The Perspective of Older Men With Depression on Suicide and Its Prevention in Primary Care.
The Perspective of Older Men With Depression on Suicide and Its Prevention in Primary Care.
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患有抑郁症的老年男性对自杀的看法及其在初级保健中的预防。
DOI：
10.1027/0227-5910/a000511
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发表时间：
2018
期刊：
影响因子：
3
通讯作者：
Hinton,Ladson
中科院分区：
文献类型：
--
作者：
Vannoy,Steven;Park,Mijung;Maroney,MeredithR;Unützer,Jürgen;Apesoa-Varano,EsterCarolina;Hinton,Ladson
背景：老年男性的自杀率高于一般人群，但他们对精神卫生服务的利用率较低。目的：本研究旨在描述：（a）初级保健提供者（PCP）可以做些什么来预防晚年自杀，（B）老年男性对与PCP讨论自杀的态度。方法：访谈的主题分析集中在抑郁症和自杀与77抑郁症，低社会经济地位，墨西哥裔老年男性，或美国出生的非西班牙裔白人从初级保健招募。结果如下：出现了几个抑制自杀的主题：这是一个有问题的解决方案，由于宗教禁令，与自我形象的冲突，对他人的影响;以及缺乏手段/能力。有三种预防自杀的方法：与他们谈论抑郁症，谈论他们的自杀对他人的影响，鼓励他们积极主动。绝大多数人，98%，对这样的对话持开放态度。一个意想不到的主题自然而然地出现了：“是什么阻止了男人自杀的想法？“结论：在抑郁症治疗的背景下，在初级保健接触中很少讨论自杀问题。我们的研究表明，老年男性很可能愿意与PCP讨论自杀问题。我们已经确定了几个务实的方法，以帮助临床医生减少老年男性的痛苦和预防自杀。
Background: Suicide rates in older men are higher than in the general population, yet their utilization of mental health services is lower. Aims: This study aimed to describe:(a) what primary care providers (PCPs) can do to prevent late-life suicide, and (b) older men's attitudes toward discussing suicide with a PCP. Method: Thematic analysis of interviews focused on depression and suicide with 77 depressed, low-socioeconomic status, older men of Mexican origin, or US-born non-Hispanic whites recruited from primary care. Results: Several themes inhibiting suicide emerged: it is a problematic solution, due to religious prohibition, conflicts with self-image, the impact on others; and, lack of means/capacity. Three approaches to preventing suicide emerged: talking with them about depression, talking about the impact of their suicide on others, and encouraging them to be active. The vast majority, 98%, were open to such conversations. An unexpected theme spontaneously arose:" What prevents men from acting on suicidal thoughts?" Conclusion: Suicide is rarely discussed in primary care encounters in the context of depression treatment. Our study suggests that older men are likely to be open to discussing suicide with their PCP. We have identified several pragmatic approaches to assist clinicians in reducing older men's distress and preventing suicide.