Bakgrund: Inledningsvis beskrivs den palliativa vårdens historia och dess utveckling sedan 1900-talet. Palliativ vård utgår ifrån fyra hörnstenar som är symtomlindring, samarbete, kommunikation och relation samt stöd till närstående. En central del inom palliativ vård är att arbeta personcentrerat och se personen utifrån ett helhetsperspektiv. Palliativ vård delas in i två faser och övergången i faserna ställs i regel genom ett brytpunktssamtal. I den avslutande fasen, livets slutskede är målet att lindra lidande och bevara patientens funktioner i största möjliga mån. Det är viktigt att sjuksköterskan ser till hela patienten eftersom det ofta är komplexa symtom i livets slutskede. Sjuksköterskan bör tillgodose patientens fysiska, psykiska, sociala och existentiella behov. Ett vårdande möte mellan sjuksköterskan och patienten i livets slutskede bygger på respekt, lyhördhet och förståelse. Att möta patienter i livets slutskede ställer höga krav på sjuksköterskan. Att vårda patienter i livets slutskede kan vara svårt för eftersom det väcker egna tankar och känslor kring döden. Syfte: Syftet var att beskriva sjuksköterskans upplevelse av palliativ omvårdnad för patienter i livets slutskede på sjukhus. Metod: En allmän litteraturöversikt baserad på 11 kvalitativa vetenskapliga artiklar har gjorts. Informationssökningen är gjord i Cinahl Complete och Pubmed. Artiklarna och dess kvalitet granskades med HKR:s granskningsmall för kvalitativa artiklar. Analysen är genomförd tre steg enligt Friberg (2017). Resultat: Ett övergripande tema utformades; Att ge patienter palliativ vård i livets slutskede involverar både sjuksköterskan personligt och professionellt. Därefter formades två huvudtema; Upplevelsen relaterat till sjuksköterskan som person och upplevelsen relaterat till sjuksköterskans profession. Från huvudtemana mynnades fem subteman ut; Att uppleva utmaningar i vårdandet, att uppleva vårdandet givande, att tillgodose värdig vård, att upplevelsen förändras med utbildning och erfarenhet och att uppleva en inre etisk konflikt. Diskussion: Metoden diskuteras enligt begreppen; Trovärdighet, pålitlighet, bekräftelsebarhet och överförbarhet. Av resultatet diskuteras tre intressanta fynd vilka beskrivs som; ”Tidsbristen på vårdavdelningarna kan bidra till att sjuksköterskan upplever skuldkänslor och otillräcklighet vid vård i livets slutskede”, ”En central del av vård i livets slutskede är att tillgodose patientens värdighet” och ”Inre etiska dilemman kan uppstå hos sjuksköterskan när hon står mellan medicinska vårdåtgärder och omvårdnadsåtgärder vid vård i livets slutskede”. Fynden relateras bland annat till Halldórsdóttirs (1996) teori caring and uncaring encounters in nursing and health care och utifrån göra-gott-principen och pliktetiken. Fynden diskuteras även ur ett samhällsperspektiv samt ger förslag på klinisk tillämpning. 

Background: A poor body perception can affect well being in a negative way and lead to detrimental results for both physical and mental health. Previous research about the phenomenon body perception is limited, especially work related, which makes it harder to understand how work can affect body perception. Purpose: To study body perception and the existence of well being amongst training instructors working at the gym. The objective is to increase the understanding of potential factors that may affect body perception and well being. Method: The study was implemented by using a qualitative methodology in the form of individual semi-structured interviews with a total of ten participants. Results: In summary the result shows that most of the participants experienced both negative and positive thoughts about their own body, although the positive thoughts were more common. A well conditioned body was considered a valuable asset in attracting clients since this was preferred. Some of the participants also competed in bodybuilding; however, this tended to have a negative impact on their well being. In a social setting there is a greater expectation about a women’s appearance than it is for men. The participants view on health can be summarized as a holistic approach where several components contributed. Conclusion: Due to the existence of limited research, there is a need for further studies about body perception from a qualitative and quantitative point of view to give a better picture of possible additional factors that affect it.

A high turnover among principals may disrupt the continuity of leadership and negatively affect teachers and, by extension, the students. The aim was to investigate to what extent various work environment factors and signs of exhaustion were associated with reported intentions to change workplace among principals working in compulsory schools. A web-based questionnaire was administered twice, in 2018 and in 2019. Part I of the study involved cross-sectional analyses of the associations 2018 (n = 984) and 2019 (n = 884) between occupational factors, signs of exhaustion, and the intention to change workplace, using Generalized Estimating Equations models. Part II involved 631 principals who participated in both surveys. The patterns of intended and actual changes of workplace across two years were described, together with associated changes of occupational factors and signs of exhaustion. Supportive management was associated with an intention to stay, while demanding role conflicts and the feeling of being squeezed between management and co-workers (buffer-function) were associated with the intention to change workplace. The principals who intended to change their workplace reported more signs of exhaustion. To increase retention among principals, systematic efforts are probably needed at the national, municipal, and local level, in order to improve their working conditions.

