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Despite legislative regulations, many students with disabilities face barriers to their participation in higher education. In professional education, the requirements for placement practice add to the barriers for both students who need to disclose their impairments and request special arrangements, and staff who need to make the arrangements to accommodate to the students' special needs. The aim of this qualitative study was to explore the perspectives of academic staff and placement supervisors on supporting students with disabilities in professional programmes within health care, social work and teaching. Data were generated from focus group discussions with 13 lecturers who worked with students on campus, and 8 professionals who supervised students during practice placement. The results indicate an ambivalence among the staff and supervisors regarding working with students with disabilities. This ambivalence seems to be triggered by conflicting roles and values, unclear outcome measures to evaluate the students, a lack of knowledge of how to accommodate, time constraints, insufficient institutional support, as well as a lack of openness regarding students with disabilities in professional courses. The results call for an increased awareness of how complex processes in the structural and cultural environments affect students' disclosure of disability and the collaboration between the stakeholders.

This study aims at exploring several individual, organizational, and contextual factors that may affect beginning teachers' turnover intentions during their first years of practice. The sample consists of 227 beginning teachers (69% female and 31% male) from 133 schools in Norway. The results show four important antecedents of beginning teachers' turnover intentions: collective teacher efficacy, teacher-principal trust, role conflict, and affective commitment. Our findings suggest that organizational and contextual factors, and not necessarily individual competence perceptions, have a significant impact on beginning teachers' turnover intentions. Also the findings suggest that beginning teachers should be studied separately from more experienced teachers. Implications for school leadership are discussed.

The study focuses on teachers' perceived certainty, a concept which is understood as being made up of didactic, practical and relational certainty, and its relationship with teacher collaboration, role ambiguity and job satisfaction. Analyses draw on data from 1,153 Norwegian elementary and junior high school teachers. Results indicate that there are statistically significant differences between the two subgroups of teachers concerning collaboration and job satisfaction. Furthermore, interesting differences regarding relations between collaboration and teacher certainty are found. Teachers in this study also report most collaboration on planning lessons, but little collaboration on activities one would expect to enhance self-awareness and reflection. A structural equation model involving relationships between all variables is tested and results reveal good fit indices.

The ideological basis for education of children with deafness has changed during the last few decades. In Norway, the new curriculum is emphasizing bilingual and bicultural ideas. Using an excerpt of an interview with a secondary student, this article discusses problems that arise when heavily emphasizing a cultural approach. (Contains 10 references.) (Author/CR)

Role conflicts and role ambiguity have been identified as important risk factors for exposure to workplace bullying, particularly when combined with inadequate leadership practices. Even though role ambiguity theoretically can be considered a causal precursor to role conflicts, previous research has mainly examined these role stressors as concurrent predictors of workplace bullying. The present study provides a more nuanced analysis by investigating role conflicts as a mediator in the relationship between role ambiguity and exposure to bullying behaviours. Adding to the understanding of the bullying process we also considered the possible moderating roles of laissez-faire and transformational leadership in the role stressor–bullying relationship. Employing a national probability sample of 1,164 Norwegian workers, with three measurements across a 12-month period, the results showed an indirect effect of employees' role ambiguity on subsequent exposure to bullying behaviours through employees' experience of role conflicts. Moreover, laissez-faire leadership exacerbated, while transformational leadership attenuated, the indirect relationship between role ambiguity and exposure to bullying behaviours through role conflicts. In summary, the present data shows that when the management of organisations neglects its inherent responsibility to adequately address employees' experiences of role ambiguity and role conflicts, the risk of exposure to workplace bullying is likely to increase. [ABSTRACT FROM AUTHOR]

