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Scand J Caring Sci. 2016 Dec;30(4):687-694. doi: 10.1111/scs.12289. Epub 2015 Oct 13.

Understanding persons with psychological distress in primary health care.

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Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Primary Health Care Research Development and Education Centre, Vänersborg, Sweden.
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Centre for Person Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.


The purpose of this study was to gain more knowledge and a deeper understanding of experiences of persons living with psychological distress who seek help in primary care. Psychological distress is a state of emotional suffering associated with stressors and demands that are difficult to cope with in daily life. The lack of effective care for and difficulty in identifying psychological distress is frustrating for patients and health professionals alike. The aim was therefore to gain more knowledge about the experience of living with psychological distress. Twelve persons (nine women and three men) aged 23-51 years were interviewed. Analyses were based on a phenomenological hermeneutic method and indicated that psychological distress may be seen as an imbalance (incongruence) between the self and the ideal self, which slowly breaks down a person's self-esteem. This imbalance was described in three dimensions: Struggling to cope with everyday life, Feeling inferior to others and Losing one's grip on life. It seems to be associated with a gradual depletion of existential capacities and lead to dissatisfaction, suffering, poor self-esteem and lack of control. As psychological distress may be a forerunner to mental, physical and emotional exhaustion, there is a need to initiate preventive or early interventions to avoid mental, physical and emotional chaos in such patients. Patients' with psychological distress need to be involved in a person-centred salutogenic dialogue with health professionals to become aware of and strengthen their own capacities to regain health and well-being.


anxiety; depression; lived experience; phenomenological hermeneutic method; primary health care; psychological distress

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