Aim Earlier research has revealed a strong relationship between alcohol use and sickness absence.... more Aim Earlier research has revealed a strong relationship between alcohol use and sickness absence. The aim of this review was to explore and uncover this relationship by looking at differences in type of design (cross-sectional vs. longitudinal), type of data (self-reported vs. registered data), and type of sickness absence (long-term vs. short term). Method Six databases were searched through June 2020. Observational and experimental studies from 1980 to 2020, in English or Scandinavian languages reporting the results of the association between alcohol consumption and sickness absence among working population were included. Quality assessment, and statistical analysis focusing on differences in the likelihood of sickness absence on subgroup levels were performed on each association, not on each study. Differences in the likelihood of sickness absence were analyzed by means of meta-analysis. PROSPERO registration number: CRD42018112078. Results Fifty-nine studies (58% longitudinal) i...
BACKGROUND A health certificate is required to work on the offshore petroleum installations of th... more BACKGROUND A health certificate is required to work on the offshore petroleum installations of the Norwegian Shelf. Loss of health certificate (loss of licence, LOL) may cause economic problems for the individual worker. A private compensation system (OSO) was established for Norwegian offshore workers in 2002, comprising 8000-11,000 individual members of workers organisations: approximately one third of the population offshore. This study aims at describing the reasons for compensation of offshore workers who have lost their certificates. MATERIALS AND METHODS Of 595 workers who applied for compensation in the period 2002-2010, 38 declined to participate in the study. Of the remaining 557, 507 were granted and 50 were denied compensation. All medical records held by the scheme concerning the 507 compensated applicants were examined. Health data were systematically extracted, analysed, and compared with general population statistics. RESULTS Musculoskeletal conditions were the most ...
For alcohol, the association with socioeconomic status (SES) is different than for other public h... more For alcohol, the association with socioeconomic status (SES) is different than for other public health challenges – the associations are complex, and heterogeneous between socioeconomic groups. Specifically, the relationship between alcohol consumption per se and adverse health consequences seems to vary across SES. This observation is called the ‘alcohol harm paradox’. This study aims to describe different patterns of alcohol use and potential problems. Next, the associations between sub-groups characterized by different patterns of alcohol use and potential problems, and age, gender, educational level, full-time employment, occupational level and income is analysed. Employing data from the ongoing cross-sectional WIRUS-study, N = 4311 participants were included in the present study. Individual response patterns of the ten-item Alcohol Use Disorders Identification Test (AUDIT) were analysed and latent class analysis (LCA) was used to identify latent groups. Next, the associations b...
Purpose To explore and synthesize the views of Supported Employment clients, employment specialis... more Purpose To explore and synthesize the views of Supported Employment clients, employment specialists and their supervisors on the core contributions of employment specialists to job support within the mental health field. Methods We systematically searched four databases with no time limitations and identified 16 qualitative studies published between 2006 and 2018 to be included in this meta-ethnographic study. Results The overarching metaphor of “Navigating an Unpredictable Iceberg-laden Sea” (a workplace) and seven themes were revealed: (1) “It’s you and me looking,” which represented the relationship between the client and ES, and (2) taking job seekers’ ambitions and needs seriously, (3) mapping the route, (4) exploring the hidden, (5) being on tap, (6) avoiding crashes, and (7) bridging, which embodied the work of employments specialists. Conclusion. Our iceberg metaphor illustrates the importance of employment specialists being competent in addressing clients’ work performance difficulties related not only to the individual’s illness, age, gender, and cultural-related challenges, but also to psychosocial, behavioral, and environmental workplace factors. Given the effects of the specific characteristics of the working alliance developed in supported employment, we suggest that employment specialists’ training and supervision be enriched by paying more attention to these important relational processes.
International Journal of Public Health and Environmental Research, 2021
Alcohol-related presenteeism (impaired work performance caused by alcohol use) is an important bu... more Alcohol-related presenteeism (impaired work performance caused by alcohol use) is an important but under-researched topic. The aim of this study was to explore whether psychosocial work environment factors were associated with alcohol-related presenteeism. A cross sectional study of Norwegian employees (n = 6620) was conducted. Logistic regression analyses were used for estimating associations with alcohol-related presenteeism, which was reported among 473 (7.1%) of the employees. Adjusted by age, gender, education level and managerial level, higher levels of overcommitment to work were associated with alcohol-related presenteeism. Higher age, male gender and higher education were also associated with alcohol-related presenteeism. Occupational health services and employers should especially focus on overcommitted employees when designing workplace health promotion programs. Modifying attitudes towards alcohol-related presenteeism among overcommitted employees may be of importance fo...
