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埃塞俄比亚 Sebeta 镇初级卫生保健就诊者的抑郁症状:患病率、相关因素以及卫生工作者的检出率。

Depressive symptoms in primary health care attendees in Sebeta Town, Ethiopia: Prevalence, associated factors, and detection by health workers.

机构信息

Research and Training Department, St. Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.

Department of Public Health, Unity University, Addis Ababa, Ethiopia.

出版信息

Sci Prog. 2021 Jul-Sep;104(3):368504211034304. doi: 10.1177/00368504211034304.

Abstract

Depression often goes unrecognized in the primary health care setting. When depression occurs in clinical settings, it increases the risk of mortality from co-morbid medical conditions. Besides, 70% of patients with depression have somatic complaints, resulting in unnecessary investigations and mismanagement. This study was intended to investigate the prevalence and associated factors of depressive symptoms in primary health care centers and the detection rate in Sebeta Town, Ethiopia. An institution-based cross-sectional study was conducted among 384 visitors of adult outpatient department of four primary health centers in Sebeta Town, Ethiopia from October 1 to November 3, 2020. Depressive symptoms were assessed using PHQ-9 at cut-off score of 5. Data were entered using EPI data version 3.1 and exported to SPSS version 20 for data analysis. Descriptive statistics and binary logistic regression analysis were conducted. The prevalence of depressive symptoms was 27.9% (95% CI: 23.4-32.6). Detection rate of depressive symptoms by PHC providers was 0.93% (95% CI: 0.0-5.1). The factors positively associated with depressive symptoms were being unmarried (adjusted odds ratio (AOR): 3.40, 95% CI: 1.56-7.40,  < 0.01), perceived worsening of illness (AOR: 3.67, 95% CI: 1.73-7.77,  < 0.01), having family history of depression (AOR: 3.78, 95% CI: 1.40-10.23,  < 0.01), current alcohol consumption (AOR: 2.73, 95% CI: 1.22-6.10,  < 0.05), and current khat consumption (AOR: 5.43, 95% CI: 2.55-11.56,  < 0.01). Moderate social support (AOR: 0.16, 95% CI: 0.06-0.41,  < 0.01) and strong social support (AOR: 0.23, 95% CI: 0.09-0.63,  < 0.01) compared to poor social support, and the age group 25-31 (AOR: 0.36, 95% CI: 0.14-0.92,  < 0.05), compared to the age group 18-24, were negatively associated. Prevalence of depressive symptoms was found to be high, while the detection rate was very low. Provision of depression care services integrated into routine health care at PHC level was recommended.

摘要

抑郁症在初级医疗保健环境中常常未被识别。当抑郁症发生在临床环境中时,它会增加合并医疗状况导致的死亡率风险。此外,70%的抑郁症患者有躯体症状,导致不必要的检查和管理不当。本研究旨在调查埃塞俄比亚 Sebeta 镇初级保健中心抑郁症的患病率和相关因素,以及检测率。 2020 年 10 月 1 日至 11 月 3 日,在埃塞俄比亚 Sebeta 镇的四个初级保健中心成人门诊部门对 384 名来访者进行了一项基于机构的横断面研究。使用 PHQ-9 评估抑郁症状,截断值为 5。使用 EPI 数据版本 3.1 输入数据,并将其导出到 SPSS 版本 20 进行数据分析。进行描述性统计和二元逻辑回归分析。抑郁症状的患病率为 27.9%(95%CI:23.4-32.6)。初级保健提供者检测到的抑郁症状的检出率为 0.93%(95%CI:0.0-5.1)。与抑郁症状呈正相关的因素有未婚(调整后的优势比(AOR):3.40,95%CI:1.56-7.40,<0.01)、疾病恶化的感知(AOR:3.67,95%CI:1.73-7.77,<0.01)、有抑郁家族史(AOR:3.78,95%CI:1.40-10.23,<0.01)、当前饮酒(AOR:2.73,95%CI:1.22-6.10,<0.05)和当前食用恰特草(AOR:5.43,95%CI:2.55-11.56,<0.01)。中度社会支持(AOR:0.16,95%CI:0.06-0.41,<0.01)和强社会支持(AOR:0.23,95%CI:0.09-0.63,<0.01)与较差的社会支持相比,25-31 岁年龄组(AOR:0.36,95%CI:0.14-0.92,<0.05)与 18-24 岁年龄组相比,与抑郁症状呈负相关。发现抑郁症状的患病率较高,而检出率非常低。建议在初级保健层面将抑郁护理服务纳入常规保健。

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