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Background: The main aim of this study is to investigate the connection between a high workload and health-related quality of life among in-home care workers in northern Sweden during the COVID-19 pandemic. We also investigate whether social support and control at work can prevent poor health due to high workload.

Methods: A cross-sectional survey was conducted during the pandemic, with 629 (response rate 33 per cent) of an estimated 1,900 in-home care workers responding. Results were compared with a nearly identical survey conducted prior to the pandemic in which 1,154 (response rate 58 per cent) of an estimated 2000 in-home care workers responded. Psychosocial factors were measured using QPSNordic and health-related quality of life using EuroQol 5 Dimensions (EQ-5D). EQ-5D responses were translated into quality-adjusted life year (QALY) scores. Propensity scores were used with absolute risk differences.

Results: During the pandemic, staff with high workload had a statistically significantly (6.2%) lower QALY score (confidence interval 2.2%–10.3%) compared to staff with a normal workload. This was also the case for the usual activities and the anxiety/depression dimensions of EQ-5D. These risk differences were greater, but not statistically significant, during the pandemic than before. The combination of a normal workload and a high degree of control over one’s work appeared to protect against a low QALY score, while social support at work did not seem to be protective.

Conclusions: High workload is related to poorer health-related quality of life. This is mainly attributable to anxiety/depression. In-home care organisations need to manage workload better to prevent poor health among staff during strained situations such as a pandemic. The results of our study indicate that in-home care organisations should increase their readiness to promote opportunities for staff to maintain a high degree of control over their work, in order to counteract variations in workload that ultimately appear to have a negative impact on HRQoL.

Background: Home care services, with the aim to support older adults in their homes, faced intense external pressure to create sustainable working conditions for staff during the COVID-19 pandemic. Studies have indicated elevated burnout and stress among residential care staff, and it is likely that similar challenges exist in home care services. Overall, the consequences for staff's work environment and health under the extremely strained conditions of the COVID-19 pandemic merit closer examination. Therefore, the aim is to illuminate home care workers’ experiences of their work environment and health risks while supporting older adults during the COVID-19 pandemic.

Methods: To gain an in-depth understanding of personal experiences during the pandemic, five focus group interviews (FG) were held in northern Sweden during spring 2022. Open-ended questions were delivered via a semi-structured interview guide. Thematic analysis was used to guide data analysis.

Results: Expanded and unclear responsibilities characterized the work environment during the pandemic. This was summarized into four sub-themes: my own health was jeopardized; a wind of change towards more responsibility; struggling between being a lifeline and being contagious; and organization and management as facilitators or hindrances.

Conclusions: The findings underscore the importance of management strategies and organizational preparedness to support staff’s mental health and mitigate challenges during crises. The health risks associated with increased workload, stress, and mental burdens were evident in the narratives. The study emphasizes the need to strive for a good work environment, set priorities to reduce workloads and mental stress, and incorporate time for recovery among staff during crises. It is also of great importance that different authorities in healthcare and social care create effective cooperation so that information, knowledge, and policies are effectively disseminated to frontline staff who have the concrete responsibility for our elderly.

Background: The in‑home work environment is the main work environment for home care workers, but it has only been sparsely studied. Our aim was to investigate the in‑home work environment for home care workers by exploring challenges that arise regardless of a pandemic and by investigating Covid‑19–specific challenges.

Methods: Two cross‑sectional studies were conducted, one before (2017) and one during the pandemic (2021/2022) in three Swedish regions (Jämtland/Härjedalen, Västerbotten and Västernorrland), in which 1,154 (58%) out of 2,000 and 629 (33%) of 1,900 invited home care workers participated, respectively. Participants responded to a question‑naire asking about 10 problems associated with the in‑home work environment as well as Covid‑19–related chal‑lenges. Comparisons were conducted between regions and between study years using univariable analyses.

Results: Daily problems with the in‑home work environment were common before the pandemic, and they increased statistically significantly during the pandemic for, among other things, non‑ergonomic beds (29% vs. 37%), impractical bathrooms (40% vs. 50%), indoor smoking (24% vs. 31%), and pets (19% vs. 25%). There were major con‑cerns about the risk of getting infected with Covid‑19 for both staff (42%) and the home care recipients (50%). There were statistically significant differences between regions, e.g. many problems were more common in the Västerbotten region than in the other two regions during the pandemic, while challenges with protective equipment was most common in the Västernorrland region.