Background: The extent to which eligible individuals in a target population are willing to partic... more Background: The extent to which eligible individuals in a target population are willing to participate in interventions is important when evaluating the efficacy of public health interventions. Objectives: As part of a process evaluation of an ongoing randomized controlled trial, this study aimed to identify the proportion of risky drinkers who were willing to participate in an alcohol prevention intervention in an occupational health setting, and correlates for such willingness. Methods: Risky drinking employees from 22 companies in Norway were identified through an alcohol screening survey. Risky drinkers' (N = 779) willingness to complete a health examination and to be randomized into an alcohol prevention intervention (digital or face-to-face intervention, or control) was recorded by personnel from occupational health services. The proportion of employees who were willing to participate was assessed on 31 potential correlates (sociodemographic, alcohol-related, work-related,...
Objective The Job Demands and Control model classifies job types as active, passive, low-strain o... more Objective The Job Demands and Control model classifies job types as active, passive, low-strain or high-strain, based on a combination of job demands and control. While studies have shown high-strain jobs to have adverse consequences for health and work participation, prognostic factors for the four job types have been less explored. The aim of this study was to assess the associations between sociodemographic factors and job descriptors and being in high-strain, low-strain, active and passive jobs. Methods The WIRUS Screening study targeted Norwegian employees in private and public enterprises. In this study, associations with job types among 4,487 employees were investigated with binary logistic regression analyses, adjusting for sociodemographic and job-related variables. Results In fully adjusted models, high-strain job was associated with female gender; lower education; shift work; and doing work outside the workplace. Low-strain job was associated with opposite scores on the s...
There is ample evidence of associations between a perceived stressful working environment and sev... more There is ample evidence of associations between a perceived stressful working environment and several health-related outcomes. To better understand potential mechanisms behind these observations some studies have focused on the relationship between effort-reward imbalance at work and alcohol consumption. So far, the findings have been inconsistent. One reason for this inconsistency might come from the focus on alcohol consumption per se, while disregarding other aspects such as adverse consequences related to the consumption of alcohol. The aim of the present study was to explore associations between perceived effort and reward, effort-reward imbalance and overcommitment, and alcohol-related problems. Using data from the alcohol screening component in the Norwegian WIRUS-project (N = 5,080), we ascertained the perceived effort, reward, effort-reward imbalance (ERI) and overcommitment using the effort-reward imbalance questionnaire. Alcohol-related problems was determined using a cut...
Background: Use of physical restraint is a common practice in mental healthcare, but is controver... more Background: Use of physical restraint is a common practice in mental healthcare, but is controversial due to risk of physical and psychological harm to patients and creating ethical dilemmas for care providers. Post-incident review (PIR), that involve patient and care providers after restraints, have been deployed to prevent harm and to reduce restraint use. However, this intervention has an unclear scientific knowledge base. Thus, the aim of this scoping review was to explore the current knowledge of PIR and to assess to what extent PIR can minimize restraint-related use and harm, support care providers in handling professional and ethical dilemmas, and improve the quality of care in mental healthcare. Methods: Systematic searches in the MEDLINE, PsychInfo, Cinahl, Sociological Abstracts and Web of Science databases were carried out. The search terms were derived from the population, intervention and settings. Results: Twelve studies were included, six quantitative, four qualitative and two mixed methods. The studies were from Sweden, United Kingdom, Canada and United States. The studies' design and quality varied, and PIR s' were conducted differently. Five studies explored PIR s' as a separate intervention after restraint use, in the other studies, PIR s' were described as one of several components in restraint reduction programs. Outcomes seemed promising, but no significant outcome were related to using PIR alone. Patients and care providers reported PIR to: 1) be an opportunity to review restraint events, they would not have had otherwise, and 2) promote patients' personal recovery processes, and 3) stimulate professional reflection on organizational development and care. Conclusion: Scientific literature directly addressing PIR s' after restraint use is lacking. However, results indicate that PIR may contribute to more professional and ethical practice regarding restraint promotion and the way restraint is executed. The practice of PIR varied, so a specific manual cannot be recommended. More research on PIR use and consequences is needed, especially PIR's potential to contribute to restraint prevention in mental healthcare.
