Transcript
8/12/2019 PCU Manual Depression
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8/12/2019 PCU Manual Depression
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29 2551
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0 2903 8257-9
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ISBN: 978-974-299-155-5
3 5 .. . .110000 2951 1286 http://www.hsri.or.thhttp://www.hph.moph.go.th
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11
21
22
1 23
2 45
3 59
81
5 97
6 119
7 125
141
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( . .)
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13
1.
2.
3. 5
.
5. (.)
/
.. (ca tchment area)
(home ward)
...
1. ()
1.1
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15
1.2
1.3
1.4
3
4 -
-
-
-
(.)
2. ( )
2.1
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17
2.2
- (Home Health Care)
- (Home Ward
Round) Ward
2.3
2.4
2.5
4 .........
1
/
2 (.)
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19
3
2
.
(.)
1.
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2. .
- /
- 1667 1323
-
- 1667 1323
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.
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. / .. .. .
2Q 15
9Q 9Q
8Q
9Q /
8Q
1
9Q
2
8Q
Non MDD MDD 9Q
Mild 9Q =7-12
Csg + Ed
Moderate
9Q = 13-18 Rx + Csg +Ed Severe9Q 19
Csg
Education
9Q
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1
(..)
1.
2.
3.
4.
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27
1
..2545 -2549 3.7
5. ..
6.
7.
8.
9.
10.
..
4
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31
1
..
2.2
(Home Health Care)
/
.. .
2.3 -
2.
2.5
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33
1
(.)
2.6
.
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35
1
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..
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..
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37
1
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(Training)
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... 9
2 .......
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39
1
(Mentoring)
(Mentee)
Mentee
.. Mentee
.......
Internet
...
.......
....
......
....
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1
1
(Coaching)
(two way communication)
(Individual Performance)
(Supervision)
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......
.....
... ()
...
...
....
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47
2
4
2020
2 1 4
1 10
100
11
5%
20 3%
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9
2
Depressive disorders
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51
2
1.
2.
3.
( 2-3 .
) 4.
1-2
5.
6.
7. (
)
8.
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07.30.......
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53
2
2.8
31-42%
!.
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55
2
3.2
15-59 800,000
(Major Depressive Disorder) 300,000
(Dysthymia)
Depressive Disorder Remission
Raplace
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57
2
( )
( )
30-45
3
2-3
1-2
8
6 1
6 1
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3
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61
3
...
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63
3
2545-2549
3.7
..
..
. ..
1.
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67
3
1. /
/
..
. 6 2549 - 2552 7 , 4 , 2 7 3 , 2 , 1 2 2549 2552
53 4 1 52 7 2 Best Practice
2
Depression Depressivedisorders Remission Relapse
2Q 9Q,8Q
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9Q, 8Q
9Q 7
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3
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2.
3.
4.
5.
6.
7.
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3
+ve =
. =
.. =
. / . = /
. = 2Q = 2
9Q = 9
8Q = 8
MDD = Major Depressive Disorder
Rx =
Csg = (Counseling)
Ed =
..
1. -
2Q
..
. / .. .. .
2Q 15
9Q 9Q
8Q
9Q /
8Q
1
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Mild 9Q =7-12
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Moderate9Q = 13-18 Rx + Csg +
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Education
9Q
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75
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85
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2.
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2.
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3.
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9Q ()
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2Q
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9
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9Q)
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2. 2 :
2 (2Q)
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90 |
91
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2.
3. 9Q
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92 |
93
()
6.
7.
7.1
9Q
7.2
2Q
9Q
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7.4 7
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9Q
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99
5
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1.
2.
3.
4.
5.
6.
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100 |
101
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102 |
103
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10 |
105
5
4.
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..1. 8Q2.
3.
4. 30 - 45
5. .
.
6.
5.
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: 19
9Q
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2.
3.
4.
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.
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109
5
- (personality disorder)
2. 7 9Q 1 8Q
. .
1.
2.
3.
4.
1. (Q = 1 - )
1.1
1.2
2. (Q = 9 - 16 )
2.1
2.2
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111
5
()
2.3
3. (Q 17 )
3.1
24
3.2
3.3 9Q
13
8
9
0
(8)
(Antidepressant)
..
..
. . .
(Antidepressant)
Nortriptyline Amitriptyline
Fluoxetine
(Antidepressant) 9Q
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115
5
1. -
2.
3.
4.
(
)
5. ..
6.
7.
9Q
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4. 9Q :
9Q
5. Suicidality :
8Q
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(
)
7.
8.
1
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(2Q)
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)
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116 |
117
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121
6
.....
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..
(Relapse) 6
22
(Recurrent)
6
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123
6
1.
( 9Q
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20
3040
6050
708090
2551 2552 2553
( 1 )
12 |
-
-
-
7
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127
7
...
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131
7
4.
5.
6.
7.
1.
2.
3.
4.
5.
6.
7.
8.
9.
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133
7
1.
2.
-
-
-
3.
2
1.
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5
1.
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135
7
2.
3.
-
-
- -
4.
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137
7
-
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8/12/2019 PCU Manual Depression
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139
7
-
-
-
- 2 - 3
-
-
5.
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12 | 13
3
(2Q)
1 2 2 2 () : ()
2 2 2 2 () :
/
2
2 (
1 2)
9Q
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2
9 (9Q)
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44 : 38-45 . .: ; 2549.
, , , , , , , . 2 . . 2550 ;52 : 138-148.
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148 |
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2 2 2 ( 1-7 >7 ()
() ) () ()
1 0 1 2 3
2 0 1 2 3
3 0 1 2 3
4 0 1 2 3
5 0 1 2 3
6 0 1 2 3
7 0 1 2 3
8 0 1 2 3
9 0 1 1 3
145
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8 (8Q)
()
1 0 1 ....
2 0 2 ...
3 .... 0 6( ()... ( ).... )...() 0 8
4 0 8
5 0 9
6 0 4
7 / 0 10
8 () 0 4 ()
1()
146 |
8/12/2019 PCU Manual Depression
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0 1 - 8 9 - 16 17
1 - 7
1 8
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