MA Thesis: Interventions for prevention of occupational psychosocial damage – Study of psychosocial risk evaluation

 

  • Author: Mihaela Rozman
  • Supervisor: Dr. Miroljub Ignjatović
  • Publisher: University of Ljubljana
  • Location, and date: Ljubljana, 2015
  • 331.101.3:159.944(043.3)
  • COBISS.SI-ID 33782877

Psychosocial risk management is a challenge for organizations across European Union (EU-OSHA 2015b). The challenges are observed by the costs of psychosocial damage not only for individual, but also for the organizations and social systems of states (Leka et Jain 2010, OECD 2015a). It is argued, that the damage can be diminished and prevented with systematic management of psychosocial risks, derived from work characteristics and organizational contexts (Chambel et al 2013, Saksvik et al 2015). Through analysis of international and European regime, and research findings across disciplinary fields, we evaluate a framework used for management of such risks (Nielsen et al 2013) in a context of higher education institutions in Austria (Clark 1983, Hochschild 2003). We propose modifications of the framework, with implications for national policies and institutional processes.

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Draft Summary

The master thesis in its six chapters, on 151 pages and with 213 pieces of literature used, focuses on the macro and miso changes in the work environment, influencing the micro level, of emotional and cognitive demands on the side of the individual. This intersection is linked with the occupational stress (Demerouti et al 2001, DG/HCP EU 2004, Dollard and Gordon 2014), connecting the concepts of the wellbeing, organization of work, and the social system of the states. The main question leading the research was: What are the mechanisms, which can be deployed by the individual and the organization, if and when the psychosocial hazards, affecting the bipolar wellbeing-line, are determined? The gap in the academic literature on implementation and evaluation of interventions for occupational psychosocial health, has been the reason for developing a research in the process of psychosocial risk management cycle at a higher education institution in Austria.

The main theoretical perspective, which has the potential for a change on the side of the individuals and the organizations, is the social construction of wellbeing in occupational setting (Griffiths and Schabracq 2003, Wainwright 2007, Edgell 2012). The main premise lies on determination of the changed socio-economic conditions of work context and work characteristics in the modern economy (Ertel et al 2010, Gallagher et al 2001, Hochschild 2003, Hohnen et al 2014), where the analysis of research from psychology, organizational behavior, social work, management and occupational health, allowed us to point out the prevailing discourse of emotionally and cognitively engaged individual as the prerequisite for productivity on the work place. However, it is not a coincidence that through the establishment of the mentioned discourse, the academic research in the field of occupational psychosocial risks has been gaining the momentum (Wharton 1999, Weber and Jaekel-Reinhard 2000, Konrad 2006, Hochschild 2003, Carod-Artal and Vazquez-Cabrera 2013).

Therefore in the first and second chapter, we present how the intersections between the social and economic spheres of society were always influencing the field of health and management of work. The review of the literature on stress and burnout, their psychological and medical symptomatic, allows us to link the management of psychosocial content and context of work, directly to not only the emotional, but also cognitive wellbeing of the employees. Issues such as anxiousness, depression, burnout, and reduced capacities in decision making and concentration (Harris in drugi 2002, O’Driscoll in Cooper 2002, Faragher in drugi 2005, Jensen in drugi 2010, Leka in Jain 2010), have been taken on also by international and European actors, when observing the costs to the productivity of organizations and to the national welfare systems (OECD 2015a, EU-OSHA 2015b).

The third chapter deals with the management of work in organizations, where the dynamic between the individual behavior and characteristics of work environment has been the illusive field of health interventions (Borritz at al 2006, Innanen 2014). This gap in the academic research, between the numerous implemented interventions, and the lack of their technical reliability and evaluation of their effectiveness (Cordes in Dougherty 1993, Cox 1997, Nielsen 2000, Toppinen-Tanner in drugi 2002, Burke in Richardsen 2003, Griffiths in Schabracq 2003, Murphy 2003, Bourbonnais in drugi 2006, Borritz in drugi 2006, Alli 2008, Blache in drugi 2011, Maslach in drugi 2012, Zanko in Dawson 2012, Hätinen in drugi 2013, Nielsen in Randall 2013, Väänänen in drugi 2014), is the main focus of the fourth chapter.

