Presented diploma theses evaluates the sickness insurance system in the Czech Republic and Europe from the point of view of the Czech Republic citizens. The aim of the work is to analyze the sickness insurance system in the Czech Republic regarding the system changes and also to find out the reform impacts on insured. Simultaneously the aim is to compare the impacts of the Czech insured with the impacts on those migratory workers who draw a claim to the insurance benefit from foreign systems of Europe. The theory of the social capital focused on the social policy and the social security and its legitimacy, theory of the inequality and poverty, the theory of the human capital and the theory of the bureaucracy were the basis of this work. In order to acquire the objective data at first it was made the comparative analysis of the chosen sickness insurance systems in Europe. Other part of this work is focused on the reform of the sickness insurance system in the Czech Republic and it analyses and compares some chosen indicators of the system focusing the years 2008 and 2009. The first half of the empirical part of the work is made on the basis of the qualitative research and it shows the impacts of the reform on the employees, presents their attitudes, their impressions and their opinions on contemporary shape...

Den här studien undersöker i vilken grad 360° video betraktad i en HMD kan ha för livskvalitetshöjande effekt på boende inom äldreomsorgen i Malmö. Ensamhet och depression är ett av de vanligaste hälsoproblemen bland personer över 65 år idag. En av anledningarna till detta är fysiska och psykiska hinder som minskar möjligheterna för dem att kontinuerligt delta i sociala sammanhang och få ett miljöbyte. Med 360° video kan vad som helst upplevas och med en HMD kan känslan av att vara närvarande på platsen förstärkas. Med hjälp av denna teknik har ett prototyptest utförts på 2 olika äldreboende i Malmö där 9 stycken deltagare har fått testa att betrakta 360° video i en HMD, i form av olika utflyktsmål i Malmö som har skapats som prototyp i denna studie. Utifrån observationer, ”think-aloud”-tekniken och enkätsvar har slutsatserna kunnat dras att prototyptestet behöver göras under en längre period för att påvisa ett säkert resultat om vilken livshöjande effekt 360° video kan ha på de boende. Resultatet av testet kunde även påvisa en ökad positivitet om deltagarna fick se en plats de besökt tidigare. / This study examines the degree to which 360 ° video viewed in an HMD can have a life-quality enhancing effect on residents of elderly care in Malmö. Loneliness and depression are one of the most common health problems today among people with an age over 65. One of the reasons for this is physical and mental barriers that reduces the opportunities for them to continuously participate in social contexts and get an environmental change. With 360° video, anything can be experienced and with an HMD the feeling of being present on the site can be enhanced. With the help of this technique, a prototype test has been performed on 2 different retirement homes in Malmö where 9 participants have been tested to view 360° video in an HMD, in the form of various excursion destinations in Malmö that have been created as a prototype in this study. Based on observations, think-aloud technology and questionnaire responses, the conclusions have been drawn that the test needs to be done for a longer period to be able to demonstrate a safe result on which life-enhancing effect 360° video can have on the residents. The result of the test could also show an increased positivity if the participants saw a place they visited in the past.

Försäkringskassan (FK) har i uppdrag av Sveriges regering att ge ekonomisk ersättning vid funktionsnedsättning och att utreda medicinska förutsättningar för arbete med tillförlitliga bedömningsverktyg. Vid kompletterande bedömning av medicinska förutsättningar för arbete har Försäkringskassan valt det arbetsterapeutiska bedömningsinstrumentet Assessment of Work Performance som en del av aktivitetsförmågeutredningen. En specifik tillämpning med namnet Assessment of Work Performance – Försäkringskassan (AWP-FK) har utvecklats. I tillämpningen ingår tre arbetsuppgifter; namnskyltsbeställning, sortering av post samt montering av hyllor. Syftet med examensarbetet var att undersöka hur yrkesverksamma arbetsterapeuter uppfattar och använder bedömningsinstrumentet AWP-FK. Metoden som valdes var en e-Delphistudie. Urvalet bestod av 11 yrkesverksamma arbetsterapeuter i Sverige som har arbetat med AWP-FK. Resultatet visar att arbetsterapeuterna tyckte att manualen var tydlig. Färdighetsområdet kommunikations- och interaktionsfärdigheter ansåg arbetsterapeuterna var svårt att bedöma med dagens arbetsuppgifter. Slutsatsen blev att det finns utvecklingsmöjligheter för AWP-FK vad gäller manualen, kommunikations- och interaktionsfärdigheter samt utveckling av nya arbetsuppgifter. I diskussionen diskuteras metodens tillförlitlighet och dess begränsningar. Metoden var fördelaktig eftersom svaren från runda ett gick att följa upp genom en konsensusberäkning. Slutsatsen blir att det är svårt att bedöma kommunikations- och interaktionsfärdigheter. Vidare diskuteras att det behövs fler arbetsuppgifter som bedömer kommunikations- och interaktionsfärdigheter samt att detta färdighetsområde bör utvecklas.

