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TAKING CARE OF OTHERS - WHAT'S IN IT FOR US? Exploring workplace-related health from a salutogenic perspective in a nursing context

Bringsén, Åsa LU (2010) In Lund University, Faculty of Medicine Doctoral Dissertation Series 2010:130.
Abstract (Swedish)
Popular Abstract in Swedish

Studier av arbetsförhållande inom sjukvården har under lång tid varit förknippade med stress och sjukfrånvaro. Ett sådant problemorienterat perspektiv hänger samman med hälsa definierat som avsaknad av sjukdom (patogenes). Hälsa kan dock definieras på många olika sätt och motsatsen till patogenes är salutogenes. Ett salutogent perspektiv innebär en mer positiv syn på hälsa, som framhåller faktorer vilka skapar hälsa. Det finns flera typer av insatser som görs för att påverka människors hälsa i positiv riktning. Dessa insatser kallas för hälsofrämjande arbete och kan till exempel fokusera på de anställdas hälsa vid olika arbetsplatser. Idag vet vi en hel del om de negativa hälsoeffekterna av... (More)
Popular Abstract in Swedish

Studier av arbetsförhållande inom sjukvården har under lång tid varit förknippade med stress och sjukfrånvaro. Ett sådant problemorienterat perspektiv hänger samman med hälsa definierat som avsaknad av sjukdom (patogenes). Hälsa kan dock definieras på många olika sätt och motsatsen till patogenes är salutogenes. Ett salutogent perspektiv innebär en mer positiv syn på hälsa, som framhåller faktorer vilka skapar hälsa. Det finns flera typer av insatser som görs för att påverka människors hälsa i positiv riktning. Dessa insatser kallas för hälsofrämjande arbete och kan till exempel fokusera på de anställdas hälsa vid olika arbetsplatser. Idag vet vi en hel del om de negativa hälsoeffekterna av arbete, inom till exempel sjukvården, men det är betydligt mer sällsynt med arbetsrelaterad forskning som har en salutogen utgångspunkt.



Syftet med denna avhandling var att utforska och skapa mening kring den salutogena relationen mellan arbetsplats, arbete, hälsofrämjande arbete och sjukvårdspersonalens hälsa. Tre av studierna genomfördes därför i samband med ett för personalen hälsofrämjande arbete på en medicinsk vårdavdelning vid ett medelstort sjukhus i Skåne. Syftet var även att ta fram användbara instrument för denna typ av hälsofrämjande arbete och därför genomfördes en enkätstudie på sjukhuset som helhet. Det hälsofrämjande arbetet på avdelningen präglades av aktionsforskning, delaktighet och en blandning av kvantitativa och kvalitativa forskningsmetoder.



Forskningsprocessen visade på betydelsen av sociala och psykologiska resurser för sjukvårdspersonalens hälsa. Hälsoresurserna samverkar på olika sätt och kan medföra hälsofrämjande positiva upplevelser bland deltagarna. Resultaten visade att det fanns möjlighet för fler positiva upplevelser av arbetet på vårdavdelningen genom till exempel mer kvalificerade medicinska arbetsuppgifter, koncentration på personalens tankemässiga (kognitiva) resurser samt upplevelser av flow. Flow innebär en ultimat upplevelse av att den individuella kompetensen matchar stora utmaningar i en given situation. Sådana situationer ger upphov till glädje, motivation och kognitiv effektivitet samt bidrar till hälsa.



Resultaten visade också att projektdeltagarna var mer eller mindre prestationsorienterade och därför också fokuserade på och uppskattade arbete eller hälsofrämjande arbete med olika karaktärsdrag. De mer prestationsorienterade deltagarna värderade flexibilitet, reflektion, lärande och utveckling av det dagliga sjukvårdsarbetet. De mindre prestationsorienterade föredrog istället stabilitet, förutsägbarhet, lugn och ro samt trivsam social samvaro.



