Syftet med studien är att undersöka betydelsen faktorer kopplade till schemaläggning har för upplevelse av delaktighet och inflytande. De faktorer som undersökts är schemaläggningssystem, organisatoriska aspekter, samarbete, och flexibilitet. De teorier som används är Job demand-control model, Social exchange theory och Structural empowerment theory. Det är en kvalitativ intervjustudie med fem informanter som jobbar hel- eller deltid inom äldrevård eller funktionshinderomsorg i Umeå kommun. Informanterna har tre olika schemasystem med det gemensamma att samtliga informanter får ge önskemål på hur de vill att deras schema för kommande schemaperiod ska se ut. Resultatet visar att informanterna upplever olika grad av delaktighet och inflytande i sitt schemaläggningssystem. Centralt schemastöd är den funktion som minskar upplevelsen av delaktighet och inflytande för majoriteten av informanterna. Ökad utbildning, avsatt tid för schemaläggning, stöd för att öka samarbete på arbetsplatsen och kontakt med Centralt schemastöd är faktorer som sammanfattningsvis föreslås kan öka de anställdas delaktighet och inflytande i schemaläggning.

Syftet med studien var att undersöka samband mellan personlighetsdimensioner och upplevd stress på arbetsplatser utifrån fem-faktormodellen samt krav-kontrollmodellen. 128 deltagare deltog i enkätundersökningen; 58 män och 66 kvinnor mellan åldern 20-69 år. Studien var en tvärsnittsstudie med självskattningsfrågor och urvalet gjordes genom ett bekvämlighetsurval. Enkäterna besvarades på arbetsplatser i Örebro, Eskilstuna, Västerås och Stockholm. Tidigare forskning påvisar samband mellan personlighet och stress, men få undersöker detta utifrån krav-kontroll-stödmodellen. Föreliggande studie undersöker detta utifrån graden av krav och kontroll. T-test visade skillnader utifrån kön, envägs ANOVA visade skillnader i yrkestitel och ålder. Korrelationsanalyser visade positivt samband mellan krav och upplevd stress samt negativt samband mellan kontroll och upplevd stress. Resultatet visade positivt samband mellan agreeableness, openness, conscientiousness och krav samt positivt samband mellan openness och kontroll. / The purpose of the study was to examine correlations between personality traits and perceived stress at work places based upon the Five Factor model and demand-control model. 128 participants attended; 58 men and 66 women aged 20-69 years. The study was cross-sectional with self-report measures and convenience sampling. Surveys were answered at work places in Örebro, Eskilstuna, Västerås and Stockholm. Previous research show correlations between personality and stress, but few examine this through the demand-control-support model. Present study examine this through the demand-control model. T-test showed differences between gender, one-way ANOVA showed differences in occupation and age. There was a positive correlation between demand and perceived stress and a negative correlation between control and perceived stress. The results showed positive correlations between agreeableness, openness, conscientiousnness and demand, positive correlations between openness and control.

O modelo demanda e controle de Karasek, elaborado na década de 1970, postula que os trabalhadores expostos a situações de alta exigência no trabalho, decorrente da combinação entre altas demandas psicológicas e baixo controle sobre o processo de trabalho, tem maior risco de apresentar eventos em saúde relacionados ao estresse, em particular doenças cardiovasculares. Os objetivos desta tese incluíram: avaliar propriedades psicométricas do instrumento Demand-Control-Support Questionnaire (DCSQ) e conduzir uma meta-análise dos estudos publicados sobre a associação entre alta exigência no trabalho e hipertensão arterial. Três artigos foram elaborados. O primeiro artigo avaliou a validade dimensional e consistência interna da versão brasileira do instrumento DCSQ, quando aplicado a trabalhadores de um hospital e nove restaurantes no Rio de Janeiro. O segundo artigo comparou as propriedades psicométricas do DCSQ no contexto dos trabalhadores de hospital no Brasil e na Suécia. O terceiro artigo apresentou uma meta-análise dos estudos de associação entre alta exigência no trabalho e hipertensão arterial. Os resultados evidenciaram que o instrumento DCSQ tem estrutura tridimensional e equivalente nas versões brasileira e sueca (original), representada por demandas psicológicas, uso de habilidades e autonomia para a decisão. O modelo de melhor ajuste excluiu a dimensão apoio social no trabalho e o item trabalho repetitivo (uso de habilidades). A meta-análise revelou que os estudos foram heterogêneos, a população-alvo foi restrita a países da Europa, EUA e Japão, sem evidência de associação