<p>The main aim of this thesis has been to compare psychosocial working conditions in workplaces with different forms of ownership, i.e. public, private and cooperative. A second aim has been to study how organisational characteristics of relevance for psychosocial working conditions (in terms of management control strategies and prerequisites for management) are manifested in these ownership forms. The empirical data is based on structured interviews with managers at 60 workplaces within the service sector and on a questionnaire to all employees working in the participating workplaces, resulting in a set of 1384 individuals. An additional seven interviews with first-line managers within geriatric care were also conducted for the last study. The results show that employees in cooperatives perceived that they had better opportunities to influence decisions concerning the workplace as a whole, although there were also results showing advantages for public and private employees. Regarding opportunities for employees to influence their own work situation, there were no differences between the ownership forms. Differences were found in the prerequisites for first-line geriatric care managers. As a result of an earlier organisational change, the public managers were now further away from the strategic level and had to focus on daily, operative work tasks, while simultaneously also being responsible for keeping within the budget. The private managers, on the other hand, having group leaders to deal with the daily work concerning personnel and operations, could focus more on strategic work related to financial results in terms of planning and follow-up of the budget. One conclusion is that there are certain differences in both psychosocial working conditions and organisational characteristics between the ownership forms, but when the comparisons were restricted to only one type of service, in this case the provision of care, it is rather the similarities within the care organisations, regardless of ownership form, that are most pronounced.</p>

The main aim of this thesis has been to compare psychosocial working conditions in workplaces with different forms of ownership, i.e. public, private and cooperative. A second aim has been to study how organisational characteristics of relevance for psychosocial working conditions (in terms of management control strategies and prerequisites for management) are manifested in these ownership forms. The empirical data is based on structured interviews with managers at 60 workplaces within the service sector and on a questionnaire to all employees working in the participating workplaces, resulting in a set of 1384 individuals. An additional seven interviews with first-line managers within geriatric care were also conducted for the last study. The results show that employees in cooperatives perceived that they had better opportunities to influence decisions concerning the workplace as a whole, although there were also results showing advantages for public and private employees. Regarding opportunities for employees to influence their own work situation, there were no differences between the ownership forms. Differences were found in the prerequisites for first-line geriatric care managers. As a result of an earlier organisational change, the public managers were now further away from the strategic level and had to focus on daily, operative work tasks, while simultaneously also being responsible for keeping within the budget. The private managers, on the other hand, having group leaders to deal with the daily work concerning personnel and operations, could focus more on strategic work related to financial results in terms of planning and follow-up of the budget. One conclusion is that there are certain differences in both psychosocial working conditions and organisational characteristics between the ownership forms, but when the comparisons were restricted to only one type of service, in this case the provision of care, it is rather the similarities within the care organisations, regardless of ownership form, that are most pronounced.

The importance of organizations for understanding differences in the working conditions and health of employees is often emphasized but rarely explored empirically. The general aim of this thesis is to describe organizational characteristics of workplaces, and to assess their impact on the psychosocial working conditions and health of employees. In modern working life, it is assumed that employees' working conditions and health are affected by a general transformation of workplaces from bureaucracy to post-bureaucracy.  