Conclusions: In‑home work environment problems are common for home care workers and worsen in a more strained situation. Efforts are needed to strengthen the work environment for home care workers.

Activity-based Flexible Offices (AFOs) provide employees with a variety of workspaces to choose from based on their tasks, rather than having assigned desks. While the adoption of AFOs is increasing due to flexibility and cost-efficiency, there is limited research about the consequences of transitioning to AFOs from the perspective of staff managers. The purpose of this study is to explore how managers experience and cope with challenges that may arise in AFOs. Our qualitative descriptive study is based on two case studies that investigate the consequences of AFOs. Data collection involved semi-structured interviews with a total of 33 managers in two organisations, 12–18 months post-relocation. An inductive, bottom-up process was used for coding and thematization of the interview transcripts. Our results show that AFOs can enhance communication and collaboration depending on the units’ collaboration needs and prior geographical distribution. However, this effect was overshadowed by task-environment misalignments on within-team communication, distractions, and limitations on adjustments and recruitments. Additionally, managers faced conflicting loyalties between defending the organisation’s decision to implement AFOs while ensuring compliance with legal work environment requirements despite limited resources. There is a risk that the implementation of flexible offices will fragment and complicate managers’ tasks, such as ensuring that daily operations run smoothly, meeting legal responsibilities, and managing and recruiting staff. This poses a risk to managers’ productivity and health, and consequently, the achievement of organisational goals. The study uncovers managerial experiences, challenges, and coping strategies in AFOs, offering valuable insights for organisations considering this office type.

Introduction: The burden of work-related ill health is increasing in working-life. The employer has the main responsibility for securing a healthy work environment, preventing ill health, andfacilitating employees’ return to work after sickness. In organizations, the responsibility for thesystematic work environmental practice is often shared or divided between a first-line managerand a Human Resource (HR) function. The aim of this study was to describe how the workenvironmental responsibility is shared or divided in large and small organizations, and how thiscould impact the organizations’ implementation and use of a health promoting workplaceintervention.

Method: The Workplace Dialogue is a digital method that guides and supports anorganization’s work environmental practice, to discover, act on and adapt work to work-relatedill health. It includes concrete support in the form of text, films, and discussion materials. Thisstudy is based on a one-year intervention which started in 2022 with the Workplace dialoguebeing implemented in five large (two public and three private) and seven small (three publicand four private) organizations. Data was collected six and twelve months into the interventionand was based on focus-group discussions with eight and three HR functions from large andsmall organizations respectively. Interviews included questions concerning how HR functionsexperienced the implementation process, and how they perceived their mandate to influencethis process. Interviews were transcribed and then analysed using qualitative content analysis.

Results: The preliminary findings indicate that, after the implementation, the practice of theWorkplace Dialogue was more established in organizations where the board of managementwere leading the project. In large organizations where HR functions were not a part of thestrategic board, the implementation was more complicated and dependent on the commitmentof certain individuals. In small companies, a structure for the organization’s systematic workenvironmental practice could be missing, which made the implementation more difficult. AlbeitHR functions overall had positive attitudes towards the Workplace dialogue and were importantresources for managers’ use of it, HR functions’ opinions and actions generally had less impacton securing the method practice in the organizations.

Conclusion: To facilitate the comprehensive implementation of a new health promotingworkplace method, such as the Workplace dialogue, it is crucial for organizations to involve HRfunctions in the strategic management board. Further, to secure the practice of such method,organizations’ management board needs to be involved in and support the implementation anduse of it. However, small companies may have less organizational resources to realise thepractice of a new health promoting workplace method.

Objective: This study aimed to investigate and explore Occupational Health and Safety (OHS) management, office ergonomics, and musculoskeletal symptoms in a group of office workers relocating from cell offices to activity-based flex offices (AFOs).

Methods: The analysis was based on qualitative interview data with 77 employees and longitudinal questionnaire data from 152 employees.

Results: Results indicate that there was a need to clarify roles and processes related to the management of OHS. Self-rated sit comfort, working posture, and availability of daylight deteriorated and symptoms in neck and shoulders increased after the relocation and seemed to be influenced by many factors, such as difficulties adjusting the workstations, the availability of suitable workplaces, and age, sex, and individual needs.

Conclusion: Research on the long-term effects of physical work environments and management of (OHS) issues after implementing activity-based flex offices is sparse. This study demonstrates the importance of planning and organising OHS issue management when implementing an AFO, and to carefully implement office ergonomics among office workers.

