The concept of `work ability' from the view point of employers

Social and health care top managers' perceptions and aims of strategic work ability management in the midst of change

BACKGROUND

Existing research has mostly focused on themes related to returning to or staying at work and studied organizations' operational rather than strategic level actions to support work ability. Top managers' understanding of work ability management (WAM) may influence how work ability support processes are implemented in organizations.

OBJECTIVE

To find out how top managers define WAM, what the aims of WAM were and whether the aims were on a strategic level.

METHODS

Altogether 28 semi-structured interviews among Finnish social and health care top managers were conducted during the years 2019-2021 and analyzed inductively using qualitative thematic analysis.

RESULTS

Top managers' definition of WAM was mainly multidimensional. Two main aims were identified, i.e., to support work ability 1) at the individual and 2) at the organizational level. The aims of the former were to anticipate the decrease of health and functional capacity, to support workers already decrease in these, to develop competence, and to manage the effects of changes on work ability. The aims at the organizational level were to improve labor availability and personnel retention, to ensure the flow of work, and to increase trust and create shared values. Top managers described the aims as being at a strategic level, but this was not yet realized in their organizations because the actions were reactive rather than proactive.

CONCLUSION

Top managers' multidimensional perception of WAM, emphasizing proactive actions, and strategic level aims are crucial and require the commitment of the top managers for strategic WAM, especially during constant changes.

Swedish managers' experience-based understanding of the Capacity to work in employees with Common Mental Disorders: a Focus Group Study

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.

A general framework for selecting work participation outcomes in intervention studies among persons with health problems: a concept paper

Background

Work participation is important for health and can be considered as engagement in a major area of life which is of significance for most people, but it can also be thought of as fulfilling or discharging a role. Currently, academic research lacks a comprehensive classification of work participation outcomes. The International Classification of Functioning is the foremost model in defining work functioning and its counterpart work disability, but it does not provide a critical (core) set of outcomes. Standardizing the definitions and nomenclature used in the research of work participation would ensure that the outcomes of studies are comparable, and practitioners and guideline developers can better decide what works best. As work participation is a broad umbrella term including outcome categories which need unambiguous differentiation, a framework needs to be developed first.

Aim

To propose a framework which can be used to develop a generic core outcome set for work participation.

Methods

First, we performed a systematic literature search on the concept of (work) participation, views on how to measure it, and on existing classifications for outcome measurements. Next, we derived criteria for the framework and proposed a framework based on the criteria. Last, we applied the framework to six case studies as a proof of concept.

Results

Our literature search provided 2106 hits and we selected 59 studies for full-text analysis. Based on the literature and the developed criteria we propose four overarching outcome categories: (1) initiating employment, (2) having employment, (3) increasing or maintaining productivity at work, and (4) return to employment. These categories appeared feasible in our proof-of-concept assessment with six different case studies.

Conclusion

We propose to use the framework for work participation outcomes to develop a core outcome set for intervention studies to improve work participation.

Changes in rehabilitation actors' mental health literacy and support to employers: An evaluation of the SEAM intervention

BACKGROUND

Lack of mental health literacy among rehabilitation professionals and employers in the return-to-work of persons with mental health problems resulted in the development of a three-day group training program, the Support to Employers from rehabilitation Actors about Mental health (SEAM) intervention.

OBJECTIVE

To evaluate the impact of SEAM on rehabilitation professionals' knowledge and beliefs, attitudes, and supporting behaviors towards people with mental health problems and employers as part of the return-to-work process.

METHODS

In this longitudinal study, 94 rehabilitation professionals were included. Data were collected prior to (T1), immediately after (T2) and 6 months after SEAM training (T3) using knowledge and attitude scales and a questionnaire on supporting behaviors. SEAM includes training in Mental Health First Aid, presentations and discussions on current research on work and mental health, and strategies and communication guidelines to use when meeting service users and employers as part of the return-to-work of persons with mental health problems. SEAM also includes a homepage with targeted employer information. Data were analyzed using non-parametric statistics.

