title: Patient's views on depression care in obstetric settings: how do they compare to the views of perinatal health care professionals?
abstract: OBJECTIVE
  The objectives were to examine patients' perspectives on patient-, provider- and systems-level barriers and facilitators to addressing perinatal depression in outpatient obstetric settings. We also compare the views of patients and perinatal health care professionals.
  
  
  METHODS
  Four 90-min focus groups were conducted with women 3-36 months after delivery (n=27) who experienced symptoms of perinatal depression, anxiety or emotional distress. Focus groups were transcribed, and resulting data were analyzed using a grounded theory approach.
  
  
  RESULTS
  Barriers to addressing perinatal depression included fear of stigma and loss of parental rights, negative experiences with perinatal health care providers and lack of depression management knowledge/skills among professionals. Facilitators included psychoeducation, peer support and training for professionals.
  
  
  CONCLUSIONS
  Patients perceive many multilevel barriers to treatment that are similar to those found in our previous similar study of perinatal health care professionals' perspectives. However, patients and professionals do differ in their perceptions of one another. Interventions would need to close these gaps and include an empathic screening and referral process that facilitates discussion of mental health concerns. Interventions should leverage strategies identified by both patients and professionals, including empowering both via education, resources and access to varied mental health care options.
authors: Department of Psychiatry and Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester, MA 01655. Electronic address: nancy.byatt@umassmemorial.org.
authors: Nancy
authors: N
authors: Byatt
authors: Kathleen
authors: K
authors: Biebel
authors: Liz
authors: L
authors: Friedman
authors: Gifty
authors: G
authors: Debordes-Jackson
authors: Douglas
authors: D
authors: Ziedonis
authors: Lori
authors: L
authors: Pbert
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000379:methods* / Q000523:psychology; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D019052:Depression, Postpartum / Q000523:psychology / Q000628:therapy; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy*; D005260:Female; D017144:Focus Groups; D006801:Humans; D009774:Obstetrics / Q000379:methods*; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology / Q000628:therapy*; D057545:Social Stigma; D055815:Young Adult
keywords: Barriers; Depression; Facilitators; Perinatal; Treatment
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