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Qualitative Health Research
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Caregivers' Experiences With Major Depression Concealed by Physical Illness in Patients Recruited From Central Ugandan Primary Health Care Centers

Wilson Winstons Muhwezi

Makerere University, Kampala, Uganda

Elialilia Sarikiaeli Okello

Makerere University, Kampala, Uganda

Stella Neema

Makerere University, Kampala, Uganda

Seggane Musisi

Makerere University, Kampala, Uganda

In this article, we present caregivers' grapples with major depression seen among their physically ill patients. A thematic analysis of 29 in-depth caregiver interviews identified four themes: (a) caregivers' perceptions of depression, (b) barriers to caregivers' focus on depression, (c) resources and opportunities for managing depression, and (d) caregivers' perspectives on consequences of depression. Patients' physical illnesses concealed depressive episodes. Caregivers could not apply the label of "depression" but enumerated its indicative features. Stigmatization of depression, common with other mental illnesses and poverty, undermined caregiving. Vital caregiving resources included caregivers' willingness to meet patients' basic needs, facilitating patients' access to health care, informal counseling of patients, and ensuring patients' spiritual nourishment. Caregivers' management of depression in physically ill patients was expensive, but they coped; however, caregiving was burdensome. Ongoing support should be given not only to patients but caregivers, as well. To provide appropriate care, caregivers deserve sensitization about depression in the context of physical illness.

Key Words: Africa • caregiving • informal • coping and adaptation • depression • developing countries • life stories • primary health care • stress • thematic analysis • Uganda

Qualitative Health Research, Vol. 18, No. 8, 1096-1114 (2008)
DOI: 10.1177/1049732308320038
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