title: Guided self-help in primary care mental health: meta-synthesis of qualitative studies of patient experience.
abstract: 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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: National Primary Care Research and Development Centre, 5th Floor Williamson Building, University of Manchester, Oxford Road, Manchester M13 9PL, UK. nagina.khan@postgrad.manchester.ac.uk
authors.forename: Nagina
authors.initials: N
authors.lastname: Khan
authors.forename: Peter
authors.initials: P
authors.lastname: Bower
authors.forename: Anne
authors.initials: A
authors.lastname: Rogers
mesh_terms: D000223:Adaptation, Psychological; D000928:Antidepressive Agents / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D006380:Helplessness, Learned; D006801:Humans; D007389:Internal-External Control; D010349:Patient Compliance / Q000523:psychology; D010817:Physician-Patient Relations; D011287:Prejudice; D011320:Primary Health Care; D012648:Self Care; D012917:Social Adjustment
chemical_list: D000928:Antidepressive Agents