Det här projektet handlar om en frisk vård i en sjuk miljö. Jag tar in naturen till sjukhuset för att få patienter att känna sig mer inbjudna, trygga och avslappnade. Mitt arbetsområde har varit patientens privata sfär kring sängen. / This project is dealing with human care in a sick environment. I bring nature into the hospital to make patients feel more invited, secure and relaxed. My work area has been patients’ private sphere around the bed, which has resulted in two patterns for drapes.

Bakgrund: Sjukfrånvaron är ett fenomen som snabbt ökar i Sverige idag. Detta är något som kostar stora summor pengar varje år men trots detta finns relativt lite forskning på området. Den forskning som finns i området undersöker till stor del endast den långvariga sjukfrånvaron. Författarna av denna studie har tydligt identifierat en lucka i forskningen vad gäller kortvarig sjukfrånvaro. Syfte: Denna studie syftar därmed att undersöka storleken på avdelningen samt chefens kommunikation och interaktions påverkan på kortvarig sjukfrånvaro. Resultat: Undersökningen resultat är sammanställt ur dels en enkät som de anställda på tre avdelningar inom ett internationellt produktionsföretag fått besvara och dels tre intervjuer genomförda med en HR-chef och två chefer över avdelningarna. Resultatet blev att fem kategorikoder identifierades; Avdelningens storlek, Chefens kommunikation och interaktion, Frånvarokultur, Arbetsuppgifter och Hälsoarbete. Slutsats: Den främsta slutsats som denna undersökning resulterat i är att storleken på avdelningen påverkar de anställdas möjlighet snarare än deras tendens till att vara kortvarigt sjukfrånvarande. Den faktor som istället anses påverka den kortvariga sjukfrånvaron är hur chefen kommunicerar och integrerar med de anställda. Fokus bör därmed läggas vid denna faktor i försök att antingen minska eller kontrollera den kortvariga sjukfrånvaron på avdelningen / Background: Sickness absence is a phenomenon on a rise in todays Sweden. This is costing large sums of money every year, but despite this, there is relatively little research in the field. The current research has its focus, for the most part, on long-term sickness absence. The authors behind this study have therefore identified a clear gap of research regarding the shortterm sickness absence. Aim: With this study, the aim is therefore to examine the size of the workplace along with the managers communication and interactions effect on the short-term sickness absence. Results: The results of the study are produced through a survey to the employees of three departments within a international production company and through three interviews performed with a HR-manager and two managers over the departments. The study resulted in the identification of five category codes; The size of the department, The managers communication and interaction, Absence culture, Assignments and Health. Conclusion: The primary conclusion that this study result in is that the size of the workplace affect the employees possibilities rather than affecting their tendency to have short-term sickness absence. The factor which instead is considered to affect the short-term sickness absence is how the manager communicates and integrates with the employees. Therefore, the focus should be aimed at this factor in attempts to either decrease or control the short-term sickness absence at the workplace.