The aim of this study was to examine in what way incels discuss violence, as well as how significant violence is for the incel-culture and their identity. Incels are a relatively new phenomenon, which has been more closely examined following recent attacks perpetrated by incels. The attacks have been aimed at civilians, and according to the Swedish Defence Research Agency (FOI), these attacks have often been preceded by the perpetrator spending time on incel forums (2020). This observation regarding the correlation between incel forums and incel attacks inspired the approach of this study, which aims to shed light on how incels talk about violence, and what role violence plays within the online incel community. The empirical material for this study consisted of 511 posts made on violence related threads from the websites incels.net and incels.is. The study applied qualitative analysis of data to examine the research questions, and the result showed that pro-violence was a common theme within the material. The result also showed that misogyny, feelings of injustice and anti-violence were recurring themes. Agnew’s General strain theory, Connell’s theory of masculinity and Goffman’s theory of stigma was used as a theoretical framework to analyse the material. Using these theories, the study explains the identified themes as coping strategies for strain, attempted staging of masculinity and a reaction to stigma. The results in this study confirm previous research made on the subject, but more research is needed to fully understand the ways incels talk about violence and the significance of violence within the incel community. 

Background

Dissatisfaction with appearance is a common phenomenon, more frequent among women than men (Frisén & Holmqvist 2010, Neighbors & Sobal 2007) but so common that it can be considered a norm (Tantleff-Dunn, Barnes & Larose 2011). Health professionals are therefore in contact with the phenomenon on a regular basis in different health settings. Previous research have shown that health professionals experience time constraints and lack of confidence in relation to patients’ appearance issues (Persson et al 2009; Konradsen et al 2009). Little is however known about the resources needed from the professionals’ point of view. The aim of the study was therefore to explore the phenomenon from a nursing perspective in general and with particular emphasis on resources needed.

Methods

Five semi-structured focus group interviews were conducted with 24 health professionals in total (19 women and 5 men). Their age varied from approximately 20 to 45 years, with adherent variation in professional experience from a variety of health settings. The interviews were digitally recorded, transcribed verbatim and analyzed through thematic analysis (Braun & Clarke, 2006). The study was done in accordance with the Swedish Law of Research Ethics, SFS 2003:460.

Findings

The analysis resulted in the two themes knowledge development and operative support, representing different resources needed according to the respondents. The respondents own knowledge and professional competence was constantly referred to as the most important resource. The findings showed the importance of appearance being included in their education, the need for a continuous process of reflection and learning on an individual level but also on group level in terms of collegial learning. In order for the knowledge and competence to be put into practice there was also need for operative support. Sufficient time for communicating with the patients and the need for appropriate technical support in some nursing situations were emphasized by the participants.

Discussion

The findings clearly shows the central role that health professionals have in relation to patients’ appearance issues and their need for resources. The findings adds to existing body of knowledge and can be used as a framework for health promotion strategies in health settings, with regards to patients’ appearance issues and distress. More research as well as action is needed from a nursing as well as public health perspective.

BACKGROUND: Health care professionals frequently interact with unknown patients in a process involving appearance-based judgements and priority-setting, all of which has an effect on health care equality. The healthcare provider-patient interaction is also highly relevant for the awareness and support of patients' appearance concerns, with an associated possibility for improving patients' satisfaction with their appearance and health. The aim was therefore to explore nursing staff's experience of patients' appearance issues in various nursing situations, with the purpose to facilitate awareness raising and knowledge development.

METHOD: A qualitative research approach with focus group interviews was chosen due to the exploratory aim of the study. Five semi-structured focus group interviews were conducted with 24 nursing staff in total (19 women and five men). The participants' ages varied (20 to 45 years) as did their professional nursing experience. The interviews lasted approximately one hour, were digitally recorded, transcribed verbatim and analysed through thematic analysis.

RESULTS: The thematic analysis resulted in the two themes Patient perspective and Professional nursing role, with associated subthemes. The findings showed the importance and impact of appearance issues in nursing situations and how these are linked to the health of the patients. Some groups of patients were identified as more vulnerable than others, which was associated with health care inequalities and health disparities. Value-based strategies along with knowledge, and skills for holistic person-centred care were identified as important resources for the development of appearance-related awareness and support in various nursing situations.

CONCLUSION: Strategies for improvement can be realised through the educational system for nursing staff, but mainly by using collective reflective learning forums in different workplaces. An empowerment approach is considered a useful framework for the implementation of holistic person-centred care, functioning as a resource for appearance-related awareness and support in various nursing situations. However, more research is needed on the complex and challenging phenomenon of appearance issues in nursing situations. Knowledge development related to successful person-centred strategies for appearance-related awareness and support is important, especially strategies with a salutogenic perspective.

BACKGROUND: There is a lack of information on positive work factors among health care workers.

OBJECTIVE: To explore salutogenic work-related factors among primary health care employees.

METHOD: Questionnaire to all employees (n = 599) from different professions in public and private primary health care centers in one health care district in Sweden. The questionnaire, which had a salutogenic perspective, included information on self-rated health from the previously validated SHIS (Salutogenic Health Indicator Scale), psychosocial work environment and experiences, recovery, leadership, social climate, reflection and work-life balance.

RESULTS: The response rate was 84%. A multivariable linear regression model, with SHIS as the dependent variable, showed three significant predictors. Recovery had the highest relationship to SHIS (1 = 0.34), followed by experience of work-life balance (1 = 0.25) and work experiences (1 = 0.20). Increased experience of recovery during working hours related to higher self-rated health independent of recovery outside work.

CONCLUSION: Individual experiences of work, work-life balance and, most importantly, recovery seem to be essential areas for health promotion. Recovery outside the workplace has been studied previously, but since recovery during work was shown to be of great importance in relation to higher self-rated health, more research is needed to explore different recoverystrategies in the workplace.

