Tuesday, 30 May 2017 20:27

Does stress lead to lengthier periods of sick leave? Featured

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The duration of a person’s unfitness for work is determined by more than his/her primary diagnosis. Patients often report psychological problems and a feeling of being burnt out. Antonius Schneider and colleagues analyzed whether an association exists between such psychological symptoms and the length of sick leave, even if patients received their sick note because of purely physical symptoms, such as back pain.

The researchers studied the data of 225 patients, from 14 general practices, who had been issued with a sickness certificate. The diagnoses that prompted the sick leave varied. Respiratory disorders and disorders of the musculoskeletal system were the most common diagnoses. The longest mean periods of sick leave were documented for patients with diagnoses of skin diseases and mental disorders. All study participants completed a questionnaire that included the Maslach Burnout Inventory, General Survey, and Patient Health Questionnaire, with the scales depression, somatization, and anxiety. Patients’ characteristics such as sex, age, relationship status, and educational attainment were also captured.
For the total study population, doctors’ sick notes were associated with longer periods of sick leave in patients with a lower level of educational attainment (less than 10 years of schooling), independently of the primary diagnosis. An association existed between the length of the sick leave period and emotional exhaustion, depersonalization, depression, anxiety, and somatization. When study participants were excluded whose unfitness for work was primarily due to psychological and psychiatric diagnoses, the sick leave period correlated with emotional exhaustion, somatization, and—almost statistically significantly—with depression. Sex and relationship status were not relevant.
In a secondary analysis, age and formal education were associated with the duration of sick leave. Each year of increase in age led to an increase in the length of the sick leave period by 1.7%. In persons with higher levels of education, the length of sick leave was reduced by 40%. In terms of the psychological burden, an association of anxiety symptoms with the duration of unfitness to work was primarily noted.
The authors conclude that a holistic approach in patient-centered communication, such as is applied in case of depression and anxiety, may be helpful in psychological or physical symptoms of unknown origin during the consultation with the primary care physician.



Source: Deutsches Aerzteblatt International
Full bibliographic information:
The implications of psychological symptoms for length of sick leave—burnout, depression, and anxiety as predictors in a primary care setting. Dtsch Arztebl Int 2017; 114: 291–7.

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  • Postgrad course on exercise as medicine is being proposed

    Dear prospective applicant,

    A proposal for a postgrad course on physical activity (PA) as a therapy for non-communicable diseases is currently being evaluated. Hereunder, a two-question survey is being forwarded for your attention in order to assess whether the idea sounds appealable or not.

    Proposed award

    M.Sc in Therapeutic Physical Activity (TPA), with postgrad certificate (PgC) and postgrad diploma (PgD) exit routes

    Proposed specialisation titles[1]

    Holders of PgC, TPA can claim the title of: ‘Clinical exercise prescriber’.

    Holders of PgD, TPA can claim the titles of: ‘Advanced exercise prescriber’ or ‘Clinical and public health exercise prescriber’.

    Holders of M.Sc, TPA can claim the title of: ‘Physical activity - health specialist’.

    Are you sure you know why physical activity is so important?

    Everyone is aware that physical inactivity is a major health concern but, do you know that through the right type of exercise you can prevent or treat at least 35 chronic conditions? In 2007 the American College of Sports Medicine officially declared an important statement: ‘Exercise is medicine’. Moreover, health-enhancing physical activity (HEPA) is important in today’s world not only in view of improving health and wellbeing but also for its economic values. For example, a lifestyle intervention involving 150 minutes of weekly PA was scientifically shown to be significantly more effective than the administration of metformin.

    Possibilities of further career development in exercise prescription

    Exercise prescription, that is, being qualified to professionally recommend the right type of exercise for health does not stop on a one-to-one basis. Do you think you are qualified to: (a) conduct research on PA interventions, and (b) develop, implement and evaluate community or population programmes involving PA strategies? Unfortunately, many wide-scale programmes that are implemented undergo no evaluation to determine how they have worked or what their effects may be. Have you ever imagined the possibility of attending a tertiary course which would be designed to: (a) give you the ability to design a project for the generation of new knowledge and be able to publish it internationally, or (b) train you on how to evaluate wide-scale interventions and how to apply strategies to sustain their continuities?


    A glimpse of the proposed programme of studies

    Intended for:

    The programme of studies is aimed at a wide and diverse cohort of students wishing to pursue any careers in HEPA sectors mainly: exercise prescription; health promotion (policies and practice); general health and fitness industry; and to further their studies (e.g. PhD). It can also serve as an adjunct to enrich one’s knowledge of his / her established profession or career. Examples include: medical practitioners; pharmacists; nurses; physiotherapists; nutritionists; public health specialists; sport medicine specialists; sport psychologists; teachers of physical education (PE); coaches; gym instructors; and personal trainers. Fitness and sport enthusiasts are also encouraged to apply.

    Duration:

    Three years part-time leading to an M.Sc in PA as an effective therapy, with postgrad certificate and postgrad diploma exit routes after the first and second years respectively.

    Mode of delivery:

    Seventy per cent will be delivered online and the rest of the thought units will be offered on a once weekly two-hour evening basis starting at 18.00hrs.

    Admission criteria:

    You should provide evidence of higher educational qualification(s) - normally, a diploma or a degree related to health and / or PA / sport. An award in PE is also ideal. Mature students without these basic qualifications would be required to present evidence of experience related to PA and health.

    Mode of assessment:

    Units will be assessed through the submission of coursework. These will vary from short assessments to long essays. If you would like to progress at Masters’ level, a traditional dissertation or paper in the format for journal publication and a final presentation (in the form of slides or poster) of your research findings will have to be undertaken.

    Round-up

    Unlike other under- and postgrad courses which only cover a fraction from the whole science of HEPA, this comprehensive programme of studies would lead to a specialization specifically on TPA. For careers in promotion, prescription and research of PA, the proposed programme of studies is a must.

    Important notice

    All the above information is subject to change and would eventually have to be approved by the Programme Validation Committee of the University of Malta. Needless to say, your feedback in the next two questions is extremely important.

    Yours in health & exercise,

    Charles Micallef B.Pharm (Hons), M.Sc PAPH (Staff)                                                8th August 2017

    The two questions hereunder.

    1. In view of the above information, would you be interested in applying for this particular postgrad course leading to a specialisation in physical activity with respect to health, that is, a qualification that gives you the right to prescribe exercise for health, even at population levels?

    Yes or No: 

    1. What would you change from or suggest to what is being proposed?

    Please state your name & surname:

    Your current job / profession:

    Please save your changes and forward your reply to Charles Micallef on: This email address is being protected from spambots. You need JavaScript enabled to view it.

    Your cooperation is greatly appreciated.


    [1] In order to professionally recommend exercise for health, you may need to be registered in the appropriate regulatory board and be in possession of a warrant to operate with the respective titles.

    University of Malta

    Written on August 19, 2017
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