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Hiemstra SR, Naaldenberg J, de Jonge A, Vaandrager L. Salutogenic mechanisms in nature-based work: fostering sense of coherence for employees with limited capability for work. Health Promot Int 2024; 39:daae127. [PMID: 39382387 PMCID: PMC11462607 DOI: 10.1093/heapro/daae127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2024] Open
Abstract
Having a job is important for the well-being and inclusion of people with limited capability for work (LCW) due to physical and/or mental disability. This study explores salutogenic mechanisms that contribute to work-related sense of coherence (Work-SoC) of employees with LCW, i.e. perceiving their work in nature as manageable, comprehensible and meaningful. Semi-structured interviews (26 in total) were conducted with employees with LCW, employee supervisors, job coaches and foresters, all working in nature management. Interviews were held at four worksites of a governmental organisation in the Netherlands that provides permanent jobs for people with LCW. Employees with LCW contributed to the design and analysis of the study as co-researchers. Thematic analysis was used and member checks were carried out on preliminary findings. We identified six salutogenic mechanisms that contribute to nature-based Work-SoC of employees with LCW: (i) having constructive working relationships, (ii) experiencing structure and clarity, (iii) receiving practical and emotional support, (iv) support in the creation of meaning, (v) experiencing and learning in practice and (vi) physical activity and (absence of) stimuli. Identified mechanisms can create a positive effect when leveraged, thereby boosting (new) salutogenic mechanisms. Our findings illustrate that nature-based work can provide resources that promote Work-SoC of employees with LCW through the identified mechanisms. However, employees with LCW, colleagues, supervisors and stakeholders must recognize, mobilize and use these resources to leverage identified mechanisms in order to facilitate health-promoting workplaces for people with LCW. This, in turn, can contribute to sustainable inclusion through enablement.
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Affiliation(s)
- Sanne Renske Hiemstra
- Health & Society, Wageningen University & Research, Hollandseweg 1, P.O. Box 8130, 6707 KN, Wageningen, Netherlands
| | - Jenneken Naaldenberg
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - A de Jonge
- Binnenwerk, Organisation and Personnel, Ministry of the Interior and Kingdom Relations, The Hague, Netherlands
| | - Lenneke Vaandrager
- Health & Society, Wageningen University & Research, Hollandseweg 1, P.O. Box 8130, 6707 KN, Wageningen, Netherlands
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Meling HM, Anderssen N, Ruths S, Hjörleifsson S, Haukenes I. Stakeholder views on work participation for workers with depression and intersectoral collaboration in depression care: a focus group study with a salutogenic perspective. Scand J Prim Health Care 2023; 41:204-213. [PMID: 37526348 PMCID: PMC10478590 DOI: 10.1080/02813432.2023.2238019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 06/02/2023] [Indexed: 08/02/2023] Open
Abstract
OBJECTIVE To explore how stakeholders in depression care view intersectoral collaboration and work participation for workers with depression. DESIGN Focus group study applying reflexive thematic analysis using a salutogenic perspective. SETTING AND SUBJECTS We conducted seven focus group interviews in six different regions in Norway with 39 participants (28 women); three groups consisted of general practitioners (GPs), two of psychologists and psychiatrists and two of social welfare workers and employers (of which one group also included GPs). RESULTS Stakeholders considered work participation salutary for most workers with depression, given the right conditions (e.g. manageable work accommodations and accepting and inclusive workplaces). They also highlighted work as an integral source of meaningfulness to many workers with depression. Early collaborative efforts and encouraging sick-listed workers to stay connected to the workplace were considered important to avoid long and passive sickness absences. Furthermore, stakeholders' views illuminated why intersectoral collaboration matters in depression care; individual stakeholders have limited information about a worker's situation, but through collaboration and shared insight, especially in in-person collaborative meetings, they (and the worker) can gain a shared understanding of the situation, thereby enabling more optimal support. Ensuring adequate information flow for optimal and timely follow-up of workers was also emphasized. CONCLUSIONS Stakeholders highlighted the salutary properties of work participation for workers with depression under the right conditions. Intersectoral collaboration could support these conditions by sharing insight and knowledge, building a shared understanding of the worker's situation, assuring proper information flow, and ensuring early and timely follow-up of the worker.
