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Background: This presentation focuses on results from studies concerning workplace health and rehabilitation interventions in one Swedish rural municipality including 19 workplaces with a population of 311 individuals. The municipality has implemented a model for human resource accounting, an extensive leader and co-worker development program and specific workplace based health and rehabilitation measures.Methods: The studies compare co-workers and leaders self-ratings of health and psychosocial working conditions, and investigate how workplace health and rehabilitation programs affect these ratings by analysing quantitative results before, during and after carried out interventions. Qualitative data collection consisted of semi-structured interviews with middle managers and an examination of documents reviewing content of the interventions that had been carried out.Findings: Results indicate differences concerning how the leaders and the co-workers judge their health and psychosocial working conditions. When comparing mean changes in scores on indexes by individuals grouped in the high quality workplace-based program group with individuals grouped in the low quality workplace-based program group, there were more positive mean changes for the former group.Discussion: The findings of differences concerning how public sector leaders and co-workers judge their health and psychosocial working conditions give support for different job characteristics for these two categories of employees. The rather strong relationships in the assumed direction between employees' assessment of changes in health, and changes concerning stress and psychosocial working conditions that resulted are in line with other research studies. Comparing workplaces grouped as having high quality workplace-based programs with workplaces with low quality workplace-based programs indicates that workplace-based prevention and rehabilitation programs in public human service organizations using a broad change strategy with high levels of participation from both managers and co-workers, and developed leadership behaviour are more effective in improving employee health and psychosocial working conditions.

AbstractIn Norway various welfare state authorities assist in disability management (DM) of long-term sick workers. This study provides empirical-based knowledge about the Norwegian DM process. The data are based on focus-group interviews with health care providers and case-workers in welfare state authorities. A key issue outlined in this article is that long-term sick workers can easily become 'stuck' in the rehabilitation system. The focus is on topics that can explain difficulties of re-employing long-term sick workers. Furthermore, we look at what challenges are typical for DM of these workers in Norway, with respect to re-employment issues.

We explore how Norwegian self-help groups are defined and managed to create a particular form of health system governmentality. Self-help groups are typically framed as therapeutic communities where participants define the agenda creating a space where open and equal interaction can produce individual learning and personal growth. In Norway, however, self-help groups are managed in a way that integrates them in to the health system but insulates them from clinical medicine; an approach that disciplines participants to act in a particular way in relation to the health system. We draw on the analysis of 1456 pages of public documents and websites from the National Nodal Point for Self-Help (NPSH), the organisation that manages self-help groups, and central government including individual testimonies from participants published between 2006 and 2014. We argue, drawing on Foucault, that self-help premised on lay-leadership and self-determination is at odds with the centrally defined regulation apparent in the model adopted in Norway and an example of disciplining that reinforces health system governmentality and serves the interests of the medical profession and the state. Further we propose that this illustrates the contestation between the pastoral power of medics, the National Nodal Point for Self-Help and the Ministry of Health. Our analysis of Norwegian self-help as a mechanism to create a particular form of health system governmentality helps explain the expansion of self-help and self-management within developed health systems and provides an explanation for why self-help within health systems, is typically situated adjacent to, rather than integrated into, clinical medicine.

The purpose of this study is to contribute to knowledge about leader-based workplace health interventions by investigating changes in psychosocial working conditions and health in Norwegian and Swedish small-scale enterprises (SSEs). The study also aims to investigate whether there are differences between position, and countries. In total, 30 leaders and 149 coworkers in 34 SSEs participated in two intervention and two reference groups. Leaders and coworkers completed the validated questionnaires (Nordic Questionnaire on Positive Organizational Psychology ([N-POP]), Work Experience Measurement Scale (WEMS), and Salutogenic Health Indicator Scale (SHIS), which cover different psychosocial working conditions and health outcomes. The interventions were carried out by advisors from occupational health services (OHSs) over a one-year period and consisted of analyses of health and psychosocial working conditions, company visits, education and networking meetings, including information and tools on issues such as leadership, work environment and health, and leadership support. The statistical methods used included principal component analyses, reliability tests, paired samplettests and three-way ANOVA. The results indicate a significant positive development concerning external job performance in the intervention groups. Regarding internal job performance, both the Norwegian intervention group and the reference group showed positive improvements. However, there were negative or nonsignificant developments for several of the psychosocial working conditions and health outcomes in the intervention groups. With regard to associations and interactions between the studied variables, there were significantly positive developments with regard to external job performance and sickness absences in the total intervention group. The study indicates that more thorough procedures and testing of leader-based interventions in SSEs are required.

Purpose: This aim of this study was to explore how hospital-based physicians in Sweden experienced the challenges in working conditions related to the provision of care during the initial response to the COVID-19 pandemic in 2020 when hospitals transitioned to pandemic care. Design/methodology/approach: The study has a qualitative design. Twenty-five hospital-based physicians were interviewed about their experiences from working in a hospital while healthcare organisations initially responded to COVID-19 pandemic in 2020. A thematic analysis was used to analyse the empirical material. Findings: The analysis resulted in four themes: involuntary self-management, a self-restrictive bureaucracy, passive occupational safety and health (OSH) management, and information overload. These themes reflect how the physicians perceived their work situation during the pandemic and how they tried to maintain quality care for their patients. Practical implications: The study gives valuable insights for formulating preparedness in regard to crisis management plans that can secure the provision of care for future emergencies in the healthcare services. Originality/value: This paper shows that a crisis management plans in the healthcare services should include decision structures and management, measures of risk assessment and OSH management, and the maintenance of personnel wellbeing. A prepared healthcare management can preserve quality care delivery while under crisis.

Purpose This aim of this study was to explore how hospital-based physicians in Sweden experienced the challenges in working conditions related to the provision of care during the initial response to the COVID-19 pandemic in 2020 when hospitals transitioned to pandemic care. Design/methodology/approach The study has a qualitative design. Twenty-five hospital-based physicians were interviewed about their experiences from working in a hospital while healthcare organisations initially responded to COVID-19 pandemic in 2020. A thematic analysis was used to analyse the empirical material. Findings The analysis resulted in four themes: involuntary self-management, a self-restrictive bureaucracy, passive occupational safety and health (OSH) management, and information overload. These themes reflect how the physicians perceived their work situation during the pandemic and how they tried to maintain quality care for their patients. Practical implications The study gives valuable insights for formulating preparedness in regard to crisis management plans that can secure the provision of care for future emergencies in the healthcare services. Originality/value This paper shows that a crisis management plans in the healthcare services should include decision structures and management, measures of risk assessment and OSH management, and the maintenance of personnel wellbeing. A prepared healthcare management can preserve quality care delivery while under crisis.

AbstractThe aim of the study is to describe and compare the health care, social security and rehabilitation systems in Singapore and Sweden. Two fundamental differences can be identified. First, the system in Singapore are strongly oriented towards a free market system, while Sweden's demonstrates strong public control. Second, following from how the systems are oriented, Singaporeans are expected to have a higher degree of independence and control over their health care, social security and rehabilitation. It appears that Singapore has had greater success in attaining and maintaining a system of health promotion, which influences the three systems. However, the Swedish welfare system provides greater security to those who are in need of health care, social security and rehabilitation.