Faculty of Health, University of East Anglia, Norwich, UK.
J Clin Nurs. 2011 Nov;20(21-22):3215-23. doi: 10.1111/j.1365-2702.2011.03828.x. Epub 2011 Aug 19.
To investigate primary care practitioner's attitudes to depression after myocardial infarction.
Depression after myocardial infarction affects almost half of all patients and has a considerable negative effect on recovery. Despite the increased prevalence of depression in this population, it is often not recognised or treated.
Survey.
A total of 813 (106 general practitioners and 707 nurses) practitioners responded. Our questionnaire developed for this project by the authors in collaboration with a group of ten cardiovascular nurse specialists contained 27 items that were summated into five subscales.
Primary care practitioners underestimated the prevalence of depression in the post-myocardial infarction population. General acknowledgement of the negative impact that depression can have was reported by the majority of participants. Diagnosing depression was perceived as complex by both groups but significantly more so by nurses. General practitioners were significantly more positive about their understanding of the signs and symptoms of depression and in using depression-screening tools. We observed that training seems to have a significant effect on reported practice. Practitioners who reported that they had recent training in the management of depression were significantly more accurate in their estimate of how common depression was in this population.
Depression may be underdiagnosed in this population because primary care practitioners, especially nurses, are not aware of how common the disorder is and lack competence in diagnosis. There is merit in developing and testing a brief training intervention to ensure competence in depression screening and treatment in post-myocardial infarction patients.
Diagnosing depression in post-myocardial infarction patients is perceived by nurses as complex but training in the management of depression is seen as helping practice.
调查初级保健医生对心肌梗死后抑郁的态度。
心肌梗死后的抑郁影响了几乎一半的患者，对康复有相当大的负面影响。尽管这一人群中抑郁的患病率增加了，但它往往没有被识别或治疗。
调查。
共有 813 名（106 名全科医生和 707 名护士）医生做出了回应。我们的问卷由作者与一组 10 名心血管护士专家合作开发，共包含 27 个项目，汇总为五个子量表。
初级保健医生低估了心肌梗死后人群中抑郁的患病率。大多数参与者都承认抑郁可能产生的负面影响。两组医生都认为诊断抑郁很复杂，但护士认为更复杂。全科医生对自己理解抑郁的迹象和症状以及使用抑郁筛查工具的能力更有信心。我们观察到，培训似乎对报告的实践有显著影响。报告最近接受过抑郁管理培训的医生对该人群中抑郁的常见程度的估计明显更为准确。
由于初级保健医生，特别是护士，不知道这种疾病有多常见，缺乏诊断能力，因此该人群中可能存在抑郁漏诊。开发和测试简短的培训干预措施，以确保在心肌梗死后患者中进行抑郁筛查和治疗的能力是有价值的。
护士认为诊断心肌梗死后患者的抑郁很复杂，但管理抑郁的培训被认为有助于实践。
