Maps, Models, and Narratives

Kokanović, Renata; Butler, Ella; Halilovich, Hariz; Palmer, Victoria; Griffiths, Frances; Dowrick, Christopher; Gunn, Jane

doi:10.1177/1049732312467231

Cited by 27 publications

(18 citation statements)

References 50 publications

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“…As mandalas are a fluid visual imagery, people can attribute different meanings and gain multiple understandings (MARI, 2011). This potential for difference is important for examining a complex topic like depression care where divergent views on causality and treatment pathways exist (Kokanovic et al, 2013). As such, mandalas appeared to be useful as a method to test with busy study participants.…”

Section: The Mandalasmentioning

confidence: 99%

Mandalas as a visual research method for understanding primary care for depression

Palmer

Dowrick

Gunn

2013

International Journal of Social Research Methodology

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Depression is a complex problem, commonly but not always successfully managed in primary care. We know relatively little about the system of primary care for depression particularly at the level of organisations. In this paper, we describe the use of mandalas as a visual data collection method within an in-depth programme of participatory action research undertaken in six primary care organisations in Victoria, Australia. We draw on mandala images, selected and discussed by 49 multidisciplinary primary health care professionals and demonstrate how they can be employed as an effective graphic elicitation method. We conclude that mandalas offer an innovative approach for qualitative data collection for two reasons. First, they can engage busy research participants in a reflective space. Second, using the mandalas as an elicitation method generates meaningful data: it provides new insights, reveals unrecognised aspects of practice, generates new learning, gives physical form to tacit processes and enables complex information to become accessible; all within short timeframes.

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Section: The Mandalasmentioning

confidence: 99%

Mandalas as a visual research method for understanding primary care for depression

Palmer

Dowrick

Gunn

2013

International Journal of Social Research Methodology

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“…Palmer et al convened patient and community perspectives to inform development of an effective primary care approach to depression [26]. Kokanovic et al have begun to reconcile lay descriptions with professional definitions of depression [27]. …”

Section: Introductionmentioning

confidence: 99%

A qualitative comparison of primary care clinicians’ and their patients’ perspectives on achieving depression care: implications for improving outcomes

et al. 2014

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BackgroundImproving the patient experience of primary care is a stated focus of efforts to transform primary care practices into “Patient-centered Medical Homes” (PCMH) in the United States, yet understanding and promoting what defines a positive experience from the patient’s perspective has been de-emphasized relative to the development of technological and communication infrastructure at the PCMH. The objective of this qualitative study was to compare primary care clinicians’ and their patients’ perceptions of the patients’ experiences, expectations and preferences as they try to achieve care for depression.MethodsWe interviewed 6 primary care clinicians along with 30 of their patients with a history of depressive disorder attending 4 small to medium-sized primary care practices from rural and urban settings.ResultsThree processes on the way to satisfactory depression care emerged: 1. a journey, often from fractured to connected care; 2. a search for a personal understanding of their depression; 3. creation of unique therapeutic spaces for treating current depression and preventing future episodes. Relative to patients’ observations regarding stigma’s effects on accepting a depression diagnosis and seeking treatment, clinicians tended to underestimate the presence and effects of stigma. Patients preferred clinicians who were empathetic listeners, while clinicians worried that discussing depression could open “Pandora’s box” of lengthy discussions and set them irrecoverably behind in their clinic schedules. Clinicians and patients agreed that somatic manifestations of mental distress impeded the patients’ ability to understand their suffering as depression. Clinicians reported supporting several treatment modalities beyond guideline-based approaches for depression, yet also displayed surface-level understanding of the often multifaceted support webs their patient described.ConclusionsImproving processes and outcomes in primary care may demand heightened ability to understand and measure the patients’ experiences, expectations and preferences as they receive primary care. Future research would investigate a potential mismatch between clinicians’ and patients’ perceptions of the effects of stigma on achieving care for depression, and on whether time spent discussing depression during the clinical visit improves outcomes. Improving care and outcomes for chronic disorders such as depression may require primary care clinicians to understand and support their patients’ unique ‘therapeutic spaces.’

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“…Prior research that investigated how people talk about depression has focused on the clinical encounter between patient and physician (Goodman, 2009;Jesse, Dolbier, & Blanchard, 2008;Karasz et al, 2012;Kokanovic et al, 2013). By moving outside the clinic, this study expands our understanding of how women grapple with postpartum depression in the broader context of their lives.…”

Section: Discussionmentioning

confidence: 90%

Internet Confessions of Postpartum Depression

Kantrowitz‐Gordon

2013

Issues in Mental Health Nursing

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Women with postpartum depression may suffer in silence due to the stigma of depression and failed motherhood. It is important to consider how mothers are able to talk about postpartum depression and what strategies they use. Foucault's idea that confession is a widespread technique for producing truth in Western societies was tested through discourse analysis of posts on an Internet forum for women with postpartum depression. The Internet forum showed women's use of confessionary language and self-judgments as well as their sense of disconnected mothering, shame, and disembodiment. Discourses of depression included the good mother, biomedical illness, and social dysfunction. Findings have implications for creating safe spaces for helping mothers with postpartum depression.

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Maps, Models, and Narratives

Cited by 27 publications

References 50 publications

Mandalas as a visual research method for understanding primary care for depression

Mandalas as a visual research method for understanding primary care for depression

A qualitative comparison of primary care clinicians’ and their patients’ perspectives on achieving depression care: implications for improving outcomes

Internet Confessions of Postpartum Depression

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