Newly educated care managers’ experiences of providing care for persons with stress-related mental disorders in the clinical primary care context

Wiegner, Lilian; Hange, Dominique; Svenningsson, Irene; Björkelund, Cecilia; Petersson, Eva‐Lisa

doi:10.1371/journal.pone.0224929

Cited by 5 publications

(7 citation statements)

References 23 publications

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“…The care of the patients was described as being of great importance, and the participants felt confident based on their experience and knowledge [ 22 ]. Care managers with long experience seemed to use their dialogue with the patients for gaining the information that was necessary for accomplishing the care managing task.…”

Section: Discussionmentioning

confidence: 99%

The care manager meeting the patients’ unique needs using the care manager model—A qualitative study of experienced care managers

et al. 2021

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Background Implementation of a care manager in a collaborative care team in Swedish primary care via a randomized controlled trial showed successful outcome. As four years have elapsed since the implementation of care managers, it is important to gain knowledge about the care managers’ long-term skills and experiences. The purpose was to examine how long-term experienced care managers perceived and experienced their role and how they related to and applied the care manager model. Method Qualitative study with a focus group and interviews with nine nurses who had worked for more than two years as care managers for common mental disorders. The analysis used Systematic Text Condensation. Results Four codes arose from the analysis: Person-centred; Acting outside the comfort zone; Successful, albeit some difficulties; Pride and satisfaction. The care manager model served as a handrail for the care manager, providing a trustful and safe environment. Difficulties sometimes arose in the collaboration with other professionals. Conclusion This study shows that long-term experience of working as a care manager contributed to an in-depth insight and understanding of the care manager model and enabled care managers to be flexible and act outside the comfort zone when providing care and support to the patient. A new concept emerged during the analytical process, i.e. the Anchored Care Manager, which described the special competencies gained through experience. Trial registration NCT02378272 Care Manager—Coordinating Care for Person Centered Management of Depression in Primary Care (PRIM—CARE).

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Section: Discussionmentioning

confidence: 99%

The care manager meeting the patients’ unique needs using the care manager model—A qualitative study of experienced care managers

et al. 2021

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“…It is essential to identify more individualized strategies that can improve health related quality of life as well as possibilities to return to work. For example, the Danish IBBIS randomized controlled trial will investigate whether integrated mental health care and vocational rehabilitation can improve return to work rates for people on sick leave because of CMD [ 38 ], and our research group has similar ongoing studies [ 39 , 40 , 41 ].…”

Section: Discussionmentioning

confidence: 99%

Associations between antidepressant therapy, work ability, and sick leave for patients with common mental disorders within a two-year perspective – A longitudinal observational cohort study in Swedish primary care

Hange

Ariai

Björkelund

et al. 2021

Heliyon

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Background An increasing number of patients are on sick leave because of common mental disorders (CMD), with or without antidepressant therapy. There is a lack of long-term follow-up studies in the primary care context, where most of the patients are treated. The importance of identifying potential factors associated with work ability for CMD patients is increasingly in focus. Objective To investigate the associations between using antidepressants, sick leave duration, reported work ability and psychological symptoms among patients with CMD during a two-year observation period in the primary care context. Methods Longitudinal observational cohort study at 28 Primary Care Centers in Region Västra Götaland, Sweden, including 182 patients with an employment and on sick leave for CMD. The following outcomes were assessed: work ability measured with WAI, depressive symptoms with MADRS-S, anxiety symptoms with BAI, fatigue symptoms with KEDS, quality of life with EQ-5D, and days of sick leave. The data were compared between the groups that used and did not use antidepressants, during the 24-months observation period. Results Work ability and health-related quality of life increased over time in both groups. A steeper decrease of depressive symptoms, anxiety symptoms as well as an increased health-related quality of life at 3, 6 and 12 months was found in the group without antidepressants, although both groups levelled off at 24 months. In both groups, a higher work ability at baseline was associated with less two-year sick leave. Conclusion Our study indicates that a high work ability at baseline has a strong association with a lower total net and gross sick leave duration during the entire two-year follow-up period for patients with CMD in primary health care, irrespective of use of antidepressants. Using WAI in primary health care could therefore be helpful in predicting return to work. Use of antidepressants during the CMD episode could indicate initially a more pronounced overall symptom pattern, motivating introduction of antidepressants, rather than prolonging the sick leave period.

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“…A crucial aspect in this approach is a working relationship built on reciprocity and hope (Le Boutillier et al, 2011 ; Topor et al, 2011 ). To support recovery, care for persons with stress-related disorders commonly occurs within primary health care (Wiegner et al, 2019 ). Sufficient evidence is lacking regarding the effect of rehabilitation and treatment for stress-related disorders, especially with a focus on primary health care (Swedish Agency for Health Technology Assessment and Assessment of Social Services, 2015 ; Wallensten et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Supporting recovery in persons with stress-related disorders: A reflective lifeworld research study of health care professionals in primary health care in Sweden

Sjösten

Hörberg

Fagerström

et al. 2023

International Journal of Qualitative Studies on Health and Well

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Purpose The study aimed to describe primary health care professionals lived experiences of supporting recovery in persons with stress-related disorders. Methods This study was based on a phenomenological approach known as reflective lifeworld research (RLR). Seventeen health care professionals working in primary health care were included in the study. Lifeworld interviews were conducted to collect data. The data were analysed in accordance with the phenomenological RLR principles of openness, flexibility and bridling. Results Health care professionals experienced supporting recovery as a complex process with a need for a tailored approach, regardless of profession. In an alliance, the health care professionals encounter the persons where they are based on their own narratives about their life situation. In an interpersonal platform, the health care professionals use a lingering and flexible approach. Support is provided by encouraging existential reflection and learning as well as guiding the person to consider their own needs. This supports the person’s quest for a sustainable recovery process in his/her life situation. Conclusions We conclude that supporting recovery requires a genuinely person-centred care in which elements of existential care are crucial. Primary health care for persons with stress-related disorders could benefit from the development of additional research and models for such an approach.

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Newly educated care managers’ experiences of providing care for persons with stress-related mental disorders in the clinical primary care context

Cited by 5 publications

References 23 publications

The care manager meeting the patients’ unique needs using the care manager model—A qualitative study of experienced care managers

The care manager meeting the patients’ unique needs using the care manager model—A qualitative study of experienced care managers

Associations between antidepressant therapy, work ability, and sick leave for patients with common mental disorders within a two-year perspective – A longitudinal observational cohort study in Swedish primary care

Supporting recovery in persons with stress-related disorders: A reflective lifeworld research study of health care professionals in primary health care in Sweden

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