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利用患者反馈实施关爱联系以减少精神科住院后的自杀相关结局。

Implementation of caring contacts using patient feedback to reduce suicide-related outcomes following psychiatric hospitalization.

作者信息

Steinberg Rosalie, Amini Jasmine, Sinyor Mark, Mitchell Rachel H B, Schaffer Ayal

机构信息

Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.

出版信息

Suicide Life Threat Behav. 2024 Dec;54(6):1041-1052. doi: 10.1111/sltb.13108. Epub 2024 Jun 27.

Abstract

INTRODUCTION

Suicide risk is substantially elevated following discharge from a psychiatric hospitalization. Caring Contacts (CCs) are brief communications delivered post-discharge that can help to improve mental health outcomes.

METHOD

This three-phase, mixed-method quality-improvement study revised an existing CC intervention using iterative patient and community feedback. Inpatients (n = 2) and community members (n = 13) participated in focus groups to improve existing CC messages (phases 1 and 2). We piloted these messages among individuals with a suicide-related concern following discharge from an inpatient psychiatric hospitalization (n = 27), sending CCs on days 2 and 7 post-discharge (phase 3). Phase 3 participants completed mental health symptom measures at baseline and day 7, and provided feedback on these messages.

RESULTS

Phase 1 and 2 focus group participants indicated preferences for shorter, more visually appealing messages that featured personalized, recovery-focused content. Phase 3 participants demonstrated reductions in depressive symptoms at day-7 post-discharge (-6.4% mean score on Hopkins-Symptom-Checklist, -9.0% mean score on Entrapment-Scale). Most participants agreed that CC messages helped them feel more connected to the hospital and encouraged help-seeking behavior post-discharge.

CONCLUSION

This study supports the use of an iterative process, including patient feedback, to improve CC messages and provides further pilot evidence that CC can have beneficial effects.

摘要

引言

精神科住院出院后自杀风险大幅升高。关爱联络(CC)是出院后进行的简短沟通,有助于改善心理健康状况。

方法

这项三阶段的混合方法质量改进研究利用患者和社区的反复反馈,对现有的CC干预措施进行了修订。住院患者(n = 2)和社区成员(n = 13)参与了焦点小组,以改进现有的CC信息(第1阶段和第2阶段)。我们在住院精神科出院后有自杀相关担忧的个体中(n = 27)对这些信息进行了试点,在出院后第2天和第7天发送CC(第3阶段)。第3阶段的参与者在基线和第7天完成了心理健康症状测量,并对这些信息提供了反馈。

结果

第1阶段和第2阶段焦点小组的参与者表示,更喜欢内容简短、更具视觉吸引力、具有个性化且以康复为重点的信息。第3阶段的参与者在出院后第7天抑郁症状有所减轻(霍普金斯症状清单平均得分降低6.4%,陷入量表平均得分降低9.0%)。大多数参与者一致认为,CC信息帮助他们感觉与医院联系更紧密,并鼓励出院后寻求帮助的行为。

结论

本研究支持使用包括患者反馈在内的迭代过程来改进CC信息,并提供了进一步的试点证据,表明CC可以产生有益效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1f6/11629600/da346272b9de/SLTB-54-1041-g001.jpg

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