Postpartum depression screening in the first year: A cross-sectional provider analysis in Oregon.
Postpartum depression screening in the first year: A cross-sectional provider analysis in Oregon.
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第一年的产后抑郁症筛查：俄勒冈州的横断面提供者分析。
DOI：
10.1097/jxx.0000000000000250
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发表时间：
2020
影响因子：
1.2
通讯作者：
Stoyles,Sydnee
中科院分区：
文献类型：
--
作者：
Docherty,Angie;Najjar,Rana;Combs,Sheryl;Woolley,Rachel;Stoyles,Sydnee
背景与目的：产后抑郁症（Postpartum depression，PPD）对母亲和孩子都有严重的后遗症。为了帮助诊断，PPD筛查应持续整个产后一年。在初级保健中，筛查的应用可能缺乏一致性。在俄勒冈州，报告的PPD率为18.2%，重要的是要确定筛查是否覆盖所有妇女。本研究的目的是探讨初级保健提供者筛选的做法，在产后一年，并确定是否有障碍，以满足PPD guidelines. Methods：一个描述性的，横断面调查进行了初级保健提供者在俄勒冈州。与会者要求提供关于筛查做法和时间安排以及潜在障碍的数据。为了帮助比较，筛查与美国儿科学会（AAP）和全国儿科护士从业者协会（NAPNAP）/美国咨询服务工作组指南进行了比较。数据进行了分析，使用R统计计算和皮尔逊卡方tests.Results：在55名受访者中，29%遵循AAP的建议，并在良好的儿童访问筛选; 64%遵循NAPNAP的建议，并在产后一年至少筛选一次;和31%不符合任何筛选指南。最常见的筛查障碍是知识有限和/或转诊服务的可用性。医生比执业护士（NPs）更有可能满足任何推荐的指南（p =. 023).实践意义：相当数量的妇女可能没有接受PPD筛查。令人关切的是，大多数没有接受筛查的人都是非土著人，因为他们的工作重点是疾病预防和健康管理。有必要进行进一步研究，以确认妇女是否错过了早期干预的机会，以及是否可以制定战略，使初级保健的方法标准化。
Background and purpose:Postpartum depression (PPD) has significant sequelae for mother and child. To aid diagnosis, PPD screening should continue throughout the postpartum year. In primary care, there may be a lack of consistency in how screening is applied. In Oregon, with a reported PPD rate of 18.2%, it is important to determine whether screening is reaching all women. The purpose of this study was to explore primary care provider screening practices in the postpartum year and determine if there are barriers to meeting PPD guidelines.Methods:A descriptive, cross-sectional survey was conducted with primary care providers in Oregon. Data were sought on screening practices and timing, as well as potential barriers. To aid comparison, screening was compared against both the American Academy of Pediatrics (AAP) and National Association of Pediatric Nurse Practitioner (NAPNAP)/US Preventative Services Task Force guidelines. Data were analyzed using R statistical computing and Pearson chi-square tests.Results:Of the 55 respondents, 29% followed the AAP recommendations and screened at well-child visits; 64% followed the NAPNAP recommendations and screened at least once in the postpartum year; and 31% did not meet any screening guidelines. The most common screening barriers were limited knowledge and/or availability of referral services. Physicians were more likely to meet any recommended guidelines than nurse practitioners (NPs)(p=. 023).Implications for practice:A notable number of women may not be receiving PPD screening. It is concerning that most of those not screening were NPs, given the focus of their practice on disease prevention and health management. Further research is warranted to confirm whether women are missing opportunities for early intervention and whether strategies can be established to standardize the approach in primary care.