Department of Family Medicine and Psychiatry, School of Medicine and Dentistry, University of Rochester, Rochester, New York 14642, USA.
J Ment Health. 2011 Oct;20(5):429-37. doi: 10.3109/09638237.2011.556164. Epub 2011 Jul 22.
Primary care occupies a strategic position in the evaluation and treatment of depression in late life, yet many older patients do not initiate or adhere to treatments available in primary care.
To explore how primary care providers describe the process of discussing depression care with older adults.
Semi-structured interviews conducted with 15 providers involved with intervention studies of depression management for older adults. We used the constant comparative method to identify themes related to negotiating the treatment of depression with older adults.
Providers felt that older patients often attribute depression to non-medical causes. They talked about the challenges and described the need to 'convince' them of the medical model of depression.
How primary care physicians surmise patients' views of depression may influence the discussion of depression in practice. As medication is most often provided for depression treatment, some may feel compelled to convince their patients of biomedical explanations while others may avoid treating depression altogether.
初级保健在评估和治疗老年抑郁症方面占据着战略地位，但许多老年患者并未在初级保健中开始或坚持使用现有治疗方法。
探讨初级保健提供者如何描述与老年人讨论抑郁症护理的过程。
对参与老年人抑郁症管理干预研究的 15 名提供者进行半结构化访谈。我们使用恒定性比较方法确定与与老年人协商治疗抑郁症相关的主题。
提供者认为老年患者通常将抑郁症归因于非医学原因。他们讨论了挑战，并描述了需要“说服”他们接受抑郁症的医学模式。
初级保健医生对患者抑郁症看法的推测可能会影响实践中对抑郁症的讨论。由于药物治疗通常是治疗抑郁症的主要方法，因此有些人可能会觉得有必要说服患者接受生物医学解释，而另一些人则可能完全避免治疗抑郁症。
