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  • 1. Ahlstrom, L.
    et al.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics. University of Borås, Sweden.
    Hagberg, M.
    Ahlberg, K.
    Women with Neck Pain on Long-Term Sick Leave — Approaches Used in the Return to Work Process: A Qualitative Study2016In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, 1-14 p.Article in journal (Refereed)
    Abstract [en]

    Purpose There are difficulties in the process of return to work (RTW) from long-term sick leave, both in general and regarding sick leave because of neck pain in particular. Neck pain is difficult to assess, problematic to rehabilitate, and hard to cure; and it is not always easy to decide whether the pain is work-related. The outcome of RTW could be dependent upon individuals’ approaches, defensive or offensive behaviors, and choices related to their self-efficacy. The aim of this study was to identify approaches used in the RTW process among women with neck pain on long-term sick leave from human service organizations. Methods This is a qualitative descriptive study based on grounded theory. A Swedish cohort of 207 women with a history of long-term sick leave with neck pain from human service organizations answered open-ended written questions at 0, 6, and 12 months, and 6 years; and 16 women were interviewed. Results Individuals expressed their coping approaches in terms of fluctuating in work status over time: either as a strategy or as a consequence. Periods of sick leave were interwoven with periods of work. The women were either controlling the interaction or struggling in the interaction with stakeholders. Conclusions Return to work outcomes may be improved if the fluctuating work status over time is taken into account in the design of rehabilitation efforts for women with a history of long-term sick leave and with chronical musculoskeletal conditions.

  • 2.
    Ahlstrom, L
    et al.
    Sahlgrenska Akademin.
    Hagberg, M
    Sahlgrenska Akademin.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Ergonomics.
    Workplace Rehabilitation and Supportive Conditions at Work: A Prospective Study2013In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 23, no 2, 248-260 p.Article in journal (Refereed)
    Abstract [en]

    Purpose To investigate the impact of rehabilitation measures on work ability and return to work (RTW), specifically the association between workplace rehabilitation/supportive conditions at work and work ability and RTW over time, among women on long-term sick leave. Methods Questionnaire data were collected (baseline, 6 and 12 months) from a cohort of women (n = 324). Linear mixed models were used for longitudinal analysis of the repeated measurements of work ability index (WAI), work ability score and working degree. These analyses were performed with different models; the explanatory variables for each model were workplace rehabilitation, supportive conditions at work and time. Results The individuals provided with workplace rehabilitation and supportive conditions (e.g. influence at work, possibilities for development, degree of freedom at work, meaning of work, quality of leadership, social support, sense of community and work satisfaction) had significantly increased WAI and work ability score over time. These individuals scored higher work ability compared to those individuals having workplace rehabilitation without supportive conditions, or neither. Additionally, among the individuals provided with workplace rehabilitation and supportive conditions, working degree increased significantly more over time compared to those individuals with no workplace rehabilitation and no supportive conditions. Conclusion The results highlight the importance of integrating workplace rehabilitation with supportive conditions at work in order to increase work ability and improve the RTW process for women on long-term sick leave.

  • 3.
    Ahlstrom, Linda
    et al.
    Högskolan Borås.
    Larsson Fallman, Sara
    Högskolan Borås.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics. Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Return to work from long-term sick leave: a five-year prospective study of the importance of adjustment latitudes at work and home2014Conference paper (Other academic)
    Abstract [en]

    Background

    Adjustment latitude among employees, i.e. adjusting work to individual’s health capacity, has been associated with successful return to work (RTW) in cross-sectional studies. The aim is to investigate the long-term importance of adjustment latitude at the workplace and at home, as well as attitudes (own and colleagues) for increased work ability (WA), working degree (WD) and health-related quality of life (HRQoL) among female human service workers (HSW) on long-term sick leave in Sweden.

    Methods

    A cohort of female HSW (n=324) on long-term sick leave (>60 day) received a questionnaire at four times (0, 6, 12, 60 months). Prevalence ratios (PR) were used to examine possible relationships between explanatory factors and outcomes. Linear mixed models were used for longitudinal analysis of the repeated measurements of WA Score (0-10), WD (0-100%) and HRQoL (0-100). Analyses were performed with different models; the explanatory variables for each model were adjustment latitude, attitudes towards breaks at work, shared or single household and amount of household work.

    Result

    Having more adjustment latitude at work was associated with both increased WA and RTW compared to having few adjustment latitude opportunities. Adjustments related to working-pace were strongly associated with increased WD (PR 3.29(95%CI=1.71-6.26)), as were adjustments to working-place. Having opportunities to take short breaks at work, and a general acceptance at work to take short breaks was associated with increased WA. At home, a higher responsibility for household work (PR 1.98(95%CI=1.33-2.95)) was related to increased WA and RTW. Individuals with possibilities for adjustment latitude, especially pace and place, at work, and an acceptance to take breaks at work, increased in WA score significantly more over time and had higher WA score compared with individuals not having such opportunities at work. These prospective results were similar for the outcome WD and HRQoL.

    Conclusions

    The results highlight the importance of possibilities for adjustment latitude at work and at home, as well as accepting attitudes to take short breaks to increase WA and RTW among female human service workers previously on long-term sick leave.

