Steinberg Rosalie, Amini Jasmine, Sinyor Mark, Mitchell Rachel H B, Schaffer Ayal
Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
Suicide Life Threat Behav. 2024 Dec;54(6):1041-1052. doi: 10.1111/sltb.13108. Epub 2024 Jun 27.
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.
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.
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.
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.
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。
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。
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。
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。