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  • 1.
    Hedman, Ann-Mari
    et al.
    Red Cross University College of Nursing.
    Fonad, Edit
    Karolinska Institutet.
    Sandmark, Helene
    Mälardalen University, School of Health, Care and Social Welfare.
    Older people living at home: Associations between falls and health complaints in men and women2013In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, no 19-20, p. 2945-2952Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To investigate the associations between self-reported falls and health complaints, among persons aged 75 years and older living at home, and to investigate gender differences in the associations. Background: There are several studies concerned with risk factors for falling, and others related to health complaints, but not many with associations between falls and health complaints. There are some inconsistent data of incidence and gender-related differences in falling. Design: Case-control community-based study. Methods: In total, 1243 persons living in two municipal districts in Sweden answered a questionnaire. Odds ratios (OR) and regression models with 95% confidence interval (CI) were used to determine the associations between self-reported falls and different health complaints. Results: The adjusted (multivariate) linear regression showed that urinary incontinence, self-rated health and tiredness were significantly associated with falls for both men and women living at home. The gender-related differences in falling were associated with the variables such as self-rated health for men and tiredness and pain in the hands, elbows, legs or knees for women. Conclusion: An association is evident between falls and urinary incontinence, poor self-rated health and tiredness for older persons living at home. Gender differences in falls show an association with poor self-rated health, tiredness and pain in the hands, elbows, legs or knees. Relevance to clinical practice: As older people are expected to live in their own homes as long as possible, more knowledge is required about what determines the risk of falling. Nurses in community care are recommended to use assessment tools that include urinary incontinence in order to detect the risk of falling.

  • 2.
    Hägglund, Karin
    et al.
    Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University,.
    Helsing, Christer
    Tabelloform, Sollentuna, Sweden.
    Sandmark, Helene
    Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University.
    Assistant nurses working in care of older people: associations with sustainable work ability2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 2, p. 325-332Article in journal (Refereed)
    Abstract [en]

    Indicators of health have shown improvements in the Swedish working population during the past decades, but with the exception of low-skilled women. Earlier research has shown that assistant nurses belong to an occupational group, which has the lowest share of individuals with long-term health in the total Swedish workforce. Sick leave research has mostly focused on determining risk factors for the development of diseases and dysfunctions. In the process of acquiring knowledge about mechanisms for sick leave, it has become obvious that there is also a need to focus on what contributes to work ability. The aim in this study was to explore what promotes sustainable work ability in female assistant nurses working in care of older people. Associations between factors related to work, health, lifestyle and sustainable work ability were investigated in a cross-sectional nested case–control study in a cohort of 366 female assistant nurses. Data were collected in self-reports in a questionnaire. Odds ratios were calculated, and a multiple logistic regression analysis was performed with sustainable work ability as the dependent variable. Sustainable work ability was associated with good self-rated health, a BMI <30, ability to sleep well, recuperation, low stress level, support from family and friends, being over 25 years of age at birth of the first child, and control over one’s own life in the ≥50 age group. In the logistic regression analysis, the significant associations were good self-rated health, being over 25 years of age at the birth of the first child and recuperation. In conclusion, the study showed that self-rated health and factors in private life are important for assistant nurse’s sustainable work ability over time. The results from this study could be applied in health promotion work for employees in the care sector to strengthen and enhance sustainable work ability.

  • 3.
    Larsson, Robert
    et al.
    Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Sustainable Development of Society and Technology.
    Ljungblad, Cecilia
    Mälardalen University, School of Health, Care and Social Welfare.
    Sandmark, Hélène
    Mälardalen University, School of Health, Care and Social Welfare.
    Åkerlind, Ingemar
    Mälardalen University, School of Health, Care and Social Welfare.
    Employers who combine organizational and individual-oriented health interventions have better health among their employees – a study of Swedish municipal social care organizations2012In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 22, no suppl. 2, p. 154-155Article in journal (Refereed)
  • 4.
    Larsson, Robert
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Ljungblad, Cecilia
    Mälardalen University, School of Health, Care and Social Welfare.
    Sandmark, Hélène
    Mälardalen University, School of Health, Care and Social Welfare.
    Åkerlind, Ingemar
    Mälardalen University, School of Health, Care and Social Welfare.
    Hälsofrämjande insatser i ett arbetsgivar- och arbetstagarperspektiv: en jämförande studie inom kommunal vård- och omsorg2012Conference paper (Refereed)
    Abstract [sv]

