187 lines
5.7 KiB
YAML
187 lines
5.7 KiB
YAML
abstract: 'Background Co-morbidity of depression with other non-communicable
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diseases (NCDs) worsens clinical outcomes for both conditions. Low- and
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middle-income countries need to strengthen mechanisms for detection and
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management of co-morbid depression within NCDs. The Behavioural
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Activation for Comorbid Depression in Non-communicable Disease (BEACON)
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study explored the acceptability and feasibility of integrating a brief
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depression intervention (behavioural activation, BA) into NCD services
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in healthcare facilities in Bangladesh and Pakistan. Methods
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Face-to-face qualitative interviews were conducted with 43 patients and
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18 health workers attending or working in NCD centres in four healthcare
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facilities in Bangladesh and Pakistan, and with three policy makers in
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each country. The interviews addressed four research questions (1) how
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NCD care is delivered, (2) how NCD patients experience distress, (3) how
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depression care is integrated within NCD provision, and (4) the
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challenges and opportunities for integrating a brief depression
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intervention into usual NCD care. The data were analysed using framework
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analysis, organised by capability, opportunity and motivation factors,
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cross-synthesised across countries and participant groups. Results
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Patients and health workers described NCD centres as crowded and time
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pressured, with waiting times as long as five hours, and consultation
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times as short as five minutes; resulting in some patient frustration.
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They did not perceive direct links between their distress and their NCD
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conditions, instead describing worries about family and finance
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including affordability of NCD services. Health worker and policy maker
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accounts suggested these NCD centres lacked preparedness for treating
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depression in the absence of specific guidelines, standard screening
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tools, recording systems or training. Barriers and drivers to
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integrating a brief depression intervention reflected capability,
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opportunity and motivation factors for all participant groups. While
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generally valuing the purpose, significant challenges included the busy
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hospital environment, skill deficits and different conceptions of
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depression. Conclusions Given current resource constraints and
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priorities, integrating a brief psychological intervention at these NCD
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centres appears premature. An opportune first step calls for responding
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to patients'' expressed concerns on service gaps in provisioning steady
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and affordable NCD care. Acknowledging differences of conceptions of
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depression and strengthening psychologically informed NCD care will in
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turn be required before the introduction of a specific psychological
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intervention such as BA.'
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affiliation: 'Wright, J (Corresponding Author), Univ York, Dept Hlth Sci, York YO10
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5DD, N Yorkshire, England.
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Wright, Jerome; Mazumdar, Papiya; Jennings, Hannah, Univ York, Dept Hlth Sci, York
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YO10 5DD, N Yorkshire, England.
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Barua, Deepa; Lina, Silwa; Huque, Rumana, Ark Fdn, House 6,Rd 109,Gulshan 2, Dhaka,
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Bangladesh.
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Bibi, Humaira; Kanwal, Ateeqa; Mujeeb, Faiza; Naz, Qirat; Safi, Rahim; Ul Haq, Baha;
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Rana, Rusham Zahra; Nizami, Asad, Rawalpindi Med Univ, Inst Psychiat, Rawalpindi
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46000, Pakistan.
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Nahar, Papreen, Univ Sussex, Brighton \& Sussex Med Sch, Med Res Bldg, Brighton
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BN1 9PX, E Sussex, England.
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Sikander, Siham, Hlth Serv Acad, PM Hlth Complex, Chak Shahzad 44000, Pakistan.
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Jackson, Cath, Valid Res Ltd, Suite 19,Sandown House,Sandbeck Way, Wetherby LS22
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7DN, England.'
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article-number: '63'
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author: 'Wright, Jerome and Mazumdar, Papiya and Barua, Deepa and Lina, Silwa and
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Bibi, Humaira and Kanwal, Ateeqa and Mujeeb, Faiza and Naz, Qirat and Safi, Rahim
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and Ul Haq, Baha and Rana, Rusham Zahra and Nahar, Papreen and Jennings, Hannah
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and Sikander, Siham and Huque, Rumana and Nizami, Asad and Jackson, Cath and Grp,
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NIHR Global Hlth Res and IMPACT, '
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author-email: jerome.wright@york.ac.uk
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author_list:
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- family: Wright
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given: Jerome
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- family: Mazumdar
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given: Papiya
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- family: Barua
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given: Deepa
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- family: Lina
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given: Silwa
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- family: Bibi
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given: Humaira
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- family: Kanwal
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given: Ateeqa
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- family: Mujeeb
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given: Faiza
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- family: Naz
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given: Qirat
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- family: Safi
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given: Rahim
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- family: Ul Haq
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given: Baha
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- family: Rana
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given: Rusham Zahra
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- family: Nahar
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given: Papreen
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- family: Jennings
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given: Hannah
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- family: Sikander
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given: Siham
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- family: Huque
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given: Rumana
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- family: Nizami
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given: Asad
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- family: Jackson
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given: Cath
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- family: Grp
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given: NIHR Global Hlth Res
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- family: IMPACT
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given: ''
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da: '2023-09-28'
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doi: 10.1186/s13033-020-00399-y
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files: []
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issn: 1752-4458
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journal: INTERNATIONAL JOURNAL OF MENTAL HEALTH SYSTEMS
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keywords: 'Non-communicable disease; Depression; Behavioural activation; South
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Asia; NCD facilities; Mental health policy; Mental-physical
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co-morbidity; Depression care integration'
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keywords-plus: 'NONCOMMUNICABLE DISEASES; HEALTH; PROGRAM; INCOME; DISORDERS; COUNTRIES;
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INDIA'
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language: English
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month: AUG 11
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number: '1'
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number-of-cited-references: '47'
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orcid-numbers: 'Jennings, Hannah Maria/0000-0002-8580-0327
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Nahar, Papreen/0000-0002-5817-8093
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Haq, Baha Ul/0000-0002-9665-3609
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Barua, Deepa/0000-0002-0122-9048
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Wright, Jerome/0000-0001-9740-0534
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Aslam, Faiza/0000-0002-7847-7250'
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papis_id: f21a10fc2022eb5fba7e65c78c242eda
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ref: Wright2020integratingdepressio
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researcherid-numbers: 'Rana, Rusham/AAD-5432-2021
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'
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times-cited: '4'
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title: 'Integrating depression care within NCD provision in Bangladesh and Pakistan:
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a qualitative study'
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type: article
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unique-id: WOS:000562256300001
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usage-count-last-180-days: '0'
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usage-count-since-2013: '2'
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volume: '14'
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web-of-science-categories: Psychiatry
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year: '2020'
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