Abstract:
Depression is the most common mental health disorder worldwide with a lifetime prevalence is about 10 percent in the general population. Primary care health care workers commonly underdiagnose depression, detecting fewer than half of depressed patients, resulting in the possibility of impaired function and an increase in hospitalizations. Understanding frontline healthcare workers' knowledge, attitudes, and practices about depression management can influence initiatives to enhance depression care, as they are increasingly the first point of contact for depressed patients. The objective of the study was to assess the knowledge, attitudes, and practices among health care workers on depression care in Kijabe and Naivasha hospitals. The study used a survey design in which consenting health care workers in the two study facilities were eligible to participate. A self-administered structured questionnaire was used to collect data on demographic characteristics, knowledge, attitude, and practices on depression. The Revised-Depression Attitude Questionnaire was incorporated into the questionnaire. Knowledge and attitude scores were determined based on the responses where higher scores suggested higher knowledge or more positive attitudes. Descriptive and regression analysis was conducted using R Statistical software and a p-value of < 0.05 was considered significant. All participants gave informed consent. Among the 316 health care workers approached, 303 (95.9%) consented and participated in the study. The majority (59.4%) of the respondents were from Kijabe Hospital, 64.0% were female and 58.4% were aged 18 to 29 years. While there was near-universal knowledge among respondents on depression as a disease and general approach to management, 34% of the respondents did not know that fluoxetine is an antidepressant (fluoxetine is the antidepressant of choice at the primary care level). Non-clinical staff scored significantly lower (β = -2.0, p<0.001) on the knowledge score compared to clinical staff. Only 9.3% of the respondents strongly agreed or agreed that they were confident in assessing suicide risk in patients with depression. Attitude score was positively associated with knowledge score (β = 0.39, p=0.023) and respondents with professional experience of 5-14 years (β = 1.7, p=0.023) compared to those with professional experience of fewer than 5 years. Nearly half (47%) of the respondents reported that they rarely or never screened patients for depression. The study recommends that a training and mentorship program on depression management for health care workers with a focus on non-clinical staff be implemented to enhance early detection and management of depressed patients.