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由基层医疗服务提供者为贫困母亲提供的抑郁症治疗:一项随机对照试验。

Depression treatment for impoverished mothers by point-of-care providers: A randomized controlled trial.

作者信息

Segre Lisa S, Brock Rebecca L, O'Hara Michael W

机构信息

College of Nursing, University of Iowa.

Department of Psychology, University of Iowa.

出版信息

J Consult Clin Psychol. 2015 Apr;83(2):314-24. doi: 10.1037/a0038495. Epub 2014 Dec 8.

Abstract

OBJECTIVE

Depression in low-income, ethnic-minority women of childbearing age is prevalent and compromises infant and child development. Yet numerous barriers prevent treatment delivery. Listening Visits (LV), an empirically supported intervention developed for delivery by British home-visiting nurses, could address this unmet mental health need. This randomized controlled trial (RCT) evaluated the effectiveness of LV delivered at a woman's usual point-of-care, including home visits or an ob-gyn office.

METHOD

Listening Visits were delivered to depressed pregnant women or mothers of young children by their point-of-care provider (e.g., home visitor or physician's assistant), all of whom had low levels of prior counseling experience. Three quarters of the study's participants were low-income. Of those who reported ethnicity, all identified themselves as minorities. Participants from 4 study sites (N = 66) were randomized in a 2:1 ratio, to LV or a wait-list control group (WLC). Assessments, conducted at baseline and 8 weeks, evaluated depression, quality of life, and treatment satisfaction.

RESULTS

Depressive severity, depressive symptoms, and quality of life significantly improved among LV recipients as compared with women receiving standard social/health services. Women valued LV as evidenced by their high attendance rates and treatment satisfaction ratings.

CONCLUSIONS

In a stepped model of depression care, LV can provide an accessible, acceptable, and effective first-line treatment option for at-risk women who otherwise are unlikely to receive treatment. (PsycINFO Database Record

摘要

目的

低收入育龄少数民族女性中的抑郁症很普遍,会影响婴幼儿的发育。然而,诸多障碍阻碍了治疗的提供。倾听访问(LV)是一种由英国家庭访视护士开展的、得到实证支持的干预措施,可满足这一未得到满足的心理健康需求。这项随机对照试验(RCT)评估了在女性常规护理点(包括家访或妇产科诊所)开展倾听访问的效果。

方法

倾听访问由护理点提供者(如家访员或医师助理)提供给抑郁的孕妇或幼儿母亲,他们此前的咨询经验都很少。四分之三的研究参与者为低收入者。在报告了种族的参与者中,所有人都认定自己为少数族裔。来自4个研究地点(N = 66)的参与者按2:1的比例随机分为倾听访问组或等待名单对照组(WLC)。在基线和8周时进行评估,评估内容包括抑郁、生活质量和治疗满意度。

结果

与接受标准社会/健康服务的女性相比,倾听访问组参与者的抑郁严重程度、抑郁症状和生活质量有显著改善。女性对倾听访问的重视体现在其高出席率和治疗满意度评分上。

结论

在抑郁症护理的阶梯式模式中,倾听访问可为有风险的女性提供一种可及、可接受且有效的一线治疗选择,否则这些女性不太可能接受治疗。(PsycINFO数据库记录)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdab/4380830/bc5110d9f1c5/nihms658720f1.jpg

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