General practitioners’ perspectives on barriers to depression care: development and validation of a questionnaire

Abstract

Background: General practitioners (GPs) regularly feel challenged by the care of depressed patients and may encounter several barriers in providing best management. GPs' perspectives on barriers to depression care are a subject of growing interest but there is a lack of validated assessment tools. The aim of this study was to develop and validate a questionnaire assessing barriers to depression care (BDC-Q) encountered by GPs in France and the French-speaking part of Switzerland. Methods: The BDC-Q was constructed in five steps: Item development, content validation, pretesting, testing phase and test-retest reliability. The questionnaire items were generated through a literature search. An expert panel of GPs (n = 16) and psychiatrists (n = 3) validated the content and 20 GPs pretested the questionnaire to provide response process validity evidence. We then tested the questionnaire among 116 GPs and used principal component analysis and internal consistency testing (Cronbach's alpha) to structure it into consistent dimensions. Test-retest reliability using Pearson correlation coefficient was assessed with 30 GPs who completed the questionnaire twice after an interval of at least 2 weeks. Results: The 25 items BDC-Q was structured in five dimensions: (i) provision of care by the general practitioner, (ii) considering patients' attitudes towards depression, (iii) guidance for care, (iv) collaboration with mental health specialists and (v) access to mental health care. Conclusions: The BDC-Q displays evidence of validity and reliability to meaningfully assess GPs' perspectives on barriers to depression care. It can be used both at a practice level within a quality improvement strategy, and at a broader level, to inform health planners and tailor appropriate strategies to improve depression care in the community.

A Cross-Sectional Study of the Prevalence and Determinants of Common Mental Health Problems in Primary Care in Switzerland

“…In primary care contexts, which is mainly represented by general practitioners (GPs) practices, many of these disorders are not properly diagnosed or are poorly treated because GPs sometimes feel that they lack the skills to treat mental health problems and cannot offer their patients enough consultation time for these problems [5][6][7][8][9][10]. Additionally, despite some GPs not having the proper screening tools to detect mental health problems [7], they are often the first healthcare professionals to be in contact with these patients, before any specialists [7,11,12]. A prevalence of 25%-60% of mental disorders in primary care medicine has been reported worldwide [13,14].…”