Wittink Marsha N, Dahlberg Britt, Biruk Crystal, Barg Frances K
University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Qual Health Res. 2008 Sep;18(9):1174-83. doi: 10.1177/1049732308321737.
Past research has suggested that patients might not accept depression treatment in part because of differences between patient and doctor understandings of depression. In this article, we use a cultural models approach to explore how older adults incorporate clinical and experiential knowledge into their model of depression. We conducted semistructured interviews about depression with 19 patients aged 65 years and older who were identified by their physicians as depressed. We found that whereas older adults viewed as helpful the doctor's ability to identify symptoms and "put it all together" into a diagnosis, they felt that this viewpoint omitted important information about the etiology and feeling of depression grounded in embodied experience and social context. Our findings suggest that more emphasis on issues related to the etiology of depression, the effect of depression on social relationships, and emotions emanating from depression might lead to more acceptable depression treatments for older adults.
过去的研究表明,患者可能不接受抑郁症治疗,部分原因在于患者与医生对抑郁症的理解存在差异。在本文中,我们采用文化模型方法来探究老年人如何将临床知识和经验知识融入他们的抑郁症模型。我们对19名65岁及以上被医生诊断为患有抑郁症的患者进行了关于抑郁症的半结构化访谈。我们发现,虽然老年人认为医生识别症状并“综合起来”做出诊断的能力很有帮助,但他们觉得这种观点遗漏了基于身体体验和社会背景的抑郁症病因及感受等重要信息。我们的研究结果表明,更多地强调与抑郁症病因、抑郁症对社会关系的影响以及抑郁症引发的情绪等相关问题,可能会使老年人更容易接受抑郁症治疗。