| 1. |
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
- Cederberg, Matilda, et al.
(författare)
-
Effects of a Person-Centered eHealth Intervention for Patients on Sick Leave Due to Common Mental Disorders (PROMISE Study): Open Randomized Controlled Trial
- 2022
-
Ingår i: Jmir Mental Health. - : JMIR Publications Inc.. - 2368-7959. ; 9:3
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Sick leave due to common mental disorders (CMDs) is a public health problem in several countries, including Sweden. Given that symptom relief does not necessarily correspond to return to work, health care interventions focusing on factors that have proven important to influence the return to work process, such as self-efficacy, are warranted. Self-efficacy is also a central concept in person-centered care. Objective: The aim of this study is to evaluate the effects of a person-centered eHealth intervention for patients on sick leave due to CMDs. Methods: A randomized controlled trial of 209 patients allocated to either a control group (107/209, 51.2%) or an intervention group (102/209, 48.8%) was conducted. The control group received usual care, whereas the intervention group received usual care with the addition of a person-centered eHealth intervention. The intervention was built on person-centered care principles and consisted of telephone support and a web-based platform. The primary outcome was a composite score of changes in general self-efficacy (GSE) and level of sick leave at the 6-month follow-up. An intention-to-treat analysis included all participants, and a per-protocol analysis consisted of those using both the telephone support and the web-based platform. Results: At the 3-month follow-up, in the intention-to-treat analysis, more patients in the intervention group improved on the composite score than those in the control group (20/102, 19.6%, vs 10/107, 9.3%; odds ratio [OR] 2.37, 95% CI 1.05-5.34; P=.04). At the 6-month follow-up, the difference was no longer significant between the groups (31/100, 31%, vs 25/107, 23.4%; OR 1.47, 95% CI 0.80-2.73; P=.22). In the per-protocol analysis, a significant difference was observed between the intervention and control groups at the 3-month follow-up (18/85, 21.2%, vs 10/107, 9.3%; OR 2.6, 95% CI 1.13-6.00; P=.02) but not at 6 months (30/84, 35.7%, vs 25/107, 23.4%; OR 1.8, 95% CI 0.97-3.43; P=.06). Changes in GSE drove the effects in the composite score, but the intervention did not affect the level of sick leave. Conclusions: A person-centered eHealth intervention for patients on sick leave due to CMDs improved GSE but did not affect the level of sick leave.
|
|
| 5. |
- Cederberg, Matilda, et al.
(författare)
-
Person-centred eHealth intervention for patients on sick leave due to common mental disorders: study protocol of a randomised controlled trial and process evaluation (PROMISE)
- 2020
-
Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 10:9
-
Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: The number of people dealing with common mental disorders (CMDs) is a major concern in many countries, including Sweden. Sickness absence resulting from CMDs is often long-lasting and advancing return to work is a complex process impacted by several factors, among which self-efficacy appears to be an important personal resource. Person-centred care (PCC) has previously shown positive effects on self-efficacy however this needs to be further investigated in relation to patients with CMDs and in an eHealth context. METHODS AND ANALYSIS: This study is an open randomised controlled trial comparing a control group receiving standard care with an intervention group receiving standard care plus PCC by telephone and a digital platform. The primary outcome measure is a composite score of changes in sick leave and self-efficacy. Participants will include 220 primary care patients on sick leave due to CMDs and data will mainly be collected through questionnaires at baseline and 3, 6, 12 and 24 months from the inclusion date. Inclusion is ongoing and expected to be completed during the fall of 2020. A process and health economic evaluation will also be conducted. ETHICS AND DISSEMINATION: This study was approved by the Regional Ethical Review Board in Gothenburg, Sweden. Results will be published in peer-reviewed scientific journals and presented at national and international scientific conferences. This project is part of a broader research programme conducted at the Gothenburg Centre for Person-Centred Care (GPCC), where extensive work is undertaken to disseminate knowledge on and implementation of PCC. TRIAL REGISTRATION NUMBER: NCT03404583.
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
- Glise, Kristina, 1952, et al.
(författare)
-
Course of mental symptoms in patients with stress-related exhaustion: Does sex or age make a difference?