Students’ grades are increasingly important in defining their future employability, and therefore... more Students’ grades are increasingly important in defining their future employability, and therefore, securing a fair assessment of students’ theses is important. This study aimed to assess the level of grade correspondence between internal and external examiners of occupational therapy students’ bachelor theses, and to evaluate the overall level of grades initially set by examiners in the two groups. The grades initially suggested for 67 bachelor theses were analyzed. Absolute agreement between internal and external examiners was estimated as the proportion of theses on which the examiners suggested identical grades (percentage agreement), and consistency in agreement was estimated by the intraclass correlation coefficient (ICC). There was absolute agreement between the internal and the external examiners in 33 of the 67 cases (49.3 %), and also consistency in agreement was high (ICC = 0.81, 95 % CI [0.68, 0.88], p < 0.001). The results from this study demonstrate a high level of a...
Alcohol use is a global health issue and may influence activity performance in a variety of domai... more Alcohol use is a global health issue and may influence activity performance in a variety of domains, including the occupational and domestic spheres. The aim of the study was to examine the influence of annual drinking frequency and binge drinking (≥6 units at one occasion) on activity impairments both at work (sickness presenteeism) and outside the workplace. Employees (n = 3278), recruited from 14 Norwegian private and public companies, responded to a questionnaire containing questions from the Alcohol Use Disorders Identification Test (AUDIT) and the Workplace Productivity and Activity Impairment questionnaire (WPAI). Multiple hierarchical regression analyses revealed that binge drinking was associated with both sickness presenteeism and impaired daily activities, even after controlling for gender, age, educational level, living status and employment sector. Annual drinking frequency was associated with impaired daily activities, but not sickness presenteeism. Binge drinking seem...
Background and objective Despite large activity worldwide in building and implementing new return... more Background and objective Despite large activity worldwide in building and implementing new return-to-work (RTW) services, few studies have focused on how such implementation processes develop. The aim of this study was to examine the development in patient and service characteristics the first six years of implementing a RTW service for persons with acquired brain injury (ABI). Methods The study was designed as a cohort study (n=189). Data were collected by questionnaires, filled out by the service providers. The material was divided into, and analyzed with, two implementation phases. Non-parametrical statistical methods and hierarchical regression analyses were applied on the material. Results The number of patients increased significantly, and the patient group became more homogeneous. Both the duration of the service, and the number of consultations and group session days were significantly reduced. Conclusion The patient group became more homogenous, but also significantly larger during the first six years of building the RTW service. At the same time, the duration of the service decreased. This study therefore questions if there is a lack of consensus on the intensity of work rehabilitation for this group.
Background: Earlier research has revealed risk factors for sick leave in the workplace, and thus ... more Background: Earlier research has revealed risk factors for sick leave in the workplace, and thus the workplace has become an important arena for sick leave prevention and return to work (RTW). Despite that, some of these aspects have received little attention in exploratory studies. Simultaneously, there is a need to translate and implement the growing knowledge base in this field in order to develop evidence-based practice (EBP). Aim: The aim of the present research was to explore some aspects of workplace-based sick leave prevention and RTW, such as workplace interventions (studies III, IV, and the appendix), leadership qualities (study I), and work demands (study II), and also to reveal challenges to translating scientific knowledge into intervention decisions in the RTW process, and possible solutions to these challenges (study III). Material and methods: Content analysis methods were applied on data from interview transcripts and documents. In addition, a Cochrane systematic review of the literature was conducted. Results: Study I identified 78 distinct leadership qualities and seven leadership types (n = 345 meaning units) perceived by 30 employees on long-term sick leave and their immediate supervisors. The three most valued leadership qualities were-ability to make contact‖,-being considerate‖, and-being understanding‖. The three most valued leadership types were the Protector, the Problem-Solver, and the Contact-Maker. The subordinates gave more descriptions of the Encourager and the Recognizer, whereas the supervisors most often described the Responsibility-Maker and the Problem-Solver. The combination of leadership types reported most frequently was the Protector together with the Problem-Solver. In study II, eight employees on long-term sick leave due to musculoskeletal diseases and disorders described 51 work demands they had experienced. The demands were perceived in some cases as having only a negative or a positive impact on work performance, but in others as both. Only seven of the demands were physical in nature, and most involved emotional and cognitive challenges in mastering the work tasks. It was also experienced that most demands came from the employee (n = 36) and only a few from the employer/work environment (n = 7) or both those sources (n = 8). Study III was a hypothetical case study aimed at revealing the challenges associated with translating scientific evidence into