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Table 5 Theoretical definitions for the properties of the model

From: Facilitators and barriers to modifying dietary and hygiene behaviours as adjuvant treatment in patients with depression in primary care: a qualitative study

Core aspects Categories/Properties Definitions
Personal aspects Personal history  
-History and comorbidity History, aetiology, course, severity of depressive disorder and comorbidity that determines psychological capacity.
-Vital changes Modifications in forms and lifestyles with significant effects for the subject.
-G. Facilitators Personal or environmental aspects that encourage participation and engagement with the programme, like the feeling of improvement, the practice of certain activities, or the ease and simplicity of compliance.
-G. Barriers Personal or environmental aspects that complicate participation and commitment to the programme, such as the symptoms of the actual disorder, and apathy.
Program aspects Presentation and monitoring  
-Instructions Clear presentation and explanation of the recommendations that make up the programme, using different channels and giving them the importance that they deserve, but with some flexibility, progressiveness and tailoring so that they are possible to implement.
-Assessment Assessment of compliance with the specific programme recommendations, with appropriate monitoring and support suited to the characteristics of patients and their disorder.
-Supervision Regular reminders and visits to a professional specialist in a personal and intimate context, which allows patients to converse in confidence.
-Pharmaceutical Managing of the antidepressant drugs, of possible improvement and their side effects.
Cognitive habits  
-Agency Determination, personal effort when carrying out the program instructions, search for security and self-confidence.
-Ruminations Negative thoughts that hinder the implementation of the habits proposed in the programme.
-Avoidance Evasion of responsibilities via distracting activities on a cognitive level.
-Restructurings Modification of the values and ways of thinking in the sense of facilitating potential inclusion of the programme recommendations within the activities of daily life.
-Guilt Feelings of guilt derived from the failure to comply with the recommendations.
Behavioural habits  
-Activation Mobilization of resources towards the carrying out of activities, breaking with inactivity and attempting to achieve behavioural objectives, little by little, generalized to all spheres.
-Empowerment To enable patients to lead their recovery.
-Time pressure Difficulties for giving instructions regarding change of habits in a short consultation.
-Habit control Personal ability to implement habit requirements and recommendations.
-Opportunities Socio-economic capacity to acquire certain foods, to follow certain instructions, and to carry out physical and pleasant activities.
Transversal aspects Social support  
-Group format of intervention Social support coming from the group format of intervention, which helps to realize one is not alone when facing difficulties, in order to cope with depression and change habits.
-Contact with others People in the patient’s close social context – apart from family members and friends – that provide face-to-face contact and the opportunity for the acquisition of recommendations.
-Adjustment Fit of the programme to the situation of each patient, with special interest in the prevention of recurrences once the patient has improved depression.
-Intervention level Special affinity of the programme with a level of individual intervention integrated in healthcare systems, although with possible connections with the media and educational systems.