Abstract

BackgroundDespite the development of various self-management programmes that attempt to ameliorate symptoms of patients with chronic major depressive disorder (MDD), little is known about what these patients perceive as helpful in their struggle during daily live. The present study aims to explore what patients believe they can do themselves to cope with enduring MDD besides professional treatment, and which self-management strategies patients perceive as being most helpful to cope with their MDD.MethodsWe used concept mapping, a method specifically designed for the conceptualisation of a specific subject, in this case patients’ point of view (n = 25) on helpful self-management strategies in their coping with enduring MDD. A purposive sample of participants was invited at the Academic Medical Center and through requests on several MDD-patient websites in the Netherlands. Participants generated strategies in focus group discussions which were successively clustered on a two-dimensional concept map by hierarchical cluster analysis.ResultsFifty strategies were perceived as helpful. They were combined into three meta-clusters each comprising two clusters: A focus on the depression (sub clusters: Being aware that my depression needs active coping and Active coping with professional treatment); An active lifestyle (sub clusters: Active self-care, structure and planning and Free time activities) and Participation in everyday social life (sub clusters: Social engagement and Work-related activities).ConclusionsMDD patients believe they can use various strategies to cope with enduring MDD in daily life. Although current developments in e-health occur, patients emphasise on face-to-face treatments and long-term relations, being engaged in social and working life, and involving their family, friends, colleagues and clinicians in their disease management. Our findings may help clinicians to improve their knowledge about what patients consider beneficial to cope with enduring MDD and to incorporate these suggested self-management strategies in their treatments.

Highlights

  • Despite the development of various self-management programmes that attempt to ameliorate symptoms of patients with chronic major depressive disorder (MDD), little is known about what these patients perceive as helpful in their struggle during daily live

  • Poor recovery occurs in 10-20% of the MDD patients [2] and can have various reasons, e.g. not seeking treatment, a preference to manage MDD on their own, insufficient adherence to or no effective use of treatment and non- or partial response to sequential treatments resulting in treatment resistant depression (TRD) [3,4,5]

  • These coping strategies can be summarized into three main themes: A focus on the depression, comprising ‘Being aware that my depression needs active coping’ and ‘Active coping with professional treatment’; An active lifestyle, comprising ‘Active self-care, structure and planning’ and ‘Free time activities’ and; Participation in everyday social life, including ‘Social engagement’ and ‘Work-related activities’

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Summary

Introduction

Despite the development of various self-management programmes that attempt to ameliorate symptoms of patients with chronic major depressive disorder (MDD), little is known about what these patients perceive as helpful in their struggle during daily live. Various chronic disease management models and (internet-based) self-management programmes have van Grieken et al BMC Psychiatry 2014, 14:331 http://www.biomedcentral.com/1471-244X/14/331 been developed [9,10,11], aimed at improving the confidence of patients with chronic diseases, empowerment, healthrelated quality of life, and changing the behaviour to ameliorate symptoms and stop disease progression. Such programmes are a widespread strategy to reduce health care costs in expanding populations with chronic diseases [12]

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