Lifestyle interventions for depression in primary care: a qualitative study

Area of Science:

• Mental Health
• Lifestyle Medicine
• Primary Care Research

Background:

• Depression often involves a detrimental cycle of depressive symptoms leading to unhealthy lifestyles, which in turn worsen symptoms and reduce life expectancy.
• Multicomponent lifestyle interventions (MLI) offer a potential strategy to interrupt this negative cycle in individuals with depression.

Purpose of the Study:

• To explore barriers and facilitators for implementing MLI in patients experiencing depressive symptoms.
• To gather perspectives from various healthcare professionals (GPs, nurses, lifestyle coaches) and patients on MLI implementation.

Main Methods:

• Qualitative study employing semi-structured interviews with 5 general practitioners (GPs), 6 mental health nurses (MHNs), 5 chronic disease practice nurses (CD-PNs), 5 lifestyle coaches (LCs), and 7 patients (PTs) in Dutch primary care.
• Thematic analysis was used to analyze interview data focusing on barriers and facilitators for MLI.
• A focus group served as a member check to validate findings.

Main Results:

• Five major themes emerged: 'expectations of effectiveness', 'motivation', 'stigma', 'logistics and organization', and 'communication by professionals'.
• Professional expectations of MLI effectiveness, participant motivation, efficient logistics, and clear communication were identified as key facilitators.
• Patient motivation, particularly the desire for program-driven motivation and support from others, emerged as significant factors for participation.

Conclusions:

• Perceptions of MLI effectiveness are critical, acting as either a facilitator or barrier.
• Positive professional expectations, participant motivation, organized logistics, and destigmatizing communication significantly facilitate MLI.
• Patient motivation and social support are crucial for engagement in MLI programs.