Dip Raj Thapa
School of Health Sciences
Dip Raj Thapa defends his thesis "A Health-promotive Approach to Maintain and Sustain Health in Women-dominated Work in Nepal and Sweden".
The dissertation is held in Room G110, G-building at the University of Skövde, but will also be livestreamed on Zoom.
Work-related health is a global concern. Work-related adverse health outcomes, such as burnout, fatigue, depression, sleep disturbances, and long-term sickness absence, are evident in women-dominated work, especially within the nursing occupation. These challenges are accompanied by an increasing population of elderly people and a shortage of nursing personnel. Health-promotive actions and interventions are needed to maintain and sustain health in women-dominated work.
The overall aim of this thesis was to identify means for promoting and sustaining health in women-dominated work in Nepal and Sweden through the evaluation and exploration of sense of coherence (SOC), work-related health, job demands, job resources, and health outcomes.
This thesis included five different Papers. Paper I is a community-based intervention study conducted in Nepal. 857 women before and 1268 after health education intervention in Nepal responded to a translated version of the SOC-13 questionnaire in Nepali. Papers II and III are based on 19 individual interviews with nurses in Nepal. Paper IV is based on 13 individual interviews with midwives and nurses in Sweden. Paper V is a quantitative study that was derived from the Swedish Longitudinal Occupational Survey of Health (SLOSH), with data from 1114 participants.
The results of this thesis showed that women in semi-urban Nepal exhibited total SOC mean values between 51.1 and 57.4. Health education strengthened women’s SOC. Considering the qualitative validation and the language translation, the participants experienced easy to medium difficulty in completing the SOC-13 questionnaire, and some items were confusing. Therefore, further development of SOC-13 questionnaire in Nepali through the language editing was done. The nursing professionals in Nepal and Sweden reported that their work-related health was strengthened through collegial support, teamwork, and opportunities for skills and competence development. Shift work, lack of rewards and appreciation from managers, high patient ratios, fewer staff, and high workloads affected their work-related health negatively. In particular, nurses in Nepal experienced a lack of a safe physical work environment, as well as insufficient managerial support. The nursing professionals’ job demands were associated with lower self-rated health, higher burnout, and higher sickness absence, while job resources were associated with higher self-rated health and lower burnout.
This thesis shows that the SOC-13 questionnaire is useful and qualitatively validated for future research in the Nepalese context. Health education can be useful in strengthening SOC. To maintain, promote, and sustain health in women-dominated work, a health-promotive approach should be fostered. Nursing professionals’ health can be strengthened and sustained through the development of a positive work environment through high staff-patient ratios, good collegial, organizational, and managerial support, offering skills and competence development opportunities, and creating a safe physical and psychosocial work environment.
Katarina Swahnberg, Professor, Linnaeus University
Anette Ekström-Bergström, Professor, University West
Alexandra Krettek, Professor, University of Skövde
Kristina Areskoug Josefsson, Professor, VID Specialized University, Sandnes, Norway
Maria Emmelin, Professor, Lund University
Jenny Hallgren, Senior Lecturer, University of Skövde
Håkan Nunstedt, Senior Lecturer, University West