1
|
Levkovich I, Elyoseph Z. Identifying depression and its determinants upon initiating treatment: ChatGPT versus primary care physicians. Fam Med Community Health 2023; 11:e002391. [PMID: 37844967 PMCID: PMC10582915 DOI: 10.1136/fmch-2023-002391] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVE To compare evaluations of depressive episodes and suggested treatment protocols generated by Chat Generative Pretrained Transformer (ChatGPT)-3 and ChatGPT-4 with the recommendations of primary care physicians. METHODS Vignettes were input to the ChatGPT interface. These vignettes focused primarily on hypothetical patients with symptoms of depression during initial consultations. The creators of these vignettes meticulously designed eight distinct versions in which they systematically varied patient attributes (sex, socioeconomic status (blue collar worker or white collar worker) and depression severity (mild or severe)). Each variant was subsequently introduced into ChatGPT-3.5 and ChatGPT-4. Each vignette was repeated 10 times to ensure consistency and reliability of the ChatGPT responses. RESULTS For mild depression, ChatGPT-3.5 and ChatGPT-4 recommended psychotherapy in 95.0% and 97.5% of cases, respectively. Primary care physicians, however, recommended psychotherapy in only 4.3% of cases. For severe cases, ChatGPT favoured an approach that combined psychotherapy, while primary care physicians recommended a combined approach. The pharmacological recommendations of ChatGPT-3.5 and ChatGPT-4 showed a preference for exclusive use of antidepressants (74% and 68%, respectively), in contrast with primary care physicians, who typically recommended a mix of antidepressants and anxiolytics/hypnotics (67.4%). Unlike primary care physicians, ChatGPT showed no gender or socioeconomic biases in its recommendations. CONCLUSION ChatGPT-3.5 and ChatGPT-4 aligned well with accepted guidelines for managing mild and severe depression, without showing the gender or socioeconomic biases observed among primary care physicians. Despite the suggested potential benefit of using atificial intelligence (AI) chatbots like ChatGPT to enhance clinical decision making, further research is needed to refine AI recommendations for severe cases and to consider potential risks and ethical issues.
Collapse
Affiliation(s)
| | - Zohar Elyoseph
- Department of Psychology and Educational Counseling, Max Stern Academic College Of Emek Yezreel, Emek Yezreel, Israel
- Department of Brain Sciences, Imperial College London, London, UK
| |
Collapse
|
2
|
Bellón JA, Rodríguez-Morejón A, Conejo-Cerón S, Campos-Paíno H, Rodríguez-Bayón A, Ballesta-Rodríguez MI, Rodríguez-Sánchez E, Mendive JM, López del Hoyo Y, Luna JD, Tamayo-Morales O, Moreno-Peral P. A personalized intervention to prevent depression in primary care based on risk predictive algorithms and decision support systems: protocol of the e-predictD study. Front Psychiatry 2023; 14:1163800. [PMID: 37333911 PMCID: PMC10275079 DOI: 10.3389/fpsyt.2023.1163800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 05/02/2023] [Indexed: 06/20/2023] Open
Abstract
The predictD is an intervention implemented by general practitioners (GPs) to prevent depression, which reduced the incidence of depression-anxiety and was cost-effective. The e-predictD study aims to design, develop, and evaluate an evolved predictD intervention to prevent the onset of major depression in primary care based on Information and Communication Technologies, predictive risk algorithms, decision support systems (DSSs), and personalized prevention plans (PPPs). A multicenter cluster randomized trial with GPs randomly assigned to the e-predictD intervention + care-as-usual (CAU) group or the active-control + CAU group and 1-year follow-up is being conducted. The required sample size is 720 non-depressed patients (aged 18-55 years), with moderate-to-high depression risk, under the care of 72 GPs in six Spanish cities. The GPs assigned to the e-predictD-intervention group receive brief training, and those assigned to the control group do not. Recruited patients of the GPs allocated to the e-predictD group download the e-predictD app, which incorporates validated risk algorithms to predict depression, monitoring systems, and DSSs. Integrating all inputs, the DSS automatically proposes to the patients a PPP for depression based on eight intervention modules: physical exercise, social relationships, improving sleep, problem-solving, communication skills, decision-making, assertiveness, and working with thoughts. This PPP is discussed in a 15-min semi-structured GP-patient interview. Patients then choose one or more of the intervention modules proposed by the DSS to be self-implemented over the next 3 months. This process will be reformulated at 3, 6, and 9 months but without the GP-patient interview. Recruited patients of the GPs allocated to the control-group+CAU download another version of the e-predictD app, but the only intervention that they receive via the app is weekly brief psychoeducational messages (active-control group). The primary outcome is the cumulative incidence of major depression measured by the Composite International Diagnostic Interview at 6 and 12 months. Other outcomes include depressive symptoms (PHQ-9) and anxiety symptoms (GAD-7), depression risk (predictD risk algorithm), mental and physical quality of life (SF-12), and acceptability and satisfaction ('e-Health Impact' questionnaire) with the intervention. Patients are evaluated at baseline and 3, 6, 9, and 12 months. An economic evaluation will also be performed (cost-effectiveness and cost-utility analysis) from two perspectives, societal and health systems. Trial registration ClinicalTrials.gov, identifier: NCT03990792.
Collapse
Affiliation(s)
- Juan A. Bellón
- Biomedical Research Institute of Malaga (IBIMA Plataforma Bionand), Málaga, Spain
- Prevention and Health Promotion Research Network (redIAPP), ISCIII, Madrid, Spain
- Network for Research on Chronicity, Primary Care, and Prevention and Health Promotion (RICAPPS), ISCIII, Madrid, Spain
- ‘El Palo' Health Centre, Servicio Andaluz de Salud (SAS), Málaga, Spain
- Department of Public Health and Psychiatry, University of Málaga (UMA), Málaga, Spain
| | - Alberto Rodríguez-Morejón
- Biomedical Research Institute of Malaga (IBIMA Plataforma Bionand), Málaga, Spain
- Prevention and Health Promotion Research Network (redIAPP), ISCIII, Madrid, Spain
- Network for Research on Chronicity, Primary Care, and Prevention and Health Promotion (RICAPPS), ISCIII, Madrid, Spain
- Department of Personality, Evaluation and Psychological Treatment, University of Málaga (UMA), Málaga, Spain
| | - Sonia Conejo-Cerón
- Biomedical Research Institute of Malaga (IBIMA Plataforma Bionand), Málaga, Spain
- Prevention and Health Promotion Research Network (redIAPP), ISCIII, Madrid, Spain
- Network for Research on Chronicity, Primary Care, and Prevention and Health Promotion (RICAPPS), ISCIII, Madrid, Spain
| | - Henar Campos-Paíno
- Biomedical Research Institute of Malaga (IBIMA Plataforma Bionand), Málaga, Spain
- Prevention and Health Promotion Research Network (redIAPP), ISCIII, Madrid, Spain
- Network for Research on Chronicity, Primary Care, and Prevention and Health Promotion (RICAPPS), ISCIII, Madrid, Spain
| | - Antonina Rodríguez-Bayón
- Prevention and Health Promotion Research Network (redIAPP), ISCIII, Madrid, Spain
- Network for Research on Chronicity, Primary Care, and Prevention and Health Promotion (RICAPPS), ISCIII, Madrid, Spain
- Centro de Salud San José, Distrito Sanitario Jaén Norte, Servicio Andaluz de Salud (SAS), Linares, Jaén, Spain
| | - María I. Ballesta-Rodríguez
- Prevention and Health Promotion Research Network (redIAPP), ISCIII, Madrid, Spain
- Network for Research on Chronicity, Primary Care, and Prevention and Health Promotion (RICAPPS), ISCIII, Madrid, Spain
- Centro de Salud Federico del Castillo, Distrito Sanitario Jaén, Servicio Andaluz de Salud (SAS), Jaén, Spain
| | - Emiliano Rodríguez-Sánchez
- Prevention and Health Promotion Research Network (redIAPP), ISCIII, Madrid, Spain
- Network for Research on Chronicity, Primary Care, and Prevention and Health Promotion (RICAPPS), ISCIII, Madrid, Spain
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Department of Medicine, University of Salamanca (USAL), Salamanca, Spain
| | - Juan M. Mendive
- Prevention and Health Promotion Research Network (redIAPP), ISCIII, Madrid, Spain
- Network for Research on Chronicity, Primary Care, and Prevention and Health Promotion (RICAPPS), ISCIII, Madrid, Spain
- ‘La Mina' Health Centre, Institut Català de la Salut (ICS), Barcelona, Spain
| | - Yolanda López del Hoyo
- Prevention and Health Promotion Research Network (redIAPP), ISCIII, Madrid, Spain
- Network for Research on Chronicity, Primary Care, and Prevention and Health Promotion (RICAPPS), ISCIII, Madrid, Spain
- Instituto de Investigación Sanitaria de Aragón (IISA), Universidad de Zaragoza (UNIZAR), Zaragoza, Spain
| | - Juan D. Luna
- Prevention and Health Promotion Research Network (redIAPP), ISCIII, Madrid, Spain
- Network for Research on Chronicity, Primary Care, and Prevention and Health Promotion (RICAPPS), ISCIII, Madrid, Spain
- Department of Statistics and Operational Research, University of Granada (UGR), Granada, Spain
| | - Olaya Tamayo-Morales
- Prevention and Health Promotion Research Network (redIAPP), ISCIII, Madrid, Spain
- Network for Research on Chronicity, Primary Care, and Prevention and Health Promotion (RICAPPS), ISCIII, Madrid, Spain
- Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Patricia Moreno-Peral
- Biomedical Research Institute of Malaga (IBIMA Plataforma Bionand), Málaga, Spain
- Prevention and Health Promotion Research Network (redIAPP), ISCIII, Madrid, Spain
- Network for Research on Chronicity, Primary Care, and Prevention and Health Promotion (RICAPPS), ISCIII, Madrid, Spain
- Department of Personality, Evaluation and Psychological Treatment, University of Málaga (UMA), Málaga, Spain
| |
Collapse
|
3
|
Xie J, Liu M, Ding S, Zhong Z, Zeng S, Liu A, He S, Zhou J. Attitudes toward depression among rural primary healthcare providers in hunan areas, China: a cross sectional study. BMC MEDICAL EDUCATION 2023; 23:226. [PMID: 37038143 PMCID: PMC10088272 DOI: 10.1186/s12909-023-04197-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 03/24/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Mental health services are not sufficient for depression patients in rural areas of China, training in mental health knowledge for primary healthcare providers has been encouraged, but the effect of this encouragement has rarely been reported. METHODS A cross-sectional survey was conducted in primary healthcare facilities that sought to include all the primary healthcare providers (registered physicians and nurses) in two cities in Hunan province, China by administering questionnaires that covered depression symptoms, typical depression cases, and the Revised Depression Attitude Questionnaire. RESULTS In total, 315 primary healthcare providers agreed to participate in the study and finished the questionnaires, of which 12.1% had training in depression. In addition, 62.9% of the rural primary healthcare providers were able to recognize most general depression symptoms, and 8.3% were able to recognize all general depression symptoms. The primary healthcare providers in the survey held a neutral to slightly negative attitude towards depression as indicated by their professional confidence (mean scores 16.51 ± 4.30), therapeutic optimism/pessimism (mean scores 29.02 ± 5.98), and general perspective (mean scores 18.12 ± 3.12) scores. Fewer rural primary healthcare providers knew (28.3%) or applied (2.9%) psychological intervention in the clinic. CONCLUSIONS Our study indicated that primary healthcare providers knew about general depression symptoms, but lacked psychological intervention skills and held low confidence in and pessimistic attitudes toward depression care. We therefore speculate that existing psychological training for primary healthcare providers is insufficient in quantity and quality, making the need to explore more effective types of training urgently.