    Tidigare forskning har visat på samband mellan olika arbetsorganisatoriska faktorer och anställdas hälsa. Dessutom framkommer att både individinriktade och organisatoriskt inriktade hälsoinsatser har betydelse för arbetsrelaterad hälsa. Ett annat resultat som tydliggörs i forskningsöversikter är att hälsointerventioner på arbetsplatsen bör ha en bred ansats, där individinriktade och organisatoriska insatser kombineras, för att vara som mest effektivt. Samtidigt finns det kunskapsluckor gällande vilken typ av hälsoinsatser som arbetsgivare erbjuder sina anställa och i vilken utsträckning utbudet utnyttjas. Arbetsgivares organisatoriska stöd för hälsoarbete är ett annat område som behöver belysas vidare. Avsikten med denna studie är därför att undersöka vilka hälsoinsatser som erbjuds vård- och omsorgspersonal i ett urval av svenska kommuner samt hur det överensstämmer med personalens uppfattningar om arbetsgivarens insatser samt den egna hälsan.

    Mer specifikt är syftet med studien att undersöka: (1) arbetsgivarens utbud av hälsofrämjande insatser, (2) sambanden mellan olika typer av hälsofrämjande insatser och självskattad hälsa bland de anställda, (3) sambanden mellan arbetsgivarnas och arbetstagarnas uppfattningar av det hälsofrämjande arbetet. Studien genomfördes genom enkäter till förvaltningschefen respektive arbetstagarna inom vård- och omsorg i ett slumpmässigt urval av 60 av Sveriges 290 kommuner. Arbetsgivarenkäten omfattade: 1) arbetsorganisation 2) verksamhetsstyrning 3) hälso- och arbetsmiljöarbete samt 4) företagshälsovård. Dessa data analyserades sedan i förhållande till tidigare insamlade aggregerade enkätdata från 9 270 anställda beträffande hälsa, sjukfrånvaro samt uppfattningar om det hälsofrämjande arbetet i samma kommuner. Alla analyser genomfördes på kommunnivå med metoder för icke-parametrisk statistik.

    Resultaten visar att individuellt inriktade hälsofrämjande insatser är mer vanligt förekommande (finns i c:a 80% av kommunerna) än organisatoriskt inriktade insatser (finns i c:a 50% av kommunerna). Båda typerna av åtgärder är dock relaterade till ett bättre hälsoläge bland personalen. Kommuner med ett bredare utbud av individinriktade hälsofrämjande åtgärder har bättre hälsa bland personalen. Det finns också en överensstämmelse mellan arbetsgivarnas och arbetstagarnas rapportering av utbudet. Av de organisatoriska insatserna så kan förekomsten av särskilt utsedda resurspersoner för hälsoarbete (hälsosamordnare, hälsoombud/ friskvårdsinspiratör) samt genomförandet av lokala hälsoprojekt relateras till de anställdas hälsa. Däremot finns det inget samband mellan detta organisatoriska stöd och hur nöjda arbetstagarna är med arbetsgivarens insatser. Vidare kunde inte chefsstöd för hälso- och arbetsmiljöarbetet relateras till de anställdas hälsa. Det samma gäller förekomsten av mer generella policys och faktorer i organisationsstrukturen.