intervention decisions in the RTW process. This investigation was performed according to EBP frameworks. The evidence seemed to differ depending on whether it came from preventive, curative, or rehabilitative interventions. Moreover, it appeared that evidence in some cases originated from-good-for-all‖ interventions but in others from-tailored-type‖ interventions. Thus, a need to differentiate the roles of evidence was revealed in terms of whether it inspired, challenged, enlightened, informed, or determined the intervention decision. In general, the evidence-based framework seemed to construct a confined decision process. Possible solutions, and revised EBP steps were suggested. In study IV, 15 workplace interventions were identified (n = 306 meaning units), which were intended to reduce sick leave rates in 12 municipalities. The interventions were divided into two groups according to their targets in the organizations: nine organizational-workplace interventions targeted structures, processes, and culture (n = 220 descriptions, 72%); six employee-workplace interventions targeted persons (n = 86 descriptions, 28%). Examples of organizational-workplace interventions were developing routines/systems, establishing cooperation/ collaboration, providing information/education, building culture/anchoring, and recruiting/staffing. Employee-workplace interventions involved well-being/lifestyle interventions, physical activity/exercise, redeployment, adaptation, follow-up of employees on sick leave, and RTW programmes. The intervention profiles varied considerably between the municipalities. In the appendix (study V), a Cochrane systematic review of the literature was conducted to reveal the content and effectiveness of workplace interventions for employees with neck pain. Of 1,995 references found, 10 randomized controlled trials (RCTs) were included. Two of the RCTs had low risk of bias, and eight of them examined office workers. Few were on sick leave. Only three of the ten studies assessed the outcome of sick leave. The workplace interventions varied considerably regarding complexity and content. Overall, evidence was of low quality and showed no significant impact of workplace interventions on pain reduction (seven RCTs, 2,368 workers). Furthermore, one RCT, with 415 workers revealed that workplace interventions were significantly more effective in reducing sick leave in the intermediate term (OR 0.56, 95% CI 0.33-0.95), but not in the short or the long term. Conclusions: The results reported in this thesis revealed a variety of terminology related to workplace interventions, leadership qualities, and work demands, which might contribute to more in-depth understanding of sick leave prevention and RTW at workplaces. It was a challenge to trying to use evidence from randomized controlled trials in the RTW process, and the results call for new EBP approaches to translate evidence into decisions concerning complex workplace interventions. The current research also revealed that knowledge about the effectiveness of workplace interventions is still limited.
Long-term sickness absence is a considerable health and economic problem in the industrialised wo... more Long-term sickness absence is a considerable health and economic problem in the industrialised world. Factors that might predict RTW are therefore of interest. To examine the impact of psychosocial work characteristics on RTW three months after the end of a RTW programme. A cohort study of 251 sick-listed employees from 40 different treatment and rehabilitation services in Norway recruited from February to December 2012. The Job Content Questionnaire was used to gather information on the psychosocial work conditions. Full or partial RTW was measured three months after the end of the RTW programme, using data from the national sickness absence register. Logistic regression analyses were performed to investigate the association between the psychosocial work characteristics and RTW. Having low psychological job demands (OR = 0.4, 95% CI: 0.2-0.9), high co-worker- (OR = 3.4, 95% CI: 1.5-5.8), and supervisor support (OR = 3.4, 95% CI: 1.6-7.3), and being in a low-strain job (low job dema...
International Journal of Disability Management, 2009
Aim: The aim of this study was to provide new insight into the factors that affect work participa... more Aim: The aim of this study was to provide new insight into the factors that affect work participation by those with cognitive deficits following an acquired brain injury. Method: The study had a qualitative exploratory design, with three focus-group interviews used to collect data. The first group comprised workers with experience of cognitive deficits after a traumatic brain injury (TBI), anoxic brain damage and stroke, the second group professionals from specialist levels of social security service and the third professionals from specialised health care services. Transcribed interviews were analysed using a conventional approach to content analysis. Major findings: A broad range of factors affected work participation. Personal factors, the psychosocial adaptation process, injury-related consequences as well as factors in the working environment were found to inhibit work participation. Acceptance of a different level of functioning and a new role in working life was an important ...
Virkemidler fra nasjonalt nivå til ledernivå i oppfølging av sykemeldte I '', som ble ive... more Virkemidler fra nasjonalt nivå til ledernivå i oppfølging av sykemeldte I '', som ble iverksatt i Norge høsten 2001, er arbeidsplassen blitt den viktigste arena for å nå avtalens mål; å redusere sykefraværet, å inkludere flere arbeidstakere med redusert funksjonsevne og å øke reell pensjoneringsalder. Konsistens og sammenheng mellom bruk av virkemidler på ulike nivåer er en vesentlig forutsetning dersom avtalen skal hindre utstøting fra arbeidslivet. Artikkelens tema er en vurdering av avtalens virkemidler på nasjonalt nivå, på virksomhetsnivå og lederes erfaringer medett av virkemidlene, 'Dialogen om sykefravær'.
