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沙特阿拉伯 COPD 患者管理抑郁症的态度、信心、障碍和当前做法:一项全国性横断面调查。

Attitudes, confidence, barriers and current practice of managing depression in patients with COPD in Saudi Arabia: a national cross-sectional survey.

机构信息

Department of Respiratory Care, College of Applied Medical Sciences, King Faisal University, Al-Ahasa, Saudi Arabia

Department of Respiratory Care, College of Applied Medical Sciences, King Faisal University, Al-Ahasa, Saudi Arabia.

出版信息

BMJ Open. 2023 May 8;13(5):e069670. doi: 10.1136/bmjopen-2022-069670.

Abstract

OBJECTIVE

To investigate physicians' perceptions and current practices of identifying and managing depression in patients with chronic obstructive pulmonary disease (COPD).

DESIGN

A cross-sectional online survey was employed between March and September 2022.

SETTINGS

Saudi Arabia.

PARTICIPANTS

1015 physicians, including general practitioners and family, internal and pulmonary medicine specialists.

PRIMARY OUTCOME MEASURES

Physicians' perceptions, confidence, practices and barriers to recognising and managing depression in patients with COPD.

RESULTS

A total of 1015 physicians completed to the online survey. Only 31% of study participants received adequate training for managing depression. While 60% of physicians reported that depression interferes with self-management and worsens COPD symptoms, less than 50% viewed the importance of regular screening for depression. Only 414 (41%) physicians aim to identify depression. Of whom, 29% use depression screening tools, and 38% feel confident in discussing patients' feelings. Having adequate training to manage depression (OR: 2.89; 95% CI: 2.02 to 3.81; p<0.001) and more years of experience (OR: 1.25; 95% CI: 1.08 to 1.45; p=0.002) were associated with the intention to detect depression in COPD patients. The most common barriers linked to recognising depression are poor training (54%), absence of standard procedures (54%) and limited knowledge about depression (53%).

CONCLUSION

The prevalence of identifying and confidently managing depression in patients with COPD is suboptimal, owing to poor training, the absence of a standardised protocol and inadequate knowledge. Psychiatric training should be supported in addition to adopting a systematic approach to detect depression in clinical practice.

摘要

目的

调查医生识别和管理慢性阻塞性肺疾病(COPD)患者抑郁的认知和当前实践。

设计

采用 2022 年 3 月至 9 月的横断面在线调查。

地点

沙特阿拉伯。

参与者

1015 名医生,包括全科医生、家庭医生、内科医生和肺病专家。

主要结果测量

医生识别和管理 COPD 患者抑郁的认知、信心、实践和障碍。

结果

共有 1015 名医生完成了在线调查。只有 31%的研究参与者接受了管理抑郁的充分培训。尽管 60%的医生报告抑郁会干扰自我管理并使 COPD 症状恶化,但不到 50%的医生认为定期筛查抑郁很重要。只有 414 名(41%)医生有意识别抑郁。其中,29%的医生使用抑郁筛查工具,38%的医生对讨论患者的感受有信心。接受充分的抑郁管理培训(OR:2.89;95%CI:2.02 至 3.81;p<0.001)和更多的工作年限(OR:1.25;95%CI:1.08 至 1.45;p=0.002)与检测 COPD 患者抑郁的意愿相关。与识别抑郁相关的最常见障碍是培训不足(54%)、缺乏标准程序(54%)和对抑郁的了解有限(53%)。

结论

由于培训不足、缺乏标准化方案和知识不足,识别和自信地管理 COPD 患者抑郁的情况并不理想。除了采用系统方法在临床实践中检测抑郁外,还应支持进行精神科培训。

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