Document Type
Article
Language
eng
Publication Date
9-2016
Publisher
Elsevier
Source Publication
Women's Health Issues
Source ISSN
1049-3867
Original Item ID
DOI: 10.1016/j.whi.2016.07.002
Abstract
Background
Health care providers are better able to diagnose depression and initiate treatment when patients disclose symptoms. However, many women are reluctant to disclose depressive symptoms. Little is known about the experience of disclosing depression symptoms in primary care among racially and ethnically diverse women across the life course. We qualitatively explore experiences of disclosure of depressive symptoms to primary care providers among self-identified African American, Hispanic and non-Hispanic White women.
Methods
Twenty-four women with depression were recruited for open-ended interviews. We recorded, transcribed, and coded interviews using inductive content analysis.
Findings
Two distinct domains emerged: participant factors that hinder and facilitate disclosure and provider cues that encourage and dissuade discussing depression. Participants described perceptions about primary care not being the appropriate place, fear of not having a choice in treatment decisions, and the emotional cost of retelling as impediments to disclosure; perceiving an increased likelihood of getting help was described as a facilitator. Women identified provider behaviors of asking about depression and showing concern as facilitators, and provider time constraints as a barrier to disclosure.
Conclusions
Women perceive that primary care is not the appropriate place to disclose depression symptoms. Increased public education about behavioral health management in primary care, as well as more robust integration of the two, is needed. Efforts to improve depression disclosure in primary care must also encompass systematic use of depression screening tools and implementation of targeted interventions to cultivate provider empathy.
Recommended Citation
Keller, Abiola O.; Valdez, Carmen R.; Schwei, Rebecca J.; and Jacobs, Elizabeth A., "Disclosure of Depression in Primary Care: A Qualitative Study of Women’s Perceptions" (2016). Physician Assistant Studies Faculty Research and Publications. 23.
https://epublications.marquette.edu/physician_asst_fac/23
Comments
Accepted version. Women's Health Issues Vol. 26, No. 5 (September-October 2016): 529-536. DOI. © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. Used with permission.