基层妇幼卫生人员对围产期抑郁症的认知现状及培训需求分析

Analysis on awareness of perinatal depression and training needs among maternity care professionals at primary-level

目的 了解基层妇幼卫生人员对围产期抑郁症的知晓情况、防治态度及培训需求,为进一步加强围产期抑郁症防治人才队伍建设提供基础数据。方法 于2022年5月采用自制电子问卷,对云南省广南县的产科医护人员和县乡村三级妇幼专干开展普查,共发放问卷854份,探索存在的问题和改进策略;对基层妇幼卫生人员开展围产期抑郁症知识技能培训预试验,采用自身前后对照设计和McNemar's检验评估培训效果。结果 623名基层妇幼卫生人员完成了问卷调查。基层妇幼卫生人员的围产期抑郁症知识高知晓率仅为37.08%,但71.11%的人员持积极态度,认为抑郁症可防可控。仅有43.50%的人员满意当前的心理卫生服务供给现状,有84.43%的人员认为应将抑郁症的筛查和早期干预等心理服务费用纳入医保报销范畴。有27.45%的人员曾在工作中遇到过抑郁孕产妇,但69.98%的人员从未接受过围产期抑郁症的相关培训,96.31%的人员有参加相关培训的意愿。工作单位级别较高的基层妇幼卫生人员遇见抑郁孕产妇的可能性更大,但他们接受相关培训的机会更少(P<0.05)。既往接受过围产期抑郁症培训的基层妇幼卫生人员没有表现出更好的知识知晓情况(P>0.05),但接受了本次培训的22名基层妇幼卫生人员的围产期抑郁症知识高知晓率由31.82%提高至86.36%。结论 基层妇幼卫生人员对围产期抑郁症的认知水平不高,但对围产期抑郁症的防治态度积极,参与培训的意愿强烈。既往的抑郁症相关培训较少且效果不佳,建议优先开展县级医疗卫生机构人员的围产期抑郁症知识技能培训,针对认知误区和实践难点进行参与式培训,再通过经验下沉、示范引领,为全社会的围产期抑郁症防治营造积极友善的氛围。

Objective To understand the knowledge,attitudes,and training needs of perinatal depression among maternity care profes-sionals at primary-level,and provide basic information for further strengthening the capacity to prevent and control perinatal depres-sion.Methods A self-administered electronic questionnaire was used to conduct a survey covering all the obstetric professionals and mater-nal health workers at county-,township-,and village-levels in Guangnan County in Yunnan Province in May 2022,a total of 854 question-nairs were sent out.The problems and improvement strategy were analyzed;pre-test of knowledge and skill training for perinatal depression was carried out among maternity care professionals at primary-level,a self-control study and MeNemar's test were used.Results A total of 623 maternity care professionals completed the survey.The proportion of professionals with high awareness of perinatal depression was only 37.08%,but 71.11% of them had a positive attitude that depression was preventable and treatable.Only 43.50% of maternity care profes-sionals were satisfied with the current status of mental health service provision,and 84.43%of them agreed that the cost of psychological services such as screening and early intervention for depression should be included in health insurance reimbursement.There were 27.45%of professionals who had met depressed pregnant women or new mothers during work,but 69.98%of them had never received training on peri-natal depression,and 96.31%of them had the desire to attend relevant training.Maternity care professionals at higher levels of the workplace were more likely to met depressed pregnant women or new mothers during work,but they had less access to relevant training(P<0.05).Al-though there was no difference in awareness of perinatal depression detected between those who had received and had not received training(P>0.05),the proportion of professionals with high awareness of perinatal depression increased from 31.82%to 86.36%among 22 materni-ty care professionals at primary-level in current training.Conclusion Maternity care professionals at primary-level have a low level of awareness of perinatal depression,but they have a positive attitude towards the perinatal depression and a strong willingness to participate in training.It is recommended that the knowledge and skills training should be firstly given to maternity care professionals at county-level.The participatory training methods should be considered to clarify the misunderstandings and address the difficulties in practice.The positive and friendly atmosphere for perinatal depression prevention and control should be created by health campaign and experience exchange.