A rapidly changing homecare service sector implies difficulties to control safety and health risks for staff and to guarantee standardised deliveries of services to recipients. This study aimed to describe staff perceptions of safety climate and practices in homecare service teams, and suggestions for improvements. A second aim was to identify if and how the appraisals of safety climate were related to individual perceptions of safety, mental strain and adverse events/injury. A convergent parallel mixed methods design was used. Nursing assistants and care aides (133 in total, representing 11 work teams) in the north of Sweden replied to a survey and participated in focus group interviews. Results were analysed with ANOVA (inter-team differences) and by qualitative content analysis. Significant diversity was identified between the teams in five of seven dimensions of safety climate. Important areas for improvement were: a need to define and agree on criteria for a safe working environment; leadership prioritising safety at work; and management able to provide trust, support and time. A prerequisite for these agreements was improved authority and communication between all parties involved. The safety climate dimensions were related to personal perceptions of safety and mental strain and, partly, to adverse events/injuries.

The aim was to examine how different aspects of time pressure are associated with health and gender. The study is based on data collected by cross-sectional questionnaire from 153 female and 167 male journalists at three editorial offices in Sweden. Spearman correlation coefficients by gender were analysed between six different time pressure variables and seven health measures. For women three health indicators correlated significantly with time pressure expressed as “short of time for reflection”. For men, health as expressed by four indicators was primarily related to “lack of efficiency”. Severe time pressure correlated especially highly with stress but only to an almost negligible degree with neck and shoulder symptoms. Our analysis showed that the relation between time pressure and health differs between women and men and that time pressure can be interpreted in several different ways.

Aims: The purpose of this study was to describe and analyse the effects of health-promoting educational interventions among employees in a municipality in Sweden. Methods: A randomized controlled educational intervention study was performed with 340 employees. Supervisors and workplace champions took part in two separate educational programmes with focus on health promotion. Intervention groups were teams of supervisors, teams of workplace champions and a mixed group (supervisors and workplace champions). The control group did not take part in any of the activities. Evaluations with physical fitness tests and a self-administrated questionnaire were performed twice. Focus group discussions were held. Results: All groups raised their physical fitness level from baseline to follow-up. Females in the supervisor group had increased their mean maximal oxygen uptake from 32.0 mlO2/kg*min to 34.9 mlO2/kg*min which was more than the others. Supervisors had reached increased knowledge within the area ‘organizational factors’ and behavioural changes had been obtained within the area ‘life-style’. Workplace champions working together with their supervisors had an easier and more motivated situation than workplace champions working by themselves. Conclusions: Coaching supervisors as well as the mixed group seemed to improve the intervention of health promotion most and should be continued.

Background: Municipal home care workers provide high-quality services to an increasing proportion of elderly people living in private homes. The work environments and working conditions of these workers vary to a great extent, implying rapid prioritymaking among both employers and employees to ensure that the work can be performed in a safe way. Objectives: This study aims to examine home care workers perceptions of health, risks, working conditions and risk management within their organisation. Method: The study was based on cross-sectional data collected from home care service staff' in a municipality in the north of Sweden. Nursing assistants and care aides(n=133) replied to a self-administered questionnaire. Descriptive statistics and between-group differences were analysed. Results: Home care work was perceived to require high levels of professional skill and ingenuity, a good psychosocial work situation, but required a high physical workload. The general health, the capacity and self-efficacy of the staff in relation to work were good. Difficulties in performing risk assessments and to follow safety regulations due to lack of time, equipment and information were identified.Conclusion: There is a need to increase participation in risk assessments among the staff, improve management support, structures and cooperation with other divisions of the social services and the medical care organisations.

Purpose: To investigate working conditions and health at gender segregated (most women, ≥ 60% women or most men, ≥ 60% men) workplaces with a focus on associations of ergonomic exposures with musculoskeletal disorders.Methods: A comprehensive questionnaire was randomly sent to 10 000 inhabitants in three municipalities in the middle of Sweden. The response rate was 50% (4965 men and women). Organisational, physical and psychosocial working conditions and the musculoskeletal symptom panorama as well as general health and psychological well-being were compared between men and women in the gender segregated workplaces.Results: There were significant differences in working conditions between men and women both in female and male dominated workplaces. Most differences concerned physical work environment factors at both workplaces. However, the level of low control and strain were more prevalent among women in male dominated workplaces. A significantly greater share of women, compared to men, reported symptoms in all body parts except in low back and knees at both workplaces. Good general health was reported by 80% of both men and women but men in male dominated workplaces perceived significantly better psychological well-being than the others.Conclusions: Women and men in this region performed different work tasks and a greater share of women than men reported musculoskeletal symptoms. This was the fact also when working in the same type of segregated workplaces.

