Is work-life interference a risk factor for sickness absence? A longitudinal study of the Swedish working population.

BACKGROUND: While there is increasing literature on the health effects of work-life interference, few studies have investigated the relationship between a direct measure of work-life interference and objective sickness absence measures. The aim of this study is to investigate whether work-life interference is a risk factor for subsequent long-term sickness absence (LTSA). METHODS: Data were derived from the Swedish Longitudinal Occupational Survey of Health 2010, 2012, 2014 and 2016. Data were linked to register data on LTSA (having at least one continuous period of medically certified sick leave exceeding 14 days) the following 2 years after each data collection wave. We applied generalized estimating equations, odds ratios (ORs) and 95% confidence intervals (CIs). The sample included 15 244 individuals (43.1% men and 56.9% women). Nearly a fifth of the sample (18.7%, n = 1110) started at least one period of LTSA at any point between 2010 and 2018. RESULTS: Work-life interference was found to be a risk factor for subsequent LTSA (OR = 1.55; 95% CI = 1.44-1.67) even when adjusting for relevant factors including general health (OR = 1.39; 95% CI = 1.29-1.51). We found no significant moderating effect of gender. CONCLUSION: The results of this study indicate that work-life interference is a risk factor for subsequent LTSA for working men and women in Sweden.

Organizational logics in time of crises: How physicians narrate the healthcare response to the Covid-19 pandemic in Swedish hospitals.

BACKGROUND: The COVID-19 pandemic has challenged healthcare organizations and puts focus on risk management in many ways. Both medical staff and leaders at various levels have been forced to find solutions to problems they had not previously encountered. This study aimed to explore how physicians in Sweden narrated the changes in organizational logic in response to the Covid-19 pandemic using neo-institutional theory and discursive psychology. In specific, we aimed to explore how physicians articulated their understanding of if and, in that case, how the organizational logic has changed during this crisis response. METHODS: The empirical material stems from interviews with 29 physicians in Sweden in the summer and autumn of 2020. They were asked to reflect on the organizational response to the pandemic focusing on leadership, support, working conditions, and patient care. RESULTS: The analysis revealed that the organizational logic in Swedish healthcare changed and that the physicians came in troubled positions as leaders. With management, workload, and risk repertoires, the physicians expressed that the organizational logic, to a large extent, was changed based on local contextual circumstances in the 21 self-governing regions. The organizational logic was being altered based upon how the two powerbases (physicians and managers) were interacting over time. CONCLUSIONS: Given that healthcare probably will deal with future unforeseen crises, it seems essential that healthcare leaders discuss what can be a sustainable organizational logic. There should be more explicit regulatory elements about who is responsible for what in similar situations. The normative elements have probably been stretched during the ongoing crisis, given that physicians have gained practical experience and that there is now also, at least some evidence-based knowledge about this particular pandemic. But the question is what knowledge they need in their education when it comes to dealing with new unknown risks.

The Swedish HealthPhys Study: Study Description and Prevalence of Clinical Burnout and Major Depression among Physicians.

Objectives: The study purpose was to describe the Swedish HealthPhys cohort. Using data from the HealthPhys study, we aimed to describe the prevalence of clinical burnout and major depression in a representative sample of Swedish physicians across gender, age, worksite, hierarchical position, and speciality in spring of 2021, during the third wave of the Covid-19 pandemic. Method: The HealthPhys questionnaire was sent to a representative sample of practising physicians (n = 6699) in Sweden in February to May of 2021 with a 41.3% response rate. The questionnaire included validated instruments measuring psychosocial work environment and health including measurements for major depression and clinical burnout. Results: Data from the HealthPhys study showed that among practising physicians in Sweden the prevalence of major depression was 4.8% and clinical burnout was 4.7%. However, the variations across sub-groups of physicians regarding major depression ranged from 0% to 10.1%. For clinical burnout estimates ranged from 1.3% to 14.5%. Emergency physicians had the highest levels of clinical burnout while they had 0% prevalence of major depression. Prevalence of exhaustion was high across all groups of physicians with physicians working in emergency departments, at the highest (28.6%) and anaesthesiologist at the lowest (5.6%). Junior physicians had high levels across all measurements. Conclusions: In conclusion, the first data collection from the HealthPhys study showed that the prevalence of major depression and clinical burnout varies across genders, age, hierarchical position, worksite, and specialty. Moreover, many practising physicians in Sweden experienced exhaustion and were at high risk of burnout.

