An inventory of support, barriers and facilitators for a multicomponent lifestyle intervention for depressive symptoms in primary care: a qualitative study

Jolien Panjer

Background:

Amongst people with depressive symptoms or a major depressive disorder a unhealthy lifestyle is more present. There seems to be a vicious circle were an unhealthy lifestyle causes more depressive symptoms, and depressive symptoms cause an unhealthy lifestyle. This unhealthy lifestyle is also associated with an increased risk for cardiovascular diseases. A possible way to break the vicious circle could be a multicomponent lifestyle intervention (MLI).

Research questions:

Is there a support base for a multicomponent lifestyle intervention for patients with depressive symptoms and what are important components of the intervention and possible barriers and facilitators for the implementation?

Method:

We interviewed 5 groups of stakeholders (general practitioners (GP), general practice based nurse specialists (POH-GGZ, POH-S) , patients and lifestyle coaches (LC)) using a thematic analytic approach.
Atlas TI was used to facilitate analysis. Mind mapping led to categories and themes. Results were used to adapt a MLI. The proposal for the adapted MLI was peer reviewed in a focus group.

Results:

We interviewed 5 GP’s, 6 POH-GGZ, 5 POH-S, 7 patients and 5 lifestyle coaches. The interviews led to 2 final mind maps containing two themes: support base and intervention. These mind maps showed several points of consideration for a MLI: there is a support base for a MLI amongst most stakeholders. Several components, barriers and facilitators came up, to which attention should be given when designing an MLI.

Conclusions:

There is a support base for designing a MLI for depressive symptoms in primary care. When implementing such a MLI, the MLI should focus on establishing a sustainable change and on increasing intrinsic motivation, accessibility should be kept in mind and attention should be paid to psycho-education. The MLI can be given by LC's, when they’re given extra education on depressive disorder and the impact it has on lifestyle.

Points for discussion:

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