Assessing Predictors of Intention to Prescribe Sick Leave Among Primary Care Physicians Using the Theory of Planned Behaviour

Providing sickness certification is a decision that primary care physicians make daily. This study utilized the Theory of Planned Behaviour (TPB) to specifically gauge the intention and other salient predictors related to sickness certification prescribing behaviour amongst primary care physicians. A cross-sectional study conducted among 271 primary care physicians from 86 primary care practices in two states in Malaysia. Questionnaires used were specifically developed based on the TPB, consisting of both direct and indirect measures related to the provision of sick leave. Questionnaire validity was established through factor analysis and the determination of internal consistency between theoretically related constructs. Structural equation modelling was conducted to determine the strength of predictors related to intentions. The mean scores for intention to provide patients with sick leaves were low. The Cronbach α value for the direct measures was good: intention to =0.77, the attitude of physician=0.77, the attitude in trusting the intention of patients=0.83. Attitudes and subjective norms were identified as important predictors for physician intention to provide sick leave to patients. An integrated behavioural model utilizing the TPB could helpfully explain the complex act of providing sick leave to patients. Findings from this study could assist relevant agencies to facilitate the creation of policies that may help regulate the provision of sick leave and alleviate the work burden of sickness leave tasks faced by physicians in Malaysia.