Center for Health Services Research, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Alexandroupoleos st, 25, Athens 115 27, Greece.
Ann Gen Psychiatry. 2013 Nov 22;12(1):37. doi: 10.1186/1744-859X-12-37.
Maternal depression has a negative impact on both the mother and child's physical and mental health, as well as impairs parenting skills and pediatric health care utilization. The pediatricians' role in identification and management of maternal depression is well established. Although it can be successfully and easily treated, maternal depression remains under-recognized and under-treated. Despite the heightened emphasis, there is lack of interventions to pediatricians in order to improve detection and management of maternal depression.
To address this gap, an educational intervention based on the 'Health Belief Model' was developed, implemented, and evaluated. The present quasi-experimental study, aimed to assess the pediatricians' knowledge, self-efficacy, beliefs, and attitudes toward maternal depression at baseline and post-intervention measurements. A total of 43 randomly selected primary care pediatricians residing in Athens completed a 59-item survey by mail in 2011. Pediatricians in the intervention group received a toolkit about the recognition and management of maternal depression, while pediatricians in the control group received a leaflet about mental health. Descriptive statistics, t test, chi-square, Fisher's exact test, and analysis of variance were used for the statistical analysis.
Post-intervention measurement revealed differences at a statistical significance level between the two groups, in the following variables: beliefs, attitudes, self- efficacy, perceived barriers, and management practices of maternal depression. Furthermore, at post-measurement, pediatricians in the intervention group demonstrated increased perceived responsibility and increased self-efficacy for detection and referral of maternal depression.
Educational interventions to pediatricians seem to be beneficial for the improvement of the pediatricians' knowledge, self-efficacy, and attitudes regarding maternal depression. Studies using large, representative population samples are needed to provide evidence if the training interventions to pediatricians for maternal depression are translated to changes in their clinical practice and improved the patients' health outcomes.
产妇抑郁对母婴身心健康都有负面影响，同时也会损害育儿技能和儿科医疗保健的利用。儿科医生在识别和处理产妇抑郁方面的作用已得到充分证实。尽管这种疾病可以得到成功和轻松的治疗，但产妇抑郁仍然未被充分认识和治疗。尽管已经引起了高度重视，但缺乏针对儿科医生的干预措施，以提高对产妇抑郁的识别和管理。
为了解决这一差距，我们开发、实施并评估了一项基于“健康信念模型”的教育干预措施。本研究采用准实验设计，旨在评估基线和干预后测量时儿科医生对产妇抑郁的知识、自我效能、信念和态度。2011 年，共有 43 名随机选择的居住在雅典的初级保健儿科医生通过邮件完成了一份 59 项的调查问卷。干预组的儿科医生收到了一个关于识别和管理产妇抑郁的工具包，而对照组的儿科医生收到了一份关于心理健康的传单。我们使用描述性统计、t 检验、卡方检验、Fisher 精确检验和方差分析进行了统计分析。
干预后测量结果显示，两组在以下变量方面存在统计学意义上的差异：信念、态度、自我效能、感知障碍和产妇抑郁的管理实践。此外，在测量后，干预组的儿科医生表现出对检测和转介产妇抑郁的责任感和自我效能感增强。
针对儿科医生的教育干预似乎对提高儿科医生对产妇抑郁的知识、自我效能和态度有益。需要进行使用大样本、代表性人群的研究，以提供证据表明，针对儿科医生的产妇抑郁培训干预措施是否转化为临床实践的改变，并改善患者的健康结果。
