孕期及产后心理健康问题：一项针对医疗服务提供者的多中心知识评估调查
Mental Health Problems during Pregnancy and the Postpartum Period: A Multicenter Knowledge Assessment Survey among Healthcare Providers.
作者信息
Patabendige M, Athulathmudali S R, Chandrasinghe S K
机构信息
Registrar in Obstetrics and Gynaecology, North Colombo Teaching Hospital, Ragama, Sri Lanka.
Registrar in Obstetrics and Gynaecology, Castle Street Hospital for Women, Colombo, Sri Lanka.
出版信息
J Pregnancy. 2020 Jun 29;2020:4926702. doi: 10.1155/2020/4926702. eCollection 2020.
BACKGROUND
Mental illness related to pregnancy can have long-lasting consequences. Healthcare providers are often the most frequent medical contact with the potential for early detection of these. Objectives were to study the awareness regarding mental health problems during pregnancy and the postpartum period among healthcare providers.
METHODS
A cross-sectional study was carried out with healthcare providers including the nursing staff, midwifery staff, and medical officers working at obstetric wards in three tertiary care hospitals in Sri Lanka. A self-administered questionnaire assessed staff experience with mothers having mental problems, knowledge on mental health problems related to pregnancy, and knowledge about risk factors, common symptoms, and possible consequences on a five-point Likert scale from "Strongly Agree" to "Strongly Disagree."
RESULTS
A total of 300 staff were approached and invited to participate. Only 152 responded to the questionnaire (response rate of 50.1%). Mean (SD) age was 35.8 (9.7) years and mean (SD) years of experience was 10.1 (9.1) years. Age more than 35 years of healthcare providers is associated with statistically significant ( = 0.02) average knowledge scores on the consequences of maternal mental health problems. The symptom of "excessively worrying about baby's health" had the lowest score across all three categories with an average of 34.2%. Only 42.8% have ever heard of EPDS. Overall awareness and knowledge about risk factors, symptoms, and consequences regarding pregnancy-related maternal mental health problems are generally good among the healthcare providers studied. However, some of the few aspects are not satisfactory. Health education of pregnant women, promoting regular in-service training sessions, improvement of infrastructure, and involvement of family members from the antenatal period were discussed by the majority.
CONCLUSION
Despite good overall awareness and knowledge, application into practice with the utilization of validated assessments is poor. This may probably explain why Sri Lanka has a high prevalence of postpartum depression suggesting urgent attention.
背景
与妊娠相关的精神疾病可能会产生长期影响。医疗保健提供者往往是与这些疾病最频繁接触的医务人员，有早期发现这些疾病的可能性。目的是研究医疗保健提供者对孕期和产后心理健康问题的认知情况。
方法
对斯里兰卡三家三级护理医院产科病房的医疗保健提供者进行了一项横断面研究，这些提供者包括护理人员、助产人员和医务人员。通过一份自填式问卷评估工作人员对有精神问题母亲的经历、对与妊娠相关心理健康问题的了解，以及对风险因素、常见症状和可能后果的了解，采用从“强烈同意”到“强烈不同意”的五点李克特量表进行评估。
结果
共邀请了300名工作人员参与。只有152人回复了问卷（回复率为50.1%）。平均（标准差）年龄为35.8（9.7）岁，平均（标准差）工作年限为10.1（9.1）年。年龄超过35岁的医疗保健提供者在孕产妇心理健康问题后果方面的平均知识得分具有统计学意义（=0.02）。“过度担心婴儿健康”这一症状在所有三个类别中得分最低，平均为34.2%。只有42.8%的人听说过爱丁堡产后抑郁量表（EPDS）。在所研究的医疗保健提供者中，对与妊娠相关的孕产妇心理健康问题的风险因素、症状和后果的总体认知和了解普遍良好。然而，有几个方面并不令人满意。大多数人讨论了对孕妇的健康教育、促进定期在职培训、改善基础设施以及让家庭成员从孕期就参与进来。
结论
尽管总体认知和了解良好，但在实践中利用经过验证的评估方法的情况较差。这可能解释了为什么斯里兰卡产后抑郁症的患病率较高，这表明需要紧急关注。
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