Hélène Sandmark

Older people living at home: associations between falls and health complaints in men and women

AIMS AND OBJECTIVES To investigate the associations between self-reported falls and health complaints, among persons aged 75 years and older living at home, and to investigate gender differences in the associations. BACKGROUND There are several studies concerned with risk factors for falling, and others related to health complaints, but not many with associations between falls and health complaints. There are some inconsistent data of incidence and gender-related differences in falling. DESIGN Case-control community-based study. METHODS In total, 1243 persons living in two municipal districts in Sweden answered a questionnaire. Odds ratios (OR) and regression models with 95% confidence interval (CI) were used to determine the associations between self-reported falls and different health complaints. RESULTS The adjusted (multivariate) linear regression showed that urinary incontinence, self-rated health and tiredness were significantly associated with falls for both men and women living at home. The gender-related differences in falling were associated with the variables such as self-rated health for men and tiredness and pain in the hands, elbows, legs or knees for women. CONCLUSION An association is evident between falls and urinary incontinence, poor self-rated health and tiredness for older persons living at home. Gender differences in falls show an association with poor self-rated health, tiredness and pain in the hands, elbows, legs or knees. RELEVANCE TO CLINICAL PRACTICE As older people are expected to live in their own homes as long as possible, more knowledge is required about what determines the risk of falling. Nurses in community care are recommended to use assessment tools that include urinary incontinence in order to detect the risk of falling.

Workplace health promotion and employee health in Swedish municipal social care organizations

AimThe aim of this explorative study was to investigate the employers’ management characteristics, their provision of workplace health promotion (WHP) measures, and employee satisfaction with WHP in relation to employee health in Swedish municipal social care organizations.Subjects and methodsA cross-sectional design was used, and questionnaires were sent to top managers (representing the employer) and employees in a nationwide random sample of 60 of the 290 municipal organizations for the social care of elderly and disabled people in Sweden. The questionnaire data from the 60 managers were linked to aggregated employee data concerning self-rated health and satisfaction with WHP from a representative sample of 8,082 employees in the same organizations. All analyses were performed at the organizational level using independent t-test, Spearman’s rank correlation and multiple linear regression analysis.ResultsIn the multivariate analysis, the organizational WHP index (i.e. local WHP projects and WHP coordinators), individual WHP index (i.e. health profile assessment, fitness activities and medical check-up), and the level of employees’ satisfied with WHP were associated with employee health (F = 9.64, p < 0.001, adjusted R2 = 0.48). General organizational and management characteristics were, however, not statistically related to employee health.ConclusionThe results suggest that the provision of individual-directed and organizational-directed health-specific measures were related to employee health in Swedish municipal social care organizations and, therefore, can be part of a comprehensive approach to address WHP.

Managing workplace health promotion in municipal organizations: The perspective of senior managers

BACKGROUND Previous research indicates that companies manage workplace health in various ways, but more in-depth empirical knowledge of how workplace health promotion (WHP) is managed in public sector organizations is needed. OBJECTIVE The aim of this study was to explore how WHP is managed and incorporated into the general management system in two large Swedish municipal organizations. METHODS A qualitative descriptive approach was used. Fourteen senior managers were purposefully selected and interviewed using semi-structured interviews. Documents were used as supplementary data. All data were analysed using qualitative content analysis. RESULTS The management of WHP was described as a set of components that together contribute to the organizations capacity for WHP. The informants described WHP as dominated by fitness programmes and as following a problem-solving cycle, in which the annual employee survey emerged as an important managerial tool. Achieving feasible WHP measures and appropriate follow-ups were described as challenges. The provision of leadership competence for WHP and use of supportive resources were described as additional components. CONCLUSIONS The WHP management approach needs to be broadened to include work environment and organizational factors. Further integration with occupational health and safety and the general management system in the organizations is also needed.

I just kept running and running until I hit the wall: working men seeking care due to stress-related problems.

BACKGROUND Stress problems are major public health problems. OBJECTIVE To gain an increased understanding of how working men seeking care due to minor mental dysfunctions related to stress recognize their symptoms, what triggers them, and how this impacts their everyday life. PARTICIPANTS Fourteen men of working age, consecutively seeking care due to minor mental dysfunctions indicating stress problems, at two clinics in the Stockholm area in Sweden during 2009 and 2010. METHODS A qualitative methodology was chosen, and interviews were performed and analyzed using qualitative content analysis. RESULTS In the manifest content, categories such as difficulties in setting limits, low social support, high work demands, and mental and physical dysfunctions were identified. Three themes finally emerged (latent content) and indicated that in this group of informants there are stressors both within the individual himself, in working life, and a lack of recovery. CONCLUSIONS Based on our findings it would be possible to implement measures to prevent stress-related problems by promoting coping strategies on an individual level, encouraging social networks, and regular physical exercise. By implementing work policies and workplace modifications, and also providing individual support at the workplace, supervisors and human resources managers could prevent, or modify stress problems among employees.