  • 4.
    Andreasson, Jörgen
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Ahlstrom, Linda
    Eriksson, Andrea
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    The importance of healthcare managers’ organizational preconditions and support resources for their appraisal of planned change and its outcomes2017In: Journal of Hospital Administration, ISSN 1927-6990, E-ISSN 1927-7008, Vol. 6, no 1Article in journal (Refereed)
    Abstract [en]

    Background: Healthcare managers are expected to lead and manage planned organizational change intended to improve healthcare process quality. However, their complex working conditions offer limited decision control, and healthcare managers often feel ill prepared and inadequately supported to perform their duties. Healthcare managers have previously described their need for organizational support, but we lack knowledge of the preconditions and resources that help managers implement planned change.Methods: This prospective cohort study examined healthcare managers at three Swedish hospitals implementing lean production and two Swedish hospitals implementing their own improvement model. Questionnaire data from 2012, 2103, and 2014 were used in following up. We used t-tests and a linear mixed model design in analysing the data.Results: Healthcare managers who perceived strong support from managers, employees, colleagues, and the organization and managers with the longest managerial experience had the least negative appraisal of change. Managers who perceived strong support from employees, management, and the organizational structure perceived higher levels of healthcare process quality.Conclusions: Long managerial experience and strong support from managers, employees, and the organization are important formanagers’ appraisal of, work on, and successful implementation of planned change. Top management must therefore ensure that the healthcare managers have sufficient managerial experience and support before they delegate to them the responsibility to implement planned change.

  • 5.
    Andreasson, Jörgen
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Health care managers' views on and approaches to implementing models for improving care processes2016In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 24, no 2Article in journal (Refereed)
    Abstract [en]

    Aim: To develop a deeper understanding of health-care managers' views on and approaches to the implementation of models for improving care processes. Background: In health care, there are difficulties in implementing models for improving care processes that have been decided on by upper management. Leadership approaches to this implementation can affect the outcome. Method: In-depth interviews with first- and second-line managers in Swedish hospitals were conducted and analysed using grounded theory. Results: 'Coaching for participation' emerged as a central theme for managers in handling top-down initiated process development. The vertical approach in this coaching addresses how managers attempt to sustain unit integrity through adapting and translating orders from top management. The horizontal approach in the coaching refers to managers' strategies for motivating and engaging their employees in implementation work. Conclusion and implications for nursing management: Implementation models for improving care processes require a coaching leadership built on close manager-employee interaction, mindfulness regarding the pace of change at the unit level, managers with the competence to share responsibility with their teams and engaged employees with the competence to share responsibility for improving the care processes, and organisational structures that support process-oriented work. Implications for nursing management are the importance of giving nurse managers knowledge of change management.

  • 6. Arman, Rebecka
    et al.
    Wikström, Ewa
    Tengelin, Ellinor
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Work activities and stress among managers in health care2012In: The Work of Managers: Towards a Practice Theory of Management / [ed] Tengblad, Sten, Oxford: Oxford University Press, 2012, 1Chapter in book (Other academic)
    Abstract [en]

    This chapter reports on the work activities, time-use patterns, and stress patterns of ten health care managers in Sweden. The qualitative and quantitative evidence reveals the fragmentation in their nine-hour working days where each activity, on average, lasts only ten minutes. The time-use patterns vary individually though some patterns are related to position and unit type. Activities deal with the coexisting and competing logics of employeeship, administration, and strategy and risk handling. None of the managers’ approaches for handling the multiple legitimation processes and delimiting their workload boundaries really challenges the complexity of the coexistence of the multiple logics or the boundlessness of their working hours. Using biophysical measures, the research finds that stress reported by the managers is caused by (a) interruptions during challenging tasks and (b) personal situations such as private dilemmas and conflict-loaded or ineffective meetings. It is important to acknowledge managers’ fragmented working situation and to recognize that management should be seen as collective process, or as part of an administrative system.

  • 7. Bergman, Caroline
    et al.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics. University of Borås, Sweden.
    Skagert, Katrin
    Exploring communication processes in workplace meetings: A mixed methods study in a Swedish healthcare organization2016In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 54, no 3, 533-541 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: An efficient team and a good organizational climate not only improve employee health but also the health and safety of the patients. Building up trust, a good organizational climate and a healthy workplace requires effective communication processes. In Sweden, workplace meetings as settings for communication processes are regulated by a collective labor agreement. However, little is known about how these meetings are organized in which communication processes can be strengthened. OBJECTIVE: The aim of this study was to explore communication processes during workplace meetings in a Swedish healthcare organization. METHODS: A qualitatively driven, mixed methods design was used with data collected by observations, interviews, focus group interviews and mirroring feedback seminars. Data were analyzed using descriptive statistics and conventional content analysis. RESULTS: The communication flow and the organization of the observed meetings varied in terms of physical setting, frequency, time allocated and duration. The topics for the workplace meetings were mainly functional with a focus on clinical processes. Overall, the meetings were viewed not only as an opportunity to communicate information top down but also a means by which employees could influence decision-making and development at the workplace. CONCLUSIONS: Workplace meetings have very distinct health-promoting value. It emerged that information and the opportunity to influence decisions related to workplace development are important to the workers. These aspects also affect the outcome of the care provided.

  • 8.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Ergonomics (Closed 20130701).
    Hållbart chefskap i hälso- och sjukvården - med vinjetter om engagemang, stress, tidsanvändning, medarbetarskap och vårdpraktik2012Other (Other (popular science, discussion, etc.))
  • 9.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Imbalanced logics of communicating with media in open management of health care service in Sweden: the managers perspectives and approaches2014Conference paper (Other academic)
  • 10.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Studiematerial: Hållbart chefskap i hälso- och sjukvården - med vinjetter om engagemang, stress, tidsanvändning, medarbetarskap och vårdpraktik2012Collection (editor) (Other academic)
    Abstract [sv]

    Detta är ett studiematerial som syftar till att stödja chefer i det vardagliga arbetet med avseende på hållbart ledarskap, chefskap och tidsanvändning. Med hållbarhet menar vi utifrån både verksamhets- och individ-/hälsoperspektiv. Studiematerialet kan användas för analys, reflektion och utveckling av ledarskap och chefskap.

