<p>At the turn of the year 2009/2010 there was a change in the regulations on sickness impact. This led to 328 persons in County of Kronoberg had an expired period of sickness benefit from the Social Insurance Office (Försäkringskassan) when they reached the maximum time for sickness or temporary disability compensation. These individuals were offered introductory programs with the employment services. The purpose of this study is to investigate how the population with expired period of sickness benefit from the Regional Social Insurance Office in the County of Kronoberg (Försäkringskassan Kronoberg) is described in the initial stage, and to explore how individuals who achieved expired period of sickness benefit from the Social Insurance Office (Försäkringskassan) talks about the meaning to get an expired period of sickness benefit regarding economic and social issues. The study was inspired by Grounded theory. The method has consisted of both quantitative and qualitative interviews. In total, six persons participated in the surveys. Narrative method was used in the interview with a person with experience of an expired period of sickness benefit from the Social Insurance Office (Försäkringskassan). The interviews indicate that the authorities have different focus on the concept of rehabilitation. This means that what is to be regarded as rehabilitation and the efforts which may benefit the individual depends on which authority has the power of definition. This study is made before preparing administrators for either statistics or working methods were established by the relevant authorities. Longer experience in the field is still missing about what the change means for both individuals who have experience of the expired period of sickness benefit and professionals. This points out; further research in this area is needed.</p>

<p>Summary</p><p>At the start of my employment at the Swedish National social insurance office I was a bit confused because there were two categories which I defined as belonging to the same category (working handicapped) but it wasn’t so. The persons I where going to meet was defined as having incapacity to work and therefore, they were defined as not standing to the labour markets conversion. They were defined as being to sick for being at the labour market. </p><p>The aim of this work is to shed light on what grounds a decision concerning a person which will be categorized as incapable of working and looking at the categorized person’s status. At the same time look if the statuses are marred to similarities or differences with the group of persons which are categorized as working handicapped defined through the definition according to enactment 2000:630 which is on of the Swedish Labour Market Board’s (AMS) laws for the Swedish labour market politic. </p><p>The way the author Mikael Holmqvist describes parts of his empiric in his book (2005): “Samhall, att bli normal i en onormal organisation” found an astonishing resemblance with my own experiences. I decided that Holmqvists book could fill a very important role in my work. To shedding more light over my question I looked very briefly on statistics concerning people with different impaired bodily functions from Statistiska centralbyrån (SCB), statistics from the National social insurance office (Försäkringskassan), and statistics from the project I was working in - FUNAKTIVA.</p><p>My theoretical perspective is in the intersection between human’s possibility to decide or not decide his/her own shape. Therefore I have chosen a role theoretical perspective. Talcott Parsons classical theory of the sick role is widely used, therefore I also used it. I also use Deborah Stones theory of explaining politics of disablement from the development of the western industrialism. </p><p>To reach some answers for my aim of the subject I have used a case method. I have analyzed five cases. I have found that my procedure for collecting data is most likely to conform to an ethnographic perspective. Conceptions for the analytical work are mostly done with the help of Pierre Bourdieu and parts of his conceptions. My empiric for this work are from journals from my work, different kind of conversations with persons in my daily work, different organizations, there are also three interviews which I had done with part of my empirics. My intention to compare the group which was defined as working handicapped with the group that I met which was defined as retarded/pensioned or incapable of working take place with Mikael Holmqvist study and my own practical experience. </p><p>The statement in the summary of the analysis is that I found an obvious perspective of conflict between the status of the persons´ when they where administrated within the Social insurance office and the local employment office as sick and the opinion that the persons in the empiric had of themselves. I also found out that there is an obvious perspective of conflict between the persons will to study and/or work and what the systems says that they are capable of doing.