Sickness certification at oncology clinics: perceived problems, support, need for education and reasons for certifying unnecessarily long sickness absences

Bränström, Richard; Arrelöv, Britt; Gustavsson, Catharina; Kjeldgård, Linnea; Ljungquist, Therese; Nilsson, Gunnar; Alexanderson, Kristina

doi:10.1111/ecc.12104

Cited by 9 publications

(17 citation statements)

References 23 publications

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“…According to the Social Insurance Code in Sweden, patients must have an active disease, specified in a medical sickness certificate, in order to qualify for SA benefits (The Swedish Ministry of Health & Social Affairs, 2010). Although consultations for sickness certification are part of everyday clinical practice for oncologists, well‐established policies regarding collaboration with and referrals to other healthcare professionals involved in the sickness absence certification process are lacking (Bränström et al, 2014). Given our findings that comorbidity and high‐stage BC increased the risk that women would need long‐term SA after their diagnosis, a cohort of women who have both high‐stage BC and comorbidities should be studied prospectively to validate our findings.…”

Section: Discussionmentioning

confidence: 99%

Section: Implications For Research and Practicementioning

confidence: 99%

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Sickness absence and disability pension among swedish women prior to breast cancer relapse with a special focus on the roles of treatment and comorbidity

et al. 2020

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Objective We aimed to determine the longitudinal prevalence and the predictors of sickness absence (SA) and disability pension (DP) in breast cancer (BC) women who eventually developed relapse. Methods A total of 1293 BC women, who were ages 20–63 years, diagnosed between 1996 and 2011 and by 2016 had all developed relapse, were identified in Swedish registers and were followed from two years before to five years after their primary diagnosis, while they were relapse‐free. Annual prevalence of SA and DP was calculated. Logistic regression was used to estimate adjusted odds ratios (AOR) for long‐term SA (>30 days) at one (y1) and three (y3) years post‐diagnosis. Results Prevalence of long‐term SA was 68.1% in y1 and 16.3% in y5. Prevalence of DP progressively increased from 16.3% in y1 to 29.0% in y5. Predictors of long‐term SA included age <50 years (y1:AOR = 1.79 [1.39–2.29]), TNM stage III (y1:AOR = 1.54 [1.03‐2.31]; y3:AOR = 2.21 [1.32–3.72]), metastasis (y1:AOR = 1.64 [1.26–2.12]; y3:AOR = 1.51 [1.05–2.18]), comorbidity (y1:AOR = 2.41 [1.55–3.76]; y3 AOR = 4.62 [2.49–8.57]) and any combination of radiotherapy, chemotherapy and hormonal therapy (y1:AOR = 2.05–5.71). Conclusion Among BC women who later developed relapse, those who had higher stages of BC, had comorbidity and received neoadjuvant and/or adjuvant therapy were at significantly higher risk of needing long‐term SA after their diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Implications For Research and Practicementioning

confidence: 99%

Sickness absence and disability pension among swedish women prior to breast cancer relapse with a special focus on the roles of treatment and comorbidity

et al. 2020

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“…A slightly larger proportion of those with other SA diagnoses (81.9%) reported having experienced this encounter. In several studies, physicians report that regarding sickness certification of patients, it is problematic to assess patients work capacity, however, oncologist report this to a lesser extent than other physicians [43–45].…”

Section: Discussionmentioning

confidence: 99%

Experiences of positive encounters with healthcare professionals among women on long-term sickness absence due to breast cancer or due to other diagnoses: a nationwide survey