The fifth chapter serves for setting standards in occupational health interventions proposed by governmental and private authorities in the field of management of health and safety (WHO, ILO, ISO, EU). At the same time, it narrows down the scope of the case study, introducing the reasons for applying the research in the sector of education (ESENER-I and ESENER-II) (EU-OSHA and Eurofound 2014), in Austria (Korunka 2013). Building on the conclusions of the previous chapters, only one model was determined to uphold the principles needed for a successfully implemented cycle of psychosocial intervention. This was model for Participatory Interventions from an Organizational Perspective – PIOP, developed by Nielsen et al 2013.

In the sixth chapter, we apply the validated model PIOP to the longitudinal process of psychosocial risks evaluation in the case study institution (Wittek et al 2007). The methods of the empirical study were mixed. They encompassed longitudinal observation, reconstruction of communication as proposed by Luhmann (1987, 1997), stakeholder analysis (Clark 1983, Mintzberg 1985), and structured observational qualitative interviews, coupled with analysis of aggregated quantitative data from BASA II (analysis of the tool).

While applying the model to the case study, we could determine the mismatch between the cros-sectional analysis of qualitative and quantitative data, and the implemented actions in the organization compared with the model PIOP. We proposed a modification of PIOP model when it comes to the role of a project champion. We could show, that the success of the intervention will be scarce. We proposed concrete actions to make the model work for the setting and how important is the social architecture of the working place, in determining the mechanisms for safeguarding the psychosocial wellbeing.

The limitation of the study is the longitudinal process of the evaluation, which did not come through the whole cycle of intervention until the thesis was published. However, the qualitative interviews did show, that the managerial notions of how to manage an institution as a social system have transdisciplinary qualities, which was the repeated loop by which the model PIOP is an appropriate tool for interventions of such kind. Additionally, it could be argued that the one case scenario is not representative pattern. Once again, due to the field of the research, where concrete actions can not follow simple “best case scenario” paradigm, together with the usage of a validated tool, the case study has given a necessary insight in the “black box” of institutional decision making, and consequently process management.

Summary Literature

Alli, Benjamin O. 2008. Fundamental principles of occupational health and safety. Geneva: International Labour Organization.

Blache, Joëlle, Adriana Borza, Kylene De Angelis, Elisabeth Frankus, Giulio Gabbianelli, Christian Korunka, Tim Scholze, Maren Satke, Sara Tement, Tanja Wehr, Niels Christian F. Vestergaard and Cristina Zdrehus. 2011. BOIT – Burnout Intervention Training for Managers and Team Leaders: A practice report, ed. Elisabeth Frankus. Wien: Die Berater.

Borritz, M., R. Rugulies, K. B. Christensen, E. Villadsen and T. S. Kristensen. 2006. Burnout as a Predictor of Self-Reported Sickness Absence among Human Service Workers: Prospective Findings from Three Year Follow up of the PUMA Study. Occupational and Environmental Medicine 63 (2):98-106.

Bourbonnais, R., C. Brisson, A. Vinet, M. Vezina, B. Abdous and M. Gaudet. 2006. Effectiveness of a Participative Intervention on Psychosocial Work Factors to Prevent Mental Health Problems in a Hospital Setting. Occupational and Environmental Medicine 63 (5):335-342.

Burke, Ronald J. and Astrid M. Richardsen. 2003. Organizational-level interventions designed to reduce occupational stressors IN Coping, Health and Organizations, ed, Philip Dewe, Michael Leiter in Tom Cox, 195-214. London in New York: Taylor in Francis.

Carod-Artal, Francisco Javier and Carolina Vázquez-Cabrera 2013. Burnout Syndrome in an International Setting. IN Burnout for Experts: Prevention in the Context of Living and Working, ed, Sabine Bährer-Kohler, 15-35. New York: Springer.

Chambel, M. Jose, M. Depolo, J. Flintrop, E. G. Cobaleda, D. Gugliemi, J. Hellgren, A. Jain, G. Keclund, C. Korunka, A. L. Luiz, S. Leka, P. Lindfors, L. Lorente, M. Milczarek, K. Nielsen, J. M. Peiro, D. R. Kouabenan, M. Sverke, F. Violante and  J. Yeves. 2013. International yearbook on psychosocial risk prevention and quality of life at work, ur. Marisa Rufino San José, Evaluation development of psychosocial risks in Europe: The state of scientific research and Institutional experiences. Jaén, Spain: Occupational Secretary of Labour Health and Environment UGT-CEC.

