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  • 101.
    Bornehag, Carl-Gustaf
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Sundell, J.
    Hagerhed-Engman, L.
    Sigsggard, T.
    Janson, S.
    Aberg, N.
    Dampness at home and its association with airway, nose and skin symptoms among 10 851 preschool children in Sweden: a cross sectional study2005In: Indoor Air 2005 15 (Suppl 10) 48-55Article in journal (Refereed)
  • 102.
    Bornehag, Carl-Gustaf
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Sundell, J.
    Hägerhed-Engman, L.
    Sigsgaard, T.
    Ventilation rate in 390 Swedish homes and the association to allergic symptoms in children. A case control study2005In: Indoor Air 2005 15:275-280Article in journal (Refereed)
  • 103.
    Bornehag, Carl-Gustaf
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Sundell, J.
    Sigsgaard, T.
    Dampness in buildings and health (DBH). Report from an on-going epidemiological investigation on the association between indoor environmental factors and health effects among children in Sweden2004In: Indoor Air. 2004;14 (Suppl 7):59-66Article in journal (Refereed)
  • 104.
    Bornehag, Carl-Gustaf
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Sundell, J.
    Sigsgaard, T.
    Janson, S.
    Potential self-selection bias in a case control study on indoor environmental factors and their association to asthma and allergy among pre-school children2006In: Scandinavian J Public Health 2006 34(5):534-43Article in journal (Refereed)
  • 105.
    Bornehag, Carl-Gustaf
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Sundell,, J.
    Weschler, C.J.
    Sigsgaard, T.
    Lundgren, B.
    Hasselgren, M.
    Hägerhed-Engman, L.
    The association between asthma and allergic symptoms in children and phthalates in house dust: a nested case-control study2004In: Environmental Health Perspective 2004;112(14):1393-1397Article in journal (Refereed)
  • 106. Bornehag, C.G.
    et al.
    Hagerhed-Engman, L.
    Sigsgaard, T.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Aberg, N.
    DBH-study group, the
    Dampness at home and its association with airway, nose and skin symptoms among 10 851 preschool children in Sweden:: A cross sectional study2005In: Indoor Air, Vol. 2005:15Article in journal (Refereed)
  • 107. Bornehag, C.G.
    et al.
    Sundell, J.
    Sigsgaard, T.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Potential self-selection bias in a nested control study on indoor environmental factors and their association to asthma and allergy among preschool children2006In: Scandinavian Journal of Public Health, Vol. Vol 34Article in journal (Refereed)
  • 108.
    Callesen, M.
    et al.
    Denmark.
    Weschler, C.
    Denmark.
    Jensen, T.
    Denmark.
    Clausen, G.
    Denmark.
    Toftum, J.
    Denmark.
    Beko, G.
    Denmark.
    Bornehag, Carl Gustaf
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Sigsgaard, T.
    Denmark.
    Hoest, A.
    Denmark.
    The adjuvant effect of phthalate exposure on IgE sensitisation in early childhood2012In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 67, 654-655 p.Article in journal (Refereed)
  • 109. Carlman, P.
    et al.
    Augustsson, C.
    Wagnsson, Stefan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Larv- ett hälsofrämjande skolprojekt: En utvärdering av åren 2004-20082008In: I A. Östnäs (Red.), Idrottsforskaren. E-tidsskrift. SVEBI. Svensk förening för beteende- och samhällsvetenskaplig idrottsforskning, nr 3, s. 27-35Article in journal (Other academic)
  • 110. Carlman, P.
    et al.
    Augustsson, Christian
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Wagnsson, S
    Carlman,P., Augustsson, C. & Wagnsson, S2008In: Idrottsforskaren. nr.3 2008Article in journal (Other academic)
  • 111.
    Carlman, Peter
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Augustsson, Christian
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Idrott i nya former? En granskning av Karlstad och Forshaga Idrottsskolor2009Report (Other (popular science, discussion, etc.))
  • 112.
    Carlman, Peter
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Augustsson, Christian
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Process evaluation of primary schools physical activity programs2010Conference paper (Refereed)
  • 113.
    Carlman, Peter
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Augustsson, Christian
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Utvärdering av SMARTIS-projektet: Slutrapport2009Report (Other academic)
  • 114.
    Carlstedt, F.
    et al.
    Landstinget i Värmland.
    Jonsson, B. A. G.
    Lunds universitet.
    Bornehag, C. -G
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    PVC flooring is related to human uptake of phthalates in infants2013In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 23, no 1, 32-39 p.Article in journal (Refereed)
    Abstract [en]

