Understanding depression treatment and perinatal service preferences of Kenyan pregnant adolescents: A discrete choice experiment.
Understanding depression treatment and perinatal service preferences of Kenyan pregnant adolescents: A discrete choice experiment.
复制标题
了解肯尼亚孕妇青少年的抑郁症治疗和围产期服务偏好：一个离散的选择实验。
DOI：
10.1371/journal.pone.0273274
复制
发表时间：
2023
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
--
作者：
了解青少年和青少年的心理健康治疗偏好对于干预措施的可接受性和成功尤为重要。以人为本的护理要求赋予个人权力，让他们能够掌控自己的健康，而不是成为服务的被动接受者。我们进行了一项离散选择实验，以定量测量青少年对不同护理特征的治疗偏好，并探索它们之间的权衡。在内罗毕非正规城市住区的两个初级医疗机构中总共招募了 153 名怀孕青少年。我们从文献综述和之前的定性工作中选择了抑郁症治疗选择模型的八个属性。贝叶斯 d 有效设计用于识别主效应。每个受访者总共被要求十项选择任务。我们使用混合 Logit 模型评估平均偏好，以调整受试者内相关性并解释未观察到的异质性。受访者表现出积极的偏好，即向护理人员提供信息表，而不是与护理人员共同参与。在治疗选择方面，与 4 次治疗相比，受访者对 8 次治疗表现出积极的偏好。关于干预实施人员，与社区卫生志愿者相比，受访者对机构护士有积极的偏好。在支持方面，与同伴支持相比，受访者对养育技能表现出积极的偏好。与青少年友好的服务和单独提供茶点相比，我们的受访者表达了对 ANC 服务与高龄母亲结合的负面偏好。与单独的旅行津贴或茶点相比，人们更倾向于组合茶点和旅行津贴。其中许多建议是关于增强她们的产科临床护理经验。这项研究强调了这一人群的独特需求。怀孕青少年重视护士提供的孕产和抑郁症护理服务。参与者都倾向于较长的心理治疗疗程，并且他们倾向于在初级保健中提供以青少年为中心的孕产妇心理健康和儿童健康服务。
Understanding mental health treatment preferences of adolescents and youth is particularly important for interventions to be acceptable and successful. Person-centered care mandates empowering individuals to take charge of their own health rather than being passive recipients of services. We conducted a discrete choice experiment to quantitatively measure adolescent treatment preferences for different care characteristics and explore tradeoffs between these. A total of 153 pregnant adolescents were recruited from two primary healthcare facilities in the informal urban settlement of Nairobi. We selected eight attributes of depression treatment option models drawn from literature review and previous qualitative work. Bayesian d-efficient design was used to identify main effects. A total of ten choice tasks were solicited per respondent. We evaluated mean preferences using mixed logit models to adjust for within subject correlation and account for unobserved heterogeneity. Respondents showed a positive preference that caregivers be provided with information sheets, as opposed to co-participation with caregivers. With regards to treatment options, the respondents showed a positive preference for 8 sessions as compared to 4 sessions. With regards to intervention delivery agents, the respondents had a positive preference for facility nurses as compared to community health volunteers. In terms of support, the respondents showed positive preference for parenting skills as compared to peer support. Our respondents expressed negative preferences of ANC service combined with older mothers as compared to adolescent friendly services and of being offered refreshments alone. A positive preference was revealed for combined refreshments and travel allowance over travel allowance or refreshments alone. A number of these suggestions were about enhancing their experience of maternity clinical care experience. This study highlights unique needs of this population. Pregnant adolescents’ value responsive maternity and depression care services offered by nurses. Participants shared preference for longer psychotherapy sessions and their preference was to have adolescent centered maternal mental health and child health services within primary care.
登录
查看更多内容
影响因子：
4
作者：
Anderson, Cheryl A.;Connolly, John P.
通讯作者：
Connolly, John P.
影响因子：
4.5
作者：
Johnson, F. Reed;Lancsar, Emily;Bridges, John F. P.
通讯作者：
Bridges, John F. P.
影响因子：
3.6
作者：
Meffert, Susan M.;Neylan, Thomas C.;Verdeli, Helen
通讯作者：
Verdeli, Helen
影响因子：
3.7
作者：
Ayele, Tadesse Awoke;Azale, Telake;Fekadu, Abel
通讯作者：
Fekadu, Abel
影响因子：
4.5
作者：
Bridges, John F. P.;Hauber, A. Brett;Mauskopf, Josephine
通讯作者：
Mauskopf, Josephine