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
DOI：
10.1037/0022-006x.68.6.1081
复制
发表时间：
2000-12-01
影响因子：
5.9
通讯作者：
Song, JW
中科院分区：
文献类型：
--
作者：
Rotheram-Borus, MJ;Piacentini, J;Song, JW
在女性青少年自杀未遂后，我们对随后 18 个月内专门急诊室 (ER) 护理干预措施的影响进行了评估。本研究采用准实验设计，分配 140 名年龄在 12-18 岁的青少年自杀未遂者 (SA) 及其母亲（88% 西班牙裔）在急诊室就诊期间接受以下任一治疗：或 (b) 标准急诊室护理。使用线性混合模型回归分析对 SA 及其母亲的调整进行了 18 个月的评估（随访，92%）。随着时间的推移，SA 对大多数心理健康指数的调整有所改善。自杀再尝试率 (12.4%) 和自杀再意念率 (29.8%) 低于预期，并且在急诊室情况下相似。专门的急诊室护理条件与 SA 的抑郁评分显着降低以及母亲对家庭凝聚力的评分较低有关。干预条件与 SA 的初始精神症状水平之间的显着交互作用表明，干预对症状严重的 SA 中的母亲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课程的情况仅与一种结果（家庭适应性）显着相关。随着时间的推移，专门的急诊干预可能会产生实质性和持续的影响，特别是对于患有严重精神症状的青少年的父母。
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.