Self-harm behavior and no-suicide contracting in psychiatric inpatient settings
Self-harm behavior and no-suicide contracting in psychiatric inpatient settings
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DOI：
10.1053/apnu.2001.23748
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发表时间：
2001-06-01
影响因子：
2.3
通讯作者：
Drew, BL
中科院分区：
文献类型：
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作者：
Drew, BL
虽然协商不自杀合同是一种常见的做法，但关于合同结果的研究是不充分的。本回顾性审查医疗记录的目的是检查不自杀合同如何影响精神科住院患者自我伤害行为的可能性。在收集数据的61个月期间，31名患者（4.8%）有自残行为，占两种研究环境中所有患者的2.64%。这些患者中大约有一半表达了自杀意图。Logistic回归分析显示，无自杀合同和限制水平较高的患者发生自残行为的可能性显著较高（OR = 7.43和2.47,p = 0.005），护理分配的一致性可能与自残行为的可能性较低相关（OR = 0.07），但当该变量被纳入模型时p = 0.068，没有显示使用无自杀合同预防自残行为。合同的谈判可能反映了工作人员的评估，即病人有很高的自杀风险。这些发现证实了对自杀风险进行彻底、持续评估的必要性，无论患者是否同意不自杀合同。桑德斯公司版权所有(C) 2001。
Although negotiation of no-suicide contracts is common practice, research regarding the outcomes of contracting is inadequate, The purpose of this retrospective review of medical records was to examine how no-suicide contracting affected the likelihood of self-harm behavior in psychiatric inpatient settings. Thirty-one patients (4.8%) engaged in self-harm behaviors representing 2.64% of all patients admitted to both study settings during the 61/2-month period from which data were collected. Approximately half of those patients expressed suicidal intent. Logistic regression analysis suggested that patients with no-suicide contracts and with higher levels of restriction had a significantly higher likelihood of self-harm behavior (OR = 7.43 and 2.47, respectively, p = .005), Consistency of nursing assignment is likely associated with a lower probability of self-harm (OR = .07) but p = .068 when this variable was included in the model, Prevention of self-harm behaviors by the use of no-suicide contracting is not shown. Negotiation of a contract is likely a reflection of staff assessment that the patient was at high risk for suicide. These findings confirm the need for thorough, ongoing assessment of suicidal risk, whether or not a patient has agreed to a no-suicide contract. Copyright (C) 2001 by W,B, Saunders Company.