Collapse
Affiliation(s)
- Jianfei Xie
- Nursing Department, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan, 410013, China
- Xiangya Nursing School, Central South University, Changsha, China
| | - Min Liu
- Nursing Department, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan, 410013, China.
| | - Siqing Ding
- Nursing Department, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan, 410013, China
| | - Zhuqing Zhong
- Nursing Department, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan, 410013, China
- Xiangya Nursing School, Central South University, Changsha, China
| | - Sainan Zeng
- Nursing Department, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan, 410013, China
| | - Aizhong Liu
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Shiwen He
- Nursing Department, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan, 410013, China.
| | - Jianda Zhou
- Nursing Department, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan, 410013, China
| |
Collapse
|
4
|
Valdevilla Figueira JA, Mautong H, Camacho L G, Cherrez M, Orellana Román C, Alvarado-Villa GE, Sarfraz Z, Sarfraz A, Agolli A, Farfán Bajaña MJ, Vanegas E, Felix M, Michel J, Espinoza-Fuentes F, Maquilón JR, Cherrez Ojeda I. Attitudes toward depression among Ecuadorian physicians using the Spanish-validated version of the Revised Depression Attitude Questionnaire (R-DAQ). BMC Psychol 2023; 11:46. [PMID: 36793136 PMCID: PMC9930300 DOI: 10.1186/s40359-023-01072-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/31/2023] [Indexed: 02/17/2023] Open
Abstract
PURPOSE Depression is inadequately recognized and managed, and physicians' attitudes toward this condition and its treatment may play a part in this. This study aimed to assess Ecuadorian physicians' attitudes toward depression. METHODS This was a cross-sectional study conducted using the validated Revised Depression Attitude Questionnaire (R-DAQ). The questionnaire was delivered to Ecuadorian physicians, and the response rate was 88.8%. RESULTS 76.4% of participants had never received previous training in depression, and 52.1% of them indicated neutral or limited professional confidence when dealing with depressed patients. More than two-thirds of the participants reported an optimistic attitude toward the generalist perspective of depression. CONCLUSION Overall, physicians in Ecuador's healthcare settings were optimistic and held positive attitudes toward patients with depression. However, a lack of confidence in the management of depression and a need for ongoing training were found, especially among medical professionals who are not in daily contact with patients with depression.
Collapse
Affiliation(s)
- José Alejandro Valdevilla Figueira
- Instituto de Neurociencias, Guayaquil, Ecuador ,Departamento de Psicología. Facultad de Marketing, Universidad Ecotec, Guayaquil, Ecuador
| | - Hans Mautong
- Respiralab Research Group, Guayaquil, Ecuador ,grid.442156.00000 0000 9557 7590Universidad Espíritu Santo, Km. 2.5 vía La Puntilla, 0901-952 Samborondón, Ecuador
| | - Genesis Camacho L
- grid.411267.70000 0001 2168 1114Universidad del Zulia, Maracaibo, Venezuela
| | | | | | | | - Zouina Sarfraz
- grid.414774.50000 0000 9694 4612Research and Publications, Fatima Jinnah Medical University, Lahore, Pakistan
| | - Azza Sarfraz
- grid.7147.50000 0001 0633 6224Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Arjola Agolli
- Division of Clinical and Translational Research, Larkin Healthcare System, Miami, USA
| | - María José Farfán Bajaña
- Respiralab Research Group, Guayaquil, Ecuador ,grid.442156.00000 0000 9557 7590Universidad Espíritu Santo, Km. 2.5 vía La Puntilla, 0901-952 Samborondón, Ecuador
| | - Emanuel Vanegas
- Respiralab Research Group, Guayaquil, Ecuador ,grid.442156.00000 0000 9557 7590Universidad Espíritu Santo, Km. 2.5 vía La Puntilla, 0901-952 Samborondón, Ecuador ,grid.422616.50000 0004 0443 7226New York City Health + Hospitals, Woodhull, Brooklyn, NY USA
| | - Miguel Felix
- Respiralab Research Group, Guayaquil, Ecuador ,grid.442156.00000 0000 9557 7590Universidad Espíritu Santo, Km. 2.5 vía La Puntilla, 0901-952 Samborondón, Ecuador ,grid.422616.50000 0004 0443 7226New York City Health + Hospitals, Lincoln, Bronx, NY USA
| | - Jack Michel
- Division of Clinical and Translational Research, Larkin Healthcare System, Miami, USA
| | - Fernando Espinoza-Fuentes
- grid.442156.00000 0000 9557 7590Universidad Espíritu Santo, Km. 2.5 vía La Puntilla, 0901-952 Samborondón, Ecuador
| | | | - Ivan Cherrez Ojeda
- Respiralab Research Group, Guayaquil, Ecuador. .,Universidad Espíritu Santo, Km. 2.5 vía La Puntilla, 0901-952, Samborondón, Ecuador.
| |
Collapse
|
5
|
Barba KA, Gautam R, Knotts P. Late Life Depression Education: Impact on Acute Care Nurses' Knowledge, Attitude, and Screening Practices. J Gerontol Nurs 2022; 48:43-51. [DOI: 10.3928/00989134-20221108-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
6
|
Sayed AA, Lim JNW, McFarlane K. Physicians’ Awareness of Depression Among Their Patients in Saudi Arabia. Cureus 2022; 14:e28742. [PMID: 36105904 PMCID: PMC9447935 DOI: 10.7759/cureus.28742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2022] [Indexed: 11/30/2022] Open
Abstract
Background Depression is a global public health burden, and although it is multifactorial, its development is highly associated with chronic diseases. Thus, physicians’ knowledge and attitude toward depression are vital for the recognition and treatment of depression among patients with chronic illnesses. This study aims to examine physicians’ knowledge and attitude toward depression in Saudi Arabia and to determine factors that significantly influence them. Methodology An online survey using a 12-item questionnaire was completed by 50 physicians between January and June 2020. Knowledge (K) and attitude (A) scores were calculated and compared nonparametrically based on scores by gender and years of experience. Results Participants’ years of clinical experience was found to significantly influence the participants’ K scores, with those with fewer than one year of experience having the highest K scores of all participants (p < 0.05). Years of experience had a similar influence on the A scores. Furthermore, gender was an influencing factor as male participants had higher A scores than female participants. Years of experience and gender influenced the A scores independently. Male physicians more commonly referred patients to a mental health specialist than female physicians, and had significantly higher A scores and more years of experience. There was a direct correlation between the K and A score, indicating that participants’ knowledge of depression positively influenced their attitude toward depression. Conclusions In this study, participants’ gender and years of experience have been identified to have a significant impact on their knowledge and attitude toward comorbid depression when treating patients with chronic illnesses. This identifies an important gap and offers preliminary insight into the readiness and practice of holistic care for patients, particularly for those treated by physicians of differing gender and experience levels. Findings further demonstrate that it is most beneficial to patients with chronic illnesses that physicians utilize a holistic approach and consider depression when developing their treatment plans. This would involve being able to detect and manage depression among their patients properly, as well as referring patients to mental health specialists when needed. Clinical guidelines should be updated to emphasize the use of depression screening tools for patients with chronic diseases.
