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Keisu, B.-I., Öhman, A. & Enberg, B. (2018). Employee effort: reward balance and first-level manager transformational leadership within elderly care. Scandinavian Journal of Caring Sciences, 32(1), 407-416
Open this publication in new window or tab >>Employee effort: reward balance and first-level manager transformational leadership within elderly care
2018 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 1, p. 407-416Article in journal (Refereed) Published
Abstract [en]

Background: Negative aspects, staff dissatisfaction and problems related to internal organisational factors of working in elderly care are well-known and documented. Much less is known about positive aspects of working in elderly care, and therefore, this study focuses on such positive factors in Swedish elderly care. We combined two theoretical models, the effort–reward imbalance model and the Transformational Leadership Style model. The aim was to estimate the potential associations between employee-perceived transformational leadership style of their managers, and employees' ratings of effort and reward within elderly care work.

Methods: The article is based on questionnaires distributed at on-site visits to registered nurses, occupational therapists, physiotherapists (high-level education) and assistant nurses (low-level education) in nine Swedish elderly care facilities. In order to grasp the positive factors of work in elderly care, we focused on balance at work, rather than imbalance.

Results: We found a significant association between employees' effort–reward balance at work and a transformational leadership style among managers. An association was also found between employees' level of education and their assessments of the first-level managers.

Conclusions: We conclude that the first-level manager is an important actor for achieving a good workplace within elderly care, since she/he influences employees' psychosocial working environment. We also conclude that there are differences and inequalities, in terms of well-being, effort and reward at the work place, between those with academic training and those without, in that the former group to a higher degree evaluated their first-level manager to perform a transformational leadership style, which in turn is beneficial for their psychosocial work environment. Consequently, this (re)-produce inequalities in terms of well-being, effort and reward among the employees at the work place.

Keywords
effort, reward, transformational leadership style, elderly care, first-level manager, quantitative method
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Work Sciences
Research subject
Sociology
Identifiers
urn:nbn:se:umu:diva-140079 (URN)10.1111/scs.12475 (DOI)000426524200042 ()28851057 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2017-09-29 Created: 2017-09-29 Last updated: 2018-06-09Bibliographically approved
Briones-Vozmediano, E., Maquibar, A., Vives-Cases, C., Öhman, A., Hurtig, A.-K. & Goicolea, I. (2018). Health-Sector Responses to Intimate Partner Violence: fitting the Response Into the Biomedical Health System or Adapting the System to Meet the Response?. Journal of Interpersonal Violence, 33(10), 1653-1678
Open this publication in new window or tab >>Health-Sector Responses to Intimate Partner Violence: fitting the Response Into the Biomedical Health System or Adapting the System to Meet the Response?
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2018 (English)In: Journal of Interpersonal Violence, ISSN 0886-2605, E-ISSN 1552-6518, Vol. 33, no 10, p. 1653-1678Article in journal (Refereed) Published
Abstract [en]

This study aims to analyze how middle-level health systems' managers understand the integration of a health care response to intimate partner violence (IPV) within the Spanish health system. Data were obtained through 26 individual interviews with professionals in charge of coordinating the health care response to IPV within the 17 regional health systems in Spain. The transcripts were analyzed following grounded theory in accordance with the constructivist approach described by Charmaz. Three categories emerged, showing the efforts and challenges to integrate a health care response to IPV within the Spanish health system: "IPV is a complex issue that generates activism and/or resistance," "The mandate to integrate a health sector response to IPV: a priority not always prioritized," and "The Spanish health system: respectful with professionals' autonomy and firmly biomedical." The core category, "Developing diverse responses to IPV integration," crosscut the three categories and encompassed the range of different responses that emerge when a strong mandate to integrate a health care response to IPV is enacted. Such responses ranged from refraining to deal with the issue to offering a women-centered response. Attempting to integrate a response to nonbiomedical health problems as IPV into health systems that remain strongly biomedicalized is challenging and strongly dependent both on the motivation of professionals and on organizational factors. Implementing and sustaining changes in the structure and culture of the health care system are needed if a health care response to IPV that fulfills the World Health Organization guidelines is to be ensured.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
intimate partner violence, health system, Spain, grounded theory
National Category
Public Health, Global Health, Social Medicine and Epidemiology Gender Studies
Identifiers
urn:nbn:se:umu:diva-114394 (URN)10.1177/0886260515619170 (DOI)000430238500005 ()26691205 (PubMedID)2-s2.0-84982278063 (Scopus ID)
Available from: 2016-01-18 Created: 2016-01-18 Last updated: 2018-10-16Bibliographically approved
Briones-Vozmediano, E., Öhman, A., Goicolea, I. & Vives-Cases, C. (2018). "The complaining women": health professionals' perceptions on patients with fibromyalgia in Spain. Disability and Rehabilitation, 40(14), 1679-1685
Open this publication in new window or tab >>"The complaining women": health professionals' perceptions on patients with fibromyalgia in Spain
2018 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, no 14, p. 1679-1685Article in journal (Refereed) Published
Abstract [en]

