Abrams Daniel, Nguyen Liem T, Murphy Jill, Lee Younji Angie, Tran Nhu K, Wiljer David
University of Toronto, Toronto, Canada.
Institute of Population, Health and Development, Hanoi, Vietnam.
Int J Ment Health Syst. 2016 Feb 24;10:10. doi: 10.1186/s13033-016-0043-0. eCollection 2016.
Preliminary research has suggested that perinatal mental disorders (PMDs), including post-partum depression, are prevalent in Vietnam. However the extent to which these disorders are recognized at the community level remains largely undocumented in the literature. PMDs have also never been investigated within Vietnam's significant ethnic minority populations, who are known to bear a greater burden of maternal and infant health challenges than the ethnic majority.
To investigate knowledge and perceptions of PMDs and their treatments at the community level in a rural, predominantly ethnic minority region of northern Vietnam.
Qualitative semi-structured interviews were conducted on the topic of common PMDs. Participant groups were primary health workers (PHWs) working at local community health centers, and pregnant or postpartum women enrolled in a program for maternal and infant health that was not mental health related. Interviews included vignette scenarios that asked respondents to interpret cases of women experiencing PMDs, as well as open-ended questions about mental disorders and their treatments.
Twelve PHWs and 14 perinatal women completed the study. Major themes that emerged from the interviews included (1) Family relationships impact psychological well-being, (2) Nutrition contributes to perinatal mental health, (3) Both traditional and western medicine play roles in perinatal health, (4) There was a lack of personal experience with women experiencing PMDs, (5) Descriptions of mental health symptoms focused on behaviours, and (6) Community care is the primary mental health support.
PHWs reported having almost never treated a woman with a PMD. However, anecdotal evidence from the women interviewed suggests that there are incidents of mental disorders during the perinatal period that go largely unaddressed. Willingness to present to primary care appears to be high, and presents an opportunity to address this need by training PHWs in effective screening, treatment, and referral. Such training should account for culturally specific presentations of mental disorders as well as the importance of the patient's social context. To the best of the author's knowledge, this research presents the first evidence of a PMD burden within Vietnam's ethnic minority communities.
初步研究表明，包括产后抑郁在内的围产期精神障碍（PMD）在越南很普遍。然而，这些障碍在社区层面的认知程度在文献中仍 largely undocumented。PMD 在越南重要的少数民族群体中也从未被研究过，众所周知，这些少数民族群体比多数民族承受着更大的母婴健康挑战负担。
调查越南北方一个以少数民族为主的农村地区社区层面关于 PMD 及其治疗的知识和认知。
就常见的 PMD 主题进行了定性半结构化访谈。参与群体是在当地社区卫生中心工作的初级卫生工作者（PHW），以及参加了一个与心理健康无关的母婴健康项目的孕妇或产后妇女。访谈包括让受访者解读患有 PMD 的女性案例的vignette 情景，以及关于精神障碍及其治疗的开放式问题。
12 名初级卫生工作者和 14 名围产期妇女完成了研究。访谈中出现的主要主题包括：（1）家庭关系影响心理健康，（2）营养有助于围产期心理健康，（3）传统医学和西医在围产期健康中都发挥作用，（4）缺乏与患有 PMD 的女性的个人经历，（5）对心理健康症状的描述集中在行为上，（6）社区护理是主要的心理健康支持。
初级卫生工作者报告几乎从未治疗过患有 PMD 的女性。然而，接受访谈的女性的轶事证据表明，围产期存在精神障碍事件，但很大程度上未得到解决。向初级保健机构就诊的意愿似乎很高，这为通过培训初级卫生工作者进行有效筛查、治疗和转诊来满足这一需求提供了机会。这种培训应考虑到精神障碍的文化特定表现以及患者社会背景的重要性。据作者所知，这项研究首次证明了越南少数民族社区存在 PMD 负担。