Background: Work related illness is based on the growth of psychiatric diagnosis. By working preventive and promotive in the workplace, the work related health can be strengthened and developed. Given that workplace health promotion has a strong link to work effectiveness, this health work needs to be emphasized. Due to the fact that the 2015 refugee flow resulted in a high workload for integration workers, this study found an interest in studying health promotion features at a municipal receiving unit for new arrivals. Purpose: To study whether employees on a receiving unit for new arrivals experienced health promotive factors at their workplace. Method: The study was implemented by using a qualitative method. Interviews of nine fulltime employees represented the results. The interviews were transcribed and analyzed with a content analysis. Results: Work task, social community, opportunity for participation, capacity building, leadership and daily health promotion activities at work time was proven to be substantial health promoting factors at the workplace. Conclusion: Because of the linkage to sence of coherence, savoring and empowerment, the activities were related as health promotive factors. The factors are important given that they can positively improve employee health. Henceforth it is vital that these factors can be strengthened and maintained to promote integration work.

Hälsoutvecklingen bland skolbarn i Sverige vittnar om att psykosomatiska besvär ökaroch att barnens självskattade hälsa minskar med stigande ålder. Samtidigt minskarockså andelen barn som uppnår tillräckliga nivåer av fysisk aktivitet, medan stillasittandeistället ökar. Interventioner för mer fysisk aktivitet i skolan är ett sätt problematikenskulle kunna bemötas med. Fysisk aktivitet fungerar som en skyddsfaktor motflera livsstilsrelaterade sjukdomar och mer fysisk aktivitet i skolan har bland annatvisats leda till förbättrade kognitiva förmågor och ökat välbefinnande. Syftet med studienvar att undersöka barns beskrivningar av välbefinnande i relation till deltagandei PULS-projektet på Degebergaskolan, en intervention för mer fysisk aktivitet i skolan.Via fokusgruppsintervjuer med elever som deltog i PULS-projektet erhölls studiensempiri, från vilken vidare induktiv kvalitativ innehållsanalys genomfördes. Resultatenfrån studien påvisade att det viktigaste för erhållandet av subjektivt välbefinnandevar att ha roligt och att känna glädje. Vidare visade resultaten att deltagarna erhöllökat subjektivt välbefinnande från sitt deltagande i PULS-projektet och att utövandetav fysisk aktivitet hade en betydande roll för välbefinnande, både i skolan och påfritiden. Detta är viktiga fynd då hälsointerventioner för mer fysisk aktivitet i skolanmedför möjligheter att motverka den negativa hälsoutveckling som förekommer blandskolbarn i Sverige. Djupare förståelse för hur barn själva definierar välbefinnande ochvilken inverkan interventioner som PULS-projektet har för deras subjektiva välbefinnandebidrar till att det skapas underlag för att också möta barnens självupplevda behovoch därmed utveckla och förbättra utformandet av lika interventioner ytterligare.

The introduction presents Skåneidrottens project Senior Sport School, which is based on the four cornerstones of prosperous ageing, i.e. physical activity, social connections, meaningfulness and dietary education. Senior Sport School encourages seniors to a lifelong sport participation. Previous research emphasizes the importance of maintaining physical functionality, social connections and good dietary habits in older age to promote self-reliance and independence from health care. The aim of the study is to investigate pensioners´ views on their participation in activities conducted at Senior Sport School, and whether their experiences can be related to healthy ageing. The method is qualitative semi-structured interviews and participants in the study were selected based on previous participation in Senior Sport School. The results are produced through the themes of the interviews. The themes are healthy ageing, social connections, education and the importance of sporting culture. The discussion emphasizes that Senior Sport School is perceived as an important social platform. The hidden education that seniors receive through Senior Sport School has a central role. Senior Sport School is a support in the seniors´ education process so that they can understand and use the information to improve their health. The conclusion is that a sport school for seniors plays an important role in healthy ageing. Social connections and physical activity is highlighted by the participants as significant, but Senior Sport School is also an important part of seniors´ education development. The study´s results are positive for public health, but further research is needed to engage other groups in society.

Background: Working life has an impact on the health of many individuals during a larger part of life, therefore a big significance for public health. Work environment is important for the well-being of the employees and the development of the business and unhealthy lifestyles can increase absence for example. Being physically active can contribute to comprehensive benefits, such as a better focus and performance at the workplace. Even research has shown increased awareness and interest in health promotion and its effects, the workplace becomes a central arena for these efforts.

Aim: The aim was to study what impact a healthcare project has had on a working group on physical activity with a focus on salutogenic perspective

Method: A qualitative study was conducted with focus groups as a method. A non-random selection was conducted by the study’s gatekeeper. A content analysis was conducted when the result was analyzed.

Result: The study found that employee well-being and community had increased and strengthened. They had become more aware of the benefits of physical activity. They felt secure when they felt support from the employer. There was also some negative experience to the healthcare project linked to its activities performed on work related time or was prevented to be a part because of physical difficulties.

Conclusion: The workplace is an important place for the health of the individual and the importance of working with health promotion has been shown more. Both for the individual and for the group, but also from a social perspective, as it has a value for public health. Where physical activity is an initiative that not only prevents people's diseases but also promotes social interaction and interaction between individuals. Therefor, physical activity is a good way to work with health promotion.

