Cecchin Hareli Fernanda Garcia, Murta Sheila Giardini, de Macedo Etiene Oliveira Silva, Moore Rafael Alberto
Universidade Federal do Tocantins, Pró-reitoria de Assuntos Estudantis - PROEST, Quadra 109 Norte, Avenida NS-15, Prédio da Reitoria, Plano Diretor Norte, 77001-090, Palmas, Tocantins, Brazil.
Department of Clinical Psychology, University of Brasília, Brasília, Brazil.
Psicol Reflex Crit. 2022 Jul 19;35(1):22. doi: 10.1186/s41155-022-00227-x.
A scoping review of systematic reviews was carried out to identify evidence of efficacy, effectiveness, and cost-effectiveness of universal and selective suicide prevention programs among university students worldwide. Five databases were reviewed using terms in English, Spanish, and Portuguese. The following were the inclusion criteria: systematic review or meta-analysis or meta-synthesis, suicide prevention in college students, evaluation of the efficacy, effectiveness and/or cost-effectiveness of interventions, and peer-reviewed studies. The quality of reviews was assessed. The field of study features three decades of publication in high-income countries. The strategy used, the components of the program, and the target audience to which they are delivered interfere with efficacy. In the psychoeducation strategy, the experiential and didactic components are more efficacious in the knowledge about suicide. And the motivational enhancement component promotes greater self-efficacy in suicide prevention. Programs that take a multimodal approach are effective in increasing short-term attitudes related to suicide and reducing rates of completed suicide. The gatekeeper strategy delivered to peer counselors is the most effective one in the outcomes, including short-term and long-term knowledge about suicide and its prevention and self-efficacy in suicide prevention. A greater number of evaluated studies of gatekeeper interventions were identified, indicating a trend in this research field. No review addressed the effects on subgroups that were classified based on sex, racial or sexual minorities, and special (indigenous) populations. Only one study addressed cost-effectiveness, pointing out that the psychoeducation and gatekeeper strategies have relevant net benefit rates, but the gatekeeper strategy has a higher cost-benefit ratio compared to the psychoeducation strategy. The findings indicate that psychoeducation and gatekeeper interventions tend to be more efficacious when they combine education and skills training to intervene in suicidal behavior. The components of the intervention and the target audience to which it is delivered influence efficacy. Multimodal interventions evaluate completed suicide outcomes, but require greater implementation efforts, in terms of human and financial resources and more time for the evaluation.
开展了一项对系统评价的范围综述,以确定全球大学生中普遍和选择性自杀预防项目的疗效、有效性和成本效益的证据。使用英语、西班牙语和葡萄牙语术语对五个数据库进行了检索。纳入标准如下:系统评价、荟萃分析或综合分析;大学生自杀预防;干预措施的疗效、有效性和/或成本效益评估;以及同行评审研究。对综述的质量进行了评估。该研究领域在高收入国家已有三十年的出版历史。所采用的策略、项目组成部分以及所针对的目标受众都会影响疗效。在心理教育策略中,体验式和讲授式组成部分在自杀知识方面更有效。而动机增强组成部分在自杀预防方面能促进更高的自我效能感。采用多模式方法的项目在增加与自杀相关的短期态度和降低自杀完成率方面是有效的。针对同伴辅导员实施的守门人策略在结果方面是最有效的,包括关于自杀及其预防的短期和长期知识以及自杀预防方面的自我效能感。发现了更多关于守门人干预措施的评估研究,表明该研究领域的一种趋势。没有综述涉及基于性别、种族或性少数群体以及特殊(土著)人群分类的亚组的影响。只有一项研究涉及成本效益,指出心理教育和守门人策略有相关的净效益率,但与心理教育策略相比,守门人策略的成本效益比更高。研究结果表明,心理教育和守门人干预措施在结合教育和技能培训以干预自杀行为时往往更有效。干预措施的组成部分及其所针对的目标受众会影响疗效。多模式干预措施评估自杀完成情况的结果,但在人力和财力资源方面需要更大的实施努力,并且评估需要更多时间。