Department of Psychiatry & Mental Health, University of Cape Town, South Africa.
Trop Med Int Health. 2010 Oct;15(10):1218-26. doi: 10.1111/j.1365-3156.2010.02606.x.
To investigate the prevalence and correlates of missed opportunities for addressing reproductive and mental health needs during patients' visits to primary healthcare facilities.
We selected a random sample of participants from 14 of the 49 clinics in Cape Town's public health sector using stratified, cluster random sampling (n = 2618). Participants were screened to identify those at risk for unsafe sexual behaviour and a mental disorder (specifically substance use, depression, anxiety, and suicide). Information pertaining to whether or not respondents were asked about these issues during clinic visits during the previous year was elicited. The rates and correlates of missed opportunities for providing reproductive and mental health interventions were calculated.
The criteria of a strict definition of a missed opportunity for reproductive or mental health care information were fulfilled by 25% of the sample, while 46% met criteria for a looser definition. After adjusting for the effects of other variables in the model, men and Coloured respondents were more likely to have satisfied the definition of a missed opportunity for an intervention, while having completed high school and having children increased the likelihood of receiving an intervention.
Consultations with primary healthcare providers in which these issues are not discussed may represent missed opportunities. Persons presenting for routine care can be counselled, screened and, if required, treated. Interventions are needed at the patient, provider, and community levels to increase the opportunities to provide reproductive and mental health care to patients during routine visits.
摘要
调查在患者就诊于基层医疗保健机构期间,解决生殖健康和心理健康需求的机会错失的流行情况及其相关因素。
我们采用分层、整群随机抽样方法,从开普敦公共卫生部门的 49 个诊所中抽取了 14 个随机样本(n=2618)。对参与者进行筛查,以确定那些有不安全性行为和精神障碍(特别是物质使用、抑郁、焦虑和自杀)风险的人。调查询问了受访者在过去一年的就诊期间是否讨论过这些问题。计算了提供生殖和心理健康干预措施的机会错失率及其相关因素。
严格定义的生殖或心理健康护理信息错失机会的标准符合 25%的样本,而 46%的标准符合较宽松的定义。在调整模型中其他变量的影响后,男性和有色人种受访者更有可能符合干预错失机会的定义,而完成高中教育和有子女则增加了接受干预的可能性。
在这些问题未被讨论的基层医疗保健提供者的咨询中,可能存在机会错失的情况。可以对接受常规护理的人员进行咨询、筛查,如果需要,还可以进行治疗。需要在患者、提供者和社区层面采取干预措施,以增加在常规就诊期间为患者提供生殖和心理健康护理的机会。