Collapse
|
7
|
Camacho-Leon G, Faytong-Haro M, Carrera K, De la Hoz I, Araujo-Contreras R, Roa K, Mautong H, Cardozo J, Briceño M, Cherrez-Ojeda I. Attitudes towards depression of Argentinian, Chilean, and Venezuelan healthcare professionals using the Spanish validated version of the revised depression attitude questionnaire (SR-DAQ). SSM Popul Health 2022; 19:101180. [PMID: 35968042 PMCID: PMC9365952 DOI: 10.1016/j.ssmph.2022.101180] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/26/2022] [Accepted: 07/19/2022] [Indexed: 11/25/2022] Open
Abstract
Background The beliefs and attitudes of physicians toward depression may predict whether they are supportive or avoidant of patients diagnosed with this condition. Describing the attitudes toward depression of Argentinian, Chilean, and Venezuelan healthcare professionals could be a valuable tool for understanding the Latin American perspective on depression recognition, management, and prevention. Materials and methods A cross-sectional study was conducted among healthcare professionals in Argentina, Chile, and Venezuela using the Spanish validated version of the revised depression attitude questionnaire (R-DAQ). The questionnaire was collected online from August to November 2021, in a quota-based sample of 1759 health professionals (the final analytical sample is 1234). Descriptive data analyses were performed using STATA version 16 statistical software. Results Depression was considered a disease that anyone could suffer by 90% of the respondents. However, 70% of professionals answered that they feel more comfortable dealing with physical illness than mental illness. Furthermore, the findings show that a quarter of the participants in the study believed that either medical treatment (28.6%) or psychosocial approach (<20%) were ineffective tools for people suffering from depression. Findings also show that depression is seen as a more natural part of life by Argentinian professionals and men. Finally, psychologists and psychiatrists are most likely to treat depression as any other physical disease. Medical providers who routinely perform surgeries are not as likely to know how to treat depression or consider it an actual disease. Conclusions Healthcare professionals in Argentina, Chile, and Venezuela have varying attitudes toward depression. While they recognize depression as a disease on the same level as other physical diseases, most do not know how to treat it. The findings point to the need for these countries to promote the training of healthcare workers in areas such as depression diagnosis, treatment, and social interventions.
Collapse
Affiliation(s)
- Genesis Camacho-Leon
- División de Estudios para Graduados, Facultad de Medicina, Universidad del Zulia. Maracaibo, 4001, Venezuela
- Division of Clinical and Translational Research, Larkin Community Hospital, South Miami, FL, USA
| | - Marco Faytong-Haro
- Ecuadorian Development Research Lab, Daule, 090656, Ecuador
- Sociology and Demography Department, The Pennsylvania State University, University Park, PA, USA
| | | | - Ivonne De la Hoz
- División de Estudios para Graduados, Facultad de Medicina, Universidad del Zulia. Maracaibo, 4001, Venezuela
| | | | - Karelis Roa
- Médicos Unidos Por Venezuela, Caracas, 1080, Venezuela
| | - Hans Mautong
- Universidad de Especialidades Espíritu Santo, Samborondón, 0901952, Ecuador
- Respiralab Research Group, Guayaquil, 090501, Ecuador
| | | | | | - Ivan Cherrez-Ojeda
- Universidad de Especialidades Espíritu Santo, Samborondón, 0901952, Ecuador
- Respiralab Research Group, Guayaquil, 090501, Ecuador
| |
Collapse
|
8
|
Salazar LJ, Ekstrand ML, Selvam S, Heylen E, Pradeep JR, Srinivasan K. The effect of mental health training on the knowledge of common mental disorders among medical officers in primary health centres in rural Karnataka. J Family Med Prim Care 2022; 11:994-999. [PMID: 35495844 PMCID: PMC9051705 DOI: 10.4103/jfmpc.jfmpc_1353_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/07/2021] [Accepted: 10/16/2021] [Indexed: 11/06/2022] Open
Abstract
Background Deficits in knowledge regarding identification and treatment of common mental disorders (CMD) and stigmatizing attitudes towards CMDs exist among primary care physicians in India. Objectives We aimed to assess the gain in knowledge of CMDs among primary health centre (PHC) doctors, after they underwent training in the identification and treatment of CMDs, and to assess the relationship between the gain in knowledge and demographic variables. We also assessed attitudes towards depression among PHC doctors who underwent training. Methods We assessed knowledge of CMDs among 38 PHC doctors before and after training using a multiple-choice questionnaire (MCQ). The training session included didactic teaching and case-based discussions. Results The post-test mean score was significantly higher compared to the pre-test mean score (P < 0.0001), indicative of a significant mean gain in knowledge of CMDs among PHC doctors following training. Significant improvements were noted on the questions assessing identification of CMDs, knowledge of depressive symptoms and identification of panic attacks, post-training (all P < 0.05). Participants with lower pre-test scores had greater improvements in knowledge post-training. Around half of the PHC doctors endorsed negative attitudes towards depression. Conclusions We demonstrated the efficacy of a training programme for PHC doctors in improving their knowledge of CMDs. Stigmatizing attitudes towards depression were present among around half the PHC doctors even after the training. This has implications for the strategy of integrating mental healthcare into primary care, with the overall goal of reducing the treatment gap for CMDs.
Collapse
Affiliation(s)
| | - Maria L. Ekstrand
- Division of Prevention Sciences, Department of Medicine, University of California, San Francisco, USA
- Division of Mental Health and Neurosciences, St. John’s Research Institute, Bengaluru, India
| | - Sumithra Selvam
- Division of Epidemiology and Biostatistics, St. John’s Research Institute, Bengaluru, India
| | - Elsa Heylen
- Division of Prevention Sciences, Department of Medicine, University of California, San Francisco, USA
| | - Johnson R Pradeep
- Department of Psychiatry, St. John’s Medical College, Bengaluru, India
| | - Krishnamachari Srinivasan
- Department of Psychiatry, St. John’s Medical College, Bengaluru, India
- Division of Mental Health and Neurosciences, St. John’s Research Institute, Bengaluru, India
| |
Collapse
|
9
|
Treatment Preferences for Pharmacological versus Psychological Interventions among Primary Care Providers in Nepal: Mixed Methods Analysis of a Pilot Cluster Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042149. [PMID: 35206331 PMCID: PMC8871897 DOI: 10.3390/ijerph19042149] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 02/03/2022] [Accepted: 02/10/2022] [Indexed: 02/04/2023]
Abstract
There is increasing evidence supporting the effectiveness of psychological interventions in low- and middle-income countries. However, primary care providers (PCPs) may prefer treating patients with medication. A secondary exploratory analysis of a pilot cluster randomized controlled trial was conducted to evaluate psychological vs. pharmacological treatment preferences among PCPs. Thirty-four health facilities, including 205 PCPs, participated in the study, with PCPs in 17 facilities assigned to a standard version of the mental health Gap Action Programme (mhGAP) training delivered by mental health specialists. PCPs in the other 17 facilities received mhGAP instruction delivered by specialists and people with lived experience of mental illness (PWLE), using a training strategy entitled Reducing Stigma among HealthcAre ProvidErs (RESHAPE). Pre- and post- intervention attitudes were measured through quantitative and qualitative tools. Qualitative interviews with 49 participants revealed that PCPs in both arms endorsed counseling’s benefits and collaboration within the health system to provide counseling. In the RESHAPE arm, PCPs were more likely to increase endorsement of statements such as “depression improves without medication” (F = 9.83, p < 0.001), “not all people with depression must be treated with antidepressants” (χ2 = 17.62, p < 0.001), and “providing counseling to people who have alcohol abuse problems is effective” (χ2 = 26.20, p < 0.001). These mixed-method secondary findings from a pilot trial suggest that in-person participation of PWLE in training PCPs may not only reduce stigma but also increase PCPs’ support of psychological interventions. This requires further investigation in a full-scale trial.
Collapse
|
10
|
Gureje O, Oladeji B, Ayinde OO, Kola L, Abdulmalik J, Abass WAL, Faregh N, Zelkowitz P. Scaling up care for perinatal depression for improved maternal and infant health (SPECTRA): protocol of a hybrid implementation study of the impact of a cascade training of primary maternal care providers in Nigeria. Int J Ment Health Syst 2021; 15:73. [PMID: 34544456 PMCID: PMC8450310 DOI: 10.1186/s13033-021-00496-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 08/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The large treatment gap for mental disorders in low- and middle-income countries (LMIC) necessitates task-sharing approaches in scaling up care for mental disorders. Previous work have shown that primary health care workers (PHCW) can be trained to recognize and respond to common mental disorders but there are lingering questions around sustainable implementation and scale-up in real world settings. METHOD This project is a hybrid implementation-effectiveness study guided by the Replicating Effective Programmes Framework. It will be conducted in four overlapping phases in maternal care clinics (MCC) in 11 local government areas in and around Ibadan metropolis, Nigeria. In Phase I, engagement meetings with relevant stake holders will be held. In phase II, the organizational and clinical profiles of MCC to deliver chronic depression care will be assessed, using interviews and a standardized assessment tool administered to staff and managers of the clinics. To ascertain the current level of care, 167 consecutive women presenting for antenatal care for the first time and who screened positive for depression will be recruited and followed up till 12 months post-partum. In phase III, we will design and implement a cascade training programme for PHCW, to equip them to identify and treat perinatal depression. In phase IV, a second cohort of 334 antenatal women will be recruited and followed up as in Phase I, to ascertain post-training level of care. The primary implementation outcome is change in the identification and treatment of perinatal depression by the PHCW while the primary effectiveness outcome is recovery from depression among the women at 6 months post-partum. A range of mixed-method approaches will be used to explore secondary implementation outcomes, including fidelity and acceptability. Secondary effectiveness outcomes are measures of disability and of infant outcomes. DISCUSSION This study represents an attempt to systematically assess and document an implementation strategy that could inform the scaling up of evidence based interventions for perinatal depression using the WHO mhGAP-IG in LMIC. Trial registration This study was registered on 03 December, 2019. https://doi.org/10.1186/ISRCTN94230307 .
