Health, Law, & Ageing Research Unit (HLARU), Department of Forensic Medicine, Monash University, Southbank, Vic., Australia.
Department of Epidemiology and Preventive Medicine, Monash University, Southbank, Vic., Australia.
Suicide Life Threat Behav. 2019 Jun;49(3):695-706. doi: 10.1111/sltb.12465. Epub 2018 Apr 17.
This study aimed to examine associations between health status and care needs of nursing home residents and risk of death from suicide compared to other causes through a retrospective data linkage cohort study examining nursing home resident deaths in Australia between 2000 and 2013. Data linkage was performed between aged care assessment tools-Resident Classification System and Aged Care Funding Instrument-and the National Coronial Information System. A competing risks survival analysis was performed to determine the association between care assessment variables (activities of daily living (ADL), behavior, and complex health care) and the risk of death from suicide and any other cause. Of the 146 nursing home residents who died from suicide, 130 (89%) were matched to their assessment data, with comparable information available for 95 residents (65%). Residents who required high levels of care with ADL, physical health care, and cognitive and behavioral issues had a higher risk of dying from all other causes, yet lower risk of dying from suicide. The study findings demonstrate the feasibility and value of linking these two data sets; highlight a need for improved data collection processes; and support a person-centered care approach for prevention of suicide among nursing home residents.
本研究旨在通过回顾性数据链接队列研究，考察养老院居民的健康状况和护理需求与自杀死亡风险与其他原因的相关性。该研究调查了 2000 年至 2013 年澳大利亚养老院居民的死亡情况。数据链接是在老年护理评估工具——居民分类系统和老年护理资金工具——与国家验尸信息系统之间进行的。采用竞争风险生存分析来确定护理评估变量（日常生活活动 (ADL)、行为和复杂医疗保健）与自杀和任何其他原因死亡风险之间的关联。在 146 名因自杀而死亡的养老院居民中，有 130 名（89%）与他们的评估数据相匹配，有 95 名（65%）居民有可比信息。日常生活活动、身体健康护理、认知和行为问题需要高水平护理的居民因所有其他原因死亡的风险更高，但自杀死亡的风险较低。研究结果表明，将这两个数据集进行链接是可行且有价值的；强调需要改进数据收集流程；并支持以患者为中心的护理方法，以预防养老院居民自杀。