This study aims to advance the understanding of drivers of fathers' parental leave rights—a new political field and a main area of leave policy debate. Theoretically informed by the policy feedback literature, this case study of father quota policy in Norway demonstrates how conflicting political feedback processes over a quarter of a century, reflected in reforms by shifting government coalitions, have sustained tensions over the policy. The polarized public debate following an extension in the father quota in 2018 suggests that countermobilization via social media may play a new role in magnifying conflict and destabilizing post-reform processes. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study is to identify and develop a framework to clarify facilitating orchestrator hub-team roles; their interactions, linked capabilities and activities; and the hub-team concept. This framework is illustrated by a case study of an orchestrator hub-team facilitating cross-country and network co-creation in Northern Sweden, Norway and Finland. Design/methodology/approach: The following two approaches are used: a conceptual approach that combines various source materials and concepts related to the "bricolage approach"; and an empirical approach that illustrates the conceptual framework using a longitudinal, qualitative, single-case study and the action research method. Findings: By combining research related to three differing yet somewhat overlapping research perspectives, three facilitating orchestrator hub-team roles are identified, linked to orchestrator capabilities and activities relevant to innovative value creation in extensive networks including both private and public actors highlighting the role of people in networks. An orchestrator hub-team framework and five related activity categories are developed and introduced. Research limitations/implications: This study contributes to research on the orchestration of innovative co-creation in extensive networks and network management by clarifying the facilitating orchestrator hub-team roles and their related capabilities and activities, and thereby describing the role of a centrally positioned hub-team. Practical implications: The hub-team framework may bring structure and understanding to hub-teams, thus easing and enabling orchestration and value co-creation. Originality/value: This study offers a further developed, integrated framework for intermediating the facilitating roles of a hub-team orchestrating extensive network and public/private co-creation. [ABSTRACT FROM AUTHOR]

In conservation planning, maps do important work in producing territories of stronger and weaker protection, and spatially fixing special handling of development. Because of this, mapping and maps are contested, yet there have been few studies of their roles in planning conflicts. The performance of maps in planning processes affecting a wild reindeer habitat in Setesdal, Norway is analysed, asking what is the productive work of maps in planning, how is this work contested, and what are the consequences for the status of the plan itself. The case study centres on a proposal for wind power development, in an area designated in regional planning as a wild reindeer area of national significance. The analysis combines empirical material from interviews, planning documents and observation. The findings show the work that maps do in producing a new conservation territory, changing the basis of planning, yet failing to resolve deep-seated conflicts of interest. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to identify and critically discuss how healthcare middle managers' (HMMs) development of the capacity and capability for leadership are experienced to influence quality improvement (QI) in nursing homes. Design/methodology/approach: This study had a critical hermeneutic perspective with data gathered using focus groups, one individual interview and participative observations. Analysis was guided by a qualitative interpretive approach. Findings: The results show how HMMs' development of the capacity and capability for leadership are experienced to influence QI in nursing homes through grasping complexity in a conflicting practice. This involves continuous knowledge development and compensating contrasted by resource shortages, role conflicts and the lack of trust and cooperation. Originality/value: HMMs have a key role in implementing QIs in healthcare. There are few studies on how HMMs develop the capacity and capability for leadership and it is unclear how clinical contexts are influenced by HMMs' development. This study provides new knowledge supporting a change facilitating HMMs' developmental processes targeting practical influence; it emphasizes continuity, coherence, presence and trust. [ABSTRACT FROM AUTHOR]

Community-oriented approaches in social work are highlighted in both social work literature and policy documents in post-financial crisis Europe, and in the Nordic welfare states where professionalized bureaucracy, universal benefits and institutionalized social work have been the norm. The aim of this article is to explore social workers' experiences of role changes in the transition to a more communityoriented approach, characterized by ambulatory work, the facilitation of local resources, multi-disciplinary collaboration and user participation. The empirical data consists of qualitative data from two cases: a political reform in the Netherlands (The Social Support Act), and a user-initialized project in Norway. Ten social workers from nine different organizations were interviewed in the Netherlands, and four social workers from one community-based project in Norway. We analysed these as a multiple case study of a transformation towards community-based practice, but one in which the political and organizational context differs. A common theme was the changing of the roles of the social worker and the subsequent experiences of challenges in different contextual settings. We present our findings under the topics of identity work, differing organizational expectations and role conflicts. Social workers in both the Norwegian and Dutch sample express experiences of multiple roles, vague roles and conflicting roles, with our analysis showing that role stress was common in both cases, regardless of whether the initiative was top-down or bottom-up. Remedying role stress could be a crucial element in processes aiming at user participation, social cohesion, cross-disciplinary cooperation and strengths perspectives. [ABSTRACT FROM AUTHOR]

