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教育干预对自杀的影响:系统评价和荟萃分析。

The effects of educational interventions on suicide: A systematic review and meta-analysis.

机构信息

Department of Philosophy, Linguistics and Theory of Science, University of Gothenburg, Gothenburg, Sweden.

出版信息

Int J Soc Psychiatry. 2019 Aug;65(5):399-412. doi: 10.1177/0020764019852655. Epub 2019 Jun 4.

Abstract

BACKGROUND

Suicide is a major public health problem. Educational interventions for preventing suicidal behaviour are widely used, although little is known regarding the collective effectiveness of these interventions.

AIM

We evaluated the existing evidence for the effectiveness of education interventions in the prevention of suicidal behaviour.

METHODS

In this systematic review and meta-analysis, we searched multiple databases using terms related to suicide prevention. The articles were reviewed by two independent reviewers, and the quality of evidence was rated according to Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Data from individual studies were combined in meta-analyses.

RESULTS

We identified 41 studies evaluating two different types of interventions: school-based education interventions and gatekeeper training. Education interventions showed significant gains in terms of knowledge and attitudes, though the effects seem to vary depending on subjects' personal characteristics. School-based education interventions significantly reduced suicidal ideation and suicide attempts in youths. Gatekeeper training showed no significant effect on suicide attempts or gatekeeper skills, though the quality of evidence for the estimate, according to GRADE criteria, was rated as very low.

CONCLUSION

The results of this study indicate that school-based education interventions are effective in preventing suicidal ideation and suicide attempts. In clinical practice, as well as in research, the development and implementation of educational interventions should focus on participants' individual characteristics.

摘要

背景

自杀是一个严重的公共卫生问题。预防自杀行为的教育干预措施被广泛应用,尽管对于这些干预措施的总体效果知之甚少。

目的

我们评估了预防自杀行为的教育干预措施的有效性的现有证据。

方法

在本次系统评价和荟萃分析中,我们使用与自杀预防相关的术语搜索了多个数据库。由两位独立的审稿人对文章进行了审查,并根据推荐评估、制定与评价(Grading of Recommendations Assessment, Development and Evaluation,GRADE)标准对证据质量进行了评级。对个别研究的数据进行了荟萃分析。

结果

我们确定了 41 项评估两种不同类型干预措施的研究:基于学校的教育干预措施和守门员培训。教育干预措施在知识和态度方面显示出显著的收益,但效果似乎因受试者的个人特征而异。基于学校的教育干预措施可显著减少青少年的自杀意念和自杀企图。守门员培训对自杀企图或守门员技能没有显著影响,但根据 GRADE 标准,对该估计值的证据质量评级为极低。

结论

本研究结果表明,基于学校的教育干预措施在预防自杀意念和自杀企图方面是有效的。在临床实践和研究中,教育干预措施的开发和实施应侧重于参与者的个人特征。

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