Department of Mental Health, Ministry of Health, Maputo, Mozambique.
Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil.
Front Public Health. 2022 Sep 28;10:919827. doi: 10.3389/fpubh.2022.919827. eCollection 2022.
Depression is the most common mental disorder among people living with HIV/AIDS and has a negative impact on HIV treatment outcomes. Training lay HIV counselors to identify and manage depression may contribute to improved patient access and adherence to treatment, and reduce stigma and discrimination among lay health workers toward both HIV and depression. The purpose of this study was to assess the current knowledge and attitudes of lay HIV counselors toward managing depression in primary care in Mozambique.
We conducted a mixed-methods cross-sectional study to assess depression-related knowledge and attitudes among lay HIV counselors in 13 primary healthcare facilities in Mozambique. We used the quantitative Depression Attitude Questionnaire (DAQ) scale, followed by open-ended questions to further explore three key DAQ domains: the nature of depression, treatment preferences, and professional attitudes or reactions.
The sample included 107 participants (77.6% female, mean age: 32.3 years, sd = 7.4). Most (82.2%) had less than a high/technical school education. Findings suggested that some HIV counselors had knowledge of depression and described it as a cluster of psychological symptoms (e.g., deep sadness, anguish, apathy, isolation, and low self-esteem) sometimes leading to suicidal thoughts, or as a consequence of life stressors such as loss of a loved one, abuse, unemployment or physical illness, including being diagnosed with HIV infection. HIV counselors identified talking to trusted people about their problems, including family and/or counseling with a psychotherapist, as the best way for patients to deal with depression. While acknowledging challenges, counselors found working with patients with depression to be rewarding.
Lay health counselors identified HIV and psychosocial issues as key risk factors for depression. They believed that the treatment approach should focus on social support and psychotherapy.
抑郁症是 HIV/AIDS 感染者中最常见的精神障碍，对 HIV 治疗结果有负面影响。培训非专业 HIV 辅导员识别和管理抑郁症，可以促进改善患者获得治疗的机会和对治疗的依从性，并减少非专业卫生工作者对 HIV 和抑郁症的污名化和歧视。本研究旨在评估莫桑比克初级保健中非专业 HIV 辅导员管理抑郁症的现有知识和态度。
我们开展了一项混合方法的横断面研究，以评估莫桑比克 13 个初级保健中心中非专业 HIV 辅导员与抑郁症相关的知识和态度。我们使用定量的抑郁态度问卷（DAQ）量表，随后使用开放式问题进一步探讨三个关键的 DAQ 领域：抑郁症的性质、治疗偏好以及专业态度或反应。
该样本包括 107 名参与者（77.6%为女性，平均年龄为 32.3 岁，标准差=7.4）。大多数（82.2%）接受的教育程度低于高中/技术学校。研究结果表明，一些 HIV 辅导员对抑郁症有一定的了解，并将其描述为一系列心理症状（例如，极度悲伤、痛苦、冷漠、孤立和自卑），有时会导致自杀念头，或者是生活压力源（例如失去亲人、虐待、失业或身体疾病，包括被诊断出 HIV 感染）的后果。HIV 辅导员确定与可信赖的人谈论他们的问题，包括家人和/或与心理治疗师进行咨询，是患者应对抑郁症的最佳方式。尽管认识到挑战，但辅导员发现与患有抑郁症的患者一起工作是有回报的。
初级卫生保健辅导员确定 HIV 和心理社会问题是抑郁症的关键风险因素。他们认为，治疗方法应侧重于社会支持和心理治疗。
