چکیده (انگلیسی):

Background:The prevalence of comorbid anxiety and depressivedisordersishighamongpatientswithchronic
diseases in primary care, and is associated with increased morbidity and mortality rates. The detection and
treatment of common mental disorders in patients with chronic diseases can be challenging in the primary
care setting. This study aims to explore the perceived needs, barriers and facilitators for the delivery of mental
health care for patients with coexisting common mental disorders and chronic diseases in primary care from the
clinician and patient perspectives.
Methods:In this qualitative descriptive study, we conducted semi-structured interviews with clinicians (family
physician, nurse, psychologist, social worker;n=18)andpatients (n= 10) from three primary care clinics in
Quebec, Canada. The themes explored included clinician factors (e.g., attitudes, perception of roles, collaboration,
management of clinical priorities) and patient factors (e.g., needs, preferences, access to care, communication
with health professionals) associated with the delivery of care. Qualitative data analysis was conducted based
on an interactive cyclical process of data reduction, data display and conclusion drawing and verification.
Results:Clinician interviews highlighted a number of needs,barriers and enablers in the provision of patient
services, which related to inter-professional collaboration, access to psychotherapy, polypharmacy as well as
communication and coordination of services within the primary care clinic and the local network. Two specific
facilitators associated with optimal mental health care were the broadening of nurses’ functions in mental health
care and the active integration of consulting psychiatrists. Patients corroborated the issues raised by the
clinicians, particularly in the domains of whole-person care, service accessibility and care management.
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