Lotta Dellve

Perceived connections between information and communication technology use and mental symptoms among young adults - a qualitative study

BackgroundProspective associations have been found between high use of information and communication technology (ICT) and reported mental symptoms among young adult university students, but the causal mechanisms are unclear. Our aim was to explore possible explanations for associations between high ICT use and symptoms of depression, sleep disorders, and stress among young adults in order to propose a model of possible pathways to mental health effects that can be tested epidemiologically.MethodsWe conducted a qualitative interview study with 16 women and 16 men (21-28 years), recruited from a cohort of university students on the basis of reporting high computer (n = 28) or mobile phone (n = 20) use at baseline and reporting mental symptoms at the one-year follow-up. Semi-structured interviews were performed, with open-ended questions about possible connections between the use of computers and mobile phones, and stress, depression, and sleep disturbances. The interview data were analyzed with qualitative content analysis and summarized in a model.ResultsCentral factors appearing to explain high quantitative ICT use were personal dependency, and demands for achievement and availability originating from the domains of work, study, social life, and individual aspirations. Consequences included mental overload, neglect of other activities and personal needs, time pressure, role conflicts, guilt feelings, social isolation, physical symptoms, worry about electromagnetic radiation, and economic problems. Qualitative aspects (destructive communication and information) were also reported, with consequences including vulnerability, misunderstandings, altered values, and feelings of inadequacy. User problems were a source of frustration. Altered ICT use as an effect of mental symptoms was reported, as well as possible positive effects of ICT on mental health.ConclusionsThe concepts and ideas of the young adults with high ICT use and mental symptoms generated a model of possible paths for associations between ICT exposure and mental symptoms. Demands for achievement and availability as well as personal dependency were major causes of high ICT exposure but also direct sources of stress and mental symptoms. The proposed model shows that factors in different domains may have an impact and should be considered in epidemiological and intervention studies.

Contemporary leadership in healthcare organizations: fragmented or concurrent leadership.

PURPOSE The purpose of this paper is to gain a deeper understanding of the main contemporary challenges for healthcare leaders in their everyday work practice, and the support they need to master their experienced dilemmas. DESIGN/METHODOLOGY/APPROACH Qualitative in-depth interviews (n=52), and focus-group interviews (n=6) with 31 first-line and 45 second-line healthcare leaders are analysed in line with constructivist grounded theory. FINDINGS In this paper, two leadership models are proposed for defining and differentiating ways of meeting different logics and demands made on leaders in the healthcare sector. The first model is leadership by separating different logics and fragmentation of time. Here, leaders express a desire for support in defining, structuring, dividing, and allocating tasks. The second model is leadership by integrating different logics and currentness of solutions. In this case, leaders want support in strengthening proactive leadership and shaping the basis for participative employeeship. RESEARCH LIMITATIONS/IMPLICATIONS This research is designed to describe what people experience rather than to assess the frequency of that experience in the studied settings. However, it would be interesting to elaborate on the findings of this study using other research methodologies. PRACTICAL IMPLICATIONS The findings contribute to contextual knowledge that is of relevance in supporting healthcare leaders. This is helpful in identifying important conditions that support the establishment of leadership and employeeship, leading to improvements in healthcare practice. ORIGINALITY/VALUE The paper describes how contemporary leadership in the healthcare sector is constituted through different strategies for meeting multiple logics.

Pushing Oneself Too Hard : Performance-Based Self-Esteem as a Predictor of Sickness Presenteeism Among Young Adult Women and Men-A Cohort Study

Objective: To examine whether young adults with highly performance-based self-esteem (PBSE) were present at work/studies when ill more frequently than were others. Methods: By using data from a Swedish cohort of young adults aged 20 to 25 years (n = 5582 at baseline), we examined the association between PBSE and sickness presenteeism (SP) >5 times/yr (retrospectively at 1-year follow-up). Results: PBSE was a predictor of SP even when adjusting for general health, psychological demands, physical demands, economic problems, and main occupation. A synergy effect was also observed between PBSE and environmental and personal factors in relation to SP. The effect of PBSE on SP was four times higher among individuals with poor health, compared to individuals with good health. Conclusions: These results provide support for the role of personality characteristics as a predictor of frequent SP.

Macro-organizational factors, the incidence of work disability, and work ability among the total workforce of home care workers in Sweden

Aims: To investigate the importance of macro-organizational factors, i.e. organizational sociodemographic and socioeconomic preconditions, of the municipal incidence of long-term sick leave, disability pension, and prevalence of workers with long-term work ability among home care workers. Methods: In an ecological study design, data from national databases were combined by record linkage. Descriptive and analytical statistics were used to estimate and interpret macro-organizational factors (economic resources, region, unemployment, employment, occupational rehabilitation, return to work, age structures of inhabitants and home care workers). Results: The incidence of long-term sick leave among female home care workers was twice as high as that of male home care workers, and incidence of disability pension was about four times as high for the women. A great variation in municipal incidence of long-term sick leave, disability pension, and long-term work ability (101—264, 0.6—19.6, and 913—1,279 per 1,000 full-time equivalent workers and year) was also found. The strongest single factor for long-term work ability was a high proportion of part-time or hourly paid employees, which explained 35% of the municipal variation. Macro-organizational factors explained long-term work ability (47—62% explained variance) better than long-term sick leave (33% explained variance). There was a low rehabilitation activity; only 2% received occupational rehabilitation and 5% of those on sick leave longer than 2 weeks returned to work within 30 days. Conclusions: The differences in the municipal proportion of work ability incidence indicate a preventive potential, especially related to employment and return to work after sick leave.

