McKevitt C, Morgan M, Dundas R, Holland W W
Department of Public Health Medicine, United Medical School, London.
J Public Health Med. 1997 Sep;19(3):295-300. doi: 10.1093/oxfordjournals.pubmed.a024633.
Few studies have investigated occupational groups reporting low rates of sickness absence because of an assumption that these rates indicate low morbidity. This is inconsistent with the view that sickness absence, which may be caused by social and psychological rather than medical factors, does not equate with morbidity. This paper investigates rates of sickness absence and factors influencing decisions not to take sick leave among doctors and a comparative professional group.
A postal survey was sent to 670 general practitioners (GPs), 669 hospital doctors and 400 company 'fee earners'. Qualitative interviews were conducted with 64 doctors reporting an illness lasting one month or more in the last three years.
Self-reported health status was similar for both groups but GPs reported higher levels of occupational stress. However, doctors were significantly less likely to report short periods of sick leave in the previous year. Over 80 per cent of all respondents had 'worked through' illness, citing cultural and organizational factors behind their decision not to take sick leave. Barriers to sick leave among doctors included the difficulty of arranging cover and attitudes to their own health.
Considerable emphasis has been given to the role of social factors in contributing to rates of sickness absence. These may also contribute to the decision not to take sick leave, resulting in possible inappropriate non-use. Measures to encourage and enable doctors to take sick leave might improve the management of their own health.
由于假定低病假率表明低发病率，很少有研究调查报告低病假率的职业群体。这与以下观点不一致，即病假可能由社会和心理而非医学因素引起，并不等同于发病率。本文调查了医生和一个对比职业群体的病假率以及影响不请病假决定的因素。
向670名全科医生（GPs）、669名医院医生和400名公司“收费员”发送了邮政调查问卷。对64名报告在过去三年中患有一种持续一个月或更长时间疾病的医生进行了定性访谈。
两组自我报告的健康状况相似，但全科医生报告的职业压力水平更高。然而，医生在前一年报告短期病假的可能性显著更低。超过80%的受访者“带病工作”，并指出他们不请病假决定背后的文化和组织因素。医生请病假的障碍包括安排替班的困难以及对自身健康的态度。
社会因素在导致病假率方面的作用已得到相当大的重视。这些因素也可能导致不请病假的决定，从而可能导致不适当的不使用病假。鼓励并使医生能够请病假的措施可能会改善他们自身健康的管理。
