Hunsager Anita, Walby Fredrik A, Midtbø Vivian, Morken Tone, Baste Valborg, Johansen Ingrid Hjulstad
National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre AS, Bergen, Norway and Department of Global Public Health and Primary Care, University of Bergen, Norway.
National Centre for Suicide Research and Prevention, University of Oslo, Norway.
Scand J Prim Health Care. 2025 Mar;43(1):85-95. doi: 10.1080/02813432.2024.2400668. Epub 2024 Sep 11.
To describe and compare contacts regarding self-injurious thoughts and behaviours to other contacts to emergency primary care.
Observational study.
A sentinel network of seven emergency primary care centres throughout Norway.
Initial contacts regarding patients 10 years and older during 12 consecutive months (11/2021-10/2022).
Contacts due to self-injurious thoughts and behaviours.
Self-injurious thoughts and behaviours were the reason for contact for 0.6% ( = 478) of initial contacts for patients aged 10 years or older ( = 77 344). When compared to other contacts, self-injurious thoughts and behaviours were associated with female gender, younger age, occurrence during evening and nighttime, higher urgency, and more physician consultations and call-outs. Of contacts about self-injurious thoughts and behaviours, 58.2% were regarding thoughts and 41.8% about behaviours, and in 75.0% a history of similar contacts was recorded. Contacts regarding thoughts often concerned threats (30.6%) and were more often handled by telephone advice than contacts regarding behaviours. Contacts regarding behaviours with suicidal intent were associated with higher urgency and more physician call-outs than contacts regarding non-suicidal behaviours.
Self-injurious thoughts and behaviours are rare reasons for contact to emergency primary care but are assessed as more urgent than other contact reasons and trigger more extensive medical help. Many of the patients are known to the service through a history of similar contacts.
The infrequency and severity of these encounters might necessitate training, decision support and procedures to compensate for the health care personnel's limited exposure.
描述并比较与自我伤害性想法和行为相关的就诊情况与其他急诊初级保健就诊情况。
观察性研究。
挪威全国七个急诊初级保健中心组成的哨点网络。
连续12个月(2021年11月至2022年10月)期间10岁及以上患者的首次就诊。
因自我伤害性想法和行为导致的就诊。
自我伤害性想法和行为是10岁及以上患者首次就诊(n = 77344)的0.6%(n = 478)的就诊原因。与其他就诊情况相比,自我伤害性想法和行为与女性、年轻、傍晚和夜间发病、更高的紧急程度以及更多的医生会诊和出诊相关。在因自我伤害性想法和行为就诊中,58.2%涉及想法,41.8%涉及行为,75.0%有类似就诊史记录。关于想法的就诊通常涉及威胁(30.6%),且比关于行为的就诊更多通过电话咨询处理。有自杀意图的行为就诊比无自杀意图的行为就诊紧急程度更高,医生出诊更多。
自我伤害性想法和行为是急诊初级保健就诊的罕见原因,但被评估为比其他就诊原因更紧急,并引发更广泛的医疗救助。许多患者因有类似就诊史而为服务机构所知。
这些就诊情况的罕见性和严重性可能需要培训、决策支持和程序,以弥补医护人员接触此类情况有限的问题。