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"一端与另一端无关":妇科和产科环境中患者对抑郁寻求帮助意向的态度。

"One end has nothing to do with the other:" patient attitudes regarding help seeking intention for depression in gynecologic and obstetric settings.

机构信息

Department of Family Medicine and Community Health, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.

出版信息

Arch Womens Ment Health. 2009 Oct;12(5):301-8. doi: 10.1007/s00737-009-0103-4.

Abstract

Many women rely on their obstetrician/gynecologist (OB/GYN) as their primary contact with the health care delivery system. There have been few studies exploring patient views on getting help for depression from these providers. The purpose of this study is to assess help seeking intention for depression and identify beliefs which moderate this intention. Telephone interviews of women following a routine gynecologic visit or in the immediate postpartum period (regarding prenatal care) were used to assess intention to seek help from their providers in a case of depression. For women who lacked this intention, related beliefs were elicited with the open ended question "why not?" Among the 225 women in the study more than half receiving gynecologic care (59%) and nearly a third of women who received prenatal care (29%; p < 0.001) stated they would not seek help from their OB/GYN for depression. Report that a prenatal provider had mentioned depression was associated with help seeking intention for depression but was not independent of confounding variables. Beliefs among women who lacked help seeking intention clustered into two attitude themes: 1) an OB/GYN is the wrong doctor for depression care and 2) OB/GYN is not a good setting for depression care. Many women have attitudes which reduce their intention to seek help for depression from their OB/GYN. Interventions aiming to increase delivery of depression care in these settings should consider these beliefs in their design.

摘要

许多女性依赖她们的妇产科医生(OB/GYN)作为她们与医疗保健系统的主要联系。很少有研究探讨患者从这些提供者那里获得抑郁症帮助的看法。本研究的目的是评估寻求抑郁症帮助的意愿,并确定影响这种意愿的信念。通过对例行妇科就诊后的女性或在产后立即(关于产前护理)进行电话访谈,评估她们在抑郁症病例中向提供者寻求帮助的意愿。对于没有这种意愿的女性,使用开放式问题“为什么不?”来引出相关信念。在这项研究的 225 名女性中,超过一半(59%)正在接受妇科护理,近三分之一(29%;p<0.001)接受过产前护理的女性表示,她们不会向 OB/GYN 寻求抑郁症帮助。报告称,产前提供者曾提到过抑郁症,这与寻求抑郁症帮助的意愿有关,但不受混杂变量的影响。缺乏寻求帮助意愿的女性的信念分为两个态度主题:1)妇产科医生不是治疗抑郁症的合适医生,2)妇产科医生不是治疗抑郁症的合适场所。许多女性对从妇产科医生那里寻求抑郁症帮助的意愿较低。旨在增加这些环境中抑郁症护理的干预措施应在其设计中考虑到这些信念。

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