University of Oulu

Work-related well-being in the transformation of nursing home work

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Author: Mäkitalo, Jorma1,2,3
Organizations: 1University of Oulu, Faculty of Medicine, Department of Public Health Science and General Practice
2University of Helsinki, Center for Activity Theory and Developmental Work Research
3Merikoski Rehabilitation and Research Centre
Format: ebook
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 3.2 MB)
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Language: English
Published: 2005
Publish Date: 2005-06-13
Thesis type: Doctoral Dissertation
Defence Note: Academic Dissertation to be presented with the assent of the Faculty of Medicine, University of Oulu, for public discussion in the Auditorium 10 of Oulu University Hospital, on June 22nd, 2005, at 12 noon
Reviewer: Professor Gustav Wickström
Professor Jaakko Virkkunen


The purpose of this study was three-fold: to analyze how the work-relatedness of well-being has been constructed by the presently prevailing work stress approach, to develop better ways of conceptualizing the work-relatedness of well-being on the basis of cultural historical activity theory, and to test these new conceptualizations with empirical data from two nursing homes for the elderly.

An analysis of the development of work stress theory and previous studies of nursing homes showed that their foundations lie in the paradigmatic person–environment formulation which inhibits taking into account the activity of the individual, the changing of the work process and the specific context in which stress is experienced. With respect to work-related well-being two activity-theoretical hypotheses were developed: the object-dependedness of work-related emotions (object-dependent well-being) and the increased physical and psychological work load as a result of disturbances in the flow of work (disturbance load).

An empirical analysis of the historical development of the two nursing homes showed how the function of the nursing homes had changed several times and continued to do so. The analysis also suggested that changes in the work-related well-being of the employees followed the developmental phases of the work activity. The second empirical analysis showed how the employees’ explanatory models of both tiring- and strength- giving events were related to several historical, present and possible future aspects of the object of their work. Signs of individual motive development could be detected in the interviews. The third empirical analysis of videorecorded morning routine episodes showed how the current institutional script carried out by the employees collided with the residents’ own script resulting in resident resistance which increased the physical and psychological workload of the employees.

Focusing on disturbance load may uncover important sources of emotional distress and physical tiredness among employees. Understanding work-related well-being also as qualitatively developing object-dependent well-being points to the need to create a dialogue between the development of the collective activity and the object and motive development of individual employees.

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Series: Acta Universitatis Ouluensis. D, Medica
ISSN-E: 1796-2234
ISBN: 951-42-7767-8
ISBN Print: 951-42-7766-X
Issue: 837
Copyright information: © University of Oulu, 2005. This publication is copyrighted. You may download, display and print it for your own personal use. Commercial use is prohibited.