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How family physicians address diagnosis and management of depression in palliative care patients

Warmenhoven, Franca; Rijswijk, Eric van; Hoogstraten, Elise van; Spaendonck, Karel van; Lucassen, Peter; Prins, Judith; Vissers, Kris C.; van Weel, Chris

Description

PURPOSE Depression is highly prevalent in palliative care patients. In clinical practice, there is concern about both insufficient and excessive diagnosis and treatment of depression. In the Netherlands, family physicians have a central role in delivering palliative care. We explored variation in family physicians' opinions regarding the recognition, diagnosis, and management of depression in palliative care patients. METHODS We conducted a focus group study in a sample of family physicians...[Show more]

dc.contributor.authorWarmenhoven, Franca
dc.contributor.authorRijswijk, Eric van
dc.contributor.authorHoogstraten, Elise van
dc.contributor.authorSpaendonck, Karel van
dc.contributor.authorLucassen, Peter
dc.contributor.authorPrins, Judith
dc.contributor.authorVissers, Kris C.
dc.contributor.authorvan Weel, Chris
dc.date.accessioned2015-12-13T22:49:27Z
dc.identifier.issn1544-1709
dc.identifier.urihttp://hdl.handle.net/1885/80544
dc.description.abstractPURPOSE Depression is highly prevalent in palliative care patients. In clinical practice, there is concern about both insufficient and excessive diagnosis and treatment of depression. In the Netherlands, family physicians have a central role in delivering palliative care. We explored variation in family physicians' opinions regarding the recognition, diagnosis, and management of depression in palliative care patients. METHODS We conducted a focus group study in a sample of family physicians with varied practice locations and varying expertise in palliative care. Transcripts were analyzed independently by 2 researchers using constant comparative analysis in ATLAS.ti. RESULTS In 4 focus group discussions with 22 family physicians, the physicians described the diagnostic and therapeutic process for depression in palliative care patients as a continuous and overlapping process. Differentiating between normal and abnormal sadness was viewed as challenging. The physicians did not strictly apply criteria of depressive disorder but rather relied on their clinical judgment and strongly considered patients' context and background factors. They indicated that managing depression in palliative care patients is mainly supportive and nonspecific. Antidepressant drugs were seldom prescribed. The physicians described difficulties in diagnosing and treating depression in palliative care, and gave suggestions to improve management of depression in palliative care patients in primary care. CONCLUSIONS Family physicians perceive the diagnosis and management of depression in palliative care patients as challenging. They rely on open communication and a long-standing physician-patient relationship in which the patient's context is of great importance. This approach fits with the patient-centered care that is promoted in primary care.
dc.publisherAnnals of Family Medicine, Inc.
dc.sourceAnnals of Family Medicine
dc.subjectKeywords: antidepressant agent; article; attitude to health; clinical competence; clinical practice; comparative effectiveness; depression; doctor patient relation; female; general practitioner; health personnel attitude; human; information processing; interpersona
dc.titleHow family physicians address diagnosis and management of depression in palliative care patients
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume10
dc.date.issued2012
local.identifier.absfor111717 - Primary Health Care
local.identifier.absfor111701 - Aboriginal and Torres Strait Islander Health
local.identifier.absfor160104 - Social and Cultural Anthropology
local.identifier.ariespublicationf5625xPUB8807
local.type.statusPublished Version
local.contributor.affiliationWarmenhoven, Franca, Radboud University Nijmegen Medical Center
local.contributor.affiliationRijswijk, Eric van, Radboud University Nijmegen Medical Centre
local.contributor.affiliationHoogstraten, Elise van, Radboud University Nijmegen Medical Centre
local.contributor.affiliationSpaendonck, Karel van, Radboud University Nijmegen Medical Centre
local.contributor.affiliationLucassen, Peter, Radboud University Nijmegen Medical Centre
local.contributor.affiliationPrins, Judith, Radboud University Nijmegen Medical Centre
local.contributor.affiliationVissers, Kris C., Radboud University Nijmegen Medical Centre
local.contributor.affiliationVan Weel, Chris, College of Medicine, Biology and Environment, ANU
local.description.embargo2037-12-31
local.bibliographicCitation.issue4
local.bibliographicCitation.startpage330
local.bibliographicCitation.lastpage336
local.identifier.doi10.1370/afm.1373
dc.date.updated2016-02-24T09:44:06Z
local.identifier.scopusID2-s2.0-84863918554
CollectionsANU Research Publications

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