School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
Gen Hosp Psychiatry. 2015 Jul-Aug;37(4):305-9. doi: 10.1016/j.genhosppsych.2015.03.008. Epub 2015 Mar 20.
Best practices for addressing women's mental health and screening for depression in public health clinics are not available. Clinic staff are often responsible for screening for depression; however, few studies examine staff perceptions on feasibility and acceptability of using perinatal screening for mood disorders in ethnically diverse public health clinics.
During December 2012, we conducted four focus groups using a semistructured interview guide with public health clinic staff of varying disciplines (n=25) in a Special Supplemental Nutrition Program for Women, Infants, and Children. All interviews were audio recorded and analyzed using thematic analysis.
We found five descriptive themes related to acceptability and feasibility of screening for perinatal depression in a public health clinic. The main themes include (1) literacy barriers, (2) need for referrals and follow-up with outside services, (3) training and capacity needs, (4) stigma of depression, and (5) location and privacy of screening. Although multiple barriers to universal depression screening in a public health clinic were identified, participants found value in practice of screening low-income women for depression.
Factors for facilitating implementation of systematic depression screening in a public health clinic have been identified. Implications discuss how policy makers and public health clinic administrators can improve the universal depression screening process.
公共卫生诊所缺乏针对女性心理健康问题和抑郁症筛查的最佳实践方法。诊所工作人员通常负责抑郁症筛查;然而,很少有研究考察工作人员对在族裔多样化的公共卫生诊所中使用围产期情绪障碍筛查的可行性和可接受性的看法。
2012 年 12 月,我们对特殊补充营养计划妇女、婴儿和儿童项目中不同学科的公共卫生诊所工作人员(n=25)进行了四次焦点小组讨论,使用半结构化访谈指南。所有访谈均进行录音,并使用主题分析进行分析。
我们发现了五个与在公共卫生诊所中筛查围产期抑郁症的可接受性和可行性相关的描述性主题。主要主题包括(1)读写障碍,(2)需要转介和与外部服务机构跟进,(3)培训和能力需求,(4)抑郁症污名化,以及(5)筛查的地点和隐私性。尽管在公共卫生诊所进行普遍抑郁症筛查存在多种障碍,但参与者认为对低收入妇女进行抑郁症筛查具有实际价值。
已经确定了在公共卫生诊所实施系统抑郁症筛查的促进因素。这些影响因素讨论了政策制定者和公共卫生诊所管理人员如何能够改进普遍抑郁症筛查过程。