Creating a safety net for patients with depression in primary care; a qualitative study of care managers’ experiences

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.

Keywords:

• Care manager
• Depression
• Healthcare professionals
• Primary health care
• Qualitative study

Acknowledgements

The authors wish to thank the Care Managers for participating in the focus group discussions.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethical approval

Ethical approval was obtained from the Regional Committee for Medical Research Ethics in Gothenburg (Dnr 903-13, T403-15, T975-14).

Trial registration: Clinical Trials.gov Identifier: NCT02378272 February 2 2015.

Additional information

Funding

This study was supported by the Region Västra Götaland and by the County Council of Dalarna.