465名产科医护人员对妊娠期妇女心理健康筛查知识态度及支持需求的水平分析
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摘要
目的了解深圳市产科医护人员对妊娠期妇女实施心理健康筛查相关知识、态度及支持需求情况。方法采用便利抽样法,于2018年3—4月选取深圳市妇幼保健院、4所区级妇幼保健院及1所区级人民医院产科医生、护士及助产士作为研究对象。采用一般资料调查表、孕期心理健康知识问卷、医护人员对围产期女性心理问题态度量表及医疗机构支持需求量表对其进行调查。结果本组产科医护人员对妊娠期妇女心理健康筛查相关知识得分为(7.16±1.54)分,正确率为55.1%,态度得分为(44.53±6.71)分,支持需求得分为(28.88±4.57)分。不同年龄、学历、工作年限、职业、精神卫生相关学习或工作经历的医护人员,其对妊娠期妇女心理健康筛查知识得分比较,差异均有统计学意义(P<0.05);不同年龄、工作年限及职业产科医护人员,其对妊娠期妇女心理健康筛查态度得分比较,差异均有统计学意义(P<0.05);不同工作年限医护人员,其对妊娠期妇女心理健康筛查支持需求得分比较,差异有统计学意义(P<0.05)。结论医护人员对妊娠期妇女心理健康相关知识了解不足,对实施心理健康筛查信心不足,医疗机构需为医护人员提供相应的知识及技能的培训,做好筛查准备。
Objective To explore the current status of obstetric staff's knowledge and perceived support needs of and attitude toward pregnant women's psychological health screening in Shenzhen. Methods With a convenience sampling method, we investigated obstetricians, obstetric nurses and midwives from Shenzhen Maternity and Child Healthcare Hospital, 4 maternal hospitals and 1 general hospital of district level in Shenzhen from March to April in 2018 by using a general information questionnaire, questionnaire of psychological health knowledge during pregnancy, scale of medical staff 's attitudes toward pregnant women' psychological distress and medical institute perceived support need scale. Results The average score of obstetric staff's knowledge on screening of pregnant women's psychological health was 7.16±1.54, with an accuracy rate of 55.1%; the average score of attitude was 44.53±6.71 and that of support need 28.88±4.57. The knowledge score of participants with different age, education background, years of working,occupation, experience of work or study on mental health showed statistical differences(P<0.05); the attitude score of participants with different age, years of working and occupation was statistical significant(P <0.05) while the score of perceived support need of participants with different years of working showed statistical differences(P <0.05). Conclusion Obstetric staff's knowledge on pregnant women's psychological health screening needs to be improved and they lack confidence for undertaking the screening task.Thus, sufficient training for improving their knowledge and skills on pregnant women 's psychological health screening before the implementation of screening is indispensible.
Objective To explore the current status of obstetric staff's knowledge and perceived support needs of and attitude toward pregnant women's psychological health screening in Shenzhen. Methods With a convenience sampling method, we investigated obstetricians, obstetric nurses and midwives from Shenzhen Maternity and Child Healthcare Hospital, 4 maternal hospitals and 1 general hospital of district level in Shenzhen from March to April in 2018 by using a general information questionnaire, questionnaire of psychological health knowledge during pregnancy, scale of medical staff 's attitudes toward pregnant women' psychological distress and medical institute perceived support need scale. Results The average score of obstetric staff's knowledge on screening of pregnant women's psychological health was 7.16±1.54, with an accuracy rate of 55.1%; the average score of attitude was 44.53±6.71 and that of support need 28.88±4.57. The knowledge score of participants with different age, education background, years of working,occupation, experience of work or study on mental health showed statistical differences(P<0.05); the attitude score of participants with different age, years of working and occupation was statistical significant(P <0.05) while the score of perceived support need of participants with different years of working showed statistical differences(P <0.05). Conclusion Obstetric staff's knowledge on pregnant women's psychological health screening needs to be improved and they lack confidence for undertaking the screening task.Thus, sufficient training for improving their knowledge and skills on pregnant women 's psychological health screening before the implementation of screening is indispensible.
引文
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[4]王彦霁,刘秀萍,宋锦平.二胎孕妇妊娠焦虑状态调查及相关因素分析[J].护理学杂志, 2016,31(8):85-87.DOI:10.3870/j.issn.1001-4152.2016.08.085.
[5]肖霄,朱社宁,张旱愉,等.产前抑郁概念分析[J].护理学报,2017,24(19):18-23.DOI:10.16460/j.issn1008-9969.2017.19.018.
