title: Decision-making in job attendance within health care--a qualitative study.
abstract: BACKGROUND
  Musculoskeletal complaints are considered a major cause of sickness absence, particularly in areas such as the health sector. However, little is known about the personal decision-making process for self-certified sickness absence.
  
  
  OBJECTIVE
  To explore female health care workers' thoughts and experiences about work attendance when experiencing musculoskeletal symptoms.
  
  
  METHODS
  A qualitative study using individual, semi-structured, in-depth interviews with eight female health care workers was performed. Questions were related to factors influencing the decision to attend work and decision-making when facing the dilemma of attending work when experiencing musculoskeletal symptoms. The data were analysed according to the systematic text condensation.
  
  
  RESULTS
  Subjects reported a high threshold before calling in sick. Self-certified sickness absence was not a strategy for coping with musculoskeletal symptoms as participants chose to be physically active and work part-time rather than taking sickness absence. Making decisions about attending work fostered conflicting norms, as women faced a dilemma between feeling guilt towards colleagues and patients and taking care of their own health.
  
  
  CONCLUSIONS
  The findings highlight the complexity of managing work when experiencing musculoskeletal symptoms, and the dilemmas faced by those affected. The importance of work environment factors and the fact that some women feel compelled to work part-time in order to prioritize their own health require further consideration.
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Kalfarveien 31, 5018 Bergen, Norway, kine.tveten@gmail.com.
authors.forename: K M
authors.initials: KM
authors.lastname: Tveten
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Kalfarveien 31, 5018 Bergen, Norway, Uni Research Health, 5008 Bergen, Norway.
authors.forename: T
authors.initials: T
authors.lastname: Morken
mesh_terms: D000041:Absenteeism; D000328:Adult; D002755:Choice Behavior; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D009664:Norway / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D036301:Qualitative Research; D018582:Sick Leave; D017132:Workplace
keywords: Coping; female health care workers; health care; musculoskeletal symptoms; qualitative research; self-certified sickness absence.