    Denna studie bidrar med kunskap om utbudet av hälsofrämjande insatser samt olika kommunala arbetsgivares sätt att organisera hälso- och arbetsmiljöarbete. Resultaten om att individinriktade insatser är mer vanligt förekommande än organisatoriska insatser överensstämmer med tidigare forskning. Samtidigt kan både individinriktade insatser och organisatoriska insatser relateras till de anställdas hälsa. Dessutom har arbetsgivare med ett mer ambitiöst utbud av insatser ett bättre hälsoläge bland de anställda. Resultaten visar att det finns anledning för arbetsgivare att implementera såväl individinriktade som organisatoriskt inriktade insatser. Resultaten är i linje med teorier om hälsofrämjande arbetsplatser, men har tidigare inte belysts i någon större utsträckning bland ett större antal arbetsgivare i offentlig sektor.

  • 5.
    Larsson, Robert
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Ljungblad, Cecilia
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sandmark, Hélène
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Åkerlind, Ingemar
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Workplace health promotion and employee health in Swedish municipal social care organizations2014In: Journal of Public Health, ISSN 2198-1833, E-ISSN 1613-2238, Vol. 22, no 3, p. 235-244Article in journal (Refereed)
    Abstract [en]

    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.

  • 6.
    Larsson, Robert
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Stier, Jonas
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Åkerlind, Ingemar
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sandmark, Hélène
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Implementing health-promoting leadership in municipal organizations: Managers' experiences with a leadership program2015In: Nordic Journal of Working Life Studies, ISSN 2245-0157, E-ISSN 2245-0157, Vol. 5, no 1, p. 93-114Article in journal (Refereed)
    Abstract [en]

    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.

  • 7.
    Larsson, Robert
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Åkerlind, Ingemar
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sandmark, Hélène
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Managing workplace health promotion in municipal organisations: the perspective of senior managers2016In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 53, no 3, p. 485-498Article in journal (Refereed)
    Abstract [en]

    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

  • 8.
    Larsson, Robert
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Åkerlind, Ingemar
    Mälardalen University, School of Health, Care and Social Welfare.
    Sandmark, Hélène
    Mälardalen University, School of Health, Care and Social Welfare.
    Workplace health management in municipal organizations: the perspective of senior managers2013Conference paper (Refereed)
  • 9.
    Lumley, M A
    et al.
    Wayne State Univ, USA.
    Shi, W
    Wayne State Univ, USA.
    Wiholm, C
    Department of Public Health and Caring Sciences, Uppsala University.
    Slatcher, R B
    Wayne State Univ, USA.
    Sandmark, Helene
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wang, S
    Wayne State Univ, USA.
    Hytter, A
    School of Business and Economics , Linneus University, Växjö, Sweden.
    Arnetz, B B
    Wayne State Univ, USA.
    The relationship of chronic and momentary work stress to cardiac reactivity in female managers: Feasibility of a smart phone-assisted assessment system2014In: Psychosomatic Medicine, ISSN 0033-3174, E-ISSN 1534-7796, Vol. 76, no 7, p. 512-518Article in journal (Refereed)
    Abstract [en]

    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.

  • 10.
    Sandmark, Helene
    Mälardalen University, School of Health, Care and Social Welfare.
    (F)Risk i arbetslivet: Om yrkesarbetande kvinnors hälsa, sjukskrivning och arbetsförmåga2011In: Perspektiv på kvinnors hälsa i arbetslivet / [ed] Hélène Sandmark, Lund: Studentlitteratur, 2011, 1:1, p. 105-134Chapter in book (Other academic)
  • 11.
    Sandmark, Helene
    Mälardalen University, School of Health, Care and Social Welfare.
    Health, sleep and professional career in female white-collar workers returning to work after long-term sick-listing due to minor mental disorders2011In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, ISSN ISSN 1403-4948, Vol. 39, no 8, p. 823-829Article in journal (Refereed)
    Abstract [en]

    AIMS:

    This study is a 3-year follow up of female white-collar workers, who were on long-term sick leave in 2004 due to stress-related and minor mental disorders. The aim is to show what promotes return-to-work (RTW) and the impact of a long period of sickness absence on professional career.

    METHODS:

    The study includes a cohort of 233 women who were currently on medically certified sick leave lasting ≥90 days in 2004. A postal questionnaire was sent out after 34 months, regarding self-rated health, quality of sleep, sick-listing status, occupational status, etc.