Aim Earlier research has revealed a strong relationship between alcohol use and sickness absence.... more Aim Earlier research has revealed a strong relationship between alcohol use and sickness absence. The aim of this review was to explore and uncover this relationship by looking at differences in type of design (cross-sectional vs. longitudinal), type of data (self-reported vs. registered data), and type of sickness absence (long-term vs. short term). Method Six databases were searched through June 2020. Observational and experimental studies from 1980 to 2020, in English or Scandinavian languages reporting the results of the association between alcohol consumption and sickness absence among working population were included. Quality assessment, and statistical analysis focusing on differences in the likelihood of sickness absence on subgroup levels were performed on each association, not on each study. Differences in the likelihood of sickness absence were analyzed by means of meta-analysis. PROSPERO registration number: CRD42018112078. Results Fifty-nine studies (58% longitudinal) i...
BACKGROUND A health certificate is required to work on the offshore petroleum installations of th... more BACKGROUND A health certificate is required to work on the offshore petroleum installations of the Norwegian Shelf. Loss of health certificate (loss of licence, LOL) may cause economic problems for the individual worker. A private compensation system (OSO) was established for Norwegian offshore workers in 2002, comprising 8000-11,000 individual members of workers organisations: approximately one third of the population offshore. This study aims at describing the reasons for compensation of offshore workers who have lost their certificates. MATERIALS AND METHODS Of 595 workers who applied for compensation in the period 2002-2010, 38 declined to participate in the study. Of the remaining 557, 507 were granted and 50 were denied compensation. All medical records held by the scheme concerning the 507 compensated applicants were examined. Health data were systematically extracted, analysed, and compared with general population statistics. RESULTS Musculoskeletal conditions were the most ...
For alcohol, the association with socioeconomic status (SES) is different than for other public h... more For alcohol, the association with socioeconomic status (SES) is different than for other public health challenges – the associations are complex, and heterogeneous between socioeconomic groups. Specifically, the relationship between alcohol consumption per se and adverse health consequences seems to vary across SES. This observation is called the ‘alcohol harm paradox’. This study aims to describe different patterns of alcohol use and potential problems. Next, the associations between sub-groups characterized by different patterns of alcohol use and potential problems, and age, gender, educational level, full-time employment, occupational level and income is analysed. Employing data from the ongoing cross-sectional WIRUS-study, N = 4311 participants were included in the present study. Individual response patterns of the ten-item Alcohol Use Disorders Identification Test (AUDIT) were analysed and latent class analysis (LCA) was used to identify latent groups. Next, the associations b...
Purpose To explore and synthesize the views of Supported Employment clients, employment specialis... more Purpose To explore and synthesize the views of Supported Employment clients, employment specialists and their supervisors on the core contributions of employment specialists to job support within the mental health field. Methods We systematically searched four databases with no time limitations and identified 16 qualitative studies published between 2006 and 2018 to be included in this meta-ethnographic study. Results The overarching metaphor of “Navigating an Unpredictable Iceberg-laden Sea” (a workplace) and seven themes were revealed: (1) “It’s you and me looking,” which represented the relationship between the client and ES, and (2) taking job seekers’ ambitions and needs seriously, (3) mapping the route, (4) exploring the hidden, (5) being on tap, (6) avoiding crashes, and (7) bridging, which embodied the work of employments specialists. Conclusion. Our iceberg metaphor illustrates the importance of employment specialists being competent in addressing clients’ work performance difficulties related not only to the individual’s illness, age, gender, and cultural-related challenges, but also to psychosocial, behavioral, and environmental workplace factors. Given the effects of the specific characteristics of the working alliance developed in supported employment, we suggest that employment specialists’ training and supervision be enriched by paying more attention to these important relational processes.
International Journal of Public Health and Environmental Research, 2021
Alcohol-related presenteeism (impaired work performance caused by alcohol use) is an important bu... more Alcohol-related presenteeism (impaired work performance caused by alcohol use) is an important but under-researched topic. The aim of this study was to explore whether psychosocial work environment factors were associated with alcohol-related presenteeism. A cross sectional study of Norwegian employees (n = 6620) was conducted. Logistic regression analyses were used for estimating associations with alcohol-related presenteeism, which was reported among 473 (7.1%) of the employees. Adjusted by age, gender, education level and managerial level, higher levels of overcommitment to work were associated with alcohol-related presenteeism. Higher age, male gender and higher education were also associated with alcohol-related presenteeism. Occupational health services and employers should especially focus on overcommitted employees when designing workplace health promotion programs. Modifying attitudes towards alcohol-related presenteeism among overcommitted employees may be of importance fo...
