Workplace health promotion activities and measures usually have an ill-health perspective. There is a need for a salutogenic perspective when measuring both health and work experiences. Such questionnaire instruments have previously been developed at Kristianstad University College and published (SHIS: Scand J Public Health, 2009. WEMS: WORK, 2009). The purpose is to present these two instruments together in relation to empirical data from hospital settings.

The purpose of the study was to to describe which factors of health related quality of life were associated with a high sense of coherence in a 5 year perspective. The sense of coherence, SOC-scale, EORTC QLQ C-30 and PR 25 questionnaires were applied to a sample of 222 men at baseline and over 5 years following radical prostatectomy. Result showed significant association to SOC in psychological aspects (emotional and cognitive functioning, p=<0.00-0.04 respectively 0.04) and for hormone treatment related symptoms (i.e. manhood p=<0.05). High SOC was associated with quality of life (index) in the early post treatment period and to aspects of general functioning (role-, emotional- respectively cognitive) in year 3 and 5. High sense of coherence was interpreted to be a health resource for experiencing life quality connected to different aspects at different time points of the data collection. The result showed stability in SOC and QoL scoring over 5 years.

Health is a resource for pupils’ learning. Including health in the curriculum and teaching will enable pupils to understand the connection between health and learning. Action research has proved to be effective from a learning perspective. Our purpose was to explore whether, and how, using action-oriented research methods in a middle school-based health promotion project contributed to metacognition about health and learning. The design was an action-oriented research model using reflection forums: a support group; a project group; and two focus groups of pupils and teachers. The latent content analysis resulted in three categories: (1) Professional aspects; (2) Educational aspects; and (3) Structural aspects, with adherent subcategories. The discussion presents a synthesis of findings about metacognition, with Structural factors and processes and Personal factors and processes. In conclusion, this article presents how action-oriented research methods, using reflection forums, can contribute to participants’ metacognition about health and learning.

The aim of this thesis was to develop and make a quality assessment of a tool, which includes a questionnaire and a dialogue process that could be useful for workplace health promotion from a salutogenic point of view. The studies have been performed within two health care organizations between 2005 and 2009, together with hospital staff. Two questionnaire studies were conducted (n=446 n=505, respectively). A focus group interview study was performed (n=78), and meetings were held in an action research process for applying a questionnaire process at two wards (n=69). The result shows a development process for a multi-dimensional questionnaire, the Work Experience Measurement Scale (WEMS), which can be used to measure work experiences from a salutogenic perspective. WEMS was shown to be a functional workplace health promotion questionnaire with the ability to discriminate between groups. Its psychometric properties support its applicability in health care settings and offer a possibility to measure trends over time regarding employees´ work experiences. A dialogue structure for progress in the questionnaire process is presented. It describes what to precede and how to proceed through a workplace questionnaire process to foster applicability, meaningfulness, and sustainability. Through WEMS, the outcome of work-related Specific Enhancing Resources (SER) may be highlighted and strengthened in workplace activities. When used as a dialogue tool in a continuous questionnaire process, WEMS has the potential of being a useful assessment tool in workplace health promotion. Such a dialogue tool is useful in discussions and tangible for the work of enhancing positive human capabilities and resources (SER) that improve work performance.

Background  In workplace health promotion, a questionnaire could be of great use. Unfortunately, fatigue regarding answering questionnaires has recently become greater than before. An action research approach could be a possible way of increasing employee participation.

Aim  This study reports an attempt to explore key aspects for participation in, and commitment to, a workplace health promotion questionnaire process.

Method  The study was conducted at two wards in a Swedish hospital. Data was collected during an action research process. Data were analysed with regard to a framework of questions.

Findings  The three key aspects for participation in, and commitment to, a workplace health promotion questionnaire process were: an applicable questionnaire, a meaningful questionnaire process and a continuous and sustainable questionnaire process. A structure is presented as practical advice to managers, describing how such a process could be established to be applicable, meaningful and sustainable.

Conclusion  This study has identified key aspects and prerequisites for questionnaire processes. The prerequisites – share decision-making, involve a core group and follow a structure – are discussed and proposed for managers and workgroups to consider in further workplace health promotion questionnaire processes.

Implications for nursing management  The key aspects and prerequisites presented could provide a stimulating standpoint or advice, useful for planning and accomplishing workplace questionnaire processes.

Background

Work organization in hospital settings has a long tradition of being confined to each respective professional category. Work tasks concerning the care of the patients have been tied to the respective roles of nurses or assistant nurses. Neither the nurses nor the assistant nurses have had a comprehensive picture of the patient’s status due to the fact that different professions did not collaborate.

Aim

The aim was to explore health care staff’s opinions about the work organization model called Patient Closer Care (PCC) that is related to perceptions of workplace health.

Method

Interviews with thirteen mixed focus groups, which included nurses, assistant nurses and medical secretaries (n=70), were conducted at five medical units in a Swedish medium sized hospital. The main question during the unstructured interviews was how the employees experienced health in relation to the work organization. The analysis was made by qualitative content analysis.

