Patient expectations of and experiences with a suicide risk identification algorithm in clinical practice.
Patient expectations of and experiences with a suicide risk identification algorithm in clinical practice.
复制标题
DOI：
10.1186/s12888-022-04129-1
复制
发表时间：
2022-07-23
期刊：
影响因子：
4.4
通讯作者：
中科院分区：
文献类型：
--
作者：
基于电子健康记录 (EHR) 和保险索赔的自杀风险预测模型是自杀预防方面的一项新颖创新，但患者对其使用的看法尚未得到充分研究。在这项定性研究中，2020 年 3 月至 11 月期间，对来自三个卫生系统的 62 名患者进行了访谈：一个预计实施 EHR 衍生的自杀风险预测模型，另外两名患者正在试验不同的实施方法。现场定制的访谈指南重点关注患者对这项技术的看法、担忧以及在临床实践中实施自杀风险预测模型的偏好和经验。使用持续的比较分析方法来得出主题。受访者普遍支持基于电子病历数据的自杀风险预测模型。人们担心会引发焦虑和自杀念头，或引发强制治疗，尤其是那些报告过寻求心理健康护理的负面经历的人。从事心理健康护理或病例管理的参与者预计会被问到他们的自杀风险，并且在很大程度上赞赏自杀风险对话，尤其是临床医生轻松讨论自杀的对话。大多数患者认可自杀风险模型，该模型使用 EHR 数据来识别有自杀风险的患者。随着卫生系统继续实施此类模型，以患者为中心的护理将涉及由在虚拟或面对面护理过程中具有评估自杀风险经验的临床医生发起的对话。卫生系统应主动监测风险模型实施带来的负面后果，以保护患者的信任。在线版本包含可在 10.1186/s12888-022-04129-1 获取的补充材料。
Suicide risk prediction models derived from electronic health records (EHR) and insurance claims are a novel innovation in suicide prevention but patient perspectives on their use have been understudied. In this qualitative study, between March and November 2020, 62 patients were interviewed from three health systems: one anticipating implementation of an EHR-derived suicide risk prediction model and two others piloting different implementation approaches. Site-tailored interview guides focused on patients’ perceptions of this technology, concerns, and preferences for and experiences with suicide risk prediction model implementation in clinical practice. A constant comparative analytic approach was used to derive themes. Interview participants were generally supportive of suicide risk prediction models derived from EHR data. Concerns included apprehension about inducing anxiety and suicidal thoughts, or triggering coercive treatment, particularly among those who reported prior negative experiences seeking mental health care. Participants who were engaged in mental health care or case management expected to be asked about their suicide risk and largely appreciated suicide risk conversations, particularly by clinicians comfortable discussing suicidality. Most patients approved of suicide risk models that use EHR data to identify patients at-risk for suicide. As health systems proceed to implement such models, patient-centered care would involve dialogue initiated by clinicians experienced with assessing suicide risk during virtual or in person care encounters. Health systems should proactively monitor for negative consequences that result from risk model implementation to protect patient trust. The online version contains supplementary material available at 10.1186/s12888-022-04129-1.
登录
查看更多内容
影响因子：
7
作者：
Yarborough BJH;Stumbo SP
通讯作者：
Stumbo SP
影响因子：
17.7
作者：
Simon, Gregory E.;Stewart, Christine;Carrell, David S.
通讯作者：
Carrell, David S.
影响因子：
15.1
作者：
Sanderson, Michael;Bulloch, Andrew G. M.;Patten, Scott B.
通讯作者：
Patten, Scott B.
DOI：
10.1176/appi.ajp.2011.10111704
发表时间：
2011-12
期刊：
The American journal of psychiatry
影响因子：
--
作者：
Posner K;Brown GK;Stanley B;Brent DA;Yershova KV;Oquendo MA;Currier GW;Melvin GA;Greenhill L;Shen S;Mann JJ
通讯作者：
Mann JJ
影响因子：
4.8
作者：
Walsh, Colin G.;Ribeiro, Jessica D.;Franklin, Joseph C.
通讯作者：
Franklin, Joseph C.