Bakgrund/Syfte*: Sjukskrivningsprocessen uppfattas ofta som osäker och otydlig av både patienter och personal. År 2020 infördes en lag om koordineringsinsater och rollen som rehabiliteringskoordinator utvecklades. För att förbättra processen utarbetades, i sydöstra sjukvårdsregionen, ett strukturerad arbetssätt för bedömning av rehabilitering och sjukskrivning (STARS). STARS består av åtta metodstöd med anvisningar, information och förslag om vad som bör/kan beaktas och göras både internt och externt vid olika tidpunkter under sjukskrivnings- och rehabiliteringsprocessen. Arbetssättet implementerades på nio vårdcentraler under 2021. Syftet med studien var att undersöka hur personal involverad i sjukskrivningsprocessen upplever det att arbeta enligt STARS.

Metod/Tillvägagångssätt*: Kvalitativ fokusgruppsstudie. Sju grupper och totalt 37 deltagare från nio vårdcentraler. Inklusionskriterier: Personal (läkare, rehabiliteringskoordinatorer, sjuksköterskor, psykologer, kuratorer, arbetsterapeuter och fysioterapeuter) vid de nio inkluderade vårdcentralerna som var direkt involverad i sjukskrivnings- och rehabiliteringsprocessen. Fokusgruppssamtalen analyserades med tematisk innehållsanalys.

Resultat/Förväntat resultat*: Fyra teman framkom som beskrev personalens upplevelser av att arbeta enligt arbetssättet: Snabbare, multiprofessionella insatser med flexibel planering; Teamarbete som skapar tillit och arbetsro; Trygghet och förutsägbarhet samt; En struktur som överbryggar. Personalen upplevde att en rehabiliteringsplan fastställdes tidigare, att färre patienter föll mellan stolarna samt att teamarbetet främjades. Rehabiliteringskoordinatorn fungerade som en sammanhållande funktion internt och externt mot andra aktörer/myndigheter och arbetsgivare vilket å ena sidan upplevdes avlastande för övrig personal men för rehabiliteringskoordinatorn upplevdes en ökad belastning.

Slutsats/Praktisk tillämpning*: Vårdpersonalen upplevde att STARS var användbart i kliniskt arbetet och skapade trygghet för patienterna. STARS möjliggjorde multiprofessionella, snabbare och mer proaktiva åtgärder. Resultat har relevans för arbetsterapeuter som arbetar inom primärvård.

Bakgrund/Syfte*: Funktionsnedsatta i Arbete (FIA) har sin verksamhet hos organisationen Funktionsrätt i Jönköpings län. FIA riktar sig till personer med långvarig frånvaro från arbetsmarknaden och agerar fristående men i samverkan med myndigheter. Coacherna i FIA har inga arbetsträningsplatser eller myndighetsutövande verktyg. Deras verktyg är samarbete med arbetsgivare, Supported Employment och MI (motiverande samtal). Kapabilitetsansatsen innebär att stödja individen att vara och göra det hen värdesätter. Huvudfokus är inte att så snabbt som möjligt bli självförsörjande utan en hållbar anställning i samklang med individens värderingar.

Syftet med utvärderingen var att beskriva erfarenheter av FIA:s arbetssätt med fokus på hållbara anställningar ur deltagares, arbetsgivares och handläggares perspektiv.

Metod/Tillvägagångssätt*: Individuella intervjuer genomfördes med arbetsgivare, handläggare och deltagare som avslutats till anställning/studier. Data analyserades genom kvalitativ innehållsanalys.

Resultat/Förväntat resultat*: Kategorin Lång förberedelsesträcka beskriver hur individens förutsättningar utforskas parallellt med arbetsgivares förutsättningar. Därefter påbörjas matchningsarbete som har likheter med mäklande. Komplexiteten med att möta individens behovoch rättigheter beskrevs i kategorin Navigerande bland samhällsinsatser och regelverk. Arbetsgivare uttryckte bristande kännedom om anställning av personer med funktionsnedsättning. Coacherna bygger Relationer som bärande strukturer för att utmana till fortsatt utveckling och samtidigt ge långsiktigt stöd till deltagare och arbetsgivare. Hos arbetsgivare identifierades två parallella diskurser. En solidaritetsdiskurs som visade engagemang och möjliggörande till delaktighet i ett arbetssammanhang och en produktivitetsdiskurs inriktad på utförandet av arbetsuppgiften.

