"A powerful intervention: general practitioners'; use of sickness certification in depression"

BMC Family Practice

Research Article

Jill Morrison¹  Philip Wilson¹  Sara Macdonald¹  Will Whittaker²  Matt Sutton²  Michael Smith³  Margaret Maxwell⁴ 

[1] General Practice and Primary Care, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, 1, Horselethill Road, G12 9LX, Glasgow, UK;Health Economics, Health Sciences Research Group, School of Community Based Medicine, University of Manchester, Jean McFarlane Building, Oxford Road, M13 9PL, Manchester, UK;Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Gartnavel Royal Hospital, 1055 Great Western Road, G12 0XH, Glasgow, UK;Mental Health, Nursing, Midwifery and AHP Research Unit, University of Stirling, FK9 4LA, Stirling, UK;

关键词: Depression;    Mood disorder;    Primary care;    Occupational;    Environmental medicine;    Doctor-patient relationship;    Mental health;   

DOI  :  10.1186/1471-2296-13-82

 received in 2012-03-26, accepted in 2012-08-01,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundDepression is frequently cited as the reason for sickness absence, and it is estimated that sickness certificates are issued in one third of consultations for depression. Previous research has considered GP views of sickness certification but not specifically in relation to depression.This study aimed to explore GPs views of sickness certification in relation to depression.MethodsA purposive sample of GP practices across Scotland was selected to reflect variations in levels of incapacity claimants and antidepressant prescribing. Qualitative interviews were carried out between 2008 and 2009.ResultsA total of 30 GPs were interviewed. A number of common themes emerged including the perceived importance of GP advocacy on behalf of their patients, the tensions between stakeholders involved in the sickness certification system, the need to respond flexibly to patients who present with depression and the therapeutic nature of time away from work as well as the benefits of work. GPs reported that most patients with depression returned to work after a short period of absence and that it was often difficult to predict which patients would struggle to return to work.ConclusionsGPs reported that dealing with sickness certification and depression presents distinct challenges. Sickness certificates are often viewed as powerful interventions, the effectiveness of time away from work for those with depression should be subject to robust enquiry.

【 授权许可】

CC BY   
© Macdonald et al.; licensee BioMed Central Ltd. 2012