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  4. PROMISE - Person-centred care via e-Health for people with mental illness

PROMISE - Person-centred care via e-Health for people with mental illness

Research project
Inactive research
Project size
SEK 8,4 million
Project period
2017 - 2023
Project owner
Institute of Health and Care Sciences
Research partners
The Institute of Stress Medicine Närhälsan Primary Care R&D centre for the regions of Gothenburg and Southern Bohuslän
Financier
Forte, ALF
Area
Health and medicine
Topic
Psychiatry Health Care Service and Management, Health Policy and Services and Health Economy

Short description

The PROMISE research project evaluated a person-centred e-health intervention for individuals on sick leave due to stress, depression, or anxiety. The intervention increased patients’ confidence in their own ability—an important factor for returning to work—and reduced symptoms of exhaustion and fatigue. The person-centred telephone conversations were the most valued component of the support. Participants described burnout as an existential crisis and highlighted the need for a supportive network. The study found that the intervention was cost-effective and that the e-health format worked well as a complement to standard care.

Mental illness 

Mental illness is the most common cause of sick leave that lasts longer than 14 days in people under 50 years of age. A large proportion of sick leave due to mental illness is related to stress, depression or anxiety. The impact on everyday life is usually great and causes difficulties for both patients and relatives. The rehabilitation period is usually long and in some cases can extend a year or more and the risk of relapse and a new episode of sick leave is high.

E-health 

E-services can create conditions for learning, accessibility and knowledge translation in the event of illness and treatment. Furthermore, e-Health contributes to increased transparency and to breaking up traditional structures. It is important to develop e-Health services that are based on a person-centred approach to identify and utilize patients' resources, to meet needs and to co-create care between patients, their relatives and health care providers.

Purpose 

PROMISE aims to evaluate whether a person-centred e-Health intervention (digital platform and telephone support) for people who are on sick leave for stress, depression or anxiety can strengthen confidence in their own abilities and reduce the extent of sick leave. The study also includes a process and health economic evaluation.

Method 

The e-health intervention is evaluated in a randomized, controlled trial. The study participants are recruited from primary care and includes people who are on sick leave for stress, depression or anxiety. In addition to the usual healthcare and treatments, the intervention group receives person-centred calls via telephone as well as access to a digital platform that has several functions that aim to make it easier for participants to manage their everyday lives. On the digital platform, they can for instance report and monitor their health status, take part in their health plan that is co-created and continuously updated together with health care professionals in the study, and invite other people who are important for their rehabilitation and recovery.

Publications

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Scientific journals:

  1. Kebede T, Cederberg M, Alsén S, Fors A, Gyllensten H. A Person-centered eHealth Intervention for Patients with Common Mental Disorders: Cost-effectiveness Analysis within a Randomized Controlled Trial. Value in Health. Accepted for publication 2025 Mar.
  2. Cederberg M, Barenfeld E, Ali L, Ekman I, Goulding A, Fors A. A lowered threshold to partnerships: a mixed methods process evaluation of participants’ experiences of a person-centred eHealth intervention. BMC Health Serv Res. 2023 Nov 2;23(1):1193. doi: 10.1186/s12913-023-10190-7.
  3. Alsén S, Hadžibajramović E, Jonsdottir IH, Ali L, Fors A. Effectiveness of a person-centred eHealth intervention in reducing symptoms of burnout in patients with common mental disorders – secondary outcome analysis of a randomized controlled trial. BMC Prim Care. 2023 Oct 19;24(1):210. doi: 10.1186/s12875-023-02172-9.
  4. Alsén S, Ali L, Ekman I, Fors A. Having allies-Experiences of support in people with stress-related exhaustion: A qualitative study. PLoS One. 2022 Nov 9;17(11):0277264. doi: 10.1371/journal.pone.0277264.
  5. Cederberg M, Alsén S, Ali L, Ekman I, Glise K, Jonsdottir IH, Gyllensten H, Swedberg K, Fors A. Effects of a Person-Centered eHealth Intervention for Patients on Sick Leave Due to Common Mental Disorders (PROMISE Study): Open Randomized Controlled Trial. JMIR Mental Health. 2022 Mar 15;9(3):e30966. doi: 10.2196/30966.
  6. Cederberg M, Fors A, Ali L, Goulding A, Mäkitalo Å. The interactive work of narrative elicitation in person-centred care: Analysis of phone conversations between health care professionals and patients with common mental disorders. Health Expect. 2022 Jun;25(3):971-983. doi: 10.1111/hex.13440.
  7. Alsén S, Ali L, Ekman I, Fors A. Facing a blind alley - Experiences of stress-related exhaustion: a qualitative study. BMJ Open. 2020 Sep 2;10(9):e038230. doi: 10.1136/bmjopen-2020-038230.
  8. Cederberg M, Ali L, Ekman I, Glise K, Jonsdottir IH, Gyllensten H, Swedberg K, Fors A. Person-centred eHealth intervention for patients on sick leave due to common mental disorders: study protocol of a randomised controlled trial and process evaluation (PROMISE). BMJ Open. 2020 Sep 1;10(9):e037515. doi: 10.1136/bmjopen-2020-037515.