Thesis (MBA (Business Management))--University of Stellenbosch, 2007. / ENGLISH ABSTRACT: The main objective of the study is to examine the components required for the successful implementation of Sickness Absence Management. Although there are various approaches to the management of absence the focus of this study is the implementation of policies which is the most frequently used approach. Sickness Absence Management represents the strategy of the organisation to enhance the performance of human capital by ensuring that employees that are not truly sick, are present at work. The importance of Sickness Absence Management is highly recognised, but few employers record and measure absence. Reasons for this include the complexity of the factors that influence absence and the lack of resources to record absence data, and to calculate and interpret absence indicators and costs. Frustrations from the study include the non-standardisation of absence terminology, and the lack of data on absence statistics. Sickness Absence Management is complicated by the behaviour of people. Absence trends indicate that abuse of sickness absence amounts to an average of 33% of sickness absence and that absence rates are higher in the public than in the private sector. Success factors for Sickness Absence Management include clear, consistent and well-communicated policies and effective information systems with the required functionalities to record absence data and to enable the tracking of absence indicators. Top management commitment transpired as the factor with the biggest influence on the success of Sickness Absence Management. Research indicated that it was better to have a policy than to have no policy at all. The quality of the policy depends on the involvement of employees and the consistent application by supervisors/managers. Furthermore, an effective computer-based information system is crucial for the management of absence. The system should have the required functionalities to enable administration and decision-making on absence issues. A strategy is necessary to set objectives and targets, and communicate commitment from top management. A strategy is also required to ensure the allocation of resources to HR for the Sickness Absence Management. / AFRIKAANSE OPSOMMING: Die vernaamste doelwit van hierdie studie is om die komponente te ondersoek wat nodig is vir die suksesvolle implementering van Siekverlofbestuur. Hoewel daar verskeie benaderings tot die bestuur van siekverlof is, is hierdie studie gerig op beleid wat as die voorkeurbenadering vir die bestuur van siekverlof beskou word. Siekverlofbestuur is die strategie van ’n onderneming om die prestasie van mensekapitaal te versterk deur te verseker dat die personeel wat nie werklik siek is nie, teenwoordig is by die werk. Die belangrikheid van Siekverlofbestuur word hoog aangeskryf, maar min werkgewers teken siekverlof aan of meet dit. Redes hiervoor sluit in die kompleksiteit van die faktore wat siekverlof beïnvloed en die gebrek aan hulpbronne vir die aantekening van siekverlofdata, en die berekening en interpretasie van siekverlofaanduiders en -koste. Frustrasies uit die studie sluit in die nie-standaardisering van siekverlof terminologie en die gebrek aan siekverlof statistiek. Siekverlofbestuur word gekompliseer deur die gedrag van mense. Siekverlof tendense toon aan dat die misbruik van siekverlof gemiddeld 33% van siekte-afwesigheid uitmaak en dat siekverlofkoerse hoër in die openbare as in die private sektor is. Suksesfaktore vir Siekverlofbestuur sluit in duidelike en konsekwente beleid wat behoorlik gekommunikeer word, en doeltreffende inligtingstelsels met die nodige funksionaliteit om siekverlofdata vas te lê en siekverlof aanwysers na te volg. Die verbintenis van topbestuur het na vore gekom as die faktor met die grootste invloed op die sukses van Siekverlofbestuur. Navorsing dui daarop dat dit beter is om 'n beleid te hê as hoegenaamd geen beleid nie. Die gehalte van die beleid hang af van die betrokkenheid van werknemers en die konsekwente toepassing daarvan deur toesighouers/bestuurders. Daarby is 'n doeltreffende rekenaar-gebaseerde inligtingstelsel noodsaaklik vir die bestuur van siekverlof. Die stelsel moet ook die nodige funksionaliteite hê vir administrasie en besluitneming oor siekverlof kwessies. 'n Strategie is nodig om doelwitte en teikens te stel, en om toewyding vanaf topbestuur te kommunikeer. 'n Strategie is ook nodig om die toewysing van hulpbronne vir Siekverlofbestuur na Menslike Hulpbronne te verseker. / cmc2010-1