Collapse
Affiliation(s)
- Oye Gureje
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria.
| | | | | | - Lola Kola
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | | | | | - Neda Faregh
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Phyllis Zelkowitz
- Division of Social and Transcultural Psychiatry, McGill University, Montreal, Canada.,Department of Psychiatry, Jewish General Hospital, Montreal, Canada
| |
Collapse
|
11
|
Taylor Salisbury T, Kohrt BA, Bakolis I, Jordans MJ, Hull L, Luitel NP, McCrone P, Sevdalis N, Pokhrel P, Carswell K, Ojagbemi A, Green EP, Chowdhary N, Kola L, Lempp H, Dua T, Milenova M, Gureje O, Thornicroft G. Adaptation of the World Health Organization Electronic Mental Health Gap Action Programme Intervention Guide App for Mobile Devices in Nepal and Nigeria: Protocol for a Feasibility Cluster Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e24115. [PMID: 34128819 PMCID: PMC8277329 DOI: 10.2196/24115] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/21/2021] [Accepted: 03/04/2021] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND There is a growing global need for scalable approaches to training and supervising primary care workers (PCWs) to deliver mental health services. Over the past decade, the World Health Organization Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) and associated training and implementation guidance have been disseminated to more than 100 countries. On the basis of the opportunities provided by mobile technology, an updated electronic Mental Health Gap Action Programme Intervention Guide (e-mhGAP-IG) is now being developed along with a clinical dashboard and guidance for the use of mobile technology in supervision. OBJECTIVE This study aims to assess the feasibility, acceptability, adoption, and other implementation parameters of the e-mhGAP-IG for diagnosis and management of depression in 2 lower-middle-income countries (Nepal and Nigeria) and to conduct a feasibility cluster randomized controlled trial (cRCT) to evaluate trial procedures for a subsequent fully powered trial comparing the clinical effectiveness and cost-effectiveness of the e-mhGAP-IG and remote supervision with standard mhGAP-IG implementation. METHODS A feasibility cRCT will be conducted in Nepal and Nigeria to evaluate the feasibility of the e-mhGAP-IG for use in depression diagnosis and treatment. In each country, an estimated 20 primary health clinics (PHCs) in Nepal and 6 PHCs in Nigeria will be randomized to have their staff trained in e-mhGAP-IG or the paper version of mhGAP-IG v2.0. The PHC will be the unit of clustering. All PCWs within a facility will receive the same training (e-mhGAP-IG vs paper mhGAP-IG). Approximately 2-5 PCWs, depending on staffing, will be recruited per clinic (estimated 20 health workers per arm in Nepal and 15 per arm in Nigeria). The primary outcomes of interest will be the feasibility and acceptability of training, supervision, and care delivery using the e-mhGAP-IG. Secondary implementation outcomes include the adoption of the e-mhGAP-IG and feasibility of trial procedures. The secondary intervention outcome-and the primary outcome for a subsequent fully powered trial-will be the accurate identification of depression by PCWs. Detection rates before and after training will be compared in each arm. RESULTS To date, qualitative formative work has been conducted at both sites to prepare for the pilot feasibility cRCT, and the e-mhGAP-IG and remote supervision guidelines have been developed. CONCLUSIONS The incorporation of mobile digital technology has the potential to improve the scalability of mental health services in primary care and enhance the quality and accuracy of care. TRIAL REGISTRATION ClinicalTrials.gov NCT04522453; https://clinicaltrials.gov/ct2/show/NCT04522453. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/24115.
Collapse
Affiliation(s)
- Tatiana Taylor Salisbury
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, United Kingdom
| | - Brandon A Kohrt
- Division of Global Mental Health, Department of Psychiatry and Behavioral Sciences, The George Washington University, Washington, DC, United States
| | - Ioannis Bakolis
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, United Kingdom
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Mark Jd Jordans
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, United Kingdom
| | - Louise Hull
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, United Kingdom
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Nagendra P Luitel
- Research Department, Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal
| | - Paul McCrone
- Institute for Lifecourse Development, University of Greenwich, London, United Kingdom
| | - Nick Sevdalis
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, United Kingdom
| | - Pooja Pokhrel
- Research Department, Transcultural Psychosocial Organization (TPO) Nepal, Kathmandu, Nepal
| | - Kenneth Carswell
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Akin Ojagbemi
- World Health Organization Collaborating Centre for Research and Training in Mental Health, Neuroscience and Substance Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Eric P Green
- Duke Global Health Institute, Duke University, Durham, NC, United States
| | - Neerja Chowdhary
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Lola Kola
- World Health Organization Collaborating Centre for Research and Training in Mental Health, Neuroscience and Substance Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Heidi Lempp
- Centre for Rheumatic Diseases, Department of Inflammation Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
| | - Tarun Dua
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Maria Milenova
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, United Kingdom
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, United Kingdom
| | - Oye Gureje
- World Health Organization Collaborating Centre for Research and Training in Mental Health, Neuroscience and Substance Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Graham Thornicroft
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, United Kingdom
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, United Kingdom
| |
Collapse
|
12
|
Muyambi K, Gillam M, Dennis S, Gray R, Martinez L, Jones M. Effect of depression awareness and management training on the attitudes of rural primary health care workers. Aust J Rural Health 2021; 29:449-454. [PMID: 34110058 DOI: 10.1111/ajr.12685] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 06/24/2020] [Accepted: 10/18/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To measure the effect of depression awareness and management training on the attitudes of rural primary health care workers. DESIGN A repeated measures design in which participants acted as their own controls. SETTING The training program occurred in 6 locations across rural South Australia. PARTICIPANTS The study enrolled primary care workers in general practitioner surgeries, Aboriginal Community Controlled Health Organisations, community health centres, public hospitals, regional health services and non-government organisations. INTERVENTION A six-session training workshop that was informed by the National Institute for Health and Care Excellence guidelines for the treatment and care of people with depression. MAIN OUTCOME MEASURE The 22-item Revised Depression Attitude Questionnaire comprised the main outcome measure. Participants were assessed 12 weeks before the training, again on the day of commencement of the training and after the training. RESULTS Seventy-two primary health workers completed the training program in depression awareness, building therapeutic relationships, working with ambivalence, and goal setting. Between the 2 pre-training assessments mean scores showed no significant difference. There were statistically significant improvements on the overall attitudes and the subscales therapeutic optimism and professional confidence between pre-training and post-training. CONCLUSION Training rural primary health care workers in depression may improve their attitudes to working with people living with depression.
Collapse
Affiliation(s)
- Kuda Muyambi
- University of South Australia Department of Rural Health, Adelaide, SA, Australia
| | - Marianne Gillam
- University of South Australia Department of Rural Health, Adelaide, SA, Australia
| | - Shaun Dennis
- University of South Australia Department of Rural Health, Adelaide, SA, Australia.,Flinders and Upper North Local Health Network, Whyalla, SA, Australia
| | - Richard Gray
- University of South Australia Department of Rural Health, Adelaide, SA, Australia.,School of Nursing and Midwifery, La Trobe University, Melbourne, Vic., Australia
| | - Lee Martinez
- University of South Australia Department of Rural Health, Adelaide, SA, Australia
| | - Martin Jones
- University of South Australia Department of Rural Health, Adelaide, SA, Australia.,School of Nursing and Midwifery, La Trobe University, Melbourne, Vic., Australia
| |
Collapse
|
13
|
Codjoe L, Barber S, Ahuja S, Thornicroft G, Henderson C, Lempp H, N'Danga-Koroma J. Evidence for interventions to promote mental health and reduce stigma in Black faith communities: systematic review. Soc Psychiatry Psychiatr Epidemiol 2021; 56:895-911. [PMID: 33866378 PMCID: PMC8053235 DOI: 10.1007/s00127-021-02068-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 03/10/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE There are significant documented inequalities for the Black community in the UK in relation to mental health care. Research has also indicated that cultural difference exists in pathways into, and engagement with, mental health services. To reduce inequalities and improve engagement with mental health services, it is important that professionals utilise culturally appropriate community networks to increase mental health awareness and reduce stigma. This systematic review considers research in Black faith settings, with two linked aims to review the evidence for the effectiveness of (i) mental health interventions, and (ii) other health stigma interventions as the latter have been implemented in Black faith settings. The review identified 'active ingredients' of interventions for this population that can be applied in future work. The authors seek to draw from the mental health and wider health stigma literature to inform the design of the ON TRAC project, a collaborative partnership between King's College London, South London and Maudsley NHS Foundation Trust and Black faith community groups in Southwark and Lambeth, London, in this currently under-researched area. METHODS A systematic search of ten major medical and social sciences databases was conducted in 2019, for studies on mental health or other health stigma interventions in Black faith settings. PRISMA guidelines were followed and search terms and search strategy ensured all possible studies were identified for review. RESULTS The review identified sixteen studies for inclusion. Ten were quantitative studies, four qualitative studies and two systematic reviews. Active ingredients of interventions included utilisation of 'bottom up' development of approaches and mental health champions. Multiple factors were found to influence effective implementation. Co-production and partnership working are key to ensure that an acceptable and accessible intervention is agreed. CONCLUSION Evidence for the effectiveness of interventions focused on mental health awareness and stigma reduction in the Black faith community is limited due to the low quality of studies. This review sheds light on the lessons learnt and necessary key requirements for interventions that can guide future projects. STUDY REGISTRATION PROSPERO registration number: CRD42018110068.