    Polyvinyl chloride (PVC) flooring material contains phthalates, and it has been shown that such materials are important sources for phthalates in indoor dust. Phthalates are suspected endocrine-disrupting chemicals (EDCs). Consecutive infants between 2 and 6 months old and their mothers were invited. A questionnaire about indoor environmental factors and family lifestyle was used. Urinary metabolites of the phthalates diethyl phthalate (DEP), dibutyl phthalate (DBP), butylbenzyl phthalate (BBzP), and dietylhexyl phthalate (DEHP) were measured in the urine of the children. Of 209 invited children, 110 (52%) participated. Urine samples were obtained from 83 of these. Urine levels of the BBzP metabolite monobenzyl phthalate (MBzP) was significantly higher in infants with PVC flooring in their bedrooms (P < 0.007) and related to the body area of the infant. Levels of the DEHP metabolites MEHHP (P < 0.01) and MEOHP (P < 0.04) were higher in the 2-month-old infants who were not exclusively breast-fed when compared with breast-fed children. The findings indicate that the use of soft PVC as flooring material may increase the human uptake of phthalates in infants. Urinary levels of phthalate metabolites during early life are associated with the use of PVC flooring in the bedroom, body area, and the use of infant formula. Practical Implications This study shows that the uptake of phthalates is not only related to oral uptake from, for example, food but also to environmental factors such as building materials. This new information should be considered when designing indoor environment, especially for children.

  • 115.
    Cassing, Gunilla
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Biology.
    Mikusinski, Grzekorz
    Grimsö Wildlife Research Station, Department of Ecology, Swedish University of Agricultural Sciences.
    Widén, Per
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Occurrence of deciduous trees in west-central Sweden in relation to ecological an cultural attributes at site and landscape scalesManuscript (Other (popular science, discussion, etc.))
  • 116.
    Clausen, G.
    et al.
    Denmark.
    Host, A.
    Denmark.
    Toftum, J.
    Denmark.
    Beko, G.
    Denmark.
    Weschler, C.
    Denmark; USA.
    Callesen, M.
    Denmark.
    Buhl, S.
    Denmark.
    Ladegaard, M. B.
    Denmark.
    Langer, S.
    Sweden.
    Andersen, B.
    Denmark.
    Sundell, J.
    Denmark; China.
    Bornehag, Carl Gustaf
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Sigsgaard, T.
    Denmark.
    Children's health and its association with indoor environments in Danish homes and daycare centres - methods2012In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 22, no 6, 467-475 p.Article in journal (Refereed)
    Abstract [en]

    The principle objective of the Danish research program Indoor Environment and Childrens Health (IECH) was to explore associations between various exposures that children experience in their indoor environments (specifically their homes and daycare centers) and their well-being and health. The targeted health endpoints were allergy, asthma, and certain respiratory symptoms. The study was designed with two stages. In the first stage, a questionnaire survey was distributed to more than 17 000 families with children between the ages of 1 and 5. The questionnaire focused on the childrens health and the environments within the homes they inhabited and daycare facilities they attended. More than 11 000 questionnaires were returned. In the second stage, a subsample of 500 children was selected for more detailed studies, including an extensive set of measurements in their homes and daycare centers and a clinical examination; all clinical examinations were carried out by the same physician. In this study, the methods used for data collection within the IECH research program are presented and discussed. Furthermore, initial findings are presented regarding descriptors of the study population and selected characteristics of the childrens dwellings and daycare centers. Practical Implications This study outlines methods that might be followed by future investigators conducting large-scale field studies of potential connections between various indoor environmental factors and selected health endpoints. Of particular note are (i) the two-stage design a broad questionnaire-based survey followed by a more intensive set of measurements among a subset of participants who have been selected based on their responses to the questionnaire; (ii) the casebase approach utilized in the stage 2 in contrast to the more commonly used casecontrol approach; (iii) the inclusion of the childrens daycare environment when conducting intensive sampling to more fully capture the childrens total indoor exposure; and (iv) all clinical examinations conducted by the same physician. We recognize that future investigators are unlikely to fully duplicate the methods outlined in this study, but we hope that it provides a useful starting point in terms of factors that might be considered when designing such a study.