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[8] Government of South Australia. Screening for Perinatal Anxiety and Depression Clinical Guideline[EB/OL].(2015-09-07)[2018-04-28].http://www.sahealth.sa.gov.au/wps/wcm/connect/067b598044c1bda7b0a5fd3f59363f11/Management+of+women+with+low+PAPP-A_July2014.pdf?MOD=AJPERES.
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[10] Rollans M, Schmied V, Kemp L, et al. We just Ask Some Questions. The Process of Antenatal Psychosocial Assessment by Midwives[J]. Midwifery, 2013,29(8):935-942.DOI:10.1016/j.midw.2012.11.013.
[11] Clarke D M, McCall L, Rowley G. A Questionnaire to Measure General Practitioners’ Attitudes to their Role in the Management of Patients with Depression and Anxiety[J]. Aust Fam Physician, 2002, 31(3):299-303.
[12] Highet N J, Gemmill A W, Milgrom J. Depression in the Perinatal Period:Awareness, Attitudes and Knowledge in the Australian Population[J]. Aust N Z J Psychiatry, 2011,45(3):223-231. DOI:10.3109/00048674.2010.547842.
[13] Noonan M, Jomeen J, Galvin R, et al. Survey of Midwives’Perinatal Mental Health Knowledge, Confidence, Attitudes and Learning Needs[J]. Women Birth, 2018(14):1-9.DOI:10.1016/j.wombi.2018.02.002.
[14] Hauck Y L, Kelly G, Dragovic M, et al. Australian Midwives Knowledge, Attitude and Perceived Learning Needs around Perinatal Mental Health[J]. Midwifery, 2014(31):247-255. DOI:10.1016/j.midw.2014.09.002.
[15] Jones C J, Creedy D K,Gamble J A. Australian Midwives’Awareness and Management of Antenatal and Postpartum Depression[J].Women Birth,2012,25(1):23-28.DOI:10.1016/j.wombi.2011.03.001.
[16] Bandura W. Social Foundations of Thought and Action:A Social Cognitive Theory. Englewood Cliffs[M]. New Jersey:PrenticeHallInc,1986:228.
[17]陈心月.临床护士心理护理知信行及需求测评工具的研制及应用[D].西安:第四军医大学,2013.
[18]石瑞君.强化心理护理在推进优质护理服务活动中的实践与应用[J].护理学报,2011,18(11A):51-53. DOI:10.16460/j.issn1008-9969.2011.21.014.
[19]吕俊健,周伟.产前抑郁状态对新生儿健康的影响[J].中国妇幼保健, 2012, 27(29):4539-4541.
[20] Milgrom J, Gemmill A W. Screening for Perinatal Depression[J]. Best Pract Res Clin Obstet Gynaecol, 2014,28(1):13-23.DOI:10.1016/j.bpobgyn.2013.08.014.
[21] Agapidaki E, Souliotis K, Jackson S F, et al. Pediatricians’and Health Visitors’ Views towards Detection and Management of Maternal Depression in the Context of a Weak Primary Health Care System:A Qualitative Study[J]. BMC Psychiatry,2014(14):108.DOI:10.1186/1471-244X-14-108.
[22] Kingston D E, Mcdonald S, Austin M P, et al. The Public’s Views of Mental Health in Pregnant And Postpartum Women:A Population-based Study[J]. BMC Pregnancy Childbirth,2014(14):84.DOI:10.1186/1471-2393-14-84.
[23]陈铭,朱晓萍,刘聪香,等.二孩政策下产科护士职业倦怠现状及应对措施探[J].护士进修杂志, 2018, 33(8):724-727. DOI:10.16821/j.cnki.hsjx.2018.08.014.
[2] Zhao Y, Kane I, Mao L P, et al. The Prevalence of Antenatal Depression and Its Related Factors in Chinese Pregnant Women who Present with Obstetrical Complications[J]. Arch PsychiatrNurs, 2016, 30(3):316-321. DOI:10.1016/j.apnu.2015.11.012.
[3]梅茹,王亚军.妊娠期妇女心理抑郁焦虑及相关影响因素分析[J].中国临床研究,2015,28(6):752-754. DOI:10.13429/j.cnki.cjcr.2015.06.021.
[4]王彦霁,刘秀萍,宋锦平.二胎孕妇妊娠焦虑状态调查及相关因素分析[J].护理学杂志, 2016,31(8):85-87.DOI:10.3870/j.issn.1001-4152.2016.08.085.
[5]肖霄,朱社宁,张旱愉,等.产前抑郁概念分析[J].护理学报,2017,24(19):18-23.DOI:10.16460/j.issn1008-9969.2017.19.018.
