Background: There has been a major shift in the organization and responsibility for the provision of geriatric care in Sweden. This was believed to be stressful. We therefore decided to launch a controlled intervention program on health care personnel aimed at enhancing their adaptation and ability to cope. The purpose of this study was to assess the impact of management change on psychosocial parameters of health care personnel and the effects, if any, of a structured intervention program. Methods: Two separate wards were randomly allocated to be either intervention (I) or control (C) ward. The I-ward personnel were subjected to a psychologist’s structured 10-session intervention program for 20 weeks. The program consisted of an initial educational part followed by a practical problem-solving discussion part. A structured questionnaire on psychosocial issues was answered by the participants before (0 weeks), immediately after (20 weeks), and 10 weeks after the intervention (30 weeks). Results: There were no significant changes in the psychosocial parameters of the C-ward personnel. In the I-ward, however, there was a significant increase in work demand as well as in positive feelings about work, as compared to the C-ward at the 30-week follow-up. There was also significantly better work comfort in the I-ward. Conclusions: We did not find any anticipated negative psychosocial effects on health care personnel undergoing an organizational change. However, by offering a structured intervention program to one group of health care personnel, we found some positive psychosocial effects. Future research is needed to pinpoint which factor or factors in the intervention program were the most crucial for the effects to occur.

Sauter SL, Hurrell JJ Jr, Cooper CL (eds): Job Control and Worker Health. New York, Wiley, 1989.
Moore JD Jr: Morale hits new low. Mod Health Care 1995;11:52–57.
Arnetz BB: Techno stress: A prospective psychophysiological study of the impact of a controlled stress-reduction program in advanced telecommunication systems design work. J Occup Environ Med 1996;38:53–65.
Parker SK, Chmiel N, Wall TD: Work characteristics and employee well-being within a context of strategic downsizing. J Occup Health Psychol 1997;2:289–303.
Vahtera J, Kivimäki M, Pentti J: Effects of organizational downsizing on health of employees. Lancet 1997;350:1124–1128.
Sykes W: Some principles of personnel and organizational change; in French WL, Bell CH, Zawachi RA (eds): Organization Development: Theory, Practice and Research. Homewood, Irwin, 1989, pp 456–458.
Jackson PR, Wall TD: How does operator control enhance performance of advanced manufacturing technology? Ergonomics 1991;34:1301–1311.
Strebel P: Why do employees resist change? Harvard Bus Rev 1996;74:86–92.
Levi L: Unemployment and health – An introduction. Special issue on unemployment and health. Soc Sci Med 1987;25:101–103.
Morris JK, Cook DG, Shaper AG: Loss of employment and mortality. BMJ 1994;308:1135–1139.
Regeringens proposition 1990/91:14 om ansvaret för service och vård till äldre och handikappade (The Swedish Government’s proposition for responsibility of service and care for elderly and handicapped). Stockholm, Riksdagen, 1990.
Folkman S, Lazarus RS: If it is changes it must be a process: Study of emotion and coping during three stages of a college examination. J Pers Soc Psychol 1987;48:150–170.
Lazarus RS: Psychological stress and the coping process. New York, McGraw-Hill, 1996.
Constable JF, Russel WR: The effects of social support and the work environment upon burn-out among nurses. J Hum Stress 1985;1:20–26.
Karasek R, Theorell T: Healthy work. New York, Basic Books, 1990.
Folkman S, Lazarus RS: Coping and emotion; in Monat A, Lazarus RS (eds): Stress and Coping. An Anthology. New York, Columbia University Press, 1991.
Lökk J: Effects on health care personnel undergoing an organizational change. Health Soc Care 1995;2:370–373.
Azrin NH: A strategy for applied research: Learning based but outcome oriented. Am Psychol 1997;32:140–149.
Levi L (ed): Emotions – Their Parameters and Measurements. New York, Raven Press, 1975.
Arnetz JE, Arnetz BB: The development and application of a patient satisfaction measurement system for hospital-wide quality improvement. Int Qual Health Care 1996;8:555–566.
Petterson I-L, Arnetz B, Arnetz J: Predictors of job satisfaction and job influence – Results from a national sample of Swedish nurses. Psychother Psychosom 1995;64:9–19.
Theorell T: Personal control at work and health: A review of epidemiological studies in Sweden; in Steptoe A, Appels A (eds): Stress, Personal Control and Health. New York, Wiley, 1989.
Petterson I-L, Arnetz B: Measuring psychosocial work quality and health: Development of health care measures of measurement. J Occup Health Psychol 1997;2:1–13.
Karasek RA: Job demands, job decision latitude and mental strain. Implications for job redesign. Adm Sci Q 1979;24:285–307.
Theorell T, Ahlberg-Hulthén G, Sigala F, Perski A, Söderholm M, Kallner A, Eneroth P: A psychosocial and biomedical comparison between men in six contrasting service occupations. Work Stress 1990;4:51–63.
Lökk J: Emotional and social effects of a controlled intervention study in a daycare unit for elderly patients. Scand J Primary Health Care 1990;8:165–172.
Theorell T, Ahlberg-Hultén G, Jodko M, Sigala F, de la Torre B: Influence of job strain and emotion on blood pressure in female hospital personnel during workhours. Scand J Work Environ Health 1993;19:313–318.
Arnetz BB: Physicians’ view of their work environment and organisation. Psychother Psychosom 1997;66:155–162.
Karasek R: Lower health risk with increased job control among white-collar workers. J Occup Behav 1990;11:171–185.
Wahlstedt KGI, Edling C: Organizational changes at a postal sorting terminal – Their effects upon work satisfaction, psychosomatic complaints and sick leave. Work Stress 1997;11:279–291.
Jackson S: Participation in decision making as a strategy for reducing job related strain. J Appl Psychol 1983;78:3–19.
Jackson PR, Wall TD, Martin R, Davids K: New measures of job control, cognitive demand and production responsibility. J Appl Psychol 1993;78:753–762.
Bech P: Measurement of psychological distress and well-being. Psychother Psychosom 1990;54:77–89.
Parad H, Parad L: Crisis intervention: An introductory overview; in Parad H, Parad L (eds): Crisis Intervention Book 2. Milwaukee, Family Service America, 1990, pp 3–68.
Gitlow H, Gitlow S: The Deeming Guide to Quality and Competitive Position. Englewood Cliffs, Prentice-Hall, 1987, pp 140–152.
Herzberg F, Hamlin RM: The motivation-hygiene concept and psychotherapy. Ment Hyg 1963;47:384–397.
Ryff CD, Singer D: Psychological well-being: Meaning, measurement, and implications for psychotherpy research. Psychother Psychosom 1996;65:14–23.
Fava GA: Well-being therapy. Psychother Psychosom 1999;68:171–179.
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