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自杀与暴力预防:急诊科的家长教育

Suicide and violence prevention: parent education in the emergency department.

作者信息

Kruesi M J, Grossman J, Pennington J M, Woodward P J, Duda D, Hirsch J G

机构信息

Department of Psychiatry, University of Illinois at Chicago 60612, USA.

出版信息

J Am Acad Child Adolesc Psychiatry. 1999 Mar;38(3):250-5. doi: 10.1097/00004583-199903000-00010.

DOI:10.1097/00004583-199903000-00010
PMID:10087685
Abstract

OBJECTIVE

To determine prospectively whether parental receipt of injury prevention education is associated with new action limiting access to lethal means and if so, what action was taken for which means.

METHOD

Prospective follow-up of 103 adults whose children made an emergency department visit for mental health assessment or treatment. Record review assessed whether hospital staff provided injury prevention education. Logistic regression was used to determine the likelihood of new caretaker action limiting access to the following potentially lethal means: firearms, alcohol, prescription medications, and over-the-counter medications.

RESULTS

Significant associations were found between exposure to injury prevention education and action to limit access (adjusted odds ratio = 3.6, 95% confidence interval = 1.1-12.1, p = .04). Five of 8 adults whose households contained firearms took new action to limit access after injury prevention education, whereas none of the 7 firearm-owning families who did not receive injury prevention education took new action to limit firearm access. Similar patterns were seen for other means. Adults more often chose to lock up rather than dispose of lethal means.

CONCLUSIONS

Injury prevention education should be provided to parents during child/adolescent emergency department mental health-related visits. Potential for violence prevention is real because parents do take new action to limit access to lethal means when means restriction education is provided.

摘要

目的

前瞻性地确定父母接受伤害预防教育是否与采取新行动限制获取致命手段相关联,若相关联,针对哪些手段采取了何种行动。

方法

对103名儿童因心理健康评估或治疗前往急诊科就诊的成年人进行前瞻性随访。通过病历审查评估医院工作人员是否提供了伤害预防教育。采用逻辑回归分析来确定新的照顾者采取行动限制获取以下潜在致命手段的可能性:枪支、酒精、处方药和非处方药。

结果

发现接受伤害预防教育与限制获取的行动之间存在显著关联(调整后的优势比 = 3.6,95%置信区间 = 1.1 - 12.1,p = 0.04)。在8个家中有枪支的成年人中,有5人在接受伤害预防教育后采取了新行动来限制获取,而在7个未接受伤害预防教育的有枪家庭中,没有一个家庭采取新行动来限制获取枪支。其他手段也呈现类似模式。成年人更常选择锁藏而非处置致命手段。

结论

应在儿童/青少年因心理健康相关问题前往急诊科就诊期间,向家长提供伤害预防教育。预防暴力的可能性是切实存在的,因为当提供手段限制教育时,家长会采取新行动来限制获取致命手段。

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