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BACKGROUND: Occupational stress has been a health-related issue among nurses for many decades. Emergency department nurses are frequently confronted with occupational stress in their workplace; in particular, they encounter stressful situations and unpredictable events. These encounters could make them feel more stressed than nurses in other departments. Research considering occupational stress from the perspective of Thai emergency department nurses is limited. OBJECTIVE: This study aimed to explore nurses' perceptions of occupational stress in an emergency department. METHODS: A qualitative approach was used to gain an understanding of nurses' experiences and perceptions regarding stress in their workplace. Semi-structured interviews were used for data collection. Twenty-one emergency department nurses working in a public hospital in Thailand were interviewed, and the data were analyzed using content analysis. RESULTS: The findings comprised three themes: (1) perceived stress, (2) consequences of stress, and (3) stress management. CONCLUSIONS: The results of this study can be used by hospital management to help them adopt effective strategies, such as support programs involving co-workers/supervisors, to decrease occupational stress among emergency department nurses. Future research that explores each of the themes found in this study could offer a more comprehensive understanding of nurses' occupational stress in the emergency department.

BACKGROUND: Previous research indicates that companies manage workplace health in various ways, but more in-depth empirical knowledge of how workplace health promotion (WHP) is managed in public sector organisations is needed.

OBJECTIVE: The aim of this study was to explore how WHP is managed and incorporated into the general management system in two large Swedish municipal organisations.

METHODS: A qualitative descriptive approach was used. Fourteen senior managers were purposefully selected and interviewed using semi-structured interviews. Documents were used as supplementary data. All data were analysed using qualitative content analysis.

RESULTS: The management of WHP was described as a set of components that together contribute to the organisation’s capacity for WHP. The informants described WHP as dominated by fitness programmes and as following a problem-solving cycle, in which the annual employee survey emerged as an important managerial tool. Achieving feasible WHP measures and appropriate follow-ups were described as challenges. The provision of leadership competence for WHP and use of supportive resources were described as additional components.

CONCLUSIONS: The WHP management approach needs to be broadened to include work environment and organisational factors. Further integration with occupational health and safety and the general management system in the organisations is also needed. 

Keywords: integration, management, occupational health and safety, public sector organisation, workplace health

The aim of this study was to analyze how line and middle managers experience and describe barriers and enablers in the implementation of a health-promoting leadership program in municipal organizations. A qualitative case study design was applied to examine the leadership program in a case involving implementation of an organizational health intervention. Data were mainly collected using semi-structured interviews with line and middle managers participating in the leadership program. Interviews with senior managers, notes from meetings/workshops, and written action plans were used as complementary data. The interview data were analyzed using a thematic analysis, and the complementary data using a summative content analysis. The findings show that the interviewed line and middle managers experienced this leadership program as a new approach in leadership training because it is based primarily on employee participation. Involvement and commitment of the employees was considered a crucial enabler in the implementation of the leadership program. Other enablers identified include action plans with specific goals, earlier experiences of organizational change, and integration of the program content into regular routines and structures. The line and middle managers described several barriers in the implementation process, and they described various organizational conditions, such as high workload, lack of senior management support, politically initiated projects, and organizational change, as challenges that limited the opportunities to be drivers of change. Taken together, these barriers interfered with the leadership program and its implementation. The study contributes to the understanding of how organizational-level health interventions are implemented in public sector workplaces.

There is a growing interest in both employee-driven innovation (EDI) and innovation in welfare services, but a lack of empirical studies addressing innovation from the employee perspective.

Accordingly, this study was designed to contribute with well-grounded empirical knowledge, aiming

to explore the barriers to and opportunities for participation in innovation experienced by employees of the Swedish welfare services. In order to reach the aim, a qualitative thematic analysis of

27 semi-structured interviews with employees in four municipalities was performed.

The study identified three main themes, with a great impact on the innovative performance of the studied organizations: support, including leadership and innovation processes; development, including creativity and learning; and organizational culture, which includes attitudes and communication, all essential ingredients in EDI. Experienced barriers for innovation were unclear or non-existing innovation processes with ambiguous goals, insufficient learning, and deficient organizational slack, thus creating a tension between day-to-day work and innovation and hindering reflection and exploration.

Attitudes of colleagues and lack of communication were also barriers to implementing innovation, suggesting the need for better management support for a communicative and open culture.

