Syftet med denna studie är att undersöka faktorer kring hög korttidssjukfrånvaro (sjukfrånvaro dag 1-14) på Ekgårdens äldreboende i Vingåkers kommun. Metoderna som använts är granskning av frånvarostatistik, intervjuer med tre chefer och enkätundersökning bland de anställda (n=26). Den undersökta gruppen består nästan uteslutande av kvinnor med relativt låg inkomst och utbildning, faktorer som enligt tidigare forskning sammanfaller med hög sjukfrånvaro. Studien visar även att de anställda i den undersökta gruppen fått erfara täta omorganisationer och chefsbyten samt att de upplever vissa brister i den fysiska arbetsmiljön i form av tunga lyft, fysiskt ansträngande arbete och dålig luft samt i den psykosociala arbetsmiljön i form av höga krav och låg egenkontroll. Dessa faktorer kan vara bidragande orsaker till den höga korttidssjukfrånvaron. / The aim of this study is to investigate factors concerning high levels of short term sick leave (absence day 1-14) at the old people’s home of Ekgården in Vingåker. Methods used include statistics revision, interviews with three managers and questionnaire among employees (n=26). The group of employees consists almost exclusively of women with relatively low salaries and low level of educational attainment, which, according to previous research, coincide with high levels of sickness absence. The study shows that the group of employees during the last couple of years has had to endure quite a few reorganizations and changes in management. They also experience some shortages in their physical work environment like heavy lifting, physical demanding work and poor air ventilation and in their psychosocial work environment with high demands and low self control. These factors might be contributing to high levels of short term sick leave.

Stress and monotonous work contribute substantially to the development of chronic musculoskeletal disorders. Yet, the pathophysiological mechanisms underlying the process, particularly the involvement of autonomic regulation, remain unclear. It has been suggested that altered motor control resulting from distorted sensory information from fatigued muscles may be an important component in the development of musculoskeletal disorders. Animal studies have shown that sympathetic nervous system activation exerts actions in skeletal muscles, such as vasoconstriction and modulation of afferent information from muscle spindles. However, few attempts have been made to address this issue in humans. Therefore, the first aim of the thesis was to investigate the impact of repetitive computer work with and without additional stressors on muscle oxygenation and position sense in the upper extremity. Assuming an important role of stress in the development of chronic musculoskeletal symptoms, one may expect open or latent manifestations of such symptoms in patients with non-specific stress-related illnesses. It is possible that sympathetic activation may influence pain perception, and that treatments aimed at reducing stress may also affect the pain experience. Thus, the second aim of the thesis was to evaluate the effects of a cognitive-behavioral training program and a physical activity program for patients with stress-related illnesses on autonomic reactivity, pain, and perceived health. First, a laboratory model of computer mouse use was characterized in terms of biomechanical exposure of the wrist, and wrist position sense was determined before and after 45 minutes of continuous mouse use. Then, the effects of performing the computer mouse work under time pressure and precision demands were determined. Autonomic activity and muscle oxygenation in the upper extremity were measured during the work, and wrist position sense was assessed before and after the work. When patients with stress-related illnesses were compared to healthy individuals in autonomic reactivity to functional tests, pressure-pain thresholds, and ratings of health, indications of a relation between autonomic reactivity and symptoms of pain was found. Hence, in a subsequent evaluation of a cognitive-behavioral training program and a physical activity program for patients with stress-related illnesses, post intervention effects on autonomic reactivity to functional tests, pressure-pain thresholds, ratings of health and return-to-work were studied during a period of 12 months after the intervention. The main findings were the following. 1) Wrist kinetics data obtained during the computer mouse work showed similarities to previously presented data for mouse-operated design tasks. 2) When time pressure and precision demands were added to the computer work, increased autonomic activity paralleled with decreased muscle oxygenation in the upper extremity was found. Wrist position sense accuracy, however, did not decrease after the work as it did when the work was performed without the additional demands. The result is intriguing, as it does not appear to be in concordance with previous animal studies. 3) Patients with stress-related illnesses showed higher autonomic reactivity to cognitive and physical laboratory tests than healthy control subjects. They also had substantially lower pressure-pain thresholds in the back, and rated poorer health and health-related behavior than the control subjects. 4) We found little difference in effect of cognitive-behavioral training and physical activity, compared to usual care, for patients with stress-related illnesses. Patients in the control group showed an improvement of about the same magnitude as in the treatment groups over the 12-month follow-up period. The present findings indicate a non-additive relation between autonomic activity during repetitive work and position sense inaccuracy. Furthermore, patients with stress-related illnesses often reported pain in the neck, shoulders, and lower back. This was associated with lower pressure-pain thresholds in the back and a modest increase in sympathetic reactivity to physical and mental tests, which might suggest a potential use of these methods in the clinical examination and rehabilitation of patients with stress-related illnesses.