Results

PCC implicated that time was set aside for the staff to be more with the patients, and it changed the focus of their caring for the patients. Today the care proceeds from the patients’ needs. There’s been a shift from nurses and assistant nurses working alone to working together in care pairs, diminishing the focus on the different professional roles and limitations. Instead reflection and learning increased through the extended collaboration. A more comprehensive picture of the patients’ situation was attained, which resulted in increased comprehensibility, manageability and meaningfulness.

Conclusion

The Swedish model of PCC offers an example of health promoting as to organizing work that is significant to both employees and patients. The model shifts its focus from fixed work roles implicit in specific professions, to task orientation, which puts the patient at the centre. The experience of the model was primarily positive in several ways. The increased sense of coherence is a health promoting factor, which decreases stress at the workplace. The employees’ perception of health in relation to PCC has a positive impact on their work performance, which then becomes more effective.

OBJECTIVE: To present validity data for the Work Experience Measurement Scale (WEMS), an instrument measuring multifaceted work experience from a salutogenic health resource perspective as a contrast to the more common pathogenic risk perspective, by exploring WEMS relationship to established measurements that are positively related to health and work. A salutogenic perspective focuses on finding conditions and resources in life, for example at work, that can enhance the individual's health and strength, instead of those causing illness and weakness.

METHOD: This study was carried out in 2009 at a Swedish hospital with a web-based survey (WEMS) to 770 employees. Different occupational groups at the hospital participated. Additional questionnaires used at the same time were the Utrecht Work Engagement Scale (UWES-9), the Salutogenic Health Indicator Scale (SHIS), the General Self-Efficacy scale (GSE), and three questions about self-rated health, general well-being, and quality of life.

RESULTS: Cronbach's Alpha of WEMS sub-indices were in the interval of 0.85—0.96. Convergent validity and discriminant validity of WEMS and its sub-indices were shown to be satisfying by correlations. In addition, WEMS demonstrated the ability to discriminate between groups. WEMS sub-indices discriminated even better between groups than the total index.

CONCLUSION: The WEMS proved to be a workplace health promotion questionnaire that was able to measure experiences of work from a salutogenic perspective. The WEMS has a potential of being a useful tool in workplace health promotion to enhance positive human capabilities and resources to improve work performance.

Purpose – In workplace health promotion, enhancing resources are less explored than risk factors. The aim of this paper is to explore the usability of the sense of coherence (SOC) theory to identify considerable and positively perceived work-related factors and processes.

Design/methodology/approach – The study had a salutogenic approach to workplace health promotion. A total of 13 focus group interviews were conducted with hospital employees in Sweden. A deductive analysis was made with the SOC theory as a framework.

Findings – Work-related specific enhancing resources (SER) were identified and analysed into the three components of SOC: comprehensibility, manageability, and meaningfulness. SER's implication in daily performance is explained by employee expressions. Through increased understanding and awareness, SER could contribute to savoring positive experiences, and enhance SOC among employees. Antonovsky's concept Generalized Resistance Resources is suggested to be enlarged based on the expressed significance of concrete daily positive work occurrences to increase one's SOC.

Research limitations/implications – Not all hospital professions were represented in the study. Further studies are required to involve physicians, paramedics, managers, as well as other settings, to compare and complement with additional experiences of workplace resources.

Practical implications – The study presents an opportunity to explore, understand, and foster workplace resources through assistance from the SOC theory. The SER presented in this study may serve as initial examples in workplace discussions about work-related resources contributing to a sense of coherence.

Originality/value – This study contributes to public health research and workplace health promotion with a salutogenic focus on how to explore enhancing work-related resources with the assistance of the practical SOC theory.

Instruments related to work are commonly illuminated from an ill-health perspective. The need for a concise and useable instrument in workplace health promotion governed the aim of this paper which is to present the development process and quality assessment of the Work Experience Measurement Scale (WEMS). A survey, using a questionnaire based on established theories regarding work and health, and a focus group study were performed in hospital settings in 2005 and 2006 respectively. A Principal Component Analysis (PCA) was used to statistically develop a model, and focus group interviews were made to compare quantitative and qualitative results for convergence and corroboration. The PCA resulted in a six factor model of dimensions containing items regarding management, reorganization, internal work experience, pressure of time, autonomy and supportive working conditions. In the analysis of the focus group study three themes appeared and their underlying content was compared to, and matched, with the dimensions of the PCA. The reliability, shown by weighted kappa values, ranged from 0.36 to 0.71, and adequate Cronbach's Alpha values of the dimensions were all above 0.7. The study validity, indicated by discriminant validity, with correlation values that ranged from 0.10 to 0.39, in relation to the content validity appeared to be good when the theoretical content of the WEMS was compared to the content of similar instruments. The WEMS presents a multidimensional picture of work experience. Its theoretical base and the psychometric properties give support for applicability and offer a possibility to measure trends in the work experience over time in health care settings. One intention of the WEMS is to stimulate the ability of organizations and the employees themselves to take action on improving their work experience. The conciseness of the instrument is intended to increase its usability.

