| Barriers to good sickness certification -- an interview study with Swedish general practitioners. | |
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MedLine Citation:
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PMID: 18539695 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: To date, there is no gold standard for sick-listing practices, and physicians find sickness certification problematic. Measures have been taken to improve physician's sick-listing practices, but with ambiguous results. To be able to make such interventions effective, it is important to identify and target barriers to good practices. Our aim was to identify barriers preventing general practitioners (GPs) from sick-listing in the way they think is best. METHODS: Semi-structured individual interviews were carried out with 19 GPs in 17 primary healthcare centres in four central Swedish counties. Interview transcripts were analysed using qualitative content analysis to identify types of barriers to good sick-listing practices. RESULTS: Barriers within the healthcare system included: complexity of clinical judgements; the physician's competence - especially, poor skills in handling situations regarding conflicting perceptions of the need for sickness certification; the performance of other healthcare professionals; and deficiencies in the healthcare system itself. Barriers outside the healthcare system included: general attitudes to sick-listing and benefits; the labour-market situation; patients' social problems; and the performance of and collaboration with other stakeholders. CONCLUSIONS: GPs experienced a number of barriers to what they perceived to be good sick-listing practice. Such barriers need to be addressed in interventions for change. We propose communication skills training, with a special emphasis on difficult situations in sick-listing practice. |
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Authors:
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Malin S Swartling; Kristina A E Alexanderson; Rolf A Wahlstrom |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Scandinavian journal of public health Volume: 36 ISSN: 1403-4948 ISO Abbreviation: Scand J Public Health Publication Date: 2008 Jun |
Date Detail:
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Created Date: 2008-06-09 Completed Date: 2008-08-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100883503 Medline TA: Scand J Public Health Country: Sweden |
Other Details:
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Languages: eng Pagination: 408-14 Citation Subset: IM |
Affiliation:
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Department of Neurosciences, Rehabilitation Medicine, Uppsala University, Sweden. malin.swartling@rehab.uu.se |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Attitude of Health Personnel Clinical Competence Communication* Community Health Centers Family Practice* Humans Physician's Practice Patterns* Physician-Patient Relations* Physicians, Family / psychology Questionnaires Sick Leave* Sweden Work Capacity Evaluation |
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