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背景抑郁症在心力衰竭(HF)患者中较未患HF者更为普遍,但由于两种疾病之间的症状重叠,其检测更加复杂。全科医生(GPs)是HF患者的首要接触者。因此,本研究旨在调查GPs对HF患者抑郁症的意识及其相关因素。方法使用基于医院焦虑和抑郁量表的方法筛选3 224例HF患者的抑郁症状,其中9项为患者健康问卷抑郁症部分的分量表,以及PROMIS中的抑郁和焦虑量表项目。通过电话采访参与研究的272例GPs的患者的身体和心理合并症。使用描述性统计分析GPs对患者的抑郁症状的意识率。应用Logistic回归分析GPs对抑郁症状的意识及其影响因素。结果 35%GPs了解患者的抑郁症状。与抑郁症状意识相关的因素包括:患者更高的教育水平、GPs了解患者的抑郁史、过去6个月由于情绪困扰进行的GPs咨询,过去6个月内GPs接触频率较高,较高的纽约心脏病协会(NYHA)分级和严重的抑郁症状。GPs的特点,包括接受过心理学/精神病学教育,与抑郁症意识无关。结论许多方面,包括意识的定义和初级保健的实际操作问题,可能会导致GPs对HF患者抑郁症状意识较低。如果GPs鼓励患者谈论自己的情绪困扰,进行详细的医疗面谈,包括抑郁史,并特别注意低学历的HF患者,意识率可能会有所增加。
Background Depression is more common in patients with heart failure (HF) than in those without HF, but its detection is more complicated due to the overlapping symptoms between the two diseases. General practitioners (GPs) are the primary contacts of HF patients. Therefore, this study aimed to investigate the GPs’ awareness of depression in HF patients and its related factors. Methods The depression-based symptoms of 3 224 HF patients were screened using a hospital-based anxiety and depression scale, of which 9 were subscales for the depression questionnaire and the Depression and Anxiety Inventory for PROMIS. Patients with physical and psychological comorbidities of 272 GPs participating in the study were interviewed by phone. Descriptive statistics were used to analyze the prevalence of GPs in patients with depressive symptoms. Logistic regression analysis of GPs on depression symptoms and its influencing factors. Results 35% GPs knew about the patient’s depressive symptoms. Factors associated with depressive symptoms include higher patient education levels, GPs’ history of depression in patients, GPs counseling for emotional distress in the past 6 months, higher frequency of contact with GPs in the past 6 months, higher New York Cardiac Association (NYHA) grading and severe depressive symptoms. The characteristics of GPs, including psychology / psychiatry education, have nothing to do with depression awareness. Conclusions Many aspects, including the definition of awareness and practical aspects of primary care, may lead to lower GPs’ awareness of depression in HF patients. If GPs encourage patients to talk about their emotional distress, conduct detailed medical interviews, including a history of depression, and pay particular attention to HF patients with low education, awareness may increase.