Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2017

Open Access 01-12-2017 | Research article

Working in dissonance: experiences of work instability in workers with common mental disorders

Authors: Louise Danielsson, Monica Bertilsson, Kristina Holmgren, Gunnel Hensing

Published in: BMC Public Health | Issue 1/2017

Login to get access

Abstract

Background

Common mental disorders have a negative impact on work functioning, but less is known about the process when the functioning starts to destabilize. This study explores experiences of work instability in workers with common mental disorders.

Methods

A grounded theory study using a theoretical sampling frame, individual in-depth interviews and a constant comparative analysis conducted by a multidisciplinary research team. The sample involved 27 workers with common mental disorders, currently working full or part time, or being on sick leave not more than 6 months. They were women and men of different ages, representing different occupations and illness severity.

Results

A general process of work instability was conceptualized by the core category Working in dissonance: captured in a bubble inside the work stream. The workers described that their ordinary fluency at work was disturbed. They distanced themselves from other people at and outside work, which helped them to regain their flow but simultaneously made them feel isolated. Four categories described sub-processes of the dissonance: Working out of rhythm, Working in discomfort, Working disconnected and Working in a no man’s land.

Conclusions

The experience of work instability in CMDs was conceptualized as “working in dissonance”, suggesting a multifaceted dissonance at work, characterized by a sense of being caught up, as if in a bubble. Focusing on how the worker can re-enter their flow at work when experiencing dissonance is a new approach to explore in occupational and clinical settings.
Appendix
Available only for authorised users
Literature
1.
Kaila-Kangas L, Haukka E, Miranda H, Kivekäs T, Ahola K, Luukkonen R, et al. Common mental and musculoskeletal disorders as predictors of disability retirement among Finns. J Affect Disord. 2014;165:38–44.CrossRefPubMed
2.
Netterstrøm B, Eller NH, Borritz M. Prognostic factors of returning to work after sick leave due to work-related Common mental disorders: a one-and three-year follow-up study. Biomed Res Int. 2015;2015
3.
Siu AM, Hung A, Lam AY, Cheng A. Work limitations, workplace concerns, and job satisfaction of persons with chronic disease. Work. 2013;45(1):107–15.PubMed
4.
5.
Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, et al. Global burden of disease attributable to mental and substance use disorders: findings from the global burden of disease study 2010. Lancet. 2013;382(9904):1575–86.CrossRefPubMed
6.
OECD. Sick on the job? Myths and realities about mental health and work. Paris: OECD Publishing; 2012.
7.
National Collaborating Centre for Mental Health (UK). Common mental health disorders: identification and pathways to care. NICE Clinical Guidelines, no 123. Leicester: British Psychological Society; 2011.
8.
Smit F, Cuijpers P, Oostenbrink J, Batelaan N, de Graaf R, Beekman A. Costs of nine common mental disorders: implications for curative and preventive psychiatry. J Ment Health Policy Econ. 2006;9(4):193–200.PubMed
9.
Sanderson K, Andrews G. Common mental disorders in the workforce: recent findings from descriptive and social epidemiology. Can J Psychiatr. 2006;51(2):63–75.CrossRef
10.
Andersen MF, Nielsen KM, Brinkmann S. Meta-synthesis of qualitative research on return to work among employees with common mental disorders. Scand J Work Environ Health. 2012;38(2):93–104.CrossRefPubMed
11.
Bertilsson M, Petersson EL, Östlund G, Waern M, Hensing G. Capacity to work while depressed and anxious - a phenomenological study. Disabil Rehabil. 2013;35(20):1705–11.CrossRefPubMed
12.
Steingrímsdóttir SH, Halldórsdóttir S. Exacerbated vulnerability in existential changes: the essence of dealing with reduced working capacity. Int J Educ Vocat Guid. 2015;
13.
