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Objective

Research shows worsening working conditions for nurses in Swedish elderly care with shortcomings exposed during the COVID-19 pandemic. Although extensively debated during the pandemic, work environment and service quality improvements are needed. Registered nurses have a key role in elderly care, balancing medical and care responsibilities for older people. However, more knowledge is required about the expectations and organisational conditions for nurses executing the role in elderly care. Therefore, the study aims to explore first line managers’ role expectations of nurses in municipal elderly care and their perceptions of barriers to nurses’ role fulfilment.

Methods

A qualitative approach was used with the study set in two Swedish municipalities. We used purposeful sampling and recruited thirteen first line managers from municipal and private care providers with experience being responsible for nurses working in elderly care. Data was collected using semi structured interviews with the managers, and the data was analysed using thematic analysis.

Results

Two themes were identified in the analysis describing Role expectations in care practice and Barriers to fulfilling role expectations. The first theme highlights the expectations of nurses in elderly care to deliver evidence-based care, foster effective team collaboration, and demonstrate strong leadership in the care work. Together, these elements should ensure a supportive environment and high quality for the residents in elderly care. The second theme addresses barriers to meeting role expectations, including excessive administration, staffing shortages, and illegitimate tasks, resulting in high workloads for nurses.

Conclusions

There is conflicting logic between nurses’ role expectations in elderly care and the possibilities for nurses to execute the role due to organisational barriers. Heavy work and administrative tasks hinder nurses’ ability to focus on core responsibilities and deliver optimal elderly care. Improving the organisational conditions for nurses requires political action.

Objectives: Public health work involves diverse types of writing to communicate health messages to various audiences. Clear, concise, audience-oriented writing is essential, yet public health practitioners often receive little training in effective writing. This study explores the writing public health practitioners do in their everyday work.

Methods: We emailed a web-based questionnaire in April 2024 to a sample of public health practitioners working in municipalities, regional health departments, governmental agencies, and nongovernmental organizations in 5 regions in Sweden. The questionnaire asked about writing, support, professional development, and writing self-efficacy. We analyzed data using descriptive statistics and content analysis.

Results: Seventy-two public health practitioners responded to our questionnaire. The most common types of writing that respondents reported engaging in were presentations (88.9%), reports (59.7%), and decision-making documents (47.2%). Scientific articles (75.0%), blog posts (69.4%), and opinion pieces (56.9%) were the least common. The most common target audiences were politicians, followed by managers and citizens. Colleagues provided the most common source of writing support, followed by communication officers and managers. Most practitioners reported a desire to develop their professional writing skills and achieve high self-efficacy in public health writing.

Conclusions: Public health practitioners in Sweden write more for politicians and managers than for the public. Expanding practitioners' writing skills beyond operational and technical document writing to include public-facing writing will benefit the public health profession by opening communication channels to diverse audiences. Communicating more clearly with public audiences can improve health literacy, promote health for all, and strengthen the effectiveness of public health initiatives.

Background

Physical activity (PA) promotes health in adults as well as children. At the same time, a large proportion of children do not meet the recommendations for PA, and more school-based efforts to increase PA are needed. This study investigates the effectiveness and feasibility of lesson-integrated PA in a Swedish primary school.

Methods

We evaluate a new method called ‘Physical Activity and Lesson in Combination’ (abbreviated FALK in Swedish) using a mixed methods approach; a quasi-experimental study followed by qualitative interviews. Two schools participated in the study, one constituting the intervention group (I-school, n = 83) and the other the control group (C-school, n = 81). In addition to regular physical education, the I-school had three 30-minute FALK lessons each week. A total of 164 students aged 7–9 years wore pedometers for a whole week, four times over two semesters, and the number of steps per day (SPD) and the proportion of students with < 10,000 SPD were compared. Statistical differences between the schools were tested with ANOVA, Chi2, t-tests, and ANCOVA. Interviews with students (n = 17), parents (n = 9) and teachers (n = 9) were conducted and analysed using qualitative content analysis.

Results

The results show that FALK led to the I-school getting more SPD and fewer students with < 10,000 SPD. Also, FALK was experienced as a positive, clear, and flexible method, simultaneously encouraging PA and learning. Challenges experienced concerned the teachers’ work situation, time, finding suitable learning activities, outdoor school environment changes, and extreme weather conditions.

Conclusions

This study indicates that FALK has the desired effects on PA and is a feasible method of integrating PA into theoretical teaching. We conclude that FALK is worth testing at more schools, given that implementation and sustainment of FALK considers both general enablers and barriers, as well as context-specific factors at the individual school.