The organizational data used are based on structured interviews with managers at workplaces in different types of operations in mid-Sweden, whereas the individual data consist of a questionnaire to all employees working in the participating workplaces, resulting in a dataset of 90 workplaces and 4306 individuals. Descriptive analysis was carried out for comparison of organizational characteristics in different types of operations, while multilevel analysis was applied to investigate the magnitude of the organizational impact on psychosocial working conditions, and to analyze associations between organizational characteristics, psychosocial working conditions and health. The results showed that the workplaces were mainly displayed by a combination of bureaucratic and post-bureaucratic characteristics, and these were unequally distributed between types of operations. A systematic variation in the psychosocial working conditions and health of employees was found between workplaces, and the variation in psychosocial working conditions was attributed to several organizational levels. The variation between workplaces was explained by both organizational characteristics of the workplaces and individual characteristics of the employees. Formalization, centralization, job enrichment, individual responsibility, soft control systems, and performance control were associated with psychosocial working conditions when controlled for occupational class, gender and age of employees, and a high degree of customer adaptation was associated with increased sickness absence of employees.   It is concluded that bureaucracy and post-bureaucracy should not be regarded as dichotomies. Organizational characteristics of workplaces have an impact on the psychosocial working conditions and health of employees beyond occupational class. This has implications for both the theory and the practice of occupational health research. / The Healthy Workplace Study

Arbetsplatsen har kommit att bli en viktigt arena där hälsan och förutsättningarna för hälsan kan påverkas. De senaste åren har det skett en positiv utveckling gällande den fysiska arbetsmiljön men inte gällande den psykosociala arbetsmiljön där speciellt anställda inom hälso- och sjukvården upplever en allt mer pressad arbetssituation. Litteraturgenomgången kring psykosociala arbetsförhållanden visar att det finns lite forskning gjord kring positiva aspekter av socialt stöd och hälsa. Detta ses som ett problem då det i arbetsmiljön ligger en avsevärd potential i främjandet av hälsa och att fokus bör förflyttas från det patogena till det salutogena synsättet. Syftet var att ur ett salutogent perspektiv se det sociala stödets betydelse på arbetsplatser inom privat hälso- och sjukvård samt undersöka medarbetarnas självuppskattade hälsa och upplevelser av arbetsplatsen och arbetssituationen. Metoden var en kvantitativ tvärsnittsstudie. En strukturerad webenkät användes för att samla in data. Totalt deltog 91 medarbetare inom närsjukvården på ett privat hälso- och sjukvårdsföretag, vilket innebar en svarsfrekvens på 43 %. Resultaten visar ett direkt positivt samband mellan socialt stöd och olika arbetsrelaterade faktorer samt hälsa. Socialt stöd medierar även effekterna av kontroll på nivån av den självuppskattade hälsan. Dock fanns det inget underlag för att socialt stöd har en större betydelse än andra arbetsrelaterade faktorer i relation till hälsa. Konklusionerna var att ett gott emotionellt klimat bidrar till gynnsamma hälsoeffekter. Ett viktigt perspektiv i det hälsofrämjande arbetet är att skapa och främja goda relationer på arbetsplatsen. Exempelvis är formella samtalsgrupper effektiva vid främjandet av goda relationer, samt bidragande till minskningen av stressupplevelser vilket även fångar in den preventiva tillämpningen. Hälsa berör flera aspekter och bör ses så holistiskt som möjligt. / The workplace has become an important arena where health- and the prospects of health can be affected. In recent years there have been positive developments regarding the physical work environment but not concerning the psychosocial development environment where employees especially in the health care system is experiencing an increasingly tight labor situation. The literature review on psychosocial working conditions show that there is little research done on the positive aspects of social support and health. This is seen as a problem when the work environment is a considerable potential in the promotion of health, and that the focus should move from the pathogenic to the salutogenic approach. The aim of this thesis was from a salutogenic perspective to study the importance of social support at workplaces in the private healthcare, and examine employees' self-estimated health and perceptions of the workplace and working conditions. The Method was a quantitative cross-sectional study. A structured web-based survey was used to collect data. A total of 91 employees of the local health services in a private healthcare company participated, representing a response rate of 43%. The Results showed a direct positive relationship between social support and various work-related factors and health. Social support also mediates the effects of control on the level of self-estimated health. However, there was no basis for social support as a greater factor than other work-related factors in relation to health. The Conclusions were that a good emotional climate contributes to beneficial health effects. An important perspective in health promotion is to create and foster good relationships in the workplace. For instance are formal discussion groups effective in the promotion of good relations, as well as contributing to the reduction of stress experiences, which also captures the preventive view. Health concerns several aspects and should be seen as holistic as possible.