  • 117. Durrant, J.
    et al.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Law reform, corporal punishment and child abuse:: The case of Sweden2005In: International Review of Victimology, Vol. 2005:12Article in journal (Refereed)
  • 118.
    Ede, Lena
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Social Studies.
    Eriksson, Ulla-Britt
    Karlstad University, Faculty of Social and Life Sciences, Department of Social Studies. Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Starrin, Bengt
    Karlstad University, Faculty of Social and Life Sciences, Department of Social Studies.
    Jansson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Sjukskrivning – sociala orsaker och innebörder: Östlandsforskning. Rapport nr 042011Report (Refereed)
  • 119.
    Engberg, Amanda
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Samuelsson, Magnus
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Patienters upplevelser vid nydebuterad ryggmärgsskada: En litteraturstudie2013Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 120.
    Engh Kraft, Lisbet
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Rahm, GullBritt
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Eriksson, Ulla-Britt
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    School Nurses Avoid Addressing Child Sexual Abuse2017In: The Journal of school nursing, Vol. 33, no 2, 133-142 p.Article in journal (Refereed)
    Abstract [en]

    Child sexual abuse (CSA) is a global public health problem with major consequences for the individual child and society. An earlier Swedish study showed that the school nurses did not initially talk about nor mention CSA as one form of child abuse. For the child to receive adequate support, the disclosure is a precondition and is dependent on an available person prepared to listen. The aim of the study was to explore the ability of the school nurses to detect and support sexually abused children. It is a secondary analysis of focus group interviews with school nurses. Thematic analysis was performed. Results showed that the school nurses avoided addressing CSA due to arousal of strong emotions, ambivalence, and a complicated disclosure process. In order to detect CSA and support abused children, attentiveness of sexual abuse as a possible cause of physical and mental illhealth is crucial.

  • 121.
    Engström, Lars-Gunnar
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Sickness Absence in Sweden: Its relation to Work, Health and Social Insurance Factors2009Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: The high levels of sickness absence and disability pensioning experienced during the 1990's and 2000's have become both socially as well as financially burdensome for society. Sickness absence implies a costly loss of production for society and large groups of individuals are risking to become marginalised on the labour market. Sickness absence is both a public health and an economic problem. Thus from both a human approach as well as from an economic perspective it is urgent to increase knowledge about what influences individual behaviour when it comes to sickness absence and return to work.

    Objectives: The overall aim of the thesis is to elucidate the decisive factors for explaining sickness absence. Three different aspects of sickness absence were considered, i.e. factors leading to sickness absence, factors preventing sickness absence and factors leading back to work ability and work when being sickness absent. This is done using a frame of reference involving broadly defined areas of work, health and social insurance related factors.

    Material and methods: Study I analyzes the outcome of unemployed sick-listed individuals. A total of 280 individuals from the county of Värmland were followed through register data between the years 2000 to 2001. Linear and logistic regression models were used to analyze the occurrence of short and long term economic incentives. Study II has a longitudinal design and explores determinants of return to work. Sick-listed individuals with a stress-related psychiatric diagnosis from the county of Värmland were analyzed over a period of three years (2000-2003) using logistic regression. The data comprised 911 individuals. Study III is a cross-sectional study using questionnaire data from the county of Värmland from year 2004. A total of 3123 persons either working or being self employed were analyzed on determinants of work presence through logistic regression. Study IV had a cross-sectional design and used questionnaire data from five counties in central Sweden. The data, from 2004, comprised 10536 individuals being employed, i.e. not self-employed, and with self reported physical and mental medical conditions. Logistic regression was mainly used in the analysis and the focus was on risk factors for long term sickness absence. Study V comprises cross-sectional data retrieved at three separate occasions between 1991 and 1994. It includes 8839 individuals from five counties in western Sweden with sickness absence spells over 60 days. The data was analysed through bi-variate probit regression with a focus on effects of vocational rehabilitation on return to work.

    Results: The results from study I were interpreted as that both short and long term economic incentives matter for the outcome of sickness absence through the interaction of different insurance systems. The principal findings from study II was that age, gender and factors implying less favourable health characteristics and thereby lower work capacity, reduce probabilities of returning to work after long term sickness absence. Considering study III determinants of work presence were found to vary between sexes and whether the determinants were counteracting long or short term sickness absence. Factors interpreted as job control counteracted short term absence. Sense of coherence was found to be an important determinant of work presence for women. In study IV long term sickness absence was found to be related to the level of ill-health. Moreover it was concluded that work environment factors as job strain, job satisfaction, physical work environment were important factors for explaining sickness absence in a population with impaired health. The results from study V indicated that vocational rehabilitation is a potentially effective instrument for improving the individual's work ability and chances of return to work. That no signs of prioritizing selection of rehabilitation participants to those likely to return to work with or without rehabilitation measures, i.e. "managerial creaming", were found was also considered as important results.

