Barr Wally, Leitner Maria, Thomas Joan
Health and Community Care Research Unit, University of Liverpool, Thompson Yates Building, Quadrangle, Brownlow Hill, Liverpool L69 3GB, UK.
Accid Emerg Nurs. 2004 Apr;12(2):108-13. doi: 10.1016/j.aaen.2003.12.002.
There is evidence that patients presenting at a hospital Accident and Emergency (A&E) department with self-harm are considerably more likely than many others to discharge themselves before their assessment or treatment are complete. This paper reports a study that is part of a broader analysis of all self-harm presentations to a hospital A&E department over a five-year period. Self-harm patients who chose to remain for assessment and treatment were compared with those who chose to discharge themselves prematurely. We found a mean proportion of 18% of self-harm patients per annum took early discharge between 1996 and 2000 and noted that these patients were more likely than other self-harm patients to have consumed alcohol in the hours immediately prior to their self-harm and attendance at the hospital. Self-harm patients who took early discharge were less likely than other self-harm patients to be admitted to an in-patient bed and less likely to receive a psychosocial assessment from a mental health specialist. We also found that aftercare arrangements were significantly less likely to be made for those patients who took early discharge. Some suggestions are made about approaches that clinical staff could adopt in order to reduce early discharge in self-harm patients.
有证据表明，在医院急诊部就诊的自残患者比其他许多人更有可能在评估或治疗完成前自行出院。本文报告了一项研究，该研究是对一家医院急诊部五年内所有自残就诊病例进行更广泛分析的一部分。将选择留下来接受评估和治疗的自残患者与那些选择过早自行出院的患者进行了比较。我们发现，1996年至2000年期间，每年平均有18%的自残患者提前出院，并注意到这些患者比其他自残患者在自残及前往医院就诊前几小时饮酒的可能性更大。提前出院的自残患者比其他自残患者更不可能被收治入院，也不太可能接受心理健康专家的社会心理评估。我们还发现，为提前出院的患者安排后续护理的可能性明显更小。文中就临床工作人员为减少自残患者提前出院可采用的方法提出了一些建议。
