Background: Occupational therapists are an essential healthcare profession and play a vital rolein rehabilitating patients in the activities of daily life. Nevertheless, many occupational therapistsin Sweden are leaving the profession and this jeopardises occupational therapy services.Objective: To explore factors that cause occupational therapists to seriously consider leavingtheir profession.Material and methods: As part of a larger national study of Swedish occupational therapists’health and work environment, qualitative content analysis with a summative approach wasapplied to explore the reasons for considering leaving their profession among 1279 Swedishoccupational therapists.Results: Three themes emerged: (1) facing work environment deficiencies, (2) pursuing owndevelopment and (3) Personal factors and external constraints. The largest category, belongingto theme 1, was stress and high work pressure given 344 times as a reason to consider leavingthe profession.Conclusions and significance: This article provides new and important insights on the reasonswhy occupational therapists may seriously consider leaving their profession. The results are significant for managers and employing organizations to consider in order to prevent a shortageof occupational therapy services.

Swedish municipalities are the main employer for the staff in eldercare, a sector where sick leave rates are high and work environment deficiencies are reported. This qualitative grounded theory study aimed to explore how the politicians accountable for eldercare in Sweden perceived their collaboration with civil servants, their understanding of the financing of eldercare, and views regarding their own existing knowledge of their assignment within eldercare. The study comprised interviews with 41 politicians from municipalities across Sweden. Three categories emerged: (1) holding a position of power, (2) lacking finance of eldercare, and (3) wanting to increase their knowledge base. The strongest finding showed that the civil servants can be viewed as holding a position of power in relation to the politicians. Politicians relied on the civil servants to gather and present information regarding eldercare so they could make accurate decisions; at the same time, they were aware that information might be incomplete. Most of the accountable politicians believe that the financial resources allocated for eldercare were insufficient. The politicians also believed they needed to increase their own knowledge base and expressed a desire to learn more about eldercare and the employees’ work environment. Further studies should explore the role of the first line managers of staff in the eldercare organization and their work environment, and how they perceived their collaboration with civil servants and the accountable politicians.

BACKGROUND: Lack of mental health literacy among rehabilitation professionals and employers in the return-to-work of persons with mental health problems resulted in the development of a three-day group training program, the Support to Employers from rehabilitation Actors about Mental health (SEAM) intervention.

OBJECTIVE: To evaluate the impact of SEAM on rehabilitation professionals' knowledge and beliefs, attitudes, and supporting behaviors towards people with mental health problems and employers as part of the return-to-work process.

METHODS: In this longitudinal study, 94 rehabilitation professionals were included. Data were collected prior to (T1), immediately after (T2) and 6 months after SEAM training (T3) using knowledge and attitude scales and a questionnaire on supporting behaviors. SEAM includes training in Mental Health First Aid, presentations and discussions on current research on work and mental health, and strategies and communication guidelines to use when meeting service users and employers as part of the return-to-work of persons with mental health problems. SEAM also includes a homepage with targeted employer information. Data were analyzed using non-parametric statistics.

RESULTS: SEAM significantly increased rehabilitation professionals' knowledge of mental health (T1-T2: z = -2.037, p = 0.042; T2-T3: z = -5.093, p = 0.001), and improved their attitudes towards persons with mental health problems (T1-T2: z = 4.984, p = 0.001). Professionals (50-60%) also estimated that they had increased their use of supporting strategies towards service users and employers.

CONCLUSIONS: The study suggests that SEAM can increase mental health literacy among rehabilitation professionals and lead to a greater focus on service users' resources and work ability, as well as on employers' support needs.

The aims of this qualitative grounded theory study were to explore how politicians accountable for Swedish elderly care viewed their assignment, their beliefs and knowledge regarding the psychosocial work environment for elderly care employees, the factors affecting their work environment, and how these politicians regarded elderly care during the COVID-19 pandemic. This study consisted of 41 interviews with politicians in municipalities across Sweden. Three categories emerged from the analysis: (1) interpretation of the assignment directs the focus; (2) recognizing shortfalls in the employees’ work environment; and (3) exposing deficiencies due to the COVID-19 pandemic. The strongest category was identified as interpretation of the assignment directs the focus and was described as the delivery of good and quality care. Nevertheless, this study highlights shortfalls in the delivery of care services where the employees’ work environment, especially in the home care sector, was frequently described as stressful. The COVID-19 pandemic adversely affected the work situation for staff in elderly care. In that setting, staff shortage and lack of competency were common. Nurses were particularly affected by high workload and responsibility. Further research should explore civil servant roles in the elderly care sector and how these actors view their collaboration with municipality politicians.

BACKGROUND:Mental health problems are the main cause of sick leave in today’s working age population. Employers are responsible for their employees’ work environment and preventing work-related illnesses, but their knowledge regarding mental health problems is lacking. Employer beliefs and support strategies need further exploration. OBJECTIVE:To explore employers’ beliefs, knowledge and strategies use in providing support to employees with mental health problems. METHODS:This grounded theory study comprised 24 interviews with employers in a variety of workplaces, and included women and men in large and small organizations in a Swedish context. RESULTS:Two categories related to the aims emerged: comprehending mental health problems is complex, and lacking established conditions to support work. The results show that employers seek to support employees with mental health problems but have low expectations and lack knowledge and strategies. Employers acknowledged experiences of inadequate support and collaboration from other actors in the return-to-work (RTW) process. CONCLUSIONS:To close the service gap and improve the RTW process, employers need to increase their mental health literacy. Other actors need to improve their understanding of employer situations and provide them with necessary support. 

