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Response to an unsolicited intervention offer to persons aged ≥ 75 years after screening positive for depressive symptoms: a qualitative study

Published online by Cambridge University Press:  16 August 2011

Gerda M. van der Weele ,
Roos de Jong ,
Margot W. M. de Waal ,
Philip Spinhoven ,
Herman A. H. Rooze ,
Ria Reis ,
Willem J. J. Assendelft ,
Jacobijn Gussekloo  and
Roos C. van der Mast
Gerda M. van der Weele
Affiliation:
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
Margot W. M. de Waal*
Affiliation:
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
Philip Spinhoven
Affiliation:
Institute of Psychology, Leiden University, Leiden, The Netherlands Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
Herman A. H. Rooze
Affiliation:
Rivierduinen, Mental Health Institution, Leiden, The Netherlands
Ria Reis
Affiliation:
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
Willem J. J. Assendelft
Affiliation:
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
Jacobijn Gussekloo
Affiliation:
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
Roos C. van der Mast
Affiliation:
Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
*
Correspondence should be addressed to: Margot W. M. de Waal, Department of Public Health and Primary Care (V0-P), Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands. Phone: +31 715268444; Fax: +31 715268259. Email: [email protected].
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Abstract

Background: Screening can increase detection of clinically relevant depressive symptoms, but screen-positive persons are not necessarily willing to accept a subsequent unsolicited treatment offer. Our objective was to explore limiting and motivating factors in accepting an offer to join a “coping with depression” course, and perceived needs among persons aged ≥75 years who screened positive for depressive symptoms in general practice.

Methods: In a randomized controlled trial, in which 101 persons who had screened positive for depressive symptoms were offered a “coping with depression” course, a sample of 23 persons were interviewed, of whom five (22%) accepted the treatment offer. Interview transcripts were coded independently by two researchers.

Results: All five individuals who accepted a place on the course felt depressed and/or lonely and had positive expectations about the course. The main reasons for declining to join the course were: not feeling depressed, or having negative thoughts about the course effect, concerns about group participation, or about being too old to change and learn new things. Although perceived needs to relieve depressive symptoms largely matched the elements of the course, most of those who had been screened were not (yet) prepared to accept an intervention offer. Many expressed the need to discuss this treatment decision with their general practitioner.

Conclusions: Although the unsolicited treatment offer closely matched the perceived needs of people screening positive for depressive symptoms, only those who combined feelings of being depressed or lonely with positive expectations about the offered course accepted it. Treatment should perhaps be more individually tailored to the patient's motivational stage towards change, a process in which general practitioners can play an important role.

Keywords

intervention acceptanceoldest olddepressionprimary carebehavioral therapy
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 2 , February 2012 , pp. 270 - 277
Copyright
Copyright © International Psychogeriatric Association 2011

