Externally assessed psychosocial work characteristics : A methodological approach to explore how work characteristics are created, related to self-reports and to mental illness

Detta är en avhandling från Stockholm : Karolinska Institutet, Department of Public Health Sciences

Sammanfattning: The general aim of this thesis was to add knowledge to the area of measurement issues of psychosocial work characteristics and job design by using a more objective methodological approach. Expert assessments were made through direct observations and interviews and are a theory guided nonemotional description that is independent of the specific individuals social or cultural frame of reference. ARIA work content analysis was used in three different ways in this thesis; as the outcome in a job design study, for validation of self-reports in two studies and as a predictor in an epidemiological study. The aim of Paper I was to identify factors at the workplace that created good and bad psychosocial work characteristics. Five cases with deteriorated work characteristics over a period of six years were compared with four cases with improved work characteristics. We found differences in managerial and employee strategies between bad and good job cases. In the good job cases, managers had an active strategy with their subordinates, upwards in the organization and outwards in inter-organizational relations. An important characteristic among employees in good job cases was the use of collective strategies. The aim of Paper II was to explore externally assessed demands and control for both women and men in each of the groups of the Job Demand Control model, which itself was based on self-reported data. Most comparative analyses of the JDC groups showed that external assessments corresponded to self-reports in the expected direction for both women and men. However, in the active job situation, external assessments deviated from self-reports in different directions for women and men. Women had more hindrances and less influence over their work, while the situation was reversed for men. It was concluded that associations between self-reported working conditions and health might be underestimated among women reporting an active job situation. Paper III investigated whether self-reporting of psychological demands and control at work is as valid for psychologically distressed subjects as for subjects with psychological well-being. Results did not indicate any systematic differences between self-reported and externally assessed working conditions for respondents reporting different levels of psychological distress. It was concluded that over-reporting of work demands or under-reporting of work control is unlikely at the levels of psychological distress studied. Paper IV studied the relation between externally assessed work characteristics and psychiatric disorders. Lack of instrumental support from colleagues and supervisors assessed as a hindrance to work performance, and deterioration in work characteristics during the past three years were associated with depression. The ARIA method and theoretical framework used in this thesis are recommended for human resources departments and occupational health services aiming to identifying areas that need to be improved in order to create sustainable jobs.

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