  • 11.
    Dellve, Lotta
    et al.
    KTH, School of Technology and Health (STH), Ergonomics.
    Ahlborg, Tone
    Sahlgrenska Akademin, Göteborgs Universitet.
    Partner relationships and long-term sick leave among female workers: consequences and impact on dimensions of health and return to work2012In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, no 4, 720-729 p.Article in journal (Refereed)
    Abstract [en]

    Few efforts have been made to prospectively identify resources and obstacles outside work that may predict regained work ability and return to work when workers are on sick leave. This study investigates the association between partner relationships and sick leave. Our research questions were as follows: (i) What is the influence of sick leave, pain, stress and domestic strain on the quality of the dyadic partner relationship?, and (ii) What is the influence of the partner and social relationship on pain, stress, work ability, self-rated health and return to work? A cohort of female workers (n = 225) on long-term sick leave (>60 days), all in a partner relationship, at 6-month intervals completed a questionnaire based on the Quality of Dyadic Relationship (QDR) instrument, the Interview Schedule of Social Interaction (ISSI), the Work Ability Index (WAI) and the Copenhagen Psychosocial Questionnaire (COPSOQ). Univariate and multivariate analyses of baseline and prospective data were performed. The results showed that decreased partner relationship quality was related to having major responsibility for household work despite being on sick leave, having pain and having decreased social integration. Among younger individuals on sick leave, a reduction in the quality of the partner relationship was shown already at the first (6-month) follow-up, while among middle-aged women, such a reduction was seen only at the 12-month follow-up. No dimensions of partner relationship quality at baseline were related to dimensions of return to work, either as a resource or as an obstacle. Consequently, our results show that a good relationship does not keep the woman from returning to work. Having main responsibility for household work, which implies domestic strain while on sick leave, predicts lower partner relationship quality. The practical implications are that healthcare professionals treating women on sick leave should emphasize the importance of keeping a social network as well as making sufficient adjustments at home for the relationship quality to be safeguarded. Special attention should be given to the young woman on sick leave as being on sick leave seems to influence her partner relationship considerably.

  • 12.
    Dellve, Lotta
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Andreasson, Jörgen
    KTH.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Strömgren, Marcus
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Williamsson, Anna
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Nyorientering av svensk sjukvård: Verksamhetstjänande implementeringslogiker bygger mer hållbart engagemang och utveckling - i praktiken2016Report (Other academic)
  • 13.
    Dellve, Lotta
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Andreasson, Jörgen
    KTH, School of Technology and Health (STH), Health Systems Engineering.
    Jutengren, Göran
    Högskolan Borås.
    Hur kan stödresurser understödja hållbart ledarskap bland chefer i vården?2013In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 90, no 6Article in journal (Refereed)
    Abstract [sv]

    Chefer kan ha stor betydelse för anställdas hälsa, stress, engagemang i arbetet och prestation. Få tidigare studier har undersökt vilket stöd chefer behöver för ett hållbart och bra ledarskap. Artikeln presenterar resultat från en prospektiv studie om betydelsen av chefers stödresurser för hållbart ledarskap. I studien, som är en del av Chefios-projektet, ingår chefer i kommunal vård och omsorg (n=344). Data från enkätstudier med instrumentet ”Gothenburg Manager Stress Inventory” har analyserats. Resultatet visar att ett stödjande privatliv och en personlig inställning till chefsuppdrag har stor betydelse för chefers hållbarhet över tid. Chefens kontrollspann och erfarenhet som chef påverkade betydelsen av stödresurser. För chefer med kortare chefserfarenhet eller fler underställda (>30) har även stöd från ledning, chefskollegor och externt stöd betydelse.

  • 14.
    Dellve, Lotta
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    ETT ARBETSMATERIAL FÖR ATT STÖDJA Hållbart och hälsofrämjande ledarskap i vardag och förändring2016Report (Other academic)
  • 15.
    Dellve, Lotta
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Health-Promoting Managerial Work: A Theoretical Framework for a Leadership Program that Supports Knowledge and Capability to Craft Sustainable Work Practices in Daily Practice and During Organizational Change2017In: Societies, ISSN 1090-9389, E-ISSN 2075-4698, Vol. 7, no 2, 12Article in journal (Refereed)
    Abstract [en]

    The aim of this article is to describe a theoretical framework, i.e., theoretical underpinnings and pedagogical principles, for leadership programs that support managers' evidence-based knowledge of health-promoting psychosocial work conditions, as well as their capability to apply, adapt, and craft sustainable managerial work practices. First, the theoretical framing is introduced, i.e., a system theory that integrates key work conditions with a practical perspective on managerial work and organization. Second, pedagogical principles and measures for leaders' training in integrated handling across system levels are described. Last, we present summarized results from an intervention study applying the theoretical framework and pedagogical principles. The complexity of interactions among different factors in a work system, and the variety in possible implementation approaches, presents challenges for the capability of managers to craft sustainable and health-promoting conditions, as well as the evaluation of the program components. Nevertheless, the evaluation reveals the strength of the program, in providing holistic and context-sensitive approaches for how to train and apply an integrative approach for improving the work environment.