[6] Grote N K, Bridge J A, Gavin A R, et al. A Meta-analysis of Depression During Pregnancy and the Risk of Preterm Birth,Low Birth Weight, and Intrauterine Growth Restriction[J].Arch Gen Psychiatry, 2010,67(10):1012-1024.DOI:10.1001/archgenpsychiatry.2010.111.
[7] American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition:DSM-5[M]. Washington DC:American Psychiatric Publishing, 2013:320-335.
[8] Government of South Australia. Screening for Perinatal Anxiety and Depression Clinical Guideline[EB/OL].(2015-09-07)[2018-04-28].http://www.sahealth.sa.gov.au/wps/wcm/connect/067b598044c1bda7b0a5fd3f59363f11/Management+of+women+with+low+PAPP-A_July2014.pdf?MOD=AJPERES.
[9] Gibson J, McKenzie-McHarg K, Shakespeare J, et al. A Systematic Review of Studies Validating the Edinburgh Postnatal Depression Scale in Antepartum and Postpartum Women[J]. Acta Psychiatr Scand, 2009,119(5):350-364.DOI:10.1111/j.1600-0447.2009.01363.x.
[10] Rollans M, Schmied V, Kemp L, et al. We just Ask Some Questions. The Process of Antenatal Psychosocial Assessment by Midwives[J]. Midwifery, 2013,29(8):935-942.DOI:10.1016/j.midw.2012.11.013.
[11] Clarke D M, McCall L, Rowley G. A Questionnaire to Measure General Practitioners’ Attitudes to their Role in the Management of Patients with Depression and Anxiety[J]. Aust Fam Physician, 2002, 31(3):299-303.
[12] Highet N J, Gemmill A W, Milgrom J. Depression in the Perinatal Period:Awareness, Attitudes and Knowledge in the Australian Population[J]. Aust N Z J Psychiatry, 2011,45(3):223-231. DOI:10.3109/00048674.2010.547842.
[13] Noonan M, Jomeen J, Galvin R, et al. Survey of Midwives’Perinatal Mental Health Knowledge, Confidence, Attitudes and Learning Needs[J]. Women Birth, 2018(14):1-9.DOI:10.1016/j.wombi.2018.02.002.
[14] Hauck Y L, Kelly G, Dragovic M, et al. Australian Midwives Knowledge, Attitude and Perceived Learning Needs around Perinatal Mental Health[J]. Midwifery, 2014(31):247-255. DOI:10.1016/j.midw.2014.09.002.
[15] Jones C J, Creedy D K,Gamble J A. Australian Midwives’Awareness and Management of Antenatal and Postpartum Depression[J].Women Birth,2012,25(1):23-28.DOI:10.1016/j.wombi.2011.03.001.
[16] Bandura W. Social Foundations of Thought and Action:A Social Cognitive Theory. Englewood Cliffs[M]. New Jersey:PrenticeHallInc,1986:228.
[17]陈心月.临床护士心理护理知信行及需求测评工具的研制及应用[D].西安:第四军医大学,2013.
[18]石瑞君.强化心理护理在推进优质护理服务活动中的实践与应用[J].护理学报,2011,18(11A):51-53. DOI:10.16460/j.issn1008-9969.2011.21.014.
[19]吕俊健,周伟.产前抑郁状态对新生儿健康的影响[J].中国妇幼保健, 2012, 27(29):4539-4541.
[20] Milgrom J, Gemmill A W. Screening for Perinatal Depression[J]. Best Pract Res Clin Obstet Gynaecol, 2014,28(1):13-23.DOI:10.1016/j.bpobgyn.2013.08.014.
[21] Agapidaki E, Souliotis K, Jackson S F, et al. Pediatricians’and Health Visitors’ Views towards Detection and Management of Maternal Depression in the Context of a Weak Primary Health Care System:A Qualitative Study[J]. BMC Psychiatry,2014(14):108.DOI:10.1186/1471-244X-14-108.
[22] Kingston D E, Mcdonald S, Austin M P, et al. The Public’s Views of Mental Health in Pregnant And Postpartum Women:A Population-based Study[J]. BMC Pregnancy Childbirth,2014(14):84.DOI:10.1186/1471-2393-14-84.
[23]陈铭,朱晓萍,刘聪香,等.二孩政策下产科护士职业倦怠现状及应对措施探[J].护士进修杂志, 2018, 33(8):724-727. DOI:10.16821/j.cnki.hsjx.2018.08.014.