Primary care physicians' perspectives on the identification and management of postnatal mental health problems

被引：0

作者：

Liow, Yiyang ^{[1
,2
,3
]}

Lazarus, Monica ^{[2
,3
]}

Loh, Victor ^{[1
,2
,3
]}

Shorey, Shefaly ^{[4
]}

Chee, Cornelia ^{[5
]}

Young, Doris ^{[2
,3
]}

Valderas, Jose M. ^{[2
,3
]}

机构：

[1] Natl Univ Polyclin, Natl Univ Hlth Syst, 1 Jurong East St 21,Tower C,Level 1M, Singapore 609606, Singapore

[2] Natl Univ Hlth Syst, Dept Family Med, Singapore, Singapore

[3] Natl Univ Singapore, Yong Loo Lin Sch Med, Div Family Med, Singapore, Singapore

[4] Natl Univ Singapore, Alice Lee Ctr Nursing Studies, Yong Loo Lin Sch Med, Singapore, Singapore

[5] Natl Univ Hlth Syst, Natl Univ Hosp, Dept Psychol Med, Singapore, Singapore

来源：

FAMILY PRACTICE | 2024年 / 41卷 / 02期

关键词：

mood disorder; family health; primary care; post-partum care; mental health; depression; POSTPARTUM DEPRESSION; PERINATAL DEPRESSION; ANXIETY; DISORDERS; DIAGNOSIS; VISITS;

D O I：

10.1093/fampra/cmae003

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Background Postnatal mental health problems (PMHPs) are prevalent and negatively affect mothers, children, and society. International and local guidelines recommend that Singapore primary care physicians (PCP) screen, assess, and manage mothers with PMHPs. However, little is known about their experiences and views.Methods We conducted semi-structured interviews with 14 PCPs in Singapore. Interview questions elicited perspectives on the identification and management of mothers with PMHPs. The interview guide was developed from a conceptual framework incorporating the knowledge-attitudes-practices, self-efficacy, and socio-ecological models. Interviews were audio-recorded and transcribed. Thematic analysis was used to identify emergent themes.Results Singapore PCPs viewed themselves as key providers of first-contact care to mothers with PMHPs. They believed mothers preferred them to alternative providers because of greater accessibility and trust. In detection, they were vigilant in identifying at-risk mothers and favoured clinical intuition over screening tools. PCPs were confident in diagnosing common PMHPs and believed that mothers not meeting diagnostic criteria must be readily recognized and supported. In managing PMHPs, PCPs expressed varying confidence in prescribing antidepressants, which were viewed as second-line to supportive counselling and psychoeducation. Impeding physician factors, constraining practice characteristics and health system limitations were barriers. Looking forward, PCPs aspired to leverage technology and multidisciplinary teams to provide comprehensive, team-based care for the mother-child dyad.Conclusion Singapore PCPs are key in identifying and managing mothers with PMHPs. To fully harness their potential in providing comprehensive care, PCPs need greater multidisciplinary support and technological solutions that promote remote disclosure and enhanced preparation for their role.

引用

页码：185 / 193

页数：9

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