entre alta exigência no trabalho, demanda e controle, e hipertensão arterial. / Proposed in the 1970s, the demand control model stated that workers in high strain jobs, a combination of high levels of psychological demands and low levels of control, have an increased risk of stress-related outcomes, particularly cardiovascular diseases. The aim of this thesis is to evaluate the psychometric properties of the Demand-Control-Support Questionnaire (DCSQ) and to conduct a meta-analysis of published studies about the association of job strain and hypertension. Three articles were presented. The first article evaluated the dimensional validity and internal consistency of the Brazilian version of DCSQ, when applied to hospital and restaurant workers in Rio de Janeiro. The second article compared the psychometric properties of the Swedish and Brazilian versions of DCSQ, when applied to hospital workers. The third article presented a meta-analysis of the association studies of job strain and hypertension. The results evidenced a three-factor structure of the DCSQ, which was equivalent in the Brazilian and Swedish versions and closely related to psychological demands, skill discretion and decision authority dimensions. The best fit model was achieved by excluding the social support at work dimension and the item repetitive work (skill discretion). The meta-analysis revealed no association between high strain, and related dimensions, and hypertension in samples restricted to European countries, USA and Japan, in which heterogeneity between studies was evidenced.

O modelo demanda e controle de Karasek, elaborado na década de 1970, postula que os trabalhadores expostos a situações de alta exigência no trabalho, decorrente da combinação entre altas demandas psicológicas e baixo controle sobre o processo de trabalho, tem maior risco de apresentar eventos em saúde relacionados ao estresse, em particular doenças cardiovasculares. Os objetivos desta tese incluíram: avaliar propriedades psicométricas do instrumento Demand-Control-Support Questionnaire (DCSQ) e conduzir uma meta-análise dos estudos publicados sobre a associação entre alta exigência no trabalho e hipertensão arterial. Três artigos foram elaborados. O primeiro artigo avaliou a validade dimensional e consistência interna da versão brasileira do instrumento DCSQ, quando aplicado a trabalhadores de um hospital e nove restaurantes no Rio de Janeiro. O segundo artigo comparou as propriedades psicométricas do DCSQ no contexto dos trabalhadores de hospital no Brasil e na Suécia. O terceiro artigo apresentou uma meta-análise dos estudos de associação entre alta exigência no trabalho e hipertensão arterial. Os resultados evidenciaram que o instrumento DCSQ tem estrutura tridimensional e equivalente nas versões brasileira e sueca (original), representada por demandas psicológicas, uso de habilidades e autonomia para a decisão. O modelo de melhor ajuste excluiu a dimensão apoio social no trabalho e o item trabalho repetitivo (uso de habilidades). A meta-análise revelou que os estudos foram heterogêneos, a população-alvo foi restrita a países da Europa, EUA e Japão, sem evidência de associação entre alta exigência no trabalho, demanda e controle, e hipertensão arterial. / Proposed in the 1970s, the demand control model stated that workers in high strain jobs, a combination of high levels of psychological demands and low levels of control, have an increased risk of stress-related outcomes, particularly cardiovascular diseases. The aim of this thesis is to evaluate the psychometric properties of the Demand-Control-Support Questionnaire (DCSQ) and to conduct a meta-analysis of published studies about the association of job strain and hypertension. Three articles were presented. The first article evaluated the dimensional validity and internal consistency of the Brazilian version of DCSQ, when applied to hospital and restaurant workers in Rio de Janeiro. The second article compared the psychometric properties of the Swedish and Brazilian versions of DCSQ, when applied to hospital workers. The third article presented a meta-analysis of the association studies of job strain and hypertension. The results evidenced a three-factor structure of the DCSQ, which was equivalent in the Brazilian and Swedish versions and closely related to psychological demands, skill discretion and decision authority dimensions. The best fit model was achieved by excluding the social support at work dimension and the item repetitive work (skill discretion). The meta-analysis revealed no association between high strain, and related dimensions, and hypertension in samples restricted to European countries, USA and Japan, in which heterogeneity between studies was evidenced.