Det har skett stora förändringar på arbetsmarknaden, där visstidsanställning/ behovsanställning blivit alltmer vanligare anställningsformen i Sverige. Individer som inte har fast anställning har även sämre psykosociala arbetsförhållanden och upplever större stress på arbetsplatsen, vilket i sin tur kan leda till mental ohälsa. Även kvinnor upplever sig ha sämre psykosociala arbetsförhållanden jämfört med män. I denna studie undersöks sambandet mellan psykosociala arbetsförhållanden, arbetsbelastning, anställningsform samt kön och mental ohälsa. De psykosociala förhållanden mäts genom den så kallade krav- och kontrollmodell som omfattar vilken typ av arbete individen utför. Resultatet uppvisade positiva samband mellan både psyksociala arbetsförhållanden, alltför många arbetsuppgifter, visstidsanställning, kvinna och mental ohälsa då mental ohälsa var större hos de individer som upplever sig ha höga krav och låg kontroll i arbetet (spänt arbete) än hos individer med låga krav och hög kontroll på arbetsplatsen. Även alldeles för stor arbetsbelastning hade en stor betydelse när det gäller mental ohälsa. Detta gäller även anställningsform då resultatet visade att visstidsanställda var i högre utsträckning utsatta av mental ohälsa än de som har fast anställning. Emellertid vad gäller kön så resultatet uppvisade att kvinnor drabbas i högre utsträckning av mental ohälsa jämfört med män däremot kan detta inte kopplas till krav och kontroll på arbetsplatsen. Studien avslutas med diskussion kring de resultat som har erhållits från regressioner. / There have been major changes in labor markets, where temporary employments have become increasingly more common form of employment in Sweden. Individuals who do not have a permanent job have also worse psychosocial working conditions and experience greater stress in the workplace, which in turn can lead to mental ill health. Although women perceive themselves as having poorer psychosocial working conditions compared to males. The present study examines the relationship between psychosocial working conditions, workload, employment status, sex and mental ill health. The psychosocial working condition measured by the so called demands and latitudes model that includes the type of working the individual performs. The result showed a positive correlation between psychosocial working conditions, too many tasks, temporary employment, women and mental ill health where mental ill health was grater in those individuals who have high demands and low control at work than those with low demands and high control in the workplace. Also heavy workload had a major role in the mental ill health. This also applies to employment status when the results showed that temporary workers were more often affected of mental ill health than those with permanent employment. However, in terms of gender, the results showed that women are affected more often of mental ill health compared to men; however, this cannot be linked to demand and control in the workplace. The study concludes with discussion of the results obtained from the regressions.

Cognitive functioning is important for managing work and life in general. However, subjective cognitive complaints (SCC), involving self-perceived difficulties with concentration, memory, decision making, and clear thinking are common in the general and in the working population and can be coupled with both lowered well-being and work ability. The present thesis investigated the extent to which SCC among people in the work force can be explained by objective cognitive functioning (study I &amp; II) and working conditions (study III), utilizing samples from the working population. The potential roles of other common psychological problems which often co-occur with SCC were also investigated in studies I-III. In Study I, high levels of SCC were associated with significantly poorer episodic memory performance during high executive demands and a trend was found towards poorer episodic memory, while not being associated with semantic memory. In Study II, high levels of SCC were associated with significantly poorer executive cognitive performance on all three executive cognitive tests used. Symptoms of depression, chronic stress and sleeping problems were found to play an important role in the relations between SCC and episodic memory during divided attention in study I and executive cognitive functioning in study II. In Study III, in all cross-sectional data analyses, high quantitative demands, information and communication technology (ICT) demands, underqualification in the work situation and inter-personal conflicts were positively associated with SCC, whereas social support, good resources at work and overqualification in the work situation were negatively associated with SCC. In all prospective data analyses, quantitative job demands, ICT demands and underqualification were positively associated with future SCC, including when adjusted for baseline cognitive complaints. The findings may guide prevention of and interventions for SCC among people in the work force. / <p>At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 1: Submitted. Paper 2: Accepted.</p>

Aims: To analyze the association between psychosocial working conditions and burnout and its core component emotional exhaustion, a systematic literature review was undertaken including cohort studies, case–control studies, and randomized controlled trials. Methods: The literature search in Medline and PsycInfo was based on a defined search string and strict exclusion and inclusion criteria. Evaluation of the 5,599 initially identified search hits by two independent reviewers and a detailed quality assessment resulted in six methodologically adequate cohort studies considering the relationship between psychosocial working conditions and burnout (one study) as well as the burnout core component emotional exhaustion (five studies). Results: The results of our systematic review point to a relationship between psychosocial working conditions and the development of emotional exhaustion/burnout. Particularly high job demands seem to play a role in the development of emotional exhaustion. However, strong intercorrelations between workplace factors, as a matter of principle, make the identification of a single psychosocial workplace factor (being associated with an especially high or low risk of burnout) difficult. Conclusions: Multidimensional approaches including reduction of work demands, enhancement of decision latitude and improving the social climate might be promising for preventing burnout and emotional exhaustion. However, methodologically adequate intervention studies are urgently needed to prove the effectiveness of workplace interventions.