The Swedish healthcare sector is currently experiencing recruitment difficulties combined with increasing demand for healthcare services.This study accordingly seeks knowledge of the obstacles to and opportunities for retaining older employees in the Swedish healthcare sector. Results of interviews with line managers and human resource (HR) partners indicate that the informants have positive attitudes toward older healthcare workers in general, particularly acknowledging their contributions based on long experience and skill. However, line managers' high workload, the absence of age-management strategies, and universal HR policies not conducive to older workers' individual needs are considered obstacles to retention on an organizational level. To retain older healthcare workers and maintain their ability and motivation, the healthcare sector and especially HR strategies need to be more proactive in addressing these issues, and formalized policies are required in order to benefit from the potential labor reserve that older employees constitute.

Among assistant nurses in the elderly care setting, the health-promoting perspective may be preferable to reduce the risk of a poor psychosocial work environment. Previous studies showed that work motivation increase if both well-being and job satisfaction exist. The aim of this study was to investigate how assistant nurses experience their psychosocial work environment from a health promoting perspective. The study had a qualitative approach with focus group interviews as a method. In total, three focus group interviews were performed with assistant nurses at two different elderly homes. There were 19 participants in the study. The analysis showed three themes that illustrated important aspects of the psychosocial environment. The categories were work motivation, a committed leadership and job satisfaction. The assistants nurses were generally satisfied with their working environment. They described a good fellowship at work and experienced a balance between the demands placed on them and the available resources. The results also showed that the workplace leadership was of great importance for the well-being of the staff. Most assistant nurses considered the nursing work with caretakers meaningful and that it felt motivating to help others. Since their workplaces are constantly being met by saving demands through hard-pressed budgets and organizational changes, a focus on the work environment of assistent nurses is recommended. Prior to future health promotion interventions in the elderly care, it is important to increase the well-being of the staff and to continue to find solutions for a sustainable quality of care.

More interventions with physical activity and movement during school time, have positive effects on the students health and performance in class, and reduces the time spent on sedentary activities. Physical activity is a health-promoting activity which decreases the risk of becoming ill in common public diseases and creates good opportunities for the public health. Sedentary lifestyle increases in the society and is a risk factor for developing chronic diseases and further to early death. physically active decreases, regarding both everyday- and intentional activities. The school is a suitable arena for increasing the physical activity, since it contains a wide target group and can offer equal conditions. The aim was to study secondary teachers attitudes to physical activity and movements during the school time for students in age 13-16, as a health-promoting intervention for a good public health. The empirical data was collected through individual interviews and a final focus group interview with the same participants. Further an inductive qualitative content analysis was conducted. The result showed that the participants were aware of the positive effects of physical activity on the students health, but the individual teacher wasn't responsible to implement more physical activity at school time. physical activity was connected to pulse-raising activities, which should be scheduled or should take place outside the lessons, suggested during the breaks and be arranged by a leisure teacher. The responsibility for the students to be less sedentary and more physically active during the school day, lays on other actors than the teachers themselves. The teachers expressed a need to gain deeper understanding and increased knowledge of physical activity and how they could continue with implementation of it to improve the conditions for the students. Increased implementation of physical activity in school with the teachers as a resource, may be of great importance to further public health interventions and individuals health. The result from the study can increase awareness of health promoting interventions, which could be applied in schools for a better public health.

Workplace surveys are used in workplace health promotion as a basis for improvements at the workplace. But there is lack of psychometrically and qualitatively validated work-health related instruments with a salutogenic approach. The purpose of this study was, therefore, to evaluate the two instruments, the Salutogenic Health Indicator Scale and the Work Experience Measurement Scale, among staff of different professions in a healthcare setting. These instruments were evaluated with cognitive interviews conducted at a hospital in Sweden. The respondents were purposefully selected from various criteria such as profession, age, and sex (N = 14). The respondents read the items aloud and then spoke about how they experienced the items. A deductive (partly inductive) content analysis was done from Tourangeau's four concepts of respondent actions: comprehension, retrieval, judgment, and response. Two main categories emerged: (1) interpreting and (2) responding, and an additional six subcategories: difficulty, essence, direction, keywords, strategy, and alternatives. The results showed strengths and weaknesses of the instruments. The results were discussed from various validity aspects: face validity, content validity, and user validity. The validity aspects were connected to concepts of respondent actions as well as to questionnaire and respondent factors for motivation.

BACKGROUND: The ageing workforce has an impact on public health. The aim of this study was to evaluate work-related disorders, work tasks and measures associated with the possibility of working beyond 65 years of age or not.

METHOD: The data comprised two sample surveys based on the Swedish population: the Survey of National Work-Related Health Disorders, and the National Work Environment Survey.

RESULTS: A logistic regression analysis showed that an active systematic work environmental management in the workplace was a statistically significant association with whether individuals could work in their current occupation until 65 years of age (OR 1.7). The final multivariate model stated that whether individuals could work until 65 years was associated with bodily exhaustion after work, frequent feeling of the own work effort being insufficient at the end of the day, experience of the work as restricted and with a lack of freedom, working alone and at risk of unsafe or threatening situations, and generally feeling dissatisfied with the work tasks. Women-dominated workplaces were more highly associated with both male and female employees not being able to work until age 65 (OR 1.6).

CONCLUSION: Deficiencies in the working environment seems to be a threat to the public health. An active systematic work environmental management in the workplace increases the possibility to extend the working life. Tools for managers, like the swAge-model, to easily perform active systematic work environmental controls could therefore be a possible way to decrease the risk of work injury as well as increase the possibility for a sustainable extended working life.

