Difficulties in suicide prevention facing primary healthcare workers based on the characteristics of people with suicide risk and healthcare systems
Difficulties in suicide prevention facing primary healthcare workers based on the characteristics of people with suicide risk and healthcare systems
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DOI：
10.1111/jan.15522
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发表时间：
2022-12-04
影响因子：
3.8
通讯作者：
Ikeuchi, Satomi
中科院分区：
文献类型：
--
作者：
Tanaka, Koji;Ikeuchi, Satomi
目的根据自杀风险人群的特征和医疗系统的特点，阐明基层医疗工作者在预防自杀方面面临的困难。定性描述性设计。方法2019年8月至10月，对日本某市政府雇用的15名初级卫生保健工作者进行了半结构化访谈。数据进行了定性描述性分析，按照COPLAN指南进行。结果分析确定了11个次主题和3个主题。主题1，“未能与支持联系”，包括“沟通障碍”和“拒绝支持”的子主题。主题2，“无法提供解决办法的支持”，包括“即使在接受精神病治疗时也死于自杀”和“决心死亡”的副主题。主题3 "孤立“包括”尽管与他人有联系但仍感到孤独“和”缺乏社区发展“两个次主题。结论针对自杀风险人群的特点，了解他们的潜意识，提高社会心理健康素养是非常重要的。要克服与初级保健系统有关的困难，就需要对专门从事心理健康和预防自杀的专业人员进行培训和继续教育。为了避免隔离医疗工作者，并确保那些需要治疗的人获得支持，应建立系统，使跨组织的心理健康专家能够合作。影响基层医护人员通常是有自杀风险人士的第一接触点，在预防自杀方面发挥关键作用。他们面临的挑战包括：难以将有自杀风险的人与支持联系起来;由于有些人甚至在接受治疗时死亡而产生的无助感;以及难以建立防止孤立的社区。这些发现有助于采取措施，减轻基层医疗工作者面临的困难，改革基层医疗系统，预防自杀和挽救生命。在这项研究中，在研究地区工作的初级保健工作者作为受访者参加。他们还确认了研究结果的真实性，从而确保了数据分析的严谨性。
AimsTo clarify difficulties in suicide prevention that primary healthcare workers face based on the characteristics of people with suicide risk and healthcare systems. DesignQualitative descriptive design. MethodsSemi-structured interviews were held with 15 primary healthcare workers employed by a Japanese municipality from August to October 2019. Data were subjected to qualitative descriptive analysis, performed in accordance with the COREQ guidelines. ResultsAnalysis identified 11 subthemes and three themes. Theme 1, 'Failure to connect with support', included the subthemes of 'Obstacles to communication' and 'Refusal of support'. Theme 2, 'Support that cannot offer a solution', included the subthemes 'Dying by suicide even while receiving psychiatric treatment' and 'Resolved to dying'. Theme 3, 'Isolation', included the subthemes 'Loneliness despite being connected with others' and 'Lack of community development'. ConclusionIn relation to difficulties based on the characteristics of people with suicide risk, it is important to be aware of their unspoken views and to increase mental health literacy in society. Overcoming difficulties in relation to the primary healthcare system requires training and continuing education for professionals specializing in mental health and suicide prevention. To avoid isolating healthcare workers and ensure that those in need of treatment access support, systems should be established that enable collaboration with mental health specialists across organizations. ImpactPrimary healthcare workers, who are often the first point of contact for people with suicide risk, play a key role in suicide prevention. The identified challenges they face include difficulties in connecting people with suicide risk with support, a sense of helplessness because some people die even while receiving treatment and difficulties in building communities that prevent isolation. These findings can contribute to measures for alleviating the difficulties primary healthcare workers face, reforming primary healthcare systems for suicide prevention and saving lives. Patient or public contributionIn this study, primary healthcare workers working in the study area participated as interviewees. They also confirmed the truthfulness of the study results, thereby ensuring the rigour of the data analysis.