During the Korean War (1950-1953) the Norwegian government sent a mobile army surgical hospital (MASH) to support the efforts of the United Nations (UN) Army. From the first, its status was ambiguous. The US-led military medical services believed that the "Norwegian Mobile Army Surgical Hospital" (NORMASH) was no different from any other MASH; but both its originators and its staff regarded it as a vehicle for humanitarian aid. Members of the hospital soon recognized that their status in the war zone was primarily that of a military field hospital. Yet they insisted on providing essential medical care to the local civilian population as well as trauma care to UN soldiers and prisoners of war. The ambiguities that arose from the dual mission of NORMASH are explored in this article, which pays particular attention to the experiences of nurses, as expressed in three types of source: their contemporary letters to their Matron-in-Chief; a report written by one nurse shortly after the war; and a series of oral history interviews conducted approximately 60 years later. The article concludes that the nurses of NORMASH experienced no real role-conflict. They viewed it as natural that they should offer their services to both military and civilian casualties according to need, and they experienced a sense of satisfaction from their work with both types of patient. Ultimately, the experience of Norwegian nurses in Korea illustrates the powerful sense of personal agency that could be experienced by nurses in forward field hospitals, where political decision-making did not impinge too forcefully on their clinical and ethical judgment as clinicians. [ABSTRACT FROM AUTHOR]

Purpose: First-line nurse managers are frequently torn between conflicting demands from management and employees, and previous research suggests that nurse managers use a variety of responses to cope with these demands. The purpose of this paper is to explore the influence of social support on nurse managers' responses to role-conflict. Design/methodology/approach: Two focused ethnographic studies involving participant observation and interviews with seven first-line nurse managers were completed. One study included first-line nurse managers from four units in two municipalities (2005), while the second included three first-line nurse managers from a hospital in Norway (2015-2016). Findings: Three types of responses were identified: the embracing managerialism career, the emphasising managerialism career and the emphasising professionalism career. Emphasising managerialism was associated with role distance from the role of nurse, whereas emphasising professionalism involved role distance from the managerial role. Originality/value: This study provides insights into first-line nurse managers' responses to role conflict, by identifying the mechanisms involved and an opportunity to develop a theoretical framework for future studies among nurse managers. [ABSTRACT FROM AUTHOR]

Objective: To study work participation of persons with hearing loss, and associations with hearing disabilities, self-reported workability, fatigue and work accommodation. Design: Cross-sectional internet-based survey. Study sample: A total of 10,679 persons with hearing loss within working-age were invited to answer the survey, where 3330 answered (35.6%). Results: Degree of hearing loss was associated with low workability, fatigue and work place accommodation, while sick leave was associated with fatigue. Degree of hearing loss was positively associated with being unemployed (p < .001) and having part-time work (p < .01) (often combined with disability benefits) for women. Work place accommodation was more frequently provided among respondents working with sedentary postures, high seniority, long-term sick leave or low workability. Additional unfavourable sensory conditions were associated with decreased employment (p < .001) and workability, and an increase in sick leave (p < .01) and fatigue (p < .001). Conclusions: Hearing loss seemed to influence work participation factors negatively; particularly, for moderate hearing loss and for women, even though the degree of employment was high. A lack of work place accommodation when there was a need for such was found. This implies increased attentiveness towards individual needs concerning the experienced disability a hearing loss may produce. A more frequent use of hearing disability assessment is suggested. [ABSTRACT FROM AUTHOR]

