目的:从所有相关利益相关者中确定与围产期抑郁症的心理求助行为相关的障碍和促进因素(例如,围产期妇女,家庭成员,精神卫生保健提供者,和政策制定者)。
方法:对六个英语数据库的文献检索(PubMed,WebofScience,Embase,PsycINFO,Cochrane图书馆,CINAHL)和三个中文数据库(中国国家知识基础设施,万芳,中国生物医学文献数据库)。包括使用定性或混合方法以英文或中文发表的研究,以探讨围产期抑郁症妇女的心理求助行为。根据实施研究综合框架,为共同主题综合了数据提取。JoannaBriggs研究所的定性评估和审查工具用于评估方法学质量。
方法:围产期妇女抑郁症,精神卫生保健提供者(例如,儿科医生/护士,社会工作者,护士-助产士,围产期精神病医生,社区卫生工作者,和管理员),合作伙伴和非正式护理人员(例如,社区助产士,老年母亲,和育龄男性)基于高,中低收入国家。
结果:这篇综述中包含了43篇文章,并根据实施研究领域的综合框架(括号中)进行了介绍。帮助寻求的最常见障碍是污名(个人特征),误解(个体特征),文化信仰(内在设置),缺乏社会支持(外部环境)。最常见的促进者是提供足够的支持(外部环境)和围产期保健专业培训,管理和讨论抑郁症;与精神卫生保健提供者建立支持关系;和侵蚀污名(所有三个实施过程)。
结论:本系统综述可作为卫生当局制定多种策略以改善围产期抑郁症妇女的心理求助行为的参考框架。更多高质量的研究侧重于现有干预措施的综合实施框架研究特征,在未来的研究中需要实施过程。
OBJECTIVE: To identify barriers and facilitators related to psychological help-seeking behaviors of perinatal depression from all related stakeholders (e.g., perinatal women, family members, mental health care providers, and policymakers).
METHODS: A literature search of six English-language databases (PubMed, Web of Science, Embase, PsycINFO, the Cochrane Library, CINAHL) and three Chinese-language databases (
China National Knowledge Infrastructure, Wan Fang, Chinese Biomedical Literature Databases). Studies published in English or Chinese using qualitative or mixed methods to explore the psychological help-seeking behaviors of women with perinatal depression were included. Data extraction was synthesized for common themes based on the Consolidated Framework for Implementation Research. The Joanna Briggs Institute Qualitative Assessment and Review Instrument was used to appraise methodologic quality.
METHODS: Perinatal women with depression, mental health care providers (e.g., pediatricians/nurses, social workers, nurse-midwives, perinatal psychiatrists, community health workers, and administrators), partners and informal caregivers (e.g., community birth attendants, elderly mothers, and men of reproductive age) based in high, middle and low income countries.
RESULTS: Forty-three articles were included in this review and presented according to the Consolidated Framework for Implementation Research domains (in parentheses). The most common barriers to help seeking were stigma (individual characteristics), misconceptions (individual characteristics), cultural beliefs (inner setting), and lack of social support (outer setting). The most common facilitators were providing adequate support (outer setting) and perinatal health care professional training on how to detect, manage and discuss depression; establishing supportive relationships with mental health care providers; and eroding stigma (all three implementation processes).
CONCLUSIONS: This systematic review could serve as a reference framework for health authorities to develop diverse strategies for improving the psychological help-seeking behaviors of women with perinatal depression. More high-quality studies focused on the Consolidated Framework for Implementation Research characteristics of available interventions, and implementation processes are needed in future research.