Perinatal Depression Care Influenced by Care Providers

Internal factors strongly influence perinatal depression care by prenatal care providers

THURSDAY, June 23 (HealthDay News) -- Prenatal care providers are largely influenced by internal factors while making decisions regarding perinatal depression care, according to a study published in the May issue of General Hospital Psychiatry.

Christie Lancaster Palladino, M.D., from the Georgia Health Sciences University in Augusta, investigated how prenatal care providers perceive influences that impede or facilitate their delivery of perinatal depression care. The investigators hypothesized that if the depression screening protocols were in place at the clinics, system-level factors such as resources, training, and coordination would influence provider decisions the most. Semistructured interviews were conducted with 20 prenatal care providers from six obstetric clinics. A conceptual model of provider decision making was built from the data collected and thematic analysis, including within-case and cross-case comparisons.

The investigators found that, even though depression screening protocols were in place, practice patterns were highly variable, with decisions to address perinatal depression being made largely at the individual provider level, and remaining undefined on a clinic level. The role of internally derived influences, including familiarity with consultants, personal engagement styles, and perceptions of role identity, were reported to be more relevant in decision making, than externally derived influences such as logistical resources and coordination of care.

"Our study identified several important themes regarding provider perspectives on perinatal depression care and demonstrated the pivotal role of internal factors in decisions to deliver such care," the authors write. "Even with depression screening protocols in place, prenatal care providers feel a significant individual burden in addressing perinatal depression."

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