PURPOSE: The aim of this study is twofold: (1) to explore health service providers' perceptions regarding fibromyalgia patients in Spain and (2) to analyze possible consequences of these perceptions in terms of how health service providers construct the disease and treat their patients.

DESIGN: Qualitative study.

SUBJECTS/PATIENTS: Twelve health service providers (eight men, four women) involved in the care of fibromyalgia patients. Providers were from different disciplines and included general practitioners, rheumatologists, occupational doctors, psychologists, psychiatrists, physiotherapists and behavioral specialists from Spain.

METHOD: We performed individual semistructured interviews, which were recorded and transcribed to conduct a qualitative content analysis supported by Atlas.ti-7.

RESULTS: We identified three categories from the interviews: (1) the fibromyalgia patient prototype: the complaining woman, (2) fibromyalgia is considered a women's health issue, but male patients are a privileged minority, and (3) health professionals' attitudes toward fibromyalgia patients: are they really suffering or pretending?

CONCLUSION: The uncertainty surrounding fibromyalgia together with the fact that those affected are primarily women, seem to influence professional practice in terms of lack of recognition of Fibromyalgia as a severe disease. Increased training of all health professionals is essential to improving the support and attention given to patients suffering from fibromyalgia.

Implications for rehabilitation: Fibromyalgia

• In order to improve fibromyalgia patients' attention, health providers should learn how to assist patients without prejudices.

• Training programs for health providers should include sensitization about the severity of fibromyalgia.

• Health providers should be aware of the existence of stereotypes about women suffering from fibromyalgia.

• Fibromyalgia protocols should give skills to health providers to avoid offering a gender-biased attention to patients.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
Fibromyalgia, gender, illness and disease, patient-provider relationships, qualitative research, social construction, women’s health
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-140103 (URN)10.1080/09638288.2017.1306759 (DOI)000428516800009 ()28385050 (PubMedID)
Available from: 2017-09-29 Created: 2017-09-29 Last updated: 2018-06-09Bibliographically approved
Goicolea, I., Öhman, A. & Vives-Cases, C. (2017). Intersections between gender and other relevant social determinants of health inequalities. Global Health Action, 10, Article ID 1397909.
Open this publication in new window or tab >>Intersections between gender and other relevant social determinants of health inequalities
2017 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 10, article id 1397909Article in journal, Editorial material (Refereed) Published
Place, publisher, year, edition, pages
Taylor & Francis, 2017
National Category
Public Health, Global Health, Social Medicine and Epidemiology Gender Studies
Identifiers
urn:nbn:se:umu:diva-142313 (URN)10.1080/16549716.2017.1397909 (DOI)000417200100001 ()29168436 (PubMedID)
Available from: 2017-11-27 Created: 2017-11-27 Last updated: 2019-04-16Bibliographically approved
Öhman, A., Keisu, B.-I. & Enberg, B. (2017). Team social cohesion, professionalism, and patient-centeredness: gendered care work, with special reference to elderly care – a mixed methods study. BMC Health Services Research, 17, Article ID 381.
Open this publication in new window or tab >>Team social cohesion, professionalism, and patient-centeredness: gendered care work, with special reference to elderly care – a mixed methods study
2017 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 17, article id 381Article in journal (Refereed) Published
Abstract [en]

Background: Healthcare organisations are facing large demands in recruiting employees with adequate competency to care for the increasing numbers of elderly. High degrees of turnover and dissatisfaction with working conditions are common. The gendered notion of care work as 'women's work', in combination with low salaries and status, may contribute to negative work experiences. There is abundant information about the negative aspects of elderly care health services, but little is known about positive aspects of this work. The study aim was to investigate work satisfaction from a gender perspective among Swedish registered nurses, physiotherapists, and occupational therapists, focusing specifically on healthcare services for the elderly.

