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澳大利亚一项试验性医院外自杀后接触(HOPE)服务运营头六个月的批判性回顾。

A critical review of the first six months of operation of a trial Hospital Outreach Post-suicidal Engagement (HOPE) service in Australia.

机构信息

Mental Health Program, Eastern Health, VIC, Australia.

Eastern Health Clinical School, Monash University, VIC, Australia.

出版信息

Australas Psychiatry. 2021 Jun;29(3):315-321. doi: 10.1177/1039856220971934. Epub 2020 Dec 27.

Abstract

OBJECTIVE

To review the Hospital Outreach Post-suicidal Engagement (HOPE) service in the first six months of the pilot program in a metropolitan Melbourne setting, including a description of: (a) socio-demographic, health and psychosocial stressors of people referred; (b) method of presentation; (c) interventions provided and (d) outcomes measured.

METHOD

A retrospective case file analysis reviewed the first six months of HOPE service operation.

RESULTS

Forty people received HOPE service during the study period, 60% female, mean age 35 years (range 17-58). The majority had previously engaged in self-harm (72.5%) or attempted suicide (67.5%). Stressors included social isolation, relationship breakdown, unemployment, financial stress, medical problems, history of mental illness, exposure to family violence and adverse childhood events. Statistically significant improvements occurred in the Outcome Rating Scale (ORS) and Session Rating Scale (SRS) following intervention. There were no deaths by suicide during the study period.

CONCLUSION

People referred to HOPE had significant health and psychosocial stressors. Engagement significantly improved subjective well-being and connection with supports. Findings highlighted the need for an integrated clinical and psychosocial model to promote hope and connection in life post suicide attempt. It remains unclear which interventions improved well-being and if this contributes to suicide prevention.

摘要

目的

在墨尔本大都市的试点项目的前六个月内,回顾医院外展自杀后干预(HOPE)服务,包括:(a)被转介者的社会人口统计学、健康和心理社会压力源;(b)就诊方式;(c)提供的干预措施;(d)测量的结果。

方法

回顾性病例档案分析了 HOPE 服务运作的前六个月。

结果

在研究期间,有 40 人接受了 HOPE 服务,其中 60%为女性,平均年龄 35 岁(范围 17-58 岁)。大多数人以前有过自残(72.5%)或自杀未遂(67.5%)。压力源包括社会孤立、关系破裂、失业、经济压力、医疗问题、精神病史、家庭暴力和不良童年经历。干预后,在结局评定量表(ORS)和会谈评定量表(SRS)上均有显著改善。在研究期间没有自杀死亡。

结论

转介至 HOPE 的人有严重的健康和心理社会压力源。参与度显著提高了主观幸福感和与支持的联系。研究结果强调需要一种综合的临床和心理社会模式,以促进自杀未遂后生活的希望和联系。目前尚不清楚哪些干预措施改善了幸福感,以及这是否有助于预防自杀。

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