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Older depressed Latinos' experiences with primary care visits for personal, emotional and/or mental health problems: a qualitative analysis

TitleOlder depressed Latinos' experiences with primary care visits for personal, emotional and/or mental health problems: a qualitative analysis
Publication TypeJournal Article
Year of Publication2014
AuthorsIzquierdo, A, Sarkisian, C, Ryan, G, Wells, KB, Miranda, J
JournalEthn DisEthn Dis
Volume24
Pagination84-91
Date PublishedWinter
ISBN Number1049-510X (Print)<br/>1049-510X (Linking)
Accession Number24620453
KeywordsAffective Symptoms/therapy, Aged, Aged, 80 and Over, Caregivers, Depression/ ethnology/therapy, Female, Hispanic Americans/ psychology, Humans, Male, Mental Health/ ethnology, Middle Aged, Primary Health Care, Qualitative Research
AbstractOBJECTIVE: To describe salient experiences with a primary care visit (eg, the context leading up to the visit, the experience and/or outcomes of that visit) for emotional, personal and/or mental health problems older Latinos with a history of depression and recent depressive symptoms and/or antidepressant medication use reported 10 years after enrollment into a randomized controlled trial of quality-improvement for depression in primary care. DESIGN: Secondary analysis of existing qualitative data from the second stage of the continuation study of Partners in Care (PIC). PARTICIPANTS: Latino ethnicity, aged > or =50 years, recent depressive symptoms and/or antidepressant medication use, and a recent primary care visit for mental health problems. Of 280 second-stage participants, 47 were eligible. Both stages of the continuation study included participants from the PIC parent study control and 2 intervention groups, and all had a history of depression. METHODS: Data analyzed by a multidisciplinary team using grounded theory methodology. RESULTS: Five themes were identified: beliefs about the nature of depression; prior experiences with mental health disorders/treatments; sociocultural context (eg, social relationships, caregiving, the media); clinic-related features (eg, accessibility of providers, staff continuity, amount of visit time); and provider attributes (eg, interpersonal skills, holistic care approach). CONCLUSIONS: Findings emphasize the importance of key features for shaping the context leading up to primary care visits for help-seeking for mental health problems, and the experience and/or outcomes of those visits, among older depressed Latinos at long-term follow-up, and may help tailor chronic depression care for the clinical management of this vulnerable population.