Abstract

Objective: The aim of this study was to explore nurses’ experiences and perceptions of working as care managers at primary care centers.Design: Qualitative, focus group study. Systematic text condensation was used to analyze the data.Setting: Primary health care in the region of Västra Götaland and region of Dalarna in Sweden.Subjects: Eight nurses were trained during three days including treatment of depression and how to work as care managers. The training was followed by continuous support.Main outcome measures: The nurses’ experiences and perceptions of working as care managers at primary care centers.Results: The care managers described their role as providing additional support to the already existing care at the primary care center, working in teams with a person-centered focus, where they were given the opportunity to follow, support, and constitute a safety net for patients with depression. Further, they perceived that the care manager increased continuity and accessibility to primary care for patients with depression.Conclusion: The nurses perceived that working as care managers enabled them to follow and support patients with depression and to maintain close contact during the illness. The care manager function helped to provide continuity in care which is a main task of primary health care.Key Points The care managers described their role as an additional support to the already existing care at the primary care center. • They emphasized that as care managers, they had a person-centered focus and constituted a safety net for patients with depression. • Their role as care managers enabled them to follow and support patients with depression over time, which made their work more meaningful. • Care managers helped to achieve continuity and accessibility to primary health care for patients with depression.

Highlights

  • The number of people with depression is increasing worldwide [1], affecting people in all ages

  • The participants willingly shared their experiences of working as care managers in primary health care

  • Results in this study indicated that the use of MADRS-S in the structured and systematic telephone follow-ups made it possible to identify personcentered topics, to involve the patient in the care process, and to increase the patient’s understanding of their depression and its consequences

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Summary

Introduction

The number of people with depression is increasing worldwide [1], affecting people in all ages. Almost 1 million lives are lost to suicide due to depression worldwide each year [1]. In Sweden, the life time risk of depression is around 35 percent for women and 25 percent for men [2]. Depression is associated with a large burden of disease and serious consequences, such as decreased quality of life and reduced ability to cope with daily life [1,3], and increased risk of disease [4]. A depressive episode is categorized as mild, moderate, or severe on the basis of the symptoms and the number of previous

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