Detta kapitel tar sin utgångspunkt i ett hälsofrämjande perspektiv på det nutida och framtida arbetslivet. I kapitlet beskrivs framväxten av hälsofrämjande arbete och idéer om arbetsplatsen som en arena för hälsofrämjande initiativ. Beskrivningen utgår ifrån vad som krävs för att skapa hälsofrämjande arbetsplatser för anställda och chefer och hälsofrämjande organisationer som är hållbara för både anställda och organisationen i stort. I kapitlet beskrivs aktuell forskning om hälsofrämjande organisationer som tar fasta på möjliggörande och hindrande faktorer vid genomförande av hälsofrämjande insatser, liksom insatsernas hälsomässiga och organisatoriska effekter. Därtill innehåller kapitlet resonemang om policyer och ett praktiskt exempel som illustrerar hur idéer och prat om hälsofrämjande i organisationer kan omsättas i konkret handling. Avslutningsvis belyses även delar av den kritik som ibland riktas mot hälsofrämjande initiativ i organisationer, som bland annat handlar om ansvar och att hälsa ges alltför stort utrymme och blir för styrande i organisationer.

Background: Physical activity (PA) promotes health in adults as well as children. A large proportion of schoolchildren don´t meet the recommendations for PA. Few scientific studies have investigated both effectiveness and feasibility regarding school-based efforts to increase PA. We have evaluated a method we call Physical Activity and Lesson in Combination (In Swedish: Fysisk Aktivitet och Lektion i Kombination, FALK).

Purpose: To investigate the effectiveness and feasibility of FALK.

Methods: Two schools participated, one constituted control group (C), the other intervention group (I). In addition to the same PA as C-group, the I-group had three FALK sessions of 30 minutes each week.

We used pedometers to assess changes in physical activity and interviews to evaluate feasibility.  

A total of 164 pupils aged 7-9 wore pedometers for a whole week on four occasions over two semesters. The number of steps per day (SPD) and the proportion of pupils with <10,000 SPDs were compared.

Interviews were carried out with students, parents, and educators (n = 35) and were analyzed by qualitative content analysis.

Findings: Pedometer data shows that students who perform FALK sessions are more physically active, and the proportion of students with insufficient PA is smaller, compared to students who don´t have FALK.

The interviews show both enabling factors and barriers, but overall FALK is experienced as positive, clear, and flexible.

Conclusions: FALK increases PA and is assessed as a useful and feasible practice to integrate PA into theoretical teaching.

Studiens syfte är att via fallstudier av socialtjänsten undersöka konkreta ledningspraktiker som kan sägas falla inom ramen för Tillitsdelegationens definition av tillitsbaserad styrning och ledning och som har betydelse för att åstadkomma hållbara arbetsmiljöer i välfärden. Analysen visar att hållbar arbetsmiljö via tillitsbaserad styrning och ledning kan kopplas till organisationens säkerställande av förmåga, integritet och hjälpvillighet. Konkreta ledningspraktiker för säkerställande och hållbar arbetsmiljö var uppdragsdialog, systemperspektiv, integrering av arbetsmiljö och verksamkvalitet samt långsiktig ekonomisk styrning. Genom att ledningen agerar tillitsvärdigt via säkerställande av tillitsvärdigheten hos dem som är satta att utföra arbetet närmast medborgarna, erhålls goda arbetsmiljöer.

Rapporten sammanfattar följeforskning om ett chefsprogram som syftat till att säkra chefsförsörjningen på högre nivåer i kommuner och regioner. Följeforskningen har genomförts inom Samhällskontraktet som är ett regionalt samverkansavtal mellan Eskilstuna kommun, Västerås stad, Region Sörmland, Region Västmanland och Mälardalens högskola. Projektet har haft sin hemvist i samverkansområdet Framtidens arbetsliv och de medverkande forskarna är anknutna till forskargruppen Hållbart arbetsliv vid akademin för hälsa, vård och välfärd vid högskolan.

So what?

Our Masters and PhD students within the field of work disability prevention are part of a global economy where challenges and commonalities between nations need to be addressed. International learning collaborations can facilitate student movement from theory (e.g. about different social security systems) to praxis, through interactive knowledge exchange amongst peers (Loisel et al, 2009).

An international on-line course can facilitate participation without the need for travel and additional related expenses is a way to foster student equity in higher education.

What is the innovation?

Our annual 10-week course, “What is fair? International perspectives on equity on work and health”, was first implemented in January 2019.

The course, based on cooperation between Mid-Sweden University, University of Waterloo and Mälardalen University in Sweden and Canada, provides the students with unique learning opportunities to work with international peers on course work and group activities while learning about international systems and policy in relation to health, work and equity.

Our partnership (with aims to expand) goes beyond the intention to provide an international learning environment; it also includes knowledge exchange between the universities. That is, the partnership includes co-operative development not only between faculty members, but also among pedagogical developers, international relations office administrators and librarians.

The outcome?

When we meet at the conference, we will have more to tell you about the specific course and experiences gained from faculty members, administrative members but foremost students who have undertaken the course.