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Title: Making sense of the experience of depression : general practitioners' and women's accounts of the management of depression in primary care
Author: Maxwell, Margaret
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2003
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Using qualitative interviews, 37 women and 20 general practitioners were recruited from practices in four NHS Board areas of Scotland. Each participant was interviewed at the start of the study, and 30 women and 19 general practitioners were re-visited approximately 9-12 months later to review the process of care. The interviews explored how women made sense of their experiences, and their evaluations of their care; and how general practitioners made sense of the women’s experiences and how they subsequently managed these women in the context of everyday practice. In making sense of their depressive experience and its management the women drew upon a range of experiential, biographical and common-sense knowledge surrounding health, illness, emotions, depression, antidepressant medications and medication use in general. However, the generally negative views surrounding depression and antidepressants created a moral dilemma for the women in accepting the diagnosis and its treatment. The women did not passively accept their general practitioner’s explanation and advice but evaluated this in relation to their own knowledge. They continually evaluated ‘formal medical knowledge’ and care in relation to their own understandings and as new knowledge (experiential and common-sense knowledge) emerged. General practitioners recognised that patients brought their own understandings to the consultation and their management involved eliciting patient beliefs and addressing the moral dilemmas that some of these beliefs created for the women. General practitioners had to negotiate care by addressing patients’ concerns and sometimes acted strategically in order to persuade, or coerce, patients to accept their advice and treatment. I draw upon the later work of Foucault which affords patient agency through the ‘technologies of the self’ and also on the work of Habermas and the relationship between ‘system’ and ‘lifeworld’ as a theoretical basis for discussion of these findings. Finally, I consider the implications of the findings for recent policy developments which call for depression to be managed as a chronic disease.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available