    RESULTS:

    After 34 months, 69% of the women had fully returned to working life. One of the most salient findings is that almost half of those had changed jobs and more than a third were in a new profession. Those who were back in working life rated less negative consequences of the long-term sick-listing on their professional career and their quality of sleep was better (OR 2.90, 95% CI 1.50-5.60 "sleeping all night"). Self-rated health did not show significant association with RTW (OR 2.83, 95% CI 0.91-8.77). Those who had returned to working life reported more control over their lives (OR 1.98, 95% CI 1.01-3.88).

    CONCLUSIONS:

    The findings imply that, in work health promotion and rehabilitation and efforts to prevent sickness absence due to stress-related disorders, important factors to be considered are job mobility, changes in present work, improved sleep, and control over one's own life.

  • 12.
    Sandmark, Helene
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Orka jobba till 65?2014Book (Other academic)
    Abstract [sv]

    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.

  • 13.
    Sandmark, Helene
    Mälardalen University, School of Health, Care and Social Welfare.
    Perspektiv på kvinnors hälsa i arbetslivet2011Collection (editor) (Other academic)
    Abstract [sv]

    Vägen till jämställdhet är lång och än har vi inte nått målet. Den politiska viljan och de sociala normer som styr mäns och kvinnors vardagsliv är ännu inte riktigt i fas. Den könsuppdelade arbetsmarknaden i Sverige betyder lägre löner för kvinnor och mer deltid. Det här skapar ett beroendeförhållande till en partner som har inkomster från ett heltidsarbete eller till bidragsberoende.

  • 14.
    Sandmark, Helene
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Hedman, Ann-Marie
    Röda Korsets Högskola.
    Fonad, Edit
    Factors Associated with falls in Elderly Living at Home in Sweden2012In: Primary Health Care: Open Access, ISSN 2167-1079, Vol. 2, no 4, p. 1-5Article in journal (Refereed)
    Abstract [en]

    Background: Falls among elderly constitute a major public health issue of increasing magnitude. For theprevention of fall at population level, it is necessary to study risk factors among community-dwelling elderly people inthe population. The aim of this explorative study is to show associations between falls and self-rated health, physicalexercise, physical functioning and physical disorders in elderly men and women living in their own homes in urbanareas in a high-income country.Methods: The associations between reported falling during the previous year and factors such as physicalfunctioning, physical disorders, exercise, and self-rated health were investigated in a case-control study. The studybase included all men and women aged 75 years and older living in their own homes in two municipal districts, onein the Stockholm area and one in the south of Sweden, from October 2008 to March 2009. A questionnaire wasdeveloped, but with questions used in earlier studies.Results: Of the1243 who participated in the study, 434 (35%) reported that they had fallen at least once duringthe previous year, and 759 (61%) reported no falls at all during the same period. Of the fallers, 158 (36%) were men,and 276 (64%) women. Unsteady gait (log reg 1.38, 95% CI 1.09-1.75) and poor self-rated health (log reg 2.04, 95%CI 1.29-3.20) were associated with falls during the previous year.Conclusion: The results from this study indicate that the most important factors related to falls are within physicalfunctioning, and that there are differences between men and women regarding the strength in the associations, andregarding marital status and age.

  • 15.
    Sandmark, Helene
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Renstig, Monica
    Duktighetssyndromet: därför går allt fler kvinnor in i väggen2005Book (Other (popular science, discussion, etc.))
  • 16.
    Sandmark, Helene
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Renstig, Monica
    Womens Business Res Inst, Stockholm, Sweden.
    Understanding long-term sick leave in female white-collar workers with burnout andstress-related diagnoses: a qualitative study2010In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 10, p. Article Number: 210-Article in journal (Refereed)
    Abstract [en]

    Background: Sick leave rates in Sweden have been significant since the end of the 1990s. In this paper we focus on individual female white-collar workers and explore various factors and setting-based sources of ill health in working life and in private life, in order to understand impaired work ability, leading ultimately to long-term sick leave. 