Clark, R. Burton. 1983. The higher education system: Academic Organization in Cross-National Perspective. Berkley in Los Angeles: University of California Press.

Cordes, Cynthia L. and Thomas W. Dougherty. 1993. A Review and an Integration of Research on Job Burnout. The Academy Of Management Review 18 (4):621-656.

Cox, Tom. 1997. Workplace health promotion. Work & Stress: An International Journal of Work, Health & Organizations 11 (1):1-5.

Demerouti, Evangelia, Arnold B. Bakker, Friedhelm Nachreiner and Wilmar B. Schaufeli. 2001. The Job Demands-Resources Model of Burnout. Journal of Applied Psychology 86 (3):499-512.

DG/HCP, EU. 2004. The State of Mental Health in the European Union: European Communities. Available at:  http://ec.europa.eu/health/archive/ph_projects/2001/monitoring/fp_monitoring_2001_frep_06_en.pdf (1.9.2015).

Dollard, Maureen F. and Jacqueline A. Gordon. 2014. Evaluation of a Participatory Risk Management Work Stress Intervention. International Journal of Stress Management 21 (1):27-42.

Edgell, Stephen. 2012. The historical transformation of work IN The Sociology of Work: Continuity and Change in Paid and Unpaid Work, 1-30. London: SAGE Publications Ltd.

Ertel, Michael, Ulrike Stilijanow, Segio Lavicoli, Elena Natali, Aditya Jain and Stevroula Leka. 2010. European social dialogue on psychosocial risks at work: Benefits and challenges. European Journal of Industrial Relations 16 (2):169-183.

EU-OSHA. 2015. ESENER-2 Summary. European Agency for Safety and health at Work. Available at: https://osha.europa.eu/en/surveys-and-statistics-osh/esener (1.9.2015).

EU-OSHA. 2015b. Healthy Workplace Manage Stress 2014-2015. Available at: https://osha.europa.eu/sites/default/files/causes-perception-of-work-related-stress-infographic1.png (1.9.2015).

EU-OSHA and Eurofound. 2014. Psychosocial risks in Europe: Prevalence and strategies for prevention. Luxembourg: Publications Office of the European Union. Dostopno pre Available at: https://osha.europa.eu/en/publications/reports/psychosocial-risks-eu-prevalence-strategies-prevention/view (1.9.2015).

EU-OSHA and European Risk Observatory. 2010. European Survey of Enterprises on New and Emerging Risks: Managing Safety and Health at Work, ed, Eusebio Rial Gonzales, William Cockburn and Xabier Irastorza. Luxemburg: European Agency for Safety and Health at Work.

Faragher, E. B., M. Cass and C. L. Cooper. 2005. The Relationship between Job Satisfaction and Health: A Meta-Analysis. Occupational and Environmental Medicine 62 (2):105-112.

Gallagher, Clare, Elsa Underhill and Malcom Rimmer. 2001. Occupational Health and Safety Management Systems: A Review of their Effectiveness in Securing Healthy and Safe Workplaces, ed, National Occupational Health and Safety Commission Sydney. Sydney: Commonwealth of Australia.

Griffiths, Amanda and Marc J. Schabracq. 2003. Work and Health Psychology as a Scientific Discipline: Facing the Limits of the Natural Science Paradigm. IN The Handbook of Work and Health Psychology, Second Edition, ed, Jaques A. M. Winnubst and Cary L. Cooper Marc J. Schabracq, 173-189. Chichester, UK: John Willey & Sons, LTD.

Harris, Claire, Kevin Daniels and Rob B. Briner. 2002. Using Cognitive Mapping for Psychosocial Risk Assessment. Risk Management 4 (3):7-21.

Hätinen, Marja, Anne Mäkikangas, Ulla Kinnunen and Mika Pekkonen. 2013. Recovery From Burnout During a One-Year Rehabilitation Intervention With Six-Month Follow-up: Associations With Coping Strategies. International Journal of Stress Management 20 (4):364-390.

Hochschild, Russell A. 2003. The Commercialization of Intimate Life. San Francisco and Los Angeles: University of California Press.

Hohnen, Pernille, Peter Hasle, Anne Helbo Jespersen and Christian Uhrenholdt Madsen. 2014. Hard Work in Soft Regulation: A Discussion of the Social Mechanisms in OHS Management Standards and Possible Dilemmas in the Regulation of Psychosocial Work Environment. Nordic journal of working life studies 4 (3):13-30.

