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Advantages and Challenges of A Village Doctor-Based Cognitive Behavioral Therapy for Late-Life Depression in Rural China: A Qualitative Study

BACKGROUND: The delivery of mental health services in rural China has been notably limited due to lack of qualified mental health professionals among other impeding factors. A village doctor-based cognitive behavioral therapy intervention may be one way of improving accessibility. The purpose of thi...

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Autores principales: Tang, Xinfeng, Yang, Fahui, Tang, Tan, Yang, Xuemei, Zhang, Weijun, Wang, Xiaohua, Ji, Li, Xiao, Yun, Ma, Kun, Wang, Ying, Kong, Xianglei, Wang, Jianping, Liu, Jun, Xu, Qian, Tian, Donghua, Qu, Zhiyong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4570773/
https://www.ncbi.nlm.nih.gov/pubmed/26371473
http://dx.doi.org/10.1371/journal.pone.0137555
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author Tang, Xinfeng
Yang, Fahui
Tang, Tan
Yang, Xuemei
Zhang, Weijun
Wang, Xiaohua
Ji, Li
Xiao, Yun
Ma, Kun
Wang, Ying
Kong, Xianglei
Wang, Jianping
Liu, Jun
Xu, Qian
Tian, Donghua
Qu, Zhiyong
author_facet Tang, Xinfeng
Yang, Fahui
Tang, Tan
Yang, Xuemei
Zhang, Weijun
Wang, Xiaohua
Ji, Li
Xiao, Yun
Ma, Kun
Wang, Ying
Kong, Xianglei
Wang, Jianping
Liu, Jun
Xu, Qian
Tian, Donghua
Qu, Zhiyong
author_sort Tang, Xinfeng
collection PubMed
description BACKGROUND: The delivery of mental health services in rural China has been notably limited due to lack of qualified mental health professionals among other impeding factors. A village doctor-based cognitive behavioral therapy intervention may be one way of improving accessibility. The purpose of this study was to explore the advantages and challenges of implementing this intervention, as delivered by trained village doctors, to treat late-life depression in rural China. METHODS: We conducted one focus group discussion with 10 village doctors, 10 individual interviews with each of the village doctors, and individual interviews with 19 older adults. The topic guides were advantages and challenges of the intervention program from the perspective of the village doctors and older adults. Interviews were audio-recorded, transcribed, coded using NVivo 8, and analyzed using thematic analysis. RESULTS: The village doctors stressed the importance of role-playing and using instructive manuals in the training. Proper supervision was also a key component of the program. The benefits received from the intervention for the village doctors and the elders were positive such that both the doctors and the older adults were willing to implement/receive this intervention. Cultural and political factors (renqing and perceived policy consideration) facilitated the elders’ access to mental health services. Challenges included a lack of real therapy (in contrast to role-playing) demonstrated in the training and lack of a step-by-step manual based on different types of problems encountered. Other impediments to the successful implementation of the intervention included the time constraints of village doctors and the presence of other people when conducting the intervention. CONCLUSIONS: The present study has demonstrated that the intervention program is likely to be an acceptable geriatric depression intervention in rural China if several challenges are appropriately addressed.
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spelling pubmed-45707732015-09-18 Advantages and Challenges of A Village Doctor-Based Cognitive Behavioral Therapy for Late-Life Depression in Rural China: A Qualitative Study Tang, Xinfeng Yang, Fahui Tang, Tan Yang, Xuemei Zhang, Weijun Wang, Xiaohua Ji, Li Xiao, Yun Ma, Kun Wang, Ying Kong, Xianglei Wang, Jianping Liu, Jun Xu, Qian Tian, Donghua Qu, Zhiyong PLoS One Research Article BACKGROUND: The delivery of mental health services in rural China has been notably limited due to lack of qualified mental health professionals among other impeding factors. A village doctor-based cognitive behavioral therapy intervention may be one way of improving accessibility. The purpose of this study was to explore the advantages and challenges of implementing this intervention, as delivered by trained village doctors, to treat late-life depression in rural China. METHODS: We conducted one focus group discussion with 10 village doctors, 10 individual interviews with each of the village doctors, and individual interviews with 19 older adults. The topic guides were advantages and challenges of the intervention program from the perspective of the village doctors and older adults. Interviews were audio-recorded, transcribed, coded using NVivo 8, and analyzed using thematic analysis. RESULTS: The village doctors stressed the importance of role-playing and using instructive manuals in the training. Proper supervision was also a key component of the program. The benefits received from the intervention for the village doctors and the elders were positive such that both the doctors and the older adults were willing to implement/receive this intervention. Cultural and political factors (renqing and perceived policy consideration) facilitated the elders’ access to mental health services. Challenges included a lack of real therapy (in contrast to role-playing) demonstrated in the training and lack of a step-by-step manual based on different types of problems encountered. Other impediments to the successful implementation of the intervention included the time constraints of village doctors and the presence of other people when conducting the intervention. CONCLUSIONS: The present study has demonstrated that the intervention program is likely to be an acceptable geriatric depression intervention in rural China if several challenges are appropriately addressed. Public Library of Science 2015-09-15 /pmc/articles/PMC4570773/ /pubmed/26371473 http://dx.doi.org/10.1371/journal.pone.0137555 Text en © 2015 Tang et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Tang, Xinfeng
Yang, Fahui
Tang, Tan
Yang, Xuemei
Zhang, Weijun
Wang, Xiaohua
Ji, Li
Xiao, Yun
Ma, Kun
Wang, Ying
Kong, Xianglei
Wang, Jianping
Liu, Jun
Xu, Qian
Tian, Donghua
Qu, Zhiyong
Advantages and Challenges of A Village Doctor-Based Cognitive Behavioral Therapy for Late-Life Depression in Rural China: A Qualitative Study
title Advantages and Challenges of A Village Doctor-Based Cognitive Behavioral Therapy for Late-Life Depression in Rural China: A Qualitative Study
title_full Advantages and Challenges of A Village Doctor-Based Cognitive Behavioral Therapy for Late-Life Depression in Rural China: A Qualitative Study
title_fullStr Advantages and Challenges of A Village Doctor-Based Cognitive Behavioral Therapy for Late-Life Depression in Rural China: A Qualitative Study
title_full_unstemmed Advantages and Challenges of A Village Doctor-Based Cognitive Behavioral Therapy for Late-Life Depression in Rural China: A Qualitative Study
title_short Advantages and Challenges of A Village Doctor-Based Cognitive Behavioral Therapy for Late-Life Depression in Rural China: A Qualitative Study
title_sort advantages and challenges of a village doctor-based cognitive behavioral therapy for late-life depression in rural china: a qualitative study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4570773/
https://www.ncbi.nlm.nih.gov/pubmed/26371473
http://dx.doi.org/10.1371/journal.pone.0137555
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