Comparing the new interdisciplinary Health in work intervention to conventional monodisciplinary welfare interventions at Norwegian workplaces: Protocol for a pragmatic cluster-randomized trial (Preprint)

BACKGROUND Musculoskeletal and mental health complaints are the dominant diagnostic categories in long-term sick leave and disability pensions in Norway. Continuing to work despite health complaints is often beneficial, and a good work environment can improve work inclusion for people affected. In 2001, the Norwegian Labour and Welfare Administration (NAV) began to offer inclusive work measures (IWM) to improve the psychosocial work environment, as well as work inclusion of people with health complaints. In 2018, NAV and specialist health services started offering the new collaborative Health in work programme. Its workplace intervention (HIW) presents health- and welfare information that may improve employees´ coping ability regarding common health complaints. It encourages understanding of coworkers´ health complaints and appropriate work adjustments, in order to increase work participation. OBJECTIVE This protocol presents an ongoing, two-arm, pragmatic cluster-randomised trial. Its aim is to compare the effect of monodisciplinary IWM (treatment as usual) and interdisciplinary HIW in terms of changes in overall sickness absence, healthcare utilisation, health-related quality of life, and costs. Secondary objectives are to compare changes in individual sickness absence, psychosocial work environment, job and life satisfaction, health, and health anxiety, both at the individual and the group level. METHODS Data will be collected from national registers, trial-specific registrations and questionnaires. Effects will be explored by difference-in-difference analysis, and regression modelling. Multilevel analysis will visualise any cluster effects by intraclass correlation coefficients. RESULTS Inclusion is completed with 97 workplaces and 1383 individual consents. CONCLUSIONS Data collection will be finished with the last questionnaires to be sent out in July 2023. This trial will contribute to fill knowledge gaps about effectiveness and costs of workplace interventions, thereby benefitting health and welfare services, political decision-makers, and the public and business sectors. CLINICALTRIAL The trial is approved by the Norwegian Regional Committee for Medical and Health Research Ethics and registered in Clinicaltrials.gov (NCT04000035). Findings will be published in reports, peer-reviewed journals and at conferences.

The role of managerial leadership in sickness absence in health and social care: antecedent or moderator in the association between psychosocial working conditions and register-based sickness absence? A longitudinal study based on a swedish cohort

Background The prevalence of sickness absence is particularly high among employees in health and social care, where psychosocial work stressors are pertinent. Managerial leadership is known to affect sickness absence rates, but the role leadership plays in relation to sickness absence is not fully understood; that is, whether poor leadership (i) is associated with sickness absence directly, (ii) is associated with sickness absence indirectly through the establishment of poor psychosocial working conditions, or (iii) whether good leadership rather has a buffering role in the association between work stressors and sickness absence. Methods Four biennial waves from the Swedish Longitudinal Occupational Survey of Health (SLOSH, 2010–2016, N=2333) were used. Autoregressive cross-lagged analyses within a multilevel structural equation modelling (MSEM) framework were conducted to test hypotheses i)–iii), targeting managerial leadership, register-based sickness absence and psychosocial work stressors (high psychological demands, poor decision authority and exposure to workplace violence). Results A direct association was found between poor leadership and sickness absence two years later, but no associations were found between leadership and the psychosocial work stressors. Finally, only in cases of poor leadership was there a statistically significant association between workplace violence and sickness absence. Conclusions Poor managerial leadership may increase the risk of sickness absence among health and social care workers in two ways: first, directly and, second, by increasing the link between workplace violence and sickness absence.

The Paradox of Political Accountability and Deficits in the Preconditions for Service Delivery in Elderly Care: A Qualitative Study of Swedish Politicians

The aims of this qualitative grounded theory study were to explore how politicians accountable for Swedish elderly care viewed their assignment, their beliefs and knowledge regarding the psychosocial work environment for elderly care employees, the factors affecting their work environment, and how these politicians regarded elderly care during the COVID-19 pandemic. This study consisted of 41 interviews with politicians in municipalities across Sweden. Three categories emerged from the analysis: (1) interpretation of the assignment directs the focus; (2) recognizing shortfalls in the employees’ work environment; and (3) exposing deficiencies due to the COVID-19 pandemic. The strongest category was identified as interpretation of the assignment directs the focus and was described as the delivery of good and quality care. Nevertheless, this study highlights shortfalls in the delivery of care services where the employees’ work environment, especially in the home care sector, was frequently described as stressful. The COVID-19 pandemic adversely affected the work situation for staff in elderly care. In that setting, staff shortage and lack of competency were common. Nurses were particularly affected by high workload and responsibility. Further research should explore civil servant roles in the elderly care sector and how these actors view their collaboration with municipality politicians.

