Hansotte Elinor, Payne Shirley I, Babich Suzanne M
1Department of Health Policy and Management, Indiana University Richard M Fairbanks School of Public Health at IUPUI, 1050 Wishard Blvd, Indianapolis, IN 46202 USA.
2Department of Applied Health Science, Indiana University School of Public Health, 1025 E. 7th Street, Suite 111, Bloomington, IN 47405 USA.
Public Health Rev. 2017 Jan 31;38:3. doi: 10.1186/s40985-017-0050-y. eCollection 2017.
Left undiagnosed and/or untreated, the short-and long-term sequelae of postpartum depression may negatively impact both mother and child. In Western countries, access to mental health care is influenced by socioeconomic factors. The objective of this systematic literature review is to compile factors that hinder and improve access to postpartum depression treatment in low-income women after a positive screen for postpartum depression. The key question of focus is: what are the characteristics associated with access to mental health treatment for low-income women with a positive postpartum depression screen in Western countries?
A PRISMA-based systematic literature review was conducted of studies published in English before February 2016 that looked at treatment for postpartum depression in low-income women who had been identified with the condition. PubMed and EBSCO databases were searched using MESH and key terms and found 100 articles that met the selection criteria. After review by two independent researchers, 18 studies with 17 unique populations were included in the literature review.
Two independent abstractors searched the included articles for themes surrounding impediments and advantages for low-income women identified with postpartum depression in obtaining mental health treatment. Characteristics of successful mental health treatment included studies that employed the use of a home visitor and those that separated outcomes for women with previous mental health treatment. Themes that emerged as treatment obstacles included cultural barriers, physical barriers, systemic health care barriers, and social barriers.
This review will help to better inform screening and treatment priorities for those in the medical field who may encounter women experiencing postpartum depression and are not aware of the various barriers to care specific to low-income women. This review will also help policymakers identify specific obstacles that are not addressed in postpartum screening mandate policies which can affect the implementation of these policies.
产后抑郁症若未得到诊断和/或治疗，其短期和长期后遗症可能会对母亲和孩子产生负面影响。在西方国家，获得心理健康护理受到社会经济因素的影响。本系统文献综述的目的是汇总那些在产后抑郁症筛查呈阳性后，阻碍和改善低收入女性获得产后抑郁症治疗的因素。重点关注的关键问题是：在西方国家，产后抑郁症筛查呈阳性的低收入女性获得心理健康治疗的相关特征有哪些？
对2016年2月之前以英文发表的、研究已确诊的低收入女性产后抑郁症治疗情况的研究进行了基于PRISMA的系统文献综述。使用医学主题词（MESH）和关键词在PubMed和EBSCO数据库中进行搜索，共找到100篇符合入选标准的文章。经两名独立研究人员审核后，18项研究（涉及17个独特人群）被纳入文献综述。
两名独立的摘要撰写人在纳入的文章中搜索了围绕产后抑郁症筛查呈阳性的低收入女性在获得心理健康治疗方面的障碍和优势的主题。成功的心理健康治疗的特征包括采用家访员的研究以及将有过心理健康治疗经历的女性的结果分开的研究。作为治疗障碍出现的主题包括文化障碍、身体障碍、系统性医疗保健障碍和社会障碍。
本综述将有助于为医疗领域中可能遇到产后抑郁症女性且不了解低收入女性特定护理障碍的人员，更好地提供筛查和治疗重点信息。本综述还将帮助政策制定者识别产后筛查强制政策中未涉及的、可能影响这些政策实施的具体障碍。