Det finns många aktörer på marknaden som säljer hälsofrämjande tjänster till företag, föreningar och organisationer. Två bolag inom Sandvik AB köper en sjuk- och friskanmälningstjänst med telefonrådgivning av Unimed Care AB. Syftet med uppsatsen var att utföra en utvärdering åt de två bolag som köper tjänsten, samt se effekten av den. Tre olika enkäter delades ut till totalt 861 medarbetare. Bortfallet i undersökningen är betydande, 21 % av undersökningspopulationen deltog i utvärderingen. En enkät riktar sig till medarbetare, en till flödeschefer och en till Human Resource (personalavdelningen). För att komplettera insamlat material har information sökts via telefon och mail. Resultatet visar att medarbetares och flödeschefers uppfattningar om tjänsten varierar. För att öka samtligas tillfredställelse med tjänsten behövs mer information och kunskap om tjänsten, samt dess syfte. Det är många som inte vet hur tjänsten kan användas. Flödescheferna kan behöva förslag på hur statistiken kan användas i arbetet med personalfrågor. Sjukfrånvaron har minskat nationellt och även inom Sandvik koncernen under 2006-2008. Att sjukfrånvaron minskat under de år bolagen köpt tjänsten från Unimed kan förklaras som en kombination av samtliga insatser som bolagen genomfört, förändringar i nationella regler för sjukskrivning, samt att sjukskrivningarna minskat i hela landet.

När en person söker en första kontakt med hälso- och sjukvården sker det oftast via ett telefonsamtal till vårdcentralen. Vid telefonsamtalet, som tas emot av en sjuksköterska, bedöms och åtgärdas vårdsökarens ärende. Sjukskrivningar är ett av många ärenden som hanteras. De senaste åren har hanteringen av sjukskrivningar i Svensk hälso- och sjukvård förändrats vilket har orsakat en minskning av antalet sjukskrivningar. Sjuksköterskor har i varierande grad deltagit i denna utveckling och denna studie vill synliggöra sjuksköterskans deltagande i vården av sjukskrivna på vårdcentralen. Syftet var att beskriva sjuksköterskors erfarenheter av telefonrådgivning på vårdcentralen och speciellt hantering av sjukskrivningar. Studien är kvalitativ med induktiv ansats. Datainsamling har skett genom fokusgruppssamtal med 14 stycken sjuksköterskor som arbetar med telefonrådgivning på tre vårdcentraler. Insamlat material analyserades med kvalitativ innehållsanalys. Gruppsamtalen visade att sjuksköterskors erfarenheter av telefonrådgivning är att arbetet är kvalificerat och stimulerande. Hanteringen av sjukskrivningar innefattar att göra bedömning, ge patienten information och bevaka patientens rättigheter. Hindrande och möjliggörande omständigheter påverkar sjuksköterskornas arbete och deras hantering. De hindrande omständigheterna kan ibland leda till att sjuksköterskan vill frånsäga sig ansvar. Studien har identifierat ett behov av att tydliggöra omvårdnadsansvaret för verksamma sjuksköterskor i telefonrådgivning på vårdcentral så att sjuksköterskans bedömningar i telefonrådgivningssituationen i högre grad baseras på omvårdnadens mål. / When a person seeks contact with community health services in Sweden it’s usually via a phone call to the primary health care centre. By the phone call, received by a nurse, the health seeker’s case is assessed and addressed. Sick leave is one of many cases being managed. In recent years, management of sick leave in Swedish primary health care has changed and decreased the number of sick leaves. However, nurses have in varying degrees, participated in this change. This study will visualize the nurse's participation in the care of patients on sick leave at the primary health care centre. The aim was to describe nurses' experiences of telephone advisory services at the primary health care centre and especially the management of sick leaves. The study is qualitative with an inductive approach. Data collection was done through focus group discussions with 14 nurses working with telephone advisory services at three primary health care centres. Collected material was analyzed by qualitative content analysis. The group discussions demonstrated nurses' experiences of telephone advisory services as qualified and stimulating. The specific management of sick leave was described as a combination of making assessment, providing patient information and monitoring the patient's rights. Obstructing and enabling circumstances affect nurses telephone advisory services and their management of sick leaves. The obstucitive cirumstances sometimes causes nurses wanting to abdicate responsibility. The study has identified a need to clarify the caring responsibility for nurses in telephone advice services so that nurse's assessments increasingly are based on caring goales.

