The incidence of mortality from ischemic heart disease in Sweden has been reported to be elevated for surgeons in comparisons with most other groups of physicians. The objective of the present investigation was to compare cardiovascular risk factors and psychosocial work characteristics of surgeons and general practitioners, the latter having a substantially lower rate of ischemic heart disease. A random sample of 36 male surgeons and 30 male general practitioners was selected. The results showed no clear-cut differences in physiological risk factors. Overall mental strain was greater among the surgeons, as was the inability to relax after work, perceived work tempo, and total number of workhours. There were significant associations between psychosocial work characteristics and traditional cardiovascular risk factors, and the study gives further support to the validity of using long-term glucose markers, such as fructosamine, as indicators of metabolic stress.
This study examines factors that contribute to work satisfaction among Swedish dental hygienists. A questionnaire was used to collect data on health, demographics, work-history, work characteristics, work satisfaction and social support at work. The questionnaire was mailed to 471 hygienists; 77.3% responded. 70% of the hygienists are highly or very satisfied with their work tasks. Active leisure and working in large cities were significantly related to high work satisfaction. The best linear regression model explained 48% of the variance in work satisfaction. Thirty percent of the variance was explained by work tasks perceived to be skills developing. Skills development in the profession appears low (median = 44%). After controlling work factors, work satisfaction increased with growing skills development for all hygienists, even for those less satisfied with their work. The findings suggest that the opportunities for developing professional skills should increase to improve satisfaction among dental hygienists. Measures should also be taken to improve the work climate, work stimulation, and job variation as well as reduce the collegial pressure at work.
A regional Swedish hospital has been the site of a quality improvement program that focuses on patient satisfaction, staff work environment and quality of hospital services. This article describes the study component that measures patients' views of the quality of care. The purpose of this study was to develop a reliable and valid instrument, to determine the predictors of patients' ratings of quality and to measure patient satisfaction at two points in time to determine whether patient ratings change following a quality improvement initiative. The instrument developed in this study was designed to assess patients' perceptions of the quality of hospital services, staff work environment and overall satisfaction for the purpose of providing feedback to hospital staff. This information would be used for quality improvement efforts within the hospital. Unique to this instrument are questions regarding patients' perceptions of the hospital staff work environment. The results revealed that the questionnaire demonstrated valid and reliable properties. The significant predictors of quality ratings were information concerning one's illness, and perceptions of the staff work environment. Patient satisfaction was measured and then reassessed following the implementation of various department-based improvement programs. The reassessment revealed significantly higher patient ratings in most areas. An intrinsic aspect of this quality program was the engagement of, and feedback process to, hospital personnel. Questionnaire results were reported graphically to hospital management and staff, thus serving as a catalyst for improvement.
The lack of a pathophysiological marker hinders studies on environmental illnesses of unknown origin. Hence, research focused on the identification of such a marker is a priority. This study investigated the nature and a possible etiology of fatigue in hypersensitivity to electricity (the most commonly reported environmental illness in Sweden). The aim was to test the hypothesis that perceived fatigue was due to alterations in cholinesterase activity. The study group consisted of 14 people who reported a hypersensitivity to electricity, including disabling fatigue. We assessed cholinesterase activity three times: twice based on current symptoms reported by the subjects (severe fatigue attributed to electromagnetic fields and absence of this symptom) and once at a randomly selected time. No significant reduction in acetylcholinesterase was identified in any subject. Examined on a group level, no significant reduction in activity was identified at the time of severe fatigue, and no correlation between reported degree of fatigue and cholinesterase activity was observed. Fatigue attributed to electromagnetic fields was nonphysical and showed a significant correlation to difficulties in concentrating. The results do not support the hypothesis that a change in cholinesterase activity mediates fatigue in people reporting hypersensitivity to electricity.
PURPOSE: This study was designed to focus on the health and well-being of dental hygienists as a function of work environment and background. METHODS: A questionnaire was mailed to 471 randomly selected dental hygienists from members of the Swedish Dental Hygienists' Association (SDHA) to collect data on health, demographics, lifestyles, and working conditions in various delivery systems. Seventy-seven percent responded. RESULTS: Small dental practices were associated with better job control, work relations, management support, and development of job skills. In contrast, large practices were associated with higher finance-related and personal job demand, anxiety, collegial pressure, and demands on social job skills. In discriminant analysis, finance-related job demands, physically demanding patients, and colleague cooperation showed significant differences in working condition variables between the delivery systems and dental practices. Dental hygienists' control over their job functions and the clarity of information explained by management had a variance in the applied competencies dimension by 41 percent. Thirty-seven percent of the variance of musculoskeletal problems in the upper-body region were attributed to physical exposure from clinical job tasks, work breaks, and anxiety over role competition with dentists. CONCLUSION: More job control and clearer information from management enables dental hygienists to optimally apply their competencies in the workplace. Physical job exposure, such as demands on manual/motor job skills, should be decreased and work breaks, as well as working relationships, with dentists should be improved to promote health and well-being.