The ability to work can be reduced if a person has health problems which may lead to periods of sick leave. In Sweden sickness certification is issued by physicians. Many general practitioners (GPs) find sickness certification to be problematic. Some studies indicate that collaboration with other health care professions could be beneficial. The aim of the thesis was to provide knowledge on how the work with the sick leave process in primary health care can be improved and how occupational therapists’ (OT) assessment could be used prior to the decision on sick leave and rehabilitation. Initially seven focus groups were held, four with OTs and three with physicians. The discussions in the focus gropes were analysed by qualitative content analysis. An intervention project was initiated, where four health care centres in northern Sweden tested a working approach where sick listed patients were offered a supplementary assessment of activity and work-related problems by an OT. Data on sick leave, sickness certificates and patient questionnaires were collected from intervention health care centres (IHCC) and other health care centres (OHCC). Interviews were conducted with patients, GPs and OTs. The quality of the information in the collected sickness certificates was evaluated. Average values of sick leave were compared between the IHCCs and the OHCCs in the county. The interviews with sick listed patients were analysed by qualitative content analysis. In order to analyse the implementation of the intervention the Consolidated Framework for Implementation Research, CFIR, was used. An overall theme and four categories emerged from the focus groups. The theme expressed work ability as an obscure, complex and unique concept. The four categories illustrate the affecting factors and confirmed the complex structure of work ability: the person, the context of life, the work, and the society. No significant differences between IHCCs and OHCCs in data on sick leave or the mandatory information in the certificates were found. Thirty-four percent of the collected sickness certificates did not contain all requested information. More certificates issued for women than certificates issued for men lacked the required information. Full-time sick leave was significantly more often prescribed for male patients than for female. Two themes revealed that highlight important areas for persons on sick leave in their healthcare encounters. The theme ‘Trust in the relationship’ contains categories describing the patients’ feelings of participation, being believed, confirmed, and listened to. The second theme ‘Structure and balance’ contains the participants’ views on important factors that could facilitate the return-to-work process such as a structured plan and support to balance activity. The analysis with CFIR clarified that coaching and education for all the users are crucial to get fidelity when new interventions are tested as well as involvement by the clinical department manager. The work with sick leave issues in primary health care can be improved by developing cooperation with several different professionals. To achieve an increased cooperation new working approaches are required. These working approaches must be anchored in management and requires an applied implementation strategy. More focus on the quality of encounters with healthcare professionals can also improve the sick leave process in primary health care centres. The healthcare encounters must build on a mutual trust and sick-listed persons’ return to work can be facilitated by providing a clear structure in the process and support in occupational balance. For issuing sickness certification further education about the descriptions of functioning and the tasks included in the patient’s work is needed. A better gender awareness in the health care encounters is also necessary.

<p>There is no common understanding on what constitutes good sick-listing, a frequent and problematic task for many physicians, especially general practitioners (GPs) and orthopaedic surgeons. Aiming to achieve a deeper understanding of sick-listing practices, 19 GPs (I, III) and 18 orthopaedic surgeons (II) in four counties were interviewed, and data analysed qualitatively for views on good sickness certification and barriers to desired practice. Data from a survey of all 7665 physicians in two counties on emotionally straining problems in sickness certification (IV) was analysed quantitatively. </p><p>Some GPs exposed narrow views of sick-listing, where their responsibility was limited to issuing a certificate, while GPs with the most inclusive view had a perspective of the patient’s total life-situation and aimed to help patients shoulder their own responsibility (I). The orthopaedic surgeons´ perceptions of good sick-listing were mainly related to their views on their role in the health-care system. Some perceived their responsibility as confined to the orthopaedic clinic only, while others had the ultimate goal of helping the patient to become well functioning in life with regained work capacity – by means of surgery <i>and</i> proper management of sick-listing (II). </p><p>Difficulty handling conflicting opinions was a barrier to good sickness certification for GPs (III), and problematic for about 50% of all physicians and about 80% of GPs (IV). Orthopaedic surgeons’ handling of such situations varied from being directed by the patient, via compromising, to being directed by professional judgement (II). Other barriers included poor stakeholder collaboration (III). GPs with a workplace-policy on sickness certification reported fewer conflicts and less worry of getting reported to the disciplinary board in relation to sick-listing (IV).</p><p>Understanding physicians’ underlying views on and barriers to practicing “good sick-listing” can inform efforts to change physician practice. Communications skills training in handling sick-listing situations with conflicting opinions is recommended.</p>