et al. 2019

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Background Experiences of encounters with professionals have been shown to influence return to work (RTW) among sickness absentees in general. The aim was to gain knowledge on experiences of encounters with healthcare professionals and the ability to RTW among women on long-term sickness absence (SA) due to breast cancer (BC) compared to among women on long-term SA due to other diagnoses. Methods Analyses of questionnaire data about experiences of encounters with healthcare professionals among 6197 women aged 19–65 years and on a SA spell lasting 4–8 months. Of those, 187 were on SA due to BC. Descriptive statistics and adjusted (for age, birth country, educational level, depressive symptoms) logistic regression analyses with 95% confidence intervals (CI) were conducted. Results About 95% in both groups of women stated that they had experienced positive encounters with healthcare, and a minority, about 20%, had experienced negative encounters. Four specific types of positive encounters had been experienced to a lesser extent by women with BC: “allowed me to take own responsibility” (odds ratio (OR) 0.6; 95% CI 0.4–0.8), “encouraged me to carry through my own solutions” (OR 0.5; 95% CI 0.4–0.7), “made reasonably high demands” (OR 0.6; 95% CI 0.4–0.9), and “sided with me/stood on my side” (OR 0.6; 95% CI 0.4–0.8). Among the women with BC, 46% stated that positive encounters promoted their ability to RTW compared to 56% among the others. Conclusion: Most of the women had experienced positive encounters and about half stated that positive encounters promoted their ability to RTW, although a slightly smaller proportion of the women with BC stated that. This study emphasizes that not only medical treatment but also encounters may influence the ability to RTW, something that is of clinical importance.

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“…Nevertheless, there may be local differences with regard to the training of communication skills. Maybe there are also differences with regard to implemented routines and joint policy concerning handling of work tasks related to sickness certification of patients [28, 29].…”

Section: Discussionmentioning

confidence: 99%

Respectful encounters from healthcare professionals and return to work among 9032 long-term sick-listed due to cancer or due to other diagnoses: results from a Swedish population-based survey

Månsson

Lynøe

Alexanderson

et al. 2019

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Purpose To examine whether experiences of positive respectful encounters and negative disrespectful encounters differ between sickness absentees with a cancer diagnosis and sickness absentees with other diagnoses, especially in relation to their ability to return to work (RTW). Methods A total of 9032 long-term sickness absentees in Sweden responded to a questionnaire (response rate 52%) about experiences of positive and negative encounters with healthcare professionals. The association between different types of such encounters and participants feeling respected or disrespected were calculated with population attributable risk with 95% confidence intervals (CI). The perceived impact on ability to RTW was also examined. Results Significantly, larger proportions among those who experienced a positive encounter and also felt respected stated that those encounters facilitated their ability to RTW, compared to those who experienced a positive encounter without feeling respected: among cancer absentees the difference in proportions were 21% (CI, 7–34) versus 50% (CI, 45–55); among absentees with other diagnoses 42% (CI, 37–47) versus 63% (CI, 61–64). Similar comparisons among sick-listed who experienced negative encounters indicated that also feeling disrespected impeded ability to RTW among a significantly larger proportion of those with other diagnoses [51% (CI, 48–54) versus 35% (CI, 31–39) of those not feeling disrespected]. Among cancer absentees, the corresponding proportions were 20% (CI, 9–30) versus 25% (CI, 9–41). Conclusions Compared to sickness absentees with other diagnoses, a larger proportion of cancer sickness absentees stated that they were facilitated by respectful encounters and not impeded by disrespectful encounters, regarding self-estimated ability to RTW. More research is needed to examine whether these differences can be associated with use of a patient-centered encountering approach.

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Sickness certification at oncology clinics: perceived problems, support, need for education and reasons for certifying unnecessarily long sickness absences

Cited by 9 publications

References 23 publications

Sickness absence and disability pension among swedish women prior to breast cancer relapse with a special focus on the roles of treatment and comorbidity

Sickness absence and disability pension among swedish women prior to breast cancer relapse with a special focus on the roles of treatment and comorbidity

Experiences of positive encounters with healthcare professionals among women on long-term sickness absence due to breast cancer or due to other diagnoses: a nationwide survey

Respectful encounters from healthcare professionals and return to work among 9032 long-term sick-listed due to cancer or due to other diagnoses: results from a Swedish population-based survey

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