A Theoretical Development of the Gender Embodiment of Enrichment: A Study of Gender Norms in Enrichment and Factors Related to Enrichment in a Sample of the Swedish Working Population.

Enrichment is a phenomenon described as the synergistic and beneficial effects of participating in both work and private life. Far too few studies have acknowledged the role of gender in enrichment. By applying a gender theoretical approach, this article has two aims; first, we aim to study the role of gender in enrichment by examining the factorial structure of enrichment in men and women; secondly, we aim to study the relationship between enrichment and work and private life factors in an approximately representative sample of the Swedish working population. A multigroup confirmatory factor analysis with measurement in variance was performed and this resulted in a two-factor solution for enrichment for both men and women, representing the two directions of enrichment: work-to-life enrichment (WLE) and life-to-work enrichment (LWE). Factor loadings differ across genders, indicating that men and women construct and value items of enrichment differently. Next, linear mixed models were used to answer the second aim. Results show that gendered cultural norms in work and private life manifest in the relationship between factors in the work and home sphere and enrichment. Factors in work and private life with more or less masculine or feminine epithets relate differently to WLE and LWE for men and women. The main conclusion is that masculine and feminine norms are embodied in the values and experiences of enrichment and factors related to enrichment.

Sickness Presenteeism among the Self-employed and Employed in Northwestern Europe-The Importance of Time Demands.

BACKGROUND: European policymakers encourage individuals to become self-employed because it is a way to promote innovation and job creation. It can be assumed that health and well-being among the self-employed and managers in small-scale enterprises are particularly crucial in this enterprise group because the smallness of the enterprise makes its members vulnerable. Earlier studies have indicated that the self-employed have a high working pace and work for long and irregular hours, indicating that it can be difficult to stay at home because of sickness. The purpose of this study is to investigate the occurrence of sickness presenteeism among the self-employed in relation to the organizationally employed and to analyze whether any differences can be explained by higher work demands among the self-employed. METHODS: The study is based on the fifth European survey on working conditions (2010) and includes the northwestern European countries in the survey. The questions cover a wide range of topics designed to meet the European Union's political needs. The main variables in this study are sickness presenteeism and several indicators of time demands. RESULTS: The results show that the self-employed report a higher level of sickness presenteeism than the employed: 52.4 versus 43.6%. All indicators of time demands are significantly related to the risk for sickness presenteeism, also when controlling for background characteristics. CONCLUSION: The results confirm that the level of sickness presenteeism is higher among the self-employed and that high time demands are a major explanation to this.

Gender Policies and Gender Inequalities in Health in Europe: Results of the SOPHIE Project.

The aim of this article is to explain the results of the SOPHIE project regarding the effect of gender policies on gender inequalities in health in Europe. We start with the results of a systematic review on how gender regimes and gender equality policies at the country level impact women's health and gender inequalities in health. Then, we report on three empirical analyses on the relationship between different family policy models existing in Europe and gender inequalities in health. Finally we present four case studies on specific examples of gender policies or determinants of gender inequalities in health. The results show that policies that support women's participation in the labor force and decrease their burden of care, such as public services and support for families and entitlements for fathers, are related to lower levels of gender inequality in terms of health. In addition, public services and benefits for disabled and dependent people can reduce the burden placed on family caregivers and hence improve their health. In the context of the current economic crisis, gender equality policies should be maintained or improved.