Collapse
Affiliation(s)
- Louisa Codjoe
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, London, SE5 8AF, UK.
| | - Sarah Barber
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Shalini Ahuja
- Centre for Implementation Science and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Graham Thornicroft
- Centre for Implementation Science and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Claire Henderson
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Heidi Lempp
- Centre for Rheumatic Diseases, Department of Inflammation Biology, King's College London, Weston Education, 10, Cutcombe Rd, London, SE5 9RJ, UK
| | - Joelyn N'Danga-Koroma
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, London, SE5 8AF, UK
| |
Collapse
|
14
|
Masud N, Masuadi E, Moukaddem A, Omair A, Mohamud M, Al Dubayee M, Althubaiti A, Alnamshan MK, Bawazeer M, AlJasser MI. Development and Validation of Authorship Order Score (AOS) for Scientific Publication. HEALTH PROFESSIONS EDUCATION 2020. [DOI: 10.1016/j.hpe.2020.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
15
|
Senchyna A, Abbiati M, Chambe J, Haller DM, Maisonneuve H. General practitioners' perspectives on barriers to depression care: development and validation of a questionnaire. BMC FAMILY PRACTICE 2020; 21:156. [PMID: 32738899 PMCID: PMC7395981 DOI: 10.1186/s12875-020-01224-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/16/2020] [Indexed: 12/04/2022]
Abstract
BACKGROUND General practitioners (GPs) regularly feel challenged by the care of depressed patients and may encounter several barriers in providing best management. GPs' perspectives on barriers to depression care are a subject of growing interest but there is a lack of validated assessment tools. The aim of this study was to develop and validate a questionnaire assessing barriers to depression care (BDC-Q) encountered by GPs in France and the French-speaking part of Switzerland. METHODS The BDC-Q was constructed in five steps: Item development, content validation, pretesting, testing phase and test-retest reliability. The questionnaire items were generated through a literature search. An expert panel of GPs (n = 16) and psychiatrists (n = 3) validated the content and 20 GPs pretested the questionnaire to provide response process validity evidence. We then tested the questionnaire among 116 GPs and used principal component analysis and internal consistency testing (Cronbach's alpha) to structure it into consistent dimensions. Test-retest reliability using Pearson correlation coefficient was assessed with 30 GPs who completed the questionnaire twice after an interval of at least 2 weeks. RESULTS The 25 items BDC-Q was structured in five dimensions: (i) provision of care by the general practitioner, (ii) considering patients' attitudes towards depression, (iii) guidance for care, (iv) collaboration with mental health specialists and (v) access to mental health care. CONCLUSIONS The BDC-Q displays evidence of validity and reliability to meaningfully assess GPs' perspectives on barriers to depression care. It can be used both at a practice level within a quality improvement strategy, and at a broader level, to inform health planners and tailor appropriate strategies to improve depression care in the community.
Collapse
Affiliation(s)
- Arun Senchyna
- Primary Care Unit, Faculty of Medicine, University of Geneva, CMU - 1 rue Michel Servet, CH1211, Geneva, Switzerland.
| | - Milena Abbiati
- Unit of Development and Research in Medical Education (UDREM), University of Geneva, Geneva, Switzerland
| | - Juliette Chambe
- General medicine department, Faculty of Medicine, University of Strasbourg, Strasbourg, France
| | - Dagmar M Haller
- Primary Care Unit, Faculty of Medicine, University of Geneva, CMU - 1 rue Michel Servet, CH1211, Geneva, Switzerland
| | - Hubert Maisonneuve
- Primary Care Unit, Faculty of Medicine, University of Geneva, CMU - 1 rue Michel Servet, CH1211, Geneva, Switzerland
| |
Collapse
|
16
|
Ni CH, Guo SL, Chao CY, Wang CH, Susanty S, Chuang YH. Nurses' Late-Life Depression Knowledge and Attitudes Toward Depression: A Cross-Sectional Study. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2020; 57:46958020945179. [PMID: 32723125 PMCID: PMC7391434 DOI: 10.1177/0046958020945179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Depression in older population is more common now. Due to increasing numbers of older patients in hospitals, nurses have more opportunities to care for these patients. Therefore, nurses should have correct knowledge of late-life depression and more favorable attitudes about depression. The study aimed to understand hospital nurses' knowledge level of late-life depression and attitudes about depression. A cross-sectional research design was used. A convenience sample of 307 nurses from 3 hospitals in Taiwan was recruited. Nurses scored 55.15% in the Late-Life Depression Quiz. The average score of the Revised Depression Attitude Questionnaire was 71.76 (SD = 6.13). The study also found that hospital nurses had more favorable attitudes about depression when their late-life depression knowledge was higher; their interest level in providing care for older patients with depression was greater; they had ever taken care of older patients with depressive symptoms or depression; they had never received in-service training on depression in the past year; and they had ever attended lectures about depression in school. Hospital nurses' knowledge about late-life depression was limited, and they had neutral to slightly favorable attitudes about depression in Taiwan. It is suggested to carefully examine and evaluate in-service training related to depression for nurses in hospitals. In addition, developing appropriate interventions to increase hospital nurses' knowledge level of late-life depression and attitudes toward depression is recommended.
Collapse
Affiliation(s)
- Cheng-Hua Ni
- School of Nursing, College of Nursing, Taipei Medical University, Taiwan.,Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taiwan.,Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taiwan
| | - Shu-Liu Guo
- School of Nursing, College of Nursing, Taipei Medical University, Taiwan.,Department of Nursing, Center of Faculty Development, Department of Education, Taipei Medical University Hospital, Taiwan
| | - Chia-Yu Chao
- Nursing Department, Taipei Veterans General Hospital, Taiwan
| | - Chia-Hui Wang
- School of Nursing, College of Nursing, Taipei Medical University, Taiwan
| | - Sri Susanty
- School of Nursing, College of Nursing, Taipei Medical University, Taiwan.,Faculty of Medicine, Halu Oleo University, Indonesia
| | - Yeu-Hui Chuang
- School of Nursing, College of Nursing, Taipei Medical University, Taiwan.,Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taiwan
| |
Collapse
|
17
|
Shoji M, Fujiwara A, Onda M. Creation and validation of a semi-quantitative instrument to assess the confidence of pharmacists in medication consultation for patients with depression: The pharmacists' confidence scale about medication consultation for depressive patients (PCMCD). Pharm Pract (Granada) 2020; 17:1628. [PMID: 31897261 PMCID: PMC6935550 DOI: 10.18549/pharmpract.2019.4.1628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 10/20/2019] [Indexed: 11/14/2022] Open
Abstract
Objectives To develop a semi-quantitative instrument to assess pharmacists' confidence in medication counseling for patients with depression, The Pharmacists' Confidence scale about Medication Consultation for Depressive patients (PCMCD), and investigated its validity. Methods Following discussions with practicing pharmacists, we developed a 12-item questionnaire to assess pharmacists' confidence in medication counseling for patients with depression. We launched web-based cross-sectional survey during November and December 2018 to 77 pharmacists employed at drug chain stores in Kansai area. Factor analysis was performed to evaluate the configuration concept validity. The least-squares method was used for factor extraction, and the resulting factors were subjected to direct oblimin rotation, with a factor loading cut-off of 0.4. To assess internal consistency, Cronbach's alpha values were calculated for each of the extracted factors (subscales). A multiple regression analysis was performed using simultaneous forced entry, with the scores obtained for each subscale as dependent variables and responder attributes as independent variables in order to investigate the factors associated with each subscale. Results During the factor analysis procedure, four questions were excluded by the cut-off rule. Eventually, a model with three subscales was identified, with a cumulative sum of squared loadings being 61.9%. The subscales were termed "relationship building," "comprehension of condition," and "information provision" based on the nature of the questions relevant for each of them. The Cronbach's alpha values for these subscales were 0.92, 0.73, and 0.72, respectively. The average inter-item correlation was 0.378. In addition, multiple regression analysis revealed that there were significant correlations between pharmacist career and both relationship building and information provision. Conclusions The PCMCD model demonstrated a satisfactory construct validity and internal consistency. This model will provide an excellent tool for assessing pharmacists' confidence in depression care.
