‘Depression is not a familiar word’: A mixed-methods approach to describe the experience of primary care nurses treating depression in rural Guatemala

2021 ◽  
pp. 002076402110478
Author(s):  
Shanna D Stryker ◽  
Rachel Kishton ◽  
Beatrice Nichols ◽  
Daniel Hargraves ◽  
Keesha Goodnow ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mixed Methods ◽  
Cultural Context ◽  
Community Education ◽  
Critical Role ◽  
Indigenous Communities ◽  
Explanatory Models ◽  
Treatment Preferences ◽  
Primary Care Nurses

Background: As the burden of mental health disorders continues to increase worldwide, there is significant need to describe the cultural variations in presentation, diagnosis and treatment of these diseases. An understanding of these variations can lead to the development of more effective programs to manage these conditions. In Guatemala, depression is the second-leading cause of disability and yet mental health treatment resources are scarce, particularly for indigenous individuals. Aims: The primary research aim was to describe primary care nurses’ explanatory models of depression in their clinical work in indigenous communities in Guatemala. A secondary research aim was to describe training and resources which would support and empower these nurses, in order to lessen risk for burnout. Methods: A cross-sectional mixed methods survey was designed to elicit nurses’ perspectives on the presentation, cause and treatment of depression in the communities they serve, as well as their clinical and emotional comfort in working with depressed individuals. Two subsequent focus groups gathered qualitative commentary which informed training and resource recommendations. Theoretical thematic analysis was used to generate codes and themes from focus group transcripts and survey responses. Results: Guatemalan primary care nurses described symptoms of depression in their cultural context, identified socioeconomic factors which contribute to depression in their communities, and detailed treatment preferences. Limited referral options and concern for privacy made connecting patients to mental health care difficult. Nurses emphasized the need for community education on depression and for supplemental mental health resources which would increase their capacity to identify and treat depression. Conclusions: Primary care nurses in Guatemala identify and treat depression despite limited resources. Further investigations should focus on creating training modalities which include front-line nurses, given their critical role in the health system.

scholarly journals What matters most to patients about primary healthcare: mixed-methods patient priority setting exercises within the PREFeR (PRioritiEs For Research) project

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e025954 ◽  
Author(s):  
Louisa Edwards ◽  
Melody Monro ◽  
Yaron Butterfield ◽  
Ravin Johl ◽  
Kent Cadogan Loftsgard ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mixed Methods ◽  
Priority Setting ◽  
Primary Healthcare ◽  
Health Resources ◽  
Primary Care Providers ◽  
Care Providers ◽  
Online Surveys ◽  
Care Research

ObjectivesTo identify patient-generated priority topics for future primary care research in British Columbia (BC), Canada within a diverse patient population.DesignMixed-methods priority setting exercises framed by the dialogue model, using the nominal group technique (rank-ordered scoring) and province-wide online surveys capturing importance ratings of the top 10 primary healthcare topics from patients and primary care providers.SettingBC, Canada.ParticipantsTopic identification was completed by 10 patient partners (7 female, 3 male) from the BC Primary Health Care Research Network Patient Advisory; online surveys were completed by 464 patients and 173 primary care providers.ResultsThe 10 members recruited to the patient advisory provided over 80 experiences of what stood out for them in BC primary care, which were grouped thematically into 18 topics, 10 of which were retained in province-wide surveys. Top-rated survey topics for both patients (n=464) and providers (n=173) included being unable to find a regular family doctor/other primary healthcare provider, support for living with chronic conditions, mental health resources and information sharing, including electronic medical records. However, all 10 topics were rated important, on average, by both groups.ConclusionsThe current project activities demonstrate the feasibility of including patients in priority setting exercises for primary healthcare in general, rather than focusing on a condition-specific population or disease area. There was considerable overlap between patient-generated topics and topics previously identified by other stakeholders, but patients identified two additional topics (mental health resources, improve and strengthen patient–provider communication). More similarities than differences in topic importance between patients and providers emerged in the online surveys. The project activities that follow (rapid literature reviews, multistakeholder dialogue) will highlight under-researched topics and inform the development of specific research questions.

scholarly journals Mental Health Treatment Preferences of Older and Younger Primary Care Patients

2004 ◽  
Vol 34 (3) ◽  
pp. 219-233 ◽  
Author(s):  
Julie Loebach Wetherell ◽  
Robert M. Kaplan ◽  
Gene Kallenberg ◽  
Timothy R. Dresselhaus ◽  
William J. Sieber ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Treatment ◽  
Treatment Preferences ◽  
Health Treatment ◽  
Primary Care Patients

scholarly journals Stakeholder perspectives on integration of mental health services into primary care: a mixed methods study in Northern Iraq

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Amanda J. Nguyen ◽  
Natalie Rykiel ◽  
Laura Murray ◽  
Ahmed Amin ◽  
Emily Haroz ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mixed Methods ◽  
Mental Health Services ◽  
Health Services ◽  
Mixed Methods Study ◽  
Working Environment ◽  
Government Support ◽  
Northern Iraq ◽  
Stakeholder Perspectives

