An interview study of the care manager function-Opening the door to continuity of care for patients with depression in primary care.
Camilla Udo, Irene Svenningsson, Cecilia Björkelund and 3 others
PMID 31367421WHAT IT FOUND
Patients already receiving CBT, interpersonal therapy and/or antidepressants described added nurse care-manager contact as supportive continuity, but rigid calls and overreliance on a depression self-rating form felt unhelpful.
Key findings
01Patients described the added nurse care-manager contact as a source of support, with continuity and availability building a trusting relationship that shared their burden.
02Some participants wanted more flexible number and frequency of contacts, and some said the contact ended too soon.
03Using the self-rating depression form as the main focus, without open dialogue, was negative; as a complement to discussion it helped self-reflection.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
A small interview study of 20 patients with mild or moderate depression, so it reports experiences, not treatment effects. All participants were also receiving usual care, such as CBT, interpersonal therapy and/or antidepressants, so the care manager contribution cannot be separated. The care managers were new to the role and the method was newly developed, and the study setting provided extended support, which may not match routine primary care. The first interviews were unexpectedly short and less rich, and the sample had minimal ethnic variation, so findings may not transfer to other populations. Some negative aspects might have emerged differently with focus groups rather than individual interviews. This paper does not describe how patients were assigned in the parent study or report quantitative outcomes, so it cannot say whether the care manager improved symptoms.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that a nurse care manager improves depression or recovery. This was a qualitative interview study of 20 patients who also received usual care such as CBT, interpersonal therapy and/or antidepressants, so it describes experiences and cannot separate the care manager contribution from other treatment.