Background: The demographic change affects the retirement age, which has been postponed in many countries. Therefore, the number of senior employees is increasing in the world. However, managers’ attitudes towards their employees’ employability affect the employees’ possibilities regarding whether they can and want to work.

Objective: The aim of this study was to evaluate managers’ attitudes towards their employees’ employability and what factors and measures that affect whether employees can and want to work in an extended working life.

Method: The study population in this study consists of 249 municipality managers in Sweden, from a baseline investigation in a follow up study following the swAge-questionnaire. The data was analysed through the method of logistic regression.

Results: 79% of the managers stated that their employees ‘can’ work and 58% that their employees ‘want to’ work until 65 years or older. Managers believed their employees’ health, physical work environment, skills and competence were associated to if they would be able to work until 65 years or older. Lack of support in the social work environment and lack of possibilities to arrange relocations if needed were associated to whether managers believed their employees want to work.

Conclusions: The results indicate that the postponement the retirement age must be followed by measures in the employees’ work situation in order to decrease demands, increase rotation or change work tasks if needed, as well as increased possibilities to recuperate through reduced workload, reduced work pace and reduced working hours. The results will hopefully contribute to the understanding of needed organisational measures in the process of extending working life.

Background: The labour force is ageing due to the demographic change and the postponement of old-age retirement in many countries.

Objective: In order to increase the possibility for employees to maintain their employability and to keep working in an extended working life this intervention project tested a distance education as a technique to integrate a theoretical model for a sustainable working life for all ages (the swAge-model) as a practical management tool in fourteen municipality managers’ ordinary work situation.

Results: Most of the participating managers had difficulty completing the entire training program in this intervention project due to external circumstances, such as the COVID-19 pandemic and re-organisations, and because no extra time during working hours had been allocated to the managers to participate in the intervention project. Despite this, all participating managers appreciated being given the opportunity to participate and take part in the content of the intervention. Everyone considered the theoretical model, the wage model, on which the intervention project was based, to be very useful and to have given them new insights into their managerial duties.

Conclusions: If society and organisations want a larger amount of employees to participate in working life until an older age, they also need to allocate working hours for managers to acquire new knowledge on how to create healthy and sustainable workplaces for all ages, as well as to implement these tools, measures and working methods permanently in the daily organisational work.

Due to the global demographic change many more people will need to work until an older age, and organisations and enterprises need to implement measures to facilitate an extended working life. The aim of this study was to investigate organisational measures and suggestions to promote and make improvements for a healthy and sustainable working life for all ages in an extended working life. This is a qualitative study, and the data were collected through both focus group interviews and individual interviews that included 145 participants. The study identified several suggestions for measures and actions to increase employability in the themes: to promote a good physical and mental work environment; to promote personal financial and social security; to promote relations, social inclusion and social support in the work situation; and to promote creativity, knowledge development and intrinsic work motivation, i.e., based on the spheres of determination in the theoretical swAge-model (sustainable working life for all ages). Based on the study results a tool for dialogue and discussion on employee work situation and career development was developed, and presented in this article. Regular conversations, communication and close dialogue are needed and are a prerequisite for good working conditions and a sustainable working environment, as well as to be able to manage employees and develop the organisation further. The identified measures need to be revisited regularly throughout the employees' entire working life to enable a healthy and sustainable working life for all ages.

This study explores managers' perspective on how co-worker dialogue [CWD] can foster co-worker health and personal development, and contribute to an empowering development culture in the workplace. The interview study was performed at a hospital in Sweden. Seventeen hospital managers participated. The managers, both men and women, worked in different areas, and a majority had 30-40 co-workers. To uncover underlying pattern phenomena in the interview data, a six-step inductive qualitative thematic analysis was conducted. The findings present three themes, each highlighting different prerequisites for CWD to function as a resource for the co-workers and the workplace: (1) Utility; (2) Content, and (3) Implementation. The study provides suggestions for and problems of practical implications from the findings. To make the findings useful in other organizations, practical implications are presented and discussed in the light of workplace health promotion [WHP]. The CWD is not focusing on performance the way traditional PA does. The CWD is therefore an important complement to PA in annual co-worker meetings, to also highlight the co-worker perspective. If managers realize the value of working with both PA and CWD, opportunities for health, personal development, and an empowering development culture are created.

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 was to examine middle school-aged pupils’ participation in an action-oriented school health promotion project and investigate its effects on their health experience, learning and influence. A survey was sent eight times to middle school-aged pupils (n = 105). A descriptive analysis with group comparisons was followed by a regression analysis. Health differences were found between gender and age. Aspects of pupil influence and learning about health showed positive progression during the project. Satisfaction with school performance was most associated with health experience. Thus, health experience, gender, and age are factors to consider when planning similar health promotion projects in schools.

Introduction: Authorities within the health care sector have a big responsibility for public health, where health promotive and preventive work methods applies to achieve a positive public health development. A big public health problem is obesity, which is a large contributing factor to lifestyle diseases that affects both adults and children. In Sweden statistic show that every fifth child is obese. An important arena is family centres which should work for guiding and supporting off families to a better health through informing the families about healthy habits. Purpose: Investigate how three family centres in southern Sweden work health promotive and preventive with families about obesity. Method: The study was performed with help from a qualitative method. Semi-structured interviews with twelve occupational professions got to represent the result. The interviews were transcribed and evaluated with a content analysis. Results: Make healthy living habits visible, guide and educate parents, different working methods, approach to the families were meaningful for the health promotive and preventive work at the family centres. The result also highlighted challenges and difficulties in the family centres work. Conclusion: The theory KASAM could be linked to the work of the family centres, as a sense of context could be important for the work with the families to perceive comprehensibility, manageability and meaningfulness. The visibility of people´s living habits is best done through a collaboration between several key players. The family centres work is important for the future public health, implementation of resources is therefore important.