Methods: A mixed methods approach was adopted in which we combined statistics and open-ended responses from a national survey with qualitative research interviews with healthcare professionals in elderly care organisations. The survey was administered to a random sample of 1578 registered nurses, physiotherapists, and occupational therapists. Qualitative interviews with 17 professionals were conducted in six elderly care facilities. Qualitative and quantitative content analyses, chi2 and constructivist grounded theory were used to analyse the data.

Results: There was a statistically significant difference in overall work satisfaction between those who worked in elderly care and those who did not (64 and 74,4% respectively, p < 0.001). Nine themes were derived from open-ended responses in the questionnaire. The qualitative interviews revealed four prominent storylines: 'Team social cohesion', 'Career development and autonomy', 'Client-centeredness', and 'Invisible and ignored power structures'.

Conclusions: The results show the complexity of elderly care work and describe several aspects that are important for work satisfaction among health professionals. The results reveal that work satisfaction is dependent on social interrelations and cohesion in the work team, in possibilities to use humour and to have fun together, and in the ability to work as professionals to provide client-centered elderly care. Power relations such as gendered hierarchies were less visible or even ignored aspects of work satisfaction. The storylines are clearly linked to the two central discourses of professionalism and gender equality.

Place, publisher, year, edition, pages
BioMed Central, 2017
Keywords
Work satisfaction, Elderly care, Nurses, Occupational therapists, Physiotherapists, Gender, Mixed methods, Clients, Power relations, Sweden
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Gender Studies
Research subject
genusvetenskap
Identifiers
urn:nbn:se:umu:diva-135755 (URN)10.1186/s12913-017-2326-9 (DOI)000403106000001 ()28578673 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, dnr. 2011- 1140
Available from: 2017-06-05 Created: 2017-06-05 Last updated: 2018-06-09Bibliographically approved
Söderholm, A., Öhman, A., Stenberg, B. & Nordin, S. (2016). Experience of living with nonspecific building-related symptoms. Scandinavian Journal of Psychology, 57(5), 406-412
Open this publication in new window or tab >>Experience of living with nonspecific building-related symptoms
2016 (English)In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 57, no 5, p. 406-412Article in journal (Refereed) Published
Abstract [en]

Nonspecific building-related symptoms (NBRS) is a combination of general, skin and mucosal symptoms related to certain buildings. Despite high prevalence in the general population and severe symptomatology in certain cases there is no scientific documentation of quality of life in NBRS. The purpose of this study was to illuminate how individuals with NBRS experience daily life. Data were collected through descriptive, written texts and through telephone interviews with 11 individuals diagnosed with NBRS, and qualitative content analysis was conducted. Three main content areas were identified: (1) attitudes from the surrounding (categories: being questioned and lack of understanding from others; from zero to full support); (2) consequences (difficulties with daily activities; financial difficulties; affecting family and friends; emotional consequences); and (3) coping (learning to accept and finding solutions; avoiding; struggling; finding the positive; making one's home a sanctuary). As a conclusion, NBRS may affect several aspects of daily life, resulting in considerable alterations, limitations and emotional impact for the afflicted person and his/her family. Both environmental factors and attitudes from the surrounding can contribute to this impact on daily life. Strategies needed to cope with this impact may include both problem-focused and emotion-focused strategies, such as struggling, avoiding trigger factors and finding positive aspects.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2016
Keywords
Attitudes, consequences, content analysis, coping, daily life, sick building syndrome
National Category
Public Health, Global Health, Social Medicine and Epidemiology Psychology
Identifiers
urn:nbn:se:umu:diva-127461 (URN)10.1111/sjop.12319 (DOI)000383707800004 ()27532686 (PubMedID)
Available from: 2016-11-14 Created: 2016-11-14 Last updated: 2018-06-09Bibliographically approved
Joffer, J., Jerdén, L., Öhman, A. & Flacking, R. (2016). Exploring self-rated health among adolescents: a think-aloud study. BMC Public Health, 16, Article ID 156.
Open this publication in new window or tab >>Exploring self-rated health among adolescents: a think-aloud study
2016 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 16, article id 156Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Despite extensive use of self-rated health questions in youth studies, little is known about what such questions capture among adolescents. Hence, the aim of this study was to explore how adolescents interpret and reason when answering a question about self-rated health.