Studiens syfte är att undersöka vad andra vårdande legitimerade sjukvårdsprofessioner har för synsätt på kuratorers psykosociala arbetsmiljö inom akutvården i Västerbotten. I magisteruppsatsen har sex semistrukturerade digitala intervjuer genomförts med ett fenomenologiskt tillvägagångssätt. De professioner som intervjuats är: arbetsterapeut, dietist, fysioterapeut, logoped, läkare och sjuksköterska. Resultatet av studien visar att rollen som hälso- och sjukvårdskurator är diffus men har en avlastande funktion för andra professioner. Kuratorerna i sjukvården är oersättliga i vissa arbetsmoment som andra professioner inte behärskar, men i andra arbetsmoment är kuratorn utbytbar och reviret därmed oklart. Resultatet visar även att legitimationen är efterlängtad av andra professioner och stärker patientsäkerheten. Det som är viktigt i den psykosociala arbetsmiljön är samarbete, känslan av delaktighet och teamets sammanhållning. Andra professioners förväntningar och synsätt påverkar kuratorns psykosociala arbetsmiljö. Slutsatserna är att mer forskning behövs om den nya legitimerade yrkesgruppen hälso- och sjukvårdskuratorers psykosociala arbetsmiljö, roll och funktion i den moderna sjukvården. Det finns kunskapsluckor och behov av att uppdatera och tydliggöra kuratorns rollbeskrivning. / The purpose of the master thesis is to investigate other healthcare professionals' views on medical healthcare counselors (social workers) in an emergency care setting in Västerbotten, Sweden. In order to try and answer the purpose of the study six semi structured digital interviews were conducted. The included medical professions in our study were: Vocational therapist, physiotherapist, speech-language pathologist, dietitian, physician/doctor and nurse. The result of the study shows that the role as a social worker in a medical setting is difficult to define but is helpful for the other professional team-members. The healthcare counselors are irreplaceable in certain aspects, but some tasks are easily replaceable by others which makes the territory difficult to define. The results also show that the certification is long-awaited by other professions and strengthens patient's safety. What is important in the medical social work environment is cooperation, the feeling of participation and team cohesion. The expectations and views of other professions affect the healthcare counselors' psychosocial working conditions. The conclusions are that more research is needed on the psychosocial environment, role and function of the new licensed group of medical social workers in modern healthcare. There are knowledge gaps and a need to update and clearly define the role description.

Organisationer behöver kvalificerad personal för att fungera effektivt och därmed blir rekrytering en viktig aktivitet. Det är också angeläget att ny personal anpassar sig väl till arbetsförhållandena. Syftet med denna avhandling var att tydliggöra möjligheterna att genom urval bidra till en långsiktigt hållbar rekrytering för organisation, individ och samhälle. Avhandlingen omfattar tre delstudier och baseras på data från rekrytering av nya poliser i Sverige. En kohort har följts från urvalet av de sökande till polisutbildningen våren 2008 (N = 1 344) över tre uppföljningstillfällen (N = 717–729), nämligen vid slutet av två års polisutbildning, vid slutet av sex månaders aspirantutbildning och vid slutet av det första anställningsåret. Studie I syftade till att undersöka möjligheterna att välja ut de sökande som är mest lämpade att bli poliser genom att kombinera information från flera urvalsmetoder. Vanligtvis används intervjuer för att i slutet av urvalsprocessen välja ut de mest lämpade kandidaterna. Analyser med flera kriterier på framgångsrik rekrytering (prestation, tillfredsställelse med utbildning respektive arbete, vilja att stanna i yrket och hälsa) vid de tre uppföljningstillfällen, visade att ett alternativt förfarande – att kombinera information från urvalsmetoder som i tidigare steg använts för att sålla bort olämpliga sökande – hade högre prognosförmåga. Det handlade om information från begåvningstest, personlighetstest och konditionstest. Ett sådant förfarande kan också vara mer tillförlitligt och resurseffektivt. Vid urval av poliser bör intervjuer däremot främst ses som ett verktyg för att sålla bort olämpliga kandidater. Studie II syftade till att öka förståelsen för hur resultat från begåvningstest ska tolkas och användas vid urval. För de flesta yrken, inklusive polisyrket, har begåvningstest visats vara en av de urvalsmetoder som bäst predicerar prestation. Det har förklarats med effekter av generell begåvning. Resultaten från Studie II visade dock att utöver generell begåvning kan också en verbal och kunskapsladdad komponent antas viktig för att