Segre Lisa S, Pollack Lauren O, Brock Rebecca L, Andrew Jeana R, O'Hara Michael W
University of Iowa, College of Nursing, Iowa City, Iowa, USA.
Issues Ment Health Nurs. 2014 Jun;35(6):444-54. doi: 10.3109/01612840.2013.879358.
Postpartum women often suffer clinically significant depressive symptoms, a problem addressed by nurse-delivered screening programs. In the past, success of these identification programs was measured in terms of screening rates; however, merely evaluating the screening rate does little to inform how to implement depression screening in clinical practice. This article describes the experiences of nurses in implementing depression screening on a maternity unit. We evaluate the practice qualitatively, by asking nurses to describe their screening strategies and their views about implementation, as well as quantitatively by assessing their screening rates and the number of women identified. Utilizing a framework of program evaluation, 20 maternity unit nurses completed qualitative assessments investigating their day-to-day experiences with this practice. To include the perspectives of nurses that declined to participate in qualitative assessments, 14 additional maternity unit nurses completed a brief survey assessing their views. We also assessed screening rates, defined as the number of women screened divided by the number eligible for screening. Maternity unit nurses viewed depression screening positively and were able to screen patients in relatively few steps, which they implemented using strategies they had developed themselves. Despite nurses' ongoing concern about finding time to screen, they achieved high screening rates and, with one exception, indicated they would opt to continue voluntarily. Depression screening on the maternity unit is feasible and embraced by attending nurses. The clinical strategies used to implement screening are extensively described and provide a basis for implementation in other settings that serve perinatal women.
产后女性常常会出现具有临床意义的抑郁症状，护士提供的筛查项目可解决这一问题。过去，这些识别项目的成功是以筛查率来衡量的；然而，仅仅评估筛查率对于指导如何在临床实践中实施抑郁症筛查作用不大。本文描述了护士在产科病房实施抑郁症筛查的经历。我们通过要求护士描述其筛查策略和对实施的看法来进行定性评估，同时通过评估她们的筛查率和识别出的女性数量进行定量评估。利用项目评估框架，20名产科病房护士完成了定性评估，调查她们在这项实践中的日常经历。为了纳入拒绝参与定性评估的护士的观点，另外14名产科病房护士完成了一项简短调查，评估她们的看法。我们还评估了筛查率，定义为筛查的女性数量除以符合筛查条件的女性数量。产科病房护士对抑郁症筛查持积极态度，并且能够通过相对较少的步骤对患者进行筛查，她们使用自己制定的策略来实施。尽管护士们一直担心没有时间进行筛查，但她们仍取得了很高的筛查率，并且除一人外，都表示会选择继续自愿进行筛查。产科病房的抑郁症筛查是可行的，并且受到值班护士的认可。文中广泛描述了用于实施筛查的临床策略，为在其他为围产期女性服务的环境中实施筛查提供了依据。