Skillnader som dessa behöver identifieras och diskuteras för att de ska fungera som en resurs för hälsofrämjande arbete på arbetsplatser. Hälsofrämjande arbete behöver enligt resultaten präglas av individuella resurser, möten mellan projektdeltagarna och stöd från externa personer. Förutom mänskliga resurser behövs också väl fungerande instrument som är anpassade för denna typ av hälsofrämjande arbete. Den framtagna SalutogenaHälsoIndikator Skalan (SHIS) är ett tillförlitligt instrument för att mäta hälsa utifrån ett salutogent perspektiv och är därför användbart för hälsofrämjande arbete på arbetsplatser. Det är dock viktigt att instrumentet används med ett salutogent perspektiv i hälsofrämjande arbete, vilket präglas av deltagande, trivsam social samvaro, interaktion, reflektion och lärande.



Forskningsresultaten bidrar till kunskapsutveckling om salutogena relationerna mellan arbetsplatsen som miljö, arbetet som aktivitet, hälsofrämjande arbete som förändringsprocess och sjukvårdspersonalens positiva upplevelser och hälsa som mål. Denna kunskap kan direkt tillämpas för att utveckla mer hälsofrämjande arbetsplatser och förändringsprocesser inom sjukvården specifikt, men även i arbetslivet generellt. (Less)
Abstract
The aim was to explore and make sense of a salutogenic relationship between workplace, work and health, through an employee perspective in a Swedish nursing context. The aim was also to make sense of the role of a workplace health promotion (WHP) process, in a salutogenic public health perspective, and develop useful instruments for this kind of health-related development work. The research process, which was predominantly carried out within the framework of a WHP process at a hospital ward, was characterized by a salutogenic perspective and an action and mixed method approach.



Four studies were carried out at a medium-sized hospital in the south of Sweden and the studies of papers I, II and III were conducted within the... (More)
The aim was to explore and make sense of a salutogenic relationship between workplace, work and health, through an employee perspective in a Swedish nursing context. The aim was also to make sense of the role of a workplace health promotion (WHP) process, in a salutogenic public health perspective, and develop useful instruments for this kind of health-related development work. The research process, which was predominantly carried out within the framework of a WHP process at a hospital ward, was characterized by a salutogenic perspective and an action and mixed method approach.



Four studies were carried out at a medium-sized hospital in the south of Sweden and the studies of papers I, II and III were conducted within the framework of a WHP process at the study ward. The development process started with a focus group study, to explore workplace-related resources and health, through the eyes of healthcare workers. The second study explored factors associated with the experience of flow during everyday nursing practice, through an experience sampling method. The third study within the framework of the project, was a focus group study attempted at making sense of the participating health care workers thoughts about the WHP process. The fourth study was a quantitative cross-sectional study aiming for a development and quality assessment of a salutogenic health indicator scale (SHIS).



The research process resulted in a predominant focus on social and psychological resources for and indicators of health. The identified workplace-related health resources interacted through a complex mutual influential relationship and they could be related to the reward, the team, the mission and the context. The resources of rewarding positive experiences and emotions were considered the core of a health promoting workplace. The findings indicated that there were possibilities for more positive workplace- and work-related experiences through focus on cognitive resources and medical care activities with adherent experiences of flow among the healthcare workers in general and among the assistant nurses in particular.



The participants were considered more or less achievement-oriented based on their preferring two rather different characteristics of work and WHP processes. More achievement-orientation was related to flexibility, reflection, learning and development of everyday practice. Less achievement-orientation was instead linked to stability, piece and quiet and WHP process-related social relations in general. These diversities were related to complexity and were considered useful for WHP practice. The diversities need to be identified and discussed in a WHP context that is characterized by individual resources, group interaction and external support. A WHP process also needs valid, reliable and practicable instrumental support. The SHIS is considered useful for measuring health with a salutogenic and holistic perspective in general and is thus useful for WHP with a salutogenic approach in particular. It is, however, important that the instrument is used together with a salutogenic perspective and in a context based on social processes, interaction, reflection, learning.