  • 16.
    Dellve, Lotta
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Hållbart ledarskap - I vardag och förändring2016Report (Other academic)
  • 17.
    Dellve, Lotta
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Fredman, Margareta
    Kullén Engström, Agneta
    Lean i hälso- och sjukvården2013In: Lean i Arbetslivet / [ed] Per Sederblad, Stockholm: Liber, 2013, 1, 142-161 p.Chapter in book (Other academic)
  • 18.
    Dellve, Lotta
    et al.
    University of Borås, Sweden.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Williamsson, Anna
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Strömgren, Marcus
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Andreasson, Jörgen
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics. University of Borås, Sweden.
    Holden, Richard
    Lean implementation approaches at different levels in Swedish hospitals: the importance for working conditions, worker engagement, health and performance2014Conference paper (Refereed)
    Abstract [en]

    Background

    Swedish healthcare organizations are investing heavily in internal reforms. Lean has been frequently used as an overall concept to improve care processes and decrease costs. Some evidence shows positive results, especially if work environment issues are considered in parallel with other desired outcomes. However, there are considerable difficulties in evaluating lean as a concept since its application and interpretation seem to vary widely. Further, like for other management concepts, lean outcomes crucially depend on the implementation process.

    Aim

    This program investigates implementations of lean and lean-like developments of processes of care, and how these affect the working conditions, health, and performance of healthcare employees. We also investigated organizational factors and conditions that mediated specific outcomes.

    Method

    Mixed method design: questionnaire to employees (n=880) and managers (n=320), qualitative interviews (n=55) and observations with follow up during three years. Five hospitals were selected, and within them five units that were connected by their flow of acute care patients, i.e. the emergency unit, the medical and surgical emergency ward (or ICU at small hospital) as well as one medical and one surgical ward. Initially we used qualitative-driven analyses and thereafter quantitative-driven mixed method analysis.

    Results

    The implementation strategies varied between the hospitals and between the strategic and operative levels. Strategic managers also used different approaches to overcome the gap between strategic and operative levels. Operative managers shared similarities in their stepwise and coaching approaches encouraging participation among employees, but differences regarding how assignments were delegated. Social capital and attitudes among health care profession were of importance for employees’ work engagement and active engagement in development work.

  • 19.
    Dellve, Lotta
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics. Högskolan i Borås, Sweden.
    Fallman, S. L.
    Ahlstrom, L.
    Return to work from long-term sick leave: a six-year prospective study of the importance of adjustment latitudes at work and home2015In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 89, no 1, 171-179 p.Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim was to investigate the long-term importance of adjustment latitude for increased work ability and return to work among female human service workers on long-term sick leave. Methods: A cohort of female human service workers on long-term sick leave (>60 days) was given a questionnaire four times (0, 6, 12, 60 months). Linear mixed models were used for longitudinal analysis of the repeated measurements of work ability and return to work. Results: Having a higher level of adjustment latitude was associated with both increased work ability and return to work. Adjustments related to work pace were strongly associated with increased work ability, as were adjustments to the work place. Having individual opportunities for taking short breaks and a general acceptance of taking short breaks were associated with increased work ability. At home, a higher level of responsibility for household work was related to increased work ability and return to work. Individuals with possibilities for adjustment latitude, especially pace and place at work, and an acceptance of taking breaks had greater increased work ability over time and a greater work ability compared with individuals who did not have such opportunities.Conclusions: This study highlights the importance of opportunities for adjustment latitude at work to increase work ability and return to work among female human service workers who have been on long-term sick leave. The results support push and pull theories for individual decision-making on return to work.

  • 20.
    Dellve, Lotta
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Galvin, Kathleen
    Hull University, UK.
    Crafting life-world led leadership2014Conference paper (Other academic)
  • 21.
    Dellve, Lotta
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Jutengren, Göran
    Högskolan Borås.
    Ahlborg, Gunnar
    Institutet för Stressmedicin.
    Chefsspecifika stressorer och stödresurser: betydelse för hållbart ledarskap bland chefer i vård och omsorg2014In: Chefskapets förutsättningar och konsekvenser: Metoder och resultat från CHEFiOS projektet – slutrapport I / [ed] Annika Härenstam, Göteborg: Institutet för Stressmedicin , 2014Chapter in book (Other academic)
  • 22.
    Dellve, Lotta
    et al.
    KTH, School of Technology and Health (STH), Ergonomics.
    Samuelsson, L.
    Waye, K. P.
    Preschool Children's Experience and Understanding of Their Soundscape2013In: Qualitative Research in Psychology, ISSN 1478-0887, E-ISSN 1478-0895, Vol. 10, no 1, 1-13 p.Article in journal (Refereed)
    Abstract [en]

    Noise may be a serious health problem in preschools. This article explores how preschool-aged children experience, understand, and cope with the soundscape at their preschools. Using a qualitative approach, 36 children (4-6 years old) were interviewed in 11 focus groups. The children related their experience of sound to the consequences the sound had for themselves, their understanding of its source, and their bodily and emotional experience of it. Their perceived trustfulness, comprehensibility, sound descriptions, and manageability of given sounds were interpreted in the model as an expression of uncontrollability. The degree of uncontrollability of sounds accounted for whether children were nondisturbed, disturbed, or distressed by their experience of it. Distressing noise was experienced as both physically and emotionally painful. The children handled such distress by flight, attempting to reduce the hearing sensation, turning to their teachers, and using cognitive strategies. It is important to increase our understanding of how children cope with distressing sounds at preschools.

