Cargando…

Making decisions about treatment for young people diagnosed with depressive disorders: a qualitative study of clinicians’ experiences

BACKGROUND: The imperative to provide effective treatment for young people diagnosed with depressive disorders is complicated by several factors including the unclear effectiveness of treatment options. Within this context, little is known about how treatment decisions are made for this population....

Descripción completa

Detalles Bibliográficos
Autores principales: Simmons, Magenta B, Hetrick, Sarah E, Jorm, Anthony F
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4029801/
https://www.ncbi.nlm.nih.gov/pubmed/24330307
http://dx.doi.org/10.1186/1471-244X-13-335
_version_ 1782317282306818048
author Simmons, Magenta B
Hetrick, Sarah E
Jorm, Anthony F
author_facet Simmons, Magenta B
Hetrick, Sarah E
Jorm, Anthony F
author_sort Simmons, Magenta B
collection PubMed
description BACKGROUND: The imperative to provide effective treatment for young people diagnosed with depressive disorders is complicated by several factors including the unclear effectiveness of treatment options. Within this context, little is known about how treatment decisions are made for this population. METHODS: In order to explore the experiences and beliefs of clinicians about treatment decision making for this population, semi-structured, qualitative interviews were conducted with 22 psychiatrists, general practitioners and allied health professionals from health care settings including specialist mental health services and primary health care. Interviews were audio taped, transcribed verbatim and analysed using thematic analysis. RESULTS: Clinicians largely reported and endorsed a collaborative model of treatment decision making for youth depression, although several exceptions to this approach were also described (e.g. when risk issues were present), highlighting a need to adapt the decision-making style to the characteristics and needs of the client. A differentiation was made between the decision-making processes (e.g. sharing of information) and who makes the decision. Caregiver involvement was seen as optional, especially in situations where no caregivers were involved, but ideal and useful if the caregivers were supportive. Gaps between the type and amount of information clinicians wanted to give their clients and what they actually gave them were reported (e.g. having fact sheets on hand). A broad range of barriers to involving clients and caregivers in decision-making processes were described relating to four levels (client and caregiver, clinician, service and broader levels) and suggestions were given to help overcome these barriers, including up-to-date, accessible and relevant information. CONCLUSIONS: The current data support a collaborative model of treatment decision making for youth depression which: 1) focuses on the decision-making processes rather than who actually makes the decision; 2) is flexible to the individual needs and characteristics of the client; and 3) where caregiver involvement is optional. Shared decision making interventions and the use of decision aids should be considered for this area.
format Online
Article
Text
id pubmed-4029801
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-40298012014-05-22 Making decisions about treatment for young people diagnosed with depressive disorders: a qualitative study of clinicians’ experiences Simmons, Magenta B Hetrick, Sarah E Jorm, Anthony F BMC Psychiatry Research Article BACKGROUND: The imperative to provide effective treatment for young people diagnosed with depressive disorders is complicated by several factors including the unclear effectiveness of treatment options. Within this context, little is known about how treatment decisions are made for this population. METHODS: In order to explore the experiences and beliefs of clinicians about treatment decision making for this population, semi-structured, qualitative interviews were conducted with 22 psychiatrists, general practitioners and allied health professionals from health care settings including specialist mental health services and primary health care. Interviews were audio taped, transcribed verbatim and analysed using thematic analysis. RESULTS: Clinicians largely reported and endorsed a collaborative model of treatment decision making for youth depression, although several exceptions to this approach were also described (e.g. when risk issues were present), highlighting a need to adapt the decision-making style to the characteristics and needs of the client. A differentiation was made between the decision-making processes (e.g. sharing of information) and who makes the decision. Caregiver involvement was seen as optional, especially in situations where no caregivers were involved, but ideal and useful if the caregivers were supportive. Gaps between the type and amount of information clinicians wanted to give their clients and what they actually gave them were reported (e.g. having fact sheets on hand). A broad range of barriers to involving clients and caregivers in decision-making processes were described relating to four levels (client and caregiver, clinician, service and broader levels) and suggestions were given to help overcome these barriers, including up-to-date, accessible and relevant information. CONCLUSIONS: The current data support a collaborative model of treatment decision making for youth depression which: 1) focuses on the decision-making processes rather than who actually makes the decision; 2) is flexible to the individual needs and characteristics of the client; and 3) where caregiver involvement is optional. Shared decision making interventions and the use of decision aids should be considered for this area. BioMed Central 2013-12-12 /pmc/articles/PMC4029801/ /pubmed/24330307 http://dx.doi.org/10.1186/1471-244X-13-335 Text en Copyright © 2013 Simmons et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Simmons, Magenta B
Hetrick, Sarah E
Jorm, Anthony F
Making decisions about treatment for young people diagnosed with depressive disorders: a qualitative study of clinicians’ experiences
title Making decisions about treatment for young people diagnosed with depressive disorders: a qualitative study of clinicians’ experiences
title_full Making decisions about treatment for young people diagnosed with depressive disorders: a qualitative study of clinicians’ experiences
title_fullStr Making decisions about treatment for young people diagnosed with depressive disorders: a qualitative study of clinicians’ experiences
title_full_unstemmed Making decisions about treatment for young people diagnosed with depressive disorders: a qualitative study of clinicians’ experiences
title_short Making decisions about treatment for young people diagnosed with depressive disorders: a qualitative study of clinicians’ experiences
title_sort making decisions about treatment for young people diagnosed with depressive disorders: a qualitative study of clinicians’ experiences
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4029801/
https://www.ncbi.nlm.nih.gov/pubmed/24330307
http://dx.doi.org/10.1186/1471-244X-13-335
work_keys_str_mv AT simmonsmagentab makingdecisionsabouttreatmentforyoungpeoplediagnosedwithdepressivedisordersaqualitativestudyofcliniciansexperiences
AT hetricksarahe makingdecisionsabouttreatmentforyoungpeoplediagnosedwithdepressivedisordersaqualitativestudyofcliniciansexperiences
AT jormanthonyf makingdecisionsabouttreatmentforyoungpeoplediagnosedwithdepressivedisordersaqualitativestudyofcliniciansexperiences