155 lines
5 KiB
YAML
155 lines
5 KiB
YAML
abstract: 'BackgroundPerinatal depression (PND) is prevalent and negatively impacts
|
|
|
|
HIV care among women living with HIV (WLHIV), yet PND remains
|
|
|
|
under-identified in Malawian WLHIV. Accordingly, this formative study
|
|
|
|
explored perceptions of the feasibility and acceptability of an
|
|
|
|
integrated, task-shifted approach to PND screening and treatment in
|
|
|
|
maternity clinics. MethodsWe completed consecutive PND screenings of
|
|
|
|
HIV+ women attending pre- or post-natal appointments at 5 clinics in
|
|
|
|
Lilongwe district, Malawi. We conducted in-depth interviews with the
|
|
|
|
first 4-5 women presenting with PND per site (n = 24 total) from July to
|
|
|
|
August 2018. PND classification was based on a score \& GE; 10 on the
|
|
|
|
Edinburgh Postnatal Depression Scale (EPDS). We conducted 10 additional
|
|
|
|
in-depth interviews with HIV and mental health providers at the 5
|
|
|
|
clinics. ResultsMost participants endorsed the feasibility of integrated
|
|
|
|
PND screening, as they believed that PND had potential for significant
|
|
|
|
morbidity. Among providers, identified barriers to screening were
|
|
|
|
negative staff attitudes toward additional work, inadequate staffing
|
|
|
|
numbers and time constraints. Suggested solutions to barriers were
|
|
|
|
health worker training, supervision, and a brief screening tool.
|
|
|
|
Patient-centered counselling strategies were favored over medication by
|
|
|
|
WLHIV as the acceptable treatment of choice, with providers supporting
|
|
|
|
the role of medication to be restricted to severe depression. Providers
|
|
|
|
identified nurses as the most suitable health workers to deliver
|
|
|
|
task-shifted interventions and emphasized further training as a
|
|
|
|
requirement to ensure successful task shifting. ConclusionImproving PND
|
|
|
|
in a simple, task-shifted intervention is essential for supporting
|
|
|
|
mental health among women with PND and HIV. Our results suggest that an
|
|
|
|
effective PND intervention for this population should include a brief,
|
|
|
|
streamlined PND screening questionnaire and individualized counselling
|
|
|
|
for those who have PND, with supplemental support groups and depression
|
|
|
|
medication readily available. These study results support the
|
|
|
|
development of a PND intervention to address the gap in treatment of PND
|
|
|
|
and HIV among WLHIV in Malawi.'
|
|
affiliation: 'Dussault, JM (Corresponding Author), Univ N Carolina, Gillings Sch Global
|
|
Publ Hlth, Dept Epidemiol, Chapel Hill, NC 27599 USA.
|
|
|
|
Kulisewa, Kazione, Kamuzu Univ Hlth Sci, Fac Med, Dept Psychiat \& Mental Hlth,
|
|
Private Bag 360, Blantyre, Malawi.
|
|
|
|
Dussault, Josee M.; Gaynes, Bradley N.; LeMasters, Katherine; Pence, Brian W., Univ
|
|
N Carolina, Gillings Sch Global Publ Hlth, Dept Epidemiol, Chapel Hill, NC 27599
|
|
USA.
|
|
|
|
Gaynes, Bradley N.; Meltzer-Brody, Samantha, Univ N Carolina, UNC Sch Med, Dept
|
|
Psychiat, Chapel Hill, NC USA.
|
|
|
|
Hosseinipour, Mina C.; Kutengule, Anna; Mphonda, Steven M., UNC Project Malawi,
|
|
Lilongwe, Malawi.
|
|
|
|
Hosseinipour, Mina C., Univ N Carolina, UNC Sch Med, Dept Med, Chapel Hill, NC USA.
|
|
|
|
Go, Vivian F., Univ N Carolina, Gillings Sch Global Publ Hlth, Dept Hlth Behav,
|
|
Chapel Hill, NC USA.
|
|
|
|
Midiani, Dalitso; Udedi, Michael, Minist Hlth, Lilongwe, Malawi.
|
|
|
|
Bengtson, Angela M., Brown Univ, Brown Sch Publ Hlth, Dept Epidemiol, Providence,
|
|
RI USA.'
|
|
article-number: '833'
|
|
author: Kulisewa, Kazione and Dussault, Josee M. and Gaynes, Bradley N. and Hosseinipour,
|
|
Mina C. and Go, Vivian F. and Kutengule, Anna and LeMasters, Katherine and Meltzer-Brody,
|
|
Samantha and Midiani, Dalitso and Mphonda, Steven M. and Udedi, Michael and Pence,
|
|
Brian W. and Bengtson, Angela M.
|
|
author-email: josee.dussault@unc.edu
|
|
author_list:
|
|
- family: Kulisewa
|
|
given: Kazione
|
|
- family: Dussault
|
|
given: Josee M.
|
|
- family: Gaynes
|
|
given: Bradley N.
|
|
- family: Hosseinipour
|
|
given: Mina C.
|
|
- family: Go
|
|
given: Vivian F.
|
|
- family: Kutengule
|
|
given: Anna
|
|
- family: LeMasters
|
|
given: Katherine
|
|
- family: Meltzer-Brody
|
|
given: Samantha
|
|
- family: Midiani
|
|
given: Dalitso
|
|
- family: Mphonda
|
|
given: Steven M.
|
|
- family: Udedi
|
|
given: Michael
|
|
- family: Pence
|
|
given: Brian W.
|
|
- family: Bengtson
|
|
given: Angela M.
|
|
da: '2023-09-28'
|
|
doi: 10.1186/s12888-022-04476-z
|
|
eissn: 1471-244X
|
|
files: []
|
|
journal: BMC PSYCHIATRY
|
|
keywords: Perinatal depression; Mental health; HIV; Malawi; Task-shifting
|
|
keywords-plus: 'OPTION B PLUS; MENTAL-HEALTH; POSTNATAL DEPRESSION; PRIMARY-CARE;
|
|
|
|
LOW-INCOME; COUNSELING INTERVENTION; ANTIRETROVIRAL THERAPY; ANTENATAL
|
|
|
|
DEPRESSION; PRENATAL DEPRESSION; POSTPARTUM'
|
|
language: English
|
|
month: DEC 29
|
|
number: '1'
|
|
number-of-cited-references: '54'
|
|
orcid-numbers: 'Udedi, Michael/0000-0001-8769-4313
|
|
|
|
Dussault, Josee/0000-0001-7434-2159'
|
|
papis_id: 4962100467fbe0b6efda38de84949f6e
|
|
ref: Kulisewa2022feasibilityacceptabi
|
|
researcherid-numbers: 'Udedi, Michael/V-6147-2017
|
|
|
|
'
|
|
times-cited: '1'
|
|
title: 'The feasibility and acceptability of a task-shifted intervention for perinatal
|
|
depression among women living with HIV in Malawi: a qualitative analysis'
|
|
type: Article
|
|
unique-id: WOS:000905932200001
|
|
usage-count-last-180-days: '0'
|
|
usage-count-since-2013: '0'
|
|
volume: '22'
|
|
web-of-science-categories: Psychiatry
|
|
year: '2022'
|