Opportunities were found, including commitment to innovation and willingness to try new ideas, but the employees must be given the mandate and sufficient time to develop the potential that emerges from continuous learning, time for reflection, and user dialogue. The conclusion was that incremental innovations existed, but the full potential of these did not benefit the entire organization due to inadequate communication and lack of innovation processes.

The study improves our understanding of how employees regard their involvement in innovation.

It also discusses how to make better use of employees’ resources in innovation processes andcontributes to important knowledge about EDI in the public sector. On the basis of our results, we suggest a model of EDI for use in practice.

BACKGROUND: Stress problems are major public health problems.

OBJECTIVE: To gain an increased understanding of howworking men seeking care due to minor metal dysfunctions related to stress recognize their symptoms, what triggers them, and how this impacts their everyday life.

PARTICIPANTS: Fourteen men of working age, consecutively seeking care due to minor mental dysfunctions indicating stress problems, at two clinics in the Stockholm area in Sweden during 2009 and 2010.

METHODS: A qualitative methodology was chosen, and interviews were performed and analyzed using qualitative content analysis.

RESULTS: In the manifest content, categories such as difficulties in setting limits, low socialsupport, high work demands, and mental and physical dysfunctions were identified. Three themes finally emerged (latent content) and indicated that in this group of informants there are stressors both within the individual himself, in working life, and a lack of recovery.

CONCLUSIONS: Based on our findings it would be possible to implement measures to prevent stress-related problems by promoting coping strategies on an individual level, encouraging social networks, and regular physical exercise. By implementing work policies and workplace modifications, and also providing individual support at the workplace, supervisors and human resources managers could prevent, or modify stress problems among employees.

Många kvinnor i Sverige närmar sig nu för första gången efter ett långt yrkesliv sin pensionering. De är den första generationen kvinnor i modern tid där de flesta har yrkesarbetat utanför hemmet under en längre period. De har mest jobbat inom vård, skola och omsorg. Undersköterska i äldreomsorg är ett av de allra vanligaste jobben i den här generationen. Det är en yrkesgrupp där arbetssjukdomar och arbetsolyckor är vanliga. Många slutar sina jobb långt före pensionen. En del stannar kvar i jobbet och det är några av de kvinnorna som har intervjuats. Vi ville veta hur de ser på sitt arbete och sitt arbetsliv, hur deras hälsa är och om de tror att de kommer att jobba till 65 år eller möjligen längre. Fokus har varit att i första hand ta reda på vad som är hälsofrämjande. Det är att ha ett salutogent perspektiv och då riktas fokus mot styrkor, resurser och faktorer som bidrar till en god hälsa och välbefinnande.

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

Aim

The aim of this explorative study was to investigate the employers’ management characteristics, their provision of workplace health promotion (WHP) measures, and employee satisfaction with WHP in relation to employee health in Swedish municipal social care organizations.

Subjects and methods

A cross-sectional design was used, and questionnaires were sent to top managers (representing the employer) and employees in a nationwide random sample of 60 of the 290 municipal organizations for the social care of elderly and disabled people in Sweden. The questionnaire data from the 60 managers were linked to aggregated employee data concerning self-rated health and satisfaction with WHP from a representative sample of 8,082 employees in the same organizations. All analyses were performed at the organizational level using independent t-test, Spearman’s rank correlation and multiple linear regression analysis.

Results

In the multivariate analysis, the organizational WHP index (i.e. local WHP projects and WHP coordinators), individual WHP index (i.e. health profile assessment, fitness activities and medical check-up), and the level of employees’ satisfied with WHP were associated with employee health (F = 9.64, p < 0.001, adjusted R² = 0.48). General organizational and management characteristics were, however, not statistically related to employee health.

Conclusion

The results suggest that the provision of individual-directed and organizational-directed health-specific measures were related to employee health in Swedish municipal social care organizations and, therefore, can be part of a comprehensive approach to address WHP.

Different kinds of applications for self-help are available on the Internet today. Some aim to intervene with users' life patterns such as negative stress exposure. It is not always an easy task to manage stressful life situations and to develop and maintain healthy living. It involves learning how to balance perceived demands from working and personal life, and to question underlying thoughts and beliefs. E-health communities can assist in this process through continuous interactions between community members. However, previous studies have shown that combining knowledge of health experts and the experiences of peers can create a good synergy. The question is how these findings can be applied to the area of stress management. In this chapter, the authors present a web-based self-help system for stress management based on a holistic view of actors and their different types of support. The system offers the user information in the form of research and real life stories, practical exercises (both text- and video-based), and the opportunity to interact with health experts and peers, all in an integrated way.