  • 23.
    Dellve, Lotta
    et al.
    Institutionen för sociologi och arbetsvetenskap.
    Strömgren, Marcus
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Williamsson, Anna
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Holden, Richard J
    School of Informatics and Computing, Indiana University, Indianapolis, US.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Health care clinicians' engagement in organizational redesign of care processes: The importance of work and organizational conditionsIn: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126Article in journal (Other academic)
  • 24.
    Dellve, Lotta
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Williamsson, Anna
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Health care professionals’ motivation, engagement and collaboration in organizational developments of processes of care2012Conference paper (Other academic)
  • 25.
    Dellve, Lotta
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Williamsson, Anna
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Strömgren, Marcus
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Holden, Richard
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Lean implementation at different levels in Swedish hospitals: the importance for working conditions and stress2015In: International Journal of Human Factors and Ergonomics, ISSN 2045-7812, Vol. 3, no 3-4, 235-253 p.Article in journal (Refereed)
    Abstract [en]

    Healthcare organisations in Sweden are reorienting toward horizontal organisation around care processes. This paper's 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.

  • 26.
    Dellve, Lotta
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Wramsten Wilmar, Maria
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Jacobsson, Christian
    Göteborgs Universitet.
    Ahlborg, Gunnar
    Göteborgs Universitet.
    Ledarskap i vården: Att möta media och undvika personfokuserade drev2014Report (Other academic)
    Abstract [sv]

    Mote med media ar alltmer vanligt for chefer i varden och en viktig del av arbetet. Motet med media har idag ocksa fatt betydelse for chefens psykosociala arbetsmiljo och hallbarhet da personfokuserat, negativt och kritiskt fokus i media kan vara utmanande och fa vidare konsekvenser. Medvetenhet om mojligheter och risker vid mediakommunikation samt proaktiva forberedelser hos individen och organisationen kan ha avgorande betydelse for att understodja mer saklig och korrekt beskrivning i media samt for att undvika personfokuserade drev. Genom en utvecklad forstaelse och handlingsberedskap samt stod i ledningsgrupper till den som moter media kan negativa konsekvenser minska.

  • 27.
    Dellve, Lotta
    et al.
    KTH, School of Technology and Health (STH), Ergonomics.
    Wramsten Wilmar, Maria
    KTH, School of Technology and Health (STH).
    Jacobsson, Christian
    Ahlborg, Gunnar jr
    Managers approaches towards media during organizational development processes2012Conference paper (Refereed)
  • 28.
    Eklund, Jörgen
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Brännmark, Mikael
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Elg, M
    Eriksson, A
    Halling, Bengt
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Halvarsson, A
    Kock, H
    Williamsson, Anna
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Andersson, K
    Håkansson, Malin
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Langstrand, J
    Poksinska, Bozena
    Renström, Jonas
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Svensson, L
    Vänje, Annika
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Lean and working conditions: a current position2013In: HELIX Conference, 2013Conference paper (Refereed)
  • 29. Englund, A. -CD.
    et al.
    Rydström, I.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Ahlstrom, L.
    Social support outside work and return to work among women on long-term sick leave working within human service organizations2016In: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 30, 187-193 p.Article in journal (Refereed)
    Abstract [en]

    Aim: To investigate the relationships between return to work and social support outside work among women on long-term sick leave from human service organizations. Background: Work is an important part of life and is, in general, considered to be supportive of health and wellbeing. Few studies have thoroughly investigated the importance of aspects of social support outside work for return to work. Methods: A cohort of women on long-term sick leave was followed with questionnaires from 2005 to 2012. Results: The availability of social attachment increased the women's work ability, return to work, and vitality significantly more over time. There were positive relationships between return to work and seeking support in terms of emotional support and comfort and expressing unpleasant feelings. Conclusions: Important resources to increase return to work can be found in factors outside work, such as close social relationships and support seeking. Thus, it is important to take the woman's whole life situation into account and not focus solely on aspects related to the workplace.

  • 30.
    Eriksson, Andrea
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Samverkan i förbättringsarbete inom sjukvård2014In: Om samverkan: för utveckling av hälsa och välfärd / [ed] Runo Axelsson och Susanna Bihari Axelsson, Lund: Studentlitteratur, 2014, 1, 91-106 p.Chapter in book (Other academic)
  • 31.
    Eriksson, Andrea
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Dellve, Lotta
    Strömgren, Marcus
    KTH.
    Emma, Edström Bard
    Utveckling av hållbart och hälsofrämjande ledarskap –  i vardag och förändring: Utvärdering av interaktiv metodik för företagshälsovårdsdrivna interventioner2016Report (Other academic)
  • 32.
    Eriksson, Andrea
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Holden, Richard J.
    Williamsson, Anna
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    A Case Study of Three Swedish Hospitals' Strategies for Implementing Lean Production2016In: Nordic Journal of Working Life Studies, ISSN 2245-0157, E-ISSN 2245-0157, Vol. 6, no 1, 105-131 p.Article in journal (Refereed)
    Abstract [en]

    Many hospitals have recently implemented the management concept lean production. The aim of this study was to learn how and why three Swedish hospitals selected and developed their hospital-wide lean production strategies. Although previous research shows that the concept is implemented in various ways, there is limited research on how and why different hospitals choose different implementation strategies and if the chosen strategies contribute to sustainable participation in organizational development. A case study of three different Swedish hospitals implementing lean production was thus performed. We studied the content of the hospitals' selected implementation strategies, conditions and rationales behind their strategy selection, and how different organizational actors participated in the implementation. Qualitative interviews with 54 key actors at the studied hospitals were performed. In addition, a self-administered survey questionnaire to employees was answered at T1 (2012, n = 557), T2 (2013, n = 554), and T3 (2014, n = 366). The three studied hospitals chose different strategies for implementing lean production due to different contextual conditions and for different reasons. The hospital-wide implementation strategies were related to employees' interest and participation in lean production. The results show that many different actors at different organizational levels need to participate in lean production in order to sustain and diffuse change processes. Furthermore, broad motives including quality of care seem to be needed for engaging different professional groups.

