Arch Suicide Res. 2024 Jan-Mar;28(1):35-49. doi: 10.1080/13811118.2023.2173113. Epub 2023 Feb 1.
Emergency department (ED) staff are often the first point of contact for individuals in suicidal crisis. Despite this, there is no published research systematically examining the factors influencing decision-making for this patient group.
MedLine, CINAHL, PsycINFO, Web of Science and Cochrane Library databases were searched for three key concepts: (1) suicide, (2) accident and emergency department and (3) decision-making. Three reviewers screened titles, abstracts and full papers independently against the eligibility criteria. Data synthesis was achieved by extracting and analyzing study characteristics and findings. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of included studies.
Seventeen studies met the eligibility criteria and were included in this systematic review. Studies were published from 2004 to 2020 and were of good methodological quality. A number of patient (method of self-harm, age, gender), contextual (availability of services and staff) and staff-related factors (attitudes, training, knowledge) were reported to influence decision-making for patients in suicidal crisis presenting to EDs.
Decision-making in the ED is complex and is influenced by patient, contextual and staff-related factors. These decisions can have an impact on the future care and clinical pathways of patients in suicidal crisis. Additional training is needed for ED staff specifically related to suicide prevention.
急诊科（ED）工作人员通常是处于自杀危机中的个人的第一个接触点。尽管如此，目前还没有发表的研究系统地检查影响这群患者决策的因素。
在 MedLine、CINAHL、PsycINFO、Web of Science 和 Cochrane Library 数据库中搜索三个关键概念：（1）自杀，（2）急症室和（3）决策。三名审查员独立根据入选标准筛选标题、摘要和全文。通过提取和分析研究特征和结果来实现数据综合。混合方法评估工具（MMAT）用于评估纳入研究的质量。
符合入选标准并纳入本系统评价的研究有 17 项。研究发表于 2004 年至 2020 年，方法学质量良好。许多患者（自残方式、年龄、性别）、环境（服务和人员的可用性）和工作人员相关因素（态度、培训、知识）被报告影响了急诊科自杀危机患者的决策。
ED 的决策是复杂的，受到患者、环境和工作人员相关因素的影响。这些决策会对自杀危机患者的未来护理和临床路径产生影响。ED 工作人员需要接受专门针对自杀预防的额外培训。