Despite recent research advances, there are still several common medical conditions whose underlying mechanisms are poorly understood. In conditions with few or diffuse physical findings, it can be difficult to diagnose and determine the state of the condition and its effects on working ability or performance, and the health care practitioners have to rely on the patient’s self-reports. Identification of objective measurements that are sensitive enough to aid in diagnosis or determination of the state of these conditions would thus be valuable. Psychophysiological measurements are generally non-invasive and have the potential to serve as such diagnostic or prognostic tools. In this thesis, psychophysiological reactions to different stressors were recorded in two selected medical conditions; namely motion sickness and chronic trapezius myalgia (musculoskeletal pain). These subjective conditions are unpleasant, unwanted and apparently serve no survival purpose. It is therefore important to elucidate any physical findings associated with them to, eventually, find new means to prevent the development of these conditions or to ameliorate symptoms. The overall aim of the thesis was to explore the development of psychophysiological responses to stressors in relation to performance and subjective reports in healthy individuals and in women with chronic trapezius myalgia. More in detail, the purpose was to identify psychophysiological responses that could provide information about the mechanisms behind, or serve as candidates for characterization of motion sickness and chronic trapezius myalgia, respectively. Responses to motion sickness, triggered by optokinetic stimulation, were studied in healthy individuals, whereas responses to repetitive low-force work and psychosocial stress were studied in women with chronic trapezius myalgia and in pain-free controls. In both medical conditions, the psychophysiological responses were accompanied by subjective reports. The effects of motion sickness on two different aspects of memory performance were tested during exposure to optokinetic stimulation. In the studies of chronic trapezius myalgia, psychophysiological responses were also related to health status, i.e., being a patient or a pain-free control and measurements of pain intensity, psychological symptoms, sleep-related problems and quality of life. The psychophysiological responses to optokinetic stimulation were inconclusive. Moderate levels of motion sickness did not affect memory performance, whereas decreased short term memory performance was seen in subjects reporting high levels of motion sickness. The autonomic responses and stress hormone secretion in response to low-force repetitive work and psychosocial stress in the chronic trapezius myalgia group were similar to those of the pain-free controls. However, muscle activity in the trapezius muscle was generally higher in the chronic trapezius myalgia group. There were indications of negative psychological states being related to a slower response and lower circadian variations of stress hormone secretion. With the present methods, it was possible to measure general stress responses but none of the measurements showed sufficient specificity to serve as predictors or indicators of motion sickness and chronic musculoskeletal pain, respectively. Summarizing, I cannot objectively measure how you feel; I still have to rely on your description of your condition.

Titel: Sjukt omhändertagande - en studie om sjukfrånvaron inom den kommunala äldrevården Författare: Tuyet Pham, Hannes Skanung och Ida Söderman Handledare: Kjell Arvidsson Kurs: Företagsekonomi III - organisation, examensarbete (kandidat)   Syfte Vårt syfte med denna uppsats var att undersöka om den generellt höga sjukfrånvaron inom äldrevården i kommunal sektor har en organisatorisk koppling. I samband med uppsatsens syfte ställdes följande forskningsfråga: vilka organisatoriska faktorer bidrar till sjukskrivningarna inom den kommunala äldrevården?   Metod Denna studie är både en kvalitativ och kvantitativ studie som antagit en abduktiv ansats. Studien går under undersökningsdesignen fallstudie där det empiriska materialet består av en enkätundersökning samt kvalitativa intervjuer. I enkätundersökningen deltar 56 medarbetare och på intervjuerna deltar nio anställda på sex avdelningar under tre enheter.   Slutsatser Den empiriska och teoretiska datainsamlingen resulterade i slutsatsen att den generellt höga sjukfrånvaron inom den kommunala äldrevården har en organisatorisk koppling. Organisatoriska faktorer som vi anser påverkar sjukfrånvaron inom den kommunala äldrevården är olika uppfattningar om ansvaret för arbetsuppgifter, låg bemanning, graden av gemenskapen i olika arbetsgrupper och frånvarokultur.  Vi menar även att dessa organisatoriska faktorer påverkas av strukturella faktorer som ligger utanför organisationen. Ett exempel på detta är det långsamma vårdsystemet. / The purpose of this study was to analyze if the sickness absence in the public elderly care is due to organizational elements. This study is based on the research question:   What organizational elements contribute to the sickness absence in the public elderly care?   Method This thesis is based on a qualitative and a quantitative research and presumes an abductive approach. The empirical study consist a survey with 56 employees and interviews with nine employees in six departments within three units.   Results The empirical and theoretical study has contributed with the result that the sickness absence in the public elderly care is due to organizational elements. Organizational elements, which are affecting the sickness absence, are different views on responsibility of work tasks, low staffing, the degree of community in various working groups and absence culture. These organizational elements are also affected by structural elements in the external environment. An example of this is the inertial healthcare system