Document Type
Article
Publication Date
5-7-2013
Journal / Book Title
Journal of General Internal Medicine volume
Abstract
BACKGROUND
Depression is prevalent in primary care (PC) practices and poses a considerable public health burden in the United States. Despite nearly four decades of efforts to improve depression care quality in PC practices, a gap remains between desired treatment outcomes and the reality of how depression care is delivered.
OBJECTIVE
This article presents a real-world PC practice model of depression care, elucidating the processes and their influencing conditions.
DESIGN
Grounded theory methodology was used for the data collection and analysis to develop a depression care model. Data were collected from 70 individual interviews (60 to 70 min each), three focus group interviews (n = 24, 2 h each), two surveys per clinician, and investigators’ field notes on practice environments. Interviews were audiotaped and transcribed for analysis. Surveys and field notes complemented interview data.
PARTICIPANTS
Seventy primary care clinicians from 52 PC offices in the Midwest: 28 general internists, 28 family physicians, and 14 nurse practitioners.
KEY RESULTS
A depression care model was developed that illustrates how real-world conditions infuse complexity into each step of the depression care process. Depression care in PC settings is mediated through clinicians’ interactions with patients, practice, and the local community. A clinician’s interactional familiarity (“familiarity capital”) was a powerful facilitator for depression care. For the recognition of depression, three previously reported processes and three conditions were confirmed. For the management of depression, 13 processes and 11 conditions were identified. Empowering the patient was a parallel process to the management of depression.
CONCLUSIONS
The clinician’s ability to develop and utilize interactional relationships and resources needed to recognize and treat a person with depression is key to depression care in primary care settings. The interactional context of depression care makes empowering the patient central to depression care delivery.
DOI
DOI: 10.1007/s11606-013-2468-3
MSU Digital Commons Citation
Baik, Seong-Yi; Crabtree, Benjamin F.; and Gonzales, Junius, "Primary Care Clinicians’ Recognition and Management of Depression: A Model of Depression Care in Real-World Primary Care Practice" (2013). Publications from Provost Junius J. Gonzales. 8.
https://digitalcommons.montclair.edu/provost_publications/8
Published Citation
Baik, Seong-Yi, Benjamin F. Crabtree, and Junius J. Gonzales. "Primary care clinicians’ recognition and management of depression: a model of depression care in real-world primary care practice." Journal of general internal medicine 28, no. 11 (2013): 1430-1439.
Included in
Behavior and Behavior Mechanisms Commons, Clinical Epidemiology Commons, Community Health and Preventive Medicine Commons, Environmental Public Health Commons, Epidemiology Commons, Health Services Administration Commons, Health Services Research Commons, International Public Health Commons, Mental Disorders Commons, Other Mental and Social Health Commons, Other Psychiatry and Psychology Commons, Patient Safety Commons, Psychiatric and Mental Health Commons, Psychoanalysis and Psychotherapy Commons, Psychological Phenomena and Processes Commons, Public Health Education and Promotion Commons