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Svärd, V., Arapovic Johansson, Z., Holmlund, L., Hellman, T., Kwak, L. & Björk Brämberg, E. (2024). Collaboration in the return-to-work process after sick leave due to common mental disorders: a qualitative study of stakeholders’ views on goals and roles. BMC Public Health, 24(1), Article ID 1567.
Open this publication in new window or tab >>Collaboration in the return-to-work process after sick leave due to common mental disorders: a qualitative study of stakeholders’ views on goals and roles
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2024 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 24, no 1, article id 1567Article in journal (Refereed) Published
Abstract [en]

Background: This study explores how the goals of collaboration in the return-to-work (RTW) process for people with common mental disorders are described by the stakeholders involved, and how they experience stakeholders’ roles and responsibilities in relation to these goals.

Methods: Interviews were conducted with 41 participants from three Swedish regions. Nine of the participants were workers, six employer representatives, four occupational health professionals, four social insurance officers, 18 RTW coordinators and five physicians. Thematic analysis was conducted.

Results: Three main themes and overarching goals when collaborating on RTW were identified. In the first theme, ‘creating an informative environment’, all stakeholders emphasised clear roles and responsibilities. The second theme, ‘striving for consensus in an environment of negotiations’, addressed negotiations about when and how to collaborate, on what and with whom, and reveal different views on stakeholders’ goals, roles and responsibilities in collaboration. The third theme identified goals for ‘creating a supportive environment’ for both workers and other stakeholders. Coordinators are found to have an important role in achieving a supportive environment, and in neutralising power imbalances between workers and their employers and social insurance officers.

Conclusions: Competing goals and priorities were identified as hindering successful collaboration, contributing to a spectrum of complex versus easy RTW collaboration. This study suggests some basic conditions for achieving a collaborative arena that is neutral in terms of power balance, where all stakeholders can share their views.

Place, publisher, year, edition, pages
Springer, 2024
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:sh:diva-54205 (URN)10.1186/s12889-024-19063-y (DOI)38862931 (PubMedID)
Available from: 2024-06-12 Created: 2024-06-12 Last updated: 2024-06-20Bibliographically approved
Murley, C., Dervish, J., Machado, A., Svärd, V., Wennman-Larsen, A., Hillert, J. & Friberg, E. (2024). Exploring the working life of people with multiple sclerosis during the COVID-19 pandemic in Sweden. BMC Public Health, 24, Article ID 1389.
Open this publication in new window or tab >>Exploring the working life of people with multiple sclerosis during the COVID-19 pandemic in Sweden
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2024 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 24, article id 1389Article in journal (Refereed) Published
Abstract [sv]

Background The COVID-19 pandemic led to vast changes in working life and conditions in which we work. Thesechanges may affect people with multiple sclerosis (PwMS) differently. We aimed to describe the working situation ofPwMS during the COVID-19 pandemic and the pandemic’s impact on their working lives.

Methods All individuals aged 20–50 listed in the Swedish Multiple Sclerosis Registry were invited to participate inan online survey in 2021. Closed and open-ended responses linked to individual-level register data were used in this exploratory mixed-methods study. Differences in the proportions reporting specific impacts were assessed with chisquare tests by sex, MS severity, education, and profession. The open-ended answers were analysed through contentanalysis.

Results Over 8500 PwMS were invited (52% response rate). We included the 3887 respondents who answered questions about the impact of the pandemic on working life. Most (93.7%) reported being in paid work. An impactof the ongoing pandemic to one’s daily occupation was reported by 26.2%, with different characteristics observedacross the impacts. Four categories of type of answers were identified from the open-ended answers: Direct impacton one’s occupation, Disclosing or concealing MS in the workplace, Worry and uncertainty, and Broader impact to lifesituation.

Conclusions PwMS navigated the pandemic by interrupting as well as continuing their working lives. Many PwMSreported that the pandemic did not affect their work situation. However, the reported impacts differed among theparticipants and a sense of uncertainty and worry was often underlying their statements. Lessons from the pandemicmay support future work participation.Keywords SARS-CoV-2, Containment measures, W

Place, publisher, year, edition, pages
Springer Nature, 2024
Keywords
SARS-CoV-2, Containment measures, Work, Employment, Occupation, Chronic disease, Remote work
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:sh:diva-54037 (URN)10.1186/s12889-024-18844-9 (DOI)
Note

This work wassupported by the Swedish Social Insurance Agency (Försäkringskassan) andthe Neuro Association (Neurofonden).