An Analysis of the Effects of Psychosocial Work Environment on the Retention Intentions of Primary Care Coordinators Nursing Patients with Chronic Illness

This study aimed to investigate the effects of psychosocial work environment on the retention intentions of care coordinators taking care of patients with chronic illness. A descriptive survey study was conducted with a convenience sample of care coordinators who organized patients and treatment teams that offered professional and persistent treatment. A total of 132 participants were recruited from 19 October to 19 November 2020. The data were analyzed through descriptive statistics, t-tests, ANOVA, Scheffé post hoc, and hierarchical multiple regression using SPSS 26.0. The results showed that work organization and job content (β = 0.254, p = 0.014) and value at the workplace (β = 0.245, p = 0.034) had significant effects on the retention intentions of participants. The final model of the study explained 40.1% of participants’ retention intentions (F = 11.830, p < 0.001). The development of educational programs and implementation of policies for improving the psychosocial work environment were found to be essential for increasing the retention intentions of professional care coordinators.

The Impact of a Workplace Terrorist Attack on the Psychosocial Work Environment: A Longitudinal Study From Pre- to Post-disaster

The psychosocial work environment is of great importance for regaining health and productivity after a workplace disaster. Still, there is a lack of knowledge about the impact of a disaster on the psychosocial work environment. The purpose of this study was to examine whether employees' perceptions of role clarity, role conflicts, and predictability in their work situation changed from before to after a workplace terrorist attack. We combined data from two prospective work environment surveys of employees in three governmental ministries that were the target of the 2011 Oslo terrorist attack. A first two-wave survey was conducted 4–5 years and 2–3 years before the attack, and a second three-wave survey took place 10 months, 2 years, and 3 years after the attack. Of 504 individuals who were employed at the time of the bombing, 220 were employed in both pre- and post-disaster periods, participated in both the first and the second survey, and consented to the linking of data from the two surveys. We found no significant changes in levels of role clarity, role conflict, and predictability from before to after the terrorist attack. Adjusting for sex, age and education had no effect on the results. The findings suggest that perceptions of the psychosocial working environment are likely to be maintained at previous levels in the aftermath of a workplace disaster. Considering the importance of the psychosocial work environment for regaining health and productivity, the findings are important for the preparation for, and management of, future crises.

Influence at Work tied to Materiality in Danish Care Work

Influence at work is known to be an important factor for workers health. Researchers have called for studies on influence at work as a contextualized phenomenon. Based on individual interviews with managers and focus group interviews with employees in three care workplaces, the article shows how the materiality of the work setting ties employees’ influence to perform tasks in both hindering and enabling ways. We show that a work environment where employees’ influence is hindered produces negative experiences in the work environment, while an environment where employees’ influence is enabled produces positive experiences. Additionally, we study how employees influence the material aspects of their workplace.We present a view of influence at work as constituted by materiality and social organization in sociomaterial assemblages. This study reintroduces materiality as a concern in psychosocial work environment research and contributes a sociomaterial view on influence at work and materiality.

Prioritizing Psychosocial Work Environment Factors for Knowledge Workers using Analytic Hierarchy Process (AHP)

Existing literature has acknowledged various factors that influence psychosocial work environment. Nevertheless, these factors need prioritisation so that policymakers and practitioners may design an effective workplace policy. This study prioritises psychosocial work environment factors using the Analytic Hierarchy Process (AHP). Fifty-seven experts from six knowledge-based industries of Pakistan provided their inputs on 36 dimensions grouped in 6 domains. Using the AHP approach, the results suggest that out of six domains, Conflict and Offensive Behaviour is the most critical domain for knowledge workers in Pakistan. Further, this study calculated Global Composite Priority Weight (GCPW) for decision making and indexing purposes for the Psychosocial Work environment. Based on GCPW results, the study suggests that highly prioritised dimensions are conflicts and quarrels, workplace bullying, unpleasant teasing, organisational justice and the threat of violence. This study also finds the traditional well studied factors such as quantitative demands, demands for hiding emotions and emotional demands are relatively least important factors for knowledge workers. The results offer the guidelines for policymakers and organisational behaviour practitioners to devise new workplace policies for knowledge workers at the national and international levels. The prioritised factors give new avenues for academic researchers to investigate further on these factors.