Community‐based intervention for depression management at the primary care level in Ha Nam Province, Vietnam: a cluster‐randomised controlled trial

Abstract

Abstractobjective To evaluate the effectiveness of an intervention including psychoeducation and yoga for depression management at the primary healthcare level in one district in the H a Nam province, Vietnam.method The Patient Health Questionnaire-9 (PHQ-9) was used for depression screening and follow-up. Screened patients were further diagnosed with the Mini-International Neuropsychiatric Diagnostic Interview, by a trained general doctor. A linear regression model, adjusted for age, gender and baseline PHQ-9 score was used to assess whether the intervention leads to decreased depression severity compared to standard care in the control communes.results Both groups had similar PHQ-9 scores at baseline. The intervention group had on average significantly lower PHQ-9 scores after the intervention than the control group. Almost half of the patients in the intervention group recovered from depression, whereas nobody did in the control group.conclusion The results indicate that the intervention can be more effective than standard care in treating depression. The mean change of the PHQ-9 score after the intervention is deemed to be of clinical relevance.

Intervention intended to improve public health professionals’ self-efficacy in their efforts to detect and manage perinatal depressive symptoms among Thai women: a mixed-methods study

“…After completion of the SIP, participants in the intervention group perceived that they should screen women for depressive symptoms during the perinatal period using the EPDS because detection and management of depressive symptoms were their responsibilities. This finding is in line with a previous study, suggesting that community health workers are suitable persons to detect and manage perinatal mental health among women [8]. However, the FGD participants also described that HCPs already have a high workload as few HCPs appear in SHPHs, and mental health tasks have not been on their agenda.…”

“…giving advice to women who were at risk in the community. The participants' selfefficacy for detection and management of depressive symptoms among women increased, which is an important factor to improve the situation for women during the perinatal period [8,16,24]. The results demonstrate that the four information sources from the theory by Bandura [17] are key components for improvement of self-efficacy among PHPs.…”

“…This implied involving women with depressive symptoms in their home visit plan, and increasing accessibility and continuity of care for women with mental health problems in the community [6,9]. Management of women with depression symptoms at a primary care level, should include referral of women with high EPDS scores (≥ 10) for treatment and diagnosis by physicians, which may result in decreased depression severity [8,24].…”

“…In resource-constrained primary healthcare centres, detection and management of depressive symptoms by trained healthcare providers (HCPs) targeting women during the perinatal period can reduce the number of women with symptoms of depression [5,8]. However, several barriers exist for this to take place, e.g.…”

“…However, in order to properly identify perinatal depressive symptoms among women, a specific screening tool should be implemented [13]. Screening for perinatal depressive symptoms is a preventive action, which could be a routine task for a PHP [8]. To achieve this, PHPs need to be trained and supervised in order to increase their self-efficacy when providing mental health promotion and screening [14][15][16].…”