General Practice Research Unit, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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15
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Thisted CN, Labriola M, Nielsen CV, Jul Håkonsen S, Bjerrum MB. Understanding depression as a workplace issue: Clarifying employers' attitudes to manage employees with depression. Work 2020; 65:857-868. [PMID: 32310215 DOI: 10.3233/wor-203137] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Sickness absence due to depression has indirect and direct costs for employers. Whilst employers play a key role in establishing supportive work environments and providing work adjustments, there is a lack of knowledge on employers' attitudes to support employees with depression. OBJECTIVE To investigate employers' attitudes to manage employees' depression, focusing on the employers' opportunities and challenges to support employees with depression. METHODS Individual interviews were conducted with five employers. Interview transcripts were analysed using qualitative content analysis. RESULTS Four categories emerged from the interviews: Attitude to and understanding of depression affect supportive practices; Dilemma between supporting employees with depression and accommodating workplace needs; The employer-employee relationship influences supportive practices; and Work accommodations target the employee's ability to work. CONCLUSION Employers may need a wider understanding of depression and the importance of the work environment influencing work disability due to depression. Studies should investigate how knowledge of work disability due to depression can be transferred to workplaces.Conflicting agendas of the vocational rehabilitation stakeholders poison opportunities to support, and initiatives may aim to promote employers' understanding of the benefits of collaborating with other stakeholders. The involvement of decision-makers to provide initiatives that support employers in managing employees with depression to promote their work participation is recommended.
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Affiliation(s)
- Cecilie N Thisted
- Department of Public Health, Research Unit for Nursing and Healthcare, Aarhus University, Aarhus, Denmark
| | - Merete Labriola
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Claus V Nielsen
- DEFACTUM, Central Denmark Region, Aarhus, Denmark.,Department of Social Medicine and Rehabilitation, Regional Hospital West Jutland, Central Denmark Region, Herning, Denmark
| | - Sasja Jul Håkonsen
- Department of Medicine and Technology, Centre for Clinical Guidelines, University of Aalborg, Aalborg, Denmark
| | - Merete B Bjerrum
- Department of Public Health, Research Unit for Nursing and Healthcare, Aarhus University, Aarhus, Denmark
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16
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Danielsson L, Fornazar R, Holmgren K, Lundgren Nilsson Å, Hensing G. Development and Construct Validity of the Work Instability Scale for People With Common Mental Disorders in a Sample of Depressed and Anxious Workers: A Rasch Analysis. Rehabil Process Outcome 2020; 9:1179572720936664. [PMID: 34497467 PMCID: PMC8282151 DOI: 10.1177/1179572720936664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 06/01/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Sick leave due to common mental disorders, encompassing depression and anxiety disorders, is high. Capturing early signs of reduced function could aid adjustments of work tasks and environment and, thus, endorse a pro-active approach to occupational and health care interventions to prevent long-term sick-leave spells. However, few measurements exist to identify early signs of imbalance, and none that is illness-specific. The aim of this study was to develop a work instability scale for people with common mental disorders and to test the fundamental psychometric properties of the scale. METHODS Participants were working adults 18-65 years old with depression or anxiety. The scale development started with qualitative interviews (n = 27) which informed the drafting of a dichotomous, self-report questionnaire. Cognitive debriefing (n = 12) was used to check face validity and modify the draft. Internal construct validity of the draft was tested using Rasch analysis (n = 128). The work ability index was used as a comparator measure. RESULTS The initial 63-item draft showed poor fit to Rasch model expectations. Items displaying poor fit or local response dependency were stepwise removed, resulting in a unidimensional 34-item scale fitting the model expectations, and with no differential item functioning. Person-item threshold distribution showed that the scale is better suited to measure low to moderate work instability, than to measure high instability. Correlations between the newly developed scale and the work ability index showed a significant, moderately strong correlation. CONCLUSIONS In the initial target sample, the 34-item scale showed acceptable fundamental properties and internal construct validity. Further validation of the scale in a larger sample, including tests for external validity, is warranted.
