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Published in: BMC Psychiatry 1/2018

Open Access 01-12-2018 | Research article

Facilitators and barriers to modifying dietary and hygiene behaviours as adjuvant treatment in patients with depression in primary care: a qualitative study

Authors: B. Olivan-Blázquez, J. Montero-Marin, M. García-Toro, E. Vicens-Pons, M. J. Serrano-Ripoll, A. Castro-Gracia, M. C. Sarasa-Bosque, J. M. Mendive-Arbeloa, Y. López-del-Hoyo, J. Garcia-Campayo

Published in: BMC Psychiatry | Issue 1/2018

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Abstract

Background

Major depression is a highly prevalent condition. Its pathogenesis is related to a wide variety of biological and psychosocial factors and among these is factors related to lifestyle. Lifestyle-based interventions seem to be appropriate strategies as coadjutant treatment. The objective of this study is to explore and identify expectations and experiences of both patients and healthcare professionals that can point to the main barriers and facilitators with regard to the promotion of healthy dietary and hygiene behaviours in patients suffering from major depression.

Methods

A qualitative design was used to collect information from a wide range of purposefully and theoretically guided samples of depressed patients and health professionals from Primary Care (PC). Both in-depth interviews and discussion groups were used. A standardized protocol was designed to guide the interviews and groups, including the preparation of a topic list to be addressed, with previously tested, open suggestions that could be of interest. A thematic analysis was performed from grounded theory in order to explore, develop and define until saturation the emergent categories of analysis derived from the individual interview and group data.

Results

Both patients as well as PC professionals noted a series of central aspects with respect to the implementation of a programme for the acquisition of healthy dietary and hygiene habits for depressive patients, which may be organized around ‘personal’, ‘programmatic’, and ‘transversal’ aspects. As for the personal aspects, categories regarding ‘patient history’, and ‘disposition’ were found; the programmatic aspects included categories such as ‘presentation and monitoring’, and modification of ‘cognitive’ and ‘behavioural’ habits; whereas the transversal aspects comprised the possibilities of ‘social support’ and defining categories of ‘objectives’.