Hjarsbech PU, Nielsen MBD, Andersen MF, Rugulies R, Christensen U. Struggling at work - a qualitative study of working Danes with depressive symptoms. Disabil Rehabil. 2015;37(18):1674–82.CrossRefPubMed
14.
Dewa CS. Worker attitudes towards mental health problems and disclosure. Int J Occup Environ Med. 2014;5(4):175–86.PubMed
15.
Lau B, Victor M, Ruud T. Sickness absence and presence among employees in treatment for common mental disorders. Scand J Public Health. 2015;
16.
Arends I, van der Klink JJL, van Rhenen W, de Boer MR, Bültmann U. Predictors of recurrent sickness absence among workers having returned to work after sickness absence due to common mental disorders. Scand J Work Environ Health. 2014;40(2):195–202.CrossRefPubMed
17.
Law M, Cooper B, Strong S, Stewart D, Rigby P, Letts L. The person-environment-occupation model: a transactive approach to occupational performance. Can J Occup Ther. 1996;63(1):9–23.CrossRef
18.
Sandqvist JL, Henriksson CM. Work functioning: a conceptual framework. Work. 2004;23(2):147–57.PubMed
19.
Ekbladh E, Sandqvist J. Psychosocial factors’ influence on work ability of people experiencing sick leave resulting from Common mental disorders. Occup Ther Ment Health. 2015;31(3):283–97.CrossRef
20.
21.
van Hooff MLM, Taris TW. Let’s study how worker health affects the psychosocial work environment. Scand J Work Environ Health. 2014;40(5):437–40.CrossRefPubMed
22.
Gilworth G, Carey A, Eyres S, Sloan J, Rainford B, Bodenham D, et al. Screening for job loss: Development of a work instability scale for traumatic brain injury. Brain Inj. 2006;20(8):835–43.CrossRefPubMed
23.
Gilworth G, Chamberlain MA, Harvey A, Woodhouse A, Smith J, Smyth MG, et al. Development of a work instability scale for rheumatoid arthritis. Arthritis Care Res. 2003;49(3):349–54.CrossRef
24.
McFadden E, Horton MC, Ford HL, Gilworth G, McFadden M, Tennant A. Screening for the risk of job loss in multiple sclerosis (MS): Development of an MS-specific work instability scale (MS-WIS). Mult Scler J. 2012;18(6):862–70.CrossRef
25.
Gilworth G, Smyth G, Smith J, Tennant A. The development and validation of the office work screen. Occup Med. 2008;58(4):289–94.CrossRef
26.
Gilworth G, Smyth MG, Smith J, Tennant A. The manual work instability scale: Development and validation. Occup Med. 2016;66(4):300–4.CrossRef
27.
Charmaz K. ‘Discovering’ chronic illness: using grounded theory. Soc Sci Med. 1990;30(11):1161–72.CrossRefPubMed
28.
Charmaz K, Belgrave LL. Qualitative interviewing and grounded theory analysis. The SAGE handbook of interview research: the complexity of the craft; 2012. p. 347–66.
29.
Corbin JM, Strauss A. Grounded theory research: procedures, canons, and evaluative criteria. Qual Sociol. 1990;13(1):3–21.CrossRef
30.
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57.CrossRefPubMed
31.
Fuchs T, Schlimme JE. Embodiment and psychopathology: a phenomenological perspective. Curr Opin Psychiatry. 2009;22(6):570–5.CrossRefPubMed
32.
Organization WH. The ICD-10 classification of mental and behavioural disorders : clinical descriptions and diagnostic guidelines. Geneva: World Health Organization; 1992.
33.
Hjarsbech PU, Andersen RV, Christensen KB, Aust B, Borg V, Rugulies R. Clinical and non-clinical depressive symptoms and risk of long-term sickness absence among female employees in the Danish eldercare sector. J Affect Disord. 2011;129(1-3):87–93.CrossRefPubMed
34.
Bech P, Olsen LR, Kjoller M, Rasmussen NK. Measuring well-being rather than the absence of distress symptoms: a comparison of the SF-36 mental health subscale and the WHO-five well-being scale. Int J Methods Psychiatr Res. 2003;12(2):85–91.CrossRefPubMed
35.
Krieger T, Zimmermann J, Huffziger S, Ubl B, Diener C, Kuehner C, et al. Measuring depression with a well-being index: further evidence for the validity of the WHO well-being index (WHO-5) as a measure of the severity of depression. J Affect Disord. 2014;156:240–4.CrossRefPubMed
36.
Boeije H. A purposeful approach to the constant comparative method in the analysis of qualitative interviews. Qual Quant. 2002;36(4):391–409.CrossRef
37.
Malterud K. Qualitative research: standards, challenges, and guidelines. Lancet. 2001;358(9280):483–8.CrossRefPubMed