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Affiliation(s)
- Heidi Marie Meling
- Research Unit for General Practice, NORCE – Norwegian Research Centre, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Norman Anderssen
- Research Unit for General Practice, NORCE – Norwegian Research Centre, Bergen, Norway
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Sabine Ruths
- Research Unit for General Practice, NORCE – Norwegian Research Centre, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Stefán Hjörleifsson
- Research Unit for General Practice, NORCE – Norwegian Research Centre, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Inger Haukenes
- Research Unit for General Practice, NORCE – Norwegian Research Centre, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Hult M, Välimäki T. Care workers' positive health during the COVID-19 pandemic: Psychometric properties of the finnish version of the salutogenic health indicator scale and an 18-month follow-up. Work 2022; 74:1289-1298. [PMID: 36565092 DOI: 10.3233/wor-220383] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND There is a need to shift from biomedical and pathogenic approaches to salutogenic approach. OBJECTIVE To validate the Finnish version of the SHIS by testing its psychometric properties in care workers and to assess the SHIS score over time. METHODS We first conducted a survey in 2020 (T1) and tested the psychometric properties of SHIS among care workers. We repeated the survey in spring 2022 (T2) among the same subjects. We analyzed the changes in SHIS, self-rated health (SRH), work ability (WAS), sickness absence and occupational calling between T1 and T2. Thereafter, we compared changes between health care sectors' and the other sectors' care workers. RESULTS The results showed an increase in positive health measured with the SHIS and the occupational calling, a decrease in the SRH, and an increase in the number of sickness-related absences among all the care workers between T1 and T2. There was no change in their WAS. The health care workers had a lower SHIS than the other sectors' care workers in both T1 and T2, but the increase in their SHIS was parallel to that of the other workers. CONCLUSION SHIS is a useful and reliable measure of positive health and can be used in studies when determining subjective health instead of, or in addition to, diagnoses. It was able to detect the health changes caused by the COVID-19 pandemic. SHIS is capable of capturing the underlying salutogenic approach of health promotive resources.
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Affiliation(s)
- Marja Hult
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Tarja Välimäki
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
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Lutz N, Dalle Grave L, Richter D, Deliens T, Verhaeghe N, Taeymans J, Clarys P. What are the economic dimensions of occupational health and how should they be measured? A qualitative study. BMC Public Health 2022; 22:1362. [PMID: 35840920 PMCID: PMC9284955 DOI: 10.1186/s12889-022-13659-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 06/15/2022] [Indexed: 11/10/2022] Open
Abstract
Background Decision makers want to know if there is a financial benefit in investing scarce resources in occupational health management (OHM). Economic evaluations (EEs) of OHM-strategies try to answer this question. However, EEs of OHM-strategies which are strongly marked by quantitative methods may be limited by contextual, qualitative residuals. Therefore, the objectives of this study were to (1) explore important economic dimensions of OHM and (2) to discuss the methods used in current EEs for measuring these dimensions. Methods In this explorative qualitative study, OHM-specialists were recruited via the Swiss organisation for health promotion. Thirteen semi-structured interviews were performed from November 2020 until May 2021. Videotapes were transcribed verbatim and organised by using an open coding strategy. Codes were clustered and synthesised as themes (i.e. the dimensions of EEs of OHM) through a mix of inductive and deductive content analysis. Member check with eight participants was accomplished to validate the results. Results The interviews had an average duration of 70.5 min and yielded 609 individual codes. These codes were merged into 28 subcategories which were finally categorised into five main themes: Understanding of OHM, costs, benefits, environmental aspects, and evaluation of OHM. Participants stated that the greater part of costs and benefits cannot be quantified or monetised and thus, considered in quantitative EEs. For example, they see a culture of health as key component for a successful OHM-strategy. However, the costs to establish such a culture as well as its benefits are hard to quantify. Participants were highly critical of the use of absenteeism as a linear measure of productivity. Furthermore, they explained that single, rare events, such as a change in leadership, can have significant impact on employee health. However, such external influence factors are difficult to control. Conclusions Participants perceived costs and benefits of OHM significantly different than how they are represented in current EEs. According to the OHM-specialists, most benefits cannot be quantified and thus, monetised. These intangible benefits as well as critical influencing factors during the process should be assessed qualitatively and considered in EEs when using them as a legitimation basis vis-à-vis decision makers. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13659-y.
