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Work and everyday activities: Experiences from two interventions addressing people with common mental disorders
Jönköping University, School of Health and Welfare, HHJ. ADULT.
Nyckeln Competence Centre for Pedagogic in Healthcare, Kalmar County Hospital, Kalmar, Sweden.
Unit for Research and Development, Kronoberg County Council, Växjö, Sweden.
Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.ORCID iD: 0000-0003-3594-4805
2014 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 21, no 4, 295-304 p.Article in journal (Refereed) Published
Abstract [en]

Objective: Lengthy sick leave makes demands on work ability enhancing interventions in primary health care. Problem-based method (PBM) and cognitive behavioural therapy (CBT) are interventions aimed at people with common mental disorders. This study aimed to describe how individuals experienced interventions and the impact the interventions had on the individuals' ability to work and perform other everyday activities. Method: Fourteen women and two men, eight each from two interventions, were interviewed. The interviews were analysed using qualitative content analysis. Results: The analysis revealed one overarching theme: "Reaching safe ground or continuing to seek help". Four categories were identified: "From being passive to making one's own efforts in the rehabilitation process", "Being stuck on a treadmill or daring to change", "Evolving from routine to more aware behaviour", and "Fitting in or not fitting in with workplace situations". Conclusions: According to the participants, experiences from both PBM and CBT had a positive impact on their ability to work and perform other everyday activities in a more sustainable way. Reflecting on behaviour and achieving limiting strategies were perceived as helpful in both interventions, although varying abilities to incorporate strategies were described. In general, the results support the use of active coping-developing interventions rather than passive treatments.

Place, publisher, year, edition, pages
2014. Vol. 21, no 4, 295-304 p.
Keyword [en]
Anxiety, cognitive behavioural therapy, depression, interview, problem-based method, qualitative content analysis, sick leave, stress, Swedish rehabilitation guarantee, vocational rehabilitation
National Category
Occupational Therapy
Identifiers
URN: urn:nbn:se:hj:diva-25911DOI: 10.3109/11038128.2014.894572ISI: 000338115100006PubMedID: 24666197Scopus ID: 2-s2.0-84903145243OAI: oai:DiVA.org:hj-25911DiVA: diva2:789194
Available from: 2015-02-18 Created: 2015-02-18 Last updated: 2016-11-24Bibliographically approved
In thesis
1. On the nature of work ability
Open this publication in new window or tab >>On the nature of work ability
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

‘Work ability’ is a multidimensional concept with importance for both society and the individual. The overall aim of this thesis was to illuminate work ability from the perspective of individuals (Studies I, III), rehabilitation (Study II) and employers (Study IV). In Study I five focus-group interviews were conducted with a total of 16 former unemployed sickness absentee participants. The interviews focused on their experiences of the environmental impact on return to work. The participants expressed a changed self-image and life rhythm. A need for reorientation and support from professionals was stressed. Experiences of being stuck in a ‘time quarantine’, i.e. a long and destructive wait for support, were also revealed. Study II was a randomised controlled study evaluating the interventional capacity of problem-based method (PBM) groups regarding anxiety, depression and stress and work ability compared to cognitive behavioural therapy (CBT) as a method within the Rehabilitation Guarantee. Effects were measured with psychometric instruments. The participants, 22 in the PBM group and 28 in the CBT group, were persons on sick leave because of common mental disorders. Within-group analysis showed significant lower degree of symptoms regarding anxiety and depression for both interventions. Between-group analysis showed significant lower degree of symptoms for CBT regarding anxiety, depression and stress. Within-group analysis of work ability showed significant improvement in one (out of five) subscales for the PBM group and in four for the CBT group. No significant between-group differences were found regarding work ability. In Study III, 16 participants were interviewed after completed interventions in Study II, eight from each intervention group. The interviews focused on their experiences from the interventions and the impact on their ability to work and perform other everyday activities. The interventions were experienced as having a positive impact on their ability to work and perform other everyday activities in a more sustainable way. Reflecting on behaviour and achieving limiting strategies were perceived as helpful in both interventions, although varying abilities to incorporate strategies were described. The findings support the use of active coping-developing interventions rather than passive treatments. Study IV included interviews with 12 employers and investigated their conceptions of ‘work ability’. In the results three domains were identified: ‘employees’ contributions to work ability’, ‘employers’ contributions to work ability’ and ‘circumstances with limited work ability’. Work ability was regarded as a tool in production and its output, production, was the main issue. The employees’ commitment could bridge other shortcomings. In summary, in the work rehabilitation process, different perspectives on work ability need to be considered in order to improve not only individual performance but also rehabilitation interventions, work-places and everyday circumstances. Clearly pronounced perspectives can contribute to better illustrating the dynamic within the relational and multifaceted concept of ‘work ability’. The ability to work can thus be enhanced through improving individual abilities, discovered through reorientation and created through support and adaptation.

Place, publisher, year, edition, pages
Jönköping: School of Health Sciences, 2014. 120 p.
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 48
Keyword
context, disability, occupational therapy, participation, work demand
National Category
Occupational Therapy
Identifiers
urn:nbn:se:hj:diva-23610 (URN)978-91-85835-47-8 (ISBN)
Public defence
2014-04-11, Forum Humanum, 13:00 (English)
Opponent
Supervisors
Available from: 2014-03-14 Created: 2014-03-14 Last updated: 2015-10-23Bibliographically approved

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