Mellor, D., McCabe, M. P, Davison, T. E, Goldhammer, D. L & Hallford, DJ. (2013). Barriers to the Detection and Management of Depression by Palliative Care Professional Carers Among Their Patients : Perspectives From Professional Carers and Patients' Family Members. American Journal of Hospice and Palliative Care,30(1), 12-20. Retrieved from https://doi.org/10.1177/1049909112438705
Introduction: Clinical depression is highly prevalent yet underdetected and poorly managed within palliative care settings.
Objectives: This qualitative study explored the identification, monitoring, and management of symptoms of depression in patients receiving palliative care from 2 juxtaposed perspectives that are of care providers and care recipients' family members. Examining the barriers that restrict professional carers detecting and managing depression in their patients was a central focus of the study.
Methods: Focus groups were held with 18 professional carers, including 8 holding managerial positions, across 2 palliative care services, 1 regional and 1 metropolitan, which provided both inpatient and community-based care. Individual interviews were conducted with 10 family members of patients who had received or were receiving palliative care through these services.
Results: Thematic analysis of these data identified that both professional carers and family members perceived that depression is a wide-spread concern for patients receiving palliative care; however, numerous barriers were identified that affect professional carers’ ability to identify depression. These included knowledge and training deficits, low self-efficacy, prioritization of physical concerns and time constraints, patient/family characteristics, and system/process issues. These themes (and related subthemes) are discussed in this article.
Conclusions: Specialized training in depression is recommended for professional carers in order to improve their depression-related knowledge, detection skills, and self-efficacy. The ultimate goal of such training is to increase the rate of recognition of depression that in turn will lead to appropriate treatment for depressed patients.
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