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Healthcare and patient factors affecting sick leave : From a primary health care perspective

Carlsson, Lars (författare)
Uppsala universitet,Allmänmedicin och preventivmedicin
Wallman, Thorne, Docent (preses)
Uppsala universitet,Allmänmedicin och preventivmedicin
Hallqvist, Johan, Professor (preses)
Uppsala universitet,Allmänmedicin och preventivmedicin
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Gutavsson, Catharina, PhD (preses)
Uppsala universitet,Allmänmedicin och preventivmedicin
Janlert, Urban, Professor (opponent)
Umeå University, Department of Public Health and Clinical Medicine
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 (creator_code:org_t)
ISBN 9789151300269
Uppsala : Acta Universitatis Upsaliensis, 2017
Engelska 70 s.
Serie: Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, 1651-6206 ; 1350
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)
Abstract Ämnesord
Stäng  
  • Background: For indeterminate reasons, there have been major variations in sick leave in Sweden, and many physicians have perceived sick leave assignments as burdensome.Aim: To gain more knowledge and understanding, from a perspective of primary health care, about factors in health care and patients that affect sick leave. Thereby help patients in the best way, facilitate the work of physicians and other health professionals involved in the rehabilitation process, and use the health care resources optimally.Methods: This thesis is based on a randomised controlled trial (RCT) in a primary health care centre with participants on short-term sick leave, due to pain and/or mental illness, who received a multidisciplinary assessment. Qualitative focus-group discussions with physicians in primary health care centres. A cohort of women on very long-term sick leave due to pain and/or mental illness, who lost sickness benefits due to a new time limit on sickness insurance, were randomised to multidisciplinary assessment and multimodal intervention (TEAM), or to Acceptance and Commitment Therapy (ACT). In an extended cohort, including some men on very long-term sick leave due to pain and/or mental illness, the importance of the motivation for return to work (RTW) was investigated.Results. Very early multidisciplinary assessment increased days on sick leave in the first three month period. Physicians at primary health care centres perceived sick leave assignments as burdensome, but clearer rules and cooperation with other professionals have made sick leave assignments less burdensome. TEAM intervention resulted in an increase in working hours per week as well as an increase in work-related engagements, compared to control in the RCT. Motivation for RTW was associated with RTW or increased employability in the rehabilitation of patientsConclusions: Continued studies are needed to find those who are at risk of long-term sick leave, the time when rehabilitation efforts should be started, and the content of rehabilitation. Collaboration in teams facilitates sick leave assignments for physicians at primary care health centres. Motivation for RTW might be a factor of importance for the effect of rehabilitation and needs to be studied further.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Allmänmedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- General Practice (hsv//eng)

Nyckelord

Sick leave
rehabilitation
return to work
primary health care
randomised controlled trial
focus-group discussions
motivation
Allmänmedicin
Family Medicine

Publikations- och innehållstyp

vet (ämneskategori)
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