Background: Patients in clinical settings are not lonely islands; they have relatives who play a more or less active role in their lives. Objectives: The purpose of this article is to elucidate the ethical challenges nursing staff encounter with patients’ next of kin and to discuss how these challenges affect clinical practice. Research design: The study is based on data collected from ethical group discussions among nursing staff in a nursing home. The discussions took place in 2011 and 2012. The data were analysed and interpreted by using hermeneutic methodology. Ethical considerations: All the data have been anonymised and handled with confidentiality. Written informed consent was obtained from all participants. Findings: Ethical challenges relating to patients’ next of kin were found to be an issue frequently discussed in the groups. Our findings indicate that next of kin have different characteristics, categorised as ‘the professionals’ and ‘the shadows’. In this article, we will describe the next of kin’s characteristics and the ethical challenges and practical implications that nursing staff experience in this connection. Discussion: We will discuss the findings in the light of the four basic principles of medical ethics and propose interventions to help nurses manage ethical challenges related to next of kin. Conclusion: The study reveals the need to enhance nursing staffs’ communicative and ethical skills on an individual level, but most importantly, to establish routines in clinical settings for informing and following up next of kin in a systematic and structured way. [ABSTRACT FROM AUTHOR]

Aim. To examine the predictive power of the subfactors of hardiness (commitment, control and challenge) on shift work tolerance (measured with sleepiness, fatigue, anxiety and depression) over 2 years in nurses working shifts. We also investigated the direct effects of psychosocial variables such as role conflict, social support and fair leadership on shift work tolerance, as well as their moderating role on the relationship between hardiness and shift work tolerance. Background. Several scholars have discussed the role of individual differences and psychosocial variables in predicting shift work tolerance. The conclusions are not clear. Design. Longitudinal questionnaire study. Methods. A sample of Norwegian nurses employed in shift work including nights participated in this longitudinal questionnaire study: 1877 at baseline, 1228 at 1-year follow-up and 659 nurses at 2-year follow-up. Data were collected in three waves, first wave in 2008 and third in 2011 and were analysed with a series of hierarchical multiple regression analyses. Results. We found that the subfactor commitment could predict fatigue over 1 year and anxiety and depression over 2 years. Challenge could predict anxiety over 1 year. Control was unrelated to shift work intolerance. Hardiness did not predict sleepiness. Social support, role conflict and fair leadership were important for some aspects of shift work tolerance; however, hardiness seemed to be more eminent for shift work tolerance than the psychosocial variables. Social support moderated the relationship between hardiness and shift work tolerance to some degree, but this interaction was weak. Conclusion. Hardiness can to some degree predict shift work tolerance over 2 years among nurses. [ABSTRACT FROM AUTHOR]

Little is known about social workers' job stress in a comparative sense, and whether job stress might negatively affect their views of clients within the welfare system. We examine these issues on the basis of cross-sectional survey data collected from professional social workers in four Nordic countries that have similar welfare systems and where workers engage in similar tasks. Job stress is measured using two indicators: workload and role conflicts. The results indicate frequent problems with job stress in all four countries, although they are especially pronounced in Finland. Social workers with limited work experience, as well as those working within the public sector, suffered the most both from an extensive workload and from role conflicts. The findings also indicate that social workers' attitudes towards clients within the welfare system are to some extent related to their level of job stress. [ABSTRACT FROM AUTHOR]

The main aims of this two-wave prospective study were to (1) present different theoretical mechanisms for relationships between bullying and personality characteristics, (2) determine forward and reverse long-term associations between victimization from bullying and personality traits included in the five-factor model and (3) establish whether these personality traits contribute to the variance in bullying, beyond work environment factors in the form of role conflict and role ambiguity. The prospective sample comprised 3066 Norwegian employees. The time lag between the two measurement points was two years. Neuroticism significantly predicted subsequent bullying in analyses of direct associations between personality traits and victimization. When adjusting for role conflict and role ambiguity, conscientiousness emerged as the only significant predictor of later victimization from bullying. In tests of reverse associations, victimization from bullying at baseline was significantly related to agreeableness, conscientiousness and openness at follow-up. Taken together, the study findings indicate that personality traits may function as both predictors and outcomes of workplace bullying. [ABSTRACT FROM PUBLISHER]

