Explanatory models of depression and treatment adherence to antidepressant medication: A qualitative interview study

Buus, Niels; Johannessen, Helle; Stage, Kurt Bjerregaard

doi:10.1016/j.ijnurstu.2012.04.012

Cited by 39 publications

(42 citation statements)

References 13 publications

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“…Findings from Wang and colleagues (31) indicated that the use of "non-health care human services," including religious and spiritual advisors, varied according to mental illness, where a higher prevalence was observed among those with mood disorders. A recent qualitative study by Buus and colleagues (35) concerning people with depressive disorders found that a majority believed that the etiology of their depression was psychosocial and did not draw on specific biological explanations. Similarly, Dejman and colleagues (36) found that coping mechanisms of persons with a depressive disorder involved seeking social support from family and neighbors, religious practice, engaging in pleasurable activities, and seeking medical support from psychologists and family counselors.…”

Section: Discussionmentioning

confidence: 99%

Roles of Religious and Spiritual Advisors Among Adults in Singapore With Mental Illnesses

Subramaniam¹,

Abdin²,

Vaingankar³

et al. 2013

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OBJECTIVE Information is limited concerning the role of religious and spiritual advisors in providing help to people with mental illnesses in Singapore. This study examined that role, as well as the satisfaction with and the perceived effectiveness of the services provided, among people with mental health problems. METHODS Data were collected as part of a nationally representative household survey of residents 18 years and older in Singapore. The Composite International Diagnostic Interview, version 3.0, was used to diagnose mental illness as well as to collect information about the mental health services respondents had sought. RESULTS A total of 6,616 respondents completed the survey; in the overall sample, 1.5% reported seeking help from religious or spiritual advisors. This rate increased to 6.6% among those with at least one mental illness, with the prevalence being higher among respondents with lifetime dysthymia, generalized anxiety disorder, or bipolar disorder. Sociodemographic correlates associated with a lower likelihood of consultation with a religious or spiritual advisor included reporting "other" race-ethnicity as well as faith in Buddhism, Hinduism, or Islam. Most respondents who sought help from a religious or spiritual advisor in the last 12 months were satisfied with the help they received, and about half reported it to be very useful. CONCLUSIONS Religious and spiritual advisors are an important source of help for people with mental illness, and a majority of respondents with a mental illness were satisfied with the support they received from these sources.

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Section: Discussionmentioning

confidence: 99%

Roles of Religious and Spiritual Advisors Among Adults in Singapore With Mental Illnesses

Subramaniam¹,

Abdin²,

Vaingankar³

et al. 2013

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“…Previous studies have shown that side effects, lack of efficacy in the weeks following treatment initiation, stigma and lack of clinician-patient alliance are potentially related to non-adherence with ADT. [7][8][9][10][11] This is problematic given that ADT non-adherence has been associated with relapse 12 and lower remission rates. 13 Community pharmacists are in position to prevent, identify and intervene on problems that patients encounter with ADT.…”

Section: Introductionmentioning

confidence: 99%

Perspective of community pharmacists on their practice with patients who have an antidepressant drug treatment: Findings from a focus group study

Guillaumie

Moisan

Grégoire

et al. 2015

Research in Social and Administrative Pharmacy

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“…This is another reason why it is important to study how people with depression view the condition. (Okello & Neema, 2007), illness experience and treatment choices (Buus, Johannessen, & Stage, 2012). Perhaps the effectiveness of depression treatment can be improved if we first investigate how individuals with depression perceive the condition.…”

Section: The Problemmentioning

confidence: 99%

“…Instead, my research will involve the perspectives of participants who self-report consulting a GP for what they consider to be depression, and also the perspectives of their GPs (more details in Chapter 7). Patient perceptions are key because they influence patients' help-seeking behaviour (Okello & Neema, 2007), illness experience, and treatment choice (Buus et al, 2012). GP perceptions are equally important because both patient and doctor viewpoints should be integrated to establish a strong therapeutic alliance (Nosè et al, 2012).…”

Section: Importance Of Perspectivementioning

confidence: 99%

“…As mentioned earlier in this chapter, patient depression EMs become de-medicalised when antidepressants are ineffective (Buus et al, 2012) [T]hey call them heart sink patients because they are always complaining of something, and never getting any better and never you know improving and never happy of anything you do for them...patients which are not typically depressed but just a nuisance.…”

Section: Doctor's Explanatory Modelsmentioning

confidence: 99%

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Depression explanatory models of primary care patients and doctors: Relationship with self-stigma, communication effectiveness, and recovery

Teh¹

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This thesis examines the role of patient and doctor perspectives in primary care depression management. The analytical term chosen to explore these perspectives is Kleinman's explanatory model (EM), defined as "notions about an episode of sickness and its treatment that are employed by all those engaged in the clinical process" (1980, p. 105). This research is exploratory and focuses mainly on patients, with input from a small number of general practitioners (GPs).I examine self-stigma in depression patients because there has been an attempt in recent years to reduce stigma by describing depression as a medical condition like diabetes. This may have decreased some public stigma, but the association between biomedical explanations for depression and patient self-stigma has not been studied in-depth. Self-stigma is the internalisation of negative stereotypes and prejudices about having mental illness and it can inhibit help-seeking and outcomes more than public stigma. Another factor that can influence depression outcomes is the therapeutic relationship between patient and their doctor. Studies report empathy and good communication as Quantitative analysis methods mainly consisted of non-parametric tests for differences between groups and strength of correlations. Interviews were analysed manually and with textual analysis software Leximancer.RQ1 results showed that most participants had a strong or moderate belief about whether biomedical and/or psychosocial factors caused their depression, and most EM beliefs did not change over time. RQ2 results indicated that biomedical belief was associated with lower helpseeking inhibition but also greater alienation. RQ3 results highlighted that endorsement of GPpatient cooperation was strongly positively correlated with communication effectiveness. Patient interviews yielded exemplars to illustrate these findings. RQ4 results from a paired study (n = 29) suggest that the GPs were aware of and concordant with their patient's EMs. Awareness appears to be more important in determining recovery than concordance. Incidentally, GP interviews showed that doctors mostly accorded importance to knowing their patient's EM but concordance was seen as less crucial.This thesis gives new understanding about depression EM beliefs that are associated with lower patient self-stigma and more effective GP-patient communication. Results from this research on awareness-concordance were not generalisable due to the small sample size, but future work with larger samples will undoubtedly yield more insights into the importance of EMs in primary care depression management.

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Explanatory models of depression and treatment adherence to antidepressant medication: A qualitative interview study

Cited by 39 publications

References 13 publications

Roles of Religious and Spiritual Advisors Among Adults in Singapore With Mental Illnesses

Roles of Religious and Spiritual Advisors Among Adults in Singapore With Mental Illnesses

Perspective of community pharmacists on their practice with patients who have an antidepressant drug treatment: Findings from a focus group study

Depression explanatory models of primary care patients and doctors: Relationship with self-stigma, communication effectiveness, and recovery

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