Postnatal depression产后抑郁症课件

Postnataldepression

产后抑郁症C.C.D.S.ModelofCareinHongKong儿童身心全面发展服务香港的保健模式Dr.BonnieSiuC.C.D.S.ComprehensiveChildDevelopmentService(C.C.D.S.)儿童身心全面发展服务Aninnovativeservicemodel一个创新的服务模式PilotlaunchedinJuly2005inHongKong于二零零五年七月在香港试行Background背景InthePolicyAddress2005,ourformerChiefExecutive,Mr.TungCheeHwastatedthat:前香港特别行政区首长董建华先生于二零零五年的施政报告中提及:

Background背景“.…FiveMaternalandChildHealthCentresinthefourcommunitieswillcooperatewithnearbynurseries,kindergartensandotherrelatedinstitutions.…”“……四区一共五间母婴健康院会与区内幼儿院及幼稚园和其它相关机构合作……”Background背景“.…usingadditionalresourcesallocatedbytheGovernmentandthroughstafftraining,anewmodeofoperationwillbeestablishedtoprovideneedyparentswithhealthandeducationalactivitiesandcounselingservices.”“……利用政府增拨的资源和提供培训，

建立一套新服务模式，使有需要的家长能得到全面的支持服务。”Background背景HeadstartprogramwasproposedbytheHealth,WelfareandFoodBureauforchildrenaged5andbelowandtobeimplementedinphases此先导计划是由前卫生福利及食物局提出，对象为五岁及以下儿童并分阶段进行Aimstoprovidecomprehensiveandtimelysupporttochildrenandtheirfamilies目的是为儿童及其家庭提供全面及适切的支持

Background背景Headstartprogramrenamedas“ComprehensiveChildDevelopmentService(C.C.D.S.)”此先导计划亦重新命名为「儿童身心全面发展服务」

Background背景EducationandManpowerBureau前教育统筹局

IntegratedFamilyServiceCentresofSocialWelfareDepartmentandNGOs社会福利署及非政府机构辖下综合家庭服务中心DepartmentofHealth(MCHCs)卫生署(母婴健康院)HospitalAuthority(DepartmentsofPsychiatry,Paediatrics,Obstetrics)医院管理局(精神科、儿科、妇产科)

ComponentsofCCDS组成部份Identificationandreferralofchildrenandfamiliesforsocialserviceintervention及早识别及转介有社会服务需要的儿童及家庭Referralandfeedbacksystemforpre-schoolchildrenwithphysical,developmental,behaviouralandfamilyproblems为有健康、发展及行为问题的学前儿童及家庭作转介并设立反馈制度PsychiatriccontributionstoCCDS服务范围Identificationandmanagementofpostnataldepression(PND)isthemainfocusforgeneraladultpsychiatriccontributionstoCCDS及早识别和处理产后抑郁症是成人精神科于儿童身心全面发展服务下的重點工作IdentificationofPND

识别产后抑郁症TheEdinburghPostnatalDepressionScale(EPDS)(Coxetal.,1987)爱丁堡产后抑郁量表10-itemself-reportscale十个项目的自行填写量表ScreeningquestionnairetoimprovethedetectionofPNDinthecommunity作为一个筛查量表以改善社区产后抑郁症的侦查率IdentificationofPND

识别产后抑郁症PostnatalmotherstocompleteEPDSatMCHCsatabout2monthspostnatally产后母亲于生产后二个月在母婴健康院填写「爱丁堡产后抑郁量表」Coincidewiththechildimmunizationschedule与儿童防疫注射安排在一起IdentificationofPND

识别产后抑郁症Formotherswithscores>or=13/>or=1onQ10(self-harm)ofEPDS:在爱丁堡产后抑郁量表得十三分或以上或在第十项(自残)中得分的母亲:RefertoCCDSPsychiatricnurseforassessmentandmanagement会被转介致精神科护士作评估及处理RoleofpsychiatricnurseinCCDS

