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Repeated short-term sick-leave and quality of life: An evaluation of a clinical socio-medical intervention
Linköpings universitet, Institutionen för hälsa och samhälle, Socialmedicin och folkhälsovetenskap. Linköpings universitet, Hälsouniversitetet.
Linköpings universitet, Institutionen för medicin och hälsa, Socialmedicin och folkhälsovetenskap. Linköpings universitet, Hälsouniversitetet.
Linköpings universitet, Institutionen för hälsa och samhälle, Socialmedicin och folkhälsovetenskap. Linköpings universitet, Hälsouniversitetet.
Linköpings universitet, Institutionen för hälsa och samhälle, Socialmedicin och folkhälsovetenskap. Linköpings universitet, Hälsouniversitetet.
1990 (Engelska)Ingår i: Scandinavian Journal of Social Medicine, ISSN 1403-4948, Vol. 18, nr 2, s. 91-95Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

The primary aim of this study was to evaluate a clinical socio-medical supportive program for repeated short-term sickleavers who exhibited no evident reason for their prolonged absence. Attention was drawn to changes in the quality of life of the participants. Ninety-nine persons took part in the full program. The sex distribution was even and the mean age was 32 years. The average number of days of sick-leave during the year preceding the entrance into the program was 28. The most common self-stated diagnosis was upper respiratory infection or gastro-intestinal problems. The evaluation showed a significant change for the better in the quality of life and well-being of the patients, although more than every other patient did not explicitly attribute any personal benefit to the intervention itself. The results coincide irrespective of measuring method and, are by and large, consistent over most areas of life and components of well-being assessed. Thus the design and the results of the evalution look very promising concerning reliability, validity and especially sensitivity. A corresponding model may be applicable more generally when evaluating health- and medical care.

Ort, förlag, år, upplaga, sidor
1990. Vol. 18, nr 2, s. 91-95
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
URN: urn:nbn:se:liu:diva-81537DOI: 10.1177/140349489001800202OAI: oai:DiVA.org:liu-81537DiVA, id: diva2:553268
Tillgänglig från: 2012-09-18 Skapad: 2012-09-18 Senast uppdaterad: 2012-09-18Bibliografiskt granskad
Ingår i avhandling
1. Integrating perspectives in social medicine
Öppna denna publikation i ny flik eller fönster >>Integrating perspectives in social medicine
2002 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

In this thesis sickness absence was studied from a socio-medical perspective using both epidemiological and clinical data and methods of analysing. The specific aim of the epidemiological studies was to analyse sickness absence patterns and its changes in the total population of Östergötland. Furthermore, variations with gender, age and occupation were analysed. Gender trends in sickness absence concerning musculoskeletal diagnoses, its changes from 1985 to 1987 and association of numerical gender segregation in occupational categories with sickness absence due to musculoskeletal diagnoses was also investigated.

The specific aim of the clinical studies was to estimate the frequency and character of psycho-social problems in a population with repeated short-term sickness absence. A clinical socio-medical supportive program for this patient-group was assessed. Finally, the vocational activity, program costs and possible benefits to society of a clinical, socio-medical case management program was evaluated.

The results showed that women had much higher sickness absence than men generally and in particular in male-dominated occupational categories. The cumulative incidence percentage of siclmess absence in all diagnoses increased for both genders from 1985 to 1987. There were large variations between different occupational categories; blue-collar occupations were high-risk for sickness absence while white-collar occupations were low risk.

Women had higher cumulative incidence than men in musculoskeletal diagnoses and also longer duration of sick leave days per sick leave insured person and per sick-listed person. The cumulative incidence for the diagnostic sub-group "neck/shoulder diagnoses" showed the highest percentage increase from 1985-87. The cumulative incidence in all musculoskeletal diagnostic groups was highest for both genders in extremely male-dominated occupational categories (>90% men).

The study of repeated short-tenn sick leave showed that the underlying reasons were less medical and more of a socio-medical origin for 2/3 of the patients in comparison with an age- and sex-matched sample of patients at the general practitioner's surgery in the same area. A majority of patients, who had taken part in a socio-medical supportive program reported a better quality of life, although they did not specifically ascribe this to the socio-medical intervention.

When investigating the long-term economic effect of a clinical case management program for patients with chronic minor disease, the benefit-cost ratio of the program was 4.9. Fifty per cent of the patients had been absent from working life for more than two years on admission to the program. The rehabilitation rate of patients back to work was 20.5% after one year and 11 .7% after five years.

Ort, förlag, år, upplaga, sidor
Linköping: Linköpings universitet, 2002. s. 61
Serie
Linköping University Medical Dissertations, ISSN 0345-0082 ; 754
Nationell ämneskategori
Samhällsvetenskap
Identifikatorer
urn:nbn:se:liu:diva-26341 (URN)10865 (Lokalt ID)91-7373-199-4 (ISBN)10865 (Arkivnummer)10865 (OAI)
Disputation
2002-11-20, Berzeliussalen, Hälsouniversitetet, Linköping, 13:00 (Svenska)
Opponent
Tillgänglig från: 2009-10-08 Skapad: 2009-10-08 Senast uppdaterad: 2012-09-18Bibliografiskt granskad

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