Collapse
Affiliation(s)
- Masaki Shoji
- PhD. Assistant Professor. Department of Social and Administrative Pharmacy, Osaka University of Pharmaceutical Sciences. Osaka (Japan).
| | - Atsuko Fujiwara
- BPharm. General manager of Division of Planning and management of pharmacists training. Apis Pharmacy. Osaka (Japan).
| | - Mitsuko Onda
- PhD. Professor. Department of Social and Administrative Pharmacy, Osaka University of Pharmaceutical Sciences. Osaka (Japan).
| |
Collapse
|
18
|
Empathy, Experience and Cultural Beliefs Determine the Attitudes Towards Depression Among Pakistani Medical Students. Community Ment Health J 2020; 56:65-74. [PMID: 31512078 DOI: 10.1007/s10597-019-00459-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 09/07/2019] [Indexed: 12/30/2022]
Abstract
The educated echelons of the Pakistani society as well as the medical fraternity have consistently reported poor knowledge of mental illnesses in past surveys. This poor knowledge further translates into poorer attitudes toward psychiatric patients in Pakistani hospitals. However, a paucity of data on predictors of attitude toward depression among Pakistani medical students, warrants further in depth investigations. This cross-sectional study was conducted in two medical colleges in the province of Punjab, Pakistan from January to July 2017. The data were collected conveniently, using a self-administered questionnaire comprising of five parts: (a) demographics, (b) a dichotomous (yes/no) scale exploring biological, psychosocial and religio-magical beliefs about causation of depression, (c) a dichotomous scale (yes/no) assessing knowledge regarding symptomatology of depression, (d) the revised depression attitude questionnaire, (e) Toronto empathy questionnaire. There were a total of 674 respondents. Students with an A-levels/high school diploma, urban background, and aspiration for a career in psychiatry, high empathy levels and endorsement of typical and atypical symptoms of psychiatry had more positive attitudes towards depression. Negative attitudes toward depression were associated with belief in religio-magical causes and false symptoms of depression. Attitude toward depression among Pakistani medical students are shaped by several modifiable and non-modifiable factors. Modifiable factors including exposure toward mentally ill patients and knowledge of depression can be mitigated by in-depth clerkship training in psychiatry.
Collapse
|
19
|
Lee C, Tseng H, Wu L, Chuang Y. Multiple brief training sessions to improve nurses’ knowledge, attitudes, and confidence regarding nursing care of older adults with depression in long‐term care facilities. Res Nurs Health 2019; 43:114-121. [DOI: 10.1002/nur.21997] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 11/13/2019] [Indexed: 01/28/2023]
Affiliation(s)
- Chia‐Chi Lee
- Foryu Postpartum Nursing Care CenterTaipei Taiwan
- School of Nursing, College of NursingTaipei Medical UniversityTaipei Taiwan
| | - Huei‐Chi Tseng
- Department of NursingTaipei Medical University‐Shuang Ho HospitalNew Taipei City Taiwan
| | - Lee‐Pin Wu
- Department of NursingWan Fang Hospital, Taipei Medical UniversityTaipei Taiwan
| | - Yeu‐Hui Chuang
- School of Nursing, College of NursingTaipei Medical UniversityTaipei Taiwan
- Center for Nursing and Healthcare Research in Clinical Practice ApplicationWan Fang Hospital, Taipei Medical UniversityTaipei Taiwan
| |
Collapse
|
20
|
Cherrez-Ojeda I, Haddad M, Vera Paz C, Valdevila Figueira JA, Fabelo Roche J, Orellana Román C, Iglesias Moré S, Felix M, Vanegas E, Alvarado-Villa GE. Spanish Validation Of The Revised Depression Attitude Questionnaire (R-DAQ). Psychol Res Behav Manag 2019; 12:1051-1058. [PMID: 32009821 PMCID: PMC6859125 DOI: 10.2147/prbm.s228249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 10/25/2019] [Indexed: 12/15/2022] Open
Abstract
Purpose The aim of the study was to develop and validate a Spanish version of the Revised Depression Attitude Questionnaire (R-DAQ). Methods The R-DAQ was used as a baseline for the study. It was translated and tested to ensure the instrument was appropriate for the target population. 537 Ecuadorian healthcare professionals completed the revised Spanish version of the R-DAQ (SR-DAQ). Statistical and exploratory factor analyses were performed to examine construct validity, internal consistency, readability and floor and ceiling effects. Results Three factors were obtained: “Professional confidence in depression care”; “Therapeutic optimism about depression”; and “Generalist perspective about depression occurrence, recognition, and management”. The internal consistency of the SR-DAQ was determined by means of Cronbach’s α coefficient, with values ranging between 0.61–0.8. The correlations with the English version reflected adequate validity. The model explained 39% of the variance. Subsequent analysis with a sample restricted to those who had received training in depression produced a model that explained 42% of the variance. Conclusion The SR-DAQ meets the psychometric requirements for measuring depression attitude in a Spanish-speaking population and shows adequate internal consistency and validity.
Collapse
Affiliation(s)
- Ivan Cherrez-Ojeda
- Universidad Espíritu Santo, Samborondón, Ecuador.,Respiralab Research Group, Guayaquil, Ecuador
| | - Mark Haddad
- Centre for Mental Health Research, School of Health Sciences, City University London, London, UK
| | - Carlos Vera Paz
- Universidad Espíritu Santo, Samborondón, Ecuador.,Respiralab Research Group, Guayaquil, Ecuador
| | | | | | | | | | - Miguel Felix
- Universidad Espíritu Santo, Samborondón, Ecuador.,Respiralab Research Group, Guayaquil, Ecuador
| | - Emanuel Vanegas
- Universidad Espíritu Santo, Samborondón, Ecuador.,Respiralab Research Group, Guayaquil, Ecuador
| | | |
Collapse
|
21
|
Yan S, Wuan EKM, Peh ALH, Tay ATS, Ho SCW, Saffari SE, Teo DCL. Impact of Experience-Based, Longitudinal Psychiatry Training on Family Medicine Residents' Attitudes Toward Depression and Psychiatry in Singapore: a Prospective Study. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2019; 43:6-12. [PMID: 30443864 DOI: 10.1007/s40596-018-1006-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 11/06/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES The primary aim of this study was to evaluate the impact of an experience-based, longitudinal psychiatry training program in a Family Medicine residency on residents' attitudes toward depression and psychiatry. The secondary aim was to identify background predictor variables of changes in attitudes. METHODS Pre- and post-training surveys were prospectively conducted on attitudes toward depression and psychiatry on Family Medicine residents undergoing an experience-based, longitudinal psychiatry training program. The primary outcome measures were pre- and post-training Depression Attitude Questionnaire (DAQ) and Modified Attitudes to Psychiatry Scale (mAPS) scores. Regression analysis was carried out to determine background variables predictive of improvement in DAQ and/or mAPS scores post-training. RESULTS Sixty-three Family Medicine residents (100% response rate) responded to the pre-training surveys. All 63 subjects completed the post-training surveys (100% retention rate). There was significant improvement in DAQ and mAPS scores post-training, indicating better attitudes toward depression and psychiatry. Significant improvement was observed in 8 out of 13 DAQ items and 3 out of 4 mAPS domains. Regression models showed having a previous 3-month elective psychiatry inpatient posting was a predictor of less improvement in mAPS scores. CONCLUSIONS Our experience-based, longitudinal psychiatry training program significantly improved Family Medicine residents' attitudes toward depression and psychiatry. Experiential and situated learning in communities of practice, as well as educational continuity with longitudinal supervision, coaching, and modeling may have contributed to this improvement.
Collapse
Affiliation(s)
- Shi Yan
- Duke-NUS Medical School, Singapore, Singapore
| | | | | | | | | | | | | |
Collapse
|
22
|
Aldahmashi T, Almanea A, Alsaad A, Mohamud M, Anjum I. Attitudes towards depression among non-psychiatric physicians in four tertiary centres in Riyadh. Health Psychol Open 2019; 6:2055102918820640. [PMID: 30729020 PMCID: PMC6350145 DOI: 10.1177/2055102918820640] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Depression is a common mental illness that has a profound impact on an estimated
number of 300 million people worldwide. Depression is stigmatised in communities
and even physicians, especially, non-psychiatric physicians, which affects
depressed patients’ care. This study aims to investigate non-psychiatric
physicians’ attitudes towards depression in Riyadh, Saudi Arabia. The study
surveyed 380 participants using Revised Depression Attitude Questionnaire.
Non-psychiatric physicians in Riyadh are optimistic and have a positive
perspective towards depression. Yet, the majority preferred dealing with
physical rather than mental illness. Understanding the attitudes of medical
practitioners is important to shape service delivery and assess training
needs.
Collapse
Affiliation(s)
- Thamir Aldahmashi
- King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia
| | | | - Abdulaziz Alsaad
- King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia
| | - Mohamud Mohamud
- King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia
| | - Irfan Anjum
- King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia
| |
Collapse
|
23
|
Chuang YH, Kuo LM. Nurses' confidence in providing and managing care for older persons with depressive symptoms or depression in long-term care facilities: A national survey. Int J Ment Health Nurs 2018; 27:1767-1775. [PMID: 29797638 DOI: 10.1111/inm.12483] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/29/2018] [Indexed: 02/04/2023]
Abstract
The prevalence of depressive symptoms among older residents in long-term care facilities (LTCFs) is high. Nurses are the main healthcare providers in LTCFs and also the persons responsible for detecting changes in residents' mental function and providing subsequent care. Therefore, it is necessary to understand nurses' knowledge, attitudes, and confidence regarding care for older residents with depressive symptoms or depression. This study aimed to understand nurses' level of knowledge of late-life depression, attitudes towards depression, and confidence levels in caring for older adults with depressive symptoms or depression in LTCFs. A cross-sectional descriptive and correlational research design was used. A nationwide self-report survey was conducted in 2016. Ultimately, 556 valid questionnaires were returned. The study found that LTCF nurses' knowledge about late-life depression was poor, and they also lacked confidence in managing and caring for older persons with depressive symptoms or depression, but nurses' attitudes towards depression were neutral or slightly positive. Moreover, nurses who had greater confidence in providing care for older persons with depression were those with more positive attitudes towards depression, a greater interest level in taking care of older adults with depression, less late-life depression knowledge, longer nursing experience in LTCFs, and a greater interest level in late-life depression issues, and who had read late-life depression pamphlets or taken courses or classes in late-life depression. The findings suggest an urgent need to develop strategies to improve nurses' late-life depression knowledge and increase their confidence in providing care to older residents with depressive symptoms or depression.