The findings adds knowledge to complex relations between workplace as a context, work as an activity, WHP with a salutogenic and bottom-up approach as a change process and health of healthcare workers as a goal. The findings can also directly be applied in practice, as support for an implementation of workplace-related health promoting structures and processes. (Less)
Please use this url to cite or link to this publication:
author
supervisor
opponent
  • Docent Nilsson, Kerstin, Institutionen för vårdvetenskap och hälsa, Göteborgs universitet
organization
publishing date
type
Thesis
publication status
published
subject
keywords
salutogenesis, health care worker, Workplace health promotion, flow, complexity, SHIS, instrument
in
Lund University, Faculty of Medicine Doctoral Dissertation Series
volume
2010:130
pages
116 pages
publisher
Faculty of Medicine, Lund University
defense location
Lilla aulan, Medicinskt forskningscentrum, ingång 59, Skånes universitetssjukhus, Malmö
defense date
2010-12-16 09:00
ISSN
1652-8220
ISBN
978-91-86671-46-4
language
English
LU publication?
yes
id
880a66fc-a8ae-4f65-9895-7783a321e15b (old id 1729813)
date added to LUP
2010-11-29 13:00:19
date last changed
2018-05-29 09:29:37
@phdthesis{880a66fc-a8ae-4f65-9895-7783a321e15b,
  abstract     = {The aim was to explore and make sense of a salutogenic relationship between workplace, work and health, through an employee perspective in a Swedish nursing context. The aim was also to make sense of the role of a workplace health promotion (WHP) process, in a salutogenic public health perspective, and develop useful instruments for this kind of health-related development work. The research process, which was predominantly carried out within the framework of a WHP process at a hospital ward, was characterized by a salutogenic perspective and an action and mixed method approach.<br/><br>
<br/><br>
Four studies were carried out at a medium-sized hospital in the south of Sweden and the studies of papers I, II and III were conducted within the framework of a WHP process at the study ward. The development process started with a focus group study, to explore workplace-related resources and health, through the eyes of healthcare workers. The second study explored factors associated with the experience of flow during everyday nursing practice, through an experience sampling method. The third study within the framework of the project, was a focus group study attempted at making sense of the participating health care workers thoughts about the WHP process. The fourth study was a quantitative cross-sectional study aiming for a development and quality assessment of a salutogenic health indicator scale (SHIS).<br/><br>
<br/><br>
The research process resulted in a predominant focus on social and psychological resources for and indicators of health. The identified workplace-related health resources interacted through a complex mutual influential relationship and they could be related to the reward, the team, the mission and the context. The resources of rewarding positive experiences and emotions were considered the core of a health promoting workplace. The findings indicated that there were possibilities for more positive workplace- and work-related experiences through focus on cognitive resources and medical care activities with adherent experiences of flow among the healthcare workers in general and among the assistant nurses in particular.<br/><br>
<br/><br>
The participants were considered more or less achievement-oriented based on their preferring two rather different characteristics of work and WHP processes. More achievement-orientation was related to flexibility, reflection, learning and development of everyday practice. Less achievement-orientation was instead linked to stability, piece and quiet and WHP process-related social relations in general. These diversities were related to complexity and were considered useful for WHP practice. The diversities need to be identified and discussed in a WHP context that is characterized by individual resources, group interaction and external support. A WHP process also needs valid, reliable and practicable instrumental support. The SHIS is considered useful for measuring health with a salutogenic and holistic perspective in general and is thus useful for WHP with a salutogenic approach in particular. It is, however, important that the instrument is used together with a salutogenic perspective and in a context based on social processes, interaction, reflection, learning.<br/><br>
<br/><br>
The findings adds knowledge to complex relations between workplace as a context, work as an activity, WHP with a salutogenic and bottom-up approach as a change process and health of healthcare workers as a goal. The findings can also directly be applied in practice, as support for an implementation of workplace-related health promoting structures and processes.},
  author       = {Bringsén, Åsa},
  isbn         = {978-91-86671-46-4},
  issn         = {1652-8220},
  keyword      = {salutogenesis,health care worker,Workplace health promotion,flow,complexity,SHIS,instrument},
  language     = {eng},
  pages        = {116},
  publisher    = {Faculty of Medicine, Lund University},
  school       = {Lund University},
  series       = {Lund University, Faculty of Medicine Doctoral Dissertation Series},
  title        = {TAKING CARE OF OTHERS - WHAT'S IN IT FOR US? Exploring workplace-related health from a salutogenic perspective in a nursing context},
  volume       = {2010:130},
  year         = {2010},
}