BACKGROUND:Individuals with mental health problems often need support from vocational rehabilitation professionals in their return-to-work (RTW) process. Research has shown that this support can be deficient, with vocational rehabilitation professionals lacking relevant knowledge and an underlying belief in the individual’s ability to resume a working life. More understanding is therefore needed of professionals’ mental health literacy and their perception of and influence on employer roles in the RTW process.OBJECTIVE:To explore the mental health literacy of Swedish vocational rehabilitation professionals and their perception of employers in the RTW process.METHOD:Qualitative grounded theory study which included 22 interviews of vocational rehabilitation professionals working with individuals with mental health problems in their RTW process.RESULTS:Three categories emerged: holding a position of power in the RTW process, viewing and believing in individuals’ work ability plays a central role, and recognizing the employer’s role as a key factor for realizing employment.CONCLUSION:Increasing the mental health literacy of vocational rehabilitation professionals is crucial since they have a decisive role with both clients and employers in the RTW process.

BACKGROUND:Depression is among the major causes of disability with a negative impact on both daily life and work performance. Whilst depression is the primary cause of sick-leave and unemployment in today’s workplace there is a lack of knowledge of the needs of individuals with depression regarding their return-to-work (RTW) process.OBJECTIVE:To explore which factors are of critical importance for people suffering from depression and who also are unemployed in their RTW-process and to explore the impact of two vocational approaches on the service users’ experiences. The study included participants in two vocational rehabilitation approaches; Individual Enabling and Support (IES) and Traditional Vocational Rehabilitation (TVR).METHOD:Qualitative methods were applied to explore critical factors in the RTW-process. Individuals with affective disorders including depression and bipolar disorder were included.RESULTSThree themes emerged as critical factors; Experiencing hope and power, professionals’ positive attitudes, beliefs and behaviours, and employing a holistic perspective and integrating health and vocational service.CONCLUSIONThis study has demonstrated critical factors for the return-to-work process as experienced by persons with depression. To experience hope and power, to meet professionals that believe “you can work”, who use a person-centred and holistic service approach, are such factors necessary for gaining a real job. In particular, professionals in TVR need to embrace this understanding since their services were not experienced as including these elements.

Purpose:  To evaluate the effect of Individual Enabling and Support (IES) on empowerment and depression severity as compared to Traditional Vocational Rehabilitation (TVR) in people with affective disorders at 12 months follow-up. Additionally, longitudinal changes within the intervention groups and the correlation over time between empowerment and depression severity were evaluated.

Method:  A single-blind randomized controlled trial of two intervention groups, IES (n = 33) and TVR (n = 28), was performed with measurement points at baseline, 6, and 12 months. Individuals with affective disorders, including depression and bipolar disorder diagnoses were included. The Empowerment Scale and Montgomery-Åsberg Depression Self-Rating Scale were administered, and Intention-To-Treat analysis was applied. The study was registered with the trial number ISRCTN93470551.

Result:  There was a statistically significant difference between the intervention groups on empowerment and depression severity at 12 months. Within-group analysis showed that IES-participants increased their perceived empowerment and decreased their depression severity between measurement points, this was not seen among TVR-participants. A moderate, inverse relationship was detected between empowerment and depression.

Conclusion:  IES is more effective in increasing empowerment and decreasing depression severity after a 12-month intervention than is TVR. This study was limited by a small sample size and larger trials in different contexts are needed.  Keywords:  Depression; bipolar disorder; return-to-work; supported employment; vocational rehabilitation.

IntroductionRecovery following distal radius fracture (DRF) is generally achieved within six months. However, a minority of patients experience functional impairments over a longer period. Traditional outcome measures are grip strength and range of movement. However, this may not reflect all parameters that are important. This study focuses on grip function as well as occupational performance in these patients over a six-month period.MethodA longitudinal study with follow-up at three to four weeks (n = 27) and six months (n = 22) after plaster removal. Patients with a DRF treated with cast or with closed reduction and cast immobilisation were included. Instruments used were the Sollerman Hand Function Test, Visual Analogue Scale, Patient-Rated Wrist Evaluation Outcome Questionnaire and Disabilities of the Arm, Shoulder and Hand. Changes over time and correlation between grip function, pain after grip function test and occupational performance were calculated.ResultsImprovements in grip function, experienced pain after grip test and occupational performance were significant. A significant correlation was found between grip function and feeling of capability, confidence and usefulness. Grip function was close to normal after six months with no differences between the two treatment methods. A wide distribution of the result in occupational performance after six months indicates the possibility of multi-dimensional reasons for remaining problems.DiscussionThe results highlight the importance of a combination of functional assessment and questionnaires addressing complexity in order to acquire a more complete picture of limitations following a DRF.Keywords Distal radius fracture, Sollerman’s Hand Function Test, VAS, PRWE, DASH