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- Björkelund, Cecilia, 1948, et al.
(författare)
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Effects of adding early cooperation and a work-place dialogue meeting to primary care management for sick-listed patients with stress-related disorders: CO-WORK-CARE-Stress - a pragmatic cluster randomised controlled trial.
- 2024
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Ingår i: Scandinavian journal of primary health care. - 1502-7724. ; , s. 1-15
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Tidskriftsartikel (refereegranskat)abstract
- To investigate whether intensified cooperation between general practitioner (GP), care manager and rehabilitation coordinator (RC) for patients sick-listed for stress-related mental disorder, combined with a person-centred dialogue meeting with employer, could reduce sick-leave days compared with usual care manager contact.Pragmatic cluster-randomised controlled trial, randomisation at primary care centre (PCC) level.PCCs in Region Västra Götaland, Sweden, with care manager organisation.Of 30 invited PCCs, 28 (93%) accepted the invitation and recruited 258 patients newly sick-listed due to stress-related mental disorder (n=142 intervention, n=116 control PCCs).Cooperation between GP, care manager and rehabilitation coordinator from start of illness notification plus a person-centred dialogue meeting between patient and employer within 3months. Regular contact with care manager was continued at the control PCCs.12-months net and gross number of sick-leave days. Secondary outcomes: Symptoms of stress, depression, anxiety; work ability and health related quality of life (EQ-5D) over 12months.There were no significant differences between intervention and control groups after 12months: days on sick-leave (12-months net sick-leave days, intervention, mean = 110.7days (95% confidence interval (CI) 82.6-138.8); control, mean = 99.1days (95% CI 73.9-124.3)), stress, depression, or anxiety symptoms, work ability or EQ-5D. There were no significant differences between intervention and control groups concerning proportion on sick-leave after 3, 6, 12months. At 3months 64.8% were on sick-leave in intervention group vs 54.3% in control group; 6months 38% vs 32.8%, and12 months 16.9% vs 15.5%.Increased cooperation at the PCC between GP, care manager and RC for stress-related mental disorder coupled with an early workplace contact in the form of a person-centred dialogue meeting does not reduce days of sick-leave or speed up rehabilitation.Trial registration: ClinicalTrials.gov Identifier: NCT03250026 https://clinicaltrials.gov/study/NCT03250026?tab=results#publicationsCO-WORK-CAREFirst Posted: August 15, 2017. Recruitment of PCCs: September 2017. Inclusion of patients from December 2017.
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| 2. |
- Björkelund, Cecilia, 1948, et al.
(författare)
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Rehabilitation cooperation and person-centred dialogue meeting for patients sick-listed for common mental disorders: 12 months follow-up of sick leave days, symptoms of depression, anxiety, stress and work ability - a pragmatic cluster randomised controlled trial from the CO-WORK-CARE project.
- 2023
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Ingår i: BMJ open. - 2044-6055. ; 13:6
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Tidskriftsartikel (refereegranskat)abstract
- To study whether early and enhanced cooperation within the primary care centres (PCC) combined with workplace cooperation via a person-centred employer dialogue meeting can reduce days on sick leave compared with usual care manager contact for patients on sick leave because of common mental disorders (CMD). Secondary aim: to study lapse of CMD symptoms, perceived Work Ability Index (WAI) and quality of life (QoL) during 12 months.Pragmatic cluster randomised controlled trial, randomisation at PCC level.28 PCCs in Region Västra Götaland, Sweden, with care manager organisation.30 PCCs were invited, 28 (93%) accepted invitation (14 intervention, 14 control) and recruited 341 patients newly sick-listed because of CMD (n=185 at intervention, n=156 at control PCCs).Complex intervention consisting of (1) early cooperation among general practitioner (GP), care manager and a rehabilitation coordinator, plus (2) a person-centred dialogue meeting between patient and employer within 3 months.regular contact with care manager.12 months net and gross number of sick leave days at group level.12 months depression, anxiety, stress symptoms, perceived WAI and QoL (EuroQoL-5 Dimensional, EQ-5D).No significant differences were found between intervention and control groups concerning days of sick leave (intervention net days of sick leave mean 102.48 (SE 13.76) vs control 96.29 (SE 12.38) p=0.73), return to work (HR 0.881, 95%CI 0.688 to 1.128), or CMD symptoms, WAI or EQ-5D after 12 months.It is not possible to speed up CMD patients' return to work or to reduce sick leave time by early and enhanced coordination among GP, care manager and a rehabilitation coordinator, combined with early workplace contact over and above what 'usual' care manager contact during 3 months provides.NCT03250026.