predicera prestation. Samtidigt gav studien stöd för att vid urval använda en samlad totalpoäng från begåvningstest. Studie III syftade till att undersöka den relativa betydelsen av urvalsfaktorer som personlighet och begåvning respektive den psykosociala arbetsmiljön för nya polisers arbetsrelaterade attityder och hälsa efter det första anställningsåret. Studien visade att arbetsmiljöfaktorer, såsom möjligheter till utveckling och återkoppling i arbetet samt rimlig arbets­belastning, var betydligt viktigare än urvalsfaktorer för nya polisers anpassning till arbetsförhållandena i yrket. Sammanfattningsvis visar föreliggande avhandling att det är meningsfullt att över tid beakta flera kriterier på framgångsrik rekrytering. Den visar också att information från flera urvalsmetoder bör kombineras för att välja ut de mest lämpade kandidaterna. Vidare visar avhandlingen på värdet av att använda verbalt laddade begåvningstest vid urval. Förmågan att predicera framgång i polisyrket med olika urvalsmetoder är dock måttlig. Avhandlingen visar däremot att arbetsförhållandena för ny personal kan ha avgörande betydelse. Det betyder att organisationer som strävar efter hållbar rekrytering bör prioritera både urval och sunda arbetsförhållanden för ny personal. Det gäller inte minst polisorganisationer där kostnaderna för rekrytering är höga. / Organizations need qualified personnel to work effectively. Accordingly recruitment is an important organizational activity. Moreover, to attain sustainability for organizations, individuals, and the society, it is assumed important that new personnel adjust well to their working conditions. The aim of this thesis was to investigate the role of selection for long-term sustainable recruitment. The thesis includes three studies based on data from the recruitment of new police officers in Sweden. A cohort of new police officers was followed from the end of the admittance process to the basic police training program in spring 2008 (N = 1,344) and then at three consecutive follow-ups (N = 717-729), 1) at the end of two years of academy training, 2) at the end of six months of field training, and 3) at the end of the first working year. Study I aimed to further the understanding of how to select suitable police applicants by using combinations of common selection methods. Analyses of several criteria (performance, satisfaction, occupational retention, and health) at the three follow-ups suggest that combining information from cognitive, personality, and physical fitness tests, that in earlier hurdles have been used to screen out unsuitable applicants, would be useful in identifying the most suitable candidates, while interviews may primarily be considered as a tool for screening out any unsuitable ones. Study II focused on how to interpret and make use of results from cognitive tests in applied settings such as selection. In most occupations, including the police, cognitive tests are among the most valid predictors of performance. This has been explained by the influence of general intelligence. However, the results from Study II showed that beyond general intelligence, a verbal and knowledge loaded component can be important in predicting performance. Also, the study supported the use of total scores in selection. Study III aimed to examine the relative importance of selection factors (e.g., personality and general intelligence) and psychosocial working conditions for new police officers’ work-related attitudes and health. The study showed that psychosocial working conditions, such as opportunities for development and feedback as well as a balanced workload, were far more important than selection factors for the new police officers’ adjustment to their occupation. Taken together, the thesis shows the value of considering several time points and several criteria of successful recruitment. Also, it demonstrates the usefulness of combining information from several selection methods to select the most suitable candidates, along with the value of using verbally loaded cognitive tests in selection. Still, the ability to predict success among police officers by using selection methods remains modest. Additionally, the thesis shows that the working conditions for new personnel can be considered crucial if recruitment is seen as a long-term process that also includes the introduction phase. Accordingly, organizations striving for sustainable recruitment need to focus on developing sound selection processes and providing sound working conditions for their new personnel. This is of particular importance for organizations such as the police, where the costs of recruitment are high. / <p>At the time of the doctoral defense, the following papers was unpublished and had a status as follows: Paper 3: Manuscript.</p>