Teachers’ work-related health has worsened in Sweden, seen in the rising number of teachers who are stressed, unmotivated and that have left work or are on sick leave (The Swedish National Agency for Education, 2013; Månsson, 2008). The thesis’s aim was to explore the relation between health, personal coping and job stress. As proposed by Antonovsky (1979; 1987), sense of coherence (SOC) was used as an important individual approach for Salutogenesis; health maintenance. Health was measured as self-reported health and job stress according to the demand-control model (DCM) by Karasek (1979). Data came from the Teacher survey, a questionnaire part of a larger research project based at the Centre for Health and Equity Studies, Stockholm University/Karolinska Institutet, focused on school environment and health for pupils and teachers. The analytical sample consisted of teachers teaching 7-9th grade (n=1092), from both private and public schools. Results indicate an association for SOC and DCM independently with self-rated health, as well as a strong role for SOC in decreasing the odds of having less than good health due to psychosocial working conditions, especially for teachers who perceive their jobs as highly demanding.

Syftet med denna studie var att få en inblick i arbetsmiljön för socialsekreterare på socialtjänstens enhet för barn- och ungdom inom Stockholms län. Vi ville även ta reda på vilka arbetsmiljöaspekter de tycker är viktiga för det dagliga arbetet. Tidigare forskning visar att viktiga aspekter vid tankar om att lämna sitt arbete är huruvida arbetstagaren upplever uppskattning, omhändertagande och intresse för hälsa och välmående från arbetsledningen. Studien är genomförd utifrån en kvalitativ ansats och sju semistrukturerade intervjuer med socialsekreterare inom barn- och ungdom har utförs. Resultatet visade att socialsekreterare skiljer mellan den fysiska och den psykiska arbetsmiljön samt att den psykiska arbetsmiljön väger tyngre gällande frågan om att vilja lämna sin arbetsplats. Vidare visade sig arbetsmiljön vara ett komplex ämne som ofta diskuteras på informanternas arbetsplatser samtidigt som ingen av våra informanter hade hört om de nya föreskrifterna från Arbetsmiljöverket. Då de nya föreskrifterna trädde i kraft i samband med att denna uppsats skrevs hoppas vi ändå att de ska kunna föra med sig en bra grund i arbetet för en bättre arbetsmiljö. Slutligen kan det finnas en poäng i att rikta de allmänna råden även till arbetstagarna och inte endast till arbetsgivaren, för att på så sätt engagera arbetstagarna ytterligare i frågan. / The aim of this study was to getting an insight of the work enviorment for the social workers at the social service department for child and youth welfare in Stockholm. We also wanted to get an insight into what kind of work enviorment factors they consider as important in their daily work. Previous research shows that whether or not the employee decides to stay in their place of work largely depends whether or not they experience appreciation, care-taking and involvement from the human resources managment. This study is made with a qualitative approach and seven semi-structured interviews with social workers working with child and youth welfare have been conducted. The results show that social workers differed in how they perceived the physical and psychological work environment and that the psychological aspect was more important for those social workers who wished to leave the workplace. Furthermore, the results showed that the work environment was a subject widely discussed among the social workers, while the new regulations from the Swedish work environment agency remained unknown to them. We hope that the new regulations will provide a good foundation and better conditions for the social workers and their work environment. In conclusion, we think that the general recommendations in these regulations ought to be directed not only to the employers but to the employees as well, thus achieving a greater involvement from the employees in questions concerning their work environment.

