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Clinical problems in the long‐term care of patients with chronic depression
Author(s) -
Koekkoek Bauke,
Van Meijel Berno,
Schene Aart,
Hutschemaekers Giel
Publication year - 2008
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1111/j.1365-2648.2008.04645.x
Subject(s) - depression (economics) , focus group , thematic analysis , mental health , chronic care , context (archaeology) , medicine , long term care , pessimism , chronic pain , chronic depression , psychiatry , quality of life (healthcare) , delphi method , qualitative research , psychology , health care , nursing , family medicine , chronic disease , social science , philosophy , mathematics , business , macroeconomics , economic growth , sociology , biology , paleontology , cognition , epistemology , marketing , statistics , economics
Title. Clinical problems in the long‐term care of patients with chronic depression.Aim. This paper is a report of a study to explore problems encountered by mental health professionals in the long‐term care of patients with chronic depression. Background. Patients who do not profit from psychopharmacological or psychotherapeutic treatment often need long‐term care. Although they experience severe symptoms and loss of functioning, little is known about these people and the care they receive. Method. Experts in chronic depression ( n = 8) participated in a four‐phase Delphi study in 2006–2007. Problems were elicited through a focus group interview (first round) which was analysed using thematic analysis. The resulting problem list was validated (second round) and scored twice on a 7‐point Likert scale (third and fourth rounds) by the participants. Urgency and changeability scores of 35 problems were obtained and a hierarchy of problems was set. In addition, qualitative data from the focus group interview were used to frame the results in the context of long‐term care for patients with chronic depression. Results. Problems were subdivided into five areas. Relapses by the patient, a pessimistic attitude by the professional and demoralization in both were major problems. Also noted were the negative societal connotations of chronic depression and the lack of a coherent view on treatment within mental health care. Conclusion. Chronicity of depression may be denied by both patients and professionals, resulting in an overly strong focus on cure and a limited quality of care. The results may be used as a starting point for construction of a best‐practice programme to improve long‐term care.