Older Depressed Latinos' Experiences with Primary Care Visits for Personal, Emotional And/Or Mental Health Problems

A Qualitative Analysis

Published in: Ethnicity & Disease, v. 24, no. 1, Winter 2014, p. 84-91

Posted on RAND.org on January 01, 2014

by Adriana Izquierdo, Catherine A. Sarkisian, Gery W. Ryan, Kenneth B. Wells, Jeanne Miranda

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OBJECTIVE: 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.

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