RESULTS

SEAM significantly increased rehabilitation professionals' knowledge of mental health (T1-T2: z = -2.037, p = 0.042; T2-T3: z = -5.093, p = 0.001), and improved their attitudes towards persons with mental health problems (T1-T2: z = 4.984, p = 0.001). Professionals (50-60%) also estimated that they had increased their use of supporting strategies towards service users and employers.

CONCLUSIONS

The study suggests that SEAM can increase mental health literacy among rehabilitation professionals and lead to a greater focus on service users' resources and work ability, as well as on employers' support needs.

Exploring the service and knowledge gap between rehabilitation professionals and employers in the return-to-work process of people with mental health problems in Sweden

BACKGROUND

Research is needed on how to optimize the return-to-work process for persons with mental health problems.

OBJECTIVE

To develop a model that explains how employer and rehabilitation professional mental health literacy may influence strategies used in the return-to-work of persons with mental health problems.

METHODS

A grounded theory study design was used to collect and analyse interview data from 23 employers and 22 rehabilitation professionals.

RESULTS

The analysis resulted in four categories, illustrated in a conceptual process model: 1) seeing mental health problems through past experiences; 2) separating understandable and incomprehensible mental health problems; 3) balancing safeguarding one's personal interest with providing adequate support; and 4) facing conflicts and uncertainty in employee/service user return-to-work. A positional map of employer/rehabilitation types was created based on level of negative attitudes and uncertainty in supporting employees/service users and the employer in relation to the level of comprehensive understanding of mental health problems.

CONCLUSIONS

Professional mental health literacy needs to be increased. Interventions need to be developed that provide employers with targeted support and knowledge in mental health literacy. Education on how to prevent and detect common mental health problems in the workplace is needed.

Physical Activity Promotion for Apprentices in Nursing Care and Automotive Mechatronics-Competence Counts More than Volume

Apprentices in the area of nursing care and automotive mechatronics are exposed to increased health risks. In this context, the promotion of physical activity (PA) is considered an effective strategy for the assurance of work ability. The goal of the PArC-AVE study was therefore to better understand the role of PA for apprentices employed in these two sectors. In an exploratory study, 55 apprentices wore an ActiGraph accelerometer over seven consecutive days and were subject to activity analysis. The objective accelerometer data (18,979 ± 3780 steps/day; 471.00 ± 159.75 min of moderate-to-vigorous PA/week), complemented by questionnaire data, indicated that most met the volume-based PA recommendations. Subsequently, we conducted a multicenter study comprising 745 apprentices from six vocational education institutions. Path analyses showed that competencies for health-enhancing PA were significantly related to indicators of work ability (0.180 ≤ b ≤ 0.452) and psychophysical health (0.139 ≤ b ≤ 0.347), whereas mere volume of PA was not (-0.048 ≤ b ≤ 0.080). In summary, apprentices of nursing care and automotive mechatronics showed high levels of PA. However, the results highlight the importance of competencies for health-enhancing PA. The PAHCO model could provide a useful framework for the conceptualization of effective interventions.

Employers' views of the impact of mental health problems on the ability to work

BACKGROUND

Mental health problems (MHP) are common in working life and can be hard to respond to for employers. Therefore, knowledge of employers' perceptions of employees with MHP is important to support coping efforts of persons and their work environments.

OBJECTIVE

Identify and characterise employers' perceptions of the impact of MHP on work ability.

METHODS

Twelve employers with experience of employees with MHP were interviewed. Data were analysed with a phenomenographic method.

RESULTS

The first main category, "Experiences of employees with MHP", included experiences of diffuse and unexpressed signs of the onset of MHP and frustration among employers and work-mates which was difficult to verbalise. MHP could also be turned off, thus having no impact on work ability. The second main category, "Strategies to handle effects of MHP in the workplace", included the importance of continual responsiveness and communication, and of fluctuating adaptations. The informants expressed diversity in the workplace as a strategy.

