Shakespeare Judy, Blake Fiona, Garcia Jo
Summertown Health Centre, 160 Banbury Road, Oxford OX2 7BS.
Br J Gen Pract. 2003 Aug;53(493):614-9.
Screening for postnatal depression using the Edinburgh Postnatal Depression Scale (EPDS) has been widely recommended and implemented in primary care, although little is known about how acceptable it is to women.
To explore the acceptability to women of postnatal screening by health visitors with the EPDS.
Qualitative interview study.
Postnatal patients from 22 general practices within the area of Oxford City Primary Care Group.
Thirty-nine postnatal women from a purposive sample were interviewed, chosen on the basis of different general practices, EPDS results at eight weeks and eight months postnatal, and whether 'listening visits' were received. The interviews were analysed using the constant comparative method.
Just over half of the women interviewed found screening with the EPDS less than acceptable, whatever their postnatal emotional health. The main themes identified were problems with the process of screening and, in particular, the venue, the personal intrusion of screening and stigma. The women interviewed had a clear preference for talking about how they felt, rather than filling out a questionnaire.
For this sample, routine screening with the EPDS was less than acceptable for the majority of women. This is of concern, as universal screening with the EPDS for the detection of postnatal depression is already recommended and widespread in primary care.
尽管对于女性对爱丁堡产后抑郁量表(EPDS)筛查的接受程度知之甚少,但使用该量表进行产后抑郁筛查已在初级保健中得到广泛推荐和应用。
探讨健康访视员使用EPDS进行产后筛查时女性的接受程度。
定性访谈研究。
牛津市初级保健集团区域内22家全科诊所的产后患者。
从有目的的样本中选取39名产后女性进行访谈,选取依据为不同的全科诊所、产后8周和8个月时的EPDS结果以及是否接受过“倾听访视”。采用持续比较法对访谈进行分析。
无论产后情绪健康状况如何,接受访谈的女性中略超半数认为使用EPDS进行筛查难以接受。确定的主要主题是筛查过程存在问题,尤其是场所、筛查对个人的侵扰以及污名化。接受访谈的女性明显更倾向于谈论自身感受,而非填写问卷。
对于该样本,大多数女性难以接受使用EPDS进行常规筛查。鉴于在初级保健中已推荐并广泛采用EPDS进行普遍筛查以检测产后抑郁,这令人担忧。