  • 33.
    Eriksson, Andrea
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Skagert, Katrin
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Utveckling av hälsofrämjande ledarskap och medarbetarskap: Erfarenheter av att arbeta med interventioner utifrån ett arbetsmaterial2013In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 90, no 6Article in journal (Refereed)
    Abstract [sv]

    Forskning pekar på är att ledarskap har stor betydelse för anställdas välmående och att ledarskapsutveckling därför bör vara huvudfokus för framtida interventioner inom arbetsmiljö- och hälsoarbete. Den här artikeln syftar till att beskriva våra erfarenheter och lärdomar från att arbeta med hälsofrämjande ledarskapsinterventioner. Interventionerna utgår från arbetsmaterialet ”Hälsofrämjande ledarskap och medarbetarskap”. I arbetsmaterialet presenteras olika forskningsbaserade metoder och verktyg som kan användas för analys, reflektion och utveckling av hälso- och arbetsmiljöarbetet på den enskilda arbetsplatsen eller för hela organisationen. Utvärderingar av interventioner utifrån arbetsmaterialet pekar på att chefer som deltagit fått ökade förmågor att vara hälsofrämjande ledare, men att organisatoriskt stöd är avgörande för långsiktigta resultat.

  • 34.
    Eriksson, Andrea
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Strömgren, Marcus
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Experiences of Implementing Occupational Health Services Driven Intervention Methods for Sustainable Leadership in Health Care2016In: International Journal for Quality in Health Care, ISSN 1353-4505, E-ISSN 1464-3677, Vol. 28, 50-51 p.Article in journal (Other academic)
  • 35.
    Eriksson, Andrea
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Strömgren, Marcus
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Experiences of implementing OHS driven intervention methods for sustainable leadership in health care2015Conference paper (Refereed)
  • 36.
    Eriksson, Andrea
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Williamsson, Anna
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Implementation of the organizational concept lean production: Case studies of two Swedish hospitals2012In: NOVO Symposium: Hållbar hälso- och sjukvård, 2012, 25-25 p.Conference paper (Other academic)
  • 37.
    Eriksson, Andrea
    et al.
    KTH, School of Technology and Health (STH), Ergonomics (Closed 20130701).
    Williamsson, Anna
    KTH, School of Technology and Health (STH), Ergonomics (Closed 20130701).
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Ergonomics (Closed 20130701).
    Motivations and strategies for why and how to implement the organizational concept lean – a case study of a Swedish hospital2012Conference paper (Refereed)
    Abstract [en]

    The aim of this study was to analyze motivations and strategies of a Swedish hospital for why and how to implement lean. A case study, including interviews with key actors, observations and document analysis, was performed. Lean was in the studied hospital viewed as tools to deal with suggestions from employees on how to improve the delivery of care. Process leaders employed for a limited time were responsible for implementing lean in the different units. The hospitals future choices of implementation strategies, including training of managers, can be seen ascritical for motivating unit-level managers to sustain lean over time.

  • 38.
    Eriksson, Andrea
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Williamsson, Anna
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Three Swedish hospitals’ lean strategies and their contribution to organizational development2014In: ODAM/NES, 2014, 657-658 p.Conference paper (Other academic)
  • 39.
    Holden, Richard J
    et al.
    Department of BioHealth Informatics, Indiana University School of Informatics and Computing, Indianapolis, IN, USA.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Andreasson, Jörgen
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Williamsson, Anna
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Healthcare workers' perceptions of lean: A context-sensitive, mixed methods study in three Swedish hospitals2015In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 46, 181-192 p.Article in journal (Refereed)
    Abstract [en]

    As the application of lean in healthcare expands, further research is needed in at least two areas: first, on the role of context in shaping lean and its consequences and second, on how healthcare workers perceive lean. Accordingly, this context-sensitive, mixed methods study addressed how hospital workers' perceptions of lean varied across contexts in three Swedish hospitals. Registered nurses and physicians at the hospitals and across units differing in acuity completed standardized surveys (N = 236, 57% response rate) about their perceptions of hospital-wide lean implementation. Perceptions varied by: hospital context, with one hospital's employees reporting the least favorable perceptions; unit acuity, with higher-acuity units reporting more favorable perceptions; and professional role, with nurses reporting more favorable perceptions than physicians. Individual interviews, group interviews, and observations provided insight about these dissimilar contexts and possible explanations for context-specific variability. Findings are discussed with respect to strategies for implementing lean in healthcare; the importance of attending to levels, context, and worker consequences of lean; and directions for future research.

  • 40.
    Holmgren, Kristina
    et al.
    Göteborgs Universtitet.
    Ekbladh, Elin
    Hensing, Gunnel
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    The Combination of Work Organizational Climate and Individual Work Commitment Predicts Return to Work in Women But Not in Men2013In: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948, Vol. 55, no 2, 121-127 p.Article in journal (Refereed)
    Abstract [en]

    Objective: To analyze if the combination of organizational climate and work commitment can predict return to work (RTW). Methods: This prospective Swedish study was based on 2285 participants, 19 to 64 years old, consecutively selected from the employed population, newly sick-listed for more than 14 days. Data were collected in 2008 through postal questionnaire and from register data. Results: Among women, the combination of good organizational climate and fair work commitment predicted an early RTW with an adjusted relative risk of 2.05 (1.32 to 3.18). Among men, none of the adjusted variables or combinations of variables was found significantly to predict RTW. Conclusions: This study demonstrated the importance of integrative effects of organizational climate and individual work commitment on RTW among women. These factors did not predict RTW in men. More research is needed to understand the RTW process among men.

