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为儿童和青少年制定出院后自杀预防干预措施:一项整合年轻人、其照顾者及心理健康临床医生生活经历的定性研究

Developing a post-discharge suicide prevention intervention for children and young people: a qualitative study of integrating the lived-experience of young people, their carers, and mental health clinicians.

作者信息

Watling David P, Preece Megan H W, Hawgood Jacinta, Bloomfield Sharyn, Kõlves Kairi

机构信息

Australian Institute for Suicide Research and Prevention, World Health Organization Collaborating Centre for Research and Training in Suicide Prevention; School of Applied Psychology, Griffith University, Mt Gravatt Campus, Brisbane, QLD, 4122, Australia.

Child and Youth Mental Health Service, Queensland Children's Hospital, Brisbane, Australia.

出版信息

Child Adolesc Psychiatry Ment Health. 2022 Mar 27;16(1):24. doi: 10.1186/s13034-022-00460-3.

Abstract

BACKGROUND

Suicide in young people is a leading cause of death. Interventions that are reflexive, tailored, and developed in concert with this at-risk population are needed. This study aimed to integrate lived-experience into the design of a suicide prevention intervention delivered by phone to young people post-discharge from an emergency department (ED) for suicide risk or self-harm.

METHODS

Qualitative study was conducted at the Queensland Children's Hospital, Brisbane Australia. Four focus groups with young people with lived-experience, parents or carers and ED mental health clinicals were conducted. In total 5 young people with lived-experience of suicidality (17-21 years, M = 19.20), 3 parents and carers with a lived-experience of caring for a young person with mental illness, and 10 ED mental health clinicians participated in focus groups. The first phase of qualitative analysis involved a phenomenological analysis and second phase included a deductive content analysis. The paper is following the Consolidated Criteria for Reporting Qualitative Research.

RESULTS

First phase, a phenomenological analysis identified three foundational themes to structure future follow-up phone interventions: a person-centred focus, the phone-call dynamic, and the phone-call purpose. Second phase, a deductive content analysis found that participants preferred an intervention that was structured, consistent, and finite. Moreover, an intervention that was authentic, able to facilitate and empower growing independence, and achievable of young people after an ED presentation was desired.

CONCLUSIONS

Participants expressed their desire for a responsive, structured, and clearly focused phone call that would recognise the young person and parent/carer's needs while providing tailored support to ease transition from the ED to available community and family led care.

摘要

背景

年轻人自杀是主要的死亡原因之一。需要采取反思性、针对性且与这一高危人群共同制定的干预措施。本研究旨在将生活经历融入到一种自杀预防干预措施的设计中,该干预措施通过电话向因自杀风险或自我伤害而从急诊科(ED)出院后的年轻人提供。

方法

在澳大利亚布里斯班的昆士兰儿童医院进行了定性研究。开展了四个焦点小组,参与者分别是有生活经历的年轻人、父母或照顾者以及急诊科心理健康临床医生。共有5名有自杀倾向生活经历的年轻人(17 - 21岁,平均年龄19.20岁)、3名有照顾患有精神疾病年轻人生活经历的父母和照顾者以及10名急诊科心理健康临床医生参与了焦点小组。定性分析的第一阶段涉及现象学分析,第二阶段包括演绎性内容分析。本文遵循定性研究报告的综合标准。

结果

第一阶段,现象学分析确定了三个基础主题,以构建未来的后续电话干预措施:以个人为中心、电话沟通动态以及电话沟通目的。第二阶段,演绎性内容分析发现参与者更喜欢结构化、一致且有限的干预措施。此外,他们希望有一种真实、能够促进并赋予成长中的独立性、且在急诊科就诊后年轻人能够实现的干预措施。

结论

参与者表达了他们对一个响应迅速、结构化且重点明确的电话的期望,该电话能够识别年轻人以及父母/照顾者的需求,同时提供针对性支持,以缓解从急诊科到社区和家庭主导的现有护理的过渡。

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