Stakeholder views on work participation for workers with depression and intersectoral collaboration in depression care: a focus group study with a salutogenic perspective
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Abstract
Objective
To explore how stakeholders in depression care view intersectoral collaboration and
work participation for workers with depression.
Design
Focus group study applying reflexive thematic analysis using a salutogenic perspective.
Setting and subjects
We conducted seven focus group interviews in six different regions in Norway with
39 participants (28 women); three groups consisted of general practitioners (GPs),
two of psychologists and psychiatrists and two of social welfare workers and employers
(of which one group also included GPs).
Results
Stakeholders considered work participation salutary for most workers with depression,
given the right conditions (e.g. manageable work accommodations and accepting and
inclusive workplaces). They also highlighted work as an integral source of meaningfulness
to many workers with depression. Early collaborative efforts and encouraging sick-listed
workers to stay connected to the workplace were considered important to avoid long
and passive sickness absences. Furthermore, stakeholders’ views illuminated why intersectoral
collaboration matters in depression care; individual stakeholders have limited information
about a worker’s situation, but through collaboration and shared insight, especially
in in-person collaborative meetings, they (and the worker) can gain a shared understanding
of the situation, thereby enabling more optimal support. Ensuring adequate information
flow for optimal and timely follow-up of workers was also emphasized.
Conclusions
Stakeholders highlighted the salutary properties of work participation for workers
with depression under the right conditions. Intersectoral collaboration could support
these conditions by sharing insight and knowledge, building a shared understanding
of the worker’s situation, assuring proper information flow, and ensuring early and
timely follow-up of the worker.
Summary Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. Methods We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting. Findings Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1–4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0–8·4) while the total sum of global YLDs increased from 562 million (421–723) to 853 million (642–1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6–9·2) for males and 6·5% (5·4–7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782–3252] per 100 000 in males vs s1400 [1279–1524] per 100 000 in females), transport injuries (3322 [3082–3583] vs 2336 [2154–2535]), and self-harm and interpersonal violence (3265 [2943–3630] vs 5643 [5057–6302]). Interpretation Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury. Funding Bill & Melinda Gates Foundation.
Title:
Scandinavian Journal of Primary Health Care
Publisher:
Taylor & Francis
ISSN
(Print):
0281-3432
ISSN
(Electronic):
1502-7724
Publication date
(Electronic, pub):
1
August
2023
Publication date
(Electronic, collection):
2023
Publication date PMC-release: 1
August
2023
Volume: 41
Issue: 3
Pages: 204-213
Affiliations
[a
]Research Unit for General Practice, NORCE – Norwegian Research Centre , Bergen, Norway
[b
]Department of Global Public Health and Primary Care, University of Bergen , Bergen, Norway
[c
]Department of Psychosocial Science, University of Bergen , Bergen, Norway
Author notes
CONTACT Heidi Marie Meling
heki@
123456norceresearch.no
Research Unit for General Practice, NORCE – Norwegian Research Centre , Årstadveien
17, 5009
Bergen, Norway
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