Innanen, Hely. 2014. Occupational Well-being. The Role of Areas of Worklife and Achievement and Social Strategies. Department of Psychology Univeristy of Jyväskylä, Jyväskylä.

Jensen, H. K., J. Wieclaw, T. Munch-Hansen, A. M. Thulstrup and J. P. Bonde. 2010. Does dissatisfaction with psychosocial work climate predict depressive, anxiety and substance abuse disorders? A prospective study of Danish public service eployees. Journal of Epidemiology and Community Health 64 (9):796-801.

Konrad, Alison M. 2006. Engaging Employees Through High-Involvement Work Practices. Ivey Business Journal. Available at: http://iveybusinessjournal.com/topics/the-workplace/engaging-employees-through-high-involvement-work-practices#.UqC4QMQ9qSo (1.9.2015).

Korunka, Christian. 2013. The evaluation of psychosocial risks. Case studies and experiences from Austria. IN International yearbook on psychosocial risk prevention and quality of life at work, ed, Marisa Rufino San José. Jaén, Spain: Occupational Secretary of Labour Health and Environment UGT-CEC.

Leka, Stavroula, Amanda Griffiths and Tom Cox. 2003. Work Organisation & Stress: Systematic Problem Approaches for Employers, Managers and Trade Union Representatives. IN Protecting workers’ health series; 3, ed, Stavroula Leka. Geneva: World Health Organization.

Luhmann, Niklas. 1987. Soziale Systeme: Grundriß einer allgemeinen Theorie Suhrkamp-Taschenbuch Wissenschaft 666. Frankfurt am Main: Suhrkamp.

Luhmann, Niklas. 1997. Die Gesellschaft der Gesellschaft. Frankfurt am Main Suhrkamp Verlag.

Maslach, Christina, Michael P. Leiter and Susan E. Jackson. 2012. Making a significant difference with burnout interventions: Researcher and practitioner collaboration. Journal of Organizational Behavior 33 (2):296-300.

Mintzberg, Henry. 1985. The organization as political arena. Journal of Management Studies 22 (2):133-154.

Murphy, Lawrence R. 2003. Stress Management at Work: Seconary Prevention of Stress. IN The Handbook of Work and Health Psychology, Second Edition, ed, Marc J Schabracq, Jaques A. M. Winnubst and Cary L. Cooper, 533-548. Chichester, UK: John Willey & Sons, LTD.

Nielsen, Klaus T. 2000. Organization theories implicit in various approaches to OHS management. IN Systematic Occupational health and safety management. Perspectives on an international development, ed, Per Langaa Jensen, Kaj Frick, Michael Quinlan and Ton Wilthagen, 99-123. Oxford: Pergamon Press.

Nielsen, Karina and R. Randall. (2013). Opening the black box: presenting a model for evaluating organizational-level interventions. European Journal of Work and Organizational Psychology 22(5): 601-617.

Nielsen, Karina, Maria Stage, Johan Simonsen Abildgaard and Charlotte V. Brauer. 2013. Participatory Intervention from an Organizational Perspective: Employees as Active Agents in Creating a Healthy Work Environment. IN Salutogenic organizations and change, ed, Georg T. Bauer and Gregor J. Jenny, 327-350. Netehrlands: Springer Netherlands.

OECD. 2015a. Mental health. Available at: http://www.oecd.org/els/health-systems/mental- health.htm (1.9.2015).

O’Driscoll, Michael P. and Cary L. Cooper. 2002. Job-related stress and burnout. IN Psychology at Work, ed, P. Warr. London, England: Penguin Group.

Toppinen-Tanner, Salla, Raija Kalimo and Pertti Mutanen. 2002. The Process of Burnout in White-Collar and Blue-Collar Jobs: Eight-Year Prospective Study of Exhaustion. Journal of Organizational Behavior 23 (5):555-570.

Zanko, Michael and Patric Dawson. 2012. Occupational Health and Safety Management in Organizations: A Review. International Journal of Management Reviews 14:328-344.

Väänänen, Ari, Michael Murray and Anna Kuokkanen. 2014. The growth and the stagnation of work stress: Publication trends and scientific representations 1960-2011. History of the Human Sciences 27 (4):116-138.

