Exploring ethical issues arising from a problem-solving intervention in the Swedish Primary Care

Abstract Background Common mental disorders count for a large percentage of sick leave cases in Europe and in Sweden. Problem-solving with workplace involvement have shown promising results in reducing the number of sick leave days for employees on sick leave for these conditions. Engaging the workplace by for example including the first-line manager in the return-to-work process changes the usual role of the primary care. Hence, this study aims to explore ethical issues that potentially arise when introducing workplace involvement as part of a problem-solving intervention. Methods A qualitative study in the Swedish Primary Care using data from semi-structured interviews with rehabilitation coordinators (n = 6), employees on sick leave for common mental disorders (n = 13), and their first-line managers (n = 8). A theoretical framework for systematic identification of ethical aspects of healthcare technologies was used to guide the interviews and reporting of results. Content analysis was used to code the data, searching for latent content. Ethical issues related to the ethical values privacy, identity, autonomy, professional values, third party, equality and justice were identified and described. The analysis was concluded by a normative discussion. Results Ethical issues were identified such as difficulties for the employees to control personal information. A need to create an integrated role of a patient and an employee and for coordinators to act neutral instead of as a patient advocate. Managers needed to balance the needs of the organization with the needs of the employee. A pre-requisite for participation was agreeing to manager involvement which may affect the equality of the intervention. Conclusions A conversation about sharing of information, roles, responsibilities and expectations during the rehabilitation should be initiated early and be continuous. Managers need support in learning the “how to” when having an employee on sick leave due to a common mental disorder. Key messages The problem-solving intervention imposed ethical issues in regard to control over personal information and role shifting, which can be handled through discussions and awareness. By analysing ethical aspects and norms and values connected to the intervention, adaptations and solutions can be discussed and handled before full scale implementation.


ssessment of
parental burnout can support the screening of at-risk parents at early stages. Abstract citation ID: ckac130.209 Managing Minds at Work: development of a digital line manager training programme
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Mental ill health is the leading cause of sickness absence with high economic burden.Workplace interventions aimed at supporting employers with prevention of mental ill-health in the workforce are urgently required.Managing Minds at Work (MMW) is a digital intervention targeting support for line managers in any work setting to promote better mental health at work through a preventative approach.Objectives: To describe the design and development of the MMW digital training programme, prior to feasibility testing.We adopted a collaborative participatory design involving co-design (users as partners) and principles of user-centred design (pilot and usability testing).Agile methodology was used to co-

eate inte
vention content with a stakeholder community of practice.Development processes were mapped to core elements of the Medical Research Council (MRC) framework for developing and evaluating complex interventions.Results:The program covers five broad areas: (i) promoting self-care techniques among line managers; (ii) designing work to prevent work-related stress; (iii) management competencies to prevent and reduce stress; (iv) having conversations with employees about mental health; (v) building a psychologically safe work environment.Pilot and usability testing (n = 37 surveys) aligned with the Technology Acceptance Model (TAM) demonstrated that MMW was perceived to be useful, relevant, and easy to use by managers across sectors, organization types and sizes.We identified positive impacts on manager attitudes and behavioural intentions related to preventing mental ill-health and promoting good mental wellbeing at work.Conclusions:MMW is a digital training programme for line managers that has been co-created using rigorous development proc

ses and aims t
support employers with primary prevention in mental health.The next step is to explore the feasibility and acceptability of this intervention with line managers in diverse employment settings.Key messages:We used co-creation and participatory design to create Managing Minds at Work -a new digital interve

ion to suppo
t line managers in preventing mental ill-health at work.The next step is to explore the feasibility and acceptability of this intervention with line managers in diverse employment settings.

Background:

Common mental disorders count for a large percentage of sick leave cases in Europe and in Sweden.Problem-solving with workplace involvement have shown promising results in reducing the number of sick leave days for employees on sick leave for these conditions.Engaging the workplace by for example including the first-line manager in the return-to-work pro

Background:
Common mental disorders count for a large percentage of sick leave cases in Europe and in Sweden.Problem-solving with workplace involvement have shown promising results in reducing the number of sick leave days for employees on sick leave for these conditions.Engaging the workplace by for example including the first-line manager in the return-to-work process changes the usual role of the primary care.Hence, this study aims to explore ethical issues that potentially arise when introducing workplace involvement as part of a problemsolving intervention.

ss change
the usual role of the primary care.Hence, this study aims to explore ethical issues that potentially arise when introducing workplace involvement as part of a problemsolving intervention.


Methods:

A qualitative study in the Swedish Primary Care using data from semi-structured interviews with rehabilitation coordinators (n = 6), employees on sick leave for common mental disorders (n = 13), and their first-line managers (n = 8).A theoretical framework for systematic identification of ethical aspects of healthcare technologies was used to guide the interviews and reporting of results.Content analysis was used to code the data, searching for latent content.Ethical issues r

Methods:
A qualitative study in the Swedish Primary Care using data from semi-structured interviews with rehabilitation coordinators (n = 6), employees on sick leave for common mental disorders (n = 13), and their first-line managers (n = 8).A theoretical framework for systematic identification of ethical aspects of healthcare technologies was used to guide the interviews and reporting of results.Content analysis was used to code the data, searching for latent content.Ethical issues related to the ethical values privacy, identity, autonomy, professional values, third party, equality and justice were identified and described.The analysis was concluded by a normative discussion.

ated to t
e ethical values privacy, identity, autonomy, professional values, third party, equality and justice were identified and described.The analysis was concluded by a normative discussion.


Results:

Ethical issues were identified such as difficulties for the employees to control personal information.A need to create an integrated role of a patient and an employee and for coordinators to act neutral instead of as a patient advocate.Managers needed

Results:
Ethical issues were identified such as difficulties for the employees to control personal information.A need to create an integrated role of a patient and an employee and for coordinators to act neutral instead of as a patient advocate.Managers needed to balance the needs of the organization with the needs of the employee.A pre-requisite for participation was agreeing to manager involvement which may affect the equality of the intervention.

o balance the
needs of the organization with the needs of the employee.A pre-requisite for participation was agreeing to manager involvement which may affect the equality of the intervention.


Conclusions:

A conversation about sharing of information, roles, responsibilities and expectatio

Conclusions:
A conversation about sharing of information, roles, responsibilities and expectations during the rehabilitation should be initiated early and be continuous.Managers need support in learning the ''how to'' when having an employee on sick leave due to a common mental disorder.

during the re
abilitation should be initiated early and be continuous.Managers need support in learning the ''how to'' when having an employee on sick leave due to a common mental disorder.


Key messages:

The problem-solving intervention imposed ethical issues in regard to control over personal information and role shifting, which can be handled through discu

Key messages:
The problem-solving intervention imposed ethical issues in regard to control over personal information and role shifting, which can be handled through discussions and awareness.By analysing ethical aspects and norms and values connected to the intervention, adaptations and solutions can be discussed and handled before full scale implementation.
15th European Public Health Conference 2022 iii397