Childhood adversity and deliberate self-poisoning in Sri Lanka: a protocol for a hospital-based case-control study
Childhood adversity and deliberate self-poisoning in Sri Lanka: a protocol for a hospital-based case-control study
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DOI：
10.1136/bmjopen-2018-027766
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发表时间：
2019-08-01
期刊：
影响因子：
2.9
通讯作者：
Rajapakse, Thilini
中科院分区：
文献类型：
--
作者：
Knipe, Duleeka W.;Bandara, Piumee;Rajapakse, Thilini
儿童期逆境（CA）已被认为是自杀行为的一个关键风险因素，但缺乏来自低收入/中等收入国家的证据。在斯里兰卡，主要在定性或案例系列工作中突出强调了虐待儿童或因母亲分离造成的儿童性虐待，认为这是自杀行为的一个潜在的重要决定因素。到目前为止，还没有定量研究来调查CA作为与斯里兰卡自杀行为相关的关键暴露。该研究的目的是了解CA和自杀行为之间的关联在斯里兰卡，并确定潜在的可修改的因素，以减少任何观察到的自杀行为与CA的风险增加。方法和分析这是一个以医院为基础的病例对照研究。病例（n=200）将从斯里兰卡Peradeniya教学医院医学毒理学病房收治的个人中抽取，用于故意自我中毒的医学管理。性别和年龄频率匹配的对照组（n=200）将从在同一医院门诊部和诊所就诊的患者或陪同访视者中招募，以治疗与关注结局无关的疾病。条件Logistic回归将被用来调查CA和故意自我中毒之间的关联，以及该关联是否被其他关键因素改变，包括社会经济地位，精神病发病率，目前的家庭暴力和社会support.Ethics的经验和传播伦理批准已获得伦理审查委员会的医学院，Peradeniya大学，斯里兰卡。研究人员接受了管理问卷的培训，并设计了参与者安全和遇险协议，以指导研究人员确保参与者的安全以及如何处理遇险的参与者。研究结果将在地方政策论坛和同行评审文章、地方媒体以及国家和国际会议上传播。
Introduction Childhood adversity (CA) has been suggested as a key risk factor for suicidal behaviour, but evidence from low/middle-income countries is lacking. In Sri Lanka, CA, in the form of child maltreatment or as a consequence of maternal separation, has been highlighted in primarily qualitative or case series work, as a potentially important determinant of suicidal behaviour. To date, there have been no quantitative studies to investigate CA as a key exposure associated with suicidal behaviour in Sri Lanka. The aim of the research is to understand the association between CA and suicidal behaviour in Sri Lanka and to identify potentially modifiable factors to reduce any observed increased risk of suicidal behaviour associated with CA.Methods and analysis This is a hospital-based case-control study. Cases (n=200) will be drawn from individuals admitted to the medical toxicology ward of the Teaching Hospital Peradeniya, Sri Lanka, for medical management of intentional self-poisoning. Sex and age frequency-matched controls (n=200) will be recruited from either patients or accompanying visitors presenting at the outpatient department and clinic of the same hospital for conditions unrelated to the outcome of interest. Conditional logistic regression will be used to investigate the association between CA and deliberate self-poisoning and whether the association is altered by other key factors including socioeconomic status, psychiatric morbidity, current experiences of domestic violence and social support.Ethics and dissemination Ethics approval has been obtained from the Ethical Review Committee of the Faculty of Medicine, University of Peradeniya, Sri Lanka. Researchers have been trained in administering the questionnaire and a participant safety and distress protocol has been designed to guide researchers in ensuring participant safety and how to deal with a distressed participant. Results will be disseminated in local policy fora and peer-reviewed articles, local media, and national and international conferences.