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References

Arean, P. A., Alvidrez, J., Barrera, A., Robinson, G. S. and Hicks, S. (2002). Would older medical patients use psychological services? Gerontologist, 42, 392–398.CrossRefGoogle ScholarPubMed
Baas, K. D. et al. , (2009). Screening for depression in high-risk groups: prospective cohort study in general practice. British Journal of Psychiatry, 194, 399–403.CrossRefGoogle ScholarPubMed
Becker, M. H. and Maiman, L. A. (1975). Sociobehavioral determinants of compliance with health and medical care recommendations. Medical Care, 13, 10–24.CrossRefGoogle ScholarPubMed
Brody, D. S., Khaliq, A. A. and Thompson, T. L. (1997). Patients' perspectives on the management of emotional distress in primary care settings. Journal of General Internal Medicine, 12, 403–406.CrossRefGoogle ScholarPubMed
Burroughs, H., Lovell, K., Morley, M., Baldwin, R., Burns, A. and Chew-Graham, C. (2006). ‘Justifiable depression’: how primary care professionals and patients view late-life depression? A qualitative study. Family Practice, 23, 369–377.CrossRefGoogle ScholarPubMed
Chapman, D. P. and Perry, G. S. (2008). Depression as a major component of public health for older adults. Preventing Chronic Disease, 5, A22.Google Scholar
Chavannes, N. H. et al. (2007). NHG-Standaard Stoppen met roken. Huisarts en Wetenschap, 50, 306–314.Google Scholar
Cooper-Patrick, L., Powe, N. R., Jenckes, M. W., Gonzales, J. J., Levine, D. M. and Ford, D. E. (1997). Identification of patient attitudes and preferences regarding treatment of depression. Journal of General Internal Medicine, 12, 431–438.CrossRefGoogle ScholarPubMed
Cuijpers, P., van Straten, A., van Schaik, A. and Andersson, G. (2009). Psychological treatment of depression in primary care: a meta-analysis. Britisch Journal of General Practice, 59, e51–e60.CrossRefGoogle ScholarPubMed
de Craen, A. J., Gussekloo, J., Blauw, G. J., Willems, C. G. and Westendorp, R. G. (2006). Randomised controlled trial of unsolicited occupational therapy in community-dwelling elderly people: the LOTIS trial. Public Library of Science Clinical Trials, 1, e2.Google ScholarPubMed
Glaser, B. and Strauss, A. (1979). The Discovery of Grounded Theory: Strategies for Qualitative Research. New York: Aldine Publishing Company.Google Scholar
Green, J. and Thorogood, N. (2004). Qualitative Methods for Health Research. Thousand Oaks, CA: Sage.Google Scholar
Gussekloo, J. et al. (2003). Auditory rehabilitation of older people from the general population: the Leiden 85-plus study. British Journal ofGeneral Practice, 53, 536–540.Google ScholarPubMed
Haringsma, R., Engels, G. I., Cuijpers, P. and Spinhoven, P. (2006). Effectiveness of the Coping With Depression (CWD) course for older adults provided by the community-based mental health care system in the Netherlands: a randomized controlled field trial. International Psychogeriatrics, 18, 307–325.CrossRefGoogle ScholarPubMed
Jacobson, M. and O'Connor, A. (2006). Population Needs Assessment: A Workbook for Assessing Patients' and Practitioners' Decision Making Needs. Univerisity of Ottawa. Available at: www.ohri.ca/decisionaid.Google Scholar
Joling, K. J. et al. (2011). How effective is bibliotherapy for very old adults with subthreshold depression? Randomized controlled trial. American Journal of Geriatric Psychiatry, 19, 256–265.CrossRefGoogle ScholarPubMed
Lang, A. J. (2005). Mental health treatment preferences of primary care patients. Journal of Behavioural Medicine, 28, 581–586.CrossRefGoogle ScholarPubMed
Lewin, S., Glenton, C. and Oxman, A. D. (2009). Use of qualitative methods alongside randomised controlled trials of complex healthcare interventions: methodological study. BMJ, 339, b3496.CrossRefGoogle ScholarPubMed
Montano, C. B. (1999). Primary care issues related to the treatment of depression in elderly patients. Journal of Clinical Psychiatry, 60 (Suppl. 20), 45–51.Google Scholar
Moore, S. L., Metcalf, B. and Schow, E. (2006). The quest for meaning in aging. Geriatric Nursing, 27, 293–299.Google Scholar
Murray, J., Banerjee, S., Byng, R., Tylee, A., Bhugra, D. and Macdonald, A. (2006). Primary care professionals' perceptions of depression in older people: a qualitative study. Social Science and Medicine, 63, 1363–1373.Google Scholar
Norcross, J. C. and Prochaska, J. O. (2002). Using the stages of change. Harvard Mental Health Letter, 18, 5–7.Google ScholarPubMed
Prochaska, J. O., DiClemente, C. C. and Norcross, J. C. (1992). In search of how people change: applications to addictive behaviors. American Psychologist, 47, 1102–1114.Google Scholar
Simon, D., Loh, A., Wills, C. E. and Harter, M. (2007). Depressed patients' perceptions of depression treatment decision-making. Health Expectations, 10, 62–74.CrossRefGoogle ScholarPubMed
van der Weele, G. M. et al. (2011). Yield and costs of direct and stepped screening for depressive symptoms in subjects aged 75 years and over in general practice. International Journal of Geriatric Psychiatry, 26, 229–238. doi: 10.1002/gps.2518.CrossRefGoogle ScholarPubMed
Wetherell, J. L., Kaplan, R. M., Kallenberg, G., Dresselhaus, T. R., Sieber, W. J. and Lang, A. J. (2004). Mental health treatment preferences of older and younger primary care patients. International Journal of Psychiatry in Medicine, 34, 219–233.CrossRefGoogle ScholarPubMed
Wittkampf, K. A., van Zwieten, M., Smits, F. T., Schene, A. H., Huyser, J. and van Weert, H. C. (2008). Patients' view on screening for depression in general practice. Family Practice, 25, 438–444.Google Scholar