Ljungquist Therese, Alexanderson Kristina, Kjeldgård Linnea, Arrelöv Britt, Nilsson Gunnar H
Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Sweden
Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Sweden.
Scand J Public Health. 2015 Feb;43(1):35-43. doi: 10.1177/1403494814558151. Epub 2014 Nov 12.
To study whether occupational health physicians (OPs) have a better work situation regarding handling of sickness certification compared with other physicians, in particular general practitioners (GPs), and to analyze associations between OPs' experiences of assessing and providing a long-term prognosis of patients' work capacity and some potentially interrelated factors.
Answers to a nationwide survey from physicians who had sickness certification consultations at least once monthly were analyzed. Differences among OPs (n=481), GPs (n=4257) and physicians working in other clinical settings (n=9452) were estimated by chi square tests. Associations between OPs' experiences as above and potentially interrelated factors were estimated using logistic regression analyses.
Among OPs, a lower proportion experienced clinical work situations related to sickness certifications as 'very problematic', compared with the other physicians, and especially so compared with GPs. A higher proportion of OPs also had organizational support for handling sickness certifications. For OPs, experience of sickness certification consultations as problematic once a month or less often, not experiencing sickness certification tasks as a work environment problem, and having a well-established workplace policy regarding sickness certification matters were significantly positively associated with finding assessing and providing a long-term prognosis of work capacity as 'not at all/somewhat problematic'.
OPs' work situation regarding sickness certifications was favorable compared with that of other physicians, and especially compared with that of GPS. Our results underline the importance of organizational support for ensuring physicians' experience of having professional competence in handling assessments of patients' work capacity.
研究职业健康医生(OPs)在疾病证明处理方面的工作状况是否比其他医生,特别是全科医生(GPs)更好,并分析OPs对患者工作能力进行评估和提供长期预后的经验与一些潜在相关因素之间的关联。
分析了对每月至少进行一次疾病证明咨询的医生进行的全国性调查的答案。通过卡方检验估计职业健康医生(n = 481)、全科医生(n = 4257)和在其他临床环境中工作的医生(n = 9452)之间的差异。使用逻辑回归分析估计上述OPs的经验与潜在相关因素之间的关联。
与其他医生相比,职业健康医生中认为与疾病证明相关的临床工作情况“非常成问题”的比例较低,与全科医生相比尤其如此。职业健康医生中也有更高比例的人在处理疾病证明方面得到组织支持。对于职业健康医生来说,每月或更少次数经历有问题的疾病证明咨询、不将疾病证明任务视为工作环境问题以及有关于疾病证明事项的完善工作场所政策,与认为评估和提供工作能力的长期预后“完全/有点没问题”显著正相关。
与其他医生相比,职业健康医生在疾病证明方面的工作状况较好,与全科医生相比尤其如此。我们的结果强调了组织支持对于确保医生在处理患者工作能力评估方面具有专业能力体验的重要性。