</p><p>The empiric shows that none of the persons were given topical interest to any of the roles in the system of work (working-handicapped and the different ways of employee one can be with the help of the code working-handicapped).</p>

<p>Personer med funktionshinder har haft betydande svårigheter att etablera sig på arbetsmarknaden, trots detta har det funnits en strävan att integrera personer med funktionshinder i samhället och normalisera deras tillvaro. En diskussion som förs kring funktionshindrades villkor i dagens arbetsliv handlar om att öka möjligheterna till betalt arbete på den öppna arbetsmarknaden.</p><p>Syftet med studien är att beskriva och analysera en arbetsförberedande insats fungerar som stöd för de unga mellan 20-29 år på deras väg ut i arbetslivet, sett ur ett deltagarperspektiv såväl som ett personalperspektiv.</p><p>Vi har använt oss av en kvalitativ ansats och har valt intervju och deltagande observation som metod. Informanterna ör 7st varav två ät personal och fem st är deltagare. I vår resultatdel redovisar vi personalperspektivet som en verksamhetsbeskrivning och stödet delas upp i tre teman; kognitivt-, emotionellt- och praktiskt stöd. Deltagarnas perspektiv på stöd redovisas utifrån samma teman. Resultatet kan bidra till att utveckla stödet som en arbetsförberedande insats ger.</p><p>Några av våra slutsatser är att deltagarnas syn på stöd inte alltid stämmer överens med personalens samt att kommunikationen har betydelse för vad som uppfattas som stöd och hjälp.</p><p> </p>

At the turn of the year 2009/2010 there was a change in the regulations on sickness impact. This led to 328 persons in County of Kronoberg had an expired period of sickness benefit from the Social Insurance Office (Försäkringskassan) when they reached the maximum time for sickness or temporary disability compensation. These individuals were offered introductory programs with the employment services. The purpose of this study is to investigate how the population with expired period of sickness benefit from the Regional Social Insurance Office in the County of Kronoberg (Försäkringskassan Kronoberg) is described in the initial stage, and to explore how individuals who achieved expired period of sickness benefit from the Social Insurance Office (Försäkringskassan) talks about the meaning to get an expired period of sickness benefit regarding economic and social issues. The study was inspired by Grounded theory. The method has consisted of both quantitative and qualitative interviews. In total, six persons participated in the surveys. Narrative method was used in the interview with a person with experience of an expired period of sickness benefit from the Social Insurance Office (Försäkringskassan). The interviews indicate that the authorities have different focus on the concept of rehabilitation. This means that what is to be regarded as rehabilitation and the efforts which may benefit the individual depends on which authority has the power of definition. This study is made before preparing administrators for either statistics or working methods were established by the relevant authorities. Longer experience in the field is still missing about what the change means for both individuals who have experience of the expired period of sickness benefit and professionals. This points out; further research in this area is needed.