Beträffande hållbarhet i arbetslivet hade samtliga deltagare varit i arbete mellan 18 månader och över fem år.

Slutsats/Praktisk tillämpning*: Genom långsiktigt stöd till både arbetsgivare och arbetstagare skapas förutsättningar för ett hållbart arbetsliv.

Purpose: To evaluate the long-term effects of an Arts on Prescription (AoP) programme on sense of coherence (SOC) in Sweden.

Design: A controlled intervention study with a quasi-experimental prospective design, including questionnaires at baseline, with follow-ups at 6 and 12 months. Participants were on sick leave due to common mental disorders (CMD) and/or non-specific musculoskeletal pain, recruited from primary care in six regions. The intervention group also included participants from open psychiatric care. The study sample comprised 586 participants (335 in the intervention group and 251 in the control group).

Results: Both groups showed a significantly stronger SOC at follow-up, with a medium effect size for the intervention group and a small effect size for the control group. No statistically significant difference in SOC change over time was observed between the groups. Participants from open psychiatric care in the intervention group showed a significant improvement in SOC compared to those from primary care. Concerns about finances had a significant main effect on SOC for the entire study population.

Originality: Unlike most AoP studies, this controlled study with a relatively large sample provides insights into the long-term effects of AoP on SOC, with results reported using p-values and effect sizes.

Background: Mental health problems (MHP) are a major public health challenge. Conventional healthcare has shown limitation on reducing MHP and there is a call for offering methods beyond healthcare as well as improve access to healthcare.

Aims: To explore experiences among people having MHP of (i) taking part in existential conversations in groups beyond conventional healthcare and (ii) seeking and receiving conventional healthcare.

Materials and methods: Four focus group interviews were conducted after finishing existential conversations in groups. Data was analyzed following thematic analysis.

Results: The theme Access to a community for exploration and acceptance describes communication through impressions and expressions together with others. A reflective perspective on everyday life, describes re-evaluation through reflection. Within the theme Experiences of healthcare related encounters, referring to the second aim, participants recollected feelings of disconnectedness, difficulties verbalizing MHP and dealing with rigid, standardized measures.

Conclusion: Existential conversations in group may contribute to a more reflected doing in accordance with one’s own values as well as improved mental health literacy. Design and measures within healthcare need to explicitly address MHP and consider individual’s own preferences.

Significance: This study contributes to understanding of coping with MHP in everyday life from an existential perspective.

Long-term unemployment impacts a person’s life and opportunities for participating in occupations. Despite the frequent occurrence of short-term unemployment, the proportion of long-term unemployment in Western contexts remains high and is growing, which particularly affects vulnerable groups and thus is an issue of relevance for occupational science. Research into the lived experiences of being long-term unemployed and how it affects daily life is limited, although the need to look more closely into unemployment has been recognized. The aim of this study was to describe people’s experiences of long-term unemployment from an occupational perspective. Due to the dearth of studies in this area, a scoping review methodological framework was used, resulting in nine relevant studies reported in English to be included in a thematic analysis. Results revealed three analytical themes: Experiences of occupations during and due to long-term unemployment; Experiences of occupational obstacles; and Experiences of occupational enablers. The daily lives of long-term unemployed people consist largely of occupations they perform for obligatory reasons, that is, to be eligible for economic subsidies for their survival, and less of anything related to what they want or need. People also experience obstacles that limit and restrict their opportunities of engaging in meaningful occupations. These obstacles could be seen as occupational injustices. Enabling factors also exist, but they are not available or possible for all. Being long-term unemployed changes people’s participation and engagement in occupations. By understanding the experience of long-term unemployment, it is possible to plan and implement better services.

Aims: Involvement in arts has shown potential to promote mental health. Thus, arts may be able to complement conventional healthcare to address common mental disorders (CMD). The aim of this study was to evaluate the long-term effect of a 10-week Arts on Prescription program regarding CMD (stress, anxiety, depression), compared to conventional healthcare. The study also aimed to examine whether CMD differed between groups.

