Amsterdam School of Communication Research/ASCoR, Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands.
Amsterdam UMC, Free University Amsterdam, Midwifery Science, AVAG, Amsterdam Public Health Research Institute, the Netherlands.
Patient Educ Couns. 2021 Oct;104(10):2393-2399. doi: 10.1016/j.pec.2021.07.032. Epub 2021 Jul 24.
This study aimed to assess the most influential barriers midwives perceive in communicating about depression-related symptoms with ethnic minority clients.
In-depth interviews were held with midwives (N = 8) and Moroccan-Dutch women (N = 6) suffering from perinatal depression to identify the most salient communication barriers. Subsequently, an online survey among midwives (N = 60) assessing their perceived barriers and the occurrence of these barriers in practice was administered. Composite scores using the QUOTE methodology were calculated to determine influential barriers.
Three types of barriers emerged from the interviews. Educational-related barriers, client-related barriers and midwife-related barriers. Results of the survey showed that the most influential barriers were educational-related barriers (e.g. lack of culturally sensitive depression screening instruments) and client-related barriers (e.g. cultural taboo about talking about depression).
Culturally sensitive screening instruments for depression and patient education materials should be developed to mitigate the educational-related barriers to communicating about depression. Patient education materials should also target the clients' social environment (e.g. husbands) to help break the cultural taboo about depression.
Based on this study's results, communication strategies to empower both midwives and ethnic minority clients with depression can be developed in a collaborative approach.
本研究旨在评估助产士在与少数民族客户就抑郁相关症状进行沟通时感知到的最具影响力的障碍。
对 8 名助产士和 6 名患有围产期抑郁症的摩洛哥裔荷兰妇女进行深入访谈，以确定最突出的沟通障碍。随后，对 60 名助产士进行了一项在线调查，评估他们感知到的障碍以及这些障碍在实践中的发生情况。使用 QUOTE 方法计算综合得分，以确定有影响力的障碍。
访谈中出现了三种类型的障碍。教育相关障碍、客户相关障碍和助产士相关障碍。调查结果显示，最具影响力的障碍是教育相关障碍（例如缺乏针对文化的敏感抑郁筛查工具）和客户相关障碍（例如对谈论抑郁的文化禁忌）。
应开发针对文化的抑郁筛查工具和患者教育材料，以减轻沟通抑郁障碍方面的教育相关障碍。患者教育材料还应针对客户的社会环境（例如丈夫），以帮助打破对抑郁的文化禁忌。
基于本研究的结果，可以以协作的方式为有抑郁问题的助产士和少数民族客户制定赋权沟通策略。