CONCLUSIONS

Employers have experiences of, as well as strategies for, how to handle MHP at times when they impact with the ability to work. However, neither experiences nor strategies were explicitly pronounced and verbalised which makes it a challenge to develop strategies and guidelines in workplaces.

The sensitivity of Galvanic Skin Response for assessing mental workload in Indonesia

BACKGROUND

Objective measures have been shown to be equally sensitive in different cultures. However, these measures need special devices that are relatively expensive and need expertise to analyze the result. In Indonesia, there is a need for a sensitive and affordable mental workload measure.

OBJECTIVE

To evaluate the sensitivity of Galvanic Skin Response (GSR) in assessing mental workload in Indonesia.

PARTICIPANTS

A total of 72 Indonesian students with normal visual capability.

METHOD

Participants were asked to work on visual memory search task with a secondary task of counting with three different levels of difficulty. GSR, Heart Rate Variability (HRV), and the NASA-TLX were administered prior to, during, and after the tasks.

RESULTS

GSR measure was compared to NASA-TLX and HRV measures. Like the HRV, GSR showed to be sensitive in distinguishing rest and task condition significantly but not sensitive in distinguishing different levels of mental workload. In contrast, both the NASA-TLX and performance measure were sensitive in differentiating different levels of mental workload.

CONCLUSIONS

GSR has potential as a simple, cost-effective tool for measuring mental workload in Indonesia.

Outpatient rehabilitation as an intervention to improve employees' physical capacity

BACKGROUND

The aging of the workforce poses new challenges for maintaining work ability. Because of limited information on the effectiveness of vocational rehabilitation performed in traditional inpatient programs, extended interest in outpatient rehabilitation has risen in the past few years.

OBJECTIVE

We examined the effects of a new outpatient rehabilitation program where every participant defined their own goals to improve work ability by the aid of a goal-oriented multi-professional team. This report will focus on the employees' physical capacity during a nine-month program.

METHODS

A total of 605 municipal employees from different production areas of the City of Tampere took part in the outpatient rehabilitation program, implemented by the occupational health unit. Groups of 12 employees participated in eight one-day sessions at intervals of two to three weeks; the final follow-up was 9 months from the beginning. Submaximal aerobic capacity was tested by a calibrated cycle ergometer with a commercial program (Aino Fitware pro, Helsinki, Finland). Musculoskeletal tests assessed muscle strength, balance and mobility.

RESULTS

During the 9-month follow-up of the rehabilitation program, the employees' physical capacity was improved. The follow-up test scores from a total of 329 employees were significantly higher in the submaximal aerobic capacity test (p < 0.001). Other tests were also improved, such as standing on one foot (p = 0.001), back side bending flexibility test (p < 0.001), dynamic sit up (p = 0.001), upper extremity right (p < 0.001), and knee bending (p = 0.029). About 40% of the participants did not have an adequate health situation to take part in physical capacity tests; however they took part in the intervention.

CONCLUSIONS

The new outpatient rehabilitation program organized by the occupational health unit had a positive influence on employees' physical capacity during a nine-month follow up.

The meaning of employment from the perspective of persons with spinal cord injuries in six European countries

BACKGROUND

People with spinal cord injuries (SCI) are underrepresented in the labour force.

OBJECTIVE

To examine the meaning of employment, as it is understood in the context of participation and integration in society, among persons with SCI in six European countries. We ask how SCI relates to employment, for the functions of employment, alternatives to employment, and its obstacles.

METHOD

Semi-structured interviews were conducted with 74 persons and qualitatively analysed using a grounded theory approach.

RESULTS

Employment was ranked as very important independent of the participants current employment status. We identified three main functions of employment: 1) employment contributes to the creation of personal and collective identity and social recognition; 2) employment enables structuring of time and distracts from impairment and pain; 3) employment is as an important social arena that facilitates interaction with other people. Voluntary work and domestic work did not fully replace the social functions of employment, nor correspond to the design of the disability compensation systems.

CONCLUSION

This study illustrates the high value of employment and a need to pay more attention to a broader range of productive work. It also reveals the interdependencies between employment status and income mediated by the disability compensation schemes.