背景:在美国,拉丁美洲人在获得和利用精神卫生保健方面面临着广泛的文化和结构性障碍。特别是拉丁裔男性接受精神保健不足的风险很高,可能是由于他们经历的与男性气质有关的额外障碍。在更普遍的男性中,更多的坚持情绪控制和自立与更高的抑郁严重程度和更少的抑郁求助相关。与女性相比,男性对抑郁症和寻求帮助的耻辱更多,并且不太可能被诊断出患有抑郁症。然而,拉丁裔男性治疗抑郁症的障碍和促进者在很大程度上仍未被探索。这项研究的目的是研究在初级保健环境中,与讲英语和西班牙语的拉丁裔男性男性气概有关的抑郁症护理障碍和促进因素。
方法:我们使用便利和有目的的抽样来招募自我认定为拉丁裔男性的初级保健患者,说英语或西班牙语,并在患者健康问卷-2中筛选出抑郁症状阳性或有抑郁症史。半结构化访谈于2020年12月至2021年8月进行。采访指南研究了抑郁症的观点和经验,阳刚之气,以及参与抑郁症护理的障碍和促进者。利用经修改的扎根理论提供的共识定性研究和主题分析,确定了抑郁症护理的障碍和促进者。
结果:我们采访了13名英语水平不同的参与者,教育,收入,和原产国。障碍和促进者被置于三个领域——抑郁的自我识别,寻求抑郁症的帮助,抑郁症的诊断和治疗。参与者将男性气质的各个方面描述为障碍(情绪控制和提供压力),促进者(诚实,勇气,合作,实用性,和责任),或者两者兼而有之(自力更生和自主)。
结论:男性气质在自我识别水平上影响拉丁裔男性抑郁护理的障碍和促进者,寻求帮助,诊断和治疗。临床医生可以通过了解患者的价值观和将抑郁症护理视为肯定男性气概来促进拉丁裔男性参与抑郁症护理。为初级保健医生和其他医疗保健专业人员提供有关性别和抑郁症的教育,并解决结构性障碍,对于为所有需要抑郁症护理的人提供服务至关重要。
In the United States, Latinos face a wide array of cultural and structural barriers to accessing and utilizing mental health care. Latino men specifically are at high risk of receiving inadequate mental health care, possibly due to additional obstacles they experience that are related to
masculinity. Among men more generally, greater adherence to emotional control and self-reliance is associated with higher depression severity and less depression help-seeking. Men experience more stigma toward depression and help-seeking and are less likely to be diagnosed with depression than women. However, Latino men\'s barriers and facilitators to depression care remain largely unexplored. The objective of this
study was to examine barriers and facilitators to depression care that are related to
masculinity among English- and Spanish-speaking Latino men in a primary care setting.
We used convenience and purposive sampling to recruit primary care patients who self-identified as Latino men, spoke English or Spanish, and screened positive for depressive symptoms on the Patient Health Questionnaire-2 or had a history of depression. Semi-structured interviews were conducted between December 2020 and August 2021. The interview guide examined views and experiences of depression, masculinity, and barriers and facilitators to engaging in depression care. Utilizing consensual qualitative research and thematic analysis informed by modified grounded theory, barriers and facilitators to depression care were identified.
We interviewed thirteen participants who varied in English proficiency, education, income, and country of origin. Barriers and facilitators were placed into three domains-Self-Recognition of Depression, Seeking Help for Depression, and Depression Diagnosis and Treatment. Participants described aspects of
masculinity as barriers (emotional control and pressure to provide), facilitators (honesty, courage, collaboration, practicality, and responsibility), or both (self-reliance and autonomy).
Masculinity influences barriers and facilitators for depression care among Latino men at the levels of self-recognition, seeking help, and diagnosis and treatment. Clinicians may promote Latino men\'s engagement in depression care by understanding patients\' values and framing depression care as affirming masculinity. Providing education to primary care physicians and other healthcare professionals on gender and depression and addressing structural barriers are essential to providing access to all who need depression care.