目的了解广州市妇幼医疗机构的医护人员对产妇产后心理行为问题的识别处理情况和相关因素。方法采用分层随机整群抽样方法,选取广州市8家妇幼医疗机构产科的245位医护人员(医师95位,护士150位)和精神专科机构(广州市精神病医院)的59位精神卫生专业人员(医师22位,护士37位),分别完成孕产妇常见心理行为问题病例分析中有关产后抑郁症患者和精神分裂症患者的识别和处理问卷。采用χ2检验和精确概率法统计妇幼机构医护人员和精神卫生专业人员的问卷答案正确率比较,采用独立样本的t检验比较妇幼机构医护人员和精神卫生专业人员的问卷得分;采用单元及多元线性回归(后退法)探寻问卷得分的影响因素。结果两组医生正确识别产后抑郁无显著性差异(94.74%vs.100%,P=0.582),妇幼机构护士低于精神卫生专业护士(86.67%vs 100%,χ2=4.216,P=0.040);正确识别精神分裂症妇幼机构医护人员低于精神卫生专业人员(医师为16.84%vs 72.73%,χ2=28.077,P<0.001;护士为6.67%vs 43.24%,χ2=33.170,P<0.001);对两个病做出转入精神专科住院的正确处理方面;妇幼机构医护人员差于精神卫生专业人员,且差异有显著性(抑郁症病例:医师为24.21%vs86.36%,χ2=29.988,P<0.001,护士为10%vs 62.16%,χ2=49.874,P<0.001;精神分裂症病例:医师为32.63%vs 90.91%,χ2=22.727,P<0.001,护士为17.33%vs 67.67%,χ2=37.759,P<0.001)。精神卫生专业人员对抑郁症病例和精神分裂症病例的问卷得分及总分均高于妇幼机构医护人员;精神专科机构、医师、培训是抑郁症问卷得分的影响因素(β=0.338、0.218、0.152,t=6.168、4.282、2.756,P均≤0.01),精神专科机构、综合医院、医师、培训是分裂症问卷得分的影响因素(β=0.460、0.119、0.241、0.133,t=8.109、2.263、4.974、2.520,P均≤0.05)。结论妇幼医疗机构医护人员对产妇产后心理行为问题识别处理能力不足,未达到国家精神卫生规划要求。 Objective To understand the maternal and child health care institutions in Guangzhou Maternal and Child Health Psychological and behavioral problems identified and handling problems and related factors. Methods Stratified stratified random cluster sampling method was used to select 245 mental health workers (95 doctors, 150 nurses) and 59 mental health professionals in psychiatric institutions (Guangzhou Psychiatric Hospital) from 8 maternity and child medical institutions in Guangzhou. (22 physicians and 37 nurses), and completed the questionnaire about identification and treatment of postpartum depression and schizophrenia in the case analysis of common maternal psychological problems respectively. The chi-square test and exact probability method were used to compare the accuracy of questionnaire answers between maternal and child health care workers and mental health professionals. The t-test of independent samples was used to compare the questionnaire scores of maternal and child health care workers and mental health professionals by using independent samples. Using unit and multiple linear regression (Backward Method) Exploring the Influencing Factors of the Questionnaire Score. Results There was no significant difference between the two groups in correct identification of postpartum depression (94.74% vs.100%, P = 0.582). Nurses in both maternal and children institutions were lower than mental health nurses (86.67% vs 100%, χ2 = 4.216, P = 0.040). The correct identification of schizophrenia in MCH institutions was less than that of mental health professionals (physician 16.84% vs 72.73%, χ2 = 28.077, P <0.001; nurses 6.67% vs 43.24%, χ2 = 33.170, P <0.001) The two diseases were transferred to the psychiatric hospital for proper treatment. The health workers in the women and children institutions were worse than the mental health professionals (the cases of depression were 24.21% vs 86.36%, χ2 = 29.988, P <0.001, nurses were 10% vs 62.16%, χ2 = 49.874, P <0.001; schizophrenia cases: physicians 32.63% vs 90.91%, χ2 = 22.727, P <0.001, nurses 17.33% vs 67.67%, χ2 = 37.759, P <0.001). Mental health professionals in depression cases and schizophrenia cases questionnaire scores and the total score higher than that of women and children institutions of health care workers; psychiatric institutions, physicians, training is the depression questionnaire score factors (β = 0.338,0.218,0.152 , t = 6.168,4.282,2.756, P≤0.01), psychiatric specialist institutions, general hospitals, physicians, and training were the influencing factors of schizophrenia questionnaire scores (β = 0.460,0.119,0.241,0.133, t = 8.109,2.263, 4.974,2.520, P <0.05). Conclusion Maternal and child health care providers have insufficient capacity to identify and deal with postpartum psychological and behavioral problems and have not met the national mental health planning requirements.