This paper discusses four major sections of a qualitative study about the effectiveness of screening methods by primary care professionals. The study, published in 2013, is entitled A qualitative study of primary care professionals’ views of case finding for depression in patients with diabetes or coronary heart disease in the UK and was conducted by Margaret Maxwell and her nine colleagues. The primary method used for collecting data was focus group discussions.
Problem Statement
Nurses often are tasked to perform cases findings/screenings for depression in patients suffering from Diabetes Mellitus (DM) and coronary heart disease (CHD). The screenings are done as one of the key areas in chronic disease management reviews. However, information about it’s the effectiveness of the screenings are not sufficient. There was therefore a need to study how the implementation of screening would impact on its effectiveness. The clinical problem is the effectiveness of the screening to identify who are suffering from depression. The research problem is the need to gather more information from the perspectives of primary care professionals.
This study is significant because the authors emphasized that nurses, in actual practice are the ones doing the screening. However, as the participants of the study have shared , they are sometimes faced with the problem of how to deal with the persons depressed when they begin to open up. The results have indicated that there is a need for additional training for the nurses so that they are better equipped to handles such situations. Some of those in the focus group discussions have mentioned that the screenings were like opening a Pandora’s box. In particular, the authors emphasized that the nurses ask the standard questions about depression, but not all of them are equipped to provide the needed response once clients open up. In addition, this study has included actual narratives from the discussions of the participants which the readers, especially nurses and general practitioners can relate to.
Purpose and Research Questions
The purpose of the study is to explore the experience of primary health care professions in “implementing screening for depression in chronic illness” and the emphasis was on “practice nurse experiences of a depression screening in primary care” (Maxwell et al., 2013, p.2). The research questions that this study aimed to answer include the following:
- Is the screening effective in identifying depression among patients with DM and CHD?
- How is the screening carried out and what questions were asked?
- Are the screening questions sufficient to identify whether the patent is depressed or not?
- How do the nurses or primary care professionals deal with a positive result during the consultation?
- What are the limitations in the screening process?
The above-mentioned questions were not explicitly enumerated by the authors. This writer therefore made use of the contents of the results section to identify the areas the research focused on. All the questions are related to the central problem identified in the problem statement. The qualitative methods were appropriate in the sense that the study centered on effectiveness of the screening from the perspectives of the primary care professionals.
Literature Review
There was however there was very little mention of the weaknesses that were present in the studies reviewed. Despite the absence of statements about weaknesses, the literature review included adequate information which contributed to the formulation of a logical argument. The paper wanted to assess the effectiveness of the depression inquiry only which was included in a whole set of questionnaire. The particular question asked had two parts. The first was “During the last month, have you often been bothered by feeling down, depressed or hopeless? The second was “During the last month , have you been bothered by having little interest or pleasure in doing things?” (Maxwell et al., 2013, p. 7).
Conceptual / Theoretical Framework
There was no particular theory that the study aimed to prove. However, there was a mention of the Normalisation Process Theory which was “used by clinicians to develop a framework for effective depression care” (Gunn et al. , 2010 as cited in Maxwell et al., 2013, p.2). The results of the study were compared to other studies and implications for further research was rather extensive.
References
Darwick C., Leydon GM., McBride, A., Howe, A., Burgess, H., Clarke P., Maisey S. & Kendrick T. (2009). Patients and doctors’ views on depression severity questionnaires incentivized in UK quality and outcomes framework: qualitative study. BMJ, 338. doi: 10.1136/bmj.b663. Retrieved from http://www.bmj.com/content/338/bmj.b663?view=long&pmid=19299474
Maxwell, M., Harris, F., Hibberd, C., Donaghy, E., Pratt, R., Williams, C., Morrison, J., Gibb, J., Watson, P. & Burton, C. (2013). A qualitative study of primary care professionals’ views of case finding for depression in patients with diabetes or coronary heart disease in the UK. BMC Family Practice , 14 (46). Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3623815/pdf/1471-2296-14-46.pdf.
