Managing Depression Among Ethnic Communities: A Qualitative Study

John Furler; Renata Kokanovic; Christopher Dowrick; Danielle Newton; Jane Gunn; Carl May

doi:10.1370/afm.1091

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Appendix 1.

The Re-order Study and the Associated Cross-Cultural Study

Note: Re-order is a 3-year study by the Australian Primary Health Care Research Institute to investigate the management of depression in general practice, conducted in partnership with a team of academics from Australia and the United Kingdom.²⁴

Re-order study. This study aims to reexamine how people experiencing depression are cared for in the community. The Re-order study draws together consumer views (computer-assisted telephone interviews with 576 people experiencing depression) and stake- holder views (a Delphi consultation with more than 300 practitioners, academics, and policy makers) exploring how family medicine should best meet the needs of people experiencing depression. The final practice phase of the study involves using both of these data sources in working with 6 family medicine practices to develop locally adapted best practice models of depression care.

Cross-cultural side study to Re-order. Designed to complement the main Re-order study and enhance the understanding of cultural perspectives in treating depression in primary care set- tings, it involved 73 in-depth qualitative interviews with patients from the Vietnamese, East Timorese, and Sudanese communities with family doctors and health care workers who were providing depression care to these communities.

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Table 1.

Family Physician Demographic Information

Characteristic	Physician 1	Physician 5	Physician 9	Physician 11	Physician 19	Physician 33	Physician 44	Physician 88
Sex	Male	Male	Female	Female	Male	Male	Female	Male
Age	50	55	55	47	40	42	35	69
Country of birth	Australia	Australia	Australia	Australia	Australia	Australia	Australia	Australia
Languages other than English spoken	None	French	Italian, Spanish	Hebrew	Italian	None	None	None
Length of time in profession, y	19	27	31	—	10	12	0.5	42
Length of time working with this community, y	12	25	24	—	10	7	0.5	7
Ethnic minority population primarily seen at regular practice	East Timorese and Vietnamese	East Timorese and Vietnamese	East Timorese and Vietnamese	East Timorese and Vietnamese	East Timorese and Vietnamese	Sudanese	Sudanese	Sudanese

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Supplemental Appendix

Supplemental Appendix. Interview Schedule.

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Supplemental data: Appendix - PDF file, 1 page, 89 KB
The Article in Brief

Managing Depression Among Ethnic Communities: A Qualitative Study

John Furler , and colleagues

Background This study reports on how family physicians experience working with patients from different ethnic minority communities in recognizing and caring for depression.

What This Study Found Working across cultural differences--with both biomedical and social models of depression and at both the community and individual levels--is not a barrier to high-quality care, but rather a central element of that care. Family physicians in this study negotiated across differences in ethnicity, culture, and language using a sensitive, implicit process.

Implications

Family physicians provide a unique form of depression care that includes dealing with difference.
Future research should explore the process of negotiating difference as part of depression care and its relationship to clinical outcomes and physician and patient characteristics.