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Abstract：
BACKGROUND: Despite the high burden of perinatal depression in Nepal, the detection rate is low. Community-based strategies such as sensitization programmes and the Community Informant Detection Tool (CIDT) have been found to be effective in raising awareness and thus promoting the identification of mental health problems. This study aims to adapt these community strategies for perinatal depression in the Nepalese context.
METHODS: We followed a four-step process to adapt the existing community sensitization program manual and CIDT. Step 1 included in-depth interviews with women identified with perinatal depression (n=36), and focus group discussions were conducted with health workers trained in community mental health (n=13), female community health volunteers (FCHVs), cadre of Nepal government for the prevention and promotion of community maternal and child health (n=16), and psychosocial counsellors (n=5). We explored idioms and understanding of depression, perceived causes, and possible intervention. Step 2 included draft preparation based on the qualitative study. Step 3 included a one-day workshop with the psychosocial counsellors (n=2) and health workers (n=12) to assess the understandability and comprehensiveness of the draft and to refine the content. A review of the CIDT and community sensitization program manual by a psychiatrist was performed in Step 4.
RESULTS: The first step led to the content development for the CIDT and community sensitization manual. Multiple stakeholders and experts reviewed and refined the content from the second to fourth steps. Idioms of depression and commonly cited risk factors were incorporated in the CIDT. Additionally, myths of perinatal depression and the importance of the role of family were added to the community sensitization manual.
CONCLUSIONS: Both the CIDT and community sensitization manual are grounded in the local context and are simple, clear, and easy to understand.
METHODS: We followed a four-step process to adapt the existing community sensitization program manual and CIDT. Step 1 included in-depth interviews with women identified with perinatal depression (n=36), and focus group discussions were conducted with health workers trained in community mental health (n=13), female community health volunteers (FCHVs), cadre of Nepal government for the prevention and promotion of community maternal and child health (n=16), and psychosocial counsellors (n=5). We explored idioms and understanding of depression, perceived causes, and possible intervention. Step 2 included draft preparation based on the qualitative study. Step 3 included a one-day workshop with the psychosocial counsellors (n=2) and health workers (n=12) to assess the understandability and comprehensiveness of the draft and to refine the content. A review of the CIDT and community sensitization program manual by a psychiatrist was performed in Step 4.
RESULTS: The first step led to the content development for the CIDT and community sensitization manual. Multiple stakeholders and experts reviewed and refined the content from the second to fourth steps. Idioms of depression and commonly cited risk factors were incorporated in the CIDT. Additionally, myths of perinatal depression and the importance of the role of family were added to the community sensitization manual.
CONCLUSIONS: Both the CIDT and community sensitization manual are grounded in the local context and are simple, clear, and easy to understand.
摘要：
背景：尽管尼泊尔的围产期抑郁症负担很高，检测率低。已经发现，以社区为基础的战略，例如宣传计划和社区线人检测工具（CIDT），可以有效地提高认识，从而促进对心理健康问题的识别。这项研究旨在在尼泊尔背景下适应围产期抑郁症的这些社区策略。
方法：我们遵循了一个四步过程，以适应现有的社区致敏计划手册和CIDT。第1步包括对被确定为围产期抑郁症的妇女（n=36）的深入访谈，与受过社区心理健康培训的卫生工作者进行了焦点小组讨论(n=13)，女性社区卫生志愿者（FCHV），尼泊尔政府预防和促进社区妇幼保健干部（n=16），和社会心理咨询师（n=5）。我们探索了习语和对抑郁症的理解，感知原因，可能的干预。步骤2包括基于定性研究的草案准备。步骤3包括与社会心理顾问（n=2）和卫生工作者（n=12）举行为期一天的研讨会，以评估草案的可理解性和全面性，并完善内容。在步骤4中，精神科医生对CIDT和社区致敏计划手册进行了审查。
结果：第一步导致了CIDT和社区致敏手册的内容开发。多个利益攸关方和专家审查和完善了从第二步到第四步的内容。抑郁症的习语和通常被引用的危险因素被纳入CIDT。此外,围产期抑郁症的神话和家庭角色的重要性被添加到社区致敏手册中。
结论：CIDT和社区宣传手册都基于当地情况，而且很简单，clear,而且很容易理解。
方法：我们遵循了一个四步过程，以适应现有的社区致敏计划手册和CIDT。第1步包括对被确定为围产期抑郁症的妇女（n=36）的深入访谈，与受过社区心理健康培训的卫生工作者进行了焦点小组讨论(n=13)，女性社区卫生志愿者（FCHV），尼泊尔政府预防和促进社区妇幼保健干部（n=16），和社会心理咨询师（n=5）。我们探索了习语和对抑郁症的理解，感知原因，可能的干预。步骤2包括基于定性研究的草案准备。步骤3包括与社会心理顾问（n=2）和卫生工作者（n=12）举行为期一天的研讨会，以评估草案的可理解性和全面性，并完善内容。在步骤4中，精神科医生对CIDT和社区致敏计划手册进行了审查。
结果：第一步导致了CIDT和社区致敏手册的内容开发。多个利益攸关方和专家审查和完善了从第二步到第四步的内容。抑郁症的习语和通常被引用的危险因素被纳入CIDT。此外,围产期抑郁症的神话和家庭角色的重要性被添加到社区致敏手册中。
结论：CIDT和社区宣传手册都基于当地情况，而且很简单，clear,而且很容易理解。