Available from: 2024-05-24 Created: 2024-05-24 Last updated: 2024-05-27Bibliographically approved
Azad, A. & Svärd, V. (2023). Competence and professionalisation among return-to-work coordinators in Sweden: comparisons by original profession. European Journal of Social Work
Open this publication in new window or tab >>Competence and professionalisation among return-to-work coordinators in Sweden: comparisons by original profession
2023 (English)In: European Journal of Social Work, ISSN 1369-1457, E-ISSN 1468-2664Article in journal (Refereed) Epub ahead of print
Abstract [en]

Return-to-work coordinators (RTWC) support people on sickness absence and is a new healthcare occupation in Sweden. Its practitioners represent a variety of professions, there is no common undergraduate training and vague role and competence descriptions. The aim was to explore differences in training and competence according to original professions (occupational therapists, physiotherapists, counselling, and other professions) and coordinators’ views on which professions they believe provide the best competence for the role. All RTWCs (82) in one region were invited to answer a questionnaire (89% response rate). Mixed-methods analyses were applied. The results showed that counselling professions were more likely than other professional groups to have further training, particularly in conversation methods, and a lower proportion of them stated needing more knowledge about gender equality, social problems, insurance/benefit and conversation methods. The analysis of free-text answers identified three competence areas of importance: advice and guidance, a holistic view, and personality over profession. Occupational therapists and social workers were seen as having the best competence for the coordinating role. The results outline some common values, norms and important competences for RTWCs that could help develop the RTW coordination training and pave the way for RTWCs professionalisation process.

Abstract [sv]

Rehabiliteringskoordinatorer är en ny yrkesroll inom hälso – och sjukvården som stödjer sjukskrivna patienter i rehabiliteringsprocessen. Koordinatorerna saknar dock en tydlig roll – och kompetensbeskrivning, och det faktum att yrkesrollen saknar en gemensam yrkesutbildning och innehas och utvecklas av olika professioner gör den unik. Syftet med studien var att undersöka skillnader i kompetens baserat på rehabiliteringskoordinatorers olika grundprofessioner, samt vilka professioner de menade hade bäst kompetens för att arbeta som rehabiliteringskoordinator. Alla rehabiliteringskoordinatorer i en region bjöds in att svara på en enkät (89% svarsfrekvens). Både kvantitativa och kvalitativa analysmetoder användes. Resultaten visade att kuratorer hade mer vidareutbildning än övriga professioner, särskilt inom samtalsmetoder, och kuratorerna uppgav mindre behov av ytterligare kompetens inom områdena jämställdhet, sociala problem, försäkringar/bidrag och samtalsmetoder. Analysen av fritextsvaren visade att holistisk syn, personlighet framför profession samt rådgivning och vägledning ansågs vara tre viktiga kompetensområden för rehabiliteringskoordinatorer. Arbetsterapeuter och socionomer ansågs ha mest passande kompetens för att arbeta som rehabiliteringskoordinator. Resultaten adresserar några gemensamma grundvärden, normer och viktiga kompetensområden för rehabiliteringskoordinatorer som kan bidra i utvecklingen av utbildning för rehabiliteringskoordinatorer och bana väg för deras professionaliseringsprocess.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
Return to work, rehabilitation, sickness, absence, coordination, collaboration, Återgång i arbete, rehabilitering, sjukskrivning, koordinering, samverkan
National Category
Social Work
Identifiers
urn:nbn:se:sh:diva-51174 (URN)10.1080/13691457.2023.2186269 (DOI)000946614800001 ()2-s2.0-85150595891 (Scopus ID)
Funder
Region Stockholm, FoUI-954268, FoUI-936413The Kamprad Family Foundation, 20190271
Available from: 2023-03-13 Created: 2023-03-13 Last updated: 2023-04-04Bibliographically approved
Svärd, V., Berglund, E., Björk Brämberg, E., Gustafsson, N., Engblom, M. & Friberg, E. (2023). Coordinators in the return-to-work process: Mapping their work models. PLOS ONE, 18(8)
Open this publication in new window or tab >>Coordinators in the return-to-work process: Mapping their work models
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2023 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 8Article in journal (Refereed) Published
Abstract [en]

