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电话联系对急诊科出院患者再次自杀未遂的影响:随机对照研究。

Effect of telephone contact on further suicide attempts in patients discharged from an emergency department: randomised controlled study.

作者信息

Vaiva Guillaume, Vaiva Guillaume, Ducrocq François, Meyer Philippe, Mathieu Daniel, Philippe Alain, Libersa Christian, Goudemand Michel

机构信息

University Hospital of Lille, School of Medicine, France.

出版信息

BMJ. 2006 May 27;332(7552):1241-5. doi: 10.1136/bmj.332.7552.1241.

Abstract

OBJECTIVE

To determine the effects over one year of contacting patients by telephone one month or three months after being discharged from an emergency department for deliberate self poisoning compared with usual treatment.

DESIGN

Multicentre, randomised controlled trial.

SETTING

13 emergency departments in the north of France.

PARTICIPANTS

605 people discharged from an emergency department after attempted suicide by deliberate self poisoning.

INTERVENTION

The intervention consisted of contacting patients by telephone at one month or three months after discharge from an emergency department for attempted suicide to evaluate the success of recommended treatment or to adjust treatment. Control patients received treatment as usual, in most cases referral back to their general practitioner.

MAIN OUTCOME MEASURES

The primary outcome measures were proportion of participants who reattempted suicide, number of deaths by suicide, and losses to follow-up at 13 months' follow-up. Secondary outcome measures were types and number of contacts with health care.

RESULTS

On an intention to treat basis, the three groups did not differ significantly for further suicide attempts, deaths by suicide, or losses to follow-up: contact at one month (intervention 23% (34/147) v controls 30% (93/312), difference 7%, 95% confidence interval - 2% to 15%), three months (25% (36/146) v 30%, difference 5%, - 4% to 14%). Participants contacted at one month were less likely at follow-up to report having reattempted suicide (12% v 22% in control group, difference 10%, 2% to 18%).

CONCLUSION

Contacting people by telephone one month after being discharged from an emergency department for deliberate self poisoning may help reduce the number of reattempted suicides over one year.

摘要

目的

确定因故意自伤中毒从急诊科出院后1个月或3个月通过电话联系患者与常规治疗相比在一年时间内的效果。

设计

多中心随机对照试验。

地点

法国北部的13个急诊科。

参与者

605名因故意自伤中毒自杀未遂后从急诊科出院的人。

干预措施

干预措施包括在因自杀未遂从急诊科出院后1个月或3个月通过电话联系患者,以评估推荐治疗的效果或调整治疗方案。对照组患者接受常规治疗,在大多数情况下转诊回他们的全科医生处。

主要结局指标

主要结局指标为再次自杀未遂的参与者比例、自杀死亡人数以及13个月随访时的失访情况。次要结局指标为与医疗保健机构接触的类型和次数。

结果

在意向性治疗的基础上,三组在进一步自杀未遂、自杀死亡或失访方面没有显著差异:1个月时联系(干预组23%(34/147),对照组30%(93/312),差异7%,95%置信区间-2%至15%),3个月时联系(25%(36/146),对照组30%,差异5%,-4%至14%)。1个月时接受联系的参与者在随访时报告再次自杀未遂的可能性较小(12%,对照组为22%,差异10%,2%至18%)。

结论

因故意自伤中毒从急诊科出院后1个月通过电话联系患者可能有助于减少一年时间内再次自杀未遂的人数。

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