A qualitative study of primary care professionals' views of case finding for depression in patients with diabetes or coronary heart disease in the UK.
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MAXWELL, M., HARRIS, F., HIBBERD, C., DONAGHY, E., PRATT, R., WILLIAMS, C., MORRISON, J., GIBB, J., WATSON, P. and BURTON, C. 2013. A qualitative study of primary care professionals' views of case finding for depression in patients with diabetes or coronary heart disease in the UK. BMC family practice [online], 14, article number 46. Available from: https://dx.doi.org/10.1186/1471-2296-14-46
Routinely conducting case finding (also commonly referred to as screening) in patients with chronic illness for depression in primary care appears to have little impact. We explored the views and experiences of primary care nurses, doctors and managers to understand how the implementation of case finding/screening might impact on its effectiveness. We identified several features of the way case finding/screening was implemented that may lead to systematic under-detection of depression. These included obstacles to incorporating case finding/screening into a clinical review consultation; a perception of replacing individualised care with mechanistic assessment, and a disconnection for nurses between management of physical and mental health. Far from being a standardised process that encouraged detection of depression, participants described case finding/screening as being conducted in a way which biased it towards negative responses, and for nurses, it was an uncomfortable task for which they lacked the necessary skills to provide immediate support to patients at the time of diagnosis.