title: Low-income cancer patients in depression treatment: dropouts and completers.
abstract: This study aims to explore reasons for depression treatment dropout among low-income, minority women with depression and cancer. Semi-structured telephone interviews are conducted with 20, predominately Latina, patients who dropped out of depression treatment and 10 who completed. Transcripts analyzed using techniques rooted in grounded theory. Treatment completion barriers cluster according to Meichenbaum and Turk's (Facilitating treatment adherence: A practitioner's guidebook, Plenum Press, New York, 1987) five adherence dimensions: (a) Barriers to Treatment (informational, instrumental, cultural [language, discrimination]); (b) Disease Features (emotional burden of cancer/depression); (c) Cancer/Depression Treatment Regimens; (d) Provider-Patient Relationship (depression treatment dissatisfaction); and (e) Clinical Setting (hospital organizational issues). Although both groups describe multiple overlapping dimensions of barriers, completers seem more motivated and satisfied with treatment, possibly due to completers experiencing the positive treatment effects after the first several sessions. More research should be conducted to determine the most effective clinical treatment methods for this population.
authors.affiliation: George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO 63130-4899, USA. awells@gwbmail.wustl.edu
authors.forename: Anjanette A
authors.initials: AA
authors.lastname: Wells
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Palinkas
authors.forename: En-Jung
authors.initials: EJ
authors.lastname: Shon
authors.forename: Kathleen
authors.initials: K
authors.lastname: Ell
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D015897:Comorbidity; D003299:Cooperative Behavior; D017281:Cost of Illness; D003866:Depressive Disorder / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D033183:Interdisciplinary Communication; D007407:Interviews as Topic; D008875:Middle Aged; D009042:Motivation; D019303:Multilingualism; D009369:Neoplasms / Q000208:ethnology / Q000523:psychology* / Q000628:therapy; D010349:Patient Compliance; D010352:Patient Dropouts / Q000523:psychology*; D017060:Patient Satisfaction; D011203:Poverty / Q000208:ethnology / Q000523:psychology*; D011320:Primary Health Care; D011340:Problem Solving; D014481:United States
chemical_list: D000928:Antidepressive Agents