Table 1.
Culture-sensitive adaptations of patient information materials for depression
| Component (standard version) | Italian | Polish | Russian | Turkish |
|---|---|---|---|---|
| Cover picture (young woman sitting in front of a laptop, holding her head and looking sad) | Cover picture changed to an elderly woman Background colour changed from grey to black |
No changes | Cover picture changed to a woman sitting on the floor | No changes |
| Illustrative case examples (German names, professions: bricklayer, doctor's receptionist, teacher, pensioner) | 50% Italian names Professions: carpenter, doctor's receptionist, cleaner, bank employee |
50% Polish names 50% pictures of people of Polish appearance |
No changes | 50% Turkish names 50% pictures of people of Turkish appearance |
| Social themes of different topics of the PIM (not in the focus) | Social themes ‘relations with friends and family’ were incorporated into several topics ‘Material conflicts on returning to Italy or staying in Germany’ was used as an example for a social risk factor for depression |
No changes | No changes | Social themes ‘relations with friends, family and neighbours’ were incorporated into several topics |
| Biological aspects (explanation of the biopsychosocial model of depression, no additional explanation on the rationale for antidepressant use) | Additional biological mechanisms/rationale for antidepressant use: explained in more depth | No changes | No changes | No changes |
| Specific metaphors/idioms (‘grey’ for depression, to feel ‘very small’) | ‘Black’ for depression | No changes | No changes | ‘Life has lost its taste’ |
| Stigma (only information on prevalence of depression in general) | No changes | Additional antistigma statement (depression can affect everyone, is not a personal failure, is a medical condition, can be treated effectively, is curable) | Additional antistigma statement (depression can affect everyone, is a medical condition, is an indication to seek professional help, is curable) | Additional antistigma statement (depression can affect everyone, is a medical condition, can be treated effectively, is curable) |
| Health insurance (information on costs for psychotherapeutic methods that are covered) | No changes | Information on costs for therapeutic methods that are covered Additional information on costs for single therapy sessions that are covered |
No changes | No changes |
| Medication (information on antidepressants: effects, side effects, no risk of dependence, no effects on personality) | No changes | Differences between antidepressants and other psychotropic drugs | No changes | No changes |
| Healthcare provider (comparison of the GP's and psychiatrist's/psychotherapist's roles) | No changes | Role of the GP as first point of contact and coordinator of care in Germany was emphasised | Encouragement to seek help for professional treatment Role of the GP as first point of contact and coordinator of care in Germany was emphasised Indications for psychiatric treatment |
Encouragement to seek help for professional treatment Encouragement to entrust GPs with, and be open about providing, private information |
| Confidentiality (no information on confidentiality) | No changes | Information on German laws on confidentiality | Information on German laws on confidentiality Freedom to start and end the treatment |
No changes |
| Other (addressing the reader formally, explanation of depression symptoms) | No changes | Reader was addressed informally | Differences between everyday experiences (sadness, bad mood) and depression were explained | No changes |
GP, general practitioner.