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Understanding significant processes during work environment interventions to alleviate time pressure and associated sick leave of home care workers--a case study.

Abstract：

BACKGROUND:Ergonomic and work stress interventions rarely show long-term positive effect. The municipality participating in this study received orders from the Norwegian Labour Inspectorate due to an identified unhealthy level of time pressure, and responded by effectuating several work environment interventions. The study aim is to identify critical factors in the interaction between work environment interventions and independent rationalization measures in order to understand a potential negative interfering effect from concurrent rationalizations on a comprehensive work environment intervention. METHODS:The study, using a historic prospective mixed-method design, comprised 6 home care units in a municipality in Norway (138 respondents, response rate 76.2%; 17 informants). The study included quantitative estimations, register data of sick leave, a time line of significant events and changes, and qualitative descriptions of employee appraisals of their work situation gathered through semi-structured interviews and open survey responses. RESULTS:The work environment interventions were in general regarded as positive by the home care workers. However, all units were simultaneously subjected to substantial contextual instability, involving new work programs, new technology, restructurings, unit mergers, and management replacements, perceived by the home care workers to be major sources of stress. Findings suggest that concurrent changes induced through rationalization resulted in negative exposure effects that negated positive work environment intervention effects, causing an overall deteriorated work situation for the home care workers. CONCLUSIONS:Establishment and active utilization of communication channels from workers to managers are recommended in order to increase awareness of putative harmful and interruptive effects of rationalization measures.

journal_name

BMC Health Serv Res

journal_title

BMC health services research

authors

Andersen GR,Westgaard RH

doi

10.1186/1472-6963-13-477

subject

Has Abstract

pub_date

2013-11-15 00:00:00

pages

477

issn

1472-6963

pii

1472-6963-13-477

journal_volume

pub_type

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Understanding significant processes during work environment interventions to alleviate time pressure and associated sick leave of home care workers--a case study.