Introdução - O ambiente psicossocial do trabalho em enfermagem influencia diretamente a qualidade de vida dos trabalhadores desta área. Diferenças entre as categorias profissionais nesta profissão podem se traduzir em diferenças na percepção de saúde e de condições de trabalho. Objetivo - Avaliar as associações entre condições de trabalho e qualidade de vida relacionada à saúde (QVRS) de enfermeiros, técnicos e auxiliares de enfermagem. Métodos Foram coletados dados em um hospital universitário no município de São Paulo, de uma população de 696 enfermeiros, técnicos e auxiliares de enfermagem, população predominantemente feminina (87,8%) e que trabalhava em turnos diurno e noturno. Os dados coletados a partir de questionário correspondiam a informações sobre aspectos sóciodemográficos, condições de trabalho e de vida, hábitos de vida e sintomas de saúde referidos desta população. Foram também utilizados os questionários: Questionário Genérico de Avaliação de Qualidade de Vida (SF-36), Escala de Estresse no Trabalho e Desequilíbrio Esforço-Recompensa (ERI). Foram ajustados modelos de regressão logística ordinal de chances proporcionais para cada dimensão do SF-36. Resultados Aproximadamente 22% da população foi classificada como trabalhando em condições de alto desgaste e 8% em desequilíbrio desfavorável entre esforços e recompensa no trabalho. Vitalidade, dor e saúde mental foram as dimensões do SF-36 com pior avaliação. Os modelos de regressão múltipla 5 demonstraram: alto comprometimento associado a todas as dimensões do SF-36, e ERI desfavorável associado a todas as dimensões relacionadas à saúde mental. Alto desgaste no trabalho, ERI desfavorável, alto comprometimento e ser enfermeira associaram-se de maneira independente aos resultados desfavoráveis da dimensão de aspectos emocionais. Conclusões As dimensões relacionadas à saúde mental foram as que mais sofreram influência dos fatores psicossociais do trabalho. ERI desfavorável e alto comprometimento mostraram-se mais significativos à saúde desta população comparados com altas demandas e baixo controle. Os resultados indicam que a análise conjunta dos modelos de desequilíbrio esforço-recompensa e demandacontrole contribui para a discussão sobre os papéis profissionais, condições de trabalho e QVRS de profissionais de enfermagem. / Introduction- The psychosocial work environment influences the quality of life of nursing professionals. Differences among job titles may lead to distinct perceptions of working conditions and health status. Aim-To evaluate working and living conditions and quality of life associated with health (HRQL) among nursing professionals. Methods- Six hundred ninety six nursing professionals, registered nurses and nurse assistants, predominantly females (87.8%), working day or night shifts, participated in a study carried out in an university hospital of São Paulo, Brazil. Data collection took place during 2004-2005 and included a comprehensive questionnaire including sociodemographic characteristics, life styles, working and living conditions, and health outcomes. HRQL was evaluated using the short form questionnaire of quality of life (SF-36). Working conditions included the job stress scale, effort-reward imbalance (ERI), and other environmental and occupational stressors. Ordinal logistic regression of proportional ratios was used to evaluate each of SF-36 dimensions. Results- Imbalance of the effort-reward ratio and high work strain were mentioned by 7.8% and 22.1% of the participants, respectively. Vitality, pain and (poor) mental health were the SF-36 worse perceived outcomes. The multiple regression models showed: over commitment associated with all SF-36 dimensions, and unfavorable ERI associated with mental health dimensions. High 7 job strain, unfavorable ERI, over commitment, and being a registered nurse were independently associated with negative emotional outcomes. Conclusions- The dimensions associated with mental health were significantly influenced by psychosocial factors at work. Unfavorable ERI and over commitment were more significantly associated with health compared to high demands and low control. These results show the importance to jointly evaluate ERI and demand- control models to discuss professional roles, working conditions and HRQL of nursing professionals.

Introdução - O ambiente psicossocial do trabalho em enfermagem influencia diretamente a qualidade de vida dos trabalhadores desta área. Diferenças entre as categorias profissionais nesta profissão podem se traduzir em diferenças na percepção de saúde e de condições de trabalho. Objetivo - Avaliar as associações entre condições de trabalho e qualidade de vida relacionada à saúde (QVRS) de enfermeiros, técnicos e auxiliares de enfermagem. Métodos Foram coletados dados em um hospital universitário no município de São Paulo, de uma população de 696 enfermeiros, técnicos e auxiliares de enfermagem, população predominantemente feminina (87,8%) e que trabalhava em turnos diurno e noturno. Os dados coletados a partir de questionário correspondiam a informações sobre aspectos sóciodemográficos, condições de trabalho e de vida, hábitos de vida e sintomas de saúde referidos desta população. Foram também utilizados os questionários: Questionário Genérico de Avaliação de Qualidade de Vida (SF-36), Escala de Estresse no Trabalho e Desequilíbrio Esforço-Recompensa (ERI). Foram ajustados modelos de regressão logística ordinal de