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Chronic illness, depression, and the...
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Teh, Carrie Farmer.
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Chronic illness, depression, and the patient-provider relationship: Toward a model of biopsychosocial care.
紀錄類型:
書目-電子資源 : Monograph/item
正題名/作者:
Chronic illness, depression, and the patient-provider relationship: Toward a model of biopsychosocial care./
作者:
Teh, Carrie Farmer.
面頁冊數:
134 p.
附註:
Source: Dissertation Abstracts International, Volume: 67-12, Section: B, page: 7001.
Contained By:
Dissertation Abstracts International67-12B.
標題:
Health Sciences, Mental Health. -
電子資源:
http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3245203
Chronic illness, depression, and the patient-provider relationship: Toward a model of biopsychosocial care.
Teh, Carrie Farmer.
Chronic illness, depression, and the patient-provider relationship: Toward a model of biopsychosocial care.
- 134 p.
Source: Dissertation Abstracts International, Volume: 67-12, Section: B, page: 7001.
Thesis (Ph.D.)--Harvard University, 2006.
Chronic medical conditions are the leading cause of disability in the United States, account for 70 percent of all deaths, and are associated with high medical expenditures. Social and psychological correlates of chronic illness can adversely affect the course and treatment of these conditions. This dissertation adds to an understanding of the complex relationships between mental, physical and social health in the context of chronic illness, providing support for a biopsychosocial approach to treatment, and explores the current state of mental health care for people with these conditions.Subjects--Topical Terms:
1017693
Health Sciences, Mental Health.
Chronic illness, depression, and the patient-provider relationship: Toward a model of biopsychosocial care.
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Source: Dissertation Abstracts International, Volume: 67-12, Section: B, page: 7001.
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Chronic medical conditions are the leading cause of disability in the United States, account for 70 percent of all deaths, and are associated with high medical expenditures. Social and psychological correlates of chronic illness can adversely affect the course and treatment of these conditions. This dissertation adds to an understanding of the complex relationships between mental, physical and social health in the context of chronic illness, providing support for a biopsychosocial approach to treatment, and explores the current state of mental health care for people with these conditions.
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Part One uses data from a national household survey to investigate the effect of having a chronic illness on the quality of depression care for people with comorbid major depressive disorder. Depressed people with a chronic illness were more likely than those without a chronic illness to have their depression recognized by a provider; this was explained by the finding that the chronically ill had stronger patient-provider relationships. Chronically ill depressed people took more antidepressant medications on average, though were no more likely to receive minimally adequate depression treatment or be satisfied with their mental health care than those without a chronic illness.
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Using the same data, Part Two examines the effects of depression treatment on medical and social outcomes for people with chronic pain and major depressive disorder. Receiving some depression treatment was associated with better mental health and less interference of pain on work, and receiving minimally adequate depression treatment was associated with improved social functioning. Addressing and treating comorbid depression should be a key feature of a biopsychosocial approach to the treatment of chronic pain.
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Part Three explores older adults' experience of getting treatment for chronic pain in the context of a transition to patient-centered care, an important piece of the biopsychosocial model. Results of a grounded theory analysis of interviews with 15 older adults with chronic pain illustrated (1) the ambivalence this population feels toward being the "source of control" in their health care and (2) the importance to this population of having meaningful and continuous patient-provider relationships.
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