    Methods: A qualitative methodology was chosen, and thematic, open-ended interviews were carried out with 16 women. The interviewees were strategically selected from a cohort of 300 women in full-time white-collar jobs in high-level positions, living in three urban areas in Sweden, and on long-term sick leave >= 90 days. A qualitative content analysis was carried out. 

    Results: The informants in the study were generally well educated, but a few had surprisingly little formal education considering their salary level and position on the labour market. The women were in professional positions more commonly held by men, either as specialists with some degree of managerial role or as executives with managerial responsibilities. Both external and internal stressors were identified. The analysis indicated that being in these gender-typed jobs could have induced sex discrimination and role conflicts. The women expressed strong agreement regarding success in working life, but emphasised the lack of competence matching in their present jobs. They also lacked the sense of having a rewarding job, saw leadership as weak, and disliked their present workplace and colleagues. Impaired health may have hindered them from changing jobs; conversely, their locked-in positions could have resulted in deterioration in their health status. The women displayed personal overcommitment, both at work and in private life, and had difficulties in setting limits.

     Conclusions: Factors in working life, as well as in private life, played an important role in the informants' deteriorated health and long-term sick leave. Job and workplace mismatching, problems in connection with company profitability, and poor leadership contributed to stress-related symptoms, resulting in reduced working capacity. On the basis of these findings, attention should be paid to identification of early indicators of exhaustion, and measures should be taken in work settings and in working life as a whole to promote retained work ability.

  • 17.
    Sandmark, Helene
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sarvento-Håkansson, M
    Sundbyberg Rehab and Fysioterapi Center, Sundbyberg, Sweden.
    Franke, C
    PhysioMind, Nacka, Sweden.
    Akhavan, Sharareh
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    “I just kept running and running until I hit the wall"- Working men seeking care due to stress-related problems.2014In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 49, no 2, p. 297-306Article in journal (Refereed)
    Abstract [en]

    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.

  • 18.
    Sandmark, Helene
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Smedberg, Åsa
    Data- och systemvetenskap, Stockholms universitet.
    Design of a Mobile Phone App Prototype for Reflections on Perceived Stress2012In: ThinkMind // eTELEMED 2012, The Fourth International Conference on eHealth, Telemedicine, and Social Medicine, 2012, p. 243-248Conference paper (Refereed)
    Abstract [en]

    In working life today, people often experience high levels of stress and display strong reactions to different stressors. Those who are exposed to high levels of stress for a long time face an increased risk for deterioration in physical and mental health often leading to sick leave and high consumption of healthcare. To prevent this, continuous support is needed. Development of IT-tools for continuous stress management is, however, in its early stages. We present a prototype of a mobile phone app for self-reflection, a tool that is also integrated in a larger web based stress management system built on research of social networks for increased well-being. The mobile phone app aims at helping people become more aware of patterns of stressful events. It logs and displays basic information about self-perceived stress situations, such as location and time, and the user can add information about the situations and perceived stress levels. As the app constitutes a part of the web based stress management system, not only self-reflection but also reflection together with peers and stress experts is possible. The prototype of the mobile phone app has been qualitatively evaluated using stress management criteria, and the paper also exemplifies its utility in the context of the larger system.

  • 19.
    Sandmark, Helene
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Mälardalens högskola.
    Smedberg, Åsa
    Stockholms universitet.
    Designing a Stress Management Program in a Swedish Setting2013Conference paper (Refereed)
  • 20.
    Sandmark, Helene
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Smedberg, Åsa
    Institutionen för Data-och systemvetenskap, Stockholms universitet.
    Dynamic Stress Management: Self-Help through Holistic System Design2013In: User-Driven Healthcare: Concepts, Methodologies, Tools, and Applications / [ed] Smedberg Å, IGI Global , 2013, vol 3, p. 1469-1486Chapter in book (Refereed)
    Abstract [en]

    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.

