背景:中国农村地区的抑郁症患者的精神卫生服务不足,鼓励对初级卫生保健提供者进行心理健康知识培训,但是这种鼓励的效果很少被报道。
方法:对湖南省两个城市的基层医疗机构进行了横断面调查,调查对象包括所有基层医疗机构(注册医生和护士)。中国通过管理涵盖抑郁症状的问卷,典型的抑郁症病例,和修订后的抑郁态度问卷。
结果:总计,315个初级医疗保健提供者同意参与这项研究,并完成了问卷,其中12.1%接受过抑郁症训练。此外,62.9%的农村初级卫生保健提供者能够识别大多数一般抑郁症状,8.3%的人能够识别所有一般抑郁症状。调查中的初级医疗保健提供者对抑郁持中立至稍微消极的态度,这表明他们的专业信心(平均得分为16.51±4.30)。治疗乐观/悲观(平均得分为29.02±5.98),和一般观点(平均得分18.12±3.12)得分。农村初级医疗保健提供者知道(28.3%)或在诊所中应用(2.9%)心理干预。
结论:我们的研究表明,初级医疗保健提供者知道一般抑郁症状,但缺乏心理干预技能,对抑郁症护理缺乏信心和悲观态度。因此,我们推测现有的初级卫生保健提供者的心理培训在数量和质量上都不足,迫切需要探索更有效的培训类型。
BACKGROUND: Mental health services are not sufficient for depression patients in rural areas of
China, training in mental health knowledge for primary healthcare providers has been encouraged, but the effect of this encouragement has rarely been reported.
METHODS: A cross-sectional survey was conducted in primary healthcare facilities that sought to include all the primary healthcare providers (registered physicians and nurses) in two cities in Hunan province,
China by administering questionnaires that covered depression symptoms, typical depression cases, and the Revised Depression Attitude Questionnaire.
RESULTS: In total, 315 primary healthcare providers agreed to participate in the study and finished the questionnaires, of which 12.1% had training in depression. In addition, 62.9% of the rural primary healthcare providers were able to recognize most general depression symptoms, and 8.3% were able to recognize all general depression symptoms. The primary healthcare providers in the survey held a neutral to slightly negative attitude towards depression as indicated by their professional confidence (mean scores 16.51 ± 4.30), therapeutic optimism/pessimism (mean scores 29.02 ± 5.98), and general perspective (mean scores 18.12 ± 3.12) scores. Fewer rural primary healthcare providers knew (28.3%) or applied (2.9%) psychological intervention in the clinic.
CONCLUSIONS: Our study indicated that primary healthcare providers knew about general depression symptoms, but lacked psychological intervention skills and held low confidence in and pessimistic attitudes toward depression care. We therefore speculate that existing psychological training for primary healthcare providers is insufficient in quantity and quality, making the need to explore more effective types of training urgently.