METHODS: A qualitative study using think-aloud interviews explored the question, "How do you feel most of the time?", using five response options ("Very good", "Rather good", "Neither good, nor bad", "Rather bad", and "Very bad"). The study involved 58 adolescents (29 boys and 29 girls) in lower secondary school (7th grade) and upper secondary school (12th grade) in Sweden.

RESULTS: Respondents' interpretations of the question about how they felt included social, mental, and physical aspects. Gender differences were found primarily in that girls emphasized stressors, while age differences were reflected mainly in the older respondents' inclusion of a wider variety of influences on their assessments. The five response options all demonstrated differences in self-rated health, and the respondents' understanding of the middle option, "Neither good, nor bad", varied widely. In the answering of potential sensitive survey questions, rationales for providing honest or biased answers were described.

CONCLUSIONS: The use of a self-rated health question including the word 'feel' captured a holistic view of health among adolescents. Differences amongst response options should be acknowledged when analyzing self-rated health questions. If anonymity is not feasible when answering questions on self-rated health, a high level of privacy is recommended to increase the likelihood of reliability.

Place, publisher, year, edition, pages
BioMed Central, 2016
Keywords
Self-rated health, Subjective health, Health assessment, Feel, Adolescence, Qualitative, Think-aloud interview, Cognitive interviewing, Sweden
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-117585 (URN)10.1186/s12889-016-2837-z (DOI)000370407800001 ()26880571 (PubMedID)
Available from: 2016-03-02 Created: 2016-03-02 Last updated: 2018-06-07Bibliographically approved
Stenmark, H., Bergström, E., Hägglöf, B., Öhman, A. & Petersen, S. (2016). Mental problems and their socio-demographic determinants in young schoolchildren in Sweden, a country with high gender and income equality. Scandinavian Journal of Public Health, 44(1), 18-26
Open this publication in new window or tab >>Mental problems and their socio-demographic determinants in young schoolchildren in Sweden, a country with high gender and income equality
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2016 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 44, no 1, p. 18-26Article in journal (Refereed) Published
Abstract [en]

AIMS: Mental problems and their potential socio-demographic determinants were investigated in young schoolchildren in Sweden, a high-income country in the top of income- and gender-equality rankings.

METHODS: Cross-sectional study of 1465 schoolchildren in grades 3 and 6. Mental health was measured by the Child Behavior Checklist and the Youth Self Report (Total problems and 14 specific problem areas). Potential socio-demographic determinants were sex, parental education and occupation, family structure, and immigrant status.

RESULTS: Mental problems were present in 14% of the sixth graders and in 7% of the third graders. In grade 3, the mean total problem score was lower in girls than in boys, but the prevalence of problems at a subclinical/clinical level did not differ by sex. Furthermore, in nine to 13 of the 14 specific problem areas, problems were equally distributed by sex, parental education, parental occupation, immigrant status, and family structure. In grade 6, both the total mean score and the overall odds of subclinical/clinical problems were similar in girls and boys. Likewise, in all the specific problem areas, problems were evenly distributed by parental education and occupation, and only independently associated with immigrant status and family structure in one problem area. In five specific problem areas, boys had higher odds of problems than girls.

CONCLUSIONS: This study shows that also in a relatively wealthy and equal country such as Sweden, mental problems are a significant child public health issue. The association between socio-demographic background and mental problems seems to be rather weak, but differ dependent on the type of mental problem in focus.