Collapse
Affiliation(s)
- Yeu-Hui Chuang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Li-Min Kuo
- Department of Gerontological Health Care, College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| |
Collapse
|
24
|
Wei Y, McGrath P, Hayden J, Kutcher S. The quality of mental health literacy measurement tools evaluating the stigma of mental illness: a systematic review. Epidemiol Psychiatr Sci 2018; 27:433-462. [PMID: 28462747 PMCID: PMC6999021 DOI: 10.1017/s2045796017000178] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 03/26/2017] [Indexed: 01/08/2023] Open
Abstract
AIMS Stigma of mental illness is a significant barrier to receiving mental health care. However, measurement tools evaluating stigma of mental illness have not been systematically assessed for their quality. We conducted a systematic review to critically appraise the methodological quality of studies assessing psychometrics of stigma measurement tools and determined the level of evidence of overall quality of psychometric properties of included tools. METHODS We searched PubMed, PsycINFO, EMBASE, CINAHL, the Cochrane Library and ERIC databases for eligible studies. We conducted risk-of-bias analysis with the Consensus-based Standards for the Selection of Health Measurement Instruments checklist, rating studies as excellent, good, fair or poor. We further rated the level of evidence of the overall quality of psychometric properties, combining the study quality and quality of each psychometric property, as: strong, moderate, limited, conflicting or unknown. RESULTS We identified 117 studies evaluating psychometric properties of 101 tools. The quality of specific studies varied, with ratings of: excellent (n = 5); good (mostly on internal consistency (n = 67)); fair (mostly on structural validity, n = 89 and construct validity, n = 85); and poor (mostly on internal consistency, n = 36). The overall quality of psychometric properties also varied from: strong (mostly content validity, n = 3), moderate (mostly internal consistency, n = 55), limited (mostly structural validity, n = 55 and construct validity, n = 46), conflicting (mostly test-retest reliability, n = 9) and unknown (mostly internal consistency, n = 36). CONCLUSIONS We identified 12 tools demonstrating limited evidence or above for (+, ++, +++) all their properties, 69 tools reaching these levels of evidence for some of their properties, and 20 tools that did not meet the minimum level of evidence for all of their properties. We note that further research on stigma tool development is needed to ensure appropriate application.
Collapse
Affiliation(s)
- Y. Wei
- Faculty of Graduate Studies, Interdisciplinary PhD, Dalhousie University, Halifax, Nova Scotia, Canada
| | - P. McGrath
- IWK Health Centre, Halifax, Nova Scotia, Canada
| | - J. Hayden
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - S. Kutcher
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| |
Collapse
|
25
|
Wang YY, Zhang WW, Feng L, Gao D, Liu C, Zhong L, Ren JW, Wu YZ, Huang L, Fu LL, He YN. Development and Preliminary Validation of a Depression Assessment Tool for Maintenance Hemodialysis Patients. Ther Apher Dial 2018; 23:49-58. [PMID: 30239119 DOI: 10.1111/1744-9987.12749] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 06/11/2018] [Accepted: 07/19/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Yun-yan Wang
- Department of Nephrology, Daping Hospital; Third Military Medical University; Chongqing China
| | - Wei-wei Zhang
- Department of Nephrology, Daping Hospital; Third Military Medical University; Chongqing China
| | - Lei Feng
- Department of Nephrology, Daping Hospital; Third Military Medical University; Chongqing China
| | - Dong Gao
- Department of Sleep and Psychology, Institute of Surgery Research, Daping Hospital; Third Military Medical University; Chongqing China
| | - Chun Liu
- Department of Nephrology; The Third People's Hospital of Chongqing; Chongqing China
| | - Ling Zhong
- Department of Nephrology, The Second Affiliated Hospital; Chongqing Medical University; Chongqing China
| | - Jiang-wen Ren
- Department of Nephrology; The First People's Hospital of Jiulongpo District; Chongqing China
| | - Ya-zhou Wu
- Department of Statistics, Preventive Medicine; Third Military Medical University; Chongqing China
| | - Long Huang
- Department of Nephrology, Daping Hospital; Third Military Medical University; Chongqing China
| | - Li-li Fu
- Department of Nephrology, Daping Hospital; Third Military Medical University; Chongqing China
| | - Ya-ni He
- Department of Nephrology, Daping Hospital; Third Military Medical University; Chongqing China
| |
Collapse
|
26
|
Coppens E, Van Audenhove C, Gusmão R, Purebl G, Székely A, Maxwell M, Koburger N, Arensman E, Hegerl U. Effectiveness of General Practitioner training to improve suicide awareness and knowledge and skills towards depression. J Affect Disord 2018; 227:17-23. [PMID: 29049931 DOI: 10.1016/j.jad.2017.09.039] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 07/14/2017] [Accepted: 09/23/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND General Practitioners (GPs) are well placed as gatekeepers for managing depression and suicidal ideation but not always well prepared. Capacity building has therefore been recommended as a useful strategy for suicide prevention. This study aimed to examine whether GPs' knowledge and attitudes towards and confidence to deal with depression and suicide improve after following a training program. METHODS As part of the OSPI-Europe multilevel intervention, a standardized training on depression and suicide was provided to 208 GPs in three European countries. Core outcomes were assessed using the Depression Attitude Questionnaire, the Attitude towards Suicide Prevention Scale, and the Morriss Confidence Scale. Data were collected before and after training, and at three to six months follow-up. RESULTS At baseline, GPs demonstrated various stigmatizing attitudes towards depression and low optimism about the therapeutic treatment of depression. They showed moderately positive attitudes towards suicide prevention but felt little confident in dealing with depression and suicide in daily practice. The training resulted in improved knowledge, attitudes and confidence regarding depression and suicide and their prevention and treatment. At follow-up, only the increase in confidence to deal with depression and suicide was sustained. LIMITATIONS The Depression Attitude Questionnaire has rather weak psychometric properties. Other external factors may have contributed to the observed training effects as the study included no control group. CONCLUSIONS The OSPI-Europe training program was able to improve the GPs' attitudes towards suicide prevention, several attitudes towards depression and its treatment as well as the GPs' confidence to deal with depression and suicide in everyday practice. At follow, only the GPs' confidence to deal with depression and suicide was preserved.
Collapse
Affiliation(s)
- Evelien Coppens
- LUCAS, Centre for Care Research and Consultancy, University of Leuven, Belgium
| | | | - Ricardo Gusmão
- CEDOC, Departamento de Saúde Mental, Faculdade de Ciências Médicas da Universidade NOVA de Lisboa, Portugal
| | - György Purebl
- Institute of Behavioural Sciences, Semmelweis University Budapest, Hungary
| | - András Székely
- Institute of Behavioural Sciences, Semmelweis University Budapest, Hungary
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professions Research Unit, Faculty of Health Sciences and Sport, University of Stirling, United Kingdom
| | - Nicole Koburger
- Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Ella Arensman
- National Suicide Research Foundation & Department of Epidemiology and Public Health, University College Cork, Ireland
| | - Ulrich Hegerl
- Depression Research Centre, German Depression Foundation, Leipzig, Germany; Department of Psychiatry and Psychotherapy, University of Leipzig, Germany
| |
Collapse
|
27
|
Desai ND, Chavda P, Shah SH, Shah N, Shah SN, Sharma E. A novel approach to suicide prevention - Educating when it matters. Ind Psychiatry J 2018; 27:115-123. [PMID: 30416302 PMCID: PMC6198601 DOI: 10.4103/ipj.ipj_10_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Looking at the burden of suicide, there is a dire need for medical schools to incorporate suicide prevention training. Effective communication helps in early detection and management of suicidal behavior. Medical students can act as a GATEKEEPER if they receive adequate training. METHODOLOGY This was an educational intervention study done at tertiary care teaching hospital to assess the knowledge and attitude of medical students toward depression and suicide and to impart and assess communication skills for suicide prevention in one of the four batches of students in 4th semester. Pretest was conducted to assess knowledge and attitude toward depression and suicide, followed by training using interactive lectures, demonstration of interview, and hands-on training with patients and role-plays. The posttest and objective structured clinical examination (OSCE) were administered for skill assessment. Feedback was taken regarding this intervention. RESULTS The mean marks of the pre- and post-test were 8.96 (8.3-9.6) and 14.58 (13.8-15.3), respectively, out of 25. The difference was statistically significant (t = 13.24, P ≤ 0.0001) which suggests improvement in knowledge. We found mixed responses in attitude statements showing limited change. Mean obtained marks on OSCE examination out of 66 was 42.7. Among various components of OSCE, students scored high on rapport building. The most useful components of trainings were role-play, OSCE, and interaction with patients as per their feedback. CONCLUSION The intervention was found effective in increasing knowledge, changing attitude, and enhancing communication skills of medical students toward suicide prevention. Training of communication skills for suicide prevention in depressed person should be given to every medical student as suggested by feedback.
Collapse
Affiliation(s)
- Nimisha D Desai
- Department of Psychiatry, Gujarat Medical Education and Research Society Medical College, Gotri, Vadodara, India
| | - Paragkumar Chavda
- Department of Community Medicine, Gujarat Medical Education and Research Society Medical College, Gotri, Vadodara, India
| | - Sandeep H Shah
- Department of Psychiatry, Gujarat Medical Education and Research Society Medical College, Gotri, Vadodara, India
| | - Nilima Shah
- Department of Psychiatry, Smt N H L Municipal Medical College, Ahmedabad, Gujarat, India
| | - Saurabh N Shah
- Department of Psychiatry, Gujarat Medical Education and Research Society Medical College, Gotri, Vadodara, India
| | - Elavatsala Sharma
- Department of Psychiatry, Gujarat Medical Education and Research Society Medical College, Gotri, Vadodara, India
| |
Collapse
|
28
|
Haddad M, Waqas A, Sukhera AB, Tarar AZ. The psychometric characteristics of the revised depression attitude questionnaire (R-DAQ) in Pakistani medical practitioners: a cross-sectional study of doctors in Lahore. BMC Res Notes 2017; 10:333. [PMID: 28750688 PMCID: PMC5530926 DOI: 10.1186/s13104-017-2652-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 07/21/2017] [Indexed: 11/10/2022] Open
Abstract
Background Depression is common mental health problem and leading contributor to the global burden of disease. The attitudes and beliefs of the public and of health professionals influence social acceptance and affect the esteem and help-seeking of people experiencing mental health problems. The attitudes of clinicians are particularly relevant to their role in accurately recognising and providing appropriate support and management of depression. This study examines the characteristics of the revised depression attitude questionnaire (R-DAQ) with doctors working in healthcare settings in Lahore, Pakistan. Methods A cross-sectional survey was conducted in 2015 using the revised depression attitude questionnaire (R-DAQ). A convenience sample of 700 medical practitioners based in six hospitals in Lahore was approached to participate in the survey. The R-DAQ structure was examined using Parallel Analysis from polychoric correlations. Unweighted least squares analysis (ULSA) was used for factor extraction. Model fit was estimated using goodness-of-fit indices and the root mean square of standardized residuals (RMSR), and internal consistency reliability for the overall scale and subscales was assessed using reliability estimates based on Mislevy and Bock (BILOG 3 Item analysis and test scoring with binary logistic models. Mooresville: Scientific Software, 55) and the McDonald’s Omega statistic. Findings using this approach were compared with principal axis factor analysis based on Pearson correlation matrix. Results 601 (86%) of the doctors approached consented to participate in the study. Exploratory factor analysis of R-DAQ scale responses demonstrated the same 3-factor structure as in the UK development study, though analyses indicated removal of 7 of the 22 items because of weak loading or poor model fit. The 3 factor solution accounted for 49.8% of the common variance. Scale reliability and internal consistency were adequate: total scale standardised alpha was 0.694; subscale reliability for professional confidence was 0.732, therapeutic optimism/pessimism was 0.638, and generalist perspective was 0.769. Conclusions The R-DAQ was developed with a predominantly UK-based sample of health professionals. This study indicates that this scale functions adequately and provides a valid measure of depression attitudes for medical practitioners in Pakistan, with the same factor structure as in the scale development sample. However, optimal scale function necessitated removal of several items, with a 15-item scale enabling the most parsimonious factor solution for this population.
Collapse
Affiliation(s)
- Mark Haddad
- Centre for Mental Health Research; School of Health Sciences, City University London, Northampton Square, London, EC1V 0HB, UK. .,East London NHS Foundation Trust, London, UK.
| | - Ahmed Waqas
- CMH Lahore Medical College and Institute of Dentistry, Lahore, Pakistan
| | | | - Asad Zaman Tarar
- CMH Lahore Medical College and Institute of Dentistry, Lahore, Pakistan
| |
Collapse
|
29
|
Abstract
Many African Americans (AAs) use clergy as their primary source of help for depression, with few being referred to mental health providers. This study used face-to-face workshops to train AA clergy to recognize the symptoms and levels of severity of depression. A pretest/posttest format was used to test knowledge (N = 42) about depression symptoms. Results showed that the participation improved the clergy's ability to recognize depression symptoms. Faith community nurses can develop workshops for clergy to improve recognition and treatment of depression.
Collapse
|
30
|
Haddad M, Waqas A, Qayyum W, Shams M, Malik S. The attitudes and beliefs of Pakistani medical practitioners about depression: a cross-sectional study in Lahore using the Revised Depression Attitude Questionnaire (R-DAQ). BMC Psychiatry 2016; 16:349. [PMID: 27756274 PMCID: PMC5070008 DOI: 10.1186/s12888-016-1069-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 10/12/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Mental disorders such as depression are common and rank as major contributors to the global burden of disease. Condition recognition and subsequent management of depression is variable and influenced by the attitudes and beliefs of clinicians as well as those of patients. Most studies examining health professionals' attitudes have been conducted in Western nations; this study explores beliefs and attitudes about depression among doctors working in Lahore, Pakistan. METHODS A cross-sectional survey conducted in 2015 used a questionnaire concerning demographics, education in psychiatry, beliefs about depression causes, and attitudes about depression using the Revised Depression Attitude Questionnaire (R-DAQ). A convenience sample of 700 non-psychiatrist medical practitioners based in six hospitals in Lahore was approached to participate in the survey. RESULTS Six hundred and one (86 %) of the doctors approached consented to participate; almost all respondents (99 %) endorsed one of various biopsychosocial causes of depression (38 to 79 % for particular causes), and 37 % (between 13 and 19 % for particular causes) noted that supernatural forces could be responsible. Supernatural causes were more commonly held by female doctors, those working in rural settings, and those with greater psychiatry specialist education. Attitudes to depression were mostly less confident or optimistic and less inclined to a generalist perspective than those of clinicians in the UK or European nations, and deterministic perspectives that depression is a natural part of aging or due to personal failings were particularly common. However, there was substantial confidence in the efficacy of antidepressants and psychological therapy. More confident and therapeutically optimistic views and a more generalist perspective about depression management were associated with a rejection of supernatural explanations of the origin of depression. CONCLUSIONS Non-psychiatrist medical practitioners in Pakistan hold a range of views about the causes of depression, with supernatural explanations held by more than a third. Depression attitudes appear less positive than among UK and European clinicians, with the notions that depression is due to a lack of stamina and will-power and a natural part of growing old being especially commonly held; more positive attitudes appear to be associated with a rejection of supernatural explanatory models of depression.
Collapse
Affiliation(s)
- Mark Haddad
- Centre for Mental Health Research, School of Health Sciences, City University London, Northampton Square, London, EC1V 0HB, UK. .,East London NHS Foundation Trust, London, UK.
| | - Ahmed Waqas
- CMH Lahore Medical College and Institute of Dentistry, Lahore, Pakistan
| | - Wahhaj Qayyum
- CMH Lahore Medical College and Institute of Dentistry, Lahore, Pakistan
| | - Maryam Shams
- CMH Lahore Medical College and Institute of Dentistry, Lahore, Pakistan
| | - Saad Malik
- CMH Lahore Medical College and Institute of Dentistry, Lahore, Pakistan
| |
Collapse
|
31
|
Wei Y, McGrath PJ, Hayden J, Kutcher S. Mental health literacy measures evaluating knowledge, attitudes and help-seeking: a scoping review. BMC Psychiatry 2015; 15:291. [PMID: 26576680 PMCID: PMC4650294 DOI: 10.1186/s12888-015-0681-9] [Citation(s) in RCA: 181] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Accepted: 11/09/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Mental health literacy has received increasing attention as a useful strategy to promote early identification of mental disorders, reduce stigma and enhance help-seeking behaviors. However, despite the abundance of research on mental health literacy interventions, there is the absence of evaluations of current available mental health literacy measures and related psychometrics. We conducted a scoping review to bridge the gap. METHODS We searched PubMed, PsycINFO, Embase, CINAHL, Cochrane Library, and ERIC for relevant studies. We only focused on quantitative studies and English publications, however, we didn't limit study participants, locations, or publication dates. We excluded non-English studies, and did not check the grey literature (non peer-reviewed publications or documents of any type) and therefore may have missed some eligible measures. RESULTS We located 401 studies that include 69 knowledge measures (14 validated), 111 stigma measures (65 validated), and 35 help-seeking related measures (10 validated). Knowledge measures mainly investigated the ability of illness identification, and factual knowledge of mental disorders such as terminology, etiology, diagnosis, prognosis, and consequences. Stigma measures include those focused on stigma against mental illness or the mentally ill; self-stigma ; experienced stigma; and stigma against mental health treatment and help-seeking. Help-seeking measures included those of help-seeking attitudes, intentions to seek help, and actual help-seeking behaviors. CONCLUSIONS Our review provides a compendium of available mental health literacy measures to facilitate applying existing measures or developing new measures. It also provides a solid database for future research on systematically assessing the quality of the included measures.
Collapse
Affiliation(s)
- Yifeng Wei
- Sun Life Financial Chair in Adolescent Mental Health team, IWK Health Centre, Dalhousie University, 5850 University Ave., P.O Box 9700, Halifax, Nova Scotia, B3K 6R8, Canada.
| | - Patrick J McGrath
- IWK Health Centre, Nova Scotia Health Authority and Dalhousie University, 5850 University Ave., P.O Box 9700, Halifax, Nova Scotia, B3K 6R8, Canada.
| | - Jill Hayden
- Centre for Clinical Research, Dalhousie University, Room 403, 5790 University Avenue, Halifax, Nova Scotia, B3H IV7, Canada.
| | - Stan Kutcher
- Sun Life Financial Chair in Adolescent Mental Health team, IWK Health Centre, Dalhousie University, 5850 University Ave., P.O Box 9700, Halifax, Nova Scotia, B3K 6R8, Canada.
| |
Collapse
|