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Affiliation(s)
- Nathanael Lutz
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium. .,Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.
| | - Lena Dalle Grave
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Dirk Richter
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.,Center for Psychiatric Rehabilitation, Bern University Hospital for Mental Health, Bern, Switzerland
| | - Tom Deliens
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Nick Verhaeghe
- Department of Public Health and Primary Care, Interuniversity Centre for Health Economics Research (I-CHER), Ghent University, Ghent, Belgium.,Research Institute for Work and Society - HIVA, KU Leuven, Leuven, Belgium
| | - Jan Taeymans
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Peter Clarys
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
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Cecon N, Krieger T, Salm S, Pfaff H, Dresen A. Salutogenesis at Work as a Facilitator for Implementation? An Explorative Study on the Relationship of Job Demands, Job Resources and the Work-Related Sense of Coherence within a Complex Healthcare Programme. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1842. [PMID: 35162864 PMCID: PMC8834699 DOI: 10.3390/ijerph19031842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/04/2022] [Accepted: 02/05/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND The implementation of complex healthcare programmes can be challenging for respective service providers (SPs) in implementation settings. A strong work-related sense of coherence (Work-SoC) promotes creation of job resources and potentially facilitates coping with demands that may arise during implementation. In this study, we analyse how SPs' Work-SoC is influenced by job resources and demands during programme implementation and identify relevant implementation strategies to ensure a salutogenic implementation process. METHODS Qualitative data were collected during the implementation of a new complex psycho-oncological care programme called isPO. Four focus groups and four interviews were conducted with SPs. All were audiotaped, transcribed and content analysis was applied, whilst ensuring inter- and intra-rater reliability. RESULTS Each Work-SoC component was influenced by specific job resources and demands. In particular, comprehensibility and manageability interacted. Manageability affected assessment of the programme's feasibility. High meaningfulness positively affected the programme's acceptance and overall assessment among SPs. Furthermore, it buffered low manageability and was strongly associated with project identification. CONCLUSION We found that Work-SoC could be used to assess SPs' work environment, and therefore programme feasibility. It may be worthwhile to use Work-SoC as an implementation outcome or as an indicator for possible programmes.
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Affiliation(s)
- Natalia Cecon
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Str. 129, D-50933 Cologne, Germany
| | - Theresia Krieger
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Str. 129, D-50933 Cologne, Germany
| | - Sandra Salm
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Str. 129, D-50933 Cologne, Germany
| | - Holger Pfaff
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Str. 129, D-50933 Cologne, Germany
| | - Antje Dresen
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Str. 129, D-50933 Cologne, Germany
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Werdecker L, Esch T. Burnout, satisfaction and happiness among German general practitioners (GPs): A cross-sectional survey on health resources and stressors. PLoS One 2021; 16:e0253447. [PMID: 34143849 PMCID: PMC8213182 DOI: 10.1371/journal.pone.0253447] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 06/02/2021] [Indexed: 12/21/2022] Open
Abstract
Well-being is a major issue among health care professionals, especially physicians. Less job satisfaction and impaired health can have an impact on health care quality. Our aim was to examine the association of stressors (illegitimate tasks) and health related resources (work-related sense of coherence; recovery experience) with life satisfaction, happiness, job satisfaction and burnout among German general practitioners (GPs). We conducted a cross-sectional survey among general medical practices in Germany. Main outcome measures were life satisfaction, happiness (Subjective Happiness Scale), job satisfaction (Work Satisfaction Scale) and burnout (Copenhagen Burnout Inventory). 548 GPs from across Germany participated (53.6% males, 45.6% females; mostly representative of German GPs). One third (35.2%) of the participants reported a high prevalence of personal, and one quarter (26.5%) indicated a high prevalence of work-related burnout symptoms. Illegitimate tasks are negatively associated with life and job satisfaction and are positively associated with personal, work-related and patient-related burnout among GPs. Work-SoC and recovery experience are positively associated with life satisfaction, happiness, and job satisfaction and are negatively associated with personal, work-related and patient-related burnout. Female physicians have a higher job satisfaction than male physicians. Being female and working as an employed physician is associated with a higher prevalence of personal burnout symptoms. GPs working in a group practice are happier and more satisfied with their job than GPs in single practices. Personal, work-related and patient-related burnout symptoms are stronger in GPs working in a single practice than in GPs in group practices. Our results highlight that Work-SoC, recovery experience and illegitimate tasks are important for creating work-related well-being among GPs. Introducing health promotion activities which aim to strengthen recovery experience and Work-SoC, as well as interventions to restructure tasks, may increase life satisfaction, happiness, and job satisfaction and reduce burnout symptoms in this health care profession.
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Affiliation(s)
- Lena Werdecker
- Institute for Integrative Health Care and Health Promotion, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
- * E-mail:
| | - Tobias Esch
- Institute for Integrative Health Care and Health Promotion, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
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