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Patients’ and practice nurses’ perceptions of depression in patients with type 2 diabetes and/or coronary heart disease screened for subthreshold depression
Version 2 2023-06-12, 08:06
Version 1 2023-06-10, 01:12
journal contribution
posted on 2023-06-12, 08:06 authored by Alide D Pols, Karen Schipper, Debbie Overkamp, Harm van MarwijkHarm van Marwijk, Maurits W Van Tulder, Marcel C AdriaanseBackground Comorbid depression is common in patients with type 2 diabetes (DM2) and/or coronary heart disease (CHD) and is associated with poor quality of life and adverse health outcomes. However, little is known about patients’ and practice nurses’ (PNs) perceptions of depression. Tailoring care to these perceptions may affect depression detection and patient engagement with treatment and prevention programs. This study aimed to explore patients’ and PNs’ perceptions of depression in patients with DM2/CHD screened for subthreshold depression. Methods A qualitative study was conducted as part of a Dutch stepped-care prevention project. Using a purposive sampling strategy, data were collected through semi-structured interviews with 15 patients and 9 PNs. After consent, all interviews were recorded, transcribed verbatim and analyzed independently by two researchers with Atlas.ti.5.7.1 software. The patient and PN datasets were inspected for commonalities using a constant comparative method, from which a final thematic framework was generated. Results Main themes were: illness perception, need for care and causes of depression. Patients generally considered themselves at least mildly depressed, but perceived severity levels were not always congruent with Patient Health Questionnaire 9 scores at inclusion. Initially recognizing or naming their mental state as a (subthreshold) depression was difficult for some. Having trouble sleeping was frequently experienced as the most burdensome symptom. Most experienced a need for care; psycho-educational advice and talking therapy were preferred. Perceived symptom severity corresponded with perceived need for care, but did not necessarily match help-seeking behaviour. Main named barriers to help-seeking were experienced stigma and lack of awareness of depression and mental health care possibilities. PNs frequently perceived patients as not depressed and with minimal need for specific care except for attention. Participants pointed to a mix of causes of depression, most related to negative life events and circumstances and perceived indirect links with DM2/CHD. Conclusion Data of the interviewed patients and PNs suggest that they have different perceptions about (subthreshold) depressive illness and the need for care, although views on its causes seem to overlap more.
History
Publication status
- Published
File Version
- Published version
Journal
BMC Family PracticeISSN
1471-2296Publisher
BMCExternal DOI
Issue
1Volume
19Page range
1-14Article number
a202Event location
EnglandDepartment affiliated with
- Primary Care and Public Health Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2021-09-30First Open Access (FOA) Date
2021-09-30First Compliant Deposit (FCD) Date
2021-09-30Usage metrics
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No categories selectedKeywords
Coronary heart diseaseDepressionIllness perceptionsNeed for careQualitative studyType 2 diabetes mellitusAdultAttitude of Health PersonnelAttitude to HealthCommunication BarriersCoronary DiseaseDiabetes MellitusType 2FemaleHumansMaleMiddle AgedNetherlandsNurse PractitionersPractice PatternsNurses'Primary Health CareQualitative ResearchQuality of LifeSocial Stigma
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