Strategies Pakistani Women Use to Self-manage Recurrent Depression.

Abstract

Major depression is a concern for Pakistani women. Considering its recurrent nature and the socio-economic,-cultural, and-health care issues Pakistani women confront, it is imperative to understand strategies they use to self-manage it. The purpose of this qualitative study was to describe Pakistani women’s perspectives on strategies to self-manage their recurrent depression. With a purposive sample of 10 Pakistani women, 27 semi-structured interviews were conducted and analyzed using content analysis. The findings generated three categories: (1) women’s experience of depression (2) factors influencing strategies, and (3) self-management strategies. Women’s experiences comprised of their perspectives and symptoms of depression. Their perspectives were captured under four themes: (a) contributors to depression, (b) depression as an insidious and hidden illness, (c) depression impacted self and beyond, and (d) experience of depression created positive insights. Women’s symptoms of depression were grouped under three themes (a) physical symptoms, (b) emotional symptoms, and (c) cognitive symptoms; physical symptoms were the most common. Seven influencing factors were personal, illness, provider, societal, interpersonal, cultural, and religious/spiritual. All seven factors contributed to the selection or use of strategies and were uniquely interrelated depending on women’s life circumstances. Self-management strategies comprised of perspectives on self-management strategies and specific strategies and their perceived effectiveness. Three themes regarding perspectives on self-management strategies were: (a) strategies were learnt from a variety of sources; (b) strategy use required a conducive milieu; and (c) strategy use involved decision making. Specific strategies and their perceived effectiveness comprised nine themes: (a) religious/spiritual, (b) help-seeking, (c) medication management, (d) self-help, (e) keeping busy, (f) cognitive strategies, (g) symptoms redirection, (h) unhealthy to healthy path, a transition, and (i) striving to meet self needs. Not all strategies were healthy and safe. Frequency of strategy use varied. Perceived effectiveness was not a constant; rather, it evolved over time and could change from being helpful to not helpful and vice versa. This research provides groundwork for future cross-cultural research and has the potential to broaden the roles and responsibilities of advanced nurses by promoting collaboration and partnerships within a patient-provider care framework.