Advertisement

Tijdschrift voor Gerontologie en Geriatrie

, Volume 47, Issue 6, pp 249–257 | Cite as

Omgaan met somberheid op oudere leeftijd: een kwalitatieve studie

  • Margaret von Faber
  • Gerda M. van der Weele
  • Geertje van der Geest
  • Jeanet W. Blom
  • Nicolette van der Zouwe
  • Ria Reis
  • Roos C. van der Mast
  • Jacobijn Gussekloo
Article
  • 563 Downloads

Samenvatting

Achtergrond

Om nieuwe inzichten te verkrijgen voor de zorg aan ouderen met somberheid, hebben we onderzocht welke opvattingen ‘screenpositieve’ ouderen hebben over oorzaken en oplossingen voor somberheid.

Methode

Afname van twee diepte-interviews bij 38 deelnemers (≥77 jaar) die op een screeningsvragenlijst in de huisartspraktijk aangaven gevoelens van somberheid te ervaren. Om de invloed van complexe problematiek te onderzoeken, werden zowel ouderen met (n = 19) als zonder complexe problemen (n = 19) geïncludeerd. Complexe problematiek werd gedefinieerd als een combinatie van functionele, somatische, psychologische en/of sociale problemen.

Resultaten

Alle deelnemers gebruikten diverse cognitieve, sociale en praktische copingstrategieën. Vier patronen kwamen naar voren: mastery, acceptatie, ambivalentie en behoefte aan steun. Vooral deelnemers met complexe problemen waren ambivalent over mogelijke interventies.

Conclusies

De meeste ouderen beschouwen hun coping als voldoende. De huisarts kan zelfmanagement ondersteunen door de (effectiviteit van de) individuele coping te bespreken, informatie te verstrekken over alternatieve interventiemogelijkheden en met ouderen hun percepties op risico’s te bespreken.

Trefwoorden

ouderen somberheid depressie interventies 

Coping strategies of older people with low mood

Abstract

Background

To gain new insights for support for older people with low mood, we explored the perceptions of ‘screenpositive’ older people on underlying causes and possible solutions.

Design and method

We conducted two in-depth interviews with 38 participants (≥77 years) who screened positive for depressive symptoms in general practice. To investigate the influence of the presence of complex health problems, we included 19 persons with and 19 without complex problems. Complex problems were defined as a combination of functional, somatic, psychological or social problems.

Results

All participants used several cognitive, social or practical coping strategies. Four patterns emerged: mastery, acceptance, ambivalence, and need for support. Some participants, especially those with complex problems, were ambivalent about possible interventions.

Conclusion

Most older participants perceived their coping strategies as sufficient. General practitioners can support self-management by exploring the (effectiveness of) personal coping strategies, providing information, elaborating on perceptions of risks and discussing alternative options with older persons.

Keywords

Older people Depressive symptoms Low mood Interventions 

Notes

Dankbetuiging

Deze studie werd gefinancierd door het Nationaal Programma Ouderenzorg (NPO) van ZonMw (projectnummer: 314060301).

