Marianne Hedlund

Factors explaining return to work for long-term sick workers in Norway

Purpose. This study investigates factors that will affect the chances of long-term sick workers returning to work. Method. The study is based on a representative sample of persons with mental illnesses and musculoskeletal disorders who received a rehabilitation allowance in Norway in 2002. Their occupational status in 2005 and experiences from the rehabilitation process were charted through their responses to a questionnaire in combination with national register data. Our analytical framework is based on three domains: the medical domain, the domain of authoritative bodies and the production domain (working life), as described by Lindqvist (Att sätta gränser: organisationer och reformer i arbetsrehabiliteringen. Umeå: Boréa; 2000). Results. Our main findings are that earlier work experience, age and other members in household, in addition, to influence over ones own rehabilitation process explains whether workers on long-term sick leave return to work. Furthermore, individual factors such as gender and diagnosis (i.e. musculoskeletal disorder and mental illness) do not explain the probability to return to work. Experience and contact with representatives of the medical, the authoritative bodies and the production domain only explain to a small extent the probability to return to work. It is even interesting to note that regular contact with the social insurance office (SIO) has a negative effect on the probability to return to work. This may indicate that contact with the SIO subjects sick workers to a risk of developing a ‘social insurance career’ to secure their income. Conclusions. The findings show that the medical, the authoritative bodies and the production domain might represent different logics that can pull a sick worker in different directions during the rehabilitation process. However, these different logics do not fully explain, which outcome a rehabilitation process takes. It is important to extend the analysis to include how the individuals respond to these logics during the rehabilitation process.

Self-help and self-help groups for people with long-lasting health problems or mental health difficulties in a Nordic context: A review

Aim: The aim of this review is to provide systematic knowledge of research from Nordic countries about the meaning of self-help and self-help groups when these are used as a concept or method addressing issues related to long-lasting health problems or mental health difficulties. Methods: Included were studies conducted in the Nordic countries that were published between January 1999 and September 2009. These studies investigated self-help and self-help groups addressing issues related to long-lasting health problems. Results: A total of 83 publications met the inclusion criteria. Four major characteristics of self-help were found to be present in the publications: self-help as an intrapsychological process, self-help as an interpsychological or group process, self-help as a coping, individual learning or empowerment process, and self-help as an alternative or complement to medical treatment. Of the 83 studies, 72 publications used a professional treatment perspective for studying self-help and 11 publications used a perspective derived from alternative or complementary therapies. Conclusions: The review shows that most of the research on self-help and self-help groups for people with long-lasting health problems or disability is conducted with an interest to improve the professional healthcare system. That is, the health-promotion strategy is mainly considered in the framework of treatment or care settings. This means that self-help in this context does not challenge the dominant biomedical health model.

Patients' contribution to the development of a web-based plan for integrated care – a participatory design study

Aims and objectives: The aim was to explore how a participatory design (PD) approach involving adult patients and parents of children with disabilities could contribute to the development of an electronic “Individual Care Plan” (e-ICP) in Norway. The system was intended to simplify multi-disciplinary cross-sector documentation and collaboration between care professionals and patients in care planning. Methods: The data in the study comprised semi-structured interviews with patients and parents, as well as field notes. Systematic text condensation (STC) in a stepwise analysis model was performed on the data. Results: Testing through three phases resulted in system improvements and additional functionality according to the participating patients’ needs and requests. PD was initially applied, enabling a constructive dialogue between developers and patients. System training and collecting patient expectations was a preliminary task. Patients then brought testing experiences to the system developers, focusing first on access to information and document filing. Later, finalizing testing towards a tool for interaction with care professionals was a main concern. Conclusion: Adult patients and parents participating in the study provided various insights and expectations that informed system improvements and resulted in new functionality. System development and testing in healthcare can successfully incorporate patient involvement.

How managers of small-scale enterprises can create a health promoting corporate culture

Purpose – Small-scale enterprises are important for sustainable development in Europe and account for a significant proportion of private enterprises and their large contribution to employment. The ...

Redefining relations among minority users and social workers: Redefinisjon av relasjoner mellom brukere med minoritetsbakgrunn og sosialarbeidere

In a global society, social practice must be imbued with an appreciation of both cultural differences and complex power relationships if services are to be adapted to peoples varied needs and lifestyles. The aim of this paper is to contribute to reflective practices and engagement with indigenous peoples worldviews and with the social workers own views and perspectives when practising social work. The authors argue that social workers must learn to consciously reflect on historical facts of discrimination and recognise their political consequences while being sensitive to cultural minorities in a helping context. Reflectivity equips social workers from majority cultures with a greater ability to reflect and re-define power positions as well as create premises for ‘good help’ when working with users from minority groups. Data for the study include qualitative interviews with Sámi users of the Norwegian health and welfare system and Norwegian social workers. Analysis was carried out following a phenomenological approach.

Transforming identity through participation in music and theatre: exploring narratives of people with mental health problems

ABSTRACT Background: There is a growing understanding that mental health problems and prolonged contact with mental healthcare systems can affect people’s identities. Working with identity is an important element in mental health recovery. Purpose: In this article, we explore the significance of participation in a music and theatre workshop in terms of people`s experiences of identity. Design and methods: This is a qualitative study based on a hermeneutical phenomenological epistemology. Data were collected from in-depth interviews with 11 participants at a music and theater workshop, analysed through a narrative analysis and presented in an ideographical “long” narrative form. The music and theater workshop is not overtly therapeutic although the activity takes place in a Norwegian mental health hospital for adults living with long-term mental health problems. Results: We identified three crosscutting themes: (1) becoming a whole person, (2) being allowed to hold multiple identities and (3) exploring diverse perspectives. Conclusion: Findings show that participation in the music and theatre workshop transformed the participants’ experiences of identity on two levels: individually and collectively. The participants developed a broader picture of themselves through their creative work with others. When they developed new identities, the narratives of themselves expanded.

Tightrope walking : external impact factors on workplace health management in small-scale enterprises

ABSTRACT Small-scale enterprises (SSEs) are important for ensuring growth, innovation, job creation, and social integration in working life. Research shows that SSEs pay little attention to and have insufficient competence in workplace health management. From the perspective of managers, this study explores how external factors influence the development of this management. The article refers to a case study among eight Norwegian and ten Swedish managers of SSEs in the middle part of Norway and Sweden. We used a stepwise qualitative approach to analyse data, using an interpretive indexing of main categories. Two main categories were found to have an influence on the development of workplace health management: (1) restricted leeway and (2) commitments. Concerning the first main category, areas that managers highlight as important comprise the legal framework and regulations; workforce and market situation, production, economy; and occupational safety and health issues. Areas related to the second main category were advice from the board, guidance from mentors, work-related networks, and family and friends as buffers. One conclusion is that despite limited scope for developing workplace health management, managers find supportive guidance and inspiration from environments that are committed to helping them and their enterprise.