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Affiliation(s)
- Louise Danielsson
- Research Unit, Angered Hospital, Gothenburg, Sweden
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Robin Fornazar
- Administration for Allocation of Social Welfare, Gothenburg, Sweden
- Department of Public Health and Community Medicine, School of Public Health, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kristina Holmgren
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Åsa Lundgren Nilsson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gunnel Hensing
- Department of Public Health and Community Medicine, School of Public Health, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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17
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Björk Brämberg E, Sandman L, Hellman T, Kwak L. Facilitators, barriers and ethical values related to the coordination of return-to-work among employees on sick leave due to common mental disorders: a protocol for a qualitative study (the CORE-project). BMJ Open 2019; 9:e032463. [PMID: 31530623 PMCID: PMC6756367 DOI: 10.1136/bmjopen-2019-032463] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Diagnoses related to common mental disorders such as anxiety, depression, adjustment disorders and stress-related disorders are one of the leading causes of long-term sick leave for both women and men in Organisation for Economic Co-operation and Development countries. To increase the rate of return-to-work workplace involvement in a coordinated return-to-work process has been included in recent best practice guidelines. This form of cooperation is a complex process, involving political structures and a wide range of stakeholders. The study's first aim is to describe facilitators and barriers to the coordination of return-to-work from the perspectives of: (A) employees on sick leave due to common mental disorders, (B) employers, (C) rehabilitation coordinators, (D) physicians and (E) other stakeholders. The second aim is to identify ethical issues that arise in the coordination of return-to-work and analyse how these can be resolved. METHODS AND ANALYSIS The study has a qualitative design using interviews with employees on sick leave due to common mental disorders, employers, rehabilitation coordinators, physicians and other stakeholders. The study is conducted in the Swedish primary healthcare. Employees, employers and rehabilitation coordinators are recruited via primary healthcare centres. Rehabilitation coordinators receive information about the study and those who consent to participation are asked to recruit employees and employers. Interview guides have been developed from the consolidated framework for implementation research and ethical values and norms found in Swedish healthcare, social services and workplace legislation. Data will be analysed with qualitative content analysis reflecting manifest and latent content, and ethical issues will be analysed by means of reflective equilibrium methodology. ETHICS AND DISSEMINATION The study was approved by the Regional Ethical Review Board in Stockholm, Sweden (Reg.no 2018/677-31/2 and 2018/2119-32). The findings will be disseminated through publication in scientific journals, social media, seminars and national and international conferences.
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Affiliation(s)
| | - Lars Sandman
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Therese Hellman
- Department of Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
| | - Lydia Kwak
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Ree E, Johnsen TL, Harris A, Malterud K. Workplace inclusion of employees with back pain and mental health problems: A focus group study about employees' experiences. Scand J Public Health 2018; 47:326-333. [PMID: 30301425 PMCID: PMC6492234 DOI: 10.1177/1403494818799611] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aim: To explore how employees experience workplace inclusion of
their colleagues or themselves when having back pain or mental health problems.
Methods: Three focus group interviews with a sample of 16
kindergarten employees were conducted. Systematic Text Condensation was used for
analysis. Results: The participants emphasized that it was
easier to include colleagues whose health problems were specific, especially
when they were open about having problems and expressed their needs for
accommodation clearly. Discussions revealed difficulties of acceptance and
accommodating colleagues with longstanding health problems, when the burden on
the other staff members was heavy, and if it had negative consequences for the
kindergarten children. Some of the participants had experienced health problems
themselves, which was also described as challenging. Having health problems at
work often induced feelings of guilt, being a burden to their colleagues, and
experiencing a disparity between the ideals and the realities of inclusion
practices. Conclusions: Workplace inclusion of employees
is difficult when their health problems are unspecific, longstanding, and
lead to negative consequences for children or colleagues. System level
efforts are necessary to reduce negative stereotypes about employees with
health problems and facilitate inclusion practices.
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Affiliation(s)
- Eline Ree
- 1 Division of Physical Medicine and Rehabilitation, Vestfold Hospital Trust, Stavern, Norway.,2 Faculty of Health Sciences, Centre for Resilience in Healthcare (SHARE), University of Stavanger, Stavanger, Norway
| | - Tone Langjordet Johnsen
- 1 Division of Physical Medicine and Rehabilitation, Vestfold Hospital Trust, Stavern, Norway
| | - Anette Harris
- 3 Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Kirsti Malterud
- 4 Research Unit for General Practice, NORCE Norwegian Research Centre, Bergen, Norway.,5 Department of Global Public Health and Primary Care, University of Bergen, Norway.,6 The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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