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Organizational Change, Health and Sick Leave among Health Care Employees: A Longitudinal Study Measuring Stress Markers, Individual and Work Site Factors
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
2008 (English)In: Work & Stress, ISSN 0267-8373, E-ISSN 1464-5335, Vol. 22, no 1, 69-80 p.Article in journal (Refereed) Published
Abstract [en]

This controlled longitudinal study was conducted to investigate the effects of organizational change on employees' self-reported health, work satisfaction, work-related exhaustion, stress, and sick leave. The population consisted of 226 employees at T1 and 198 at T2, divided into a study group affected by organizational changes, and a reference group not affected by them. Group differences for the outcome measures self-rated health (SRH), work satisfaction, work-related exhaustion, and hormones associated with stress were analysed using a two-factor ANOVA design for repeated measurements. Our findings showed no significant differences, either across time or between groups for SRH, work satisfaction, and work-related exhaustion. However, we did find significant change across time and between groups for the recovery hormone DHEA-S. Days of sick leave increased by 7% for employees in the study group and by 2% in the reference group. Serum cortisol showed significantly decreased levels across time but not between groups. The decreased recovery potential in the study group might have long-term health implications. The study points to the importance of looking at the impact of organizational change on employee well-being from a number of perspectives, such as self-reported health parameters, registered sick-leave data, and biological stress markers.

Place, publisher, year, edition, pages
2008. Vol. 22, no 1, 69-80 p.
Keyword [en]
organizational change, self-rated health, biological stress markers, sick leave, work related stress
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-97169DOI: 10.1080/02678370801996236ISI: 000255041300005OAI: oai:DiVA.org:uu-97169DiVA: diva2:171989
Available from: 2008-04-28 Created: 2008-04-28 Last updated: 2011-12-19Bibliographically approved
In thesis
1. Determinants of Individual and Organizational Health in Human Service Professions
Open this publication in new window or tab >>Determinants of Individual and Organizational Health in Human Service Professions
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The psychosocial work environment in human service organizations is in many respects rewarding from the aspect of human interaction. However, it has also been described in several research reports as demanding and stressful both physically and mentally, resulting in a negative impact on employee health and a high degree of sickness absence. From a public health perspective it is important to focus on determinants of health in occupational groups that are characterized by caring and human relations. This thesis aims at identifying determinants of individual and organizational health in human service professions from a multifactorial perspective.

Based on both cross-sectional and longitudinal data, four studies of various aspects of psychosocial work exposures are carried out. Study I, an explorative and qualitative study, examines determinants of the psychosocial work environment in the Church of Sweden. Study II consists of a retrospective, randomized study assessing effects of goal clarity work on organizational well-being in the Church. Study III examines exposures resulting in stress-related sick leave among elderly care employees. Study IV is a longitudinal study that assesses effects of organizational change on health and sickness absence among elderly care employees.

The results show some positive experiences, despite overall demanding work conditions within both of the studied professions. In the Church (Paper I), experiences of freedom and influence at work and the Christian values tend be factors with modifying effect on health. Four patterns are identified for negative health impact; these include unclear organization, a sense of being different, stressful work and destructive communication style. Effects of goal clarity work (Paper II) indicate an overall positive impact on organizational well-being. In elderly care (Paper III), the results suggest, in general, a positive work climate and high effectiveness. Work related exhaustion was significantly higher among employees with stress related sickness absence. Factors of risk for being absent due to stress are approximately three times higher among employees dissatisfied with both their work and their social situations. Finally, measuring effects of organizational change (Paper IV), the results reveal evidence of unchanged self-rated health (SRH), work satisfaction and work exhaustion after reorganization. However, sickness absence increased across time and there is an indication of impaired levels of the anabolic hormone DHEA-S among those individuals affected by the reorganization.

The results point to a challenge for further research on the interplay between perceived stressors, resources available, biological stress markers and health in order to find adequate measures for improvements in psychosocial work environment in human service professions.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2008. 71 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 348
Keyword
Social medicine, Psychosocial work environment, health, human service profession, Socialmedicin
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-8715 (URN)978-91-554-7191-0 (ISBN)
Public defence
2008-05-24, Auditorium Minus, Museum Gustavianum, Akademigatan 3, 753 10 Uppsala, 13:15
Opponent
Supervisors
Available from: 2008-04-28 Created: 2008-04-28 Last updated: 2012-01-04Bibliographically approved

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