Although mental illness remains the leading cause of both sickness absence and incapacity benefit in most high-income countries, little is known about how frequently patients with mental ill-health receive sickness certificates and what conditions are most commonly certified for. This study aims to use general practice consultation data to determine the rate of sickness certification for common mental health problems.

Analysis of a general practice consultation database rates of certification are presented for people consulting with a mental health problem, along with the proportion of these consultations in which a certificate was issued.

The highest rates of certification among those consulting with mental health problems occurred for depression, stress-related problems and bereavement. Almost two-thirds of the consultations for bereavement resulted in a sickness certificate being issued. At least one in three mental health consultations resulted in a sickness certificate being issued.

Consultation for mental health problems in primary care frequently results in the issuing of a sickness certificate. Further study is urgently needed to provide adequate support systems to enable patients to return to work whenever possible.

The aim of this study is to investigate whether individuals diagnosed with chronic diseases associated with the metabolic syndrome (MetS) receive favorable quality of care processes in the primary care setting relative to other individuals with and without chronic diseases.

Data from the 2010 Brazos Valley Health Status Assessment (BVHSA) (n = 3964) were analyzed. Individuals diagnosed with chronic diseases that are collectively associated with a diagnosis of MetS, namely obesity, diabetes, high cholesterol, and hypertension, were characterized as a group (ie, analytic sample, n = 168). Clinical guidelines were utilized to identify indicators representing the quality of care processes received by these individuals during visits with their health-care provider.

Measures of quality of care processes were analyzed relative to a comparator group comprising individuals with no chronic diseases and an alternative test group comprising those diagnosed with other chronic diseases (eg, arthritis, depression, and cancer among others) using multinomial and binary logistic regression.

Physician communication of critical issues such as diet, stress, and weight status was statistically more pronounced in the analytic sample relative to the comparator group. However, differences in physician communication about physical activity were not statistically significant relative to the comparator group (OR = 1.26, P = 0.533). Differences in testing of cholesterol (OR = 0.94, P = 0.743) and blood pressure (OR = 1.16, P = 0.619) were also not statistically significant relative to the comparator group. Individuals who may have MetS generally receive favorable quality of care processes from their health-care provider, but opportunities exist to enhance provider communication about physical activity, and to possibly improve frequency of cholesterol and blood pressure testing.

Leg ulceration presents a significant health-care problem for patients and it is likely to be associated with pain. Poorly managed persistent pain may lead to insomnia, depression and suicidal ideation. To manage leg ulcer pain effectively, it is necessary first to assess pain, but there is little evidence of this activity in the literature. This study aimed to explore community nurses’ knowledge and beliefs about the management of painful leg ulceration.

A feasibility study surveyed the knowledge and views of a sample of community nurses in the North of England, United Kingdom. Data were collected using a postal questionnaire.

A total of 115 completed questionnaires were returned (response rate = 32%). The majority of the respondents were female (n = 102, 91.8%). The nurses in this clinical study claimed to be aware of the pain that patients with leg ulceration may experience. Over 90% of the patients were aware of the key consequences of this pain, including insomnia, depression, social isolation and others. However, over one-third of the nurses reported that they had not received pain management training. Approximately one half reported not assessing pain appropriately. Nurses reported using pain triggers and severity to diagnose aetiology and complications of leg ulceration.

This study suggested inadequate pain management practices despite the fact that there were a significant number of the nurses who were aware of the associated pain and possible outcomes. Pain assessment was lacking, suggesting a lack of formal pain assessment procedures. They described not using effective pain management techniques and were aware of their need for education in this area.