Samuels S, Abrams R, Shengelia R, Reid M C, Goralewicz R, Breckman R, Anderson M A, Snow C E, Woods E C, Stern A, Eimicke J P, Adelman R D
Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York, NY, USA.
Int J Geriatr Psychiatry. 2015 May;30(5):539-46. doi: 10.1002/gps.4180. Epub 2014 Jul 30.
Colocation of mental health screening, assessment, and treatment in primary care reduces stigma, improves access, and increases coordination of care between mental health and primary care providers. However, little information exists regarding older adults' attitudes about screening for mental health problems in primary care. The objective of this study was to evaluate older primary care patients' acceptance of and satisfaction with screening for depression and anxiety.
The study was conducted at an urban, academically affiliated primary care practice serving older adults. Study patients (N = 107) were screened for depression/anxiety and underwent a post-screening survey/interview to assess their reactions to the screening experience.
Most patients (88.6%) found the length of the screening to be "just right." A majority found the screening questions somewhat or very acceptable (73.4%) and not at all difficult (81.9%). Most participants did not find the questions stressful (84.9%) or intrusive (91.5%); and a majority were not at all embarrassed (93.4%), upset (93.4%), or uncomfortable (88.8%) during the screening process. When asked about frequency of screening, most patients (72.4%) desired screening for depression/anxiety yearly or more. Of the 79 patients who had spoken with their physicians about mental health during the visit, 89.8% reported that it was easy or very easy to talk with their physicians about depression/anxiety. Multivariate results showed that patients with higher anxiety had a lower positive reaction to the screen when controlling for gender, age, and patient-physician communication.
These results demonstrate strong patient support for depression and anxiety screening in primary care.
在初级保健中进行心理健康筛查、评估和治疗，可减少污名化、改善就医机会，并增强心理健康与初级保健提供者之间的护理协调。然而，关于老年人对初级保健中心理健康问题筛查的态度，现有信息很少。本研究的目的是评估老年初级保健患者对抑郁症和焦虑症筛查的接受度和满意度。
该研究在一家为老年人服务的城市学术附属初级保健机构进行。研究患者（N = 107）接受了抑郁症/焦虑症筛查，并在筛查后进行了调查/访谈，以评估他们对筛查体验的反应。
大多数患者（88.6%）认为筛查时间“恰到好处”。大多数人认为筛查问题有点或非常可以接受（73.4%），而且一点也不难（81.9%）。大多数参与者不觉得问题有压力（84.9%）或侵扰性（91.5%）；而且大多数人在筛查过程中一点也不尴尬（93.4%）、心烦（93.4%）或不舒服（88.8%）。当被问及筛查频率时，大多数患者（72.4%）希望每年或更频繁地进行抑郁症/焦虑症筛查。在就诊期间与医生谈论过心理健康的79名患者中，89.8%报告说与医生谈论抑郁症/焦虑症很容易或非常容易。多变量结果显示，在控制性别、年龄和医患沟通后，焦虑程度较高的患者对筛查的积极反应较低。
这些结果表明患者对初级保健中的抑郁症和焦虑症筛查给予了大力支持。
