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Objective: To investigate whether mental and work-related stress predicts a one-year incidence of sick leave in a cohort of middle-aged working women. Design: The 2016/17 survey was part of the Population Study of Women in Gothenburg, Sweden, with registry data information on sick leave during one year pre- and post-baseline. Subjects: A cohort of women aged 38 and 50 in 2016/17 (n = 573; 68% participation), of which 504 women were gainfully employed and not on sick leave ± 2 weeks around baseline examination; 493 women had complete data on stress exposure. Methods: We studied associations between self-assessed mental and work-related stress and incident sick leave of >14 days during the year following the baseline examination. We used multiple logistic regression, adjusting for age and previous sick leave, and additionally for sleep quality, well-being, and physical activity. Results: Overall, 75 women (16%) experienced at least one period of sick leave after baseline. Permanent stress during the last five years almost tripled the risk for incident sick leave, OR = 2.8 (95% CI 1.2–6.3), independent of previous sick leave, OR = 2.3 (95% CI 1.3–4.2). Among 21 specific work-related problems, conflicts at work, OR = 2.2 (95% CI 1.3–3.6), and low decision latitude, OR = 1.7 (95% CI 1.0–2.9), were associated with incident sick leave. The association with conflicts at work remained upon further covariate adjustment. Conclusion: Low decision latitude and conflicts at work are risk factors for incident sick leave among working women. The impact of conflicts at work, irrespective of own involvement, may indicate a specific vulnerability among women of interest for future interventions. KEY POINTS: About 75% of around 500 middle-aged women reported mental stress in 2016/17. Low decision latitude and conflicts at work predicted incident sick leave independent of general mental stress and previous periods of sick leave. Efforts to improve the work environment may be essential for interventions aiming to reduce absenteeism among working women. [ABSTRACT FROM AUTHOR]

Purpose: Return to work often requires collaboration between different stakeholders. Rehabilitation coordination is a resource in coordinating efforts during sick leave to facilitate return to work. The purpose of the present study was to describe how people at risk for sick leave or on sick leave with mental health problems experienced rehabilitation coordination. Materials and Method: The study had a qualitative approach using qualitative content analysis as described by Graneheim and Lundman. Eleven semi-structured interviews were conducted with persons at risk for sick leave or on sick leave due to mental health problems and with experience of rehabilitation coordination. Results: The participants experience of rehabilitation coordination were described by the overarching theme Building a bridge with many bricks between the person and society. The theme was formed by four categories and eleven subcategories reflecting the complex context of rehabilitation coordination. The categories were Collaboration in a new setting, Unburdened within certain limits, The way back to work is a joint project and Recognising challenges beyond the person. Conclusions: People with mental health problems experienced rehabilitation coordination as a meaningful link between healthcare and work. However, rehabilitation coordination needs to be more recognised within healthcare to increase accessibility. It seems important that interventions are directed not only towards the person, but also include the workplace for a sustainable return to work. KEY POINTS: It is important to make rehabilitation coordination visible within primary health care and actively inform people on sick leave with mental health problems that it is an option, as they often have difficulties finding information. It will increase their accessibility and enable autonomous decisions. A respectful interplay based on a person-centred care approach seems fundamental for rehabilitation coordination. The interplay with rehabilitation coordinators and with other stakeholders affects the sick leave process and all parties need to collaborate for a sustainable return to work. Three-party meetings with the person on sick leave, the rehabilitation coordinator and the employer, as well as teamwork, may provide better conditions for return to work as this can ensure that all stakeholders are working towards prioritised goals. Targeted interventions at the workplace seem to be important and rehabilitation coordination could be a valuable bridge between healthcare and work for creating sustainable conditions for return to work. [ABSTRACT FROM AUTHOR]

