How GPs in Norway conceptualise functional ability: a focus group study

Krohne, Kariann; Brage, Sören

doi:10.3399/bjgp08x376131

Cited by 34 publications

(41 citation statements)

References 11 publications

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“…The type of disease was most important for prognosis of work ability in the short and long term [15]. In a focus group study, PHC physicians conceptualised functioning as a physical, mental, and social ability, but in clinical practice they emphasised physical ability [24]. The results in our study show that the component of the body was dominating in the total certificates.…”

Section: According To Icf Functioning Is Conceptualised As Consequenmentioning

confidence: 63%

Description of functioning in sickness certificates

Nilsing

Söderberg

Normelli

et al. 2011

Scand J Public Health

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Aims. Sickness certificates are to provide information on a disease and its consequences on the patient's functioning. This information has implications for the patient's rights to sickness benefits and return to work measures. The objective of this study was to investigate the description of functioning in sickness certificates according to WHO's International Classification of Functioning, Disability, and Health (ICF), and to describe the influence of patients' age, gender, diagnostic group, and affiliation of certifying physician. Method. A content analysis of written statements regarding how the disease limits the patient's

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Section: According To Icf Functioning Is Conceptualised As Consequenmentioning

confidence: 63%

Description of functioning in sickness certificates

Nilsing

Söderberg

Normelli

et al. 2011

Scand J Public Health

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show abstract

“…Yet, how this complex decision-making process is conducted and which values, incentives and obstacles influence it, has hardly been investigated. There is some indication that doctors tend to underestimate the importance of health-related everyday life issues for older patients [10-12] mainly due to the influence of the biomedical paradigm [13,14]. We want to explore whether this position and other reasons define the perception of importance and affect the determination of treatment priorities.…”

Section: Introductionmentioning

confidence: 99%

What is important, what needs treating? How GPs perceive older patients’ multiple health problems: a mixed method research study

et al. 2012

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BackgroundGPs increasingly deal with multiple health problems of their older patients. They have to apply a hierarchical management approach that considers priorities to balance competing needs for treatment. Yet, the practice of setting individual priorities in older patients is largely unexplored. This paper analyses the GPs’ perceptions on important and unimportant health problems and how these affect their treatment.MethodsGPs appraised the importance of health problems for a purposive sample of their older patients in semi-structured interviews. Prior to the interviews, the GPs had received a list of their patients’ health problems resulting from a geriatric assessment and were asked to rate the importance of each identified problem. In the interviews the GPs subsequently explained why they considered certain health problems important or not and how this affected treatment. Data was analysed using qualitative content analysis and quantitative methods.ResultsThe problems GPs perceive as important are those that are medical and require active treatment or monitoring, or that induce empathy or awareness but cannot be assisted further. Unimportant problems are those that are well managed problems and need no further attention as well as age-related conditions or functional disabilities that provoke fatalism, or those considered outside the GPs’ responsibility. Statements of professional actions are closely linked to explanations of important problems and relate to physical problems rather than functional and social patient issues.ConclusionsGPs tend to prioritise treatable clinical conditions. Treatment approaches are, however, vague or missing for complex chronic illnesses and disabilities. Here, patient empowerment strategies are of value and need to be developed and implemented. The professional concepts of ageing and disability should not impede but rather foster treatment and care. To this end, GPs need to be able to delegate care to a functioning primary care team.Trial RegistrationGerman Trial Register (DRKS): 00000792

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“…2009; Von Knorring et al . 2008; Krohne and Brage 2007, 2008; Löfgren et al . 2007; Mowlam and Lewis 2005).…”

Section: Introductionmentioning

confidence: 99%

“…Researchers and physicians responsible for illness certification have criticized this assumption extensively (Engblom et al 2009(Engblom et al , 2010Krohne and Brage 2008;Von Knorring et al 2008;Löfgren et al 2007; Krohne and Brage 2007;Bollag et al 2007;Meershoek et al 2007;De Boer and Houwaart 2006;Mowlam and Lewis 2005;Söderberg and Alexanderson 2003;Hussey et al 2000;Stone 1984). They have argued that a person's incapacity to work cannot be solely deduced from that person's medical condition.…”

Section: Introductionmentioning

confidence: 99%

Controlling Access to Sick Leave Programmes: Practices of Physicians in the Netherlands

Meershoek

2011

Soc Policy Adm

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Policymakers in industrialized countries attempt to contain the costs of sick leave and disability schemes by limiting access to include medically proven cases only. However, a person's incapacity to work cannot be fully deduced by referring to his or her medical condition. It is the question whether using more restrictive eligibility criteria that focus on medical evidence actually reduces the number of benefit recipients and makes access to employee benefit arrangements fairer. This ethnographic study shows that physicians working in Dutch illness certification practices use alternative methods to restrict access to sick leave programmes. Doctors do not control their clients in a restrictive sense of the word. Rather, they exercise control over their clients by inciting them to internalize norms about being active and responsible. While we do not claim that this is good per se, we do contend that this control style may have some advantages over and above more restrictive control mechanisms. Elaborating on policy that supports this alternative notion of control, therefore, seems worthwhile.

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How GPs in Norway conceptualise functional ability: a focus group study

Cited by 34 publications

References 11 publications

Description of functioning in sickness certificates

Description of functioning in sickness certificates

What is important, what needs treating? How GPs perceive older patients’ multiple health problems: a mixed method research study

Controlling Access to Sick Leave Programmes: Practices of Physicians in the Netherlands

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