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| 3. |
- Saxvik, Ausra, et al.
(författare)
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Experiences of patients with common mental disorders concerning team-based primary care and a person-centered dialogue meeting: An intervention to promote return to work.
- 2022
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Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 17:7
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Tidskriftsartikel (refereegranskat)abstract
- Common mental disorders in combination with work-related stress are widespread in the western world, not least in Sweden. Various interactive factors, primarily work-related, have impact on the return to work process, for example; a supportive communicative function between the person on sick leave and the employer may facilitate this process. The aim was to investigate experiences of being part of a collaborative care model including a person-centered dialogue meeting with the employer and with a rehabilitation coordinator as the moderator.A qualitative design based on individual interviews with 13 persons diagnosed with common mental disorders who participated in an extensive collaborative care model, called the Co-Work-Care model. Persons were recruited as a heterogeneous sample with respect to age, gender, work background, and time since the intervention. All interviews were analyzed with Systematic Text Condensation.Five codes synthesized the results: 1) A feeling of being taken care of, 2) Collaboration within the team was perceived as supportive, 3) An active and sensitive listener, 4) Structure and planning in the dialogue meeting, 5) The person-centered dialogue meeting was supportive and provided increased understanding.Participants experienced the close collaborative contact with the care manager and the rehabilitation coordinator as highly valuable for their rehabilitation process. Participants valued a well-structured dialogue meeting that included initial planning and a thorough communication involving the patient, the employer, and coordinator. Further, participants appreciated having an active role during the meeting, also empowering the return to work process.
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| 4. |
- Saxvik, Ausra, et al.
(författare)
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"Gaining control through close collaboration" - GPs' experiences of a Collaborative Care Model for patients with Common Mental Disorders who need sick leave certification.
- 2022
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Ingår i: BJGP open. - 2398-3795. ; 6:4
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Tidskriftsartikel (refereegranskat)abstract
- General Practitioners (GPs) are an important part of collaboration around patients with common mental disorders in primary care. To further improve collaboration, the model Co-Work-Care was implemented, which emphasised working more closely with patients through active dialogues among care managers, rehabilitation coordinators and GPs. This enhanced collaborative model also included a person-centred dialogue meeting with patients' employers.To explore GPs' experiences of the Co-Work-Care model - a collaborative care organisation at the primary care centre including a person-centred dialogue meeting in the care of patients with common mental disorders who need sick leave certification.Qualitative individual and group interviews among Swedish GPs with experience of the Co-Work-Care trial where the primary care centre (PCC) was an intervention PCC with the enhanced collaboration model.GPs were sampled purposefully from different Co-Work-Care intervention PCCs in Sweden. Focus group and individual in-depth semi-structured interviews were conducted. All interviews were analysed by Systematic Text Condensation according to Malterud.Three codes describing the GPs' experiences of working in the Co-Work-Care model were identified: 1) A structured work approach, 2) Competency of the care manager and the rehabilitation coordinator, and 3) Gaining control through close collaboration.Overall, GPs experienced that the enhanced collaboration reduced their workload and enabled them to focus on the medical care. Patient care was perceived as safer and more effective. These advantages may result in higher quality in medical and rehabilitation decisions, as well as a more sustainable and less stressful work situation for GPs.
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