Supporting mental health - Effects, communicative processes and experiences of a person-centred eHealth intervention

Abstract

Corresponding to the appeal to develop supportive strategies for people on sick leave with common mental disorders (CMDs), focusing beyond illness and towards mental health, this thesis evaluates an eHealth intervention based on person-centred care (PCC). The overall aim was to evaluate and explore the effects and processes of a person-centred eHealth intervention for patients on sick leave with CMDs by illuminating experiences and communicative practices constituting and taking part in a PCC intervention in an eHealth setting. Different methods were used in the individual studies, corresponding to the overarching and individual aims. One paper comprised a study protocol of the design and methodological choices of the project. Effects were evaluated in a randomised controlled trial, interactive processes related to narrative elicitation were explored in a conversation analysis, and participants’ experiences were explored in a mixed methods analysis. Findings: the evaluation of effects demonstrated an increase in general self-efficacy among intervention participants but no effect on level of sick leave. The elicitation of narratives was a central communicative task in the patient-professional interaction which provided opportunities for meaning-making processes but could also give rise to interactive challenges. Patients in the intervention group overall found the intervention to have offered meaningful support, particularly the phone communication with intervention professionals. The support participants perceived was due to the recognition they felt from the intervention professionals and the continuous availability that was enabled by the eHealth format. In conclusion, the thesis contributes to understanding how health care can support persons on sick leave with CMDs. Drawing from findings in the individual studies, communicative processes inherent to the PCC agenda of eliciting narratives and forming partnerships were central to how support was enacted in the intervention and to the participants’ experience of the intervention’s meaningfulness. The essential elements of the intervention were the provision of a meaningful professional support within reach, through the continuous access to professionals provided by the eHealth format.