In line with the 'Work environment hypothesis,' role stressors have been proposed as important antecedents of bullying in the workplace. Only a few longitudinal studies on the relationship between role stressors and bullying exist, however, and earlier studies have largely been cross-sectional. The aim of the present prospective study was to determine whether role stressors at baseline predict new cases of workplace bullying at follow-up. A total of 2,835 Norwegian employees participated at both baseline and follow-up, with an interval of two years between the measurements. The study supports the hypotheses that role ambiguity and role conflict, independently, contribute to subsequent new reports of workplace bullying. However, there was a weak reverse effect: reporting being bullied at work at baseline predicted reporting increased levels of role ambiguity and role conflict at follow-up. Even though the results may indicate a circular relationship between the variables at hand, the weak reverse relationship seems to have little practical impact compared to the stronger relationship from role stressors to bullying. Hence, the results mainly support the hypotheses stating that role ambiguity and role conflict, independently, predict subsequent exposure to workplace bullying. [ABSTRACT FROM AUTHOR]

Abstract: Despite an increased focus on fathers' importance for children's development and the Nordic countries' focus on gender equality, a number of studies claim that the Child Welfare Service (CWS) fails to involve fathers. However, few studies have taken the perspective of CWS workers. The aim of the article is to identify central discourses on fathers among CWS workers in Norway. Two central questions are: How do CWS workers understand fathers? And from their perspectives: What promotes and inhibits the involvement of fathers? To explore these themes, four focus group interviews were conducted, with 14 CWS workers. Four central discourses on fathers were identified: Mothers and fathers as gender neutral, fathers as little involved, fathers as (more) involved, and mothers and fathers as different. Factors that promote the involvement of fathers were society's increased focus on gender equality, society's and fathers' own changed perception of fathers' role, and increased focus on children's networks. Factors identified as inhibiting involvement were lack of resources, fear of conflicts, negative descriptions of fathers, and uncertainty regarding legislation. Explanations for fathers' own lack of involvement were fear of confrontations, prioritisation of a new family, and a lack of understanding of their importance for the child. Different discourses on fathers lead to different practices regarding the involvement of fathers. By failing to involve fathers, an incomplete picture of the family's resources and challenges is provided. This hampers targeted measures to ensure the best outcome for the child. [Copyright &y& Elsevier]

We investigated whether fatigue can be used to screen nursing populations for risk of sickness absence. Data were available from a prospective cohort study of 2,059 Norwegian nurses working in hospital care, psychiatric care, and nursing home/home care settings. Physical and mental fatigue were measured at baseline with Chalder's Fatigue Questionnaire (FQ). Self-rated sickness absence at 1-year follow-up was considered high if nurses reported >30 sick days in the past year. Physical fatigue accurately predicted high sickness absence and adequately discriminated between high- and low-risk nurses in nursing home/home care settings. Mental fatigue was not predictive in any setting. The FQ is suitable for screening specific nursing populations for the risk of high sickness absence. [ABSTRACT FROM AUTHOR]

Objective: To examine the impact of occupational role conflict and emotional demands on subsequent psychological distress. Methods: A randomly drawn cohort from the general Norwegian working-age population was followed up for 3 years (n = 12,550; response rate = 67%). Eligible respondents were in paid work during the reference week in 2006 and 2009 or temporarily absent from such work (n = 6,745; response rate = 68%). Results: In the fully adjusted model, both high role conflict (odds ratios = 1.53; 95% CI = 1.15 to 2.03) and high emotional demands (odds ratios = 1.38; 95% CI = 1.13 to 1.69) were significant predictors of psychological distress. Additional significant predictors were low job control, bullying/harassment, and job insecurity (P < 0.05). Conclusions: Considering all of the evaluated work- related factors, role conflict and emotional demands contributed the most to the population risk of developing psychological distress. [ABSTRACT FROM AUTHOR]

