Department of Family Medicine, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614, USA.
J Rural Health. 2010 Winter;26(1):44-50. doi: 10.1111/j.1748-0361.2009.00264.x.
Rates and types of screening for depression in rural primary care practices are unknown.
To identify rates of depression screening among rural women in a sample of rural health clinics (RHCs).
A chart review of 759 women's charts in 19 randomly selected RHCs across the nation. Data were collected from charts of female patients of rural primary care providers, using trained data collectors (inter-rater reliability .88 to .93). The Women's Primary Care Screening Form, designed by the authors, was used to collect demographic, health, and screening data. Data describing the characteristics of the clinics were collected using the National Rural Health Clinic Survey. Data regarding formal screening (validated instrument used) or informal (documentation of specific questions and answers regarding depression) in the previous 5 years were recorded.
Characteristics of participating clinics and demographics of the women were similar to published data. Formal screening was documented in 2.4% of patients' charts. Informal screening was documented in 33.2% of charts. Patients with a history of anxiety were more likely to be screened (P < .001), and younger women were more likely to be screened than older women (P < .001).
Primary care providers in RHCs use more informal than formal depression screening with their female patients. Providers are more likely to screen younger patients or patients with a diagnosis of anxiety.
农村初级保健实践中抑郁症筛查的比率和类型尚不清楚。
在全国范围内随机选择的 19 家农村卫生保健所（RHC）的农村妇女样本中，确定抑郁症筛查的比率。
对全国 19 家农村卫生保健所的 759 名女性患者的图表进行回顾。数据由农村初级保健医生的女性患者图表收集，使用经过培训的数据收集员（组内相关系数为 0.88 至 0.93）。作者设计的《妇女初级保健筛查表》用于收集人口统计学、健康和筛查数据。使用《国家农村卫生诊所调查》收集描述诊所特征的数据。记录过去 5 年内正式筛查（使用验证工具）或非正式筛查（记录关于抑郁的具体问题和答案）的信息。
参与诊所的特征和女性的人口统计学特征与已发表的数据相似。在 2.4%的患者图表中记录了正式筛查。在 33.2%的图表中记录了非正式筛查。有焦虑病史的患者更有可能接受筛查（P<.001），年轻女性比老年女性更有可能接受筛查（P<.001）。
RHC 的初级保健提供者更倾向于对女性患者进行非正式而非正式的抑郁症筛查。提供者更倾向于筛查年轻患者或被诊断为焦虑的患者。
