What is the Potential for Family Physicians to Coach Patients? Self-care of Depression: An Exploratory Study

Abstract

BACKGROUND: The potential for family physicians (FPs) to be self-care coaches for patients with depression was explored within a feasibility study examining lay coach support for self-care of depressive symptoms in adults with chronic physical illness. METHODS: FPs were approached from a list of 400 randomly generated urban FPs to assist recruitment of adults with chronic illness and depressive symptoms. Patients received, independent of usual FP care, six months of lay coaching for self-care of depression. Nested within this intervention FPs completed questionnaires at study entry and termination exploring how they normally used self-care, the degree to which they promoted it, and their hypothetical interest in coaching self-care. Two-sided paired T-tests and McNemar's tests were performed respectively for continuous and binary outcomes to assess significance of change from study onset to completion. RESULTS: 110 / 400 FPs were contactable and eligible. 63 consented to participate, and 4 withdrew at onset. Of the 59 FP participants 86% (51/59) completed entry questionnaires and 63% (37/59) terminal ones. For physical illness versus depression significantly more FPs were familiar with self-care (p=0.002) and felt it more effective (p=0.013). Of 7 targeted illnesses for which self-care might be recommended depression was ranked 5th by them. Attitudes and practice did not change as a result of study participation. CONCLUSIONS: At present it is unlikely that FPs will act as depression self-care coaches, except perhaps on an individual basis. Changes in FP training, practice styles, practice support, and remuneration may be required to improve this. Language: en