改善住院产后抑郁症筛查:结果从质量改进倡议。

IF 3.2 3区 医学 Q2 PSYCHIATRY
Rebecca Woofter, Gwendolyn Hill, Emily Wong, Tiffani J Bright, Catherine Bresee, Sarah J Kilpatrick, Eynav E Accortt
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引用次数: 0

摘要

目的:筛查是必要的,以识别产后抑郁或焦虑患者,并促进获得心理保健。本研究评估了住院产后抑郁症筛查的质量改进倡议,该倡议的实施是为了更好地识别需要心理保健的患者。这一举措取代了由护士口头填写的患者健康问卷(PHQ-9),取而代之的是由患者通过ipad自行填写的爱丁堡产后抑郁量表(EPDS-10)。方法:对雪松西奈医院2020年6月至2023年10月分娩的患者的电子病历进行分析(N = 17,403)。采用卡方检验和多元logistic回归模型检验了主动行动前后完成筛查、积极抑郁筛查、自杀意念和社会工作转介的差异。与EPDS-10阳性焦虑筛查相关的因素也被确定。结果:总体而言,98.6%的患者完成了抑郁症筛查。在完成筛检的人当中,主动行动前后,积极抑郁筛检率从4.0%上升到11.4%,确定自杀意念率从0.2%上升到1.1%,社会工作转介率从64.1%上升到84.0%。与主动治疗前相比,主动治疗后,患者有更高的几率进行积极的抑郁筛查,表明有自杀念头,并接受社会工作转介。在完成EPDS-10筛查的人中,31%的人焦虑呈阳性。结论:与护士口头给药的PHQ-9相比,患者通过ipad自我给药的EPDS-10有更高的积极抑郁筛查率、确定的自杀意念率和社会工作转介率。必须准确筛查产后抑郁和焦虑患者,以促进获得精神保健并解决发病率和死亡率问题。临床试验号:不适用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Improving inpatient postpartum depression screening: results from a quality improvement initiative.

Purpose: Screening is necessary to identify patients with postpartum depression or anxiety and facilitate access to mental healthcare. This study evaluated a quality improvement initiative for inpatient postpartum depression screening, which was implemented to better identify patients in need of mental healthcare. This initiative replaced the Patient Health Questionnaire (PHQ-9) administered verbally by nurses with the Edinburgh Postnatal Depression Scale (EPDS-10) self-administered by patients via iPads.

Methods: Electronic medical records for patients who delivered June 2020-October 2023 at Cedars-Sinai were analyzed (N = 17,403). Differences in completed screenings, positive depression screenings, suicidal ideation, and social work referrals before and after the initiative were examined with chi-square tests and multiple logistic regression models. Factors associated with positive anxiety screenings on the EPDS-10 were also identified.

Results: Overall, 98.6% of patients completed depression screenings. Among those who completed screenings, positive depression screenings increased from 4.0 to 11.4%, identified suicidal ideation increased from 0.2 to 1.1%, and social work referrals increased from 64.1 to 84.0%, before and after the initiative. Post-initiative, patients had higher odds of positive depression screenings, indicating suicidal ideation, and receiving social work referrals compared to pre-initiative. Among those who completed EPDS-10 screenings, 31% were positive for anxiety.

Conclusions: Compared to the PHQ-9 administered verbally by nurses, the EPDS-10 self-administered by patients via iPads resulted in higher rates of positive depression screenings, identified suicidal ideation, and social work referrals. It is imperative to accurately screen patients for postpartum depression and anxiety to facilitate access to mental healthcare and address morbidity and mortality.

Clinical trial number: Not applicable.

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来源期刊
Archives of Women's Mental Health
Archives of Women's Mental Health 医学-精神病学
CiteScore
8.00
自引率
4.40%
发文量
83
审稿时长
6-12 weeks
期刊介绍: Archives of Women’s Mental Health is the official journal of the International Association for Women''s Mental Health, Marcé Society and the North American Society for Psychosocial Obstetrics and Gynecology (NASPOG). The exchange of knowledge between psychiatrists and obstetrician-gynecologists is one of the major aims of the journal. Its international scope includes psychodynamics, social and biological aspects of all psychiatric and psychosomatic disorders in women. The editors especially welcome interdisciplinary studies, focussing on the interface between psychiatry, psychosomatics, obstetrics and gynecology. Archives of Women’s Mental Health publishes rigorously reviewed research papers, short communications, case reports, review articles, invited editorials, historical perspectives, book reviews, letters to the editor, as well as conference abstracts. Only contributions written in English will be accepted. The journal assists clinicians, teachers and researchers to incorporate knowledge of all aspects of women’s mental health into current and future clinical care and research.
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