    Conclusions: This thesis shows that we need different models and approaches to improve knowledge about the various aspects of sickness absence as entry into absence, return to work or into disability retirement. It also has the implications that sickness absence behaviour can be influenced. Largely depending on what long term path is chosen for welfare policy at the political level it should be acknowledged that other means, improving working conditions and promoting rehabilitation rather than reducing benefit levels and narrowing the eligibility criteria for the insurance benefits are at hand.

  • 122.
    Engström, Lars-Gunnar
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Eriksson, Ulla-Britt
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Arbetsmiljö och ohälsa2009In: Värmlänningarnas liv & hälsa 2008, Karlstad: Karlstad University Press , 2009, 93-103 p.Chapter in book (Other academic)
  • 123.
    Engström, Lars-Gunnar
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Eriksson, Ulla-Britt
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Illness and work as predictors of sickness absence in a population of individuals with impaired healthArticle in journal (Refereed)
  • 124.
    Engström, Lars-Gunnar
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Jakobsen, LiselotteKarlstad University, Faculty of Arts and Education.Krekula, ClaryKarlstad University, Faculty of Social and Life Sciences, Department of Social Studies.
    Jämställdhet, mångfald och svenska räddningstjänster: Om föreställningar och förändringsviljor2012Collection (editor) (Refereed)
    Abstract [sv]

    Denna skrift avrapporterar en delundersökning inom forskningsprojektet GeRd – ”Den genuskodade räddningstjänsten”. GeRd är ett mångvetenskapligt forskningsprojekt som bedrivs vid Karlstads universitet. Projektet syftar till att identifiera förutsättningarna för jämställdhet och mångfald inom svenska räddningstjänster, och vidare till att identifiera förändringsmöjligheter. Forskarna ser det också som avgörande att bidra med kunskap som bygger på praktisk erfarenhet och som fortlöpande förs ut i verksamheterna.

    Resultaten i denna rapport baseras huvudsakligen på en omfattande enkät som distribuerades till olika personalkategorier i 25 stycken slumpvis utvalda räddningstjänster i Sverige våren 2011. Rapporten ger därmed en kvantitativ bild av skilda förhållanden inom räddningstjänsterna i relation till jämställdhet och mångfald, något som tidigare saknats. Den besvarades av 1176 anställda inom räddningstjänsterna. Av dessa var 38 procent heltidsanställda brandmän, 24 procent var räddningspersonal i beredskap, 30 procent fanns i operativ arbetsledning och 5 procent i annan ej operativ tjänst. 94 procent av de som besvarat enkäten var män och 6 procent kvinnor.Rapportens 13 kapitel påvisar tydliga skillnader, både mellan olika räddningstjänster och mellan olika personalkategorier inom dem, beträffande inställningen till det förändringsarbete som pågår i organisationerna. Samtidigt finns övergripande mönster och tendenser i materialet. Resultaten diskuteras i relation till aktuell forskning och teoribildning.

  • 125.
    Engström, Lars-Gunnar
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Predictors of Work Presence: Sickness Absence in a salutogenic perspective2009In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, Vol. 33, no 3, 287-295 p.Article in journal (Refereed)
    Abstract [en]

    The objective of the study was to identify determinants of work presence, i.e. factors that counteract short and/or long term sickness absence. The analyses were based on logistic regression analyses on Swedish regional survey data. Individuals who had not reported sickness absence during the preceding year were compared to on one hand individuals with short term sickness absence (< 28 days) and on the other hand with long term sickness absence (> 28 days). We found predictors of work presence in personal background as well as in work related variables. A high level of sense of coherence was found to counteract short as well as long term sickness absence. Gender specific differences were observed. Although a set of predictors common for the short and long term perspective were found the predictors in general were found to differentiate substantially with respect to short or long term sickness absence. Implications for sickness absence prevention and health promotion could be drawn from the results. Primarily different aspects of control over working situation, work satisfaction and for women a high level of sense of coherence were believed to have these implications.