Summary At the start of my employment at the Swedish National social insurance office I was a bit confused because there were two categories which I defined as belonging to the same category (working handicapped) but it wasn’t so. The persons I where going to meet was defined as having incapacity to work and therefore, they were defined as not standing to the labour markets conversion. They were defined as being to sick for being at the labour market. The aim of this work is to shed light on what grounds a decision concerning a person which will be categorized as incapable of working and looking at the categorized person’s status. At the same time look if the statuses are marred to similarities or differences with the group of persons which are categorized as working handicapped defined through the definition according to enactment 2000:630 which is on of the Swedish Labour Market Board’s (AMS) laws for the Swedish labour market politic. The way the author Mikael Holmqvist describes parts of his empiric in his book (2005): “Samhall, att bli normal i en onormal organisation” found an astonishing resemblance with my own experiences. I decided that Holmqvists book could fill a very important role in my work. To shedding more light over my question I looked very briefly on statistics concerning people with different impaired bodily functions from Statistiska centralbyrån (SCB), statistics from the National social insurance office (Försäkringskassan), and statistics from the project I was working in - FUNAKTIVA. My theoretical perspective is in the intersection between human’s possibility to decide or not decide his/her own shape. Therefore I have chosen a role theoretical perspective. Talcott Parsons classical theory of the sick role is widely used, therefore I also used it. I also use Deborah Stones theory of explaining politics of disablement from the development of the western industrialism. To reach some answers for my aim of the subject I have used a case method. I have analyzed five cases. I have found that my procedure for collecting data is most likely to conform to an ethnographic perspective. Conceptions for the analytical work are mostly done with the help of Pierre Bourdieu and parts of his conceptions. My empiric for this work are from journals from my work, different kind of conversations with persons in my daily work, different organizations, there are also three interviews which I had done with part of my empirics. My intention to compare the group which was defined as working handicapped with the group that I met which was defined as retarded/pensioned or incapable of working take place with Mikael Holmqvist study and my own practical experience. The statement in the summary of the analysis is that I found an obvious perspective of conflict between the status of the persons´ when they where administrated within the Social insurance office and the local employment office as sick and the opinion that the persons in the empiric had of themselves. I also found out that there is an obvious perspective of conflict between the persons will to study and/or work and what the systems says that they are capable of doing. The empiric shows that none of the persons were given topical interest to any of the roles in the system of work (working-handicapped and the different ways of employee one can be with the help of the code working-handicapped).

Personer med funktionshinder har haft betydande svårigheter att etablera sig på arbetsmarknaden, trots detta har det funnits en strävan att integrera personer med funktionshinder i samhället och normalisera deras tillvaro. En diskussion som förs kring funktionshindrades villkor i dagens arbetsliv handlar om att öka möjligheterna till betalt arbete på den öppna arbetsmarknaden. Syftet med studien är att beskriva och analysera en arbetsförberedande insats fungerar som stöd för de unga mellan 20-29 år på deras väg ut i arbetslivet, sett ur ett deltagarperspektiv såväl som ett personalperspektiv. Vi har använt oss av en kvalitativ ansats och har valt intervju och deltagande observation som metod. Informanterna ör 7st varav två ät personal och fem st är deltagare. I vår resultatdel redovisar vi personalperspektivet som en verksamhetsbeskrivning och stödet delas upp i tre teman; kognitivt-, emotionellt- och praktiskt stöd. Deltagarnas perspektiv på stöd redovisas utifrån samma teman. Resultatet kan bidra till att utveckla stödet som en arbetsförberedande insats ger. Några av våra slutsatser är att deltagarnas syn på stöd inte alltid stämmer överens med personalens samt att kommunikationen har betydelse för vad som uppfattas som stöd och hjälp.

