Bradley-Ewing Andrea, Sullivant Shayla A, Williams David D, Lanzillo Elizabeth, Aguinaldo Laika, Wharff Elizabeth, Horowitz Lisa M, Goggin Kathy
Arch Suicide Res. 2022 Jul-Sep;26(3):1173-1185. doi: 10.1080/13811118.2020.1864536. Epub 2020 Dec 28.
Suicide rates among adolescents in the United States continue to climb and many at-risk youths are undetected. Screening for suicidal thoughts has become the primary approach to identify those at risk, but no studies have assessed reactions to its deployment in pediatric outpatient settings. This mixed-method study assessed parents' and adolescents' thoughts about suicide risk screening in non-psychiatric, pediatric outpatient specialty settings.As part of a multi-site measurement validation study, adolescents ( = 269; ages 10-21) and parents ( = 246) at pediatric specialty clinics in the Midwest completed a survey regarding thoughts about suicide risk screening. Data were collected on tablet computers and transcribed verbatim. Three study team members independently coded transcripts of open-ended responses to identify major themes, and frequency data were analyzed using StataSE 15.1. Inter-rater agreement was substantial (Fleiss' Kappa ranged 75-86%).Parents (55% 41-50 years of age, 20% male, 80% White) and adolescents (Mean age = 14.3, 50% male, 77% White) agreed medical providers should screen adolescents for suicide risk (93% and 88%, respectively). Majority of parents indicated that the pediatric outpatient setting is appropriate for suicide risk screening. Major themes included the important role of providers in identifying at-risk youth, the potential for screening to prevent suicides, and concerns about iatrogenic risk and misdiagnosis.Most parents and adolescents support screening for suicide risk in pediatric outpatient settings. Nevertheless, some have concerns about the screening process and implications. As suicide risk screening becomes standard practice in adolescent care, it's critical to develop screening processes that maximize comfort and address concerns.
美国青少年的自杀率持续攀升，许多高危青少年未被发现。筛查自杀念头已成为识别高危人群的主要方法，但尚无研究评估其在儿科门诊环境中的应用效果。这项混合方法研究评估了父母和青少年对非精神科儿科门诊专科环境中自杀风险筛查的看法。作为多地点测量验证研究的一部分，中西部儿科专科诊所的青少年（n = 269；年龄10 - 21岁）和父母（n = 246）完成了一项关于自杀风险筛查看法的调查。数据通过平板电脑收集并逐字转录。三名研究团队成员独立对开放式回答的转录本进行编码以确定主要主题，并使用StataSE 15.1分析频率数据。评分者间一致性很高（Fleiss' Kappa范围为75 - 86%）。父母（55%年龄在41 - 50岁，20%为男性，80%为白人）和青少年（平均年龄 = 14.3岁，50%为男性，77%为白人）一致认为医疗服务提供者应该对青少年进行自杀风险筛查（分别为93%和88%）。大多数父母表示儿科门诊环境适合进行自杀风险筛查。主要主题包括提供者在识别高危青少年方面的重要作用、筛查预防自杀的可能性以及对医源性风险和误诊的担忧。大多数父母和青少年支持在儿科门诊环境中进行自杀风险筛查。然而，一些人对筛查过程和影响存在担忧。随着自杀风险筛查成为青少年护理的标准做法，制定能最大程度提高舒适度并解决担忧的筛查流程至关重要。