  • 126.
    Engström, Lars-Gunnar
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Social Studies.
    Starrin, Bengt
    Karlstad University, Faculty of Social and Life Sciences, Department of Social Studies.
    Eriksson, Ulla-Britt
    Karlstad University, Faculty of Social and Life Sciences, Department of Social Studies.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Influence of insecure social bonds at work and adverse life events: a comparison between longterm sickness absentees with mental diagnoses and a healthy population2011In: Social aspects of Illness, Disease and Sickness Absence / [ed] Halvor Nordby, Rolf Rønning and Gunnar Tellnes, Oslo: Unipub forlag, 2011Chapter in book (Refereed)
  • 127. Engström, L.G.
    et al.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Stress related sickness absence and return to labour market in Sweden2006In: Accepted by Disability and RehabilitationArticle in journal (Refereed)
  • 128.
    Enochsson, Ann-Britt
    et al.
    Karlstad University, Faculty of Arts and Education, Department of Education.
    Jernfält, Margareta
    Sundberg-Wincent, Marija
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Barns och ungdomars hälsa i norra Värmland1998Report (Other academic)
  • 129. Ericsson, JS
    et al.
    Abrahamsson, KH
    Östberg, Anna-Lena
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Hellström, MK
    Jönsson, K
    Wennström, JL
    Periodontal health status in Swedish adolescents: an epidemiological, cross-sectional study2009In: Swedish Dental Journal, ISSN 0347-9994, Vol. 33, no 3, 131-139 p.Article in journal (Refereed)
  • 130.
    Eriksson, Jan Ove
    et al.
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Media and Communication Studies. Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Gustavsson, Bengt Ove
    Äldreomsorg och välfärd - En jämförande undersökning om levnadsnivå för äldre i Arvika kommun1982Other (Other (popular science, discussion, etc.))
  • 131. Eriksson, U-B
    et al.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Long-term sickness absence due to burn out: A qualittative interview study of absentees experiences. Qualitative Health Research2008Article in journal (Refereed)
  • 132. Eriksson, U-B.
    et al.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Starrin, B.
    Long-term sickness absence due to burn out:: A qualitative interview study of absentees' experiences2007In: Accepted by Qualitative Health ResearchArticle in journal (Refereed)
  • 133.
    Eriksson, Ulla-Britt
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    "Man är ju inte mer än människa": Långtidssjukskrivning ur ett emotionellt, relationellt och strukturellt perspektiv2009Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The background to this thesis is the dramatic increase of the long-term sickness absence that took place in Sweden from the late 1990s. There was also a shift in the diagnostic pattern with rising mental diagnoses.

    The overall purpose was to describe and try to understand the process leading to long-term sickness absence from the perspective of the sickness absentees, in order to get a better knowledge base for preventive and rehabilitative actions.

    The thesis comprises four studies (I-IV). Research methods have been both qualitative and quantitative. In study I data from individual interviews with 32 persons on long-term sick leave due to burnout was analyzed using a grounded theory approach. In study II the study population comprised of 2064 employed sick-listed persons, a sub sample derived from the 2002 national Swedish survey on health, working conditions, life situation and sick-listing. It was analyzed if persons with burnout had higher probability of having experienced the steps in the burnout staircase compared to other diagnostic groups in accordance with the previously suggested hypothesis of "the burnout staircase". Study III comprised of 2521 employed persons, a sub sample derived from the same national survey as in study II. It was analyzed if psychosocial work environment and conflicts and losses in private life independently or in combination were more strongly associated to sickness absence with mental diagnoses as compared to a healthy population. In study IV individual interviews with 25 professional rehabilitation actors and 14 unemployed sick-listed persons were conducted. Data were analyzed according to grounded theory method.

    The process that led to sicknes absence can be described as an emotional deprivation process, illustrated as a flight of stairs (the burnout staircase) describing a sequence of steps toward sickness absence (I). In accordance with the tested hypothesis persons with burnout to a noticeable higher extent reported expereince of being in the different steps in the burnout staircase compared to sickness absentees with other diagnoses. The model seemed to be valid also for persons with other mental diagnoses (II). Reorganization and conflicts at work as well as adding adverse private life events were associated with increased risk for sickness absence with mental diagnosis (III). Three significant factors behind the weak co-operation between local social insurance and employment agencies were identified: indistinct regulation of co-operation, shifting political goals over time and conflicting goals between agencies (IV).

    In this thesis it has been suggested that the course of events preceding sickness absence might be understood as a process of emotional deprivation, where the individual is gradually emptied of the life-giving emotional energy revealed in joy, commitment, and empathy. This life-giving force finds its nourishment in safe and secure social relations with others and in a social structure that promotes this type of social relations. The profound changes in the Swedish labour market during the 1990s influenced not just the psychosocial work climate but also the rehabilitation efforts for unemployed sick-listed persons. When the political goal of reducing the unemployment level came to the forefront the indistinct regulation and the conflicting goals in addition were factors that impaired co-ordinated rehabilitation. In this process also the physicians were involved. A labour market problem was turned into a medical problem.

  • 134.
    Eriksson, Ulla-Britt
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    Insecure social relations at work and long-term sickness absence due to burnout and other mental diagnoses2011In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, Vol. 38, no 4, 319-327 p.Article in journal (Refereed)
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