Attributing recovery from depression. Perceptions of people cared for in primary care

Abstract

The aim of the study was to understand how people treated for depression in primary care perceived the care they received. The focus was specifically on ascertaining their perceptions of what had helped during their treatment, their understanding of the factors to which they attributed their recovery, and their reflections on their experience of depression. Although knowledge of the factors that promote recovery from depression is growing, personal accounts of attributions of recovery are largely absent from the literature. Identifying and understanding people's accounts of their recovery is particularly important for practitioners involved in medication management and prescribing. A purposeful sample of 60 people who had accessed primary care and been prescribed medication because of depressive symptoms was interviewed using a semistructured approach. Interviews explored people's experiences of accessing and using primary care, their assessments of care offered, experiences of medication management and their attributions of recovery. Recovery from depression was characterized by its multifactorial nature, and two-thirds of the participants felt that medication had contributed to their recovery. Factors in recovery changed with the passage of time and many perceived personal strengths as important to recovery. Practitioners who acknowledged and encouraged people's roles in recovery and supported multifaceted care were perceived by users as caring and offering holistic, individualized care. People with depression are keen to regard their recovery as multifactorial and to have their own roles in recovery acknowledged. Preferences for a 'portfolio' of care, the components of which change as recovery progresses, were evident. Practitioners involved in prescribing and medication management for depression must aim to explore patients' beliefs about appropriate treatments and recovery. Addressing these can potentially promote treatment concordance and enhance recovery from depression by establishing and sustaining therapeutic relationships.