The purpose of this study was to obtain a deeper understanding of the experiences of Family Caregivers (FC) living close to a patient with cancer. This article reports on the findings from individual interviews with 15 FCs of patients with cancer. The interview transcripts were analyzed using qualitative hermeneutic analysis. This study revealed that living close to a cancer patient over the course of his or her illness affected many aspects of FCs lives in significant ways. Their experiences can be summarized with two major themes: (1) living in an ever changing life world and (2) balancing between conflicting interests and dilemmas. This study contributed to deeper insights into FC's experiences than previously reported in the literature. [ABSTRACT FROM PUBLISHER]

Environmental conditions have long been assumed to create climates that can encourage workplace bullying. Although several studies have supported this assumption, the vast majority have applied the individual as the unit of both measurement and analysis. We argue, however, that the appropriate level of inference regarding environmental conditions is the work-group. In a large sample of some 10,000 employees distributed across 685 departments, we tested the hypothesis that leadership practices and the presence of role stressors will predict the incidence of bullying within departments. The results showed leadership practices and role conflict to predict bullying at the departmental level, while role ambiguity did not when taking into account the effects of the other predictors. The robustness of the findings was demonstrated after excluding responses of targets of bullying, still showing leadership practices and role conflict as potent predictors of bullying, supporting the assumption that bullying will be prevalent within unfavorable working environments. [ABSTRACT FROM AUTHOR]

This article concerns a sociological study of face-to-face interaction taking place in social welfare offices in Norway. Qualitative data from interpreted dialogues between Norwegian social workers and their clients from minority groups of refugees and immigrants, bureaucratic voices and discourses are examined. For the social worker, face-to-face interaction is a matter of a professional performance characterized by an ambiguity between impartiality on the one hand and participatory involvement and understanding on the other. Power and control prevails significantly within the interactions as they strive to perform communicative actions between equals. Through some specific examples from my own observational studies, I have attempted to describe issues that can illustrate how the bureaucratic voice and prevalent discourses can be expressed in a variety of ways. For the social worker, it is a matter of a professional performance which is characterized by impartiality, counselling, objective verbal actions, the exercise of discretion, information distribution, etc. [ABSTRACT FROM AUTHOR]

This article analyses how nursing students being trained in a Norwegian hospital interact and communicate with their patients – a task that seems to be one of the hardest of all for the students. Based on data from a fieldwork study, the article investigates the development of empathy among student nurses. In doing so, it addresses the concept of a social defence system developed by Isabel Menzies Lyth, who referred to a hypothetical construction describing certain features of a nursing hospital such as a high level of tension, distress and anxiety among the nurses. The findings point to the fact that the nursing students were constantly in danger of losing their focus on the relational aspect of their work; instead, they were being drawn towards an instrumental nursing style. This took place despite the conviction that ‘creating a relationship’ was one of the most important dimensions of being a competent nurse. [ABSTRACT FROM AUTHOR]

Hauge, L. J., Skogstad, A. & Einarsen, S. (2010). The relative impact of workplace bullying as a social stressor at work. Scandinavian Journal of Psychology, 51, 426–433. Exposure to workplace bullying has been argued to be a severe social stressor and a more crippling and devastating problem for affected individuals than the effects of all other work-related stressors put together. However, few studies have explicitly investigated this assumption. In a representative sample of the Norwegian working population, the present study investigated the relative contribution of workplace bullying as a predictor of individual and organizational related outcomes after controlling for the well-documented job stressors of job demands, decision authority, role ambiguity and role conflict. Bullying was found to be a significant predictor of all the outcomes included, showing a substantial relative contribution in relation to anxiety and depression, while for job satisfaction, turnover intention and absenteeism, more modest relative contributions were identified. Workplace bullying is indeed a potent social stressor with consequences similar to, or even more severe than, the effects of other stressors frequently encountered within organizations. Thus, the finding that bullying has a considerable effect on exposed individuals also when controlling for the effects of other job stressors demonstrates bullying as a serious problem at workplaces that needs to be actively prevented and managed in its own right. [ABSTRACT FROM AUTHOR]