  • 21.
    Sandmark, Helene
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Smedberg, Åsa
    Stockholms universitet.
    Stress at work: Designing a stress management program in a Swedish webb-based setting2013Conference paper (Refereed)
  • 22.
    Sandmark, Helene
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Smedberg, Åsa
    Stressmanagment 2.0: A Holistic Approach to Self-management Online2010Conference paper (Refereed)
    Abstract [en]

    The last years have put stress management on the agenda of healthcare. Intense lifestyles with job and domestic demands let people experience high levels of stress and to react strongly to different stressors. Long-term sickness and absence from work can be a consequence of too high stress exposure during a long period of time. This negative trend can be counteracted if we allow a combination of actions to support people who experience stressful lives. Different online programs are available for people with stress symptoms. However, there is a lack of conceptual understanding and a holistic approach to learning online for this group of people. In this article, we present a holistic and integrated approach to ‘stress management 2.0’ that considers several areas: stress management, self-management, informatics and continuous learning through communication and feedback. The approach is based on findings from previous research studies of web based solutions for learning new lifestyles, stress management and results from clinical trials. At the end of the article, we present some design principles to be used for developing systems in accordance with ‘stress management 2.0’ from a holistic view.

     

     

  • 23.
    Smedberg, Å.
    et al.
    Department of Computer and Systems Sciences (DSV), Stockholm University, Sweden.
    Sandmark, Hélène
    Dynamic stress management: Self-help through holistic system design2011In: E-Health Communities and Online Self-Help Groups: Applications and Usage, IGI Global , 2011, p. 136-154Chapter in book (Other academic)
    Abstract [en]

    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.

  • 24.
    Smedberg, Åsa
    et al.
    Inst för data- och systemvetenskap. Stockholms universitet.
    Sandmark, Helene
    Mälardalen University, School of Health, Care and Social Welfare.
    A Holistic Stress Intervention Online System: Designing for Self-help through Multiple Help2011In: International Journal on Advances in Life Sciences, Vol. 3, no 3, p. 47-55Article in journal (Refereed)
  • 25.
    Smedberg, Åsa
    et al.
    The Department of Computer and Systems Sciences Stockholm University.
    Sandmark, Helene
    Mälardalen University, School of Health, Care and Social Welfare.
    Stress Intervention Online: Designing for Self-help through Multiple Help2011In: eTELEMED 2011 : The Third International Conference on eHealth, Telemedicine, and Social Medicine, IARIA , 2011, Vol. 5, no 30, p. 120-126Conference paper (Refereed)
    Abstract [en]

    E-health has undergone many changes during theyears. One is the development of web-based self-help services forpatients and citizens with health concerns. This paper presentsdesign ideas for a stress management web-based system thattakes the development of self-help services further. The aim ofthe system is to help people with mild to intermediate levels ofstress problems change patterns of behavior and take control oftheir stressful life situations. The system includes not only selfhelpthrough individual work with stress-related issues, but italso complements the individual efforts with help from peers andmedical professionals. The system then becomes a platform forcombining multiple help online. The system design ideas haveresulted from research studies and practical experiences of stressmanagement and web-based self-help systems. The paper also presents a couple of scenarios to illustrate in what ways the system usage can be characterized by multiple help online and aholistic approach to stress intervention.

  • 26. Smedberg, Åsa
    et al.
    Sandmark, Hélène
    Mälardalen University, School of Health, Care and Social Welfare.
    Web-based stress management system goes mobile: Considerations of the design of a mobile phone app2012In: Lecture Notes of the Institute for Computer Sciences, Social-Informatics and Telecommunications Engineering, 2012, p. 67-75Conference paper (Refereed)
    Abstract [en]

    High levels of stress at work, great demands and lack of balance between work and family; these are examples of components in the daily lives of many people in modern society. Interventions of different kinds are needed. However, changing patterns of thinking and behaviors is not an easy task, and it demands for continuous support and learning efforts. This paper presents a web-based stress management system and the way it was transferred to a mobile phone app. The solution and considerations are presented. The design principles of the web-based system were used to examine the use of the mobile phone app. The results showed that the app to a large extent meets the design principles, and some of the principles seemed even more applicable in the mobile phone setting due to its mobility. 

