Preventing post-discharge suicides in psychiatric patients: insights from patients, lay healthcare supporters, and mental health professionals-a qualitative analysis.
Preventing post-discharge suicides in psychiatric patients: insights from patients, lay healthcare supporters, and mental health professionals-a qualitative analysis.
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DOI：
10.1186/s12889-023-17475-w
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发表时间：
2024-01-02
影响因子：
4.5
通讯作者：
中科院分区：
文献类型：
--
作者：
与一般人相比，出院的精神病患者由于生活中的各种危险因素而有更高的自杀风险。然而，这些患者出院后的具体问题和需求仍不清楚。这项研究是更广泛的实施研究的一部分，旨在制定针对中国精神疾病患者出院后自杀的干预策略。本研究试图从患者、他们的非专业医疗保健支持者(LHS)和精神卫生专业人员(MPS)的角度定性地调查问题和需求，旨在提高干预策略的有效性。这项研究是基于深圳康宁医院(深圳康宁医院)的更大实施研究的一部分，中国。在基于社区的参与式研究框架下，我们招募了出院精神病患者、他们的LHS和医生作为一个协作的社区团队，并对患者和LSHS进行了个人深入访谈，并与MPS进行了焦点小组访谈。我们利用主题分析方法，通过系统地对数据进行编码和分析，从访谈中确定子主题和主题。总共招募了45名参与者进行访谈，其中包括17名患者、8名LHS和20名MPS。我们进行了25次个人深度访谈和3次焦点小组访谈。通过访谈，我们确定了出院后问题的三个主题：与自我有关的问题，与家庭有关的问题，与社会和社区有关的问题。我们还确定了与减少出院后自杀有关的四个主题：积极主动的自我管理、多功能亲属、多功能MP小组和温暖的社会。重点强调了来自LHS的有形支持和来自议员的情感支持。后续干预被确定为解决这些未得到满足的需求的最重要方式。来自社区的辅助支持以及为精神障碍患者提供关爱和非歧视性的环境对于降低自杀风险至关重要。建立一个综合的精神健康服务网络，连接精神病患者、LHS和MPS跨社区和社会部门，以患者为中心的后续护理为核心，是更好地满足患者需求和减少出院后自杀的切实可行的方法。注册号：NCT04907669。注册日期：2021年5月26日。网上版载有补充材料，可在10.1186/s12889-023-17475-w查阅。
Discharged psychiatric patients are at higher risk of suicide due to various risk factors in their lives compared to the general population. However, specific problems and needs of these patients after discharge remain unclear. This research constitutes a segment of a broader implementation study designed to formulate an interventional strategy targeting post-discharge suicide among Chinese psychiatric patients. The present study seeks to qualitatively investigate the problems and needs from the perspectives of patients, their lay healthcare supporters (LHSs), and mental health professionals (MPs), aiming to enhance the efficacy of the interventional strategy. This study is part of a larger implementation study based on Shenzhen Kangning Hospital (SKH) in Shenzhen, Guangdong, China. Under the community-based participatory research framework, we recruited discharged psychiatric patients, their LHSs, and MPs as a collaborative community team, and we conducted individual in-depth interviews for patients and LSHs and focus group interviews with MPs. We utilized a thematic analysis approach to identify sub-themes and themes from interviews through systematically coding and analyzing the data. A total of 45 participants were recruited for interviews, comprising 17 patients, 8 LHSs, and 20 MPs. We conducted 25 individual in-depth interviews and 3 focus group interviews. Through the interviews, we identified three themes of post-discharge problems: problems related to self, family-related problems, societal and community-related problems. We also identified four themes related to reducing post-discharge suicide: proactive self-management, multifunctional relatives, multifunctional MP group, and a warm society. The tangible support from LHSs and emotional support from MPs are strongly emphasized. Follow-up interventions were identified as the most significant way to addressing these unmet needs. Instrumental support from the community and a caring and non-discriminatory environment for individuals with mental disorders are essential for reducing suicide risk. Establishing an integrated mental health care service network that connects psychiatric patients, LHSs, and MPs cross community and societal sectors, with patient-centered follow-up care at its core, is a practical approach to better address patients’ needs and reduce post-discharge suicide. Registration number: NCT04907669. Date of registration: May 26th,2021. The online version contains supplementary material available at 10.1186/s12889-023-17475-w.
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影响因子：
3.8
作者：
Cramer RJ;Kapusta ND
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