在儿科初级保健和急诊室的综合行为健康服务,用于自杀风险的自杀风险
Brianna C M Wellen1,2, Naomi M Wright1, Mira A Bickford3
1Department of Pediatrics, Oregon Health & Science University, Portland, OR, United States.
Frontiers in psychiatry
|November 29, 2023
概括
在初级保健中进行普遍的自杀风险查有助于识别有需要的年轻人. 综合行为健康咨询可能会增加急诊室的访问,但会改善后续护理和服务利用率.
科学领域:
- 儿科初级医疗保健的儿童初级医疗保健.
- 青少年心理健康 青少年心理健康
- 自杀预防 自杀预防
背景情况:
- 在初级保健中进行普遍的自杀风险查对于早期干预至关重要.
- 综合行为健康 (IBH) 旨在优化护理并防止不必要的急诊室 (ED) 住院.
- 之前的研究表明,IBH可以降低查后的ED使用.
研究的目的:
- 评估同一天综合行为健康 (IBH) 咨询对应急部门 (ED) 招生和自杀风险查的年轻人服务利用的影响.
- 为了测试同一天IBH将减少ED招生,但增加未来服务联系的假设.
主要方法:
- 对3649名年轻人 (年龄在10-18岁) 的回顾性图表审查,这些年轻人使用"问自杀选问题" (ASQ) 进行了选.
- 收集的数据包括ASQ分数,PHQ-9分数,以及与IBH,ED和初级保健的接触.
- 使用后勤回归和千平方分析来评估当天IBH与后续结果之间的关联.
主要成果:
- 超过90%的青少年有积极的自杀选被转移到ED.
- 同一天的IBH咨询与一般ED访问的可能性更高.
- 没有接受同一天IBH的患者因自杀而死亡;这些患者在接下来的一个月没有被录取到ED.
- 同一天的IBH积极预测了未来的IBH和初级保健服务的使用情况,特别是在少数民族青年中.
结论:
- 在初级保健中,系统的自杀查和IBH有效地识别风险,并促进适当的分拣.
- 与假设相反,同一天的IBH与ED访问的增加有关,但对于那些检测阳性的人来说,随后的ED入院并不相关.
- IBH咨询似乎可以加强与心理健康和初级保健服务的接触.
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