Lisa Björk

I shouldn't have to do this: Illegitimate tasks as a stressor in relation to organizational control and resource deficits

Abstract The performance of tasks that are perceived as unnecessary or unreasonable – illegitimate tasks – represents a new stressor concept that refers to assignments that violate the norms associated with the role requirements of professional work. Research has shown that illegitimate tasks are associated with stress and counterproductive work behaviour. The purpose of this study was to provide insight into the contribution of characteristics of the organization on the prevalence of illegitimate tasks in the work of frontline and middle managers. Using the Bern Illegitimate Task Scale (BITS) in a sample of 440 local government operations managers in 28 different organizations in Sweden, this study supports the theoretical assumptions that illegitimate tasks are positively related to stress and negatively related to satisfaction with work performance. Results further show that 10% of the variance in illegitimate tasks can be attributed to the organization where the managers work. Multilevel referential analysis showed that the more the organization was characterized by competition for resources between units, unfair and arbitrary resource allocation and obscure decisional structure, the more illegitimate tasks managers reported. These results should be valuable for strategic-level management since they indicate that illegitimate tasks can be counteracted by means of the organization of work.

Involving the employer to enhance return to work among patients with stress-related mental disorders – study protocol of a cluster randomized controlled trial in Swedish primary health care

BackgroundWork-related stress has become a major challenge for social security and health care systems, employers and employees across Europe. In Sweden, sickness absence particularly due to stress-related disorders has increased excessively in recent years, and the issue of how to improve sustainable return to work in affected employees is high up on the political agenda. The literature on interventions for return to work in patients with common mental disorders is still inconclusive. This randomized controlled trial (RCT) aims to contribute with knowledge about how physicians and rehabilitation coordinators in primary health care can involve the employer in the rehabilitation of patients with stress-related disorders. The objective is to evaluate whether the early involvement of the patient’s employer can reduce the time for return to work compared to treatment as usual. A process study will complete the RCT with information about what prerequisites primary health caregivers need to succeed with this endeavor.MethodsTwenty-two primary care centers were randomized to either intervention or control group. At the intervention centers, physicians and rehabilitation coordinators underwent training, providing them with both knowledge and practical tools to involve the employer in rehabilitation. At the patient level, employed patients with an ICD-10 F43 diagnosis were eligible for participation (n=132). Difference in proportion of patients on full- or part-time sick leave at three, six and 12 months after inclusion will be investigated. Register data, logbooks and interviews with coordinators and physicians at both intervention and control centers will be used for process evaluation.DiscussionAlthough the issue of how to tackle work-related stress can be recognized all across Europe, Sweden face an urgent need to curb the disproportional increase of stress-related disorders in the sick-leave statistics. Since physicians are limited by time constraints, the rehabilitation coordinator may be a helpful resource to take this contact. The current study will contribute to knowledge about how this collaboration can be organized to facilitate employer involvement and reduce time to return to work among patients suffering from work related stress.Trial registrationRegistered on 1 November 2016, ClinicalTrials.gov, NCT03022760.