Wainwright, David. 2007. The Changing Face of Medical Sociology. IN A sociology of health, 1-19. London: SAGE Publications Ltd.

Weber, A. and A. Jaekel-Reinhard. 2000. Burnout syndrome: a disease of modern societies? Occupational Medicine 50 (7):512-517.

Wharton, Amy S. 2009. The Sociology of Emotional Labor. Annual Review of Sociology 35:147-165.

Wittek, Rafael, Uwe Schimank and Thomas Groß. 2007. Governance – A Sociological Perspective. V New Forms of Governance in Research Organizations: Disciplinary Approaches, Interfaces and Integration, ed, Dorothea Jensen, 71-106. Netherlands: Springer Netherlands.

WHO (Mediterranean, World Health Organization. Regional Office for the Eastern). 2012. Health education: theoretical concepts, effective strategies and core competencies: a foundation document to guide capacity development of health educators. Cairo: World Health Organization. Regional Office for the Eastern Mediterranean.

Alli, Benjamin O. 2008. Fundamental principles of occupational health and safety. Geneva: International Labour Organization.

Blache, Joëlle, Adriana Borza, Kylene De Angelis, Elisabeth Frankus, Giulio Gabbianelli, Christian Korunka, Tim Scholze, Maren Satke, Sara Tement, Tanja Wehr, Niels Christian F. Vestergaard and Cristina Zdrehus. 2011. BOIT – Burnout Intervention Training for Managers and Team Leaders: A practice report, ed. Elisabeth Frankus. Wien: Die Berater.

Borritz, M., R. Rugulies, K. B. Christensen, E. Villadsen and T. S. Kristensen. 2006. Burnout as a Predictor of Self-Reported Sickness Absence among Human Service Workers: Prospective Findings from Three Year Follow up of the PUMA Study. Occupational and Environmental Medicine 63 (2):98-106.

Bourbonnais, R., C. Brisson, A. Vinet, M. Vezina, B. Abdous and M. Gaudet. 2006. Effectiveness of a Participative Intervention on Psychosocial Work Factors to Prevent Mental Health Problems in a Hospital Setting. Occupational and Environmental Medicine 63 (5):335-342.

Burke, Ronald J. and Astrid M. Richardsen. 2003. Organizational-level interventions designed to reduce occupational stressors IN Coping, Health and Organizations, ed, Philip Dewe, Michael Leiter in Tom Cox, 195-214. London in New York: Taylor in Francis.

Carod-Artal, Francisco Javier and Carolina Vázquez-Cabrera 2013. Burnout Syndrome in an International Setting. IN Burnout for Experts: Prevention in the Context of Living and Working, ed, Sabine Bährer-Kohler, 15-35. New York: Springer.

Chambel, M. Jose, M. Depolo, J. Flintrop, E. G. Cobaleda, D. Gugliemi, J. Hellgren, A. Jain, G. Keclund, C. Korunka, A. L. Luiz, S. Leka, P. Lindfors, L. Lorente, M. Milczarek, K. Nielsen, J. M. Peiro, D. R. Kouabenan, M. Sverke, F. Violante and  J. Yeves. 2013. International yearbook on psychosocial risk prevention and quality of life at work, ur. Marisa Rufino San José, Evaluation development of psychosocial risks in Europe: The state of scientific research and Institutional experiences. Jaén, Spain: Occupational Secretary of Labour Health and Environment UGT-CEC.

Clark, R. Burton. 1983. The higher education system: Academic Organization in Cross-National Perspective. Berkley in Los Angeles: University of California Press.

Cordes, Cynthia L. and Thomas W. Dougherty. 1993. A Review and an Integration of Research on Job Burnout. The Academy Of Management Review 18 (4):621-656.

Cox, Tom. 1997. Workplace health promotion. Work & Stress: An International Journal of Work, Health & Organizations 11 (1):1-5.

Demerouti, Evangelia, Arnold B. Bakker, Friedhelm Nachreiner and Wilmar B. Schaufeli. 2001. The Job Demands-Resources Model of Burnout. Journal of Applied Psychology 86 (3):499-512.

DG/HCP, EU. 2004. The State of Mental Health in the European Union: European Communities. Available at:  http://ec.europa.eu/health/archive/ph_projects/2001/monitoring/fp_monitoring_2001_frep_06_en.pdf (1.9.2015).

