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Titolo:
Primary care pediatricians' roles and perceived responsibilities in the identification and management of depression in children and adolescents
Autore:
Olson, AL; Kelleher, KJ; Kemper, KJ; Zuckerman, BS; Hammond, CS; Dietrich, AJ;
Indirizzi:
Dartmouth Hitchcock Med Ctr, Dept Pediat, Lebanon, NH 03756 USA Dartmouth Hitchcock Med Ctr Lebanon NH USA 03756 t, Lebanon, NH 03756 USA Dartmouth Coll Sch Med, Lebanon, NH USA Dartmouth Coll Sch Med Lebanon NHUSA outh Coll Sch Med, Lebanon, NH USA Univ Pittsburgh, Sch Med, Pittsburgh, PA USA Univ Pittsburgh Pittsburgh PA USA ittsburgh, Sch Med, Pittsburgh, PA USA Childrens Hosp, Dept Pediat, Pittsburgh, PA 15213 USA Childrens Hosp Pittsburgh PA USA 15213 t Pediat, Pittsburgh, PA 15213 USA Childrens Hosp, Dept Psychiat, Pittsburgh, PA 15213 USA Childrens Hosp Pittsburgh PA USA 15213 Psychiat, Pittsburgh, PA 15213 USA Childrens Hosp, Dept Med, Boston, MA 02115 USA Childrens Hosp Boston MA USA 02115 s Hosp, Dept Med, Boston, MA 02115 USA Harvard Univ, Sch Med, Boston, MA USA Harvard Univ Boston MA USAHarvard Univ, Sch Med, Boston, MA USA Boston Univ, Sch Med, Dept Pediat, Boston, MA 02118 USA Boston Univ Boston MA USA 02118 ch Med, Dept Pediat, Boston, MA 02118 USA Dartmouth Coll Sch Med, Dept Community & Family Med, Hanover, NH USA Dartmouth Coll Sch Med Hanover NH USA nity & Family Med, Hanover, NH USA
Titolo Testata:
AMBULATORY PEDIATRICS
fascicolo: 2, volume: 1, anno: 2001,
pagine: 91 - 98
SICI:
1530-1567(200103/04)1:2<91:PCPRAP>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
PSYCHOSOCIAL PROBLEMS; UNITED-STATES; HEALTH; DISORDERS; PHYSICIANS; SYSTEM;
Keywords:
adolescents; children; continuing medical education; depression; family; mental health care services; primary care;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
26
Recensione:
Indirizzi per estratti:
Indirizzo: Olson, AL Dartmouth Hitchcock Med Ctr, Dept Pediat, 1 Med Ctr Dr, Lebanon,NH 03756 USA Dartmouth Hitchcock Med Ctr 1 Med Ctr Dr Lebanon NH USA 03756SA
Citazione:
A.L. Olson et al., "Primary care pediatricians' roles and perceived responsibilities in the identification and management of depression in children and adolescents", AMBU PEDIAT, 1(2), 2001, pp. 91-98

Abstract

Objective.-To describe primary care pediatricians' 1) approach to the identification and management of childhood and adolescent depression and 2) perception of their skills, responsibilities, and barriers in recognizing and managing depression in children and adolescents. Design and Methods.-National cross-sectional survey of randomly selected primary care pediatricians that assessed the management of recalled last case of child or adolescent depression, attitudes, limitations to care from barriers and skills, and willingness to implement new educational or intervention strategies to improve care. Results.-There were 280 completed surveys about child and adolescent depression (63% response rate). Pediatricians overwhelmingly reported it was their responsibility to recognize depression in both children and adolescents (90%) but were unlikely to feel responsible for treating children or adolescents (26%-27%). Those with most of their practice in capitated managed care were less likely to feel responsible for recognizing depression in eitherchildren or adolescents. Forty-six percent of pediatricians lacked confidence in their skills to recognize depression in children, and few of them (10%-14%) had confidence in their skills in different aspects of treatment with children or adolescents. Diagnostic, assessment, and management details for their last recalled case of depression in a child or adolescent were provided by 248 of these pediatricians. In addition to referring 78%-79% of the cases to mental health care professionals, 77% of pediatricians provideda wide range of brief interventions. Only 19%-20% prescribed medication. Major factors cited that limited their diagnosis or management were time (56%-68%) and training or knowledge of issues (38%-56%). Fewer pediatricians noted limitations due to insurer or financial issues (8%-39%) or patient issues (19%-31%). The 35% of pediatricians who were motivated to change their recognition and management of suspected depression were significantly more interested in implementing in the future a variety of new strategies to improve care. Conclusion.-Primary care pediatricians felt responsible for recognizing but not for treating child and adolescent depression. Although the lack of confidence and lack of knowledge and/or skills and time issues are major barriers that limit pediatricians in their treatment of childhood and adolescent depression, pediatricians varied in their readiness to change, with some being more willing to implement new strategies to care for depression. Educational and practice interventions need to focus on how to assist all pediatricians in diagnosis and to prepare these motivated pediatricians to manage depression in primary care settings.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/01/20 alle ore 15:16:09