Department of Psychiatry, Inha University Hospital, Incheon, Republic of Korea.
Department of Internal Medicine, Inha University Hospital, Incheon, Republic of Korea.
Psychooncology. 2018 Mar;27(3):824-830. doi: 10.1002/pon.4546. Epub 2017 Oct 26.
This study was performed to identify relationships between physicians' perceived stigma toward depression and psycho-oncology service utilization on an oncology/hematology ward.
The study participants were 235 patients in an oncology/hematology ward and 14 physicians undergoing an internal medicine residency training program in Inha University Hospital (Incheon, South Korea). Patients completed the Patient Health Questionnaire-9 (PHQ-9), and residents completed the Perceived Devaluation-Discrimination scale that evaluates perceived stigma toward depression. A total PHQ-9 score of ≥5 was defined as clinically significant depression. Physicians decided on referral on the basis of their opinions and those of their patients. The correlates of physicians' recommendation for referral to psycho-oncology services and real referrals psycho-oncology services were examined.
Of the 235 patients, 143 had PHQ-9 determined depression, and of these 143 patients, 61 received psycho-oncology services. Physicians recommended that 87 patients consult psycho-oncology services. Multivariate analyses showed that lower physicians' perceived stigma regarding depression was significantly associated with physicians' recommendation for referral, and that real referral to psycho-oncology services was significantly associated with presence of a hematologic malignancy and lower physicians' perceived stigma toward depression.
Physicians' perceived stigma toward depression was found to be associated with real referral to psycho-oncology services and with physician recommendation for referral to psycho-oncology services. Further investigations will be needed to examine how to reduce physicians' perceived stigma toward depression.
本研究旨在确定肿瘤科/血液科病房医生对抑郁症的感知污名与心理肿瘤学服务利用之间的关系。
研究对象为仁川建国大学医院（韩国）的 235 名肿瘤科/血液科病房患者和 14 名内科住院医师。患者完成了患者健康问卷-9（PHQ-9），住院医师完成了评估对抑郁症的感知污名的贬值歧视量表。PHQ-9 总分≥5 定义为临床显著抑郁。医生根据自己和患者的意见决定转诊。检查了医生推荐转介心理肿瘤学服务和实际转介心理肿瘤学服务的相关性。
在 235 名患者中，143 名患者的 PHQ-9 确定患有抑郁症，其中 143 名患者接受了心理肿瘤学服务。医生建议 87 名患者咨询心理肿瘤学服务。多变量分析显示，医生对抑郁症的感知污名程度越低，越推荐转介心理肿瘤学服务，而实际转介心理肿瘤学服务与血液恶性肿瘤的存在和医生对抑郁症的感知污名程度较低显著相关。
发现医生对抑郁症的感知污名与实际转介心理肿瘤学服务以及医生推荐转介心理肿瘤学服务有关。需要进一步研究如何减少医生对抑郁症的感知污名。
