Social and health care top managers' perceptions and aims of strategic work ability management in the midst of change

BACKGROUND

Existing research has mostly focused on themes related to returning to or staying at work and studied organizations' operational rather than strategic level actions to support work ability. Top managers' understanding of work ability management (WAM) may influence how work ability support processes are implemented in organizations.

OBJECTIVE

To find out how top managers define WAM, what the aims of WAM were and whether the aims were on a strategic level.

METHODS

Altogether 28 semi-structured interviews among Finnish social and health care top managers were conducted during the years 2019-2021 and analyzed inductively using qualitative thematic analysis.

RESULTS

Top managers' definition of WAM was mainly multidimensional. Two main aims were identified, i.e., to support work ability 1) at the individual and 2) at the organizational level. The aims of the former were to anticipate the decrease of health and functional capacity, to support workers already decrease in these, to develop competence, and to manage the effects of changes on work ability. The aims at the organizational level were to improve labor availability and personnel retention, to ensure the flow of work, and to increase trust and create shared values. Top managers described the aims as being at a strategic level, but this was not yet realized in their organizations because the actions were reactive rather than proactive.

CONCLUSION

Top managers' multidimensional perception of WAM, emphasizing proactive actions, and strategic level aims are crucial and require the commitment of the top managers for strategic WAM, especially during constant changes.

The concurrent validity of the Abilitator: a self-assessment questionnaire on functioning and work ability

Aim

The Abilitator is a self-assessment questionnaire which was developed to evaluate the perceived work ability and different aspects of functioning of working-age people. The present study aimed to explore the concurrent validity of the Abilitator.

Subject and methods

The participants (n = 177) were patients of a rehabilitation outpatient clinic. Their mean age was 47.1 years. Using Spearman’s correlation coefficients, we assessed the concurrent validity of the Abilitator to compare it to the HAD, RAND-36, EQ-5D, and WHODAS 2.0 (12-item short version) questionnaires.

Results

The five domains of the Abilitator showed fair to moderate correlation coefficients with the previously validated and accepted measures of functioning. The strongest correlations were found in specific domains measuring similar constructs, namely social inclusion and RAND-36 vitality/fatigue (rs = 0.58), psychological functioning and RAND-36 emotional well-being (rs = 0.67) and HAD depression (rs = −0.65), everyday activities and total score of EQ-5D (rs = 0.63), cognitive functioning and WHODAS 2.0 cognition (rs = 0.57), and physical condition and RAND-36 physical functioning (rs = 0.70). Analysis by subpopulations of gender and age group showed a broadly similar pattern to that of the total sample. In general, stronger correlations were seen among women and among those of a younger age (50 years or under).

Conclusion

The Abilitator questionnaire has acceptable concurrent validity for assessing different aspects of the functioning of working-age people.

The association between changes in functional capacity and work ability among unemployed individuals

PURPOSE

Unemployment has multidimensional effects. This study investigated how the changes in functioning are associated with the changes in perceived work ability among unemployed people.

METHODS

The participants were clients in projects funded by the European Social Fund (ESF) targeted for unemployed individuals. They answered a questionnaire covering work ability (Work Ability Score) and functioning (cognitive, psychological and social functioning, physical condition and everyday activities) and perceived health at the beginning and at the end of the project (mean follow-up 173 days). The study included data from unemployed respondents (N = 502) aged 19-64 years.

RESULTS

Overall, during the follow-up, both work ability and different aspects of functioning improved, excluding physical condition. Changes in cognitive and psychological functioning, physical condition and everyday activities were significantly associated with the changes in work ability. The physical condition had the strongest association with the changes in work ability. Short unemployment time and especially good perceived health improved WAS over time. Age, gender and follow-up time were not associated with changes in work ability.

CONCLUSIONS

Maintaining or improving health and functioning and shortening the length of unemployment appeared to be important issues in enhancing work ability and thus increasing re-employability potential.

Development and content validity of the Abilitator: a self-report questionnaire on work ability and functioning aimed at the population in a weak labour market position

BACKGROUND

The unemployed have lower work ability and poorer health than the employed. This situation deteriorates when unemployment continues. The long-term unemployed often have co-morbidities and face many other challenges. This increases the need for a multidimensional assessment of work ability and functioning in different service settings. In this study, we describe the development and analyse the content validity of the Abilitator, a self-report questionnaire on work ability and functioning for those in a weak labour market position.

METHODS

The Abilitator was developed in 2014-2017. Its construct was assessed by members of academic expert panels (n = 30), practical expert panels of professionals (n = 700) and target group clients (n = 28). The structure and the content of the questionnaire was co-developed in 29 workshops and adjusted twice based on the expert panels' feedback. The Abilitator was also implemented among target group clients (n = 3360) in different services and projects. During its development the Abilitator was linked to the International Classification of Functioning, Disability and Health (ICF). The content validation process followed the guidelines recommended by the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) panel.

RESULTS

The construct of the Abilitator combines the multidimensional and biopsychosocial models of work ability and functioning. It also includes aspects of social inclusion and employability. It evaluates social, psychological, cognitive and physical functioning, and the ability to cope with everyday life. The content of these concepts was validated by the academic and practical expert panels. The Abilitator's 79 ICF codes covered 57% of the Generic, 77% of the Brief Vocational Rehabilitation, and 8% of the Minimal Environmental ICF Core Sets. When compared with the Work Ability Index (WAI) and the World Health Organization Disability Assessment Schedule (WHODAS 2.0), the direct equivalences of the ICF codes were 36 and 44%, respectively.

