Stanners Melinda N, Barton Christopher A, Shakib Sepehr, Winefield Helen R
Discipline of General Practice, Flinders University, Bedford Park, South Australia, Australia.
BMC Fam Pract. 2014 Jun 19;15:124. doi: 10.1186/1471-2296-15-124.
We explored experiences of depression diagnosis and treatment amongst multimorbid patients referred to a metropolitan multidisciplinary outpatient clinic to identify commonalities across this patient group.
Patients with two or more chronic conditions and a diagnosis of depression participated in semi-structured interviews that were digitally recorded and transcribed. Thematic analysis was performed on the transcriptions.
Multimorbid patients attributed depressive symptoms to the loss of 'normal' roles and functionality and struggled to reconcile the depression diagnosis with their sense of identity. Beliefs about themselves and depression affected their receptivity to diagnosis and intervention strategies. These included prescribed interventions, such as psychotherapy or pharmacotherapy, and patient-developed strategies.
Functional and social role losses present a clear context in which GPs should raise the subject of mood, with the situational attribution of depression suggesting that psychotherapy, which is rarely offered, should be prioritised in these circumstances.
我们探讨了转诊至大都市多学科门诊诊所的多病患者的抑郁症诊断和治疗经历，以确定该患者群体的共性。
患有两种或更多慢性疾病且被诊断为抑郁症的患者参与了半结构化访谈，访谈进行了数字录音和转录。对转录内容进行了主题分析。
多病患者将抑郁症状归因于“正常”角色和功能的丧失，并难以使抑郁症诊断与他们的身份感相协调。对自己和抑郁症的信念影响了他们对诊断和干预策略的接受度。这些策略包括规定的干预措施，如心理治疗或药物治疗，以及患者自行制定的策略。
功能和社会角色丧失为全科医生提出情绪问题提供了明确背景，抑郁症的情境归因表明，在这些情况下应优先考虑很少提供的心理治疗。