Keywords
adolescent, anxiety, aggression, attention deficit disorder with hyperactivity, child, conduct disorder, depression, mental disorders, prevalence, socio-demographic factors
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-110310 (URN)10.1177/1403494815603544 (DOI)000369969000005 ()26392422 (PubMedID)
Available from: 2015-10-20 Created: 2015-10-20 Last updated: 2018-06-07Bibliographically approved
Salazar, M., Goicolea, I. & Öhman, A. (2016). Respectable, Disreputable, or Rightful? Young Nicaraguan Women's Discourses on Femininity, Intimate Partner Violence, and Sexual Abuse: A Grounded Theory Situational Analysis. Journal of Aggression, Maltreatment & Trauma, 25(3), 315-332
Open this publication in new window or tab >>Respectable, Disreputable, or Rightful? Young Nicaraguan Women's Discourses on Femininity, Intimate Partner Violence, and Sexual Abuse: A Grounded Theory Situational Analysis
2016 (English)In: Journal of Aggression, Maltreatment & Trauma, ISSN 1092-6771, E-ISSN 1545-083X, Vol. 25, no 3, p. 315-332Article in journal (Refereed) Published
Abstract [en]

This situational analysis study aims to position the discourses that young Nicaraguan women use in their understanding of femininities, male intimate partner violence (IPV), and men's sexual violence toward women (SA). Eight focus group discussions with a total of 59 women were conducted. Positional maps were used to display the data. The findings show a dominant discourse that portrays femininity as enacting attributes habitually bestowed to men such as independence and agency, while still upholding key patriarchal conceptions (respectability) limiting women's agency. Tolerance of IPV and SA by nonpartners varies depending on women's perceived respectability and agency. Most important, we identified a pro-women's rights resistance discourse that constructs femininity and advocates nonviolence from a human rights perspective.

Keywords
Femininities, gender, IPV, nicaragua, sexual abuse
National Category
Public Health, Global Health, Social Medicine and Epidemiology Gender Studies
Identifiers
urn:nbn:se:umu:diva-124014 (URN)10.1080/10926771.2015.1081662 (DOI)000377701100006 ()
Available from: 2016-07-07 Created: 2016-07-07 Last updated: 2018-06-07Bibliographically approved
Waenerlund, A.-K., Stenmark, H., Bergström, E., Hägglöf, B., Öhman, A. & Petersen, S. (2016). School experiences may be important determinants of mental health problems in middle childhood: a Swedish longitudinal population-based study. Acta Paediatrica, 105(4), 407-415
Open this publication in new window or tab >>School experiences may be important determinants of mental health problems in middle childhood: a Swedish longitudinal population-based study
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2016 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, no 4, p. 407-415Article in journal (Refereed) Published
Abstract [en]

AimLittle is known about the association between school experiences and mental health in young schoolchildren. This study explored the cross-sectional and prospective associations between children's school experiences and mental health in middle childhood. MethodsWe gathered comprehensive population-based data on the school experiences and mental health of 592 schoolchildren attending grades three and six in Sweden (ages approximately nine and 12 years). The KIDSCREEN questionnaire was used to measure school experiences in both age groups while the Child Behavior Checklist and the Strengths and Difficulties Questionnaire measured mental health in grades three and six, respectively. ResultsChildren with problematic school experiences in grade three had an approximately two times higher odds for concurrent total, internalised, externalised, attention-hyperactivity and social problems. They also had a 1.5-2.5 higher odds for these mental health problems three years later. Likewise, there was an association between problematic school experiences in grade three and lower levels of prosocial behaviour three years later. These associations were shown in both boys and girls, but were particularly pronounced in girls. ConclusionThis study indicated that school experiences in young schoolchildren may be important determinants of concurrent and later mental health problems.

Place, publisher, year, edition, pages
John Wiley & Sons, 2016
Keywords
Child, Longitudinal studies, Mental health, Psychosocial factors, Schools
National Category
Psychiatry Public Health, Global Health, Social Medicine and Epidemiology Pediatrics
Identifiers
urn:nbn:se:umu:diva-119061 (URN)10.1111/apa.13326 (DOI)000371892200022 ()26742093 (PubMedID)
Available from: 2016-04-22 Created: 2016-04-11 Last updated: 2018-06-07Bibliographically approved
Projects
The public health turn on violence against women - healthcare system´s readiness and governance [2015-00929_Forte]; Umeå University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-3083-106x

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