Customer contact in retail has become increasingly psychological and emotionally demanding. A meeting between the employed and the customer is usually a friendly meeting and the customer are usually satisfied with the service. However, in recent times, situations of threats and violence, insecure employment and high workload have increased for retail workers which may cause the employees to experience negative stress and insecurity. Still, many remain and enjoy their work in retail.

The purpose of the study is to identify factors that affect the psychosocial working environment in retail and employee health and well-being. Method: Data collection was done through two individual interviews and two group interviews.

The results of the study show that community and support, clear and direct communication and influence in your work, experienced a positive impact on employee health and well-being. Lack of recovery, inadequate leadership and unclear delegation were a few factors that adversely affected employee health. Knowledge and understanding of the impact of the psychosocial work environment on both the profitability of the business and above all for the individual should be met. Knowledge and understanding can have a positive impact on national economi and the public health.

Background: While poor mental health and psychiatric disorders attributed to stressful work conditions are a public health concern in many countries, the health consequences of the occupational stress experienced by school principals is an understudied issue. Although current data is lacking, some research suggests that principals have a stressful work situation that eventually may lead to burnout and exhaustion disorder, thus negatively affecting the ability of principals to function as leaders. To gauge the situation in Sweden, and as a basis for future preventive actions, we examined to what extent principals displayed signs of exhaustion and whether the prevalence rates of exhaustion differed across school levels, length of work experience as a principal, and gender.

Methods: Principals (N = 2219; mean age 49 years [SD 7 years]; 78% women) working at least 50% in pre-schools, compulsory schools, upper secondary schools or adult education completed a cross-sectional web survey entailing two validated inventories: The Karolinska Exhaustion Disorder Scale (KEDS) and the Lund University Checklist for Incipient Exhaustion (LUCIE). Data was analysed using traditional non-parametric methods. Gender stratification achieved covariate balance when analysing school level and length of work experience.

Results: Altogether, 29.0% of the principals met the exhaustion criteria in KEDS. The prevalence rates for the four LUCIE-steps of increasing signs of exhaustion were: no signs of stress, 48.8%; weak signs of stress, 25.6%; clear signs of stress but no exhaustion, 15.4%; possible exhaustion disorder, 10.2%. Compared with male principals, female principals reported more signs of possible exhaustion disorder in both LUCIE and KEDS. School level was not associated with reports of exhaustion symptoms in neither LUCIE nor KEDS. Among male principals, length of work experience was associated with exhaustion symptoms in KEDS.

Conclusions: A large group of Swedish principals working in pre-schools, compulsory schools, upper secondary schools or adult education displayed a symptomatology of signs of exhaustion that if sustained might lead to poor health. This observation suggests that education authorities, or other relevant stakeholders, ought to take some form of preventive action. However, effective combinations of individual, group, organisational, and/or societal preventive activities remain to be identified and tested.

Background: The leadership of principals is important for school, teacher and student related outcomes. To be capable of doing their work (i.e., having sufcient workability), school principals need proper organisational preconditions, motivation, and good health. It is therefore concerning that some studies suggest that principals have a work situation that risks taxing their health and reducing their workability. However, few studies have examined the psychosocial working conditions of principals and no study has gauged principals’ workability. Accordingly, we decided to examine Swedish principals’ workability and their perceptions of eight demanding and five supportive managerial circumstances as well as the associations between managerial circumstances and reports of excellent workability.

Methods: The participants comprised 2219 Swedish principals (78% women) who completed a cross-sectional web survey in 2018. A brief version of the Gothenburg Manager Stress Inventory (GMSI-Mini) gauged managerial circumstances. Workability was assessed with the workability score (0–10; WAS). Unadjusted and adjusted logistic regression analyses were used to examine associations between managerial circumstances and reports of excellent workability (WAS≥9). Covariates were: length of work experience as a principal, school level, self-rated health, and general self-efcacy.

Results: The results showed that circa 30% of the principals reported excellent workability. The GMSI-Mini results showed that role conficts, resource defcits, and having to harbour co-workers’ frustrations were the most frequently encountered managerial demands. Meanwhile, cooperating co-workers, supportive manager colleagues, and a supportive private life were the most supportive managerial circumstances. Adjusted logistic regression analyses showed that role conficts and role demands were associated with an increased likelihood of reporting less than excellent workability. In contrast, supportive managerial colleagues, a supportive private life and supportive organisational structures were associated with an increased likelihood of reporting excellent workability.

Conclusion: Circa 30% of the participating principals perceived their workability to be excellent. Reducing role demands, clarifying the principals’ areas of responsibility and accountability in relation to other actors in the governing chain (role conficts), striving for increased role clarity, and striving to find ways to separate work and private life, seem to be promising intervention areas if increasing principals’ workability is desired.