Abstract Background Integrating evidence-based mental health services into primary care has been identified as one strategy for overcoming the treatment gap in low and middle-income countries, yet their uptake into standard practice remains poor. The purpose of this study was to understand stakeholder perspectives regarding barriers and facilitators to integration of mental health services into primary care settings in Northern Iraq. Methods Using a convergent mixed methods study design, quantitative and qualitative questionnaires assessed respondent perceptions of implementation factors under the domains of Autonomy, Acceptability, Appropriateness, Feasibility, Penetration/Accessibility, Sustainability, and Organizational Climate. We interviewed four types of stakeholders: clients, providers of mental health services, non-mental health (MH) staff working at the centers, and center directors. Interviews were conducted with clients at the completion of services, and with all other stakeholder groups in the latter half of the first year of program implementation, by Kurdish-speaking interviewer pairs. Qualitative and quantitative data were analyzed separately and merged using qualitative data transformation to quantify frequency of theme and integrate with quantitative findings through woven narrative. Results 123 clients, 26 providers, 40 non-MH staff, and 12 directors provided data. Positive perceptions of the program’s acceptability, appropriateness, feasibility, and positive impacts were reported across all stakeholder levels. Providers reported that the program length (8–12 sessions) was a challenge. Clients described logistical challenges (e.g.: transportation, childcare, home duties); support from family and friends appeared to be critical. Lack of private space, insufficient staffing, and need for greater government support were also important issues. Conclusions This mixed methods study is unique in its inclusion of non-MH staff and director perspectives on integration of mental health services in primary care clinics. Their inclusion proved vital since they included critical human resource barriers to feasibility. Providers reported generally positive integration experiences but that some colleagues (clinic staff not involved in mental health services) were unsupportive. Most non-MH staff were supportive, but some did report negative impacts on their working environment. Future studies of integration of mental health services into other service platforms should include the perspectives of stakeholders not involved in provision of mental health services.

scholarly journals Evaluating process and clinical outcomes of a primary care mental health integration project in rural Rwanda: a prospective mixed-methods protocol

BMJ Open ◽  
2017 ◽  
Vol 7 (2) ◽  
pp. e014067 ◽  
Author(s):  
Stephanie L Smith ◽  
Claire Nancy Misago ◽  
Robyn A Osrow ◽  
Molly F Franke ◽  
Jean Damascene Iyamuremye ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mixed Methods ◽  
Clinical Outcomes ◽  
Primary Care Mental Health ◽  
Mental Health Integration ◽  
Integration Project

Primary care nurses lack training in mental health

2003 ◽  
Vol 17 (17) ◽  
pp. 8-8 ◽  
Author(s):  
Frank Rawlins ◽  
Sarah Harrison
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Primary Care Nurses

scholarly journals Relationship Between Work Engagement, Psychosocial Risks, and Mental Health Among Spanish Nurses: A Cross-Sectional Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Juan Jesús García-Iglesias ◽  
Juan Gómez-Salgado ◽  
Mónica Ortega-Moreno ◽  
Yolanda Navarro-Abal
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Work Engagement ◽  
Well Being ◽  
Health Problems ◽  
Emergency Nurses ◽  
Cross Sectional ◽  
Psychosocial Risks ◽  
Increased Risk ◽  
Primary Care Nurses

Background: Exposure to risk factors may lead to health problems of varied nature and to an increased risk of suffering accidents at work.Objectives: The aim of this study was to evaluate the work engagement, psychosocial risks, and psychological well-being of Spanish nurses, analyzing existing relationships, and their associations with self-reported mental health problems of nurses.Methods: To this end, a cross-sectional observational study was carried out with a sample of 1,704 Spanish nurses between January 2019 and January 2020, using a self-administered questionnaire containing sociodemographic variables, the Spanish version of the Copenhagen Psychosocial Questionnaire (CoPsoQ-istas21), the Utrecht Work Engagement Scale (UWES-9), and the General Health Questionnaire (GHQ-12).Results: The Kruskal-Wallis test showed that nurses' perceptions for each of the tests significantly differed among different healthcare areas (p < 0.05). The results indicated that emergency nurses offered higher scores in all dimensions of the CoPsoQ-istas21 and GHQ-12 tests; and in primary care, nurses scored higher in all three dimensions of the UWES-9 test. In addition, self-perceived health and vigor at work were identified as predictive factors of mental health.Conclusions: A high percentage of Spanish nurses perceived a high level of psychosocial risk in the exercise of their duties and nearly 41% could suffer from some mental health-related problem. Primary Care nurses showed higher levels of work engagement and lower perception of psychosocial risks than Emergency nurses. Results may allow to identify a professional profile which is more likely to suffer from psychological distress, as both the working conditions and the work commitment expressed by nurses in their daily work are key elements in assessing the possible psychosocial risks to which they may be exposed.

Sign in / Sign up

Export Citation Format

Share Document