The association between poor organizational climate and high work commitments, and sickness absence in a general population of women and men.

Objectives: To investigate the association between organizational climate and work commitment, and sickness absence in a general population of workers and consecutively selected employed sick-listed. Methods: Questionnaire data used in this cross-sectional study consisted of two cohorts: (1) randomly selected individuals in a general working population cohort (2763) and (2) consecutively selected employed sick-listed cohort (3044) for more than 14 days over 2 months. Results: Poor organizational climate was associated with increased odds of belonging to the employed sick-listed cohort among both women and men, while high work commitments were associated with increased odds only among women. The increased adjusted odds ratio for the combinations of poor organizational climate and high work commitment was 1.80 (confidence interval 1.36 to 2.37) among women and 2.74 (confidence interval 1.84 to 4.08) among men. Conclusions: These results support the magnitude of combining organizational climate and work commitment.

The school nursing profession in relation to Bourdieu’s concepts of capital, habitus and field

Scand J Caring Sci; 2012; 26; 355–362 The school nursing profession in relation to Bourdieu’s concepts of capital, habitus and field Aim:  The aim was to define the work and professional role of school nurses, in terms of Bourdieu’s key concepts of capital and habitus. Method:  A qualitative study with a deductive approach, based on data from six focus-group interviews with 24 school nurses and 15 individual interviews with school nurses. Thus, a total of 39 school nurses participated in the study. The data were analysed using content analysis. Results:  The results explain, in terms of Bourdieu’s key concepts of capital and habitus, how school nurses experience their work in the educational setting. A model including different aspects of school nurses’ work is shown. Conclusion:  The new Swedish Education Act focuses on promoting students’ general health, so that they are able to reach their academic potential. In this task, the school nurse is to be one of a group of several professionals working together. The present study shows how school nurses experience their professional role and their work in relation to Bourdieu’s concepts of capital, habitus and field. To strengthen the school nursing profession, school nurses need to show their competence in promoting students’ health.

Workplace health promotion and working conditions as determinants of employee health

Purpose - The purpose of this paper is to investigate general psychosocial work conditions and specific workplace health promotion (WHP) measures in relation to employee health and sickness absence in Swedish municipal social care organizations. Design/methodology/approach - In a random sample of 60 out of the 290 municipalities in Sweden, 15,871 municipal social care employees working with elderly and disabled clients were sent a questionnaire concerning psychosocial work environment, WHP, and self-rated health. The responses (response rate 58.4 per cent) were complemented by register data on sickness absence (agt;14 days). All data were aggregated to employer level. Findings - A structural equation modelling analysis using employer-level data demonstrated that employers with more favourable employee ratings of the psychosocial work conditions, as well as of specific health-promoting measures, had better self-rated health and lower sickness absence level among employees. Practical implications - The results from this representative nationwide sample of employers within one sector indicate that employers can promote employee health both by offering various health-specific programmes and activities, such as work environment education, fitness activities, and lifestyle guidance, as well as by forming a high-quality work environment in general including developmental and supportive leadership styles, prevention of role conflicts, and a supportive and comfortable social climate. Originality/value - This study with a representative nationwide sample demonstrates: results in line with earlier studies and explanations to the challenges in comparing effects from specific and general WHP interventions on health.

Constructed space and legitimacy for health work in the educational system: Perspectives of school nurses

Increasing health problems among children place demands on school health care. It is unclear how contextual issues, e.g. reduced resources and low priority, impact the practising of health care work within the educational system. The aim was to gain a deeper understanding of school nurses’ perceptions of their opportunities for practising and handling health support work within the educational system. A qualitative study in line with constructivist grounded theory based on data from six focus group interviews with 24 school nurses. The results explain the conditions in which school nurses practise health support work within the educational system, as described in a conceptual model. The core category in the model was labelled construction of space and legitimacy for individual health support work within the educational setting. The model comprised four additional categories: experiencing restricted conditions for practising health support work; working alone and in isolation: retaining individual health support; and compromising and negotiating position and legitimacy. Interests and positions of political and organisational leaders, the school personnel and children/parents, as well as the school nurses own strategies, constructed a limited space and legitimacy for health support work.

Span of control and the significance for public sector managers’ job demands: A multilevel study

The aim of this article is to investigate how span of control influences seven job demands common amongst operational public sector managers. Self-administrated surveys were collected from 434 managers organized in 37 municipal operations, i.e. management teams in a set of public organizations in Sweden, and complemented with register data. Multilevel analyses were performed and it was shown unfavorable to have a large number of subordinates for the majority of job demands investigated. Furthermore, managers who were members of management teams with a higher average span of control experience some job demands to an even higher extent. Thus, the results of this study demonstrate that span of control is a key upstream component of managers’ job demands and emphasize the value of a reasonable number of subordinates.

Lean implementation at different levels in Swedish hospitals: the importance for working conditions and stress

Healthcare organisations in Sweden are reorienting toward horizontal organisation around care processes. This papers aim was to investigate how implementation approaches for improvements of care processes in line with lean production (LP), at hospital strategic and operative levels, are associated with working conditions and stress-related health among the employees. Five hospitals working with improvements to care processes were studied using questionnaires to employees (n = 1,303) and interviews at strategic and operative levels at baseline and follow-up. The process redesign implementation strategies varied between the strategic and operative levels. There were associations between a higher degree of LP at operative level and increased work resources and decreased work demands. Physical, cognitive and mental stress-related symptoms were only weakly associated with strategic or operative LP initiatives. There was evidence of more beneficial or improved working conditions in relation to higher degree of LP at operative levels.