Methods: A quasi-experimental prospective design with intervention and control group and 6- and 12-month follow-up was used to evaluate an Arts on Prescription program in Sweden, focusing on the effects on stress, anxiety, and depression. Participants were on sick leave due to CMD and/or musculoskeletal pain. Data was collected using questionnaires.

Results: The study population consisted of 479 participants (n=247 intervention group, n=232 control group). The result indicates a greater effect size (ŋ) in the intervention group compared to the control group for reduction in stress, anxiety, and depression at follow-up after 12 months. The difference in depression was significant.

Conclusions: The results indicate AoP could be an adjunct to conventional healthcare interventions to address CMD, especially depression.

I denna artikel beskrivs tankar och reflektioner utifrån två pågående studier. Båda studerar gruppsamtal om existentiella dimensioner, men har olika målgrupper, klienter respektive professionella inom hälso- och sjukvård. Studierna har olika syften och teoretisk anknytning.

I klientstudien användes de inom aktivitetsvetenskapen förekommande begreppen doing, being, belonging och becoming medan professionsstudien använde det teoretiska ramverket praktikarkitekturer samt resonans för att förstå vad som händer i samtalsgrupperna när de pågår.

Fem gemensamma områden från resultaten har identifierats och dessa belyses utifrån respektive studies syfte och teorianknytning. Dessa områden är Existentiell inramning och ledning, Frihet inom ramar för tid och rum, Gruppens betydelse, Reflekterat omdöme och Becoming och transformativt lärande.

Avslutningsvis delar författarna med sig av sina erfarenheter när två studiers forskningsprocesser får flätas samman i arbetet med denna artikel.

This article describes thoughts and reflections based on two ongoing studies. Both concern existential group conversations, but with different target groups: clients and healthcare professionals respectively. The two studies differ in aims and theoretical frameworks.

In the client study the concepts doing, being, belonging, and becoming, all commonly used in occupational science, were applied; whereas the study of the healthcare professionals applied the theoretical framework of practice architectures together with the concept resonance to understand what happens in ongoing practices.

Five common areas from the results have been identified, and these are illuminated from the respective studies’ aims and theoretical frameworks. These areas are: Existential framing and leadership, Freedom framed by time and space, The significance of the group, Reflective judgement and Becoming and transformative learning.

Finally, the authors share their experiences when two studies’ research processes become intertwined in the work with this article.   

Arts on Referral (AoR) is a complementary intervention used to support people who are on sick leave due to common mental disorders (CMD) and/or musculoskeletal pain, challenging public health.

Aim: To deepen the understanding of how AoR works from a health-promoting perspective and how people with CMD and/or musculoskeletal pain experience AoR.

Design: The study adopted a qualitative approach. Thirty women (21–65 years old) participated in a total of five focus groups after the AoR intervention, which consisted of two sessions a week for ten weeks.

Findings: A qualitative content analysis of the focus group identified four categories: 1. Place of belonging including descriptions of social connectedness and understanding; 2. Experiences of AoR as a respite from demands; 3. Arts activities offering challenge and reward; and 4. Contributing to health-promoting changes. The findings were discussed in the light of Wenger’s concept of community of practice and Csikszentmihalyi’s concept of flow.

Value: This study describes how AoR contributed to health-promoting changes by offering a place of belonging, free from demands but still with opportunities to challenge oneself and explore new skills. Findings suggest that AoR can be helpful in improving mental wellbeing and feelings of belonging.

Occupational therapy has a lot to contribute to sustainable development considering the discipline's occupational focus and knowledge. This has been recognised by researchers and professional associations, but there is still a scarcity of research explicitly mentioning sustainability. Relevant contributions may be identified by relating education and research to the Agenda 2030 sustainable development goals. The aim of this article was to describe explicit and implicit inclusion of sustainable development and Agenda 2030 goals in occupational therapy education and research at one Swedish university. Current course syllabi and study guides, as well as research over the past five-year period, were examined and related to sustainability. The results showed that although only a few courses and articles were explicitly related to sustainable development, more course and research content became relevant when this content was compared with the sustainable development goals. It can be concluded that sustainability was more extensively addressed than first visible, but further studies including more universities are warranted.