| 1. |
- af Winklerfelt Hammarberg, Sandra, et al.
(författare)
-
Clinical effectiveness of care managers in collaborative primary health care for patients with depression : 12-and 24-month follow-up of a pragmatic cluster randomized controlled trial
- 2022
-
Ingår i: BMC Primary Care. - : Springer Nature. - 2731-4553. ; 23:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background In previous studies, we investigated the effects of a care manager intervention for patients with depression treated in primary health care. At 6 months, care management improved depressive symptoms, remission, return to work, and adherence to anti-depressive medication more than care as usual. The aim of this study was to compare the long-term effectiveness of care management and usual care for primary care patients with depression on depressive symptoms, remission, quality of life, self-efficacy, confidence in care, and quality of care 12 and 24 months after the start of the intervention. Methods Cluster randomized controlled trial that included 23 primary care centers (11 intervention, 12 control) in the regions of Vastra Gotaland and Dalarna, Sweden. Patients >= 18 years with newly diagnosed mild to moderate depression (n = 376: 192 intervention, 184 control) were included. Patients at intervention centers co-developed a structured depression care plan with a care manager. Via 6 to 8 telephone contacts over 12 weeks, the care manager followed up symptoms and treatment, encouraged behavioral activation, provided education, and communicated with the patient's general practitioner as needed. Patients at control centers received usual care. Adjusted mixed model repeated measure analysis was conducted on data gathered at 12 and 24 months on depressive symptoms and remission (MADRS-S); quality of life (EQ5D); and self-efficacy, confidence in care, and quality of care (study-specific questionnaire). Results The intervention group had less severe depressive symptoms than the control group at 12 (P = 0.02) but not 24 months (P = 0.83). They reported higher quality of life at 12 (P = 0.01) but not 24 months (P = 0.88). Differences in remission and self-efficacy were not significant, but patients in the intervention group were more confident that they could get information (53% vs 38%; P = 0.02) and professional emotional support (51% vs 40%; P = 0.05) from the primary care center. Conclusions Patients with depression who had a care manager maintained their 6-month improvements in symptoms at the 12- and 24-month follow-ups. Without a care manager, recovery could take up to 24 months. Patients with care managers also had significantly more confidence in primary care and belief in future support than controls.
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
- Ayoub, Maria, 1990-, et al.
(författare)
-
Promoting social engagement for young adults living in social isolation: Social workers and health care professionals' perceptions of success factors
- 2019
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Today the global number of young adults not in employment, education or training seem to increase. A large proportion of the group are unemployed and disengaged and have not been in contact with any authority. Thus, they are invisible to many community services and official agencies. The situation standing outside the society may have negative long-term health effects and statistics shows that more than a third of the target group after ten years still not work or study. Socially withdrawn youth is a complex phenomenon and very few young adults seek help, often due to their lack of motivation. For this reason, unemployed and inactive young people are often described as being a difficult group to support and engage. Further, there is currently limited evidence on the effects of interventions directed to socially withdrawn youth not in employment or education and the use of evidence-based practice has to be improved.Aim: The aim of this study was to investigate social workers and health care professionals’ experiences of working with young adults living in social isolation, and to identify which interventions the professionals find most successful in supporting the young adults’ engagement in society.Methods: In this study a qualitative method was used. Ten semi-structured interviews were conducted that included thirteen employees from social services and outpatient psychiatric clinics in a Swedish county. Data were analyzed using thematic network analysis.Results: Analysis resulted in two general thematic networks: ”barriers of the transition into adulthood” and ”to manage complex needs”. Participants tended to associate the issues of young adults with difficulties related to transition into adulthood. Mental health problems, low self-esteem, school related problems and limited social networks also came out in the interviews as factors that characterized unemployed and disengaged socially withdrawn youths. Participants described that successful work to re-engage these young adults included an empowerment-oriented perspective with a focus on the individual strengths, integrated and coordinated interventions and a flexible working approach.Conclusion: Today the societal changes and the process of individualization place greater demands on individual resources and capabilities which might increase the risk of social exclusion. Participants indicated that the complex problems of socially isolated young adults and experiences of long-term disengagement may contribute to stable and persistent withdrawal from society. Early identification and support for youths at risk of social withdrawal, a holistic approach, multifaceted interventions and tailored and flexible activities is deemed crucial to help reintegrate these young people. Further investigation is required to examine the effects of interventions targeting socially withdrawn and inactive young adults.
|
|
| 5. |
- Ayoub, Maria, 1990-, et al.
