Depression-related stigma among primary care providers.
Depression-related stigma among primary care providers.
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DOI：
10.9740/mhc.2021.05.175
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发表时间：
2021-05
期刊：
影响因子：
--
通讯作者：
Trinkley K
中科院分区：
文献类型：
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作者：
Kluemper A;Heath L;Loeb D;Kroehl M;Trinkley K
抑郁症是美国最常见的精神疾病之一，通常在初级保健机构中接受治疗。尽管抑郁症很普遍，但由于各种原因（包括耻辱），其诊断和治疗仍然不足。这可能会导致抑郁症的治疗效果不佳。评估美国初级保健提供者 (PCP) 耻辱感的研究很少。本研究的主要目的是描述一组 PCP 中的耻辱感。我们使用经过验证的问卷来衡量耻辱感（分数范围为 15 至 75，分数越低表明耻辱感程度越低）。向 2 个学术内科诊所的 PCP 发送了一份电子问卷，并因回复而获得小额金钱奖励。除了耻辱调查之外，我们还收集了人口统计数据，包括年龄、提供者类型、性别以及与精神疾病的社会接近度相关的其他数据。为了描述耻辱感，适当使用 t 检验和方差分析测试来评估提供者特征之间的耻辱感差异。在 107 名 PCP 中，有 71 名做出答复（答复率为 66.4%）。男性受访者的耻辱感得分高于女性（31.8 vs 27.4，P = .0021）。住院医师比非住院医师表现出更高的耻辱分数（31.3 vs 27.2，P = .0045）。个人接触过精神疾病的提供者和那些报告自己经常治疗抑郁症的提供者的耻辱感较少。总体而言，接受调查的 PCP 中存在一系列耻辱感。男性、住院医师、没有接触过精神疾病的人、年轻的主治医生以及报告治疗抑郁症的频率较低的人的耻辱程度较高。未来的研究应该利用更大的样本量，并重点关注耻辱对护理质量的影响。
Depression is one of the most common mental illnesses in the United States and is often treated in primary care settings. Despite its prevalence, depression remains underdiagnosed and undertreated for a variety of reasons, including stigma. This may result in suboptimal management of depression. Studies evaluating stigma in US primary care providers (PCP) are scarce. The main objective of this study was to describe stigma in a cohort of PCPs. We utilized a validated questionnaire to measure stigma (score range 15 to 75 with lower scores indicating lower stigma levels). PCPs in 2 academic internal medicine clinics were sent an electronic questionnaire and received a small monetary incentive for responding. In addition to the stigma survey, we collected demographic data, including age, provider type, gender, and other data related to social proximity to mental illness. To describe stigma, differences in stigma between provider characteristics were evaluated using t tests and ANOVA tests as appropriate. Of 107 PCPs, 71 responded (66.4% response rate). Male responders displayed higher stigma scores than females (31.8 vs 27.4, P = .0021). Medical residents displayed higher stigma scores than nonresidents (31.3 vs 27.2, P = .0045). Providers with personal exposure to mental illness and those who reported they frequently treated depression had less stigma. Overall, a range of stigma was present among PCPs surveyed. Higher levels of stigma were found in men, medical residents, those without personal exposure to mental illness, younger PCPs, and those who reported treating depression less frequently. Future studies should utilize larger sample sizes and focus on the impact of stigma on quality of care.