Murphy Briony J, Bugeja Lyndal, Pilgrim Jennifer, Ibrahim Joseph E
Monash University Department of Forensic Medicine, Victorian Institute of Forensic Medicine, Southbank, VIC, Australia.
Int J Geriatr Psychiatry. 2015 Aug;30(8):802-14. doi: 10.1002/gps.4299. Epub 2015 May 25.
The aim of this study is to systematically review published research describing the frequency, nature, and contributing factors of completed suicides among nursing home residents.
In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement, this review examined all original, peer-reviewed literature published in English between 1 January 1949 and 31 December 2013 describing completed suicides among nursing home residents. Information extracted for analysis included: study and population characteristics, method of suicide, potential risk factors, and interventions.
Eight studies were identified; the majority (n = 5) conducted in the United States of America. There were 113 suicides in nursing homes reported in the literature, 101 with detailed information available for aggregate analysis. The majority were male (n = 62, 61.4%), aged between 61 and 93 years. Suicide was most commonly by hanging (n = 27, 38.0%) or falling from a height (n = 27, 38.0%). Risk factors were considered in a proportion of studies. Depression was examined in 27 cases and present in 18 (67%). Duration of residence was examined in 25 cases, 13 (52%) of which had resided in the nursing home less than 12 months. Physical health was examined in 22 cases, 11 (50%) of whom were experiencing physical decline. Prior suicidal behaviour, cognitive function, and personal loss were also examined. Organizational risk factors and intervention strategies were rarely considered.
There is a paucity of research describing completed suicide among nursing home residents. More large-scale research is required using standardized methods for reporting information to better understand and prevent completed suicides in this setting.
本研究旨在系统回顾已发表的关于疗养院居民自杀死亡的频率、性质及相关因素的研究。
按照系统评价与Meta分析的首选报告项目声明，本综述检索了1949年1月1日至2013年12月31日期间以英文发表的所有描述疗养院居民自杀死亡情况的原创性、经同行评审的文献。提取用于分析的信息包括：研究及人群特征、自杀方式、潜在风险因素及干预措施。
共纳入8项研究；多数研究（n = 5）在美国开展。文献报道了疗养院中的113例自杀事件，其中101例有详细信息可用于汇总分析。多数为男性（n = 62，61.4%），年龄在61至93岁之间。自杀最常见的方式是上吊（n = 27，38.0%）或高处坠落（n = 27，38.0%）。部分研究考虑了风险因素。27例中检查了抑郁情况，18例（67%）存在抑郁。25例中检查了居住时长，其中13例（52%）在疗养院居住不到12个月。22例中检查了身体健康状况，11例（50%）身体机能在下降。还检查了既往自杀行为、认知功能及个人损失情况。组织层面的风险因素及干预策略很少被考虑。
关于疗养院居民自杀死亡的研究较少。需要开展更多采用标准化信息报告方法的大规模研究，以更好地了解并预防该环境下的自杀死亡事件。
