Clinical problems in the long-term care of patients with chronic depression
Article first published online: 26 MAY 2008
© 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd
Journal of Advanced Nursing
Volume 62, Issue 6, pages 689–697, June 2008
How to Cite
Koekkoek, B., Van Meijel, B., Schene, A. and Hutschemaekers, G. (2008), Clinical problems in the long-term care of patients with chronic depression. Journal of Advanced Nursing, 62: 689–697. doi: 10.1111/j.1365-2648.2008.04645.x
- Issue published online: 26 MAY 2008
- Article first published online: 26 MAY 2008
- Accepted for publication 20 February 2008
- chronic depression;
- community mental health services;
- Delphi study;
- focus group;
- long-term care;
- mental health nursing;
- psychosocial rehabilitation
Title. Clinical problems in the long-term care of patients with chronic depression.
Aim. This paper is a report of a study to explore problems encountered by mental health professionals in the long-term care of patients with chronic depression.
Background. Patients who do not profit from psychopharmacological or psychotherapeutic treatment often need long-term care. Although they experience severe symptoms and loss of functioning, little is known about these people and the care they receive.
Method. Experts in chronic depression (n = 8) participated in a four-phase Delphi study in 2006–2007. Problems were elicited through a focus group interview (first round) which was analysed using thematic analysis. The resulting problem list was validated (second round) and scored twice on a 7-point Likert scale (third and fourth rounds) by the participants. Urgency and changeability scores of 35 problems were obtained and a hierarchy of problems was set. In addition, qualitative data from the focus group interview were used to frame the results in the context of long-term care for patients with chronic depression.
Results. Problems were subdivided into five areas. Relapses by the patient, a pessimistic attitude by the professional and demoralization in both were major problems. Also noted were the negative societal connotations of chronic depression and the lack of a coherent view on treatment within mental health care.
Conclusion. Chronicity of depression may be denied by both patients and professionals, resulting in an overly strong focus on cure and a limited quality of care. The results may be used as a starting point for construction of a best-practice programme to improve long-term care.