Clinician themes/subthemes | Patient themes/subthemes |
---|---|
Theme #1 - Patient’s journey to receive depression care | Theme #1- Patient’s journey to achieving depression care |
Subtheme Facilitators | Subtheme Facilitators |
a. Quality improvement projects (S*) | a. Supportive family members (R*) |
b. Clinic staff training (S) | b. Friendly office atmosphere (R) |
c. Television advertisements for antidepressant medication (S) | |
Subtheme Barriers | Subtheme Barriers |
a. Fragmented specialty mental health sector (S) | a. Fragmented health care system (S) |
b. Fear of opening “Pandora’s box” (S, R) | b. Stigma (R) |
c. Payment structure (S) | c. Rushed primary care clinicians (S) |
d. Poor patient follow-up (S) | d. Clinicians appearing to lack adequate mental health expertise (C*) |
e. Perceived potential for inappropriate office staff behaviors (S) | |
Theme #2 - Aiding patients to come to a personal understanding of depression | Theme #2 - The search for a very personal understanding of their depression |
Subtheme Facilitators | Subtheme Facilitators |
a. Education (C, R) | a. Family history, contact with depressed person in past (R) |
b. Screening for bipolar disorder (S, Cl*) | b. History of psychotherapy or counseling (R) |
Subtheme Barriers | Subtheme Barriers |
a. Somatic presentation (Cl, R) | a. Somatic presentation (Cl, R) |
b. Patient’s secondary gain agenda (S, R) | |
c. Physical pain (Cl) | |
d. Substance abuse (Cl) | |
e. Stigma (R) | |
Theme #3 – Supporting the patient’s therapeutic space | Theme #3 - Creation of a personalized therapeutic space |
Subtheme Facilitators of an effective therapeutic space | Subtheme Facilitators of an effective therapeutic space |
a. Antidepressant medication. (Cl) | a. Antidepressant medication (Cl) |
b. Counseling/Psychotherapy (Cl, R, S) | b. Counseling/Psychotherapy (Cl, R, S) |
c. Primary care clinician (C, Cl, R, S) | c. Primary care clinician (C, Cl, R, S) |
- Multifaceted, team approach (C, Cl, R, S) | d. Therapeutic aspects of working (R, S) |
- Emphasis on follow-up compliance (Cl, R) | e. Values |
- Empathetic, active listening (R) | f. Nature and Family (R, S) |
d. Physical activity (Cl) | g. Faith (R, S) |
e. Social support (R) | h. Positive memories (Cl, R) |
f. Depression prevention (Cl, R) | i. Reframing depression (Cl, R) |
j. Preventing recurrent depression (Cl, R, S) | |
Subtheme Barriers to an effective therapeutic space | Subtheme Barriers to an effective therapeutic space |
a. Emphasis on follow-up compliance (Cl, R) | a. Poor communication between the primary care clinician and other members of the care team (S, R) |
b. Antidepressant side effects (Cl) | b. Depression |
c. Over-reliance on antidepressant medication (Cl, R, S) | |
d. Antidepressant non-adherence (Cl, R) | |
e. Difficulties finding a good ‘fit’ with a counselor or psychotherapist (R, S) | |
f. Short clinic visits and busy schedules (S) |