     

Dissertations: 

  1. Matilda Cederberg. Supporting mental health - Effects, communicative processes and experiences of a person-centred eHealth intervention. https://hdl.handle.net/2077/70944
  2. Sara Alsén. Understanding mental illness and promoting mental health - Experiences of exhaustion disorder and effects of a person-centred eHealth intervention. https://hdl.handle.net/2077/71635
  3.  

Conference talks and posters :

  1. Alsén S, Ali L, Ekman I, Fors A. Experiences of support in people with stress-related exhaustion. oral presentation. 23 May 2022. International Conference on Integrated Care (ICIC). Odense, Denmark.
  2. Cederberg M, Mäkitalo Å, Goulding A, Ali L, Ekman I, Fors A. The pivotal position of narratives in the practice of person-centred care. Poster presentation. 17 June 2021. International Philosophy of Nursing Conference (IPONS) (online). Gothenburg, Sweden.
  3. Alsén S, Ali L, Ekman I, Fors A. Exploring the patient-professional partnership within clinical encounters. Poster presentation. 17 June 2021. International Philosophy of Nursing Conference (IPONS) (online). Gothenburg, Sweden.
  4. Cederberg M, Alsén S, Ali L, Barenfeld E, Wallström S, Gyllensten H, Swedberg K, Ekman I, Fors A. Person-centred care via eHealth for people with stress-related mental illness – PROMISE. Poster presentation. 6–7 February 2020. GPCC 10-årsjubileumskonferens – Tillsammans för en bättre hälso- och sjukvård.Gothenburg, Sweden.
  5. Alsén S, Ali L, Ekman I, Fors A. The experience of being affected by stress-related exhaustion. Poster presentation. 13-14 November 2019. Advances in Health Care Sciences Conference. Flemingsberg, Stockholm, Sweden.
  6. Fors A, Björkelund C, Hensing G, Larsson ME. Vi vill utveckla nya arbetssätt för att patienter ska stärka sin arbetsförmåga. 1 October 2019. Seminariepresentation vid Nationella Primärvårdskonferensen. Gothenburg, Sweden.

Book chapter 

  1. Psykisk hälsa i arbetslivet. Redaktörer: Hensing G, Holmgren K, Björk L. Del av kapitel 4. Att behandla psykisk ohälsa i primärvården. Lund: Studentlitteratur. 978-91-44-14233-3.

Researchers

Research project/group
Person-centred care in long term conditions
Institute of Health and Care Sciences
Welcome to the Institute of Health and Care Sciences. As part of the Sahlgrenska Academy, we are dedicated to excellence in…
Centre for Person-centred Care - GPCC
Welcome to The University of Gothenburg Centre for Person-centred Care - GPCC!
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