The 18-month impact of an emergency room intervention for adolescent female suicide attempters.
The 18-month impact of an emergency room intervention for adolescent female suicide attempters.
复制标题
急诊室干预对青少年女性自杀未遂者的 18 个月影响。
DOI：
10.1037//0022-006x.68.6.1081
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发表时间：
2000
影响因子：
5.9
通讯作者：
Song,J
中科院分区：
文献类型：
--
作者：
Rotheram-Borus,MJ;Piacentini,J;Cantwell,C;Belin,TR;Song,J
在一名女性青少年自杀未遂后，在随后的18个月中评估了专门的急诊室(ER)护理干预的影响。使用准实验设计，本研究分配了140名年龄在12-18岁的女性青少年自杀未遂者(SA)及其母亲(88%西班牙裔)在急诊室就诊期间接受：(A)专门的急诊室护理，旨在通过提供关于自杀、家庭治疗和工作人员培训的肥皂剧视频来提高对门诊治疗的依从性；或(B)标准急诊室护理。用线性混合模型回归分析评价SA及其母亲18个月后的适应情况(随访率为92%)。随着时间的推移，SA对大多数精神健康指数的调整都有所改善。再次自杀未遂(12.4%)和自杀再构思(29.8%)的比率低于预期，在急诊室条件下类似。专门的急诊室护理条件与SA显著较低的抑郁评分和较低的母亲对家庭凝聚力的评分有关。干预条件与SA的精神症状学初始水平的显著交互作用表明，在高度症状的SA中，干预对母亲的情绪困扰和家庭凝聚力的影响最大。SA在急诊室就诊后参加治疗的情况只与一个结果显著相关--家庭适应性。随着时间的推移，专门的急诊室干预可能会产生实质性和持续的影响，特别是对患有高度精神症状的年轻人的父母。
Following a suicide attempt by female adolescents, the impact of a specialized emergency room (ER) care intervention was evaluated over the subsequent 18 months. Using a quasi-experimental design, this study assigned 140 female adolescent suicide attempters (SA), ages 12–18 years, and their mothers (88% Hispanic) to receive during their ER visit either:(a) specialized ER care aimed at enhancing adherence to outpatient therapy by providing a soap opera video regarding suicidality, a family therapy session, and staff training; or (b) standard ER care. The adjustment of the SA and their mothers was evaluated over 18 months (follow-up, 92%) using linear mixed model regression analyses. SA's adjustment improved over time on most mental health indices. Rates of suicide reattempts (12.4%) and suicidal reideation (29.8%) were lower than anticipated and similar across ER conditions. The specialized ER care condition was associated with significantly lower depression scores by the SA and lower maternal ratings on family cohesion. Significant interactions of intervention condition with the SA's initial level of psychiatric symptomatology indicated that the intervention's impact was greatest on maternal emotional distress and family cohesion among SA who were highly symptomatic. SA's attendance at therapy sessions following the ER visit was significantly associated with only one outcome—family adaptability. Specialized ER interventions may have substantial and sustained impact over time, particularly for the parents of youth with high psychiatric symptomatology.