Aim

Synthesise qualitative evidence of healthcare professionals’ (HCP) experiences of diabetes distress and depression screening in people with type 2 diabetes (T2DM) in primary care to identify HCP barriers and enablers to screening implementation.

Methods

Searched six electronic databases in October 2020 for qualitative studies exploring HCPs’ experiences of diabetes distress and depression screening in T2DM populations. Applying a best-fit framework synthesis, data were coded to the theoretical domains framework (TDF), followed by thematic analysis of data that did not fit the TDF. Study quality and confidence in findings were assessed using CASP and GRADE-CERQual respectively.

Findings

Of 4942 unique records identified, 10 articles were included. We identified fifteen barriers and enablers in 8 TDF domains and 1 new domain; people with T2DM factors. One barrier (poor awareness about the rationale for screening) and 2 enablers (perceived impacts on T2DM care, receiving financial reimbursement) were assessed as findings of high confidence.

Conclusion

HCPs experience many barriers and enablers to diabetes distress and depression screening among people with T2DM in primary care. Future interventions and policies should ensure HCPs understand the rationale for screening, highlight the benefits of screening, resource screening appropriately and address HCP group specific barriers.

中文翻译：

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筛查和诊断 2 型糖尿病患者的糖尿病困扰和抑郁症的障碍和促成因素：定性证据综合

目标

综合医疗保健专业人员 (HCP) 对初级保健中 2 型糖尿病 (T2DM) 患者的糖尿病困扰和抑郁筛查经验的定性证据，以确定 HCP 障碍和筛查实施的促成因素。

方法

于 2020 年 10 月搜索了六个电子数据库，以进行定性研究，探索 HCP 在 T2DM 人群中进行糖尿病困扰和抑郁筛查的经验。应用最佳拟合框架综合，将数据编码到理论域框架 (TDF)，然后对不符合 TDF 的数据进行主题分析。分别使用 CASP 和 GRADE-CERQual 评估研究质量和对结果的信心。

发现

在确定的 4942 条唯一记录中，包括 10 篇文章。我们在 8 个 TDF 领域和 1 个新领域中确定了 15 个障碍和促成因素；患有 T2DM 因素的人。一个障碍（对筛查原理的认识不足）和 2 个促成因素（对 T2DM 护理的感知影响，接受财务报销）被评估为高可信度的结果。

结论

在初级保健中的 T2DM 患者中，HCP 在糖尿病困扰和抑郁筛查方面遇到了许多障碍和促成因素。未来的干预措施和政策应确保 HCP 了解筛查的基本原理，突出筛查的好处，适当地进行资源筛查，并解决 HCP 群体的特定障碍。