School of Social Work, University of Southern California, Los Angeles, CA, USA.
J Immigr Minor Health. 2012 Dec;14(6):1097-106. doi: 10.1007/s10903-012-9590-x.
This qualitative study examines help-seeking pathways to depression care of low-income Latinos with diabetes and major depression. A purposive sample (N = 19) of Spanish-speaking, immigrant, low-income Latinos was selected from a randomized clinical trial targeting Latinos with diabetes and major depression. Four focus groups followed by 10 in-depth qualitative interviews were conducted. Narratives were analyzed using the constant comparative method informed by grounded theory. Need for formal care was described in relation to acute somatic symptoms, functional impairment, and mood changes. Treatment initiation occurred through family members and primary care physicians who encouraged or inhibited help-seeking. Adherence to depression care focused on interpersonal aspects of care, evaluated symptom relief, and improved functioning. Help-seeking barriers included self-reliance, language barriers, stigma, competing health demands, and structural barriers. Findings from this study highlight potential points of intervention for developing culturally-appropriate collaborative care approaches for low-income Latinos with diabetes and major depression.
本定性研究考察了寻求抑郁症治疗的途径，研究对象为患有糖尿病和重度抑郁症的低收入西班牙语裔拉丁裔人群。采用目的性抽样法，从一项针对患有糖尿病和重度抑郁症的拉丁裔人群的随机临床试验中选取了 19 名讲西班牙语、移民、低收入的拉丁裔人群作为样本。共开展了 4 次焦点小组讨论和 10 次深入的定性访谈。采用扎根理论指导的持续比较方法对叙事进行分析。对正式治疗的需求与急性躯体症状、功能障碍和情绪变化有关。治疗始于家庭成员和初级保健医生，他们鼓励或阻碍了寻求帮助。对抑郁症治疗的依从性侧重于治疗的人际方面，评估症状缓解和功能改善情况。寻求帮助的障碍包括自力更生、语言障碍、耻辱感、健康需求竞争以及结构性障碍。本研究的结果强调了针对患有糖尿病和重度抑郁症的低收入拉丁裔人群开发文化适宜的合作护理方法的潜在干预点。