  • 41.
    Håkansson, Malin
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Waldenstrom, Mans
    Holden, Richard J.
    Sustained lean transformation of working conditions: A Swedish longitudinal case study2017In: Human Factors and Ergonomics in Manufacturing, ISSN 1090-8471, E-ISSN 1520-6564, Vol. 27, no 6, 268-279 p.Article in journal (Refereed)
  • 42.
    Lindgren, Å
    et al.
    Sahlgrenska Akademin.
    Bååthe, Fredrik
    Sahlgrenska Akademin.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Ergonomics (Closed 20130701).
    Why risk professional fulfilment: a grounded theory of physician engagement in healthcare development2013In: International Journal of Health Planning and Management, ISSN 0749-6753, E-ISSN 1099-1751, Vol. 28, no 2, e138-e157 p.Article in journal (Refereed)
    Abstract [en]

    The need for trans-professional collaboration when developing healthcare has been stressed by practitioners and researchers. Because physicians have considerable impact on this process, their willingness to become involved is central to this issue.

    OBJECTIVE:

    This study aims to gain a deeper understanding of how physicians view their engagement in healthcare development.

    METHOD:

    Using a grounded theory approach, the study developed a conceptual model based on empirical data from qualitative interviews with physicians working at a hospital (n = 25).

    RESULTS:

    A continual striving for experiences of usefulness and progress, conceptualized as 'striving for professional fulfilment' (the core category), emerged as a central motivational drive for physician engagement in healthcare development. Such experiences were gained when achieving meaningful results, having impact, learning to see the greater context and fulfilling the perceived doctor role. Reinforcing organizational preconditions that facilitated physician engagement in healthcare development were workplace continuity, effective strategies and procedures, role clarity regarding participation in development and opportunities to gain knowledge about organization and development. Two opposite role-taking tendencies emerged: upholding a traditional doctor role with high autonomy in relation to organization and management, clinical work serving as the main source of fulfilment, or approaching a more complete 'employeeship' role in which organizational engagement also provides a sense of fulfilment.

    CONCLUSION: Experiencing professional fulfilment from participation in healthcare development is crucial for sustainable physician engagement in such activities.

  • 43. Ljungblad, C.
    et al.
    Granström, F.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Ergonomics.
    Åkerlind, I.
    Associations between workplace health promotion and employee health in 60 municipal social care organizations in Sweden 20082012In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 22, 28-29 p.Article in journal (Other academic)
  • 44. Ljungblad, C.
    et al.
    Granström, F.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Åkerlind, I.
    Workplace health promotion and working conditions as determinants of employee health2014In: International Journal of Workplace Health Management, ISSN 1753-8351, E-ISSN 1753-836X, Vol. 7, no 2, 89-104 p., 17112741Article in journal (Refereed)
    Abstract [en]

    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 (>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.

  • 45. Orvik, Arne
    et al.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics. University of Borås, Sweden.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Organisatorisk hälsa och värdebaserat ledarskap – Behovet av systemperspektiv för en hållbar styrning och ledning av hälso- och sjukvården2013In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 90, no 6Article in journal (Refereed)
    Abstract [sv]

    Anställda inom hälso- och sjukvården rapporterar ökade hälsoproblem. Syftet med denna artikel är att ge exempel på systemperspektiv på hälsoutmaningar inom hälso- och sjukvården utifrån begreppen organisatorisk hälsa och värdebaserat ledarskap. En tillämpning av begreppet organisatorisk hälsa inom hälso- och sjukvården innebär att hälsoproblem hos anställda och chefer ses i relation till de värdekonflikter som är kopplade till rådande styrningsideal.  Organisatorisk hälsa är ett exempel på ett begrepp som har ett tydligt systemperspektiv och kan definierats som en organisations förmåga att hantera spänningar mellan olika konkurrende värden på ett sätt som gynnar både patienter och anställda, och därmed organisationen som helhet. En tillämpning av begreppet organisatorisk hälsa inom sjukvården skulle kunna hjälpa chefer inom sjukvård att syna de värdekonflikter som finns och kunna bidra till reflektion kring hur dessa värdekonflikter skulle kunna hanteras. Vi menar att ett hälsofrämjande och hållbart ledarskap inom hälso- och sjukvården i större utsträckning kräver ett värdebaserat ledarskap som medvetet, tydligt och öppet hanterar de värdekonflikter som finns i vården.

  • 46.
    Schmidt, Lisa
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics. IVL Svenska Miljöinstitutet.
    Gunnarsson, Kristina
    Uppsala Universitet.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Antonsson, Ann-Beth
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics. IVL Svenska Miljöinstitutet.
    Utilizing occupational health services in small-scale enterprises: a 10-year perspective2016In: Small Enterprise Research: The Journal of SEAANZ, ISSN 1321-5906, Vol. 23, no 2, 101-115 p.Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore how small-scale enterprises (SSEs) utilize occupational health services (OHS) and how the possibility of OHS providers to support occupational health and safety management (OHSM) has developed over a 10-year period. Qualitative interviews were carried out with four OHS providers and their SSE clients, with follow-up interviews being conducted with three of the four OHS providers and their clients after 10 years. The decade saw a change in market conditions for the OHS providers with each becoming larger and developing more effective marketing tools. Despite these changes, the OHS providers had not developed more collaborative or closer relationships with their small enterprise clients. Rather than increasing, the utilization of OHS had declined, with health examinations remaining the most purchased service. In addition, the three OHS providers had not improved their support for OHSM in small enterprises during the decade.