Background: The work for Swedish home care workers is challenging with a variety of support and healthcare tasks for home care recipients. The aim of our study is to investigate how these tasks relate to workload and health-related quality of life among home care workers in Sweden. We also explore staff preferences concerning work distribution.

Methods: A cross-sectional study was conducted in 16 municipalities in Northern Sweden. Questionnaires with validated instruments to measure workload (QPSNordic) and health-related quality of life (EQ-5D), were responded by 1154 (~ 58%) of approximately 2000 invited home care workers. EQ-5D responses were translated to a Quality-adjusted life-year (QALY) score. For 15 different work task areas, personnel provided their present and preferred allocation. Absolute risk differences were calculated with propensity score weighting.

Results: Statistically significantly more or fewer problems differences were observed for: higher workloads were higher among those whose daily work included responding to personal alarms (8.4%), running errands outside the home (14%), rehabilitation (13%) and help with bathing (11%). Apart from rehabilitation, there were statistically significantly more (8–10%) problems with anxiety/depression for these tasks. QALY scores were lower among those whose daily work included food distribution (0.034) and higher for daily meal preparation (0.031), both explained by pain/discomfort dimension. Personnel preferred to, amongst other, spend less time responding to personal alarms, and more time providing social support.

Conclusion: The redistribution of work tasks is likely to reduce workload and improve the health of personnel. Our study provides an understanding of how such redistribution could be undertaken.

Implementation of activity-based flex offices (AFOs) are becoming increasingly common. The aim of this study was to evaluate the effects of an AFO on perceived productivity, satisfaction, work environment and health. Questionnaire data from the longitudinal, quasi-experimental Active Office Design Study was used. The study evaluates a public organization relocating staff to either an AFO or to cell offices. Measures from baseline, 6 and 18 months after relocation, were analyzed. Employees in the AFO experienced a decreased productivity and satisfaction with the office design. Lack of privacy as well as increased noise disturbance, less satisfaction with sit comfort and work posture were reported. Employees in the AFO with work tasks requiring a high degree of concentration experienced lower productivity while those with a high proportion of teamwork rated productivity to be continually high. No significant group differences were found between the two office types in general health, cognitive stress, salutogenic health indicators or pain in the neck, shoulder or back. The study highlights the importance of taking work characteristics into account in the planning and implementation process of an AFO. Flexible and interactive tasks seem more appropriate in an AFO, whereas individual tasks demanding concentration seem less fit.

OBJECTIVE: Previous studies have shown that high workload affects health negatively. However, studies are lacking among home care workers. The aim of this study is to examine the burden of perceived workload on health-related quality of life (HRQoL) among home care workers and to determine whether psychosocial factors modify such a relationship.

METHODS: A cross-sectional study was conducted in which 1162 (58% response rate) home care workers participated. The psychosocial factors were measured by QPSnordic. HRQoL was measured by EuroQol 5 dimensions, from which responses were translated into quality-adjusted life year scores (QALY). Propensity scores were used with absolute risk differences (RD). Stratified analysis was used to test the buffer hypothesis of the demand-control-support model.

RESULTS: Personnel with a high workload had a statistically significant 0.035 lower QALY than personnel with a normal workload. This difference was also statistically significant for the Visual Analogue Scale (RD 5.0) and the mobility (RD 0.033) and anxiety/depression scales (RD 0.20) dimensions of EQ-5D. For QALY, the effect of a high workload compared to a normal workload was higher, with low (RD 0.045, significant) compared with high (RD 0.015, non-significant) social support; while it was similar, and non-significant results, for low and high control.

CONCLUSIONS: Our study shows that lowered work burden would be beneficial for home care personnel. Furthermore, our results suggest that interventions aimed at increasing social support could reduce work-related illness.

Arbetsgivares juridiska ansvar för arbetsmiljö och ett hållbart arbete återfinns i en mängd olika bestämmelser av varierande karaktär, samt i domar och beslut från Arbetsmiljöverket, vilket inte underlättar vare sig överskådlighet och förståelse av regelverkets innebörd. Avsikten är att i den här artikeln dels analysera arbetsgivares juridiska ansvar för arbetstagares arbetsbelastning inom arbetsmiljörätten, dels undersöka hur problem med arbetsbelastning upplevs samt om, och i så fall hur, dessa problem hanteras inom såväl manligt och kvinnligt dominerade arbetsplatser som inom privat och offentlig verksamhet.