38.
Danielsson L, Rosberg S. Depression embodied: an ambiguous striving against fading. Scand J Caring Sci. 2015;29(3):501–9.CrossRefPubMed
39.
Jingrot M, Rosberg S. Gradual loss of homelikeness in exhaustion disorder. Qual Health Res. 2008;18(11):1511–23.CrossRefPubMed
40.
Nakamura J, Csikszentmihalyi M. The concept of flow. Flow and the foundations of positive psychology: the collected works of Mihaly Csikszentmihalyi; 2014. p. 239–63.
41.
Engeser S, Rheinberg F. Flow, performance and moderators of challenge-skill balance. Motiv Emot. 2008;32(3):158–72.CrossRef
42.
Fuchs T. Psychopathology of depression and mania: symptoms, phenomena and syndromes. J Psychopathol. 2014;20(4):404–13.
43.
Fuchs T. Depression, intercorporeality, and interaffectivity. J Conscious Stud. 2013;20(7-8):219–38.
44.
Bassett D, Bear N, Nutt D, Hood S, Bassett S, Hans D. Reduced heart rate variability in remitted bipolar disorder and recurrent depression. Aust N Z J Psychiatry. 2016;50(8):793–804.CrossRefPubMed
45.
Michalak J, Troje NF, Fischer J, Vollmar P, Heidenreich T, Schulte D. Embodiment of sadness and depression-gait patterns associated with dysphoric mood. Psychosom Med. 2009;71(5):580–7.CrossRefPubMed
46.
Knapstad M, Øverland S, Henderson M, Holmgren K, Hensing G. Shame among long-erm sickness absentees: correlates and impact on subsequent sickness absence. Scand J Public Health. 2014;42(1):96–103.CrossRefPubMed
47.
Bertilsson M, Löve J, Ahlborg G, Hensing G. Health care professionals’ experience-based understanding of individuals’ capacity to work while depressed and anxious. Scand J Occup Ther. 2015;22(2):126–36.CrossRefPubMed
48.
Holmgren K, Ivanoff SD. Women on sickness absence - views of possibilities and obstacles for returning to work. A focus group study. Disabil Rehabil. 2004;26(4):213–22.CrossRefPubMed
49.
Boström M, Holmgren K, Sluiter JK, Hagberg M, Grimby-Ekman A. Experiences of work ability in young workers: an exploratory interview study. Int Arch Occup Environ Health. 2016;89(4):629–40.CrossRefPubMed
50.
Bonde JPE. Psychosocial factors at work and risk of depression: a systematic review of the epidemiological evidence. Occup Environ Med. 2008;65(7):438–45.CrossRefPubMed
51.
Stansfeld SA, Fuhrer R, Head J. Impact of common mental disorders on sickness absence in an occupational cohort study. Occup Environ Med. 2011;68(6):408–13.CrossRefPubMed
52.
Charmaz K. The power of constructivist grounded theory for critical inquiry. Qual Inq. 2016;23(1):34–45.CrossRef
53.
Charmaz K. Constructivist grounded theory. J Positive Psychol. 2017;12(3):299–300.CrossRef
54.
Baker C, Wuest J, Stern PN. Method slurring: the grounded theory/phenomenology example. J Adv Nurs. 1992;17(11):1355–60.CrossRefPubMed
55.
Koopmans PC, Roelen CAM, Bültmann U, Hoedeman R, Van Der Klink JJL, Groothoff JW. Gender and age differences in the recurrence of sickness absence due to common mental disorders: a longitudinal study. BMC Public Health. 2010;10:426.CrossRefPubMedPubMedCentral
Metadata
Title
Working in dissonance: experiences of work instability in workers with common mental disorders
Authors
Louise Danielsson
Monica Bertilsson
Kristina Holmgren
Gunnel Hensing
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2017
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-017-4388-3

Other articles of this Issue 1/2017

BMC Public Health 1/2017 Go to the issue

Study protocol

Preventing diabetes in obese Latino youth with prediabetes: a study protocol for a randomized controlled trial

Research article

Perceptions of activity-supportive environment and motorcycle use among urban Taiwanese adults

Research article

Neighborhood-resources for the development of a strong SOC and the importance of understanding why and how resources work: a grounded theory approach

Research article

Please sir, I want some more: an exploration of repeat foodbank use

Research article

A qualitative analysis of smokers’ perceptions about lung cancer screening

Study protocol

A tailored online safety and health intervention for women experiencing intimate partner violence: the iCAN Plan 4 Safety randomized controlled trial protocol