CONCLUSION

The Abilitator sufficiently comprehensively covers the relevant aspects to enable the assessment of the overall work ability and functioning of the population in a weak labour market position.

Efficiency of workplace surveys conducted by Finnish occupational health services

In Finland, workplace surveys are used to identify and assess health risks and problems caused by work and make suggestions for continuous improvement of the work environment. With the aid of the workplace survey, occupational health services can be tailored to a company. The aims of this study were to determine how occupational health professionals gather data via the workplace survey and the effect survey results have on companies. A total of 259 occupational health nurses and 108 occupational health physicians responded to the questionnaire: 84.2% were women and 15.8% were men. The mean age of the respondents was 48.8 years (range, 26 to 65 years). Usually occupational health nurses and foremen and sometimes occupational health physicians and occupational safety and health representatives initiate the workplace survey. More than 90% of the surveys were followed by action proposals, and about 50% of these were implemented. The proposals implemented most often concerned personal protective equipment and less often leadership. Survey respondents should have both the opportunity and the authority to affect resources, the work environment, work arrangements, and tools. Teamwork among occupational health and safety professionals, management, and employees is vital for cost-effectively solving today's complex problems at workplaces around the globe.

Perceived mental stress and reactions in heart rate variability--a pilot study among employees of an electronics company

In this study perceived mental stress during occupational work was compared to heart rate variability (HRV) using a traditional questionnaire and a novel wristop heart rate monitor with related software. The aim was to find HRV parameters useful for mental stress detection. We found the highest correlation between perceived mental stress with the differences between the values of triangular interpolation of rhythm-to-rhythm (RR) interval histogram (TINN) and the root mean square of differences of successive RR intervals (RMSSD) obtained in the morning and during the workday (r=-.73 and r=-.60, respectively). The analysis shows that as the RMSSD and TINN value differences increase from night to morning, the stress decreases.

Sick leaves in four factories--do characteristics of employees and work conditions explain differences in sickness absence between workplaces?

OBJECTIVES

The study explored whether differences in sickness absence between four factories of a food industry company were explained by common determinants of sickness absence, such as employee health, sociodemographic characteristics, and physical and psychosocial work conditions.

METHODS

Survey responses of 582 employees were linked to the records of short-term (1-3 days) and long-term (>3 days) absence, as well as to records of absences due to musculoskeletal diagnoses. Multilevel models were applied in assessing the between-factory absence differences.

RESULTS

Compared with the levels in the factory with the lowest sickness absence, in one factory the levels of short-term [rate ratio (RR) 1.72], long-term (RR 1.96), and musculoskeletal (rate ratio 2.93) absence were significantly higher. Another factory also had higher levels of long-term and musculoskeletal absence (RR 2.17 and 2.52, respectively). Adjustment for the background factors explained 35% of the difference in short-term absence, 3-9% of the differences in long-term absence, and 18-12% of the differences in musculoskeletal absence, but the between-factory differences were still highly significant.

CONCLUSIONS

This study showed large differences in sickness absence between factories that were only partly explained by common determinants. Moreover, economic factors and formal control were unlikely explanatory factors, as the study was conducted within a single company. These results justify further research on local absence practices and cultures, including those of health service organizations and professionals.

A 16-year follow-up study of physical capacity in relation to perceived workload among ageing employees

The main purpose of this study was to ascertain musculoskeletal and cardiovascular capacity among ageing employees in relation to workload over a period of 16 years. The data were obtained by physical capacity tests and ratings of perceived exertion (RPE) during working day. The study group consisted of 89 subjects, who were all employed in the municipal branch and were on average 51.9 years old at the beginning of the follow-up period in 1981 and 67.3 years in 1997, when the most of the subjects had retired (with only two subjects still working). During the 16-year follow-up period, age-related decline in physical capacity was observed. Nevertheless the improvement in flexibility of spine and in isometric trunk muscle strength compared with the same age subjects was more common among the subjects with high workload than among the subjects with low workload. However, among the subjects with high workload, physical capacity was poorer than among the subjects with low workload, especially among the women. The results suggest the conclusion that there are differences in workers' physical capacity in relation to their perceived workload during working life. These differences remained when the subjects had retired. Interestingly, those who had high workload had lower muscle strength than those who had low workload. This may indicate that high physical workload does not have any training effect on the muscle strength of ageing workers.

Changes in Physical Capacity Among Middle-Aged Municipal Employees Over 16 Years

The purpose of the present study was to identify changes in different components of physical capacity among middle-aged women and men employed in the municipal branch for 16 years. The data were obtained by laboratory measurements and postal questionnaires. The study group consisted of 45 middle-aged subjects, who were on average 51.5 years old at the beginning of the follow-up in 1981 and 67.3 years in 1997. During the 16-year follow-up period, the average physical capacity of these workers decreased by approximately 20%. The study showed that the greatest changes occurred in isometric trunk muscle strength and in the flexibility of the spine, whereas smaller changes were noted in anthropometrics. The decrease of physical capacity was greater among men (range 11.6% to 33.7%) than among women (range 3.3% to 26.7%), although women had more individual variations. On average, people without disease or who were physically active displayed better physical capacity than people with disease or who were physically passive.