Conclusion

The implementation of intervention programmes that combine dietary and hygiene-related factors in patients with depression is complex, given the nature of the disorder itself, and its symptoms such as apathy and feelings of guilt or incompetence. Key issues exist for the success of the intervention, such as the simplicity of guidelines, tailoring through motivational interviewing, prolonged and intense monitoring throughout the different stages of the disorder, and the provision of adequate feedback and social support. PC could be an appropriate level in which to implement these interventions.
Literature
3.
go back to reference Stegmann ME, Ormel J, de Graaf R, Haro JM, de Girolamo G, Demyttenaere K, Kovess V, Matschinger H, Vilagut G, Alonso J, Burger H, ESEMED/MHEDEA Investigators. Functional disability as an explanation of the associations between chronic physical conditions and 12-month major depressive episode. J Affect Disord. 2010;124(1–2):38–44. https://doi.org/10.1016/j.jad.2009.10.026.CrossRefPubMed Stegmann ME, Ormel J, de Graaf R, Haro JM, de Girolamo G, Demyttenaere K, Kovess V, Matschinger H, Vilagut G, Alonso J, Burger H, ESEMED/MHEDEA Investigators. Functional disability as an explanation of the associations between chronic physical conditions and 12-month major depressive episode. J Affect Disord. 2010;124(1–2):38–44. https://​doi.​org/​10.​1016/​j.​jad.​2009.​10.​026.CrossRefPubMed
8.
go back to reference Oliver-Quetglas A, Torres E, March S, Socias IM, Esteva M. Risk factors of depressive syndrome in young adults. Actas Esp Psiquiatr. 2013;41(2):84–96.PubMed Oliver-Quetglas A, Torres E, March S, Socias IM, Esteva M. Risk factors of depressive syndrome in young adults. Actas Esp Psiquiatr. 2013;41(2):84–96.PubMed
22.
go back to reference Daubenmier JJ, Weidner G, Sumner MD, Mendell N, Merritt-Worden T, Studley J, Ornish D. The contribution of changes in diet, exercise, and stress management to changes in coronary risk in women and men in the multisite cardiac lifestyle intervention program. Ann Behav Med. 2007;33(1):57–68.CrossRefPubMed Daubenmier JJ, Weidner G, Sumner MD, Mendell N, Merritt-Worden T, Studley J, Ornish D. The contribution of changes in diet, exercise, and stress management to changes in coronary risk in women and men in the multisite cardiac lifestyle intervention program. Ann Behav Med. 2007;33(1):57–68.CrossRefPubMed
28.
go back to reference Green L, Fryer GJ, Yawn B, Lanier D, Dovey S. The ecology of medical care revisited. N Engl J Med. 2001;344(26):2021–5.CrossRefPubMed Green L, Fryer GJ, Yawn B, Lanier D, Dovey S. The ecology of medical care revisited. N Engl J Med. 2001;344(26):2021–5.CrossRefPubMed
29.
go back to reference van’t Veer-Tazelaar PJ, van Marwijk HW, van OP, van der Horst HE, Smit F, Cuijpers P, et al. Prevention of late-life anxiety and depression has sustained effects over 24 months: a pragmatic randomized trial. Am J Geriatr Psychiatry. 2011;19(3):230–9.CrossRefPubMed van’t Veer-Tazelaar PJ, van Marwijk HW, van OP, van der Horst HE, Smit F, Cuijpers P, et al. Prevention of late-life anxiety and depression has sustained effects over 24 months: a pragmatic randomized trial. Am J Geriatr Psychiatry. 2011;19(3):230–9.CrossRefPubMed
30.
go back to reference Pope C, Mays N, editors. Qualitative Research in Health Care. London: BMJ books; 2000. p. 168. Pope C, Mays N, editors. Qualitative Research in Health Care. London: BMJ books; 2000. p. 168.
31.
go back to reference Montero-Marín J, Prado-Abril J, Botella C, Mayoral-Cleries F, Baños R, Herrera-Mercadal P, Romero-Sanchiz P, Gili M, Castro A, Nogueira R, García-Campayo J. Expectations among patients and health professionals regarding web-based interventions for depression in primary care: a qualitative study. J Med Internet Res. 2015;17(3):e67. https://doi.org/10.2196/jmir.3985.CrossRefPubMedPubMedCentral Montero-Marín J, Prado-Abril J, Botella C, Mayoral-Cleries F, Baños R, Herrera-Mercadal P, Romero-Sanchiz P, Gili M, Castro A, Nogueira R, García-Campayo J. Expectations among patients and health professionals regarding web-based interventions for depression in primary care: a qualitative study. J Med Internet Res. 2015;17(3):e67. https://​doi.​org/​10.​2196/​jmir.​3985.CrossRefPubMedPubMedCentral
32.
go back to reference Denzin N, Lincoln Y. Introduction: Entering the field of qualitative research. In: Denzin N, Lincoln Y, editors. Handbook of Qualitative Research. California: Sage; 1994. p. 1–18. Denzin N, Lincoln Y. Introduction: Entering the field of qualitative research. In: Denzin N, Lincoln Y, editors. Handbook of Qualitative Research. California: Sage; 1994. p. 1–18.
34.
go back to reference Beck AT, Steer RA, Brown GK. BDI-II –Beck depression inventory manual, volume second. San Antonio: The Psychological Corporation; 1996. Beck AT, Steer RA, Brown GK. BDI-II –Beck depression inventory manual, volume second. San Antonio: The Psychological Corporation; 1996.
37.
go back to reference Strauss A, Corbin J. Basics of qualitative research. 2nd ed. London: Sage; 1998. Strauss A, Corbin J. Basics of qualitative research. 2nd ed. London: Sage; 1998.
38.
go back to reference Strauss A. Qualitative analysis for social scientists. Cambridge: Cambridge University Press; 1987.CrossRef Strauss A. Qualitative analysis for social scientists. Cambridge: Cambridge University Press; 1987.CrossRef
39.
go back to reference Glaser BG, Strauss AL. The discovery of grounded theory. Chicago: Aldine; 1967. Glaser BG, Strauss AL. The discovery of grounded theory. Chicago: Aldine; 1967.
40.
go back to reference Alonso LE. A qualitative approach to sociology. An interpretative approach. Madrid: Editorial Fundamentos; 1998. Alonso LE. A qualitative approach to sociology. An interpretative approach. Madrid: Editorial Fundamentos; 1998.
41.