Sammanfattning Syftet med denna uppsats är att utreda om och hur gällande rätt har förändrats senaste 40 åren angående alkoholsjuka arbetstagares anställningsskydd. Alkoholberoende arbetstagare missköter sitt arbete. Misskötsamheten visar sig ofta i beteenden och handlingar som tolkas som symtom på alkoholsjukdom. Denna misskötsamhet skulle för en frisk arbetstagare bedömas som oacceptabel av såväl arbetsgivare som arbetsdomstol. Uppsatsen tydliggör det juridiska problem som uppstår när arbetsgivaren vill säga upp eller avskeda arbetstagaren på grund av misskötsamhet som kan relateras till alkoholsjukdom. Uppsatsen beskriver också hur praxis de senaste 15 åren tyder på att arbetsgivare till viss del har lättare att få gehör för sina yrkanden i arbetsdomstolen vad gäller den problematik alkoholsjukdomen förorsakar på arbetsplatsen jämfört med tidigare. Uppsatsens slutsats är att den praxis från 1970 och 1980-talet som hittills varit prejudicerande i viss mån är obsolet. Detta kan relateras till Sveriges inträde i EU 1995 samt förändringar i arbetsmiljölagen och tillkomsten av ett lagstadgat arbetstagaransvar angående rehabilitering. Numera kan onykterhet i tjänsten som enda faktor vara saklig grund för uppsägning om beteendet upprepats och det är ett uttalat krav i anställningsavtalet, kollektivavtalet eller arbetsplatsens drogpolicy att drogfrihet gäller på arbetsplatsen. Allvarliga förseelser som grovt åsidosätter arbetstagarens åliggande mot arbetsgivaren i samband med onykterhet bedöms numera inte som symtom på alkoholsjukdom, utan ger laga grund för avsked. En sammanfattande slutsats är att arbetsdomstolen har förändrat sin syn på den alkoholberoende arbetstagarens anställningsskydd. På 1970 och 1980-talet sågs denne som ett offer för sin alkoholsjukdom som behöver hjälp, medan man idag ställer krav på den alkoholsjukes eget ansvar för att bli fri från missbruket, samtidigt som denne har en lagstadgad rätt till rehabilitering som bekostas av arbetsgivaren eller socialförsäkringen.   Nyckelord: alkoholsjukdom, alkoholberoende, alkoholstrategi, alkoholism, anställningsskydd arbetsgivaransvar, arbetstagaransvar, arbetsförmåga, avsked, bevisbörda, beroendevård drogpolicy, informationsskyldighet, missbruksbehandling, misskötsamhet, onykterhet, rattfylleri, rehabilitering, saklig grund, sjukintyg, säkerhetsrisk, uppsägning

Sammanfattning Syftet med denna uppsats är att utreda om och hur gällande rätt har förändrats senaste 40 åren angående alkoholsjuka arbetstagares anställningsskydd. Alkoholberoende arbetstagare missköter sitt arbete. Misskötsamheten visar sig ofta i beteenden och handlingar som tolkas som symtom på alkoholsjukdom. Denna misskötsamhet skulle för en frisk arbetstagare bedömas som oacceptabel av såväl arbetsgivare som arbetsdomstol. Uppsatsen tydliggör det juridiska problem som uppstår när arbetsgivaren vill säga upp eller avskeda arbetstagaren på grund av misskötsamhet som kan relateras till alkoholsjukdom. Uppsatsen beskriver också hur praxis de senaste 15 åren tyder på att arbetsgivare till viss del har lättare att få gehör för sina yrkanden i arbetsdomstolen vad gäller den problematik alkoholsjukdomen förorsakar på arbetsplatsen jämfört med tidigare. Uppsatsens slutsats är att den praxis från 1970 och 1980-talet som hittills varit prejudicerande i viss mån är obsolet. Detta kan relateras till Sveriges inträde i EU 1995 samt förändringar i arbetsmiljölagen och tillkomsten av ett lagstadgat arbetstagaransvar angående rehabilitering. Numera kan onykterhet i tjänsten som enda faktor vara saklig grund för uppsägning om beteendet upprepats och det är ett uttalat krav i anställningsavtalet, kollektivavtalet eller arbetsplatsens drogpolicy att drogfrihet gäller på arbetsplatsen. Allvarliga förseelser som grovt åsidosätter arbetstagarens åliggande mot arbetsgivaren i samband med onykterhet bedöms numera inte som symtom på alkoholsjukdom, utan ger laga grund för avsked. En sammanfattande slutsats är att arbetsdomstolen har förändrat sin syn på den alkoholberoende arbetstagarens anställningsskydd. På 1970 och 1980-talet sågs denne som ett offer för sin alkoholsjukdom som behöver hjälp, medan man idag ställer krav på den alkoholsjukes eget ansvar för att bli fri från missbruket, samtidigt som denne har en lagstadgad rätt till rehabilitering som bekostas av arbetsgivaren eller socialförsäkringen. Nyckelord: alkoholsjukdom, alkoholberoende, alkoholstrategi, alkoholism, anställningsskydd arbetsgivaransvar, arbetstagaransvar, arbetsförmåga, avsked, bevisbörda, beroendevård drogpolicy, informationsskyldighet, missbruksbehandling, misskötsamhet, onykterhet, rattfylleri, rehabilitering, saklig grund, sjukintyg, säkerhetsrisk, uppsägning / The aim of this paper is to describe if and how Swedish law has changed due to employment protection of alcoholics over the last 40 years. Employees suffering from alcoholism mismanage their work. This negligence appears in actions that can be interpreted as symptoms of alcoholic disease. For