Call centres (CCs) are one of the most rapidly growing forms of workplaces in Sweden. The overall aim of this thesis was to describe work characteristics, physical and psychosocial exposures, and health related outcomes, for CC operators in selected CC in Sweden. The purpose was also to study the test-retest reliability and internal consistency of questions, and the inter-rater reliability of observations and measurements in studies of CCs. This thesis is based on two projects, where study I was a cohort study and studies II-V were a cross-sectional survey. Fifty-seven CC operators were compared with a reference group of 1459 professional computer users from other occupations, study I, and 1183 operators (848 women and 335 men) (response rate 77%) from 28 CCs were studied in studies II-V . Questionnaires covering organisation and work characteristics, physical and psychosocial exposures, individual characteristics and symptoms during the previous month was used, studies I-V. Structured observations in accordance with an ergonomic checklist were used to assess workstation design during the subject’s ordinary work, study I and II. Operators at external CCs spent longer time on customer calls and had less varied tasks. Additional remuneration, call logging and monitoring was more common at external CCs. There were deficiencies in workspace, keyboard- and input device placement. External CCs showed somewhat more problems in the work environment compared with the internal CCs. The CC group spent longer continuous time in front of the computer than other professional computer users. Emotional and cognitive demands and time pressure were reported considered high. Emotional demands and limited decision latitude were dominating features in CC work. A higher proportion of the CC group reported musculoskeletal symptoms compared to other professional computer users. Three out of four operators reported symptoms in the Neck/shoulder or Arm/hand region, with no major differences between internal and external CCs. Comfort of the work environment showed the strongest association with symptoms in the Neck/shoulder or Arm/hand, in both types of CCs. Other exposures associated with symptoms in the Neck/shoulder or Arm/hand in either type of CC were: low complexity of work, long total time of customer calls per day, continuous computer work without a break, high psychological demands, low decision latitude, lack of social support from colleagues and lack of support from a supervisor. The thesis confirms previously suggested associations between unfavourable work characteristics and management, as well as poor physical and psychosocial environment, and musculoskeletal symptoms in computer-interactive tasks. Among operators at internal CCs, symptoms were particularly related to the nature of calls during work, whereas at external CCs critical exposures were the time spent seated with continuous computer work. About half of the questions were classified as having fair to good or higher testretest reliability and can be recommended in further analyses. Other questions should be used with care. A majority of the variables on the ergonomic checklist are classified as having fair to good or higher inter-rater reliability.

När människan blir patient och kräver inneliggande vård påverkas hela livsvärlden vilket även inkluderar den omgivande miljön. Vårdmiljöns betydelse för återhämtning framkom redan under Florence Nightingales tid. Begreppet vårdmiljö innefattar olika dimensioner som fysisk, psykosocial samt estetiska miljöaspekter. Dessa dimensioner samspelar men kan också leda till konflikter. Hur denna vårdmiljö upplevs är en subjektiv upplevelse bland annat beroende på tidigare erfarenheter. Alla som på något sätt involveras i vårdmiljön påverkas av dess utformning och atmosfär. Syftet var att beskriva vårdmiljöns betydelse för återhämtning utifrån ett patientperspektiv. Metoden som användes för denna studie var en allmän litteraturöversikt, tio vårdvetenskapliga artiklar analyserades (9 kvalitativa och 1 kvantitativ). I resultatet framkom två huvudteman och sju subteman som belyser patienternas upplevelse av vårdmiljön och hur den kan vara både positiv och negativ för återhämtningsprocessen. Ljud och ljus kan upplevas både som en trygghet men också som ett irritationsmoment, och kan där med inverka både positivt och negativt på återhämtningen. Vidare framkommer att patienter försöker distrahera sig från vårdmiljön, bland annat genom att fly undan den på olika sätt. Vårdmiljön blir således en central men subjektiv upplevelse som innefattar flera dimensioner, vilket kan bidra till konflikter. En enskild aspekt av vårdmiljön kan för en del patienter upplevas som en trygghet, medan andra patienter upplever en känsla av otrygghet och kan således påverka återhämtningen olika. Vårdmiljöns utformning kan därför bli svår att anpassa enskilt utifrån patienter, närstående, vårdpersonal eller organisationens behov. / When a person becomes a patient and requires care, the entire life world is affected. The surrounding care environment also has an impact on the life world when a human becomes a patient. The importance of the care environment for recovery already emerged during Florence Nightingale's time. The concept of care environment includes various dimensions such as physical, psychosocial and aesthetic environmental aspects. These dimensions interact but can also lead to conflicts. How this care environment is perceived is a subjective experience depending, among other things, on previous experiences. Everyone who is somehow involved in the care environment is affected by its design and atmosphere. The aim was to describe the importance of the care environment for recovery from a patient perspective. The method used for this study was a general literature review, ten health science articles were analyzed (9 qualitative and 1 quantitative). The results revealed two main themes and seven sub-themes that highlight the patients' experience of the care environment and how it can be both positive and negative for the recovery process. Sound and light can be experienced both as a sense of security but also as an annoyance, and can therefore have both a positive and negative impact on recovery. Furthermore, it appears that patients try to distract themselves from the care environment, including by escaping in various ways. The care environment thus becomes a central but subjective experience that contains several dimensions, which can contribute to conflicts. For some patients, a single aspect of the care environment can be experienced as safe, while other patients experience a feeling of unsafe and can thus affect recovery differently. The design of the healthcare environment can be difficult to adapt individually based on the needs of patients, relatives, healthcare staff or the organisation.