Wittink Marsha N, Joo Jin Hui, Lewis Lisa M, Barg Frances K
Department of Family Medicine and Community Health, University of Pennsylvania, 3400 Spruce Street, 2 Gates Building, Philadelphia, PA 19104, USA.
J Gen Intern Med. 2009 Mar;24(3):402-7. doi: 10.1007/s11606-008-0897-1. Epub 2009 Jan 21.
Older African Americans are often under diagnosed and under treated for depression. Given that older African Americans are more likely than whites to identify spirituality as important in depression care, we sought to understand how spirituality may play a role in the way they conceptualize and deal with depression in order to inform possible interventions aimed at improving the acceptability and effectiveness of depression treatment.
Cross-sectional qualitative interview study of older African American primary care patients.
Forty-seven older African American patients recruited from primary care practices in the Baltimore, MD area, interviewed in their homes.
Semi-structured interviews lasting approximately 60 minutes. Interviews were transcribed and themes related to spirituality in the context of discussing depression were identified using a grounded-theory approach.
Participants in this study held a faith-based explanatory model of depression with a particular emphasis on the cause of depression and what to do about it. Specifically, participants described depression as being due to a "loss of faith" and faith and spiritual/religious activities were thought to be empowering in the way they can work together with medical treatments to provide the strength for healing to occur.
The older African Americans in this study described an intrinsically spiritual explanatory model of depression. Addressing spirituality in the clinical encounter may lead to improved detection of depression and treatments that are more congruent with patient's beliefs and values.
老年非裔美国人的抑郁症常常诊断不足且治疗不足。鉴于老年非裔美国人比白人更倾向于认为灵性在抑郁症治疗中很重要，我们试图了解灵性如何在他们对抑郁症的认知和应对方式中发挥作用，以便为可能的干预措施提供信息，旨在提高抑郁症治疗的可接受性和有效性。
对老年非裔美国初级保健患者进行横断面定性访谈研究。
从马里兰州巴尔的摩地区的初级保健机构招募了47名老年非裔美国患者，并在他们家中进行访谈。
进行持续约60分钟的半结构化访谈。访谈内容被转录，并采用扎根理论方法确定在讨论抑郁症背景下与灵性相关的主题。
本研究的参与者持有基于信仰的抑郁症解释模型，特别强调抑郁症的成因以及应对方法。具体而言，参与者将抑郁症描述为“信仰缺失”所致，并且认为信仰和精神/宗教活动在与医疗治疗协同作用以提供康复力量方面具有赋能作用。
本研究中的老年非裔美国人描述了一种内在的灵性抑郁症解释模型。在临床诊疗中关注灵性可能会改善抑郁症的检测，并使治疗更符合患者的信仰和价值观。
