BACKGROUND Clinically significant depressive symptoms are prevalent in people attending low vision clinics and often go undetected. The Low Vision Service Wales (LVSW) plans to introduce depression screening and management pathways. Prior to implementation there is an unmet need to understand how eye care practitioners providing the service currently address depression with patients, and the characteristics and beliefs that influence their practice. METHODS A mixed methods convergent design was employed. Twelve low vision practitioners were purposively selected to engage in individual semi-structured interviews which were analysed using thematic analysis. A further 167 practitioners were invited to complete a questionnaire assessing professional background, current practice, confidence and perceived barriers in working with people with low vision and suspected depression. Multiple regression analyses were performed to determine the characteristics related to the Rasch-transformed questionnaire scores. RESULTS Of the 122 practitioners that responded to the questionnaire, 33% aimed to identify depression in patients, and those who were more confident were more likely to do so. Those who scored higher on the perceived barriers scale and lower on confidence were less likely to report acting in response to suspected depression (all p < 0.05). Three qualitative themes were identified; depression is an understandable response to low vision, patients themselves are a barrier to addressing depression and practitioners lacked confidence in their knowledge and skills to address depression. The qualitative data largely expanded the quantitative findings. CONCLUSIONS Practitioners viewed their own lack of knowledge and confidence as a barrier to the identification and management of depression and expressed a need for training prior to the implementation of service changes. The study findings will help to inform the development of a training programme to support low vision practitioners and those working with other chronic illness in Wales, and internationally, in the identification and management of people with depression.

中文翻译：

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社区眼保健从业者如何应对低视力患者的抑郁症？混合方法研究。

背景技术临床上显着的抑郁症状在低视力诊所就诊的人群中普遍存在，并且常常未被发现。威尔士低视力服务中心 (LVSW) 计划引入抑郁症筛查和管理途径。在实施之前，需要了解提供服务的眼保健从业者目前如何解决患者的抑郁症，以及影响他们的实践的特征和信念，这一需求尚未得到满足。方法采用混合方法收敛设计。特意选择了 12 名低视力从业者进行个人半结构化访谈，并使用主题分析进行分析。另外 167 名从业者被邀请完成一份调查问卷，评估专业背景、当前实践、信心以及在与低视力和疑似抑郁症患者一起工作时遇到的障碍。进行多元回归分析以确定与 Rasch 转换问卷分数相关的特征。结果 在回答问卷的 122 名从业者中，33% 的人旨在识别患者的抑郁症，而那些更有信心的人更有可能这样做。那些在感知障碍量表上得分较高且在信心上得分较低的人不太可能报告对疑似抑郁症做出反应（所有 p < 0.05）。确定了三个定性主题；抑郁症是对低视力的一种可以理解的反应，患者本身就是解决抑郁症的障碍，而从业者对自己解决抑郁症的知识和技能缺乏信心。定性数据很大程度上扩展了定量研究结果。结论 从业者认为自己缺乏知识和信心是识别和管理抑郁症的障碍，并表示需要在实施服务变革之前进行培训。该研究结果将有助于为培训计划的制定提供信息，以支持威尔士和国际上低视力从业者和从事其他慢性疾病工作的人员识别和管理抑郁症患者。