PURPOSE: In recent decades, many countries have implemented return-to-work coordinators to combat high rates of sickness absence and insufficient collaboration in the return-to-work process. The coordinators should improve communication and collaboration between stakeholders in the return-to-work process for people on sickness absence. How they perform their daily work remains unexplored, and we know little about to what extent they collaborate and perform other work tasks to support people on sickness absence. This study examines which work models return-to-work coordinators use in primary healthcare, psychiatry and orthopaedics in Sweden. METHODS: A questionnaire was sent to all 82 coordinators in one region (89% response rate) with questions about the selection of patients, individual patient support, healthcare collaboration, and external collaboration. Random forest classification analysis was used to identify the models. RESULTS: Three work models were identified. In model A, coordinators were more likely to select certain groups of patients, spend more time in telephone than in face-to-face meetings, and collaborate fairly much. In Model B there was less patient selection and much collaboration and face-to-face meetings. Model C involved little patient selection, much telephone contact and very little collaboration. Model A was more common in primary healthcare, model C in orthopaedics, while model B was distributed equally between primary healthcare and psychiatry. CONCLUSION: The work models correspond differently to the coordinator's assignments of supporting patients and collaborating with healthcare and other stakeholders. The differences lie in how much they actively select patients, how much they collaborate, and with whom. Their different distribution across clinical contexts indicates that organisational demands influence how work models evolve in practice. 

Place, publisher, year, edition, pages
Public Library of Science (PLoS), 2023
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:sh:diva-52114 (URN)10.1371/journal.pone.0290021 (DOI)001051741800073 ()37561796 (PubMedID)2-s2.0-85167723146 (Scopus ID)
Available from: 2023-08-21 Created: 2023-08-21 Last updated: 2023-10-24Bibliographically approved
Svärd, V. & Sernbo, E. (2023). Health social work with migrants: Constructing a specialist profession. International Social Work, 66(6), 1655-1668
Open this publication in new window or tab >>Health social work with migrants: Constructing a specialist profession
2023 (English)In: International Social Work, ISSN 0020-8728, E-ISSN 1461-7234, Vol. 66, no 6, p. 1655-1668Article in journal (Refereed) Published
Abstract [en]

In 2016–2017, a large Swedish hospital introduced a mobile team of asylum social workers to work with asylum-seeking and undocumented patients. Based on interviews with the asylum social workers and the theoretical concepts of jurisdiction and professional discretion, this study explores how they experienced their work and developed their specialist competence and strategies for health social work with migrants. The findings show that they not only relieved staff and supported patients and relatives but also systemised the knowledge about health social work with migrants and created a professional specialty with a socially, rather than medically, defined group of patients.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
Discretion, health social work, jurisdiction, migrants, professionalisation, social determinants of health, specialisation
National Category
Social Work
Identifiers
urn:nbn:se:sh:diva-49502 (URN)10.1177/00208728221107484 (DOI)000824762000001 ()2-s2.0-85133884338 (Scopus ID)
Available from: 2022-07-06 Created: 2022-07-06 Last updated: 2023-11-24Bibliographically approved
Svärd, V. & Jannas, S. (2023). Organisational prerequisites for coordinating the return-to-work process for people with multimorbidity and psychosocial difficulties. Disability and Rehabilitation, 5(18), 2915-2924
Open this publication in new window or tab >>Organisational prerequisites for coordinating the return-to-work process for people with multimorbidity and psychosocial difficulties
2023 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 5, no 18, p. 2915-2924Article in journal (Refereed) Published
Abstract [en]

Purpose: The return-to-work (RTW) process for people with multimorbidity and psychosocial difficulties can be complicated. This study explores the organisational prerequisites for coordinating these patients’ RTW processes from the perspective of coordinators in different clinical areas in Sweden.

Material and methods: Six focus group interviews were conducted with 24 coordinators working in primary healthcare (PHC), psychiatric and orthopaedic clinics. The data were analysed thematically, inspiredby organisation theory.

