Adolescent depression screening in primary care: Feasibility and acceptability
Adolescent depression screening in primary care: Feasibility and acceptability
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DOI：
10.1542/peds.2005-2965
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发表时间：
2007-01-01
期刊：
影响因子：
8
通讯作者：
Shaffer, David
中科院分区：
文献类型：
--
作者：
Zuckerbrot, Rachel A.;Maxon, Laura;Shaffer, David
目标。尽管有治疗抑郁症的方法，但只有四分之一到三分之一的抑郁青少年接受治疗。如果对自杀和抑郁的评估成为常规儿科护理的一个更正式的部分，那么诊断不足和转诊不足的问题可能会得到纠正。本研究的目的是探讨在临床实践中实施青少年抑郁症筛查的可行性和可接受性。在这项研究中，我们在繁忙的初级保健儿科实践中实施了两阶段的青少年识别协议，第一阶段的纸笔筛查和第二阶段的计算机化评估。提供者追踪了在健康维护和紧急护理访问中接受筛查的合格患者的数量，并提供了关于筛查给实践带来的负担以及对患者/父母-提供者关系的影响的调查回应。79%的青少年患者进行了健康维护访问，大多数患者进行了任何类型的访问。纸质筛管的平均完井时间为4.6分钟。提供者认为家长和患者对筛查程序的满意多于不满意，而且增加的时间负担是可以处理的。所有提供者都希望在协议结束时继续使用纸质屏幕。采用标准化的筛查工具，在实践中建立普遍的系统性抑郁症筛查，很少遇到患者和家长的阻力，并被提供者很好地理解和接受。
OBJECTIVE. Despite available depression treatments, only one fourth to one third of depressed adolescents are receiving care. The problem of underdiagnosis and underreferral might be redressed if assessment of suicidality and depression became a more formal part of routine pediatric care. Our purpose for this study was to explore the feasibility and acceptability of implementing adolescent depression screening into clinical practice.METHODS. In this study we implemented a 2-stage adolescent identification protocol, a first-stage pen-and-paper screen and a second-stage computerized assessment, into a busy primary care pediatric practice. Providers tracked the number of eligible patients screened at both health maintenance and urgent care visits and provided survey responses regarding the burden that screening placed on the practice and the effect on patient/parent-provider relationships.RESULTS. Seventy-nine percent of adolescent patients presenting for health maintenance visits were screened, as were the majority of patients presenting for any type of visit. The average completion time for the paper screen was 4.6 minutes. Providers perceived parents and patients as expressing more satisfaction than dissatisfaction with the screening procedures and that the increased time burden could be handled. All providers wished to continue using the paper screen at the conclusion of the protocol.CONCLUSIONS. Instituting universal systematic depression screening in a practice with a standardized screening instrument met with little resistance by patients and parents and was well perceived and accepted by providers.