Kai Sing Sun1, Tai Pong Lam2, Kwok Fai Lam3, Tak Lam Lo4, David Vai Kiong Chao5, Edmund Wing Wo Lam1. 1. Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong. 2. Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong. Electronic address: tplam@hku.hk. 3. Department of Statistics and Actuarial Science, The University of Hong Kong, Hong Kong. 4. Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong; Kwai Chung Hospital, Hong Kong. 5. Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong; Department of Family Medicine and Primary Health Care, United Christian Hospital and Tseung Kwan O Hospital, Hong Kong.
Abstract
BACKGROUND: Most of the previous studies on help seeking for psychological distress were derived from Western countries. This study investigated the barriers to help-seeking for psychological distress among Chinese primary care attenders in Hong Kong. METHODS: Nine focus groups and 6 individual interviews were conducted among Chinese primary care attenders with/without known distress, patients' significant others and the general public. The identified barriers were investigated in a questionnaire survey with data from 1626 primary care attenders recruited from 13 private clinics and 6 public clinics. RESULTS: Worries about side effects of drugs (79.9%, 95% CI:(77.9%, 81.8%)) and drug dependency (74.7%, 95% CI:(72.5%, 76.8%)) were rated as the top barriers in the survey. Qualitative interviews found both worries and actual experience of the side effects of drugs, which weakened patients' trust in the treatment. Factor analysis on all barrier items suggested three factors: 1) worries of treatment, 2) uncertainties on primary care physicians' capacity, 3) public's limited knowledge on distress and sources of help. Distress level, education level and age were associated with factor 1, whereas distress level and healthcare setting were associated with the other two factors. Qualitative interviews revealed that not having a regular primary care physician in the public setting discouraged disclosure of psychological problems. LIMITATIONS: The findings were based on self-reported data from the respondents. Hong Kong is influenced by a mixed Chinese and Western culture. CONCLUSIONS: Relevant public education in a Chinese context should target at reducing patients' worries of drug treatment and strengthening the image of primary care physicians as a feasible source of help.
BACKGROUND: Most of the previous studies on help seeking for psychological distress were derived from Western countries. This study investigated the barriers to help-seeking for psychological distress among Chinese primary care attenders in Hong Kong. METHODS: Nine focus groups and 6 individual interviews were conducted among Chinese primary care attenders with/without known distress, patients' significant others and the general public. The identified barriers were investigated in a questionnaire survey with data from 1626 primary care attenders recruited from 13 private clinics and 6 public clinics. RESULTS: Worries about side effects of drugs (79.9%, 95% CI:(77.9%, 81.8%)) and drug dependency (74.7%, 95% CI:(72.5%, 76.8%)) were rated as the top barriers in the survey. Qualitative interviews found both worries and actual experience of the side effects of drugs, which weakened patients' trust in the treatment. Factor analysis on all barrier items suggested three factors: 1) worries of treatment, 2) uncertainties on primary care physicians' capacity, 3) public's limited knowledge on distress and sources of help. Distress level, education level and age were associated with factor 1, whereas distress level and healthcare setting were associated with the other two factors. Qualitative interviews revealed that not having a regular primary care physician in the public setting discouraged disclosure of psychological problems. LIMITATIONS: The findings were based on self-reported data from the respondents. Hong Kong is influenced by a mixed Chinese and Western culture. CONCLUSIONS: Relevant public education in a Chinese context should target at reducing patients' worries of drug treatment and strengthening the image of primary care physicians as a feasible source of help.
Authors: Kai Sing Sun; Tai Pong Lam; Kwok Fai Lam; Leon Piterman; Tak Lam Lo; David Vai Kiong Chao; Edmund Wing Wo Lam Journal: PLoS One Date: 2017-10-02 Impact factor: 3.240