BACKGROUND: There has been a major shift in the organization and responsibility for the provision of geriatric care in Sweden. This was believed to be stressful. We therefore decided to launch a controlled intervention program on health care personnel aimed at enhancing their adaptation and ability to cope. The purpose of this study was to assess the impact of management change on psychosocial parameters of health care personnel and the effects, if any, of a structured intervention program. METHODS: Two separate wards were randomly allocated to be either intervention (I) or control (C) ward. The I-ward personnel were subjected to a psychologist's structured 10-session intervention program for 20 weeks. The program consisted of an initial educational part followed by a practical problem-solving discussion part. A structured questionnaire on psychosocial issues was answered by the participants before (0 weeks), immediately after (20 weeks), and 10 weeks after the intervention (30 weeks). RESULTS: There were no significant changes in the psychosocial parameters of the C-ward personnel. In the I-ward, however, there was a significant increase in work demand as well as in positive feelings about work, as compared to the C-ward at the 30-week follow-up. There was also significantly better work comfort in the I-ward. CONCLUSIONS: We did not find any anticipated negative psychosocial effects on health care personnel undergoing an organizational change. However, by offering a structured intervention program to one group of health care personnel, we found some positive psychosocial effects. Future research is needed to pinpoint which factor or factors in the intervention program were the most crucial for the effects to occur.
Implementation and evaluation of a practical intervention programme for dealing with violence towards health care workers The aim of this study was to implement and evaluate a practical intervention programme designed to help staff in health care work-places to deal with patient violence towards staff. The programme was part of a controlled, prospective study that ran for 1 year. The study population was comprised of staff at 47 health care work-places, randomly assigned to either the intervention or control group. The Violent Incident Form (VIF), a checklist designed to simplify the registration of violent events, was introduced at all 47 work sites, where staff were instructed to register all types of violent and threatening incidents directed towards them during the 1-year study period. The intervention work-places also followed a structured feedback programme, where the circumstances concerning registered incidents were discussed on a regular basis with work-place staff. Baseline examination of the study groups revealed no statistically significant difference with regard to self-reported violence in the past year. At the conclusion of the 1-year period, the difference between groups was statistically significant (P
Demands on workload and work efficiency have increased because of ongoing global changes in health care organizations. Assessing and evaluating effects of changes on organizational and individual well-being require valid and reliable methods. Questionnaires from 3 large health care studies were used to develop instruments for work quality and health. Variable fields of work quality, health and well-being, and modifying factors were factor analyzed with replicated structures in new samples, including 6 factors of work quality, 5 health factors, and 2 modifying factors. All except 2 factors had high internal consistency (Cronbach's alpha = .69-.84) and low factor intercorrelations within areas. Social climate (but not individual resources) had, according to our model, a modifying effect on the work-health interaction.
The study examines individual and occupational factors and physical and psychosocial exposures related to musculoskeletal complaints in dental hygienists. A standardized questionnaire was sent to 471 registered Swedish hygienists; 77.3% (n = 364) responded, which allows for reliable conclusions for Swedish dental hygienists. Musculoskeletal complaints increased significantly in several body parts with age. And in lower right arm and both elbows with profession years. Public dental health service (PDHS) hygienists experienced significantly more complaints, in the lower right arm (fingers, wrist/hand and elbow). Their work was more demanding, and they had less control compared to work in private practice (PP). In a multiple regression analysis, strainful ergonomics, solitary work, patient treatment hours, and working hours were significant predictors that explained 29% of the variance of musculoskeletal complaints in neck, shoulders, and upper back. Solitary work, years in the profession, strainful ergonomics, and PDHS work explained 15% of the variance of musculoskeletal complaints in the lower right arm. So physical environmental factors contribute to musculoskeletal complaints. Using multivariate analysis, the importance of psychosocial factors did not remain as significant predictors. But a high decision latitude at PP seems health promoting. The results are a useful baseline to discuss the physical layout, organization of dental hygienists' work, and its future direction.