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The association of patient's family, leisure time, and work situation with sickness certification in primary care in Sweden
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
2010 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 28, no 2, 76-81 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To investigate associations between patients’ family, leisure time and work related factors and physicians' measure whether or not to sickness certify the patient in connection with the consultation. Design: Questionnaire survey to physicians in general practice and their patients. Setting: General practitioners (GPs) and their patients in Örebro county, Sweden. Subjects: 474 patient-physician consultations from 65 physicians with up to ten patients each. Main outcome measure: Whether or not a sickness certificate was issued. Results: Among work related factors, high ‘authority over decisions’ and high "social support" correlated with 30% or more reduced sickness certification probability. Worrying about becoming ill or being injured from work correlates to almost doubled sickness certification risk. Among family and leisure time variables, only living with a common law partner and having no children correlated to increased sickness certification risk. In addition to analyses of the whole group (all diagnoses), the two largest diagnostic subgroups, infectious diseases and musculoskeletal diseases, were examined. For the infectious diseases subgroup, high demands in work correlated to increased sickness certification risk, while in the musculoskeletal diseases subgroup, worry about work related injury or illness was the main factor correlating to increased risk for sickness certification. Conclusions: Work related factors were the most important factors related to sickness certification in this study. Determinants for sickness certification risk differed between diagnostic subgroups.

Place, publisher, year, edition, pages
2010. Vol. 28, no 2, 76-81 p.
Keyword [en]
Family medicine, sick leave, work capacity, work strain, work demands, authority over decisions, social support
National Category
Family Medicine
Research subject
Family Medicine
Identifiers
URN: urn:nbn:se:uu:diva-120555DOI: 10.3109/02813431003765265ISI: 000279026600003PubMedID: 20429740OAI: oai:DiVA.org:uu-120555DiVA: diva2:303567
Projects
Försäkringsmedicin
Available from: 2010-03-13 Created: 2010-03-13 Last updated: 2017-12-12Bibliographically approved
In thesis
1. To be or not to be Sick Certified with Special Reference to Physician and Patient Related Factors
Open this publication in new window or tab >>To be or not to be Sick Certified with Special Reference to Physician and Patient Related Factors
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Objectives The aim of this thesis was to assess the importance of general practitioners (GP) and patient related factors for the GPs’ decision to sick certify or not to sick certify the patients.

Study population and methods The data were obtained from a cross-sectional questionnaire study of GP-patient consultations. 65 GPs responded to one questionnaire about themselves and one questionnaire about each of the altogether 642 consultations. The patients responded to a questionnaire about themselves and the consultation, altogether 521 consultations. Various combinations of the three questionnaires were used in the four papers on which this thesis is based.

Results Among GPs, long experience of family medicine and working part-time were significant determinants for issuing more sick leave certificates. Complaints perceived as clearly somatic by the physician decreased the chance of sick certifications, and complaints resulting in severe limitation of occupational work capacity, as assessed by the patient as well as the physician, increased the chance of sick certification, as did appointments for loco-motor complaints. Among work related factors, high ‘authority over decisions’ and high ‘social support’ were associated with reduced sickness certification probability. Worrying about illness or injury risks from work increased sickness certification. GPs and their patients took a fairly similar view to statements on health related and insurance system related matters. GPs’ opinions seem to have a greater impact than patients’ on the GPs’ decision to sickness certify a patient or not.

Conclusions A number of patient and GP related factors were associated with the probability of getting sick certified. The patient’s own judgement of impaired work ability was important for sickness certification, but a shared judgement and decision between the GP and the patient appears probable in most cases.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2010. 80 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 535
Keyword
sick leave, absenteeism, primary care, family medicine, consultation, professional competence, work capacity, work strain, work demands, authority over decisions, social support, attitude.
National Category
Family Medicine
Research subject
Family Medicine
Identifiers
urn:nbn:se:uu:diva-120559 (URN)978-91-554-7747-9 (ISBN)
Public defence
2010-05-03, Wilandersalen, M-huset, Universitetssjukhuset, Örebro, 13:15 (Swedish)
Opponent
Supervisors
Projects
Försäkringsmedicin
Available from: 2010-04-09 Created: 2010-03-14 Last updated: 2010-04-09Bibliographically approved

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