致命手段的质量 咨询文件 在退伍军人卫生管理局
Gillian Geffen1, Lauren R DiPaolo1, Christopher B Roberts2
1Mental Illness Research, Education, and Clinical Center (MIRECC), Corporal Michael J. Crescenz Department of Veterans Affairs (VA) Medical Center, Philadelphia.
Psychiatric services (Washington, D.C.)
|March 17, 2026
概括
安全规划干预 (SPI) 中的致命手段咨询 (LMC) 行动计划的文档质量很低. 虽然解决了枪支准入问题,但其他手段和具体计划需要为退伍军人改进.
科学领域:
- 公共卫生 公共卫生
- 心理健康服务研究 心理健康服务研究
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 安全规划干预 (SPI) 包括致命手段咨询 (LMC) 以减少退伍军人的自杀风险.
- 有效的LMC行动计划对于减轻对致命手段的获取至关重要.
- 美国退伍军人事务部医疗中心 (VAMCs) 中的LMC计划的文档质量需要检查.
研究的目的:
- 在SPI中评估LMC行动计划的特点和质量.
- 根据患者和临床因素,识别文档质量的差异.
- 为提高LMC文档和退伍军人护理有效性的策略提供信息.
主要方法:
- 从六个不同的VAMC中审查了910个LMC行动计划.
- 三位独立评级人员使用SPI评分算法 (0-3级) 评估计划质量.
- 分析与退伍军人人口统计和临床环境相关的文档质量.
主要成果:
- 低质量医疗保健行动计划的质量评分一般很低 (平均值=1.29±0.86),通常缺乏具体的减肥策略.
- 74%的相关计划记录了减少枪支准入的情况,而药物治疗 (20%) 和其他手段 (13%) 的情况较少.
- 文件质量因退伍军人特征和护理环境而异,男性和门诊机构的得分更高.
结论:
- 在这个VAMC样本中,LMC行动计划的整体质量低于最佳.
- 临床医生表现出对枪支风险的认识,但对其他致命手段的关注较少.
- 需要改进培训和实施策略,以提高LMC行动计划文件的质量.
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