go back to reference Gaitán JA, Piñuel JL. Técnicas de Investigación en comunicación social (Research techniques in social communication). Madrid: Síntesis; 1998. p. 281–311. Gaitán JA, Piñuel JL. Técnicas de Investigación en comunicación social (Research techniques in social communication). Madrid: Síntesis; 1998. p. 281–311.
42.
go back to reference Vallés MS. Técnicas Cualitativas de Investigación Social (Qualitative Social Research Techniques). Madrid: Síntesis Sociología; 2003. Vallés MS. Técnicas Cualitativas de Investigación Social (Qualitative Social Research Techniques). Madrid: Síntesis Sociología; 2003.
43.
go back to reference Rapley T. Doing conversation, discourse and document analysis. London: Sage; 2007. Rapley T. Doing conversation, discourse and document analysis. London: Sage; 2007.
44.
go back to reference Gibbs G. The analysis of qualitative data in qualitative research. Madrid: Morata; 2012. Gibbs G. The analysis of qualitative data in qualitative research. Madrid: Morata; 2012.
45.
go back to reference Callejo Gallego J, Val Cid C, Gutiérrez BritoJ, Viedma Rojas A. Introduction to social research techniques. Madrid: Ed. Ramón Areces; 2017. Callejo Gallego J, Val Cid C, Gutiérrez BritoJ, Viedma Rojas A. Introduction to social research techniques. Madrid: Ed. Ramón Areces; 2017.
47.
go back to reference Phillips N, Hardy C. Discourse analysis. Investigating processes of social construction. Thousand Oaks: Sage; 2002. p. 104. Phillips N, Hardy C. Discourse analysis. Investigating processes of social construction. Thousand Oaks: Sage; 2002. p. 104.
52.
go back to reference Post RM. Heading off depressive illness evolution and progression to treatment resistance. Dialogues Clin Neurosci. 2015;17(2):105–9.PubMedPubMedCentral Post RM. Heading off depressive illness evolution and progression to treatment resistance. Dialogues Clin Neurosci. 2015;17(2):105–9.PubMedPubMedCentral
53.
go back to reference Molina Siguero A, García Pérez MA, Alonso González M, Cecilia Cermeño P. Prevalence of worker burnout and psychiatric illness in primary care physicians in a health care area in Madrid. Aten Primaria. 2003;31(9):564–71.CrossRefPubMedPubMedCentral Molina Siguero A, García Pérez MA, Alonso González M, Cecilia Cermeño P. Prevalence of worker burnout and psychiatric illness in primary care physicians in a health care area in Madrid. Aten Primaria. 2003;31(9):564–71.CrossRefPubMedPubMedCentral
54.
60.
go back to reference Goldberg D, Kendler K, Sirovatka P, Regier D. Diagnostic Issues in Depression and Generalized Anxiety Disorder Refining the Research Agenda for DSM-V. Arlington: American Psychiatric Association; 2010. Goldberg D, Kendler K, Sirovatka P, Regier D. Diagnostic Issues in Depression and Generalized Anxiety Disorder Refining the Research Agenda for DSM-V. Arlington: American Psychiatric Association; 2010.
62.
go back to reference Leskelä US, Melartin TK, Lestelä-Mielonen PS, Rytsälä HJ, Sokero TP, Heikkinen ME, Isometsä ET. Life events, social support, and onset of major depressive episode in finnish patients. J Nerv Ment Dis. 2004;192(5):373–81.CrossRefPubMed Leskelä US, Melartin TK, Lestelä-Mielonen PS, Rytsälä HJ, Sokero TP, Heikkinen ME, Isometsä ET. Life events, social support, and onset of major depressive episode in finnish patients. J Nerv Ment Dis. 2004;192(5):373–81.CrossRefPubMed
63.
go back to reference Brotons C, Björkelund C, Bulc M, Ciurana R, Godycki-Cwirko M, Jurgova E, et al. Prevention and health promotion in clinical practice: the views of general practitioners in Europe. Prev Med. 2005;40(5):595–601.CrossRefPubMed Brotons C, Björkelund C, Bulc M, Ciurana R, Godycki-Cwirko M, Jurgova E, et al. Prevention and health promotion in clinical practice: the views of general practitioners in Europe. Prev Med. 2005;40(5):595–601.CrossRefPubMed
65.
go back to reference White S, Schmidt W, Sahanggamu D, Fatmaningrum D, van Liere M, Curtis V. Can gossip change nutrition behaviour? Results of a mass media and community-based intervention trial in east java, Indonesia. Tropical Med Int Health. 2016;21(3):348–64. https://doi.org/10.1111/tmi.12660.CrossRef White S, Schmidt W, Sahanggamu D, Fatmaningrum D, van Liere M, Curtis V. Can gossip change nutrition behaviour? Results of a mass media and community-based intervention trial in east java, Indonesia. Tropical Med Int Health. 2016;21(3):348–64. https://​doi.​org/​10.​1111/​tmi.​12660.CrossRef
66.
go back to reference Aunger R, Curtis V. Behavior Centred Desig. London: London School of Hygiene and Tropical Medicine; 2015. Aunger R, Curtis V. Behavior Centred Desig. London: London School of Hygiene and Tropical Medicine; 2015.
68.
go back to reference Michie S, Wood CE, Johnston M, Abraham C, Francis JJ, Hardeman W. Behaviour change techniques: the development and evaluation of a taxonomic method for reporting and describing behaviour change interventions (a suite of five studies involving consensus methods, randomised controlled trials and analysis of qualitative data). Health Technol Assess. 2015;19(99):1–188. https://doi.org/10.3310/hta19990.CrossRefPubMedPubMedCentral Michie S, Wood CE, Johnston M, Abraham C, Francis JJ, Hardeman W. Behaviour change techniques: the development and evaluation of a taxonomic method for reporting and describing behaviour change interventions (a suite of five studies involving consensus methods, randomised controlled trials and analysis of qualitative data). Health Technol Assess. 2015;19(99):1–188. https://​doi.​org/​10.​3310/​hta19990.CrossRefPubMedPubMedCentral
Metadata
Title
Facilitators and barriers to modifying dietary and hygiene behaviours as adjuvant treatment in patients with depression in primary care: a qualitative study
Authors
B. Olivan-Blázquez
J. Montero-Marin
M. García-Toro
E. Vicens-Pons
M. J. Serrano-Ripoll
A. Castro-Gracia
M. C. Sarasa-Bosque
J. M. Mendive-Arbeloa
Y. López-del-Hoyo
J. Garcia-Campayo
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2018
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-018-1779-7

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