BACKGROUND: To address the increase in sick leave for nonspecific chronic pain and mental illness, the Swedish government and the Swedish Association of Local Authorities and Regions entered into an agreement on a "Rehabilitation Guarantee" to carry out multimodal rehabilitation (MMR). OBJECTIVE: To investigate whether components of primary care MMR are associated with changes in sick leave. METHODS: A web-based survey was conducted in conjunction with a retrospective cross-sectional observational study of 53 MMR units. Sick leave data for the years before and after MMR completion was collected for 846 individuals. RESULTS: There was great disparity in how MMR was delivered. The average duration of rehabilitation was 4–8 weeks, and 74% of the MMR teams reported having fewer patients than recommended (≥20/year). Only 58% of the teams met the competence requirements. In-depth competence in pain relief and rehabilitation was reported by 45% of the teams and was significantly associated with fewer sick leave days after MMR (26.53, 95% CI: 3.65; 49.42), as were pain duration (17.83, 95% CI: –9.20; 44.87) and geographic proximity (23.75, 95% CI: –5.25; 52.75) of the health care professionals included in the MMR unit. CONCLUSIONS: In-depth competence and knowledge about the complex health care needs of patients seem essential to MMR teams' success in reducing sickness benefits for patients with nonspecific chronic pain and mental illness. Further research is needed to elucidate the optimal combination of primary care MMR components for increasing the return-to work rate and to determine whether involvement of the Social Insurance Agency or employers could support and further contribute to recuperation and help patients regain their previous work capacity. [ABSTRACT FROM AUTHOR]

Most people with common mental disorders are working despite symptoms. This study explores individuals' experiences of a work-directed rehabilitation, provided by occupational therapists and physiotherapists, aiming to promote work capacity in persons with common mental disorders. A qualitative content analysis was used, and 11 women and 8 men with depression or anxiety disorder were interviewed. They were 25–66 years old, had different occupations and were working full or part-time. The participants experienced a process interpreted as Increasing belief in one's capacity through supported reflection and practice. This theme reflects the shifting between "reflecting" and "doing" through rehabilitation and the growing hope for change. The increasing belief in one's capacity was developed through three stages, comprised of the categories To be supported by a professional, To realise things about oneself and To try new strategies for change. Strategies suggested by occupational therapists and physiotherapists have the potential to promote work capacity in people who are working while depressed and anxious. The results may deepen the understanding among rehabilitation professionals about the importance of a person-centred approach to people with common mental disorders, and to combine reflection and practical exercises to support the development of work-related strategies. Work-directed rehabilitation provided by occupational therapists and/or physiotherapists is beneficial to people with common mental disorders. Rehabilitation professionals should focus on facilitating self-efficacy among people with common mental disorders. An individualised person-centred approach seems important in order to initiate change. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to explore support persons' views on remote communication for persons with communicative and cognitive disabilities, and on factors enabling self-determination and participation. Materials and methods: Five focus groups with 21 support persons were conducted. They were recorded and transcribed and data were analyzed qualitatively using focus group analysis methodology. Results: The participants experience how remote communication can enable users to have increased control in their lives and how remote communication can enable self-determination and participation. Access to remote communication has a dual effect on safety. There are experiences about communicative rights of the users not being met and there is a need for better access to technology, information, and experts. There is also a need for more competence and coordination among staff and support to the users. Challenges emerge in the support persons' dedication to the users' right to communicate. Conclusion: People with communicative and cognitive disabilities need access to remote communication in order to have control over their own lives and to achieve self-determination and participation in society. Support persons carry a large responsibility and can provide valuable insights of users' communication situation. Remote communication is important for safety; it is necessary to be able to call for help independently. To ensure the communicative rights of people with communicative and cognitive difficulties, professionals must provide assessments of standard technology or assistive technology for remote communication. There is a need for more support to and education of staff from the professions. The users themselves are also in need of long-term support. Support persons face ethical dilemmas regarding user safety on social media and internet and need guidelines and support. [ABSTRACT FROM AUTHOR]