Relationships at work are important to the psychosocial work environment and may be resources for the employees' well-being. There is a need for a better understanding of what generate positive relationships at work. The aim of the study was to gain a better understanding of the relationship between employees and managers in municipal healthcare. A qualitative study with twenty-seven individual interviews was conducted with healthcare employees and managers in municipal healthcare. The relationship between manager and employees and its possible contribution to well-being was a key focus. A comparison and tentative analysis, inspired by hermeneutics, was used in order to analyse similarities and differences in employee and manager experiences. The findings revealed similarities as well as considerable differences between employees and managers in their experiences. Two themes emerged from the interpretation of the text: (i) Health-promoting relationships are characterized by asymmetry and by a manager that stands outside the group; and (ii) Health-promoting relationships are characterized by mutuality and symmetry and by a manager that is part of the group. The relationship between the employees and the managers are both a resource for doing a good job and a means for achieving belongingness at work. To highlight well-working aspects of relationships at work, may contribute to a better psychosocial work environment and, ultimately, the well-being among healthcare recipients.

Relationships among colleagues, managers, and care recipients are mutually important, and need to be highlighted in workplace health promotion. The aim was to explore prerequisites for flourishing workplace relationships in a municipal healthcare setting for old people. As part of this process, we explored the staff’s suggestions on how work relationships could be improved. The study had a salutogenic and participatory approach, examining staff perceptions of what was required for flourishing relationships to be created, and their suggestions for the relationships to be more promotive. Four multi-stage focus groups, which met three times each, were conducted with staff (n = 26) in old age healthcare settings. A deductive analysis was performed, based on components of the flourishing concept: challenge, connectivity, autonomy, and competence. Informal and formal meetings at work were shown to build positively perceived relationships. The study describes meetings and relationships connected to the four components of flourishing. Suggestions for improving work relationships are also presented. This study contributes to workplace health promotion, and has a salutogenic and participatory focus on how to explore workplace relationships as a resource. The flourishing concept shows how workplace relationships can be explored as prerequisites for workplace health promotion.

BACKGROUND: The impact of positive social relationships on the health of municipal employees in the elder care sector in Sweden needs further examination.

OBJECTIVE: To explore the association between health and relationships among elderly care employees using a salutogenic perspective.

METHOD: Survey of all employees (n = 997) in special housing, home care and Disabled Support and Services in a Swedish municipality. The questionnaire, which had a salutogenic perspective, included information on self-rated health from the previously validated SHIS (Salutogenic Health Indicator Scale), psychosocial work environment and experiences, social climate, and health-promoting workplace relationships.

RESULTS: The response rate was 69% . Results of a multivariable linear regression model showed four significant predictors of health: general work experiences, colleague belongingness and positive relationships with managers and care recipients. In another model, colleague belongingness was significantly related to satisfaction with care recipients, work, length of employment as well as general work experiences and relationships with managers.

CONCLUSION: Strengthening of positive work relationships, not only between workmates but also with managers and care recipients, seems to be an essential area for employee health promotion. Colleague belongingness may be deepened by development of a positive work climate, including satisfactory work experiences, positive manager relationships and a stable work force.

AIMS AND OBJECTIVES: The aim of this study was to explore municipal healthcare employees' experiences of relationships with care recipients and colleagues. The specific research questions were when do the relationships enhance well-being, and what prerequisites are needed for such relationships to occur?.

BACKGROUND: Employees in health and social care for older people often depict their work in negative terms, and they often take a high number of sick leaves. Despite the heavy workload, other employees express well-being at work and highlight social relationships as one reason for this. However, a greater understanding of how these relationships can act as resources for workplace well-being is needed.

DESIGN: The design of the study was qualitative and exploratory.

METHODS: Qualitative interview studies were conducted with twenty-three healthcare employees in municipal healthcare. Thematic analysis was used to analyse the data.

RESULTS: Two themes were identified as resources for promoting relationships between employees and care recipients or colleagues: (i) Being personal - a close interpersonal relationship to a care recipient - and (ii) Colleague belongingness - a sense of togetherness within the working group. Spending quality time together, providing long-term care and providing additional care were antecedents for a close interpersonal relationship with care recipients. Trust, mutual responsibility and cooperation were antecedents for a sense of togetherness within the working group.

CONCLUSIONS: The findings provide an empirical base to raise awareness of relationships with care recipients and colleagues as health aspects. Relationships among employees in healthcare are vital resources that must be considered to create sustainable workplaces, and consequently improve the quality of care. This article is protected by copyright. All rights reserved.

Mental illness is increasing among high school girls. At the same time the use of social media is increasing which is considered to be a major part of Western society. Increased body weight is considered to be associated with dissatisfaction whit the appearance. A dissatisfaction whit body perception can lead to problems such as depression, anorexia nervosa, self-injury and drug abuse. Never before has it been considered as difficult as it is today to fit into the today's society regarding apperance and it has been a negative trend over recent years. Through increased self-confidence and physical activity can body perception be improved. The purpose of the study was to investigate the thoughts of high school girls regarding how body perception, body ideals and living habits affect their health. Through semistructured interviews of six high school girls the study's empirical content was obtained from which further a inductive qualitative concentanylsis was conducted. The results of the study showed that the thoughts differ and aspects which affect the health most are considered to be the circle of friends and social media. Furthermore, the result showed that the individuals need to find factors in life to create and maintain good health, these factors differ from each individual. In addition to this, the result showed that physical activity, in excessive amounts, did contribute to a better health. From a public-health perspective is it important to increase the health of the population and prevent mental illness, especially among the young people who are the future of Sweden. Further studies on the subject can lead to more and better methods and strategies to prevent mental illness among high school girls.