Results: Coordinators described varying approaches to people with multimorbidity and psychosocial difficulties, with more hesitancy among PHC coordinators, who were perceived by other coordinators as hindering patient flows between clinical areas. Most organisational barriers to RTW were identified in the healthcare sector. These were long waiting times, physicians drawing up inadequate RTW plans, coordinators being involved late in the sickness absence process, and lack of rehabilitation programmes for people with multimorbidity. The barriers in relation to organisations such as Social Insurance Agency and Employment Services were caused by regulations and differing perspectives, priorities, and procedures.

Conclusion: Our findings indicate what is needed to improve the RTW process for patients with complex circumstances: better working conditions, steering, and guidelines; shorter waiting times; and a willingness among coordinators from different clinical areas to collaborate around patients. 

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
Coordinator, return-to-work, rehabilitation, sickness absence, organisation, organisation theory, multimorbidity, psychosocial problems, focus groups
National Category
Work Sciences
Identifiers
urn:nbn:se:sh:diva-49762 (URN)10.1080/09638288.2022.2114019 (DOI)000844709300001 ()36006799 (PubMedID)2-s2.0-85136631740 (Scopus ID)
Funder
The Kamprad Family Foundation, 20190271
Available from: 2022-08-29 Created: 2022-08-29 Last updated: 2023-08-29Bibliographically approved
Berglund, E., Friberg, E., Engblom, M. & Svärd, V. (2023). Physicians’ experience of and collaboration with return-to-work coordinators in healthcare: a cross-sectional study in Sweden. Disability and Rehabilitation
Open this publication in new window or tab >>Physicians’ experience of and collaboration with return-to-work coordinators in healthcare: a cross-sectional study in Sweden
2023 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165Article in journal (Refereed) Epub ahead of print
Abstract [en]

Purpose: Return-to-work coordinators (RTWCs) give people on sick leave individualized support and coordinate between different stakeholders, including physicians.  The aim of this study was to explore physicians’ experience of RTWCs and investigate factors that influence how much physicians collaborate with RTWCs, or refer patients to them, in primary, orthopaedic, and psychiatric care clinics.

Materials and methods: Of the 1229 physicians responding to a questionnaire, 629 physicians who had access to a RTWC in their clinic answered to questions about collaborating with RTWCs.

Results: Among physicians who had access to a RTWC, 29.0% collaborated with a RTWC at least once a week. Physicians with a more favourable experience of RtWcs reported more frequent collaboration (adjusted OR 2.92, 95% CI 2.06–4.15). Physicians also collaborated more often with RTWCs if they reported to often deal with problematic sick-leave cases, patients with multiple diagnoses affecting work ability, and conflicts with patients over sickness certification.

