A View of Older Patients' Explanatory Models of Depression: Through the Primary Care Providers' Lens

THEORETICAL FRAMEWORK OF THE STUDY: Whether and how primary care providers consider older patients' perceptions of depression may have an impact on patients' acceptance of treatment.

STUDY OBJECTIVES: To examine primary care providers' beliefs about what drives older patients' acceptance or refusal of treatment.

RESEARCH AND ANALYTIC APPROACHES: Fifteen semi-structured interviews were conducted with primary care providers who were involved with intervention studies of depression management for older adults (PROSPECT and PRISM-E). We used the constant comparative method to identify themes related to patient acceptance of treatment.

MAJOR FINDINGS: Primary care providers felt that older patients often attribute depression to non-medical causes and discussed the need to “convince” older patients of the medical model for depression to enter them into standard treatments.

CONCLUSIONS: Since providers may believe that older patients hold explanatory models of depression not consistent with a biomedical model, some may try to convince their patients of a biomedical model in order to treat them, while others may avoid discussing depression with patients altogether. Whether or not physicians may make correct assumptions about older patients' attitudes towards depression, how physicians surmise patients' views of depression may influence whether and how depression is discussed in practice.