Dollard, Maureen F. and Jacqueline A. Gordon. 2014. Evaluation of a Participatory Risk Management Work Stress Intervention. International Journal of Stress Management 21 (1):27-42.

Edgell, Stephen. 2012. The historical transformation of work IN The Sociology of Work: Continuity and Change in Paid and Unpaid Work, 1-30. London: SAGE Publications Ltd.

Ertel, Michael, Ulrike Stilijanow, Segio Lavicoli, Elena Natali, Aditya Jain and Stevroula Leka. 2010. European social dialogue on psychosocial risks at work: Benefits and challenges. European Journal of Industrial Relations 16 (2):169-183.

EU-OSHA. 2015. ESENER-2 Summary. European Agency for Safety and health at Work. Available at: https://osha.europa.eu/en/surveys-and-statistics-osh/esener (1.9.2015).

EU-OSHA. 2015b. Healthy Workplace Manage Stress 2014-2015. Available at: https://osha.europa.eu/sites/default/files/causes-perception-of-work-related-stress-infographic1.png (1.9.2015).

EU-OSHA and Eurofound. 2014. Psychosocial risks in Europe: Prevalence and strategies for prevention. Luxembourg: Publications Office of the European Union. Dostopno pre Available at: https://osha.europa.eu/en/publications/reports/psychosocial-risks-eu-prevalence-strategies-prevention/view (1.9.2015).

EU-OSHA and European Risk Observatory. 2010. European Survey of Enterprises on New and Emerging Risks: Managing Safety and Health at Work, ed, Eusebio Rial Gonzales, William Cockburn and Xabier Irastorza. Luxemburg: European Agency for Safety and Health at Work.

Faragher, E. B., M. Cass and C. L. Cooper. 2005. The Relationship between Job Satisfaction and Health: A Meta-Analysis. Occupational and Environmental Medicine 62 (2):105-112.

Gallagher, Clare, Elsa Underhill and Malcom Rimmer. 2001. Occupational Health and Safety Management Systems: A Review of their Effectiveness in Securing Healthy and Safe Workplaces, ed, National Occupational Health and Safety Commission Sydney. Sydney: Commonwealth of Australia.

Griffiths, Amanda and Marc J. Schabracq. 2003. Work and Health Psychology as a Scientific Discipline: Facing the Limits of the Natural Science Paradigm. IN The Handbook of Work and Health Psychology, Second Edition, ed, Jaques A. M. Winnubst and Cary L. Cooper Marc J. Schabracq, 173-189. Chichester, UK: John Willey & Sons, LTD.

Harris, Claire, Kevin Daniels and Rob B. Briner. 2002. Using Cognitive Mapping for Psychosocial Risk Assessment. Risk Management 4 (3):7-21.

Hätinen, Marja, Anne Mäkikangas, Ulla Kinnunen and Mika Pekkonen. 2013. Recovery From Burnout During a One-Year Rehabilitation Intervention With Six-Month Follow-up: Associations With Coping Strategies. International Journal of Stress Management 20 (4):364-390.

Hochschild, Russell A. 2003. The Commercialization of Intimate Life. San Francisco and Los Angeles: University of California Press.

Hohnen, Pernille, Peter Hasle, Anne Helbo Jespersen and Christian Uhrenholdt Madsen. 2014. Hard Work in Soft Regulation: A Discussion of the Social Mechanisms in OHS Management Standards and Possible Dilemmas in the Regulation of Psychosocial Work Environment. Nordic journal of working life studies 4 (3):13-30.

Innanen, Hely. 2014. Occupational Well-being. The Role of Areas of Worklife and Achievement and Social Strategies. Department of Psychology Univeristy of Jyväskylä, Jyväskylä.

Jensen, H. K., J. Wieclaw, T. Munch-Hansen, A. M. Thulstrup and J. P. Bonde. 2010. Does dissatisfaction with psychosocial work climate predict depressive, anxiety and substance abuse disorders? A prospective study of Danish public service eployees. Journal of Epidemiology and Community Health 64 (9):796-801.

Konrad, Alison M. 2006. Engaging Employees Through High-Involvement Work Practices. Ivey Business Journal. Available at: http://iveybusinessjournal.com/topics/the-workplace/engaging-employees-through-high-involvement-work-practices#.UqC4QMQ9qSo (1.9.2015).

Korunka, Christian. 2013. The evaluation of psychosocial risks. Case studies and experiences from Austria. IN International yearbook on psychosocial risk prevention and quality of life at work, ed, Marisa Rufino San José. Jaén, Spain: Occupational Secretary of Labour Health and Environment UGT-CEC.

Leka, Stavroula, Amanda Griffiths and Tom Cox. 2003. Work Organisation & Stress: Systematic Problem Approaches for Employers, Managers and Trade Union Representatives. IN Protecting workers’ health series; 3, ed, Stavroula Leka. Geneva: World Health Organization.

Luhmann, Niklas. 1987. Soziale Systeme: Grundriß einer allgemeinen Theorie Suhrkamp-Taschenbuch Wissenschaft 666. Frankfurt am Main: Suhrkamp.

Luhmann, Niklas. 1997. Die Gesellschaft der Gesellschaft. Frankfurt am Main Suhrkamp Verlag.

Maslach, Christina, Michael P. Leiter and Susan E. Jackson. 2012. Making a significant difference with burnout interventions: Researcher and practitioner collaboration. Journal of Organizational Behavior 33 (2):296-300.

Mintzberg, Henry. 1985. The organization as political arena. Journal of Management Studies 22 (2):133-154.

Murphy, Lawrence R. 2003. Stress Management at Work: Seconary Prevention of Stress. IN The Handbook of Work and Health Psychology, Second Edition, ed, Marc J Schabracq, Jaques A. M. Winnubst and Cary L. Cooper, 533-548. Chichester, UK: John Willey & Sons, LTD.

Nielsen, Klaus T. 2000. Organization theories implicit in various approaches to OHS management. IN Systematic Occupational health and safety management. Perspectives on an international development, ed, Per Langaa Jensen, Kaj Frick, Michael Quinlan and Ton Wilthagen, 99-123. Oxford: Pergamon Press.

Nielsen, Karina and R. Randall. (2013). Opening the black box: presenting a model for evaluating organizational-level interventions. European Journal of Work and Organizational Psychology 22(5): 601-617.

Nielsen, Karina, Maria Stage, Johan Simonsen Abildgaard and Charlotte V. Brauer. 2013. Participatory Intervention from an Organizational Perspective: Employees as Active Agents in Creating a Healthy Work Environment. IN Salutogenic organizations and change, ed, Georg T. Bauer and Gregor J. Jenny, 327-350. Netehrlands: Springer Netherlands.

OECD. 2015a. Mental health. Available at: http://www.oecd.org/els/health-systems/mental- health.htm (1.9.2015).

O’Driscoll, Michael P. and Cary L. Cooper. 2002. Job-related stress and burnout. IN Psychology at Work, ed, P. Warr. London, England: Penguin Group.

Toppinen-Tanner, Salla, Raija Kalimo and Pertti Mutanen. 2002. The Process of Burnout in White-Collar and Blue-Collar Jobs: Eight-Year Prospective Study of Exhaustion. Journal of Organizational Behavior 23 (5):555-570.

Zanko, Michael and Patric Dawson. 2012. Occupational Health and Safety Management in Organizations: A Review. International Journal of Management Reviews 14:328-344.

Väänänen, Ari, Michael Murray and Anna Kuokkanen. 2014. The growth and the stagnation of work stress: Publication trends and scientific representations 1960-2011. History of the Human Sciences 27 (4):116-138.

Wainwright, David. 2007. The Changing Face of Medical Sociology. IN A sociology of health, 1-19. London: SAGE Publications Ltd.

Weber, A. and A. Jaekel-Reinhard. 2000. Burnout syndrome: a disease of modern societies? Occupational Medicine 50 (7):512-517.

Wharton, Amy S. 2009. The Sociology of Emotional Labor. Annual Review of Sociology 35:147-165.

Wittek, Rafael, Uwe Schimank and Thomas Groß. 2007. Governance – A Sociological Perspective. V New Forms of Governance in Research Organizations: Disciplinary Approaches, Interfaces and Integration, ed, Dorothea Jensen, 71-106. Netherlands: Springer Netherlands.

WHO (Mediterranean, World Health Organization. Regional Office for the Eastern). 2012. Health education: theoretical concepts, effective strategies and core competencies: a foundation document to guide capacity development of health educators. Cairo: World Health Organization. Regional Office for the Eastern Mediterranean.

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