精神科护士的角色AtMCHClevel在母婴健康院层面:ProvideoutreachclinicsessionsatMCHCs为母婴健康院提供外展诊症服务ReceivereferralfromnurseanddoctorofMCHCandfromCommunityPaediatrician接受母婴健康院医护人员及社区儿科医生的转介RoleofpsychiatricnurseinCCDS

精神科护士的角色Offerpsychiatricassessmentandcounseling提供精神科评估及辅导Referinneedcasestopsychiatrist转介精神科医生Expertisesharing/trainingtoMCHCstaff分享专科知识及培训母婴健康院医护人员Delivermentalhealthtalktomothersandtheirpartners为母亲及其配偶提供精神健康讲座RoleofpsychiatricnurseinCCDS

精神科护士的角色FunctionasaservicecoordinatorbetweenMCHC,CommunityPaediatrician,ObstetricUnit,andPsychiatricUnit作为母婴健康院、社区儿科医生、妇产科及精神科的服务协调人员CasediscussionwithMCHCstaffandstaffofIntegratedFamilyServiceCentres与母婴健康院医护人员及综合家庭服务中心社工作个案讨论RoleofpsychiatristinCCDS

精神科医生的角色Athospitallevel在医院层面:Specialistperinatalout-patientclinic专科门诊(围产期诊所)ReceivereferralfromMCHCsandothersourcesforantenatalandpostnatalwomensuspectedtohavementalhealthproblem接受母婴健康院及其它途径的转介Consultationliaisonservicetoantenatalandpostnatalwomeningeneralhospital(mainlyobstetricdepartment)提供医院内生产前后妇女的会诊服务RoleofpsychiatristinCCDS

精神科医生的角色Psychiatricin-patientserviceforantenatalandpostnatalwomen生产前后妇女的精神科住院服务Internalcaseroundwithpsychiatricnurseandbackuppsychiatricnurseatanyothertime统筹内部个案会议及作为精神科护士的后援ServicemeetingandcasediscussionwithmidwifeofobstetricdepartmentandCommunityPaediatrician与助产士及社区儿科医生作个案讨论RoleofpsychiatristinCCDS

精神科医生的角色AtMCHClevel在母婴健康院层面:Outreachpsychiatristclinicsession外展精神科诊症服务ReceivereferralfromMCHCdoctor,Psychiatricnurse,CommunityPaediatrician接受母婴健康院医生、精神科护士及社区儿科医生的转介RoleofpsychiatristinCCDS

精神科医生的角色Delivermentalhealthtalkstopublic为公众提供精神健康讲座CoordinatetrainingprogramsforHospitalAuthoritystaffandnon-HospitalAuthoritystaff(MCHC,IntegratedFamilyServiceCentres)onperinatalpsychiatry为医院管理局职员及非医院管理局职员统筹及提供有关的专业培训HongKongSituation概览19districts十九个地区7clusters(inHospitalAuthority)七个医院联网31MCHCs三十一所母婴健康院CCDSinHongKongPilotedinShamShuiPodistrictofKowloonWestCluster(KWC)inJuly2005于二零零五年七月在深水埗地区(九龙西医院联网)推行试行计划PilotsiteatWestKowloonMCHC西九龙母婴健康院为试行地点CCDSinHongKong(current)

现况RolledouttoNewTerritoriesWestCluster(NTWC)andKowloonEastCluster(KEC)graduallysinceJanuary2006于二零零六年一月，扩展至新界西及九龙东医院联网Currentlycovers6districts,3clustersand9MCHCs现共服务六个地区、三个医院联网及九所母婴健康院CCDSinHongKong(current)

现况InNTWC新界西医院联网:TuenMunandYuenLongdistricts屯门及元朗地区Annualbirthrateof6000-7000withapopulationofabout1million地区人口约一百万而年度出生率约六千至七千CCDSinHongKong(current)

现况

4MCHCs四所母婴健康院1Psychiatrist,4Psychiatricnurses,1CommunityPaediatrician,1Midwife一名