Presents a pilot study on the frequency and seriousness of role conflict among 152 advertising professionals carried out in autumn 1993 in Norway. Other questions dealt with our reactions to such conflicts, and what the respondents would expect from a "beaware code" as an aid to conflict solution. Conflicts related to professional quality standards, personal ethics, environment, clients and consumers were reported as most frequent and most serious. Almost half of the respondents claimed they would speak up in such cases. About one-third of the respondents said they would probably ask their peers; one-third said they would ask more experienced colleagues or superiors, whereas one-quarter would seek advice from their private network. Concludes by suggesting future research foci and design triangulation, especially by using qualitative strategies as a next step. [ABSTRACT FROM AUTHOR]

Background: It has been shown that a recently defined stressor, 'illegitimate tasks', has negative effects on employees' work motivation and health. Better understanding of the illegitimate tasks undertaken by physicians might contribute to a more resource-efficient division of labour within the health care system, with beneficial effects on organisational economics and employee performance. We aimed to investigate the prevalence of unreasonable illegitimate tasks, their associations with workplace variables and their impact on health, in particular sickness presenteeism., Methods: Cross-sectional data were collected in 2012. A sample of 545 Norwegian physicians answered an online questionnaire. The response rate was high (71.8%). The data were analysed using independent-samples t-tests, ANOVA and logistic regression., Results: About 50.2% of physicians in all clinical positions reported that at least 11% of their everyday tasks could have been done by other hospital personnel. Seven percent of the physicians reported that at least 31% of their daily workload consisted of unreasonable illegitimate tasks. There were no significant differences in unreasonable illegitimate tasks according to clinical position, age or gender. Administrative task load and role conflict were positively associated with unreasonable illegitimate tasks that physicians reported could be reallocated to non-medical professionals. Moreover, unreasonable illegitimate task was associated with a higher probability of sickness presenteeism after controlling for age, gender, role conflict, control over work pace, exhaustion and administrative tasks., Conclusions: The results confirm that physicians' workload includes a high proportion of unreasonable illegitimate tasks and that this can contribute to sickness presenteeism. Investigation of work environmental factors can provide insight into the mechanisms behind unreasonable illegitimate tasks. Decreasing the amount of administrative tasks and role conflicts faced by physicians should be a priority. These findings could be used to make hospital task management more resource-efficient. Our results indicate that a substantial proportion of physicians' work capacity could be re-allocated to core tasks. Further research is needed into the specific type and content of unreasonable illegitimate tasks undertaken by physicians in order to determine to whom they should be allocated to ensure a healthy and motivated workforce and provision of high quality, resource-efficient health care services.

Background: Concerns about protecting patient's privacy can interfere with proper stress adaptation which is associated with physician's health. It is important to investigate relevant organizational confounders to this phenomenon to enable interventions that can ameliorate the subjective burden of patient confidentiality., Objectives: This study investigates factors in the psychosocial work environment that can explain patient confidentiality's prominence in social support seeking among physicians, and if these factors covary differently with support seeking according to country., Participants: University hospital physicians in four European cities (N=2095) in Sweden, Norway, Iceland and Italy participated in a cross-sectional survey., Methods: Questionnaire comprised items on psychosocial work environment, basic socio-demographics, presence of formal and informal meetings at work, and measurement of confidentiality as a barrier for support., Results: High role conflict, availability of formal or informal meetings, lack of control over decisions, and lack of control over work pace were predictors of confidentiality as a barrier to support. There were differences between countries in how these factors covaried with confidentiality as a barrier to support. High role conflict was the strongest predictor of confidentiality as a barrier to support across all samples., Conclusions: Psychosocial work factors predicted confidentiality as a barrier to support seeking among physicians. It is important to create routines and an organizational framework that ensures both the patient's right to privacy and physician's ability to cope with emotional demanding situations from work.