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自杀精神疾病患者的后期护理和临床特征:一项病例对照研究
L Appleby1, J A Dennehy, C S Thomas
1School of Psychiatry and Behavioural Sciences, University Hospital of South Manchester, UK.
Lancet (London, England)
|May 5, 1999
概括
减少精神病患者的精神病治疗与自杀有很强的联系. 即使在临床康复后,保持护理对于保护高风险患者和预防自杀至关重要.
科学领域:
- 精神病学是一个精神病学.
- 公共卫生 公共卫生
- 心理健康服务研究 心理健康服务研究
背景情况:
- 预防自杀是全球卫生重点,在英国有具体目标.
- 证据证明卫生服务在降低自杀率方面的有效性有限.
- 自杀与医疗保健服务之间缺乏明确的联系.
研究的目的:
- 调查从住院护理出院的患者中精神病治疗和自杀风险之间的关联.
- 识别可能导致自杀的卫生服务提供因素.
- 为改善心理健康护理和预防自杀的策略提供信息.
主要方法:
- 进行了一项病例控制研究,涉及149例自杀病例,并与幸存的精神病患者进行了匹配.
- 从病例笔记中收集数据,比较精神病医护的各个方面,临床和社会变量.
- 统计分析考虑了混因素,包括评估的自杀风险.
主要成果:
- 在最后一次社区预约时减少精神病治疗与自杀有显著的相关性 (OR 3.7).
- 自伤史 (OR 3.1),随时护理期间的自杀想法 (OR 1.9) 和第一次入院是最近的 (OR 2.0) 也与自杀有关.
- 只有34%的自杀案有可识别的关键工作者,这表明在实施护理计划方法方面存在挑战.
结论:
- 减少精神病治疗与精神病患者自杀的可能性密切相关.
- 在临床康复之后维持护理对于保护高风险患者至关重要.
- 当前的卫生服务可能无法充分解决已识别的高风险临床变量.
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