The aim of this study is to evaluate the outcome of adoptions and to study the gene-environment influences on psychiatric illness as well as sick-leave patterns. The material consists of 2 966 adopted persons born between 1917 and 1949, their 5 932 adoptive parents and 5 438 identified biological parents.Adopted persons had a higher incidence of personality disorders and substance abuse than non-adopted controls. Adopted men also had an increased incidence of neuroses. Adopted women had an increased sick-leave because of somatic complaints, especially upper respiratory tract infections and abdominal complaints of short duration. Somatization i.e. more than 2 sick-leaves/year because of somatic complaint together with nervous complaints was more frequent among adopted women. Women with somatization could be separated into 2 types according to the pattern of sick-leave. Type 1 ("high frequency") had frequent sick-leaves for psychiatric, abdominal and back complaints. They also had a high frequency of alcohol abuse. Type 2 ("diversiform") had more diverse complaints and had fewer sick-leaves because of nervous complaints.High frequency somatizers had biological fathers with teenage onset of criminality and frequent registrations for alcohol abuse. Diversiform somatizers had the same genetic background as adopted men with petty criminality or male limited alcoholism.No specific genetic influences on treated depression or substance abuse were found in this study. However, a non-specific vulnerability of the biological mother influenced on the risk of depression and substance abuse among adopted women.There were some indications that placement in the adoptive home between 6 and 12 months of age was associated with reactive neurotic depression in adult life. Otherwise early negative experiences in term of unstable placements before adoption did not significantly influence on psychiatric illness in adulthood.Affective disorders in the adoptive father were associated with treatment for depressions or substance abuse in the adoptee. Low social status in the part of the adoptive father increased the risk of somatization of both types in the adoptee. / <p>S. 1-80: sammanfattning, s. 81-236: 6 uppsatser</p> / digitalisering@umu

The issue of sick leave and an increase of ill health in the workplace is a social problem inSwedenthat is currently an important topic. Public human service organisations are one of the sectors where this is a major problem. The aim of this study is to examine what significance the leadership in public human service organisations has on the health and sense of well being among the staff within the organisation. We have chosen to look at this issue from a health promoting perspective where we focused on health factors and to what extent the management can influence and promote the possibilities for a healthy workplace with healthy staff. The results of the study are based on interviews with three leaders within the public human service sector. Results shows that having staff that are content and healthy is a key ingredient in the organisations goal to provide the best possible care and service to their clients. The results also identify leadership qualities and tools that are important such as being present in the workplace and available for the staff and also setting a good example. Other leadership qualities such as being clear in their role as to what they expect from their staff, being goal orientated, and being strong and secure in their leadership proved to be important in relation to health in the workplace. Making sure that the staff feel that they have the possibility to influence their working conditions and given the opportunity to participate in changes were also identified as important health promoting factors. The study also shows that showing trust in the staff and allowing them to take responsibility as well as seeing them as individuals is also important health promoting factors. It became evident that achieving a healthy workplace is a process where all the factors are equally important.

The aim of the study was to examine the knowledge and experience women, who participants in the project Steget vidare, have to health, quality of life and empowerment and how long-term sickness absence has affected these components. A further aim of this study was to examine whether and if so, how the project's rehabilitative efforts targeted to health may be related to increased opportunities to return to work. The methods for generating data were qualitative interviews based on seven long-term sick individuals who participated in the project Steget vidares health group. The result indicates that the interviewees have a clear picture of what health and quality of life are, while the concept of empowerment is not as obvious. Further, long-term sickness seemed to affect the individual’s health, quality of life and empowerment in various ways, usually in a negative sense. Before their participation in the project, several of the interviewees experienced being caught in an area of nowhere between different social agencies. However, the result indicates that since they started in the project they have received a more individual approach tailored to their specific situation. Due to the result, the social interaction between the health group participators has contributed to an improved life situation for several of them which have strengthened their potential to become competitive on the labor market. Finally, we can conclude that despite of the interviewees’ positive experiences of the project and the process which it includes it is difficult to locate and explain how and to what extent health interventions contribute to participants’ ability to return to work.