Literatuur

  1. 1.
    Beekman AT, Penninx BW, Deeg DJ, Beurs E de, Geerling SW, Tilburg W van. The impact of depression on the well-being, disability and use of services in older adults: a longitudinal perspective. Acta Psychiatr Scand. 2002;105:20–7.CrossRefPubMedGoogle Scholar
  2. 2.
    Cuijpers P, Van Straten A, Schaik A van, Andersson A. Psychological treatment of depression in primary care: a meta-analysis. Br J Gen Pract. 2009;59:51–60.CrossRefGoogle Scholar
  3. 3.
    Comijs HC, Marwijk HW van, Mast RC van der, et al. The Netherlands study of depression in older persons (NESDO); a prospective cohort study. BMC Res Notes. 2011;4:524.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Stek ML, Gussekloo J, Beekman AT, Tilburg W van, Westendorp RGJ. Prevalence, correlates and recognition of depression in the oldest old: the Leiden 85-plus study. J Affect Disord. 2004;78:193–200.CrossRefPubMedGoogle Scholar
  5. 5.
    Mitchel AJ, Rao S, Vaze A. International comparison of clinicians’ ability to identify depression in primary care: meta-analysis and meta-regression of predictors. Br J Gen Pract. 2011;61:72–80.CrossRefGoogle Scholar
  6. 6.
    Romijn G, Ruiter M, Smit F. Meer effect met depressiepreventie? Strategieën voor publieksvoorlichting, vroegherkenning en terugvalpreventie. Utrecht: Trimbos Instituut; 2007.Google Scholar
  7. 7.
    Lyness JM, Pin Q, Tang W, Tu X, Conwell Y. Risk for depression onset in primary care elderly patients: potential targets for preventive interventions. Am J Psychiatry. 2009;166:1375–83.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Van der Weele GM, Jong R de, Waal M de, et al. Response to an unsolicited intervention offer to persons aged ≥ 75 years after screening positive for depressive symptoms: a qualitative study. Int Psychogeriatr. 2012;24:270–7.CrossRefPubMedGoogle Scholar
  9. 9.
    Van Schaik DJ, Klijn AF, Hout HP van, et al. Patients’ preferences in the treatment of depressive disorder in primary care. Gen Hosp Psychiatry. 2004;26:184–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Prins MA, Verhaak PF, Bensing JM, Meer K van der. Health beliefs and perceived need for mental health care of anxiety and depression-the patients’ perspective explored. Clin Psychol Rev. 2008;28:1038–58.CrossRefPubMedGoogle Scholar
  11. 11.
    Wittkampf K, Zwieten M van, Smits F, Schene A, Huyser J, Weert H van. Wat denken gescreende patiënten met een depressie over hun diagnose? Huisarts Wet. 2009;52:274–80.CrossRefGoogle Scholar
  12. 12.
    Beljouw IMJ, Laurant MGH, Heerings M, Stek ML, Marwijk HWJ van, Exel E van. Implementing an outreaching, preference-led stepped care intervention programme to reduce late life depressive symptoms: results of a mixed methods study. Implement Sci. 2014;9:107.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Joo JH, Wittink M, Dahlberg B. Shared conceptualizations and divergent experiences of counseling among african american and white older adults. Qual Health Res. 2011;21:1065–74.CrossRefPubMedGoogle Scholar
  14. 14.
    Murray J, Banerjee S, Byng R, Tylee A, Bugra D, MacDonald A. Primary care professionals’ perceptions of depression in older people: a qualitative study. Soc Sci Med. 2006;63:1363–73.CrossRefPubMedGoogle Scholar
  15. 15.
    Burroughs H, Lovell K, Morley M, Baldwin R, Burns A, Chew-Graham C. ‘Justifiable depression’: How primary care professionals and patients view late-life depression? A qualitative study. Fam Pract. 2006;23:369–77.CrossRefPubMedGoogle Scholar
  16. 16.
    Prins MA, Meadows G, Bobevski I, et al. Perceived need for mental health care and barriers to care in the Netherlands and Australia. Soc Psychiatry Psychiatr Epidemiol. 2011;46:1033–44.CrossRefPubMedGoogle Scholar
  17. 17.
    Lawrence V, Banerjee S, Bhugra D, Sangha K, Turner S, Murray J. Coping with depression in later life: a qualitative study of help-seeking in three ethnic groups. Psychol Med. 2006;36:1375–83.CrossRefPubMedGoogle Scholar
  18. 18.
    Conner KO, Lee B, Mayers V, et al. Attitudes and beliefs about mental health among African-American older adults suffering from depression. J Aging Stud. 2010;24:266–77.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Blom JW, Elzen W den, Houwelingen AH van, et al. Effectiveness and cost-effectiveness of a proactive, goal-oriented, integrated care model in general practice for older people. A cluster randomized controlled trial: Integrated Systematic Care for older People – the ISCOPE study. Age Ageing. 2016;45:30–41.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Sheikh JA, Yesavage JA. Geriatric depression scale (GDS): recent findings and development of a shorter version. In: Brink LT (redactie). Clinical gerontology; a guide to assessment and intervention. New York: Howarth; 1986.Google Scholar
  21. 21.
    Strauss A, Corbin J. Basics of qualitative research: techniques and procedures for developing Grounded Theory. London: SAGE; 1998.Google Scholar
  22. 22.
    Corbin JM, Strauss A. Unending work and care: managing chronic illness at home. San Francisco: Jossey-Bass; 1988.Google Scholar
  23. 23.
    Switzer JF, Wittink MN, Karsch BB, Barg FK. “Pull yourself up by your bootstraps”: a response to depression in older adults. Qual Health Res. 2006;16:1207–16.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Wittink MN, Barg FK, Gallo JJ. Unwritten rules of talking to doctors about depression: integrating qualitative and quantitative methods. Ann Fam Med. 2006;4:302–9.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Stanners MN, Barton CA, Shakib S, Winefield HR. Depression diagnosis and treatment amongst multimorbid patients: a thematic analysis. BMC Fam Pract. 2014;15:124.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Gerrits MJG, Oppen P van, Leone SS, Marwijk HWJ van, Horst HE van der, Penninx BW. Pain, not chronic disease, is associated with the recurrence of depressive and anxiety disorders. BMC Psychiatry. 2014;14:187.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Chew-Craham C, Kovandžić M, Gask L, et al. Why may older people with depression not present to primary care? Messages from secondary analysis of qualitative data. Health Soc Care Community. 2012;20:52–60.CrossRefGoogle Scholar
  28. 28.
    Cornford CS, Hill A, Reilly J. How patients with depressive symptoms view their condition: a qualitative study. Fam Pract. 2007;24:358–64.CrossRefPubMedGoogle Scholar

Copyright information

© Vilans 2016

Authors and Affiliations

  • Margaret von Faber
    • 1
    • 2
  • Gerda M. van der Weele
    • 3
  • Geertje van der Geest
    • 1
  • Jeanet W. Blom
    • 1
  • Nicolette van der Zouwe
    • 4
  • Ria Reis
    • 1
    • 5
    • 6
  • Roos C. van der Mast
    • 7
    • 8
  • Jacobijn Gussekloo
    • 1
  1. 1.Afdeling Public Health en EerstelijnsgeneeskundeLeiden University Medical CenterLeidenNederland
  2. 2.MarenteVoorhoutNederland
  3. 3.Afdeling Richtlijnontwikkeling en WetenschapNederlands Huisartsen GenootschapUtrechtNederland
  4. 4.GGD Hollands MiddenLeidenNederland
  5. 5.Amsterdam Institute for Social Science ResearchUniversiteit van AmsterdamAmsterdamNederland
  6. 6.The Children’s InstituteUniversity of Cape TownCape TownZuid-Afrika
  7. 7.Afdeling PsychiatrieLeiden University Medical CenterLeidenNederland
  8. 8.Afdeling PsychiatrieCAPRI-Universiteit van AntwerpenAntwerpBelgië

Personalised recommendations