The subject of the thesis is work-oriented rehabilitation of people on long-term sick-leave. The overall aim of my thesis is to: - analyse work-oriented rehabilitation as a gender theoretical phenomenon. - analyse how this phenomenon is expressed, maintained and changed on a societal, authority and individual level. The specific aims of the different reports were: I) to analyse the collaboration between the different authorities taking part in local rehabilitation groups, the results from these groups, as well as how the clients experienced the groups II) to analyse the situation of these clients some years after completed rehabilitation. III) to analyse gender related differences in rehabilitation. IV) to analyse factors in the rehabilitation process of importance for gender related differences in rehabilitation as well as the attitudes to gender constructions among clients and rehabilitation administrative staff. V) to give a broader context to the study of rehabilitation as gender theoretical, in which work rehabilitation as well as gender are constructed. Both quantitative and qualitative methods were used in the first and second study. Study number three and four used qualitative methods. The fifth study consisted of a literature review on womens work and gender related to illness. 　 The studies of local rehabilitation groups (I, II) revealed that it was more common for male social services workers to formulate concrete decisions regarding work or training for male clients, which can be interpreted as long-term ill men are the first chosen to be helped. The results of the third investigation. Rehabilitation for men?y highlighted the gender related differences in long-term illness and rehabilitation. The rehabilitation staff seemed to adopt a gender-neutral or equality-based position in relation to themselves, their clients and the world around. In spite of that, women were sometimes considered more difficult to rehabilitate because of their responsibility for unpaid work and care in their homes. In the study, "Women's private burden the conceptions of the clients' and rehabilitation staff of the meaning of gender in relation to long-term illness and rehabilitation were divided into three groups. I chose to call the first group androgynous since the interviewees, only men held the position that gender was meaningless. In the second group the meaning of gender was related to the primary responsibility for paid and unpaid work and the division of labour was according to gender. The third group is represented by rehabilitation staff who held the position that gender had meaning on a structural level, in the labour market and in rehabilitation, and the system worked in such a way that women were unfairly treated. The shaping of social insurance is gender-neutral - there are neither men nor women but rather "the insured". But gender neutrality produces paradoxical results since it overlooks the fact that men and women do not live in an equal society. The lack of conformity between ideals and reality is found in, amongst other contexts, services provided for rehabilitation and long-term illness. / digitalisering@umu

En balans mellan krav, kontroll och stöd i arbetet är betydelsefullt för att inte drabbas av för hög mental belastning som i förlängningen kan leda till psykisk ohälsa. Studien undersöker hur HR-konsulter inom kommunal verksamhet som stödjer chefer i arbetslivsinriktad rehabilitering, hanterar balansen i sin yrkesroll utifrån de krav som ställs på dem samt hur de hanterar egna känslor som uppstår. Åtta HR-konsulter vid tre kommuner i Mellansverige deltog. Data samlades in genom semistrukturerade intervjuer och materialet analyserades induktivt. Resultatet visade fyra delar för hantering av balansen, (1) förhållningssätt, (2) strukturering, (3) chefscoachning och (4) medarbetarcoachning och tre för hantering av egna känslor, (1) socialt stöd, (2) handledning och (3) agerande. Slutsatsen blev att för att hålla balans i yrkesrollen behöver förhållningssätt och struktur vara tydligt samt så behöver samarbetet med chef och medarbetare fungera väl.