Begreppet hälsa kan beskrivas utifrån skiftande perspektiv. Studien fokuserar på det salutogena tänkesättet kring hälsa, och faktorer som kan generera hälsa sätts i centrum. Intresset inriktas på friskfaktorer i vardagen som gör att människor kan möta påfrestningar med bibehållen hälsa. Arbete bör i det sammanhanget ses som en av de viktigaste hälsofrämjande resurserna för människans personliga utveckling och livskvalitet.

Studien hade flera syften, varav ett var att lära känna och beskriva verksamheterna på vårdenheten, medan ett annat var att undersöka hur medarbetarna upplevde sin hälsa i relation till sitt arbete. Ytterligare syften var att identifiera vilka behov som fanns av att förändra organisationen för att förbättra hälsan för de anställda samt att slutligen att ta reda på hur pågående förändringsarbete inom organisationen uppfattades av medarbetarna.

Studien genomfördes genom 14 fokusgruppsintervjuer. Urvalet av respondenter skedde slumpmässigt på varje avdelning och antalet medlemmar i varje fokusgrupp var fem till sex personer. De olika yrkeskategorierna som deltog i studien var undersköterskor, sjuksköterskor, avdelningschefer och sekreterare.

Resultatet visade på att respondenterna på olika sätt upplever sitt arbete på vårdenheten som lustfyllt och hälsobringande. Framträdande var upplevelser kring införandet av Patientnärmre vård, som innebär ett annorlunda arbetssätt än tidigare parvård eller gruppvård. Utmärkande i resultatet var även den goda stämningen på vårdenheten, men samtidigt sågs inte förhållningssättet mot varandra på arbetet som en direkt hälsoskapande faktor. Förhållningssätt i relation till materiella belöningar är en viktig faktor som behöver belysas ytterligare, i strävan mot en mer hälsoskapande arbetsplats. Ett annat tänkesätt som bör genomsyra och främjas är känslan av sammanhang i arbetssituationen. På så sätt kan till exempel förändringsarbeten bli mer förståeliga och genomförbara. Ur resultatet utkristalliserades fyra begrepp: begriplighet, kommunikation, tydliga mål och reflektionstid. Begreppen är övergripande, och skulle kunna appliceras och diskuteras i relation till studiens resultat av arbetsrelaterade friskfaktorer. Respondenterna önskade en mer gemensam och helhetsskapande bild av verksamheterna de arbetar inom. Kontinuerlig reflektionstid föreslogs som ett sätt att byta bilder med varandra och öka förståelsen för situationer och händelser medarbetarna kan ställas inför. I dialog är kommunikation en förutsättning, och begriplighet för förändringar kan skapas genom reflek­tion, vilket även kan komma att underlätta förändringsprocesserna på avdelningarna.

Som en följd av fokusgruppsintervjuerna framkom önskemål att diskutera begreppen ytterli­gare inom varje avdelning. Därför initierades avdelningsforum, med syfte att diskutera,

re­flektera och skapa en stor gemensam bild av medarbetarnas och avdelningschefens uppfatt­ningar kring verksamheten i termer av hälsoskapande arbetsplats.

Sveriges befolkning blir alltmer äldre och det gör att behovet av en välfungerad hälso och sjukvård blir större. För att vi ska behålla hälsan längre upp i åldrarna behövs åtgärder som är hälsofrämjande, vilket kan vara i form av kulturella aktiviteter. Syftet med studien var att undersöka äldre personers beskrivningar av hur kultur kan främja upplevelse av hälsa. Kvalitativ metod användes i studien med semi-strukturerade intervjuer.Deltagarna valdes ut genom ett strategiskt urval med fokus på givna kriterier, där deltagarna inte skulle ha någon form av demenssjukdom. Kvalitativ innehållsanalys genomfördes för att få fram kategorier med tillhörande subkategorier. Utifrån resultatet har tre kategorier tagits fram som var Ett liv med kultur, Kultur som påverkansfaktor för hälsa och Kulturaktiviteter som hälsoarbete. Det övergripande temat Äldreperspektiv på kultur har två underliggande subteman Äldres individperspektiv och Äldres grupperspektiv. Slutsats:Kulturella aktiviteter ökar välbefinnandet och livskvaliteten för äldre, vilket ingår för upplevelse av hälsan. Kulturella aktiviteter ökar även gemenskapoch tillhörighet. Det har framkommit att hälsoarbete inom kultur är väsentligtur både ett individ- och grupperspektiv för upplevelsen av hälsa för äldre. Resultatet i studien kan bidra med förståelse för hur kultur kan främja äldres upplevelser av hälsa.