liu.seSearch for publications in DiVA
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
A female lay perspective on health, disease, and sickness absence
Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
2001 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Knowledge about a female perspective on health and disease is important to understand what happens in e.g. the medical meeting. A deeper understanding for the phenomenon of health also has social and economic importance. In Sweden women account for about 60% of the long-term cases of sickness absence.

Aim: To explore and describe women's perceptions of health and disease and their accounts of sickness absence.

Methods: The chronic diseases mentioned by elderly women in an interview study are compared with those documented in their respective medical records (n=199). The prevalence of positive diagnoses, overall agreement, and the kappa-coefficient were calculated for each group of diagnoses. Semi-stmctnred interviews were conducted with 82 women who had been on sick leave (60 days or more) or who had disability pension. Sixty of these middle-aged women also carried out a Q-sort.

Results: The lowest overall agreement between the elderly women report during interviews and their medical records was observed for psychiatric diseases, followed by diseases of the gastrointestinal system. Poor chance-adjusted agreement was found concerning diseases of the gastrointestinal system and diseases of the skin (Paper I). Long-term sickness absence can be said to arise in three distinguishable "spaces": the workspace, the medical-legal space, and the mental space. In the beginning, the women were positive about sick leave as such, which they saw as an opportunity for physical rest. But as time went on, they came to regard sick leave as creating a vicious circle of new problems related to inactivity and isolation. Apart from this vicious circle and chronic physical impairments, certain conditions at the workplace, at the hospital, and the social insurance office transformed seemingly trivial sick leaves into long-term and irreversible sickness absences (Paper II). The women's accounts of being sickness absent contained interpretations of what had happened to them, how things were for the moment, and what they thought the future would bring. Three different accounts could be distinguished: the crisis, the breakpoint, and the migration. The perceptions of their own situation and especially what they thought about their future were associated with their feelings of power to initiative and well-being. The descriptions of life on sick leave are connected to a theory of "loss of work" (Paper III). For these women, to be able to get back to work was found to be equivalent to breaking away from the prospect of isolation and loneliness. Five actors were identified along with suggestions for their actions: the woman who is on sick leave herself, the employer, the health care provider, the social insurance official, and the shop-steward. It was found important to take oneself seriously and also to be taken seriously by others. The results are related to a theory of enduring and suffering (Paper IV). Six accounts representing different conceptions of health, illness, and medicine were identified and described (Paper V).

Conclusions: The results point to the importance of doing research from different perspectives, using different methods and different sources of information to obtain a deeper understanding of a complex phenomenon like health. Above all, the results presented in this thesis point to a large variation at the individual level in perceptions, which implies the need for care in, for example, the planning of rehabilitation programs. The results also highlight the point that sick leave without follow-up from work, health care, and the social insurance office might have negative consequences on health. Implications for practice are suggested along with proposals for future research.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet , 2001. , 68 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 699
Keyword [en]
sickness absence, sick leave, women, lay explanation models, phenomenology, interview, Q-methodology, account, health, vital goal, life plan, sense of coherence, prevention, rehabilitation, diagnosis, medical records, patients, medical decision making
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-28617Local ID: 13773ISBN: 91-7373-141-2 (print)OAI: oai:DiVA.org:liu-28617DiVA: diva2:249428
Public defence
2001-11-23, Administrationsbyggnadens aula, Universitetssjukhuset, Linköping, 09:00 (Swedish)
Opponent
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2012-08-23Bibliographically approved
List of papers
1. Patient-doctor Concordance in Elderly Women’s Self-reported Health and Medical Records
Open this publication in new window or tab >>Patient-doctor Concordance in Elderly Women’s Self-reported Health and Medical Records
2002 (English)In: Methods of Information in Medicine, ISSN 0026-1270, Vol. 41, no 2, 119-124 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To compare the chronic diseases mentioned by elderly women in an interview study with those documented in their respective medical records.

METHODS: The prevalence of positive diagnoses, overall agreement, and the kappa-coefficient were calculated for each group of diagnoses.

RESULTS: The lowest overall agreement was observed for psychiatric diseases, followed by diseases of the gastrointestinal system. Poor chance-adjusted agreement was found concerning diseases of the gastrointestinal system and diseases of the skin.

CONCLUSIONS: The results suggest that a main reason for discordance was that the elderly women feared "losing face" by reporting some diseases.