healthy workers, such mismanagement would be deemed as unacceptable both by employers as well as the Labour Court. An important policy of Swedish law is that it is illegal to terminate an employee contract or dismiss someone because of illness or acts that can be related to illness. Legal dilemmas arise when the employer needs to dismiss an employee because of mismanagement related to his or her alcoholism. The paper concludes that the practice from the 1970s and 1980s that has been prejudicial to some extent may be obsolete. It is currently somewhat easier for employers to get a hearing for their claims in the Labour Court regarding problems caused by alcoholism at work. This may be related to Sweden's entry into the EU in 1995, changes in the "Occupational Safety and Health Act" and the creation of a statutory employee responsibility regarding rehabilitation. Misbehaviour related to drunkenness at work may nowadays be grounds for dismissal if the behavior is repeated, and if it is an explicit requirement of the employment contract, collective agreement or workplace drug policy that abstinence applies in the workplace. Concerning drunkenness related to serious offences that gravely infringe the worker's obligation to the employer, it is considered irrelevant that these acts are symptoms of alcohol disease. Nowadays, these acts provide the legal basis for dismissal. A conclusive summary is that the Labour Court in Sweden has to some extent changed its view of the employment protection of workers suffering from alcoholism. In the 1970s and 1980s, these workers were seen as victims of their illness, victims who needed help. Nowadays, Swedish Law requires the alcoholic employees’ own responsibility in order to be free from abuse, while they also have the legal right to rehabilitation funded by employers or social security.

AWP-FK är en specifik tillämpning av bedömningsinstrumentet Assessment of Work Performance (AWP) och består av aktiviteterna: montering av hyllor, sortering av post samt administrativ aktivitet. Utveckling av instrumentet med fler aktiviteter har efterfrågats i tidigare studier. Syftet med studien är att undersöka hur arbetsterapeuter beskriver att nuvarande aktiviteter i AWP-FK fungerar och kan utvecklas. Metoden e-Delphi användes och två webbaserade rundor utfördes. Studien bestod av elva arbetsterapeuter som använder AWP-FK i försäkringsmedicinska utredningar. Det kvalitativa materialet analyserades genom kvalitativ innehållsanalys och det kvantitativa materialet sammanställdes i en tabell. Resultatet visar att nuvarande aktiviteter i AWP-FK till viss del utformas olika i verksamheter. Experterna ger förslag på nya aktiviteter och utformning av aktiviteter. Mer likvärdiga bedömningar önskas i AWP-FK. Kommunikations- och interaktionsfärdigheter är svårbedömda i nuvarande aktiviteter och möjligheten till bedömning av motoriska färdigheter varierar mellan aktiviteterna. En mer omfattande studie bestående av fler arbetsterapeuter kan genomföras för att vidare undersöka om och hur experternas förslag på nya aktiviteter och utformning av aktiviteter kan användas för att utveckla AWP-FK. / AWP-FK is a specific application of the instrument Assessment of Work Performance (AWP) and consists of the following activities: assembly of shelves, sorting of mail, and administrative activity. A development of the instrument including more activities has been requested in previous studies. The aim of this study is to investigate how occupational therapists describe how the activities in AWP-FK work and can be developed. An e-Delphi method was used and two web-based rounds were conducted. The study subjects consisted of eleven occupational therapists that were using AWP-FK in insurance medical investigations. Qualitative material was analysed using qualitative content analysis and quantitative material was compiled in a table. The results show that the current activities in AWP-FK are to some extent arranged differently at different workplaces. Experts provide suggestions for new activities and how to construct activities. More equivalent assessments are desired in AWPFK. Communication and interaction skills are difficult to assess in current activities, and the ability to assess motor skills varies between activities. A more comprehensive study involving more occupational therapists could be conducted to further investigate whether and how the experts’ suggestions for new activities and the construction of activities could be used to develop AWP-FK.

