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Depressive Symptoms and Reduced Preventive Care Use in Older Adults

The Mediating Role of Perceived Access

Dados Bibliográficos

ID9101726
AutoresJoshua M Thorpe (University of Wisconsin–Madison, autor correspondente), Carolyn T Thorpe (0000-0002-5970-8359, University of Wisconsin–Madison), Korey A Kennelty (0000-0001-6470-9594, autor correspondente), Betty Chewning (0000-0003-1686-2329, University of Wisconsin–Madison, autor correspondente), Betty A Chewning
Ano2012
Volume50
Fascículo4
Páginas302-310
Data de publicação2012-04-01
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoMedical Care (JOURNAL)
Identificadores do periódicoISSN: 0025-7079 • E-ISSN: 1537-1948
EditoraOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e31821a933f
PMID21577167
PMCIDPMC3240709
OpenAlexW2007327870
IdiomaEN
Citações recebidas8
Referências citadas28

BACKGROUND: Depressive symptomatology is common in older adults and is associated with reduced adherence to recommended preventive care, but little is known as to why. Understanding how depressive symptoms may interfere with adherence can help to identify leverage points for interventions to increase preventive service use. OBJECTIVE: This study examined perceived access to medical care as a possible mediator linking depressive symptomatology to reduced preventive service use in older adults. METHODS: We analyzed data from 5465 respondents completing the 1993 and 2003/2004 waves of the Wisconsin Longitudinal Study. Depressive symptomatology was assessed using the Center for Epidemiologic Studies Depression Scale. Perceived access survey items were organized through factor analysis to represent key dimensions of access: availability/accessibility, affordability, acceptability, and accommodation. The primary outcome was the total number of 7 recommended preventive services that respondents received. Multivariate path analysis was used to estimate direct and indirect effects between depressive symptomatology, perceived access, and preventive service use. RESULTS: Older adults with depressive symptomatology received fewer recommended services. Depressive symptomatology reduced preventive service use by adversely affecting 2 dimensions of perceived access: (1) acceptability, pertaining to poor patient-provider trust and communication, and (2) accommodation, pertaining to inconveniently organized services. CONCLUSIONS: Depressive symptomatology may negatively alter older adults' perceptions of access and, in turn, negatively impact their preventive service use. In addition to treating depression, interventions designed to mitigate the impact of depression on the patient-provider relationship, and organizational changes to practice that better accommodate the needs of depressed patients, may increase adherence to preventive care guidelines in depressed older adults

Depression (economics) · Depressive symptoms · Path analysis (statistics) · Psychiatry · Psychological intervention · Chronic Disease Management Strategies · Clinical Psychology · Health disparities and outcomes · Medicine · Mental Health Treatment and Access · Psychology · Gerontology

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Obras citantes distintas8
Citações por ano0,57
Intervalo de citações2012 - 2026 (15)
Velocidade de citaçãocurrent
Altamente citadoNão
Tipos de citaçãoNeutras: 8
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