- 2012
-
Ingår i: BMC Psychiatry. - 1471-244X. ; 12:1
-
Tidskriftsartikel (refereegranskat)abstract
- Abstract Background Long-term sick leave due to mental health problems, especially among women, is a substantial problem in many countries, and a major reason for this is thought to be psychosocial stress. The recovery period of different patient groups with stress-related mental health problems can differ considerably. We have studied the course of mental health symptoms during 18 months of multimodal treatment in relation to sex and age in a group of patients with stress-related exhaustion. Methods The study group includes 232 patients (68% women) referred to a stress clinic and who fulfilled the criteria for Exhaustion Disorder (ED). The majority also fulfilled diagnostic criteria for depression and/or anxiety; this was similar among women and men. Symptoms were assessed at baseline, three, six, 12 and 18 months by the Shirom-Melamed Burnout Questionnaire (SMBQ) and the Hospital Anxiety and Depression scale (HAD). A total SMBQ mean score of ≥ 4 was used to indicate clinical burnout, which correlates well with the clinical diagnosis of ED. Results There were no statistically significant differences between women and men or between young and old patients in the self-reported symptoms at baseline. The proportion that had high burnout scores decreased over time, but one-third still had symptoms of clinical burnout after 18 months. Symptoms indicating probable depression or anxiety (present in 34% and 65% of the patients at baseline, respectively) declined more rapidly, in most cases within the first three months, and were present only in one out of 10 after 18 months. The course of illness was not related to sex or age. The duration of symptoms before seeking health care, but not the level of education or co-morbid depression, was a predictor of recovery from symptoms of burnout after 18 months. Conclusions The course of mental illness in patients seeking specialist care for stress-related exhaustion was not related to sex or age. The burden of mental symptoms is high and similar for men and women, and at the 18 month follow-up, one-third of the study group still showed symptoms of burnout. A long duration of symptoms before consultation was associated with a prolonged time of recovery, which underlines the importance of early detection of stress-related symptoms.
|
|
| 9. |
- Glise, K., et al.
(författare)
-
Long-term follow-up of residual symptoms in patients treated for stress-related exhaustion
- 2020
-
Ingår i: BMC Psychology. - : Springer Science and Business Media LLC. - 2050-7283. ; 8:1
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Many patients with stress-related exhaustion seem to struggle with long-term recovery. The primary aim of this study was to explore residual symptoms and perceived recovery in patients previously treated for stress-related exhaustion, 7 years after seeking care. METHODS: A total of 217 former patients (74% women) previously treated for exhaustion disorder were asked to participate in follow-ups 2, 3, 5, and 7years post treatment. Symptoms of depression, and anxiety were measured with questionnaires. Remaining symptoms of extreme fatigue, sleep disturbances, problems with concentration, problems with memory and reduced stress tolerance, were rated with single item questions. A subgroup of patients (n=163) participated in a clinical assessment to confirm residual stress-related exhaustion not caused by other diseases. RESULTS: Almost half of the patients previously treated for stress-related exhaustion perceive fatigue 7 years after initially seeking care, and as many as 73% reported decreased stress tolerance. The clinical assessment confirmed that a third of the patients were clinically judged as still suffering from stress-related exhaustion. Male and female patients showed similar patterns regarding residual symptoms. CONCLUSIONS: One third of patients with exhaustion disorder are clinically judged to have exhaustion, 7 years after seeking care. Further studies are needed to elucidate the reason for such a long-term recovery and ultimately to identify methods for prevention.
|
|
| 10. |
- Glise, Kristina, 1952, et al.
(författare)
-
Prevalence and course of somatic symptoms in patients with stress-related exhaustion: does sex or age matter
- 2014
-
Ingår i: BMC Psychiatry. - 1471-244X. ; 14:118
-
Tidskriftsartikel (refereegranskat)abstract
- Abstract Background Both mental and somatic symptoms are commonly reported in patients with stress-related problems. We have explored the prevalence of somatic symptoms in patients seeking medical care for stress-related mental health problems and followed the course of illnes alongside with that the patients receive multimodal treatment. Method This study comprises data from 228 patients (69% women, mean age 43 years) who fulfilled the criteria for Exhaustion Disorder (ED). Somatic symptoms were assessed at baseline and after 3, 6, 12 and 18 months using the one-page questionnaire Primary Care Evaluation of Mental Disorders. Prevalence of different symptoms was compared between men and women and patients, over and below 40 years of age, and possible predictors of recovery were explored. Results Tiredness and low energy are the core symptom reported by the patients. Almost all (98%) reported at least one somatic symptom and 45% reported six symptoms or more, which was similar for men and women. Nausea, gas or indigestion are the most common symptoms (67%) followed by headaches (65%) and dizziness (57%). The number of symptoms reported was significantly related to the severity of mental health problems. The only difference between the sexes was that “chest pain” and “pain or problems during sexual intercourse” were more common among males. Patients over forty more often reported “pain in arms, legs or joints, knees, hips” and this was also the only symptom that did not significantly decline during treatment. Neither sex, age, symptom duration before seeking medical care, education or any other predictor tested was shown to predict recovery in patients reporting six symptoms or more. Conclusion A heavy burden of somatic symptoms was generally seen in most patients with stress-related exhaustion. Somatic symptoms are equally common in males and females and in younger and older patients. The somatic symptoms seem to be mostly stress-related since all symptoms, except musculoskeletal pain, reduce with individualised treatment designed for stress-related mental problems. This study brings to attention the complicated burden of both somatic and mental symptoms in patients with stress-related exhaustion, raising several clinical implications of interest to discuss.
|
|