In workplace health promotion, all potential resources needs to be taken into consideration, not only factors relating to the absence of injury and the physical health of the workers, but also psychological aspects. A dynamic balance between the resources of the individual employees and the demands of work is an important prerequisite. In the home care services, there is a noticeable trend towards increased psychosocial strain on employees at work. There are a high frequency of work-related musculoskeletal disorders and injuries, and a low prevalence of sustainable work ability. The aim of this research was to identify factors promoting work ability and self-efficacy in care aides and assistant nurses within home care services.This study is based on cross-sectional data collected in a municipality in northern Sweden. Care aides (n = 58) and assistant nurses (n = 79) replied to a self-administered questionnaire (response rate 46%). Hierarchical multiple regression analyses were performed to assess the influence of several independent variables on self-efficacy (model 1) and work ability (model 2) for care aides and assistant nurses separately.Perceptions of personal safety, self-efficacy and musculoskeletal wellbeing contributed to work ability for assistant nurses (R2adj of 0.36, p < 0.001), while for care aides, the safety climate, seniority and age contributed to work ability (R2adj of 0.29, p = 0.001). Self-efficacy was associated with the safety climate and the physical demands of the job in both professions (R2adj of 0.24, p = 0.003 for care aides), and also by sex and age for the assistant nurses (R2adj of 0.31, p < 0.001).The intermediate factors contributed differently to work ability in the two professions. Self-efficacy, personal safety and musculoskeletal wellbeing were important for the assistant nurses, while the work ability of the care aides was associated with the safety climate, but also with the non-changeable factors age and seniority. All these factors are important to acknowledge in practice and in further research. Proactive workplace interventions need to focus on potentially modifiable factors such as self-efficacy, safety climate, physical job demands and musculoskeletal wellbeing.

Background In workplace health promotion, all potential resources needs to be taken into consideration, not only factors relating to the absence of injury and the physical health of the workers, but also psychological aspects. A dynamic balance between the resources of the individual employees and the demands of work is an important prerequisite. In the home care services, there is a noticeable trend towards increased psychosocial strain on employees at work. There are a high frequency of work-related musculoskeletal disorders and injuries, and a low prevalence of sustainable work ability. The aim of this research was to identify factors promoting work ability and self-efficacy in care aides and assistant nurses within home care services. Methods This study is based on cross-sectional data collected in a municipality in northern Sweden. Care aides (n=58) and assistant nurses (n=79) replied to a self-administered questionnaire (response rate 46%). Hierarchical multiple regression analyses were performed to assess the influence of several independent variables on self-efficacy (model 1) and work ability (model 2) for care aides and assistant nurses separately. Results Perceptions of personal safety, self-efficacy and musculoskeletal wellbeing contributed to work ability for assistant nurses (R2adj of 0.36, p=0.001), while for care aides, the safety climate, seniority and age contributed to work ability (R2adj of 0.29, p=0.001). Self-efficacy was associated with the safety climate and the physical demands of the job in both professions (R2adj of 0.24, p=0.003 for care aides), and also by sex and age for the assistant nurses (R2adj of 0.31, p<0.001). Conclusions The intermediate factors contributed differently to work ability in the two professions. Self-efficacy, personal safety and musculoskeletal were important for the assistant nurses, while the work ability of the care aides was associated with the safety climate, but also with the non-changeable factors age and seniority. All these factors are important to acknowledge in practice and in further research. Proactive workplace interventions need to focus on potentially modifiable factors such as self-efficacy, safety climate, physical job demands and musculoskeletal wellbeing.

Purpose: The present study aims to describe home care service workers' perceptions of safety climate and safety activities at work as well as working conditions, self-efficacy, and health and work ability. Relevance: High frequencies of work-related musculoskeletal disorders and injuries and low prevalence of sustainable work ability in home care services workers are of great concern. They are to provide high quality services to an increasingly proportion of elderly people living in private homes. In order to promote health and safety for the home care workers, increased focus should be on organisational, psychosocial and physical factors contributing to a healthy working environment. Participants: 158 nursing assistants and nursing aides divided in 18 work units participated in this study. They all met the criterion of having worked in the same home care services unit in the last 6 months. Their mean age was 46 years, the majority were women, and the distribution of nursing aides and nursing assistants was about 40/60%. Methods: This study is based on cross-sectional data gathered in February 2009 in home care services in a municipality in the North of Sweden. All the home-care work units shared the experiences of using a model for participatory risk management in home care services. Data were obtained through a comprehensive self-administered questionnaire, covering working conditions, safety climate, safety activities, self-efficacy, health and work ability. Analysis: Descriptive statistics as well as data on between-group differences are analysed. Results: In general, the results showed fairly good levels of safety climate but only moderate levels of safety activities and of perceived safety grade at work. These variables differed significantly between work units. Environmental barriers, such as lack of time and equipment, were given as reasons for not complying with safety rules or participating in proactive risk assessment. Besides a high frequency of musculoskeletal symptoms and high physical exposure at work, the home care workers in general reported being in good health and with good work ability. They also expressed high decision making latitude, skill discretion, social support and self-efficacy. Conclusions: To promote health and safety for the home care workers, interventions could build on the high levels of safety climate and proactive activities in single work units, proposing good solutions and safe behaviour. Focus need to be placed on improved safety climate, communication and coordination with all professionals forming the home care services setting. Also, on individuals' and work units' awareness of safe behaviour and on alternatives of actions in critical risk situations at work. This may act preventive on musculoskeletal well-being and a good working environment. Implications: There need to be an increase in means given to physical therapists in occupational health services, to work with these issues. The ergonomic skills and the safety climate of the front-line home care services workers need to be addressed, as well as the organisational prerequisites for workplace safety and health.

RR-PO-210-6-Thu Professional practice - Occupational health