Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/12876
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: A qualitative study of primary care professionals' views of case finding for depression in patients with diabetes or coronary heart disease in the UK
Authors: Maxwell, Margaret
Harris, Fiona Margaret
Hibberd, Carina
Donaghy, Edward
Pratt, Rebekah
Williams, Chris
Morrison, Jill
Gibb, Jennifer
Watson, Philip
Burton, Chris
Contact Email: margaret.maxwell@stir.ac.uk
Keywords: Depression
Case finding
Screening,
PHQ9
Diabetes
Coronary heart disease
Primary care
Issue Date: Apr-2013
Publisher: BioMed Central
Citation: Maxwell M, Harris FM, Hibberd C, Donaghy E, Pratt R, Williams C, Morrison J, Gibb J, Watson P & Burton C (2013) A qualitative study of primary care professionals' views of case finding for depression in patients with diabetes or coronary heart disease in the UK , BMC Family Practice, 14 (Article 46).
Abstract: BACKGROUND: Routinely conducting case finding (also commonly referred to as screening) in patients with chronic illness for depression in primary care appears to have little impact. We explored the views and experiences of primary care nurses, doctors and managers to understand how the implementation of case finding/screening might impact on its effectiveness. METHODS: Two complementary qualitative focus group studies of primary care professionals including nurses, doctors and managers, in five primary care practices and five Community Health Partnerships, were conducted in Scotland. RESULTS: We identified several features of the way case finding/screening was implemented that may lead to systematic under-detection of depression. These included obstacles to incorporating case finding/screening into a clinical review consultation; a perception of replacing individualised care with mechanistic assessment, and a disconnection for nurses between management of physical and mental health. Far from being a standardised process that encouraged detection of depression, participants described case finding/screening as being conducted in a way which biased it towards negative responses, and for nurses, it was an uncomfortable task for which they lacked the necessary skills to provide immediate support to patients at the time of diagnosis. CONCLUSION: The introduction of case finding/screening for depression into routine chronic illness management is not straightforward. Routinized case finding/screening for depression can be implemented in ways that may be counterproductive to engagement (particularly by nurses), with the mental health needs of patients living with long term conditions. If case finding/screening or engagement with mental health problems is to be promoted, primary care nurses require more training to increase their confidence in raising and dealing with mental health issues and GPs and nurses need to work collectively to develop the relational work required to promote cognitive participation in case finding/screening.
Type: Journal Article
URI: http://hdl.handle.net/1893/12876
DOI Link: http://dx.doi.org/10.1186/1471-2296-14-46
Rights: © 2013 Maxwell et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1471-2296/14/46
Affiliation: NMAHP Research
NMAHP Research
NMAHP Research
University of Minnesota
University of Glasgow
University of Glasgow
Robert Gordon University
University of Edinburgh
University of Edinburgh

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