(författare)
-
The Family Talk Intervention in Pediatric Oncology : Potential Effects Reported by Parents
- 2024
-
Ingår i: Children. - : MDPI. - 2227-9067. ; 11:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Childhood cancer impacts the family system and has psychosocial consequences for all family members. For the parents, the ill child, and the siblings to be able to adjust to this challenging situation, the whole family needs access to psychosocial support. However, only a few such family interventions in pediatric oncology have been evaluated. The aim of this study was to explore the potential effects of a family-centered intervention, the Family Talk Intervention (FTI), in pediatric oncology from the parents' perspectives. Methods: A concurrent mixed methods design was used for this study. Data were derived from a pilot study of 26 families recruited from one pediatric oncology center in Sweden. This study focused on questionnaire and interview data from 52 parents. Results: After participation in FTI, the parents felt more satisfied with the conversations within the family about the illness. FTI also contributed to strengthened family togetherness, including more open communication and improved family relations, as described by the parents. Parents further expressed that they felt more empowered in their parenting role following FTI. Conclusions: The findings regarding FTI's ability to improve family communication and family relations, thus strengthening family togetherness in families with childhood cancer, are promising. This provides motivation for a large-scale study of FTIs in pediatric oncology.
|
|
| 6. |
- Björkelund, Cecilia, 1948, et al.
(författare)
-
Clinical effectiveness of care managers in collaborative care for patients with depression in Swedish primary health care: a pragmatic cluster randomized controlled trial
- 2018
-
Ingår i: Bmc Family Practice. - : Springer Science and Business Media LLC. - 1471-2296. ; 19:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Depression is one of the leading causes of disability and affects 10-15% of the population. The majority of people with depressive symptoms seek care and are treated in primary care. Evidence internationally for high quality care supports collaborative care with a care manager. Our aim was to study clinical effectiveness of a care manager intervention in management of primary care patients with depression in Sweden. Methods: In a pragmatic cluster randomized controlled trial 23 primary care centers (PCCs), urban and rural, included patients aged >= 18 years with a new (< 1 month) depression diagnosis. Intervention consisted of Care management including continuous contact between care manager and patient, a structured management plan, and behavioral activation, altogether around 6-7 contacts over 12 weeks. Control condition was care as usual (CAU). Outcome measures: Depression symptoms (measured by Mongomery-Asberg depression score-self (MADRS-S) and BDI-II), quality of life (QoL) (EQ-5D), return to work and sick leave, service satisfaction, and antidepressant medication. Data were analyzed with the intention-to-treat principle. Results: One hundred ninety two patients with depression at PCCs with care managers were allocated to the intervention group, and 184 patients at control PCCs were allocated to the control group. Mean depression score measured by MADRS-S was 2.17 lower in the intervention vs. the control group (95% CI [0.56; 3.79], p = 0.009) at 3 months and 2.27 lower (95% CI [0.59; 3.95], p = 0.008) at 6 months; corresponding BDI-II scores were 1.96 lower (95% CI [-0.19; 4.11], p = 0.07) in the intervention vs. control group at 6 months. Remission was significantly higher in the intervention group at 6 months (61% vs. 47%, p = 0.006). QoL showed a steeper increase in the intervention group at 3 months (p = 0.01). During the first 3 months, return to work was significantly higher in the intervention vs. the control group. Patients in the intervention group were more consistently on antidepressant medication than patients in the control group. Conclusions: Care managers for depression treatment have positive effects on depression course, return to work, remission frequency, antidepressant frequency, and quality of life compared to usual care and is valued by the patients.
|
|
| 7. |
- Björkelund, Cecilia, 1948, et al.
(författare)
-
[Effects of a care manager organization for care of people with mild-moderate depression in Swedish primary care]. : Vårdsamordnare för depression – effektivt grepp i primärvården - Gav friskare patienter och hälsoekonomiska vinster.
- 2019
-
Ingår i: Lakartidningen. - 1652-7518. ; 116
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- By strengthening accessibility and continuity and support via a care manager for primary care patients with depression corresponding to 20-30% of a nursing service, patients recovered significantly faster and to a greater extent than in primary care-as-usual. Return to work occurred significantly earlier in the first three months, and net sick leave period was significantly shorter during the following 4-6 months. To introduce a collaborative care organizational change where the care manager is the hub and coordinates care for the patient and makes it possible to adapt the care according to the patient's needs throughout the care process, is thus the individual effort shown to have the greatest efficiency in Swedish primary care to increase the quality of care of depression. This approach, where the clinic and academy work closely and continuously in the development and evaluation phases, makes it possible to rapidly develop new ways of working where consideration is given to the complexity of primary care and the complexity of care needs and care efforts.
|
|
| 8. |
|
|
| 9. |
|
|
| 10. |
|
|