Background: The extent to which eligible individuals in a target population are willing to partic... more Background: The extent to which eligible individuals in a target population are willing to participate in interventions is important when evaluating the efficacy of public health interventions. Objectives: As part of a process evaluation of an ongoing randomized controlled trial, this study aimed to identify the proportion of risky drinkers who were willing to participate in an alcohol prevention intervention in an occupational health setting, and correlates for such willingness. Methods: Risky drinking employees from 22 companies in Norway were identified through an alcohol screening survey. Risky drinkers' (N = 779) willingness to complete a health examination and to be randomized into an alcohol prevention intervention (digital or face-to-face intervention, or control) was recorded by personnel from occupational health services. The proportion of employees who were willing to participate was assessed on 31 potential correlates (sociodemographic, alcohol-related, work-related,...
Objective The Job Demands and Control model classifies job types as active, passive, low-strain o... more Objective The Job Demands and Control model classifies job types as active, passive, low-strain or high-strain, based on a combination of job demands and control. While studies have shown high-strain jobs to have adverse consequences for health and work participation, prognostic factors for the four job types have been less explored. The aim of this study was to assess the associations between sociodemographic factors and job descriptors and being in high-strain, low-strain, active and passive jobs. Methods The WIRUS Screening study targeted Norwegian employees in private and public enterprises. In this study, associations with job types among 4,487 employees were investigated with binary logistic regression analyses, adjusting for sociodemographic and job-related variables. Results In fully adjusted models, high-strain job was associated with female gender; lower education; shift work; and doing work outside the workplace. Low-strain job was associated with opposite scores on the s...
There is ample evidence of associations between a perceived stressful working environment and sev... more There is ample evidence of associations between a perceived stressful working environment and several health-related outcomes. To better understand potential mechanisms behind these observations some studies have focused on the relationship between effort-reward imbalance at work and alcohol consumption. So far, the findings have been inconsistent. One reason for this inconsistency might come from the focus on alcohol consumption per se, while disregarding other aspects such as adverse consequences related to the consumption of alcohol. The aim of the present study was to explore associations between perceived effort and reward, effort-reward imbalance and overcommitment, and alcohol-related problems. Using data from the alcohol screening component in the Norwegian WIRUS-project (N = 5,080), we ascertained the perceived effort, reward, effort-reward imbalance (ERI) and overcommitment using the effort-reward imbalance questionnaire. Alcohol-related problems was determined using a cut...
Background: Use of physical restraint is a common practice in mental healthcare, but is controver... more Background: Use of physical restraint is a common practice in mental healthcare, but is controversial due to risk of physical and psychological harm to patients and creating ethical dilemmas for care providers. Post-incident review (PIR), that involve patient and care providers after restraints, have been deployed to prevent harm and to reduce restraint use. However, this intervention has an unclear scientific knowledge base. Thus, the aim of this scoping review was to explore the current knowledge of PIR and to assess to what extent PIR can minimize restraint-related use and harm, support care providers in handling professional and ethical dilemmas, and improve the quality of care in mental healthcare. Methods: Systematic searches in the MEDLINE, PsychInfo, Cinahl, Sociological Abstracts and Web of Science databases were carried out. The search terms were derived from the population, intervention and settings. Results: Twelve studies were included, six quantitative, four qualitative and two mixed methods. The studies were from Sweden, United Kingdom, Canada and United States. The studies' design and quality varied, and PIR s' were conducted differently. Five studies explored PIR s' as a separate intervention after restraint use, in the other studies, PIR s' were described as one of several components in restraint reduction programs. Outcomes seemed promising, but no significant outcome were related to using PIR alone. Patients and care providers reported PIR to: 1) be an opportunity to review restraint events, they would not have had otherwise, and 2) promote patients' personal recovery processes, and 3) stimulate professional reflection on organizational development and care. Conclusion: Scientific literature directly addressing PIR s' after restraint use is lacking. However, results indicate that PIR may contribute to more professional and ethical practice regarding restraint promotion and the way restraint is executed. The practice of PIR varied, so a specific manual cannot be recommended. More research on PIR use and consequences is needed, especially PIR's potential to contribute to restraint prevention in mental healthcare.
