Table 2

Citations

Concerned—looking for adviceFear of not to coping any longerLooking for a way back or out
Perspective and experiencesI would say that stress and lack of sleep and the ongoing need to perform causes something like increased stress levels all the time. And that can't be healthy in the long run, I think. Interview 6
I hoped every day that I wouldn’t have to go to work. I almost hoped I would fall and break a leg so that I couldn't go to work. I was almost relieved when my youngest, who had started kindergarten, fell ill and I could stay at home. So, in a way, there was never a day when I was okay with work tasks. I felt bad every day, and I cried on my way down to the car or at work—almost every day. Interview 1
Yes, you could say that, but in many ways I have been and felt well during this time, I may have sometimes felt that the days are exhausting and heavy going, but I haven't felt sick. Interview 9
Not just work—I feel the situation is most difficult at home. But it’s the total situation—capturing how one feels in trying to stretch oneself so far in all directions. Interview 10
On a number of occasions in recent months, there were several things that I thought can't be normal. Sometimes I can't find words. Interview 10
Okay, I have had high blood pressure in recent years. That hasn't really been a problem, but I think it is related to why I came to Modum (Villa Sana)—for depression, anxiety, and sleep problems.
It was the same in May, when I hadn't slept for many nights, and I finally said that I felt I was no longer functioning well. I'm also beginning to be worried about making mistakes. Interview 5
It was as if everything just stopped for a while, and it became so difficult. Everything seemed difficult, every day—dealing with patients, even shopping and sleeping, and so on. So then I thought, ‘Oh God, I really have to do something.’ Interview 8
Yes, I told her that I couldn't do it any longer, that I’m so scared of making a mistake with the patients. My GP recommended sick leave—I contacted my GP because I was no longer a doctor. I said to my boss that I could no longer handle the day, every day at work. Interview 7
And yes, before, when things were difficult, there was always an extra gear that enabled you to push a little more, thinking it's only for a finite period of time, and that it will probably get better. A kind of wishful thinking….
And then you think, ‘Now it will get better, now it will get better—I have to give and push even more…’ And then, finally, there just isn't anything left to give, and that’s a feeling I’ve never had before. Interview 3
…these depressive down periods are so frightening. I get…with this one, I also experienced strong suicidal thoughts, so I would say it’s serious depression. Interview 4
I don't feel like a doctor. I just feel like a patient who is very scared. Interview 7
Expectations of helpIt’s described as a course, so I understood that this is not therapy–that much I knew for sure. Interview 1
And then I was a bit scared of having unduly high expectations. So I just told myself that it would be a day to sort things through in my mind, in the hope that we—that I—can understand the situation better. Interview 9
I found it extremely helpful to talk to somebody who, I suppose, knows the profession, and understands what you could call the ‘lifestyle’—what a doctor’s life is like. That was very reassuring. And [that it was someone] who had talked to others in similar situations. [It was] good to know that I was talking to someone who was experienced in that field. Interview 6
I thought that it [Resource Centre Villa Sana] was perhaps only a place to start… where one could reflect on the situation, possibly for more than one day…if that was needed. Interview 8
… this is a kind of introduction, where you get to know about your possibilities. You learn some terms; you discuss and reflect; you develop some thoughts. You get some counselling, and some pegs to hang things on. Interview 11
I thought it [coming to the Resource Centre] might be important to get some tools for [handling the situation]. Interview 10
… I didn’t think that medication would be discussed or evaluated during the counselling session. No—I thought it would be advice about the future, perhaps including treatment by a psychiatrist. Interview 4
If accepted at Villa Sana, I hoped to get some peace of mind, some counselling. Interview 7
I think my expectations of Villa Sana differed from what I got… I know I was thinking ‘Okay, I need something tangible. I need a date for when I can get back to work; I need new medication.’ Interview 13
Barriers and facilitatorsConfidentiality:
… it meant a lot to me that there would be no record (of the counseling session). Interview 6
…so I thought that was good—because she didn't adopt the therapist role. It was a conversation—it wasn’t logged, and it felt very agreeable, as well as extremely professional. Interview 9
It's not important. He said he wouldn't be writing a medical record, but it wouldn't have mattered to me if he did. Interview 12
Sick leave:
I've never had a GP. I [once] had gallstones, which needed to be removed, so they took out the gall bladder. I haven't been on sick leave related to that or anything else, other than a few self-reported days off. Interview 6
Threshold:
I hesitated [to contact the Villa Sana Resource Centre] because, first of all, I thought that this counselling was reserved for people on sick leave. Secondly, I thought that it was more specialized care [at the Resource Centre]. Interview 1
No, I can also contact my GP, but this was not an appropriate issue [for the GP]. I don't have a high threshold for asking for help, which may be atypical for a doctor. Interview 12
I think perhaps [the threshold for] seeking help from a GP or other parts of the health care system is much higher for me than [seeking help] at Villa Sana, but I wouldn’t say the threshold for contacting Villa Sana is low. I’ve thought about it for a long time, but I didn’t want to do it because I thought that, to do so, I would have to have a much more serious mental condition. Interview 6
Confidentiality:
No, I trust the confidentiality in patient records. I’m not concerned about that. Interview 8
Yes, I think it’s really important. It lowers the threshold (for seeking support)….
Interview 11
Sick leave:
I haven't ever really been on sick leave. I was on partial (20%) sick leave for a short while because of exhaustion and stress at the end of my third pregnancy…deep inside, it feels difficult to view sick leave as the solution to anything at all. Interview 10
No, I can't stay away, I feel I have to go to work. If I'm away, someone else has to do extra work, or my colleagues have to stand in for me if I'm not there. So it doesn't feel okay [to be on sick leave]. Interview 8
Threshold:
So it was a bit random [contacting Villa Sana]. I was in a group professional guidance setting, and one colleague there had been to this counselling session in Oslo. So then I thought ‘That's doable! I can't get away for a week, but I can use one of my administrative days and attend counseling.’ Interview 8
Confidentiality:
It works as an offer of wellness because this is not therapy, and no records are kept. Because we come as a result of serious overload and are not in treatment, we attend a course … for reflection. So that and the guarantee of confidentiality encourages us to muster our strengths. Interview 2
I felt I was as low as I could get, and I had so many patient records …in different hospitals, so keeping up a façade is kind of too late, you know. One more or less didn’t matter to me at that time, but I know it matters to other people. Interview 3
… I think that might be important in keeping the threshold low [for seeking peer support] for all kinds of problems—and because it’s clear that some things are difficult to talk about, [people might not] make contact if everything was to be recorded. Then, either the Norwegian Labour and Welfare Administration or supervisory authorities could ask for information….If [the service] is to protect people who struggle with alcohol or drugs or serious psychiatric illness …or with things even more difficult than I am struggling with [it is important that records are not kept]. Interview 4
Yes, it is important. I hope I can look back at this and see it as a state of emergency. Interview 13.
Sick leave:
It was a very difficult decision to accept sick leave. In the end, I realized I'm a patient now, and I have to let my GP take care of me. Interview 7
Threshold:
I've had colleagues who mentioned Villa Sana, but it was my GP who asked me on multiple occasions to get in contact [with Villa Sana]. Interview 3
There's a long way to go from first realizing that there’s a problem to realizing that one has a problem. And then, it’s a long way from there to accepting that one has a problem—and an even longer way to seeking help for the problem. That whole process is really a kind of recognition that one doesn't cope by oneself. Interview 3
  • GP, general practitioner.