Older depressed Latinos' experiences with primary care visits for personal, emotional and/or mental health problems: a qualitative analysis.

Izquierdo A, Sarkisian C, Ryan G, Wells KB, Miranda J. Older depressed Latinos' experiences with primary care visits for personal, emotional and/or mental health problems: a qualitative analysis. Ethnicity & disease. 2014 Jan 1; 24(1):84-91.

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Abstract:

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.