The overall aim of this thesis was threefold; first, to explore resources associated with work-life balance (WLB), with a focus on the work and private lives of human service employees. Second, to develop a workplace health promotion (WHP) intervention with a WLB focus. Third, to explore the participants’ experiences of the developed WHP intervention done in the workplace. A mixed method approach was used to answer the research questions. The thesis is based on two qualitative studies, one quantitative study and one paper that describe the content and development process of the intervention. The qualitative studies were based on individual interviews and focus group interviews (I, IV). Thirteen semi-structured individual interviews and two focus group interviews were conducted with home help service nurses in Sweden (I). Eight focus group interviews and eight semi-structured individual interviews were conducted with participants in the intervention (IV). A qualitative content analysis was used for the analyses in the qualitative studies. The quantitative study was based on a questionnaire survey to a population of two municipality departments (n = 631, response rate 76%) (II). A linear regression model and logistics regressions models were used for the analyses. The planning and development of the intervention was done using an intervention mapping approach (III). The findings showed a complex picture of resources related to WLB. Resources could be found in the work domain, the private domain and the individual domain (I, II). In the work domain, it seems to be important to have a positive time experience and a meaningful job, but also to work part-time and do shift work. In the private domain, a positive time experience and social support was highlighted. Individual resources such as good health, well-being, reflection and satisfaction with one´s life situation were seen as essential to WLB. The development process of the intervention resulted in the “Balance in Everyday Life Empowerment” (BELE) program (III). The findings showed that a majority of the participants taking part in the BELE program experienced a process of change, often enhanced by an increased awareness, support and inner strength, which promoted well-being and balance in their everyday life (IV). In conclusion, it seems important to use a holistic approach where resources in the employees’ overall life situation are included for the enhancement of WLB. The BELE program was an attempt to contribute to WHP with a WLB focus, and the result indicates that the program was effective with regard to promoting employee well-being.

BACKGROUND: In many European countries, women have a higher sickness absence rate than men. Women also report higher levels of work-life conflict, which has a negative impact on women's self-perceived health. Interventions studies on work-life balance literature are scarce. This research adds knowledge about work-life balance by examining female employees' experiences of a newly developed intervention program, the BELE program (Balance in Everyday Life Empowerment program), aiming to enhance the work-life balance and wellbeing of female employees.

METHODS: All participants in the BELE program were included in the sample (n = 55) of the study. The methods used for gathering data were focus group interviews (n = 8) and semi-structured individual interviews (n = 8). A qualitative content analysis was used for the analyses.

RESULTS: The results showed that a majority of the participants experienced a process of change for enhancement of wellbeing and balance in their everyday life when taking part in the BELE program. In the analyses, three main themes emerged. Reflecting and strengthening inner resource, Trying to change everyday patterns and habits and Experiencing more balance and well-being.

CONCLUSIONS: The results point out the importance of awareness and reflection on everyday life to promote work-life balance and wellbeing. The BELE program was described as a wakeup call to one's own life and as an enhancer of empowerment processes and equality in the homes. Moreover, the results showed the need for health education in the workplace focusing on both work and private life to enhance balance and wellbeing among female employees'. The findings indicate that it is important to work at individual and group levels in work-life balance interventions and not merely at the organizational level or in the workplace setting.

BACKGROUND: Despite an increase in work-life balance literature, the development of successful support to help employees manage their work -life balance is slow. Moreover, there are few interventions with a comprehensive approach to workplace health promotion focusing on work-life balance.

OBJECTIVE: This paper aims to present the development and building blocks of a holistic interdisciplinary health-promoting program, the BELE program, to enhance female employees working in human service organizations health and well-being with a focus on work-life balance.

METHODS: The planning and development of the program was done through an intervention mapping and research circles methodology.

RESULTS: The planning- and development process of the program resulted in a theoretical framework, and a program structure with a program content. The intervention program was named "The Balance in Everyday Life Empowerment program" (BELE program).

CONCLUSIONS: The BELE program adds to the existing body of work-life balance knowledge, so far often based on a conflict approach. Interventions focusing on a comprehensive approach to health and work-life balance with a salutogenic approach are rare. Furthermore, the integration with occupational therapy and health promotion in a workplace health promotion framework is innovative. In a previous study, the BELE program has shown that it enhances women's well-being and balance in their everyday life.

Appearance-related concerns resulting from disfigurement or pressure to conform to beauty ideals, indiscriminately affect patients’ mental and physical health. Healthcare professionals face the challenge of addressing patients’ support needs. Therefore a European University Consortium developed a course to address learning needs. Prior to its design, a study with multi-disciplinary European healthcare professionals was conducted to maximize its relevance and acceptability. Healthcare professionals (n = 718; 48% nurses, 30% doctors, 22% allied health professionals) were surveyed regarding the nature and impact of patients’ appearance concerns, confidence in key areas associated with detecting/addressing concerns, and training/educational needs. Participants reported that this subject is highly relevant and 70% described the psychosocial impact of appearance concerns across the lifespan resulting from disfiguring conditions, disability, neurological disease, ageing and weight/shape dissatisfaction. Participants, irrespective of their experience, self-reported inadequate knowledge regarding appearance-specific care, 87% requested further information and 70% wanted access to an accredited course; barriers deterring participation in training were identified. Healthcare professionals across multiple specialties are caring for patients with a wide-range of appearance concerns that impact on physical and mental health and want to increase their appearance-specific knowledge and expertise. Results have informed training/courses which have the potential to improve patient care and ameliorate health-related outcomes.