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Qualitative study of depression management in primary care: GP and patient goals, and the value of listening

Qualitative study of depression management in primary care: GP and patient goals, and the value of listening
Qualitative study of depression management in primary care: GP and patient goals, and the value of listening
Background: Guidelines for depression management have been developed but little is known about GP and patient goals, which are likely to influence treatment offers, uptake, and adherence.
Aim: To identify issues of importance to GPs, patients, and patients' supporters regarding depression management. GP and patient goals for depression management became a focus of the study.
Design of study: Grounded theory-based qualitative study. Setting: GPs were drawn from 28 practices. The majority of patients and supporters were recruited from 10 of these practices.
Method: Sixty-one patients (28 depressed, 18 previously depressed, 15 never depressed), 18 supporters, and 32 GPs were interviewed.
Results: GPs described encouraging patients to view depression as separate from the self and 'normal' sadness. Patients and supporters often questioned such boundaries, rejecting the notion of a medical cure and emphasising self-management. The majority of participants who were considering depression-management strategies wanted to 'get out' of their depression. However, a quarter did not see this as immediately relevant or achievable. They focused on getting by from day to day, which had the potential to clash with GP priorities. GP frustration and uncertainty could occur when depression was resistant to cure. Participants identified the importance of GPs listening to patients, but often felt that this did not happen.
Conclusion: Physicians need greater awareness of the extent to which their goals for the management of depression are perceived as relevant or achievable by patients. Future research should explore methods of negotiating agreed strategies for management.
care, gps, physician-patient relations, psychiatry, family practice, patient acceptance of health care, research, female, psychology, 80 and over, methods, aged, primary-care, attitude of health personnel
0960-1643
1E-14E
Johnston, Olwyn
cf28d016-bc32-4db0-9502-38b811ca29c6
Kumar, Satinder
a95ff9c1-b421-4712-aeb5-f4d414ebbc02
Kendall, Kathleen
7c1c7abc-513b-4da5-b99d-268cd1d8bc58
Peveler, Robert
93198224-78d9-4c1f-9c07-fdecfa69cf96
Gabbay, John
d779b76c-febe-461b-b3bb-e110163f114a
Kendrick, Tony
c697a72c-c698-469d-8ac2-f00df40583e5
Johnston, Olwyn
cf28d016-bc32-4db0-9502-38b811ca29c6
Kumar, Satinder
a95ff9c1-b421-4712-aeb5-f4d414ebbc02
Kendall, Kathleen
7c1c7abc-513b-4da5-b99d-268cd1d8bc58
Peveler, Robert
93198224-78d9-4c1f-9c07-fdecfa69cf96
Gabbay, John
d779b76c-febe-461b-b3bb-e110163f114a
Kendrick, Tony
c697a72c-c698-469d-8ac2-f00df40583e5

Johnston, Olwyn, Kumar, Satinder, Kendall, Kathleen, Peveler, Robert, Gabbay, John and Kendrick, Tony (2007) Qualitative study of depression management in primary care: GP and patient goals, and the value of listening. British Journal of General Practice, 57 (544), 1E-14E. (doi:10.3399/096016407782318026).

Record type: Article

Abstract

Background: Guidelines for depression management have been developed but little is known about GP and patient goals, which are likely to influence treatment offers, uptake, and adherence.
Aim: To identify issues of importance to GPs, patients, and patients' supporters regarding depression management. GP and patient goals for depression management became a focus of the study.
Design of study: Grounded theory-based qualitative study. Setting: GPs were drawn from 28 practices. The majority of patients and supporters were recruited from 10 of these practices.
Method: Sixty-one patients (28 depressed, 18 previously depressed, 15 never depressed), 18 supporters, and 32 GPs were interviewed.
Results: GPs described encouraging patients to view depression as separate from the self and 'normal' sadness. Patients and supporters often questioned such boundaries, rejecting the notion of a medical cure and emphasising self-management. The majority of participants who were considering depression-management strategies wanted to 'get out' of their depression. However, a quarter did not see this as immediately relevant or achievable. They focused on getting by from day to day, which had the potential to clash with GP priorities. GP frustration and uncertainty could occur when depression was resistant to cure. Participants identified the importance of GPs listening to patients, but often felt that this did not happen.
Conclusion: Physicians need greater awareness of the extent to which their goals for the management of depression are perceived as relevant or achievable by patients. Future research should explore methods of negotiating agreed strategies for management.

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More information

Published date: November 2007
Keywords: care, gps, physician-patient relations, psychiatry, family practice, patient acceptance of health care, research, female, psychology, 80 and over, methods, aged, primary-care, attitude of health personnel

Identifiers

Local EPrints ID: 61833
URI: http://eprints.soton.ac.uk/id/eprint/61833
ISSN: 0960-1643
PURE UUID: ee21015a-7966-48da-b5f5-db0a9f74c621
ORCID for Robert Peveler: ORCID iD orcid.org/0000-0001-5596-9394
ORCID for Tony Kendrick: ORCID iD orcid.org/0000-0003-1618-9381

Catalogue record

Date deposited: 10 Sep 2008
Last modified: 09 Jan 2022 02:57

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Contributors

Author: Olwyn Johnston
Author: Satinder Kumar
Author: Robert Peveler ORCID iD
Author: John Gabbay
Author: Tony Kendrick ORCID iD

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