Department of Industrial Economics and Technology Management, Norwegian University of Science and Technology, Alfred Getz veg 3, SB1, 12,etg, N-7491 Trondheim, Norway.
BMC Health Serv Res. 2013 Nov 15;13:477. doi: 10.1186/1472-6963-13-477.
Ergonomic and work stress interventions rarely show long-term positive effect. The municipality participating in this study received orders from the Norwegian Labour Inspectorate due to an identified unhealthy level of time pressure, and responded by effectuating several work environment interventions. The study aim is to identify critical factors in the interaction between work environment interventions and independent rationalization measures in order to understand a potential negative interfering effect from concurrent rationalizations on a comprehensive work environment intervention.
The study, using a historic prospective mixed-method design, comprised 6 home care units in a municipality in Norway (138 respondents, response rate 76.2%; 17 informants). The study included quantitative estimations, register data of sick leave, a time line of significant events and changes, and qualitative descriptions of employee appraisals of their work situation gathered through semi-structured interviews and open survey responses.
The work environment interventions were in general regarded as positive by the home care workers. However, all units were simultaneously subjected to substantial contextual instability, involving new work programs, new technology, restructurings, unit mergers, and management replacements, perceived by the home care workers to be major sources of stress. Findings suggest that concurrent changes induced through rationalization resulted in negative exposure effects that negated positive work environment intervention effects, causing an overall deteriorated work situation for the home care workers.
Establishment and active utilization of communication channels from workers to managers are recommended in order to increase awareness of putative harmful and interruptive effects of rationalization measures.
人体工程学和工作压力干预措施很少显示出长期的积极效果。参与这项研究的市政府接到了挪威劳动监察局的命令，因为发现了不健康的时间压力水平，并通过实施多项工作环境干预措施做出了回应。本研究的目的是确定工作环境干预措施与独立合理化措施之间相互作用的关键因素，以便了解综合工作环境干预措施中来自同期合理化措施的潜在负面干扰效应。
本研究采用历史前瞻性混合方法设计，包括挪威一个市政府的 6 个家庭护理单位（138 名受访者，回应率 76.2%；17 名知情人）。该研究包括定量估计、病假登记数据、重大事件和变化的时间表，以及通过半结构化访谈和开放式调查回复收集的员工对其工作情况的评估的定性描述。
家庭护理人员普遍认为工作环境干预措施是积极的。然而，所有单位同时都面临着重大的背景不稳定，涉及新的工作方案、新技术、重组、单位合并和管理层更替，家庭护理人员认为这些是主要的压力源。研究结果表明，通过合理化同时引发的变化导致了负面的暴露效应，抵消了积极的工作环境干预效应，导致家庭护理人员的整体工作情况恶化。
建议建立和积极利用工人向管理人员的沟通渠道，以提高对合理化措施可能产生的有害和中断影响的认识。
