The British Journal of Psychiatry (2007) 191: 206-211. doi: 10.1192/bjp.bp.106.032011
© 2007 The Royal College of Psychiatrists
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REVIEW ARTICLES

Guided self-help in primary care mental health

Meta-synthesis of qualitative studies of patient experience

Nagina Khan, BHSc, PGC, Peter Bower, BSc, PhD and Anne Rogers, BA, MSc, PhD

National Primary Care Research and Development Centre, University of Manchester, Manchester, UK

Correspondence: Nagina Khan, MRC Research Training Fellow, National Primary Care Research and Development Centre, 5th Floor Williamson Building, University of Manchester, Oxford Road, Manchester M13 9PL, UK. Email: nagina.khan{at}postgrad.manchester.ac.uk

Declaration of interest None.

Funding detailed in Acknowledgements.

Background There is a gap between the supply of trained cognitive-behavioural therapists to treat depression and demand for care in the community. There is interest in the potential of self-help interventions, which require less input from a therapist. However, the design of effective self-help interventions is complex. Qualitative research can help to explore some of this complexity.

Aims The study aimed to identify qualitative studies of patient experience of depression management in primary care, synthesise these studies to develop an explanatory framework, and then apply this framework to the development of a guided self-help intervention for depression.

Method A meta-synthesis was conducted of published qualitative research.

Results The synthesis revealed a number of themes, including the nature of personal experience in depression; help-seeking in primary care; control and helplessness in engagement with treatment; stigma associated with treatment; and patients' understandings of self-help interventions.

Conclusions This meta-synthesis of qualitative studies provided a useful explanatory framework for the development of effective and acceptable guided self-help interventions for depression.


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