Alderson, S orcid.org/0000-0002-5418-0495, Foy, RC orcid.org/0000-0003-0605-7713 and House, A orcid.org/0000-0001-8721-8026 (2015) Understandings of depression associated with chronic physical illness – a q-methodology study. British Journal of General Practice, 65 (635). pp. 401-408. ISSN 1478-5242
Abstract
Background
Detection of depression can be difficult in primary care, particularly when associated with chronic illness. Patient beliefs may affect detection and subsequent engagement with management. Q-methodology can help to identify viewpoints that are likely to influence either clinical practice or policy intervention.
Aim
To identify socially shared viewpoints of co-morbid depression, and characterise key overlaps and discrepancies.
Design and setting
A Q-methodology study of patients registered with general practices or community clinics in Leeds, UK.
Method
We invited patients with coronary heart disease or diabetes and depression from three practices and community clinics. In a Q-sorting exercise participants ranked 57 statements about co-morbid depression. We undertook factor analyses to identify independent accounts, and drew upon additional interview data to support interpretation.
Results
Thirty-one patients took part; 13 (42%) had current depression symptoms. Five accounts towards co-morbid depression were identified: overwhelmed resources; something medical or within me; a shameful weakness; part of who I am; and recovery-orientated. The main differences in attitudes related to the cause of depression and its relationship with their chronic illness, experience of shame and whether medical interventions would help recovery.
Conclusion
There are groups of patients who do not see a relationship between their depression and chronic illness; they may not understand the intention behind policy initiatives to identify depression during chronic illness reviews. Tailoring detection strategies for depression to take account of different clusters of attitudes and beliefs could help improve identification and personalise management.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Keywords: | depression; chronic disease; general practice; screening |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Psychiatry and Behavioural Sciences (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 08 Oct 2019 11:22 |
Last Modified: | 08 Oct 2019 11:22 |
Status: | Published |
Publisher: | Royal College of General Practitioners |
Identification Number: | 10.3399/bjgp15X685309 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:86562 |