Skip to main content
×
×
Home

Guided self-help in primary care mental health: Meta-synthesis of qualitative studies of patient experience

  • Nagina Khan (a1), Peter Bower (a1) and Anne Rogers (a1)
Abstract
Background

There is a gap between the supply of trained cognitive – behavioural therapists to treat depression and demand for care in the community. There is interest in the potential of self-help interventions, which require less input from a therapist. However, the design of effective self-help interventions is complex. Qualitative research can help to explore some of this complexity Aims The study aimed to identify qualitative studies of patient experience of depression management in primary care, synthesise these studies to develop an explanatory framework, and then apply this framework to the development of a guided self-help intervention for depression.

Method

A meta-synthesis was conducted of published qualitative research.

Results

The synthesis revealed a number of themes, including the nature of personal experience in depression; help-seeking in primary care; control and helplessness in engagement with treatment; stigma associated with treatment; and patients' understandings of self-help interventions.

Conclusions

This meta-synthesis of qualitative studies provided a useful explanatory framework for the development of effective and acceptable guided self-help interventions for depression.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Guided self-help in primary care mental health
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Guided self-help in primary care mental health
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Guided self-help in primary care mental health
      Available formats
      ×
Copyright
Corresponding author
Nagina Khan, MRC Research Training Fellow, National Primary Care Research and Development Centre, 5th Floor Williamson Building, University of Manchester, Oxford Road, Manchester M13 9PL, UK. Email: nagina.khan@postgrad.manchester.ac.uk
Footnotes
Hide All

Declaration of interest

None.

Funding detailed in Acknowledgements.

Footnotes
References
Hide All
Anderson, L., Lewis, G., Araya, R., et al (2005) Self-help books for depression: how can practitioners and patients make the right choice? British Journal of General Practice, 55, 387392.
Britten, N., Campbell, R., Pope, C., et al (2002) Using meta ethnography to synthesise qualitative research: a worked example. Journal of Health Services Research and Policy, 7, 209215.
BSA Medical Sociological Group (1996) Criteria for the evaluation of qualitative research papers. Medical Sociology News, 22, 6871.
Burr, J. & Chapman, T. (2004) Contextualising experiences of depression in women from South Asian communities: a discursive approach. Sociology of Health and Illness, 26, 433452.
Campbell, M., Fitzpatrick, R., Haines, A., et al (2000) Framework for design and evaluation of complex interventions to improve health. BMJ, 321, 694696.
Campbell, R., Pound, P., Pope, C., et al (2003) Evaluating meta-ethnography: a synthesis of qualitative research on ay experiences of diabetes and diabetes care. Social Science and Medicine, 56, 671684.
Davison, C., Davey Smith, G. & Frankel, S. (1991) Lay epidemiology and the prevention paradox: the implications of coronary candidacy for health education. Sociology of Health and Illness, 13, 119.
Department of Health (2001) Treatment Choice in Psychological Therapies and Counselling: Evidence Based Clinical Practice Guideline. UK Department of Health.
Donovan, J., Mills, N., Smith, M., et al (2002) Improving design and conduct of randomised trials by embedding them in qualitative research: ProtecT (prostate testing for cancer and treatment) study. BMJ, 325, 766770.
Gask, L., Rogers, A., Oliver, D., et al (2003) Qualitative study of patients’ perceptions of the quality of care for depression in general practice. British Journal of General Practice, 53, 278283.
Glasman, D., Finlay, W. & Brock, D. (2004) Becoming a self-therapist: Using cognitive behavioural therapy for recurrent depression and/or dysthymia after completing therapy. Psychology and Psychotherapy: Therapy, Research and Practice, 77, 335351.
Grime, J. & Pollock, K. (2004) Information versus experience: a comparison of an information leaflet on antidepressants with lay experience of treatment. Patient Education and Counseling, 54, 361368.
Horowitz, A. (1983) The Social Control of Mental Illness. Academic Press.
Kadam, U., Croft, P., McLeod, J., et al (2001) A qualitative study of patients’ views on anxiety and depression. British Journal of General Practice, 51, 375380.
Knudsen, P., Hansen, E., Traulsen, J., et al (2002) Changes in self-concept while using SSRI antidepressants. Qualitative Health Research, 12, 932944.
Lovell, K., Richards, D. & Bower, P. (2003) Improving access to primary care mental health: uncontrolled evaluation of a pilot self-help clinic. British Journal of General Practice, 53, 133135.
Marrs, R. (1995) A meta-analysis of bibliotherapy studies. American Journal of Community Psychology, 23, 843870.
Maxwell, M. (2005) Women's and doctors’ accounts of their experiences of depression in primary care: the influence of social and moral reasoning on patients’ and doctors’ decisions. Chronic Illness, 1, 6171.
Mead, N., MacDonald, W., Bower, P., et al (2005) The clinical effectiveness of guided self-help versus waiting list control in the management of anxiety and depression: a randomised controlled trial. Psychological Medicine, 35, 16331643.
Medical Research Council (2000) A Framework for Development and Evaluation of RCTs for Complex Interventions to Improve Health. MRC.
Noblit, G. & Hare, R. (1988) Meta-ethnography: Synthesising Qualitative Studies. Sage.
Prior, L., Wood, F., Lewis, G., et al (2006) Stigma revisited, disclosure of emotional problems in primary care consultations in Wales. Social Science and Medicine, 56, 21912200.
Proudfoot, J., Ryden, C., Everitt, B., et al (2004) Clinical efficacy of computerised cognitive-behavioural therapy for anxiety and depression in primary care: randomised controlled trial. British Journal of Psychiatry, 185, 4654.
Richards, D., Lovell, K. & McEvoy, P. (2003) Access and effectiveness in psychological therapies: self-help as a routine health technology. Health and Social Care in the Community, 11, 175182.
Rogers, A. & Pilgrim, D. (2005) Sociology of Mental Health and Illness. Oxford University Press.
Rogers, A., May, C. & Oliver, D. (2001) Experiencing depression, experiencing the depressed: the separate worlds of patients and doctors. Journal of Mental Health, 10, 317333.
Rogers, A., Oliver, D., Bower, P., et al (2004) People's understanding of a primary care based mental health self-help clinic. Patient Education and Counseling, 53, 4146.
Salkovskis, P., Rimes, K., Stephenson, D., et al (2006) A randomized controlled trial of the use of self-help materials in addition to standard general practice treatment of depression compared to standard treatment alone. Psychological Medicine, 36, 325333.
Thorne, S., Jensen, L., Kearney, M., et al (2004) Qualitative metasynthesis: reflections on methodological orientation and ideological agenda. Qualitative Health Research, 14, 13421365.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×
Type Description Title
PDF
Supplementary materials

Khan et al. supplementary material
Supplementary Table S1

 PDF (30 KB)
30 KB
UNKNOWN
Supplementary materials

Khan et al. supplementary material
Supplementary Material

 Unknown (538 bytes)
538 bytes

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 26 *
Loading metrics...

Abstract views

Total abstract views: 84 *
Loading metrics...

* Views captured on Cambridge Core between 2nd January 2018 - 22nd April 2018. This data will be updated every 24 hours.

Guided self-help in primary care mental health: Meta-synthesis of qualitative studies of patient experience

  • Nagina Khan (a1), Peter Bower (a1) and Anne Rogers (a1)
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *