Institute for Environmental Medicine, Karolinska Institutet, Unit of Occupational Medicine, 171 77 Stockholm, Sweden.
Department of Public Health and Caring Sciences, Uppsala University, 751 22 Uppsala, Sweden.
Int J Environ Res Public Health. 2021 Mar 29;18(7):3546. doi: 10.3390/ijerph18073546.
Work-related stress is a global problem causing suffering and economic costs. In Sweden, employees in human service occupations are overrepresented among persons on sick leave due to mental health problems such as stress-related disorders. The psychosocial work environment is one contributing factor for this problem, making it urgent to identify effective methods to decrease stress at the workplace. The aim of the study is to evaluate a participatory intervention to improve the psychosocial work environment and mental health using an embedded mixed methods design. The study is a controlled trial with a parallel process evaluation exploring fidelity and participants' reactions to the intervention activities, experiences of learning and changes in behaviours and work routines. We collected data through documentation, interviews and three waves of questionnaires. Our results show small changes in behaviours and work routines and no positive effects of the intervention on the psychosocial work environment nor health outcomes. One explanation is end-users' perceived lack of involvement over the process causing the intervention to be seen as a burden. Another explanation is that the intervention activities were perceived targeting the wrong organisational level. A representative participation over both content and process can be an effective strategy to change psychosocial working conditions and mental health.
工作相关压力是一个全球性问题，会给人们带来痛苦和经济成本。在瑞典，由于压力相关障碍等心理健康问题而请病假的员工中，从事人类服务职业的员工比例过高。心理社会工作环境是造成这一问题的一个因素，因此迫切需要确定有效的方法来减少工作场所的压力。本研究旨在使用嵌入式混合方法设计评估一项参与式干预措施，以改善心理社会工作环境和心理健康。该研究是一项对照试验，同时进行平行的过程评估，以探索对干预活动的保真度和参与者的反应、学习经验以及行为和工作常规的变化。我们通过文件、访谈和三波问卷调查收集数据。我们的结果表明行为和工作常规有微小的变化，但干预对心理社会工作环境和健康结果没有积极影响。一种解释是最终用户对整个过程的参与感不足，导致干预被视为一种负担。另一种解释是干预活动被认为针对的是错误的组织层面。代表参与内容和过程可以是改变心理社会工作条件和心理健康的有效策略。
