University of California San Diego Health, La Jolla, CA, USA.
Department of Psychiatry, University of California San Diego School of Medicine, La Jolla, CA, USA.
Worldviews Evid Based Nurs. 2020 Feb;17(1):6-15. doi: 10.1111/wvn.12419.
Previous studies have demonstrated nurses are at risk of suicide. This is the first national longitudinal study of U.S. nurse suicide.
To identify the longitudinal incidence, method, and risks of nurse suicide in the United States.
2005 to 2016 Centers for Disease Control and Prevention National Violent Death Reporting System retrospective analysis of suicide incident rate ratios (IRR).
A total of 1,824 nurse and 152,495 non-nurse suicides were evaluated. Nurses were at greater risk of suicide than the general population (female IRR 1.395, 95% confidence intervals [CI] 1.323, 1.470, p < .001; male IRR 1.205, 95% CI 1.083, 1.338, p < .001). Female nurses who completed suicide did so most frequently by pharmacologic poisoning (n = 399, 27.2% vs. n = 8,843, 26.9%), whereby male nurses and the general public used firearms (n = 148, 41.7% vs. n = 57,887, 48.4%). Job problems were more likely in nurses (female odds ratio [OR] 1.989, 95% CI 1.695, 2.325, p < .001; male OR 1.814, 95% CI 1.380, 2.359, p < .001), as well as mental health history (female OR 1.126, 95% CI 1.013, 1.253, p < .027; male OR 1.302, 95% CI 1.048, 1.614, p = .016) and leaving a suicide note (female OR 1.221, 95% CI 1.096, 1.360, p < .001; male OR 1.756 [1.412, 2.181], p < .001).
The increased risk of suicide in nurses is congruent with previous reports. The consistency in results increases confidence that findings are generalizable and warrant action. The use of pharmacologic poisoning as a method of suicide, most often by opioids and benzodiazepines, indicates a need for improved identification and treatment of nurses with substance use. Workplace wellness programs need to focus on reducing workplace stressors. Further research is indicated to determine best prevention methods. Policy indications include the need to accurately track gender in nursing, enhance substance use disorder programs, and mandate suicide prevention activities.
先前的研究表明护士有自杀的风险。这是第一项针对美国护士自杀的全国性纵向研究。
确定美国护士自杀的纵向发生率、方法和风险。
对 2005 年至 2016 年疾病控制与预防中心全国暴力死亡报告系统的自杀事件发生率比（IRR）进行回顾性分析。
共评估了 1824 名护士和 152495 名非护士自杀事件。与一般人群相比，护士自杀的风险更高（女性 IRR 为 1.395，95%置信区间[CI]为 1.323-1.470，p<0.001；男性 IRR 为 1.205，95%CI 为 1.083-1.338，p<0.001）。选择自杀的女性护士最常通过药物中毒（n=399，27.2%），而男性护士和普通公众则使用枪支（n=148，41.7%）。护士更容易出现工作问题（女性比值比[OR]为 1.989，95%CI 为 1.695-2.325，p<0.001；男性 OR 为 1.814，95%CI 为 1.380-2.359，p<0.001），以及有心理健康史（女性 OR 为 1.126，95%CI 为 1.013-1.253，p=0.027；男性 OR 为 1.302，95%CI 为 1.048-1.614，p=0.016）和留下自杀遗言（女性 OR 为 1.221，95%CI 为 1.096-1.360，p<0.001；男性 OR 为 1.756[1.412-2.181]，p<0.001）。
护士自杀风险增加与先前的报告一致。结果的一致性增加了对发现具有普遍性并值得采取行动的信心。药物中毒作为自杀手段的使用，最常见的是阿片类药物和苯二氮䓬类药物，表明需要改进对有药物使用问题的护士的识别和治疗。工作场所健康计划需要侧重于减少工作场所压力源。需要进一步研究以确定最佳预防方法。政策指示包括需要准确跟踪护理中的性别、加强物质使用障碍计划以及强制进行自杀预防活动。
