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多中心社区实践中的围产期情绪和焦虑障碍管理:临床医生的培训、当前实践和改善未来实施的策略。

Perinatal Mood and Anxiety Disorder Management in Multicenter Community Practices: Clinicians' Training, Current Practices and Perceived Strategies to Improve Future Implementation.

机构信息

Mayo Clinic, Rochester, MN, USA.

Denver Health Midwives, Denver, CO, USA.

出版信息

J Prim Care Community Health. 2021 Jan-Dec;12:2150132721996888. doi: 10.1177/2150132721996888.

Abstract

BACKGROUND

This study aimed to explore clinicians' perspectives on the current practice of perinatal mood and anxiety disorder (PMAD) management and strategies to improve future implementation.

METHODS

This study had a cross-sectional, descriptive design. A 35-item electronic survey was sent to clinicians (N = 118) who treated perinatal women and practiced at several community clinics at an academic medical center in the United States.

RESULTS

Among clinicians who provided care for perinatal women, 34.7% reported never receiving PMAD management training and 66.3% had less than 10 years of experience. Out of 10 patients who reported psychiatric symptoms, 47.8% of clinicians on average reported providing PMAD management to 1 to 3 patients and 40.7% noted that they conducted screening only when patient expresses PMAD symptoms. Suggested future improvements were providing training, developing a referral list, and establishing integrated behavioral health services.

CONCLUSIONS

Results from this study indicated that while PMAD screening and management was implemented, improvements are warranted to meet established guidelines. Additionally, clinicians endorsed providing PMAD management to a small percentage of perinatal patients. Suggested strategies to increase adoption and implementation of PMAD management should be explored to improve access to behavioral health services for perinatal women.

摘要

背景

本研究旨在探讨临床医生对当前围产期情绪和焦虑障碍(PMAD)管理实践的看法,以及改善未来实施策略的方法。

方法

本研究采用横断面描述性设计。对在美国一所学术医疗中心的几家社区诊所治疗围产期妇女并从业的临床医生(N=118)进行了一项 35 项的电子调查。

结果

在为围产期妇女提供护理的临床医生中,34.7%的人报告从未接受过 PMAD 管理培训,66.3%的人从业经验不足 10 年。在报告有精神科症状的 10 名患者中,平均有 47.8%的临床医生表示他们为 1 至 3 名患者提供了 PMAD 管理,40.7%的临床医生表示他们仅在患者表达 PMAD 症状时进行筛查。未来建议的改进措施包括提供培训、制定转诊名单和建立综合行为健康服务。

结论

本研究结果表明,尽管已经实施了 PMAD 筛查和管理,但为了符合既定指南,仍需要改进。此外,临床医生认可为一小部分围产期患者提供 PMAD 管理。应探讨增加 PMAD 管理采用和实施的策略,以改善围产期妇女获得行为健康服务的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b120/7905716/29c47662ba0e/10.1177_2150132721996888-fig1.jpg

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