Students’ grades are increasingly important in defining their future employability, and therefore... more Students’ grades are increasingly important in defining their future employability, and therefore, securing a fair assessment of students’ theses is important. This study aimed to assess the level of grade correspondence between internal and external examiners of occupational therapy students’ bachelor theses, and to evaluate the overall level of grades initially set by examiners in the two groups. The grades initially suggested for 67 bachelor theses were analyzed. Absolute agreement between internal and external examiners was estimated as the proportion of theses on which the examiners suggested identical grades (percentage agreement), and consistency in agreement was estimated by the intraclass correlation coefficient (ICC). There was absolute agreement between the internal and the external examiners in 33 of the 67 cases (49.3 %), and also consistency in agreement was high (ICC = 0.81, 95 % CI [0.68, 0.88], p < 0.001). The results from this study demonstrate a high level of a...
Alcohol use is a global health issue and may influence activity performance in a variety of domai... more Alcohol use is a global health issue and may influence activity performance in a variety of domains, including the occupational and domestic spheres. The aim of the study was to examine the influence of annual drinking frequency and binge drinking (≥6 units at one occasion) on activity impairments both at work (sickness presenteeism) and outside the workplace. Employees (n = 3278), recruited from 14 Norwegian private and public companies, responded to a questionnaire containing questions from the Alcohol Use Disorders Identification Test (AUDIT) and the Workplace Productivity and Activity Impairment questionnaire (WPAI). Multiple hierarchical regression analyses revealed that binge drinking was associated with both sickness presenteeism and impaired daily activities, even after controlling for gender, age, educational level, living status and employment sector. Annual drinking frequency was associated with impaired daily activities, but not sickness presenteeism. Binge drinking seem...
Background and objective Despite large activity worldwide in building and implementing new return... more Background and objective Despite large activity worldwide in building and implementing new return-to-work (RTW) services, few studies have focused on how such implementation processes develop. The aim of this study was to examine the development in patient and service characteristics the first six years of implementing a RTW service for persons with acquired brain injury (ABI). Methods The study was designed as a cohort study (n=189). Data were collected by questionnaires, filled out by the service providers. The material was divided into, and analyzed with, two implementation phases. Non-parametrical statistical methods and hierarchical regression analyses were applied on the material. Results The number of patients increased significantly, and the patient group became more homogeneous. Both the duration of the service, and the number of consultations and group session days were significantly reduced. Conclusion The patient group became more homogenous, but also significantly larger during the first six years of building the RTW service. At the same time, the duration of the service decreased. This study therefore questions if there is a lack of consensus on the intensity of work rehabilitation for this group.
Background: Earlier research has revealed risk factors for sick leave in the workplace, and thus ... more Background: Earlier research has revealed risk factors for sick leave in the workplace, and thus the workplace has become an important arena for sick leave prevention and return to work (RTW). Despite that, some of these aspects have received little attention in exploratory studies. Simultaneously, there is a need to translate and implement the growing knowledge base in this field in order to develop evidence-based practice (EBP). Aim: The aim of the present research was to explore some aspects of workplace-based sick leave prevention and RTW, such as workplace interventions (studies III, IV, and the appendix), leadership qualities (study I), and work demands (study II), and also to reveal challenges to translating scientific knowledge into intervention decisions in the RTW process, and possible solutions to these challenges (study III). Material and methods: Content analysis methods were applied on data from interview transcripts and documents. In addition, a Cochrane systematic review of the literature was conducted. Results: Study I identified 78 distinct leadership qualities and seven leadership types (n = 345 meaning units) perceived by 30 employees on long-term sick leave and their immediate supervisors. The three most valued leadership qualities were-ability to make contact‖,-being considerate‖, and-being understanding‖. The three most valued leadership types were the Protector, the Problem-Solver, and the Contact-Maker. The subordinates gave more descriptions of the Encourager and the Recognizer, whereas the supervisors most often described the Responsibility-Maker and the Problem-Solver. The combination of leadership types reported most frequently was the Protector together with the Problem-Solver. In study II, eight employees on long-term sick leave due to musculoskeletal diseases and disorders described 51 work demands they had experienced. The demands were perceived in some cases as having only a negative or a positive impact on work performance, but in others as both. Only seven of the demands were physical in nature, and most involved emotional and cognitive challenges in mastering the work tasks. It was also experienced that most demands came from the employee (n = 36) and only a few from the employer/work environment (n = 7) or both those sources (n = 8). Study III was a hypothetical case study aimed at revealing the challenges associated with translating scientific evidence into intervention decisions in