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一种新颖的急诊自杀风险评估方法:虚拟协作自杀风险评估与管理。

A novel engagement of suicidality in the emergency department: Virtual Collaborative Assessment and Management of Suicidality.

机构信息

Evidence-Based Practice Institute, LLC, 3303 South Irving Street, Seattle, WA 98144, USA.

The Catholic University of America, O'Boyle Hall, Room 314, 620 Michigan Ave NE, Washington, DC 20064, USA.

出版信息

Gen Hosp Psychiatry. 2020 Mar-Apr;63:119-126. doi: 10.1016/j.genhosppsych.2018.05.005. Epub 2018 May 20.

Abstract

OBJECTIVE

A novel avatar system (Virtual Collaborative Assessment and Management of Suicidality System; V-CAMS) for suicidal patients and medical personnel in emergency departments (EDs) was developed and evaluated. V-CAMS facilitates the delivery of CAMS and other evidence-based interventions to reduce unnecessary hospitalization, readmissions, and suicide following an ED visit.

METHOD

Using iterative user-centered design with 24 suicidal patients, an avatar prototype, "Dr. Dave" (based on Dr. Jobes) was created, along with other patient-facing tools; provider-facing tools, including a clinical decision support tool were also designed and tested to aid discharge disposition.

RESULTS

Feasibility tests supported proof of concept. Suicidal patients affirmed the system's overall merit, positive Perception of Care, and acceptability; medical providers (n = 21) viewed the system as an efficient, effective, and safe method of improving care for suicidal ED patients and reducing unnecessary hospitalization.

CONCLUSIONS

Technology tools including a patient-facing avatar and e-caring contacts, along with provider-facing tools may offer a powerful method of facilitating best-practice suicide prevention interventions and point-of-care tools for suicidal patients seeking ED services and their medical providers. Future directions include full development of V-CAMS and integration into a health electronic medical record and a rigorous randomized controlled trial to study its effectiveness.

摘要

目的

为急诊科的自杀患者和医务人员开发并评估了一种新的虚拟化身系统(虚拟协作评估和管理自杀系统;V-CAMS)。V-CAMS 有助于提供 CAMS 和其他基于证据的干预措施,以减少 ED 就诊后的不必要住院、再入院和自杀。

方法

使用迭代的以用户为中心的设计,与 24 名自杀患者一起,创建了一个虚拟化身原型“Dave 博士”(基于 Jobes 博士),以及其他面向患者的工具;还设计和测试了面向提供者的工具,包括临床决策支持工具,以帮助确定出院情况。

结果

可行性测试支持概念验证。自杀患者肯定了该系统的整体价值、对护理的积极感知和可接受性;医疗提供者(n=21)认为该系统是一种提高对自杀 ED 患者护理质量和减少不必要住院的有效、有效和安全的方法。

结论

包括面向患者的虚拟化身和电子关怀联系人在内的技术工具,以及面向提供者的工具,可能为促进最佳实践的自杀预防干预措施以及为寻求 ED 服务的自杀患者及其医疗提供者提供即时护理工具提供一种强大的方法。未来的方向包括全面开发 V-CAMS 并将其集成到健康电子病历中,并进行严格的随机对照试验以研究其有效性。

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