The relationship of chronic and momentary work stress to cardiac reactivity in female managers: Feasibility of a smart phone-assisted assessment system

Objectives To evaluate a wireless smart phone–assisted (SPA) system that assesses ongoing heart rate (HR) and HR-triggered participant reports of momentary stress when HR is elevated during daily life. This SPA system was used to determine the independent and interactive roles of chronic and momentary work stress on HR reactivity among female managers. Methods A sample of 40 female managers reported their chronic work stress and wore the SPA system during a regular workday. They provided multiple reports of their momentary stress, both when triggered by increased HR and at random times. Relationships among chronic stress, momentary stress, and HR were analyzed with hierarchical linear modeling. Results Both chronic work stress (b = 0.08, standard error [SE] = 0.03, p = .003) and momentary work stress (b = 1.25, SE = 0.62, p = .052) independently predicted greater HR reactivity, adjusting for baseline HR, age, smoking, caffeine, alcohol use, and momentary physical activity levels. More importantly, chronic and momentary stress significantly interacted (b = 1.00, SE = 0.04, p = .036); high momentary stress predicted elevated HR only in the context of high chronic stress. Conclusions Female managers who experience chronic work stress displayed elevated cardiac reactivity during momentary stress at work. The joint assessment of chronic stress and momentary stress and their relationship to physiological functioning during work clarifies the potential health risks associated with work stress. Moreover, this wireless SPA system captures the immediate subjective context of individuals when physiological arousal occurs, which may lead to tailored stress management programs in the workplace.

Factors Associated with falls in Elderly Living at Home in Sweden

Background: Falls among elderly constitute a major public health issue of increasing magnitude. For the prevention of fall at population level, it is necessary to study risk factors among community ...

Online Stress Management: Design for Reflections and Social Support

An increasing number of people suffer from high levels of stress and experience strong and unhealthy reactions to different stressors. Various kinds of applications for self-help are available on the Internet. However, the technology for stress management purposes is still in its early phase. This paper presents the ideas behind the design of an artifact that combines different technologies and offers support for individual as well as social reflections. The work is anchored in conventional system development methods and interdisciplinary research in the field of e-health. It is based on the holistic idea of combining areas of self-help, evidence-based information and learning through feedback and communication in groups and with experts that have been manifested in a web-based stress management system. The work presented in this paper is a further development towards integration of different technologies and learning aids. It integrates a mobile phone app with a web-based system for people with stress management issues. The proposed system supports social reflections through the possibility to share reflections in various social forums.

Online Stress Management for Self- and Group-Reflections on Stress Patterns

In today’s society, many people suffer from unhealthy levels of stress. A result of being exposed to a lot of stressors for a longer period of time, and showing strong stress reactions to these, is decreased wellbeing and eventually sick leaves. To intervene at an early stage is therefore important. However, learning about one’s stress reactions and struggling for empowerment can be a challenge. Different types of applications for self-help are available on the Internet, but the ones for stress management are still in their early phase. In this article, we emphasize the social aspects of stress management. We present an artifact designed for analyzing and reflecting upon stress patterns, through both self- and group-reflections. This artifact is a result of further research work towards an integrated holistic stress management platform. The holistic platform includes a mobile application for storing data about events that cause stress reactions and a web-based system in which different actors and functions can complement each other, through self-help exercises, evidence-based information and learning through interaction with peers and experts. The research is based on traditional system development methods and interdisciplinary research in the area of e-health.

Employers who combine organizational and individual-oriented health interventions have better health among their employees – a study of Swedish municipal social care organizations

Positive work experience factors relate to salutogenic health-a survey among Swedish hospital employeesLarge scale surveys show that perceived stress and stress-related complaints are common among young people. Perceived stress increase with age and are more common in girls than boys, resulting in l ...

Web-Based Stress Management System Goes Mobile: Considerations of the Design of a Mobile Phone App

High levels of stress at work, great demands and lack of balance between work and family; these are examples of components in the daily lives of many people in modern society. Interventions of different kinds are needed. However, changing patterns of thinking and behaviors is not an easy task, and it demands for continuous support and learning efforts. This paper presents a web-based stress management system and the way it was transferred to a mobile phone app. The solution and considerations are presented. The design principles of the web-based system were used to examine the use of the mobile phone app. The results showed that the app to a large extent meets the design principles, and some of the principles seemed even more applicable in the mobile phone setting due to its mobility.