Conclusions: Physicians who had more problematic sick-leave cases to handle and a favourable experience of RTWCs, also reported collaborating more often with RTWCs. The results indicate that RTWCs’ facilitation of contacts with RtW stakeholders and improvements in the sickness certification process may be of importance for physicians.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
sick leave, vocational rehabilitation, return-to-work (RTW), RTW coordinator (RTWC), medical decision-making
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:sh:diva-52432 (URN)10.1080/09638288.2023.2261851 (DOI)001073063000001 ()37772755 (PubMedID)2-s2.0-85173933578 (Scopus ID)
Funder
The Kamprad Family Foundation, 20190271Region Stockholm, FoUi-954268Region Stockholm, FoUi-936413
Available from: 2023-10-03 Created: 2023-10-03 Last updated: 2023-10-26Bibliographically approved
Matérne, M., Svärd, V. & Sernbo, E. (2023). Teorier – vilka är de och vad gör de?. In: NaPSa 2023 - Nationell paperkonferens i socialt arbete [webbplats]: C5. Paper presented at NaPSa 2023 - Nationell paperkonferens i socialt arbete, Huddinge, mars 22-23, 2023. (pp. 23-24).
Open this publication in new window or tab >>Teorier – vilka är de och vad gör de?
2023 (Swedish)In: NaPSa 2023 - Nationell paperkonferens i socialt arbete [webbplats]: C5, 2023, p. 23-24Conference paper, Oral presentation with published abstract (Refereed)
National Category
Social Work
Identifiers
urn:nbn:se:sh:diva-51223 (URN)
Conference
NaPSa 2023 - Nationell paperkonferens i socialt arbete, Huddinge, mars 22-23, 2023.
Available from: 2023-03-23 Created: 2023-03-23 Last updated: 2023-03-24Bibliographically approved
Svärd, V., Bertilsdotter Rosqvist, H. & Jannas, S. (2023). The emergence of return‐to‐work coordinators in Sweden: A focus groupstudy about professionalisation, competence and boundary work in relation to health social work. In: NaPSa 2023 - Nationell paperkonferens i socialt arbete [webbsida]: . Paper presented at NaPSa 2023, Huddinge, Mars 22-23, 2023. (pp. 14). , Article ID B4.
Open this publication in new window or tab >>The emergence of return‐to‐work coordinators in Sweden: A focus groupstudy about professionalisation, competence and boundary work in relation to health social work
2023 (English)In: NaPSa 2023 - Nationell paperkonferens i socialt arbete [webbsida], 2023, p. 14-, article id B4Conference paper, Oral presentation with published abstract (Refereed)
National Category
Social Work
Identifiers
urn:nbn:se:sh:diva-51222 (URN)
Conference
NaPSa 2023, Huddinge, Mars 22-23, 2023.
Funder
The Kamprad Family Foundation, 20190271
Available from: 2023-03-23 Created: 2023-03-23 Last updated: 2024-03-26Bibliographically approved
Schindele, A. C., Nannesson, M., Ljungcrantz, D., Svärd, V., Källberg, H., Rubin, J. & Navér, L. (2022). Associations between and intersectional implications on openness about HIV status and suicide thoughts in a diverse national sample of young people living with HIV in Sweden. In: : D22: Interventions to reduce stigma and discrimination. Paper presented at 24th International AIDS Conference, Montreal, Canada, July 29 - August 2, 2022..
Open this publication in new window or tab >>Associations between and intersectional implications on openness about HIV status and suicide thoughts in a diverse national sample of young people living with HIV in Sweden
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2022 (English)In: : D22: Interventions to reduce stigma and discrimination, 2022Conference paper, Oral presentation with published abstract (Other academic)
Abstract [en]

Background

The focus in HIV care so far have been to reach good physical conditions and through the UNAIDS 90-90-90 target. However, health also includes mental and social well-being as well as the absence of stigma and discrimination. The overall aim of this study is to explore the association between living as open with HIV as one wants and suicide thoughts among 16-29-year old young people living with HIV in Sweden. A secondary aim is to see how this can be understood in the intersections of gender and sexual identity.

Methods

This study is based on a national survey of young people living with HIV conducted at HIV-clinics in 2018. The survey had 173 respondents, giving a response rate of 36 percent. Logistic regression models were used to calculate odds ratios (OR) using suicide thoughts as the outcome variable and open with HIV status, gender and sexual identity as exposure variables. Gender and sexual identity was combined to investigate intersections.Results: The results show that suicidal thoughts are more common among young people who report that they were not as open as they wanted to be with their HIV status (OR 1.71 95% CI : 0.90 – 3.25). The analysis also indicate that the associations of suicide thoughts intersects with gender, sexual identity and openness with one’s HIV. In general, men had higher odds ratios of suicide thoughts if they reported not being as open as they wanted to with their HIV status, or belonging to a sexual minority, compared to heterosexual men being as open as they wanted. In women, the groups were smaller and the same pattern was not observed.

Conclusions

The findings add to previous knowledge and guide policy and practise as it point not only to the possibilities if being as open as one wants with HIV status but also to how this has different implications depending on the intersection of sex and sexual identity. The results pinpoint the need of larger studies to investigate intersections further.

Keywords
HIV, openess, suicide, intersectionality, health, stigma, discrimination
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:sh:diva-49071 (URN)
Conference
24th International AIDS Conference, Montreal, Canada, July 29 - August 2, 2022.
Funder
Public Health Agency of Sweden
Available from: 2022-04-05 Created: 2022-05-24 Last updated: 2022-05-24Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-3868-0254

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