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Patient experiences of psychological therapy for depression: a qualitative metasynthesis.
BMC Psychiatry ( IF 3.4 ) Pub Date : 2020-06-18 , DOI: 10.1186/s12888-020-02682-1
Susan McPherson 1 , Claire Wicks 1 , Ilaria Tercelli 1
Affiliation  

Globally, national guidelines for depression have prioritised evidence from randomised controlled trials and quantitative meta-analyses, omitting qualitative research concerning patient experience of treatments. A review of patient experience research can provide a comprehensive overview of this important form of evidence and thus enable the voices and subjectivities of those affected by depression to have an impact on the treatments and services they are offered. This review aims to seek a comprehensive understanding of patient experiences of psychological therapies for depression using a systematic and rigorous approach to review and synthesis of qualitative research. PsychINFO, PsychARTICLES, MEDLINE, and CINAHL were searched for published articles using a qualitative approach to examine experiences of psychological therapies for depression. All types of psychological therapy were included irrespective of model or modes of delivery (e.g. remote or in person; group or individual). Each article was assessed following guidance provided by the Critical Appraisal Skill Programme tool. Articles were entered in full into NVIVO and themes were extracted and synthesized following inductive thematic analysis. Thirty-seven studies, representing 671 patients were included. Three main themes are described; the role of therapy features and setting; therapy processes and how they impact on outcomes; and therapy outcomes (benefits and limitations). Subthemes are described within these themes and include discussion of what works and what’s unhelpful; issues integrating therapy with real life; patient preferences and individual difference; challenges of undertaking therapy; influence of the therapist; benefits of therapy; limits of therapy and what happens when therapy ends. Findings point to the importance of common factors in psychotherapies; highlight the need to assess negative outcomes; and indicate the need for patients to be more involved in discussions and decisions about therapy, including tailoring therapy to individual needs and taking social and cultural contexts into account.

中文翻译:

抑郁症心理治疗的患者体验:定性合成。

在全球范围内,国家抑郁症指南优先考虑了来自随机对照试验和定量荟萃分析的证据,而忽略了有关患者治疗经验的定性研究。对患者经验研究的回顾可以提供这一重要证据形式的全面概述,从而使抑郁症患者的声音和主观性能够对其所提供的治疗和服务产生影响。本文旨在通过系统,严格的方法对定性研究进行综述和综合,以寻求对抑郁症心理疗法患者经验的全面理解。使用定性方法对PsychINFO,PsychARTICLES,MEDLINE和CINAHL进行搜索,以查找发表的文章,以检查抑郁症心理治疗的经验。包括所有类型的心理治疗,无论分娩的模式或方式如何(例如,远程的或亲自的;小组或个人的)。每篇文章均按照“关键评估技能计划”工具提供的指导进行评估。文章已全部输入NVIVO,并通过归纳主题分析提取了主题并进行了综合。纳入了代表671名患者的37项研究。描述了三个主要主题。治疗功能和设置的作用;治疗过程及其对结果的影响;和治疗结果(好处和局限性)。子主题在这些主题中进行了描述,其中包括对什么有效,什么无益的讨论;将治疗与现实生活相结合的问题;患者的喜好和个体差异;接受治疗的挑战;治疗师的影响力;治疗的好处;治疗极限以及治疗结束时会发生什么。研究结果指出了心理治疗中公共因素的重要性。强调需要评估负面结果;并指出需要患者更多地参与有关治疗的讨论和决策,包括根据个人需要量身定制治疗方法,并考虑到社会和文化背景。
更新日期:2020-06-18
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