RESUMEN
BACKGROUND: This study aimed to explore clinicians' perspectives on the current practice of perinatal mood and anxiety disorder (PMAD) management and strategies to improve future implementation. METHODS: This study had a cross-sectional, descriptive design. A 35-item electronic survey was sent to clinicians (N = 118) who treated perinatal women and practiced at several community clinics at an academic medical center in the United States. RESULTS: Among clinicians who provided care for perinatal women, 34.7% reported never receiving PMAD management training and 66.3% had less than 10 years of experience. Out of 10 patients who reported psychiatric symptoms, 47.8% of clinicians on average reported providing PMAD management to 1 to 3 patients and 40.7% noted that they conducted screening only when patient expresses PMAD symptoms. Suggested future improvements were providing training, developing a referral list, and establishing integrated behavioral health services. CONCLUSIONS: Results from this study indicated that while PMAD screening and management was implemented, improvements are warranted to meet established guidelines. Additionally, clinicians endorsed providing PMAD management to a small percentage of perinatal patients. Suggested strategies to increase adoption and implementation of PMAD management should be explored to improve access to behavioral health services for perinatal women.
Asunto(s)
Trastornos de Ansiedad , Ansiedad , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/terapia , Niño , Estudios Transversales , Femenino , Humanos , Recién Nacido , Atención Perinatal , Embarazo , Derivación y Consulta , Estados UnidosRESUMEN
PURPOSE: To develop and test a decision support tool that identifies patients who would benefit from early consult with discharge planners. DESIGN AND METHODS: A predictive, correlational design was used with parents/guardians of children (1 month to 18 years; N = 197). Data were collected by interviews and record reviews. Expert consensus determined referral to discharge planning. RESULTS: Mean age was 8.7 years; mean length of stay was 7.5 days. Forty percent (n = 79) were identified for early referral. The variable "substantial post-acute care needs" had the strongest association with expert consensus (internally validated AUC = 0.79). PRACTICE IMPLICATIONS: Findings from this study provide preliminary evidence for a decision support tool to improve the discharge planning process by reducing individual decision-making variability through systematic matching of patient needs to service delivery.