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首页> 外文期刊>BMC Family Practice >Talking about depression during interactions with GPs: a qualitative study exploring older people’s accounts of their depression narratives
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Talking about depression during interactions with GPs: a qualitative study exploring older people’s accounts of their depression narratives

机译：谈论与全科医生互动时的抑郁症：一项定性研究，探索老年人对抑郁症叙述的叙述

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Older people can struggle with revealing their depression to GPs and verbalising preferences regarding its management. This contributes to problems for GPs in both detecting and managing depression in primary care. The aim of this study was to explore older people’s accounts of how they talk about depression and possible symptoms to improve communication about depression when seeing GPs. Adopting a qualitative Interpretivist methodological approach, semi-structured interviews were conducted by IG based on the principles of grounded theory and situational analysis. GPs working in north east England recruited patients aged over 65 with depression. Data analysis was carried out with a process of constant comparison, and categories were developed via open and axial coding and situational maps. There were three levels of analysis; the first developed open codes which informed the second level of analysis where the typology was developed from axial codes. The typology derived from second level analysis only is presented here as older people’s views are rarely reported in isolation. From the sixteen interviews with older people, it was evident that there were differences in how they understood and accepted their depression and that this influenced what they shared or withheld in their narratives. A typology showing three categories of older people was identified: those who appeared to talk about their depression freely yet struggled to accept aspects of it (Superficial Accepter), those who consolidated their ideas about depression aloud (Striving to Understand) and those who shared minimal detail about their depression and viewed it as part of them rather than a treatable condition (Unable to Articulate). The central finding was that older people’s acceptance and understanding of their depression guided their depression narratives. This study identified differences between older people in ways they understand, accept and share their depression. Recognising that their?depression?narratives?can change and listening for patterns in what older people share or withhold may help GPs in facilitating communication to better understand the patient when they need to implement alternative approaches to patient management.
机译：老年人可能难以向GP透露自己的沮丧情绪，并表达了对其管理的偏爱。这给全科医生带来了在初级保健中发现和管理抑郁症的问题。这项研究的目的是探讨老年人关于他们如何谈论抑郁症和可能出现的症状的记录，以改善在看全科医生时关于抑郁症的交流。 IG采用定性的解释论方法论方法，根据扎根理论和情境分析的原则，进行了半结构化访谈。在英格兰东北部工作的全科医生招募了65岁以上患有抑郁症的患者。数据分析是通过不断比较的过程进行的，并且类别通过公开和轴向编码以及情况图来开发。分析分为三个级别：第一个开发的开放代码为第二层次的分析提供了依据，其中类型学是从轴向代码发展而来的。由于仅很少报告老年人的观点，因此此处仅介绍了从第二级分析得出的类型。从对老年人的十六次采访中，很明显，他们在理解和接受抑郁症的方式上存在差异，这影响了他们在叙事中分享或不表达的内容。确定了一种显示三类老年人的类型学：看起来自由地谈论自己的抑郁症却努力地接受抑郁症的人（肤浅的接受者），大声巩固自己对抑郁症的观念（努力理解）的人和分享最小的老年人的人详细介绍他们的抑郁症，并将其视为抑郁症的一部分，而不是可治疗的状况（无法表达）。中心发现是，老年人对抑郁症的接受和理解指导了他们的抑郁症叙事。这项研究确定了老年人在理解，接受和分享抑郁方面的差异。认识到他们的“抑郁症”叙述会发生变化，并聆听老年人分享或保留的方式，这可能会帮助GP促进沟通，从而在他们需要实施其他患者管理方法时更好地了解患者。

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