Sammanfattning Arbetslivsinriktad rehabilitering utgör ett ämnesområde vars kunskapsfält är tämligen outforskat, detta trots att antalet sjukskrivningar i Sverige följer en uppåtgående trend. Det saknas studier där man undersökt arbetsgivares/chefers syn på möjliga framgångsfaktorer, av vilken anledning förevarande studie genomförts. Syftet med studien var att undersöka chefers upplevelser av verksamma faktorer i rehabiliteringsförsäkringen ”ComeBack med Samtalsstöd”, utifrån aspekterna hållbar hälsa och ökad/kvarvarande arbetsförmåga. Detta baserat på den insyn de haft då en eller flera anställda använt försäkringen till följd av psykisk ohälsa. Sju semistrukturerade telefonintervjuer genomfördes, varefter materialet analyserades genom en tematisk analys. Med hjälp av den tematiska analysen konstruerades följande teman: (1) Tidsaspektens betydelse, (2) Att bli tagen på allvar, (3) Att möta individens behov samt (4) Vikten av en utomstående part. Resultatet indikerar att försäkringen innefattar flera verksamma faktorer, vilka är relativt överensstämmande med tidigare forskning. Trots studiens begränsningar kan den bidra med värdefull information kring rehabiliteringsprocessens utformning.   Nyckelord: arbetslivsinriktad rehabilitering, chefers upplevelser, sjukskrivning, psykisk ohälsa, tematisk analys / Abstract Work-oriented rehabilitation is a quite unexplored field of research, even though the sickness absence rate for employees in Sweden is following an upward trend. There have not been many studies examining the subject from the perspective of managers, which is the reason this study was conducted. The purpose of the study was to investigate the experience of important factors in the work-oriented rehabilitation insurance “ComeBack with Counseling Support”, linked to sustainable health and increased/remaining work capacity. The participants were managers who have had one or more employees that have used the insurance due to mental health issues. Data was collected through seven semi-structured telephone interviews, after which it was analyzed using a thematic analysis. Using the thematic analysis, the following themes were constructed: (1) The significance of time, (2) To be taken seriously, (3) Meeting the needs of every individual and (4) The significance of a third party. The results indicate that the insurance consist of several important factors, which are consistent with earlier findings in the field. Despite the limitations, the contributions and implications of the study are noteworthy, for example, regarding the design of a rehabilitation process.   Keywords: work-oriented rehabilitation, the experience of managers, sick leave, mental illness, thematic analysis

Personer med psykiska funktionsnedsättningar har svårare att erhålla och behålla ett arbete på den reguljära arbetsmarknaden. Målgruppen löper större risk att drabbas av ohälsa då de ofta exkluderas från arbetsmarknaden på grund av deras svårigheter och behov av anpassningar i arbetsmiljön. Syftet är att beskriva hur personer med psykiska funktionsnedsättningar som erhållit insatser via metoden Supported Employment upplever att arbetsmiljön påverkar deras välbefinnande. Det var 17 personer med olika psykiska funktionsnedsättningar som hade erfarenhet av en arbetsmiljö som deltog i studien. Bedömningsinstrumentet Work Environment Impact Scale (WEIS) användes till datainsamlingen tillsammans med tillhörande intervjuguide för att samla information kring hur deltagarna upplevde välbefinnande i sin arbetsmiljö. I resultatet framkom det att faktorer som samarbete med arbetskamrater, utformning av arbetsuppgifter, arbetets stimulans, arbetstider och arbetets värde och betydelse var de faktorer som upplevdes mest stödjande för välbefinnande i arbetsmiljön. De faktorer som upplevdes mest hindrande för välbefinnande i arbetsmiljön var arbetsuppgiftens krav, förmåner, sensoriska egenskaper, förväntningar på prestation i arbetet och arbetsredskap. Flera studier visar på att en fungerande arbetsmiljö är viktigt för att kunna utföra sitt arbete. Förslagsvis behövs fler studier som fokuserar på att utveckla arbetsmiljöinterventioner som stödjer personer med psykiska funktionsnedsättningar att trivas och behålla sitt arbete. / People with mental disabilities have difficulty obtaining and keeping a job in the regular labor market. The target group is at greater risk of developing illness, as they are often excluded from the labor market due to their difficulties and their needs for adaptations in the work environment. The purpose of this study is to describe how people with mental disabilities who have received interventions through the ‘Supported Employment’ method experience their work environment and how it affects their well-being. Seventeen people with different mental disabilities and with experience of a specific work environment participated in the study. The ‘Work Environment Impact Scale’ (WEIS) assessment was used for data collection along with the associated interview guide to gather information about how the participants perceived their work environment. In the results it emerged that factors such as cooperation with coworkers, job design, the stimulus of work, working hours, and the value and importance of work were the factors that were most supportive for well-being in the work environment. The most obstructive factors for well-being in the work environment were the work demands, benefits, sensory characteristics, expectations of performance at work, and work tools. Several studies show that a soundly functioning work environment is important in order to perform at work. More studies are needed that focus on developing work environment interventions that help people with mental disabilities to enjoy and keep their jobs.