PurposeThe aim of the study was to understand the social and organisational factors in the workplace that shape managers' actions and attitudes towards workers with repeated short-term sickness absence.Design/methodology/approachThis was a qualitative interview study. Semi-structured interviews were conducted with 19 managers at 15 different workplaces. The analysis had an abductive approach, using thematic analysis which focused on the latent content of managers attitudes towards employees with repeated short-term sickness absence.FindingsResults indicate that the managers' views of people on short-term sick leave shift and move through several phases, which was analysed as they were acts in a play, where their given roles are prescribing which actions to take given the available resources for acting these parts. These acts depict an increasingly controlling attitude, where the sick leave is ultimately seen as an individual problem best managed by repressive tactics.Originality/valueRole theory offers the possibility to analyse managers' attitudes and behaviours by considering the workplace and the manager-employee relationship as regulated by norms and organisational factors.

Purpose Sickness absence has been identified as needing to be addressed through multilevel interventions, but knowledge regarding optimal design and implementation of such interventions is scarce. The aim of this study was to evaluate the implementation and effects of a large-scale multilevel intervention in the public sector in Sweden. Methods The overall effect of the intervention was assessed using mixed-effect models. Sickness absence data (before, and 6 or 12 months after the intervention) for 90 intervention groups and 378 reference groups was retrieved from administrative personnel systems from the two participating regional councils. The implementation processes were evaluated using qualitative content analysis of qualitative interviews conducted at two timepoints. Results The results show that the vast majority of implemented measures were on an individual level and the integration of the intervention differed between the two regions. The reception and perception of the intervention activities seem to have been influenced by the implementation process, and how well the interventions were communicated and integrated, both regarding the integration of the different interventions and their integration into the discrete context and existing routines. No short-term overall effects on sickness absence were found. Conclusions The results point to the many challenges in implementing complex interventions, especially where organizational measures are involved—including adequate participation by, and communication between, the involved actors, as well as sufficient resources. The results indicate potential learning effects regarding the awareness of organizational factors in sick leave, after implementing and integrating multilevel strategies.

The overarching aim of this thesis was to explore social norms in relation to work and its influence on individuals' actions and mindsets. This has been done through four empirical studies which investigated the work norm from three different perspectives: 1) the work norm in practice, through the actions of individuals on sick leave during their rehabilitation process and in relation to the system and the actors within the system, as well as managers actions within their organisations; 2) exploring perceptions of the work norm in terms of socialisation to working life and structural changes; 3) a comparative exploration of the work norm between different contexts. This thesis focuses on our relationship to work and what possible consequences it might entail. It draws upon the concepts of structure and agency, which are seen as interrelated, where the structure precedes agency, in turn shaping actions through reflexivity. The actions of the individual then either reshape or maintain the current structure . The structure is made up by formal and informal institutions, that is the formal rules and laws as well as the norms, beliefs and values within a society. The empirical data in this thesis has been derived from individuals on sick leave, managers, and young adults in Sweden and The Netherlands. The groups studied can be seen to differ in relation to the work norm. This provides a nuanced empirical material, allowing the work norm, that can be both elusive and prominent, to be noticed and captured.