Uncovering the hidden burden: A mixed methods study on the implementation of depression screening among persons with type 2 diabetes mellitus seeking health care in an urban primary health center of South India.

IF 1.4 Q3 EDUCATION, SCIENTIFIC DISCIPLINES
Journal of Education and Health Promotion Pub Date : 2024-10-28 eCollection Date: 2024-01-01 DOI:10.4103/jehp.jehp_127_24
Ojaswini Trivedi, Pracheth Raghuveer
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引用次数: 0

Abstract

Background: Diabetes is linked with depression, but screening rates for depression are low, indicating a need for periodic assessments among those with diabetes. The study aimed to determine depression prevalence and associated factors in persons with type 2 diabetes mellitus (T2DM) in an urban primary care setting of Karnataka, as well as implementation challenges in depression screening for persons with T2DM as perceived by healthcare providers.

Material and methods: A mixed-methods study was performed for 6 months in 2022-2023 at an Urban Primary Health Centre (UPHC) in Bengaluru. The sample size was calculated to be 110, and convenience sampling was applied to select persons with T2DM. The participants were screened for depression using Patient Health Questionnaire-9. Key informant interviews were performed among various health care providers of the UPHC. Data were captured using EpiCollect Version 5.0. Univariate logistic regression was performed to find the factors associated with depression.

Result: Of the 110 participants, 60 (54.5%) screened positive for depression. Men had 0.474 (95% Confidence Intervals-CI: 0.126, 1.782) lesser odds of depression when compared with women (P = 0.269). Those with comorbidities had 1.975 more odds (95% CI: 0.538, 7.252) when compared with absence of comorbidities (P = 0.305). Statistically significant associations were not found with any of the factors. Key facilitators for screening were willingness to implement screening, empathetic attitude, and awareness of mental health, whereas the challenges included lack of training in mental health assessment and patient reluctance to adhere to treatment due to stigma.

Conclusion: The study found that 54.5% of persons with T2DM seeking heath care at the UPHC screened positive for depression. Several challenges in implementing depression screening for T2DM in primary care settings were noted.

揭示隐藏的负担:在印度南部城市初级卫生保健中心寻求保健的2型糖尿病患者中实施抑郁症筛查的混合方法研究。
背景:糖尿病与抑郁症有关,但抑郁症的筛查率很低,这表明需要对糖尿病患者进行定期评估。本研究旨在确定卡纳塔克邦城市初级保健机构中2型糖尿病(T2DM)患者的抑郁症患病率及其相关因素,以及医疗保健提供者认为的T2DM患者抑郁症筛查的实施挑战。材料和方法:于2022-2023年在班加罗尔的城市初级卫生中心(UPHC)进行了为期6个月的混合方法研究。计算样本量为110人,选择T2DM患者采用方便抽样。使用患者健康问卷-9对参与者进行抑郁症筛查。在UPHC的各种卫生保健提供者中进行了关键信息提供者访谈。使用EpiCollect Version 5.0捕获数据。采用单因素logistic回归分析抑郁症的相关因素。结果:在110名参与者中,60名(54.5%)筛查出抑郁症阳性。与女性相比,男性患抑郁症的几率低0.474(95%可信区间:0.126,1.782)(P = 0.269)。与无合并症的患者相比,有合并症患者的患病几率高出1.975 (95% CI: 0.538, 7.252) (P = 0.305)。没有发现与任何因素有统计学意义的关联。筛查的主要促进因素是实施筛查的意愿、移情态度和对心理健康的认识,而挑战包括缺乏心理健康评估方面的培训,以及患者因耻辱感而不愿坚持治疗。结论:研究发现54.5%的在UPHC就诊的2型糖尿病患者抑郁症筛查呈阳性。在初级保健机构实施2型糖尿病抑郁症筛查的几个挑战被注意到。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.60
自引率
21.40%
发文量
218
审稿时长
34 weeks
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