title: A descriptive qualitative study of the roles of family members in older men's depression treatment from the perspectives of older men and primary care providers.
abstract: OBJECTIVE
  The aim of this study is to describe the roles of family members in older men's depression treatment from the perspectives of older men and primary care physicians (PCPs).
  
  
  METHODS
  Cross-sectional, descriptive qualitative study conducted from 2008-2011 in primary care clinics in an academic medical center and a safety-net county teaching hospital in California's Central Valley. Participants in this study were the following: (1) 77 age ≥ 60, noninstitutionalized men with a 1-year history of clinical depression and/or depression treatment who were identified through screening in primary care clinics and (2) a convenience sample of 15 PCPs from the same recruitment sites. Semi-structured and in-depth qualitative interviews were conducted and audiotaped then transcribed and analyzed thematically.
  
  
  RESULTS
  Treatment-promoting roles of family included providing an emotionally supportive home environment, promoting depression self-management and facilitating communication about depression during primary care visits. Treatment-impeding roles of family included triggering or worsening men's depression, hindering depression care during primary care visits, discouraging depression treatment and being unavailable to assist men with their depression care. Overall, more than 90% of the men and the PCPs described one or more treatment-promoting roles of family and over 75% of men and PCPs described one or more treatment-impeding roles of family.
  
  
  CONCLUSIONS
  Families play important roles in older men's depression treatment with the potential to promote as well as impede care. Interventions and services need to carefully assess the ongoing roles and attitudes of family members and to tailor treatment approaches to build on the positive aspects and mitigate the negative aspects of family support.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA.
authors.forename: Ladson
authors.initials: L
authors.lastname: Hinton
authors.forename: Ester Carolina
authors.initials: EC
authors.lastname: Apesoa-Varano
authors.forename: Jürgen
authors.initials: J
authors.lastname: Unützer
authors.forename: Megan
authors.initials: M
authors.lastname: Dwight-Johnson
authors.forename: Mijung
authors.initials: M
authors.lastname: Park
authors.forename: Judith C
authors.initials: JC
authors.lastname: Barker
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D002140:California; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000628:therapy*; D005190:Family; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D036301:Qualitative Research; D012944:Social Support; D055815:Young Adult
keywords: depression; family; men; primary care; qualitative