Park Elyse R, Storfer-Isser Amy, Kelleher Kelly J, Stein Ruth E K, Heneghan Amy M, Chaudron Linda, Hoagwood Kimberly Eaton, O'Connor Karen G, Horwitz Sarah McCue
Department of Psychiatry, Institute for Health Policy, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
Ambul Pediatr. 2007 May-Jun;7(3):239-46. doi: 10.1016/j.ambp.2007.03.002.
Pediatricians are in a good position to identify women who struggle with depression, but studies show low rates of pediatrician identification and management. It is likely that pediatricians' management of maternal depression may vary on the basis of their attitudes, but no instrument has been developed to measure these attitudes. We sought to develop a measure of pediatricians' attitudes about managing maternal depression and to identify characteristics associated with pediatricians' attitudes about managing maternal depression.
We conducted a cross-sectional analysis of data provided by 651 practicing, nontrainee pediatricians (response rate 57.5%) surveyed through an American Academy of Pediatrics 2004 Periodic Survey. An exploratory principal components analysis was used to investigate the interrelationships among the attitudinal items. Multivariable linear regression was used to assess the adjusted associations between physician and practice characteristics and attitudes.
The attitudinal measure consisted of 3 subscales: acknowledging maternal depression, perceptions of mothers' beliefs, and treating maternal depression. Clinical approaches (eg, interest in further education on identifying or treating maternal depression) and training and work characteristics were significantly related to pediatricians' attitudes; patient characteristics (eg, type of insurance and ethnicity/race) were not significantly associated with pediatricians' attitudes.
We developed a measure to assess pediatricians' attitudes about managing maternal depression. The findings from this study can be used to develop and assess interventions that improve pediatricians' attitudes about acknowledging maternal depression, perceptions of mothers' beliefs, and treating maternal depression.
儿科医生很适合识别患有抑郁症的女性,但研究表明儿科医生识别和管理此类情况的比例较低。儿科医生对产后抑郁症的管理可能因其态度而异,但尚未开发出衡量这些态度的工具。我们试图开发一种衡量儿科医生对管理产后抑郁症态度的方法,并确定与儿科医生对管理产后抑郁症态度相关的特征。
我们对651名执业非实习儿科医生(回复率57.5%)通过美国儿科学会2004年定期调查提供的数据进行了横断面分析。采用探索性主成分分析来研究态度项目之间的相互关系。多变量线性回归用于评估医生和执业特征与态度之间的校正关联。
态度测量包括3个分量表:承认产后抑郁症、对母亲信念的认知以及治疗产后抑郁症。临床方法(例如,对识别或治疗产后抑郁症的继续教育的兴趣)以及培训和工作特征与儿科医生的态度显著相关;患者特征(例如,保险类型和种族/民族)与儿科医生的态度无显著关联。
我们开发了一种评估儿科医生对管理产后抑郁症态度的方法。本研究结果可用于开发和评估干预措施,以改善儿科医生对承认产后抑郁症、对母亲信念的认知以及治疗产后抑郁症的态度。