M. Tech. Business Administration / The objective of this study was to identify factors that are responsible for employee absenteeism in Vodacom SA, which is the largest mobile cell phone company in South Africa. In the literature, it has been extensively reported that absenteeism is a major cause of loss of income and revenues among mobile cell phone operators in South Africa. The purpose of this study was to identify the root causes of absenteeism in the cellular phone industry in South Africa. Data was collected from a random sample of 120 employees of Vodacom SA working in Midrand.

Syftet med denna studie var att undersöka hur fyra olika aktörer med skilda yrkesroller upplevde organisationens befintliga rehabiliteringsprocess med dess möjligheter och begränsningar samt deras synpunkter på vad som kan förbättras för att undvika sjukskrivningar. En förhoppning var också att kunna ge konkreta förslag på hur man kan arbeta förebyggande i syfte att undvika sjukskrivningar inom organisationen. Fyra minifokusgruppintervjuer, bestående av två till fyra personer, genomfördes där två fiktiva fall användes som diskussionsgrund. Materialet analyserades med hjälp av en induktiv tematisk analys, vilket resulterade i de fyra temaområdena; Verktyg för att förbättra hälsoarbetet, Insatser för att motverka sjukskrivningar, Begränsningar i hälsoarbetet samt Chefens roll i hälsoarbetet. I studien framkom att deltagarna ansåg att rehabiliteringsprocessen är ett bra verktyg som förenklar rehabiliteringsarbetet, men att den behöver fortsatt utveckling. Resultatet visade även att deltagarna hade många förslag på åtgärder för att förbättra den fysiska och psykosociala arbetsmiljön. / The aim of this study was to examine the experience, of four different actors’ with diverse occupational roles, of the existing rehabilitation process in the organization, with its limitations and possibilities. A further aim was to examine the preventive work and hopefully contribute with some practical solutions to counteract sick leave within the organization. Four mini focus group interviews with two to four people were carried out with two fictitious cases as a base for discussion. Data was analyzed by an inductive thematic analysis and resulted in four thematic areas; Tools to improve the health work, Efforts to avoid sick leave, Health work limitations and The manager’s role in health work. The study showed that the participants considered that the rehabilitation process was a good tool that simplifies the rehabilitation work, but it needs further development. The results also showed that the participants had many suggestions of how to improve the physical and psychosocial work environment.

Bakgrund och problem: Långtidssjukfrånvaron har länge varit ett uppmärksammat problem och flertalet åtgärder har satts in för att minska denna. På senare tid har korttidssjukfrånvaron dock lyfts fram som ett ytterligare problem och erhållit en större uppmärksamhet i takt med dess ökning. Korttidssjukfrånvaro syns inte i offentlig statistik förrän efter den åttonde dagen och är därmed svår att studera. Likaså kan kostnaden för korttidssjukfrånvaron vara svår att fastställa eftersom korttidssjukfrånvaro består av både direkta- och indirekta kostnader. Syfte: Syftet med denna studie är att beskriva och förklara hur stora kostnaderna är för den korttidssjukfrånvarande socialsekreteraren på en enhet i Växjö kommun. Utifrån dessa kostnader ska sedan en metodik utformas för att kunna fastställa en standardkostnad för vad korttidssjukfrånvaro per timme kostar. Metod: Under studiens gång har en abduktiv forskningsansats, en kvalitativ forskningsstrategi och en fallstudie som undersökningsdesign nyttjats. Vidare har de metodologiska valen motiverats väl. Slutsats: Vi har i denna studie kommit fram till att kostnader för korttidssjukfrånvaro på berörd enhet består av kvarvarande lönekostnader och kostnader för överanställningar. / Background and Problem: Long-term sick leave has long been a recognized problem and several measures have been taken to reduce it. However more recently, short-term sick leave has been highlighted as an additional problem and received a greater attention in pace with its growth. Short-term sick-leave doesn’t appear in official statistics until after the eighth day and is therefore difficult to study. Similarly, the cost of short-term sick-leave is difficult to establish since it consists of both direct and indirect costs. Objective: The aim of this study is to describe and explain what the costs are for the short-term sick leave social worker at a unit in Växjö municipality. Based on these costs a methodology then will be designed to establish a standard cost for what short-term sick leave per hour costs. Method: During the study an abductive research approach, a qualitative research approach and a case study research design has been utilized. Furthermore, the methodological choices have been justified well. Conclusion: We have in this study concluded that the cost of short-term sick leave for the unit in question consists of the remaining wage costs and over employment costs.