BACKGROUND: Being able to communicate through digital channels is a prerequisite for participation in contemporary society. People with communicative and cognitive disabilities (CCDs) face challenges in this area, thus often being excluded from participating fully in society. OBJECTIVE: This qualitative study focuses on aspects of technology that facilitate or impede remote communication in people with CCDs. METHODS: Support persons for people with CCDs (N = 21) participated in five focus groups to discuss this topic. RESULTS: Data analysis yielded two themes: using standard technology and using assistive technology. Each theme encompasses categories describing aspects and functions of technology that facilitated or impeded remote communication. The support persons felt that standard and assistive technology needed possibilities for personalization for ease and accessibility. There is a need for increased compatibility between assistive and standard technology and between platforms. Remote communication technology must be made more accessible and easier to use for both people with CCDs and those in their networks. CONCLUSIONS: The study provides an overview and illustrative examples of how technology can enhance or hinder remote communication. We offer suggestions on how technology can be developed to meet the specific needs of people with CCDs and simplify remote communication for them. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study was to explore the experiences of remote communication (i.e., communication between persons who are not in the same place) among people with communicative and cognitive disabilities.Materials and methods: Eleven adolescents and adults were interviewed using Talking Mats and interview data was analyzed qualitatively with systematic text condensation.Results: The use of remote communication varies between the participants. The participants also value remote communication differently. Having the possibility to choose between different means of remote communication is important. Being able to determine whether to communicate independently or with support from another person is also valued as relevant. Strategies used to manage remote communication include facilitating for the communication partner and preparing for future communication situations. Those who are able to use writing as an alternative to problematic spoken remote communication like phone calls, for example by using chat or text messaging. Decisions regarding means of communication and human support relate to the concept of self-determination.Conclusion: Better access to remote communication trough assistive technology such as speech synthesis and picture symbols would make remote communication easier and facilitate participation for people with communicative and cognitive disabilities. Implications for rehabilitation People with communicative and cognitive disabilities face challenges with access to remote communication.Access to communication technology including remote communication is important for self-determination, for personal safety and for overall participation in society.Communication technology should be considered in the rehabilitation process and training is crucial.To understand the possible benefits of remote communication, people with communicative and cognitive disability need to get the possibility to practice.Professionals play a key role in the assessment and intervention of remote communication for their patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: In the complex interaction between individual and environmental factors the return to work self- efficacy (RTWSE) plays a key role. RTWSE is the belief in the capacity to meet the demands required for RTW. OBJECTIVE: The purpose of this study was to explore how individuals on sick leave experience their RTWSE. METHOD: A modified phenomenology method was used. This perspective is useful in qualitative research to understand complex phenomena such as RTWSE. It was designed as an interview study and nine individuals participated in the age from 30 to 60 years. RESULTS: Four main themes with a total of ten sub-themes emerged from the analysis showing different aspects of RTWSE. The experience of working capacity in terms of health perception and the general sense of self-efficacy shaped the more specific RTWSE. The pursuit towards an active and fulfilling life and regaining control together with autonomy and the experience of support from others influenced the RTWSE. CONCLUSIONS: RTWSE is a global phenomenon reflecting the experience of vital parts of the life-world. RTWSE is about working capacity, but also concerns engagement in a meaningful occupation, being independent and participating. A holistic approach is therefore needed in order to strengthen self-efficacy. [ABSTRACT FROM AUTHOR]

Objective: To analyze if organizational climate and work commitment, demand and control, job strain, social support, and physical demands at work are associated with remain in work (R1W), that is, work attendance without sick leave over 15 days per year. Methods: This Swedish cross-sectional study was based on 4013 workers (aged 19 to 64 years), randomly selected from a general population. Data were collected (2008) through postal questionnaire and registers. Results: Fair organizational climate, the combination of fair organizational climate and fair work commitment, high control, and low physical demands were associated with RIW for women and men. Conclusions: This study adds to the rather scarce research findings on factors that promote RIW by identifying work organizational factors and physical prerequisites as being important. Preventive work to create a healthy work environment could be directed at improving organizational climate and reducing physical demands. [ABSTRACT FROM AUTHOR]

The article focuses on a study demonstrating the importance of integrative effects of organizational climate and individual work commitment on return to work (RTW) among women in the occupational health sector. It mentions the importance of emphasizing the prevention of work-related health problems and sickness absence. It also mentions the broad concept of organizational climate.