Keyword
diagnosis, women, medical records, patients, medical decision making
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-26291 (URN)12061118 (PubMedID)10807 (Local ID)10807 (Archive number)10807 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
2. A female lay perspective on the establishment of long-term sickness absence
Open this publication in new window or tab >>A female lay perspective on the establishment of long-term sickness absence
2001 (English)In: International Journal of Social Welfare, ISSN 1369-6866, E-ISSN 1468-2397, Vol. 10, no 1, 74-79 p.Article in journal (Refereed) Published
Abstract [en]

In Sweden women account for about 60% of the long-term cases of sickness absence. The aim of this study was to describe women's explanations as to how long-term sickness absence arises and becomes permanent, with reference to their personal experience. Semi-structured interviews were performed with 82 middle-aged women who have personal experience of long-term sickness absence. Long-term sickness absence can be said to arise in three distinguishable “spaces”: the work space, the medico-legal space and the mental space. In the beginning, the women were positive about sick-leave as such, which they saw as an opportunity for physical rest. But as time went on, they came to regard sick-leave as creating a vicious circle of new problems related to inactivity and isolation. Apart from this vicious circle and chronic physical impairments, certain conditions at the workplace, at the hospital and the social insurance office transformed seemingly trivial sick-leaves into long-term and irreversible sickness absences

Keyword
sickness absence, lay explanation models, women, phenomenology, interview
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-26067 (URN)10.1111/1468-2397.00154 (DOI)10526 (Local ID)10526 (Archive number)10526 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
3. Women's experiences of long term sickness absence: Is there a "loss of work syndrome"?
Open this publication in new window or tab >>Women's experiences of long term sickness absence: Is there a "loss of work syndrome"?
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Background: In most European countries, long-term sickness absence contribute the greatest number of days that are reimbursed due to sickness absence. This group is growing and it is constituted mainly of women.

Aim: The present study seeks further knowledge about what happens then and there, i.e., how long-term sickness absent women handle and explain, for themselves and others, this interruption in their daily life.

Methods: Semi-structured interviews were performed with 82 middle-aged women with personal experience from long-term sickness absence.

Results: The women's accounts of being sickness absent contained interpretations of what had happen to them, how things were for the moment, and what they thought the future would bring. Three different accounts could be distinguished: the crisis, the breakpoint, and the migration. The perception of their own situation and especially what they thought about their future was associated with their feeling of power to initiative and well-being.

Conclusion: From our study we have found implications for central topics of importance: time elapse, sense of coherence, reorientation/adaptation, and vital goals.

Keyword
Vital goal, life plan, sense of coherence, phenomenology, women, sickness absence
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-80264 (URN)
Available from: 2012-08-23 Created: 2012-08-23 Last updated: 2013-09-05Bibliographically approved
4. How to avoid the frightening scenario of long-term sickness absence: The advice from women with personal experience
Open this publication in new window or tab >>How to avoid the frightening scenario of long-term sickness absence: The advice from women with personal experience
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Aims: The aim of this study was to describe women's perceptions of what can be done to avoid long-term sickness absence.

Methods: Interviews were conducted with 82 women who had been on sickness absence ( 60 days or more) or had disability pensions.

Results: For these women, to be able to get back to work was found to be equivalent to breaking away from the prospect of isolation and loneliness. Five actors were identified along with suggestions for their actions: the woman who is on sick leave herself, the employer, the healthcare provider, the social insurance official, and the shop-steward.

Conclusions: It is important to take oneself seriously and also to be taken seriously by others. Thus, it is important to not wait too long to take action which concerns both the individual herself and all those who get involved in her case at work, at hospital or at the social insurance office. Practical advice to reach recovery and avoid sickness absence is presented.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-80265 (URN)
Available from: 2012-08-23 Created: 2012-08-23 Last updated: 2013-09-05Bibliographically approved
5. Accounts of health, illness and medicine in women on long-term sickness absence
Open this publication in new window or tab >>Accounts of health, illness and medicine in women on long-term sickness absence
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Long-term sickness absence has grown to an important social and economic question and it affects women more than men. The specific aim of the study was to identify patterns of association between ideas of health endorsed by groups of women having a close firsthand experience of long-term sickness absence. Using the Q-methodology, in a group of 60 middle-aged women, six accounts representing different conceptions of health, illness, and medicine were identified. Future studies should be implemented to investigate the prospective value of the categorisation identified in this study e.g. to see whether, and in that case how, these conceptions affect sick leave and rehabilitation.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-80266 (URN)
Available from: 2012-08-23 Created: 2012-08-23 Last updated: 2013-09-05Bibliographically approved

Open Access in DiVA

No full text

Authority records BETA

Ockander, Marlene

Search in DiVA

By author/editor
Ockander, Marlene
By organisation
Division of Preventive and Social Medicine and Public Health ScienceFaculty of Health Sciences
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

isbn
urn-nbn

Altmetric score

isbn
urn-nbn
Total: 258 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf