The treatment of postnatal depression by health visitors: impact of brief training on skills and clinical practice

被引:27
作者
Appleby, L [1 ]
Hirst, E
Marshall, S
Keeling, F
Brind, J
Butterworth, T
Lole, J
机构
[1] Univ Manchester, Ctr Womens Mental Hlth Res, Manchester M13 9PL, Lancs, England
[2] Univ Manchester, Sch Nursing Midwifery & Hlth Visiting, Manchester M13 9PL, Lancs, England
[3] Mancunian Community Hlth NHS Trust, Manchester M21 7RL, Lancs, England
关键词
depression; postpartum; counselling; community health nursing; cognitive therapy;
D O I
10.1016/S0165-0327(02)00145-3
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Postnatal depression can be effectively treated by cognitive behavioural counselling (CBC), a simple intervention designed to be delivered by non-specialists in mental health. Methods: Health visitors were trained in CBC and post-training changes in counselling skills, clinical practice and costs were assessed. Results: Following training health visitors showed improved counselling skills, and they carried Out more mental health assessments, recorded mental symptoms more often and treated more women themselves. However, their mean number of contacts with depressed women did not change; and the number of urgent contacts diminished. Referrals to general practitioners did not increase but there was an increase in referrals to mental health services. Costs to health visitor practice did not increase. Limitations: Assessment of clinical practice was based on health visitor records. The study uses a 'before and after' design rather than randomisation of subjects. Conclusions: Training health visitors in CBC leads to improved counselling skills and corresponding changes in clinical practice, without increasing the costs of health visitor practice. (C) 2002 Elsevier B.V. All rights reserved.
引用
收藏
页码:261 / 266
页数:6
相关论文
共 8 条
[1]   A controlled study of fluoxetine and cognitive-behavioural counselling in the treatment of postnatal depression [J].
Appleby, L ;
Warner, R ;
Whitton, A ;
Faragher, B .
BRITISH MEDICAL JOURNAL, 1997, 314 (7085) :932-936
[2]   An educational intervention for front-line health professionals in the assessment and management of suicidal patients (The STORM Project) [J].
Appleby, L ;
Morriss, R ;
Gask, L ;
Roland, M ;
Lewis, B ;
Perry, A ;
Battersby, L ;
Colbert, N ;
Green, G ;
Amos, T ;
Davies, L ;
Faragher, B .
PSYCHOLOGICAL MEDICINE, 2000, 30 (04) :805-812
[3]  
COX JL, 1987, BRIT J PSYCHIAT, V150, P782, DOI 10.1007/978-94-007-1694-0_2
[4]   IMPROVING THE PSYCHIATRIC SKILLS OF ESTABLISHED GENERAL-PRACTITIONERS - EVALUATION OF GROUP TEACHING [J].
GASK, L ;
MCGRATH, G ;
GOLDBERG, D ;
MILLAR, T .
MEDICAL EDUCATION, 1987, 21 (04) :362-368
[5]   THE TREATMENT OF SOMATIZATION - EVALUATION OF A TEACHING PACKAGE WITH GENERAL-PRACTICE TRAINEES [J].
GASK, L ;
GOLDBERG, D ;
PORTER, R ;
CREED, F .
JOURNAL OF PSYCHOSOMATIC RESEARCH, 1989, 33 (06) :697-703
[6]   Teaching front-line health and voluntary workers to assess and manage suicidal patients [J].
Morriss, R ;
Gask, L ;
Battersby, L ;
Francheschini, A ;
Robson, M .
JOURNAL OF AFFECTIVE DISORDERS, 1999, 52 (1-3) :77-83
[7]  
NETTEN A, 1998, UNIT COSTS HLTH SOCI
[8]   Maternal thinking and the treatment of postnatal depression [J].
Whitton, A ;
Appleby, L ;
Warner, R .
INTERNATIONAL REVIEW OF PSYCHIATRY, 1996, 8 (01) :73-78