Abstract
BackgroundGeneral practitioners (GPs) regularly feel challenged by the care of depressed patients and may encounter several barriers in providing best management. GPs’ perspectives on barriers to depression care are a subject of growing interest but there is a lack of validated assessment tools. The aim of this study was to develop and validate a questionnaire assessing barriers to depression care (BDC-Q) encountered by GPs in France and the French-speaking part of Switzerland.MethodsThe BDC-Q was constructed in five steps: Item development, content validation, pretesting, testing phase and test-retest reliability. The questionnaire items were generated through a literature search. An expert panel of GPs (n = 16) and psychiatrists (n = 3) validated the content and 20 GPs pretested the questionnaire to provide response process validity evidence. We then tested the questionnaire among 116 GPs and used principal component analysis and internal consistency testing (Cronbach’s alpha) to structure it into consistent dimensions. Test-retest reliability using Pearson correlation coefficient was assessed with 30 GPs who completed the questionnaire twice after an interval of at least 2 weeks.ResultsThe 25 items BDC-Q was structured in five dimensions: (i) provision of care by the general practitioner, (ii) considering patients’ attitudes towards depression, (iii) guidance for care, (iv) collaboration with mental health specialists and (v) access to mental health care.ConclusionsThe BDC-Q displays evidence of validity and reliability to meaningfully assess GPs’ perspectives on barriers to depression care. It can be used both at a practice level within a quality improvement strategy, and at a broader level, to inform health planners and tailor appropriate strategies to improve depression care in the community.
Highlights
General practitioners (GPs) regularly feel challenged by the care of depressed patients and may encounter several barriers in providing best management
The remaining 13 items were revised in their wording through discussion between the research team members, in accordance with propositions highlighted during the cognitive interviews
In order to obtain a balanced questionnaire, half of the items were positively worded (e.g. “It is easy to distinguish between simple sadness and a depressive disorder”) and the other half negatively (e.g. “Obtaining feedback on patients from mental health care professionals is difficult”)
Summary
General practitioners (GPs) regularly feel challenged by the care of depressed patients and may encounter several barriers in providing best management. GPs’ perspectives on barriers to depression care are a subject of growing interest but there is a lack of validated assessment tools. The aim of this study was to develop and validate a questionnaire assessing barriers to depression care (BDC-Q) encountered by GPs in France and the French-speaking part of Switzerland. The current research on perceived barriers to depression care have mostly focused on explorative studies using qualitative designs. These methodological choices have enabled the gain of insight into the complexity of depression care in PC. The aim of the current study was to develop and validate a questionnaire assessing barriers to depression care (BDC-Q) from GPs’ perspectives in order to provide a structured instrument to use in clinical practices
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