Institute for Health and Sport, Victoria University, Melbourne, Vic., Australia.
Int J Ment Health Nurs. 2019 Feb;28(1):278-287. doi: 10.1111/inm.12531. Epub 2018 Aug 18.
Depression is the most prevalent mental illness among older adults. However, help-seeking by older adults is frequently delayed, resulting in longer duration of untreated symptoms, poorer health outcomes, and consequent higher healthcare use. Early help-seeking and access to appropriate support benefits individuals, while providing better outcomes from health systems constrained by limited resources. The aim of this study, which is abstracted from a larger study, was to identify the factors that inhibited and enabled formal help-seeking in older adults with a diagnosis of moderate depression. Corbin and Strauss' approach to grounded theory informed data collection and analysis. Two themes and related subthemes concerning help-seeking barriers and facilitators were abstracted from the data. Help-seeking barriers were attributable to stigma, self-motivation, accessing formal support, ageism, and difficulty obtaining an initial diagnosis. Help-seeking facilitators were accepting personal responsibility, mental health literacy, therapeutic alliances, and informal support. Findings have implications for the role of mental health nurses, who are well-placed to provide support to community-based older adults with depression. More broadly, mental health nurses and other clinicians should seek to reduce help-seeking barriers and implement ways to facilitate help-seeking in this cohort.
抑郁症是老年人中最常见的精神疾病。然而，老年人寻求帮助常常被延迟，导致未治疗症状的持续时间更长、健康状况更差，进而导致更高的医疗保健使用。早期寻求帮助和获得适当的支持对个人有益，同时为资源有限的卫生系统提供更好的结果。本研究的目的是从一项更大的研究中确定哪些因素阻碍和促进了被诊断为中度抑郁症的老年人寻求正式帮助。科宾和斯特劳斯的扎根理论方法为数据收集和分析提供了信息。从数据中提取了与寻求帮助的障碍和促进因素有关的两个主题和相关的子主题。寻求帮助的障碍归因于污名化、自我激励、获得正式支持、年龄歧视和获得初步诊断的困难。寻求帮助的促进因素包括接受个人责任、心理健康素养、治疗联盟和非正式支持。研究结果对心理健康护士的作用具有启示意义，他们非常适合为社区内患有抑郁症的老年人提供支持。更广泛地说，心理健康护士和其他临床医生应该努力减少寻求帮助的障碍，并在这一人群中实施促进寻求帮助的方法。