the RTW process. This investigation was performed according to EBP frameworks. The evidence seemed to differ depending on whether it came from preventive, curative, or rehabilitative interventions. Moreover, it appeared that evidence in some cases originated from-good-for-all‖ interventions but in others from-tailored-type‖ interventions. Thus, a need to differentiate the roles of evidence was revealed in terms of whether it inspired, challenged, enlightened, informed, or determined the intervention decision. In general, the evidence-based framework seemed to construct a confined decision process. Possible solutions, and revised EBP steps were suggested. In study IV, 15 workplace interventions were identified (n = 306 meaning units), which were intended to reduce sick leave rates in 12 municipalities. The interventions were divided into two groups according to their targets in the organizations: nine organizational-workplace interventions targeted structures, processes, and culture (n = 220 descriptions, 72%); six employee-workplace interventions targeted persons (n = 86 descriptions, 28%). Examples of organizational-workplace interventions were developing routines/systems, establishing cooperation/ collaboration, providing information/education, building culture/anchoring, and recruiting/staffing. Employee-workplace interventions involved well-being/lifestyle interventions, physical activity/exercise, redeployment, adaptation, follow-up of employees on sick leave, and RTW programmes. The intervention profiles varied considerably between the municipalities. In the appendix (study V), a Cochrane systematic review of the literature was conducted to reveal the content and effectiveness of workplace interventions for employees with neck pain. Of 1,995 references found, 10 randomized controlled trials (RCTs) were included. Two of the RCTs had low risk of bias, and eight of them examined office workers. Few were on sick leave. Only three of the ten studies assessed the outcome of sick leave. The workplace interventions varied considerably regarding complexity and content. Overall, evidence was of low quality and showed no significant impact of workplace interventions on pain reduction (seven RCTs, 2,368 workers). Furthermore, one RCT, with 415 workers revealed that workplace interventions were significantly more effective in reducing sick leave in the intermediate term (OR 0.56, 95% CI 0.33-0.95), but not in the short or the long term. Conclusions: The results reported in this thesis revealed a variety of terminology related to workplace interventions, leadership qualities, and work demands, which might contribute to more in-depth understanding of sick leave prevention and RTW at workplaces. It was a challenge to trying to use evidence from randomized controlled trials in the RTW process, and the results call for new EBP approaches to translate evidence into decisions concerning complex workplace interventions. The current research also revealed that knowledge about the effectiveness of workplace interventions is still limited.
Long-term sickness absence is a considerable health and economic problem in the industrialised wo... more Long-term sickness absence is a considerable health and economic problem in the industrialised world. Factors that might predict RTW are therefore of interest. To examine the impact of psychosocial work characteristics on RTW three months after the end of a RTW programme. A cohort study of 251 sick-listed employees from 40 different treatment and rehabilitation services in Norway recruited from February to December 2012. The Job Content Questionnaire was used to gather information on the psychosocial work conditions. Full or partial RTW was measured three months after the end of the RTW programme, using data from the national sickness absence register. Logistic regression analyses were performed to investigate the association between the psychosocial work characteristics and RTW. Having low psychological job demands (OR = 0.4, 95% CI: 0.2-0.9), high co-worker- (OR = 3.4, 95% CI: 1.5-5.8), and supervisor support (OR = 3.4, 95% CI: 1.6-7.3), and being in a low-strain job (low job dema...
International Journal of Disability Management, 2009
Aim: The aim of this study was to provide new insight into the factors that affect work participa... more Aim: The aim of this study was to provide new insight into the factors that affect work participation by those with cognitive deficits following an acquired brain injury. Method: The study had a qualitative exploratory design, with three focus-group interviews used to collect data. The first group comprised workers with experience of cognitive deficits after a traumatic brain injury (TBI), anoxic brain damage and stroke, the second group professionals from specialist levels of social security service and the third professionals from specialised health care services. Transcribed interviews were analysed using a conventional approach to content analysis. Major findings: A broad range of factors affected work participation. Personal factors, the psychosocial adaptation process, injury-related consequences as well as factors in the working environment were found to inhibit work participation. Acceptance of a different level of functioning and a new role in working life was an important ...
Virkemidler fra nasjonalt nivå til ledernivå i oppfølging av sykemeldte I '', som ble ive... more Virkemidler fra nasjonalt nivå til ledernivå i oppfølging av sykemeldte I '', som ble iverksatt i Norge høsten 2001, er arbeidsplassen blitt den viktigste arena for å nå avtalens mål; å redusere sykefraværet, å inkludere flere arbeidstakere med redusert funksjonsevne og å øke reell pensjoneringsalder. Konsistens og sammenheng mellom bruk av virkemidler på ulike nivåer er en vesentlig forutsetning dersom avtalen skal hindre utstøting fra arbeidslivet. Artikkelens tema er en vurdering av avtalens virkemidler på nasjonalt nivå, på virksomhetsnivå og lederes erfaringer medett av virkemidlene, 'Dialogen om sykefravær'.
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