  • 27.
    Wihlman, Thomas
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Hoppe, Magnus
    Mälardalen University, School of Business, Society and Engineering, Industrial Economics and Organisation.
    Wihlman, Ulla
    Independent Researcher, Sweden.
    Sandmark, Helene
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Employee-driven Innovation in Welfare Services2014In: Nordic Journal of Working Life Studies, ISSN 2245-0157, E-ISSN 2245-0157, Vol. 4, no 2, p. 159-180Article in journal (Refereed)
    Abstract [en]

    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.

  • 28.
    Wihlman, Thomas
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Hoppe, Magnus
    Mälardalen University, School of Business, Society and Engineering, Industrial Economics and Organisation.
    Wihlman, Ulla
    Independent Researcher.
    Sandmark, Hélène
    Stockholm University, Sweden.
    Innovation Management in Swedish Municipalities2016In: European Journal of Workplace Innovation, ISSN 2387-4570, Vol. 2, no 1, p. 43-62Article in journal (Refereed)
    Abstract [en]

    Research on public sector innovation is still limited, and increased knowledge of innovation processes is needed. This article is a based on a study of the implementation of innovation policies in Swedish municipalities, and gives a first-hand, empirical view of some of the complexities of innovation in the public sector. The study took place in four municipalities in central Sweden. The municipalities varied in size and organisational forms. Interviews and policy documents were used for data collection.The results showed that the innovation policies were not followed by action, which may be described as not mobilizing dynamic capabilities to create innovativeness. Thus, dynamic capabilities, such as learning and HRM, Human Resource Management, were not used in conjunction with innovation. Particularly amongst senior management there was a negative attitude towards the innovative capacity of their organization. Middle management saw possibilities. However, barriers such as extensive control systems removed the focus from innovation. There was a lack of communication between senior management and middle management regarding innovation. The conclusion was that innovation, as both concept and practice, was not fully embraced by the municipalities.

    It is suggested that generative leadership, opening up communication within the organisations, especially between employees, could be beneficial, and that a common understanding and definition of the innovation concept is needed. Integration of top-down processes with bottom-up processes, such as employee-driven innovation, is also suggested.

  • 29.
    Wihlman, Thomas
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sandmark, Hélène
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Hoppe, Magnus
    Mälardalen University, School of Business, Society and Engineering, Industrial Economics and Organisation.
    Innovation policy for welfare services in a Swedish context2013In: Offentlig Förvaltning. Scandinavian Journal of Public Administration, ISSN 2000-8058, E-ISSN 2001-3310, Vol. 16, no 4, p. 27-48Article in journal (Refereed)
    Abstract [en]

    The aim of the study is to explore the role of public welfare services expressed in theSwedish government’s innovation policy. The focus is on municipal and county services,such as education and health care. The study is based on an analysis of 55 documentsproduced by the government and its agencies. Although innovation policy is a major issue in Sweden, and Sweden has a large public sector, research on innovation within this fieldis very limited. The results show that the municipality and county services are visible ininnovation policy when they are a driving force for innovation in the private sector. Thisapplies especially when public procurement becomes a vehicle for business innovation.Innovation is not used as a concept representing radical change and general progress ofthe public sector as such. When municipal welfare services become visible in the studieddocuments, there are often references to a need for efficiency improvements and forprocurement leading to innovation. For the public sector, including local welfare services, no coherent innovation policy is present, but this study found elements that could becomepart of an innovation policy. Policy development is important for the future, consideringthe public sector´s role in the important and increasing service sector and in the society as a whole.

  • 30.
    Yuwanich, Nuttapol
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sandmark, Hélène
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Ramazzini Research Institute, Lidingo, Sweden .
    Akhavan, Sharareh
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Emergency department nurses' experiences of occupational stress: A qualitative study from a public hospital in Bangkok, Thailand2016In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 53, no 4, p. 885-897Article in journal (Refereed)
    Abstract [en]

    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.

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