Bakgrund: För att bättre kunna tillgodose behoven av stöd hos sjukskrivna personer, korta ner tiden som sjukskriven och minska antalet personer som får avslag på sjukpenning behövs mer forskning inom rehabiliteringsstöd och återgång till arbete.  Det är inte fullt utrett huruvida self-efficacy, socialt stöd och socioekonomi har effekt på hälsa och arbetsförmåga över tid för en person i slutet av sin sjukskrivning. Syfte: Syftet med studien var att undersöka om self-efficacy, socialt stöd och socioekonomi predicerar hälsa, välbefinnande och arbetsförmåga för personer som är i slutet av en sjukskrivningsperiod. Metod: Studien baserades på en kvantitativ longitudinell  studie. Datamaterialet användes som en kohortstudie med två mätpunkter där 193 respondenter ingick. De predicerande variablerna self-efficacy, socialt stöd och socioekonomi mättes vid baslinjen och utfallsvariablerna självskattad hälsa, psykiskt välbefinnande och arbetsförmåga mättes vid uppföljningen.  Datamaterialet analyserades med korrelationsanalyser och logistiska regressionsanalyser i  statistikprogrammet SPSS. Resultat: En högre self-efficacy predicerade en högre självskattad hälsa (justerad OR 3,05; 95 % CI 1,30 till 7,16), ett högre psykiskt välbefinnande (justerad OR 3,00; 95% CI 1,01 till 8,91) och en högre arbetsförmåga (justerad OR; 3,63; 95% CI 1,50 till 8,80). Emotionellt socialt stöd predicerade psykiskt välbefinnande (justerad OR; 4,76; 95% CI 1,12 till 20,22). Slutsats: En högre self-efficacy predicerade en högre självskattad hälsa, psykiskt välbefinnande och arbetsförmåga hos målgruppen och emotionellt socialt stöd predicerade ett högre psykiskt välbefinnande. För framtida forskning anses att interventionsstudier och effektutvärderingar vid återgång till arbete samt faktorer som påverkar self-efficacy vid sjukskrivning studeras. / Introduction: To increase the support for those on sick leave, shorten the time of sick leave and reduce the number of people who have been refused social insurance despite reduced work ability,  more research on support of rehabilitation and return to work is required. It is not fully explored whether self-efficacy, social support and socioeconomics have an effect on health and work ability, it is therefore appropriate to study the health factors of those who have been on sick leave for a long period of time. Aim: The aim of this study was to investigate whether self-efficacy, social support, and socioeconomics predict health, wellbeing, and work ability for people who are at the end of a period of sick leave. Method: The study were based on quantitative longitudinal study. The data material was used as a cohort with two measuring points (N = 193). The predictive variables self-efficacy, social support and socioeconomics as well as the outcome variables self-rated health, mental wellbeing and work ability was analyzed with correlation analysis and logistic regression analysis, in the statistical program SPSS. Result: Higher self-efficacy predicted higher self-rated health (adjusted OR 3,05; 95% CI 1,30 to 7,16), higher mental wellbeing (adjusted OR 3,00; 95% CI 1,01 to 8,91) and higher work ability (adjusted OR; 3,63; 95% CI 1,50 to 8,80). Emotional social support predicted higher mental wellbeing (adjusted OR; 4,76; 95% CI 1,12 to 20,22).    Conclusion: Higher self-efficacy predicted higher self-rated health, mental wellbeing and work ability in the target group, and emotional social support predicted higher mental wellbeing. For future research, intervention studies and effect evaluations of returning to work and factors that affect self-efficacy on sick leave need to be studied.