chances proporcionais para cada dimensão do SF-36. Resultados Aproximadamente 22% da população foi classificada como trabalhando em condições de alto desgaste e 8% em desequilíbrio desfavorável entre esforços e recompensa no trabalho. Vitalidade, dor e saúde mental foram as dimensões do SF-36 com pior avaliação. Os modelos de regressão múltipla 5 demonstraram: alto comprometimento associado a todas as dimensões do SF-36, e ERI desfavorável associado a todas as dimensões relacionadas à saúde mental. Alto desgaste no trabalho, ERI desfavorável, alto comprometimento e ser enfermeira associaram-se de maneira independente aos resultados desfavoráveis da dimensão de aspectos emocionais. Conclusões As dimensões relacionadas à saúde mental foram as que mais sofreram influência dos fatores psicossociais do trabalho. ERI desfavorável e alto comprometimento mostraram-se mais significativos à saúde desta população comparados com altas demandas e baixo controle. Os resultados indicam que a análise conjunta dos modelos de desequilíbrio esforço-recompensa e demandacontrole contribui para a discussão sobre os papéis profissionais, condições de trabalho e QVRS de profissionais de enfermagem. / Introduction- The psychosocial work environment influences the quality of life of nursing professionals. Differences among job titles may lead to distinct perceptions of working conditions and health status. Aim-To evaluate working and living conditions and quality of life associated with health (HRQL) among nursing professionals. Methods- Six hundred ninety six nursing professionals, registered nurses and nurse assistants, predominantly females (87.8%), working day or night shifts, participated in a study carried out in an university hospital of São Paulo, Brazil. Data collection took place during 2004-2005 and included a comprehensive questionnaire including sociodemographic characteristics, life styles, working and living conditions, and health outcomes. HRQL was evaluated using the short form questionnaire of quality of life (SF-36). Working conditions included the job stress scale, effort-reward imbalance (ERI), and other environmental and occupational stressors. Ordinal logistic regression of proportional ratios was used to evaluate each of SF-36 dimensions. Results- Imbalance of the effort-reward ratio and high work strain were mentioned by 7.8% and 22.1% of the participants, respectively. Vitality, pain and (poor) mental health were the SF-36 worse perceived outcomes. The multiple regression models showed: over commitment associated with all SF-36 dimensions, and unfavorable ERI associated with mental health dimensions. High 7 job strain, unfavorable ERI, over commitment, and being a registered nurse were independently associated with negative emotional outcomes. Conclusions- The dimensions associated with mental health were significantly influenced by psychosocial factors at work. Unfavorable ERI and over commitment were more significantly associated with health compared to high demands and low control. These results show the importance to jointly evaluate ERI and demand- control models to discuss professional roles, working conditions and HRQL of nursing professionals.

Psykisk ohälsa, dit utmattningssyndrom hör, är en av de vanligast förekommande orsakerna till längre sjukskrivningar i Sverige. Detta är särskilt vanligt i människonära yrken, såsom vård och omsorg. Detta är väl utforskat, men vad som är mindre väl utforskat är de organisatoriska faktorer som bidrar till förekomsten av utmattningssyndrom. I en tolkande fenomenologisk analys av fem personers upplevelse av utmattningssyndrom framkom att tung arbetsbörda; bristande ledarskap; brister i det sociala stödet och brist på återhämtning lyftes fram som faktorer som påverkat att de hade drabbats av utmattningssyndrom. Särskilt bristen av återhämtning lyftes fram som viktig. Detta hängde ofta samman med nya typer av scheman, bland annat så kallade hälsoscheman (scheman framtagna i linje med rådande forskning kring bra skiftscheman, ofta med fokus på att korta nattarbetarnas arbetspass från tio till åtta timmar). Intressanta studieområden för framtiden borde således vara återhämtningens roll i förhindrandet av eller uppkomsten av utmattningssyndrom samt att närmare studera vad införandet av dessa hälsoscheman betyder. / Mental health issues, among them burnout syndrome, are one of the common causes behind longer sick leave absences in Sweden. They’re especially common in sectors working closely with people, such as healthcare. This area is well explored, but what is less researched is the organisational factors that contribute to the occurrence of burnout syndrome. In an interpretative phenomenological analysis of five persons’ experience of burnout, it was found that heavy workload, deficient leadership, a lack of social support and a lack of recuperation was seen as factors that impacted on persons with  burn out syndrome. Especially lack of recuperation was pointed out as significant. It was often seen linked to new types of work schedules, particularly what is known as health schedules (schedules developed according to research about what constitutes a good shift schedule, often focusing on shortening night-workers’ shifts from ten to eight hours). Interesting areas for future research should therefore be the role of recuperation as prevention of or cause of burnout, as well studies about the implementation of these health schedules.