  • 47.
    Skagert, Katrin
    et al.
    ISM.
    Ahlborg, Gunnar
    ISM.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Ergonomics (Closed 20130701). University of Borås, Sweden .
    A prospective study of managers' turnover and health in a healthcare organization2012In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 20, no 7, 889-899 p.Article in journal (Refereed)
    Abstract [en]

    Aims To assess turnover and health of Swedish healthcare managers, and identify important supporting factors relating to work and individual resources. Background Individual managers' own sustainability in terms of turnover and health may be influenced by managerial working conditions and individual resources. Methods A 4-year prospective questionnaire study of 216 healthcare managers. Turnover and indicators of good health (healthy work attendance and no burnout) were related to work factors and individual resources using Cox regressions with constant time at risk. Results Forty per cent of the healthcare managers had left after 4years. Fifty-two per cent had a healthy work attendance record and the proportion with no burnout had increased. Experiencing moderate/high job control was a predictor of remaining in the managerial position. Good health was predicted by having energy left for domestic work and being thoroughly rested after sleep. Conclusions Managerial turnover seems high in Swedish healthcare and linked to working conditions, while sustained health are linked to individual resources. Implications for nursing management Healthcare organizations should focus not only on developing individuals in their managerial role but also on strengthening the conditions that allow managers to exercise their leadership and to ensuring that the managers most suitable for their posts do not leave.

  • 48.
    Strömgren, Marcus
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Health promoting leadership – a structure to build capacity for health in a healthcare organization2014Conference paper (Refereed)
  • 49.
    Strömgren, Marcus
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH).
    Ahlstrom, Linda
    Högskolan i Borås, Sweden.
    Bergman, David
    Karolinska Institutet, Sweden.
    Dellve, Lotta
    KTH, School of Technology and Health (STH).
    The importance of Leadership for social capital among healthcare professionals2015Conference paper (Refereed)
    Abstract [en]

    Introduction

    Social capital, operationalized as perceived trust, reciprocity and recognition has in earlier research shown to be important for employees´ job satisfaction and to health care staffs´ engagement in clinical improvements of patient safety and quality of care as well as job satisfaction, health and wellbeing. Since social capital has an impact, it is of interest to investigate which factors that influence workplace social capital. Research findings shows that leadership has great importance to staffs´ health and wellbeing, and affects a number of factors in the work environment factors as job satisfaction and work engagement. If and how leadership is associated with social capital is rarely described in previous research. However the few studies performed indicate that there are associated correlations between leadership and social capital, and leadership quality and social capital. Leadership within healthcare sector has been in focus when working with redesign of care processes and it would be of interest to investigate the role of leadership and the quality of leadership with respect to social capital. The aim was to assess the importance of leadership for workplace social capital in hospital settings.

     

    Materials and methods

    This study was a longitudinal cohort study. Questionnaires to physicians, nurses, assistant nurses at five Swedish midsize hospitals was used to collect data (T0, n=865, T1, n=908). Bivariate, multivariate analyses was used and a mixed model repeated measurement for the longitudinal analyses (n=477) were performed.

     

    Results

    Relationship between staffs perceived quality of leadership and staffs´ social capital was found (R = 0.58, p-value <0.0001). Results of the analysis showed significant differences in levels of social capital between the groups of low, medium and high levels in quality of leadership. The differences between the groups sustained over time where the group with high levels in quality of leadership remained higher in levels of social capital than the other groups. Same pattern were seen in the other groups.

     

    Conclusion

    Leadership quality were related to-, had importance for- and influenced workplace social capital among health care staff.

  • 50.
    Strömgren, Marcus
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Eriksson, Andrea
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Ahlstrom, Linda
    Bergman, David Kristofer
    Dellve, Lotta
    Leadership quality: a factor important for social capital in healthcare organizations2017In: Journal of Health Organisation & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 31, no 2, 175-191 p.Article in journal (Refereed)
    Abstract [en]

    Purpose - The purpose of this paper is to investigate the relation between leadership and social capital and what qualities of leadership are important for social capital among employees in hospital settings over time. Design/methodology/approach - A cohort of employees in hospitals answered a questionnaire at three occasions. Five small (approx. 100-bed) or mid-sized (approx. 500-bed) hospitals were included. The response rate was 54 percent at baseline (n = 865), 59 percent at one-year follow-up (n = 908) and 67 percent at two-year follow-up (n = 632). Findings - Repeated measures over time showed differences between groups in levels of social capital with respect to levels of leadership quality. Relation-oriented leadership had the strongest association with social capital. There was evidence that leadership was associated with social capital over time and that different kinds of leadership qualities were associated with social capital. Research limitations/implications - This study conducted and analyzed quantitative data, and therefore, there is no knowledge of managers' or employees' own perceptions in this study. However, it would be interesting to compare managers' decreased and increased leadership quality and how such differences affect social capital over time. Practical implications - The findings feature the possibility for healthcare leaders to build high quality leadership as an important resource for social capital, by using different leadership orientations under different circumstances. Originality/value - The paper showed that leadership was an important factor for building social capital and that different leadership qualities have different importance with respect to certain circumstances.

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