Kaitlyn Barrow, BS, Mercer University School of Medicine, Macon, GA, USA.
Analise McGreal, BS, Mercer University School of Medicine, Macon, GA, USA.
J Am Psychiatr Nurses Assoc. 2022 Nov-Dec;28(6):444-454. doi: 10.1177/1078390320971358. Epub 2020 Nov 11.
The American Academy of Pediatrics (AAP) recommends that pediatric providers screen mothers for postpartum depression at the 1-, 2-, 4-, and 6-month well-child visits. However, compliance with this recommendation varies greatly and is far from 100%. This is significant, as perinatal mood and anxiety disorders (PMADs) represent the most common complication of childbearing.
This investigation was conducted to explore barriers to screening in the pediatric setting, reported advantages of screening, providers' knowledge of mental health supports in the community, and commonly observed (and explicitly stated) mental health issues in new mothers. All data collection took place in the state of Georgia, which has the worst rates of maternal mortality and morbidity in the United States.
A convenience sample of five pediatric practices was selected through the Mercer University School of Medicine's community preceptor network. All clinical staff at each site participated in one of five focus groups for a total of 31 participants. The conversations were audio-taped, transcribed, and thematically analyzed.
Providers from two practices were formally screening for Postpartum Depression; they indicated that it added value to their practice. Those not screening cited several barriers including lack of time, training, and access to the mother's medical records. Several clinicians asserted that they were not trained to address mental health issues in their pediatric patients' mothers and that it was out of their realm of expertise.
Provider compliance with the current AAP recommendations may increase with mandatory, specialized training in recognizing and treating PMADs.
美国儿科学会（AAP）建议儿科医生在婴儿 1 个月、2 个月、4 个月和 6 个月的常规就诊时对产妇进行产后抑郁症筛查。然而，对这一建议的遵循情况差异很大，远未达到 100%。这很重要，因为围产期情绪和焦虑障碍（PMADs）是生育最常见的并发症。
本研究旨在探讨儿科环境中筛查的障碍、筛查的优势、提供者对社区心理健康支持的了解，以及新妈妈中常见的（明确指出的）心理健康问题。所有数据收集都在佐治亚州进行，该州的孕产妇死亡率和发病率在美国是最差的。
通过默瑟大学医学院的社区导师网络，选择了五个儿科诊所的便利样本。每个地点的所有临床工作人员都参加了五个焦点小组中的一个，共有 31 名参与者。对话被录音、转录，并进行主题分析。
来自两个诊所的提供者正式对产后抑郁症进行了筛查；他们表示这为他们的实践增加了价值。那些没有进行筛查的人列举了几个障碍，包括缺乏时间、培训和获取母亲医疗记录的机会。一些临床医生断言，他们没有接受过在儿科患者母亲中识别和治疗 PMADs 的培训，这超出了他们的专业领域。
随着对识别和治疗 PMADs 的强制性、专业化培训的增加，提供者对当前 AAP 建议的遵循情况可能会增加。
