Baik S, Oakely LD, Bowers BJ, Kindig DA; Academy for Health Services Research and Health Policy. Meeting.

Abstr Acad Health Serv Res Health Policy Meet. 2001; 18: 166.

College of Nursing, University of Cincinnati, 3110 Vine Street, Cincinnati, OH 45221, E-mail: Seongyi.baik@uc.edu

RESEARCH OBJECTIVE: Under-recognition of depression in primary care has been a complex phenomenon of interest in health services research over the last decade. However, very little is understood about the contexts of patient and provider interactions that can affect how primary care providers come to recognize depression. Therefore, the purpose of this study was to qualitatively investigate contextual conditions that can influence primary care providers' recognition of depression during the patient visit.STUDY DESIGN: Thirteen semi-structured and unstructured interviews were conducted with eight primary care providers (5 MDs and 3 NPs, 4 female and 4 male) and, for comparison purposes, five mental health specialists (2 MDs and 3 NPs, 3 female and 2 male). All providers practiced in managed care settings. The providers talked about how they recognize depression in the patient interaction from their perspectives. Grounded Theory constant comparative analysis and dimensional analysis methods were used to analyze transcribed interview data. Interview data with mental health specialists were constantly compared with that of primary care providers in order to identify and theoretically refine contextual conditions and dimensions relevant to the recognition of depression in primary care.POPULATION STUDIED: Thirteen semi-structured and unstructured interviews were conducted with eight primary care providers (5 MDs and 3 NPs, 4 female and 4 male) and, for comparison purposes, five mental health specialists (2 MDs and 3 NPs, 3 female and 2 male). All providers practiced in managed care settings. The providers talked about how they recognize depression in the patient interaction from their perspectives. Grounded Theory constant comparative analysis and dimensional analysis methods were used to analyze transcribed interview data. Interview data with mental health specialists were constantly compared with that of primary care providers in order to identify and theoretically refine contextual conditions and dimensions relevant to the recognition of depression in primary care.PRINCIPAL FINDINGS: Familiarity, experience, and time were identified as interactional or contextual conditions that can influence primary care provider's recognition of depression. Familiarity and experience emerged as contextual conditions that could make relatively short primary care visits sufficient time for the recognition of depression. Critical subdimensions of familiarity and experience as contextual conditions were identified.CONCLUSIONS: The recognition of depression is more than the recognition of symptoms of depression. The contextual conditions under which providers and patients interact infuse significant complexity into the recognition of depression. These findings are consistent with those of Bertakis et al. (1999) and Carney et al. (1999). Both researchers also found that interactional contexts offer alternative ways of understanding provider performance and practice patterns.IMPLICATIONS FOR POLICY, DELIVERY, OR PRACTICE: These results suggest that quality of care in the recognition of depression can be improved by organizational strategies that facilitate provider familiarity with patients. Thus, familiarity is best viewed as an effective mechanism by which provider performance in the recognition of depression in primary care can be improved.

Publication Types:

• Meeting Abstracts

Keywords:

• Biomedical Research
• Community Mental Health Services
• Conditioning (Psychology)
• Depression
• Depressive Disorder
• Female
• Humans
• Male
• Managed Care Programs
• Mental Disorders
• Mental Health
• Mental Health Services
• Primary Health Care
• economics
• hsrmtgs

Other ID:

• GWHSR0001813

UI: 102273489

From Meeting Abstracts