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儿童和青少年精神科住院部的自伤行为:复杂护理提供的实际情况

Self-Injurious Behavior in Child and Adolescent Psychiatry Inpatient Units: Actual Aspects of the Complex Care Provision.

作者信息

Lesinskienė Sigita, Afrahi Mariam, Pociūtė Kamilė

机构信息

Clinic of Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.

Faculty of Medicine, Vilnius University, Vilnius, Lithuania.

出版信息

Acta Med Litu. 2024;31(2):275-287. doi: 10.15388/Amed.2024.31.2.7. Epub 2024 Dec 4.

Abstract

BACKGROUND

Nonsuicidal self-injurious behavior in children and adolescents is a major concern that requires mental health professionals' attention. The aim of this study is to analyze clinical care aspects of children and adolescents who self-harm in psychiatric hospitals.

MATERIALS AND METHODS

In 2023, 30 various specialists from five different child and adolescent psychiatric units in Lithuania were interviewed. The survey used a semistructured interview consisting of twelve questions related to complex clinical care methods of children and adolescents who self-harm. The interview responses were summarized and grouped into 5 categories: assessment and monitoring, methods and consequences of self-injury, safety measures, prevention and treatment, insights from staff.

RESULTS

Self-injurious behavior in psychiatric inpatient settings was managed through risk assessment, monitoring, communication, medication, counselling, removal of sharp objects, patient allocation, and a several of other methods such as safety contracts, rewards or alternate pain-inducing or self-harm mimicking stimuli. Despite the hospital's safety procedures patients frequently devised alternate methods to self-harm, such as hitting and scratching themselves and using nonspecific materials.

CONCLUSIONS

The management of self-harm in children and adolescents psychiatric settings remains insufficient. Further research is needed to explore alternative ways of managing self-injurious behavior in child and adolescent psychiatric hospitals.

摘要

背景

儿童和青少年的非自杀性自伤行为是一个重大问题,需要心理健康专业人员的关注。本研究的目的是分析在精神病医院自伤的儿童和青少年的临床护理方面。

材料与方法

2023年,对立陶宛五个不同儿童和青少年精神科单位的30名不同专家进行了访谈。该调查采用了半结构化访谈,包括12个与自伤儿童和青少年的复杂临床护理方法相关的问题。访谈回答被总结并分为5类:评估与监测、自伤的方法与后果、安全措施、预防与治疗、工作人员的见解。

结果

精神科住院患者的自伤行为通过风险评估、监测、沟通、药物治疗、咨询、移除尖锐物品、患者分配以及其他几种方法进行管理,如安全契约、奖励或替代疼痛诱导或自伤模仿刺激。尽管医院有安全程序,但患者经常想出其他自伤方法,如击打和抓挠自己以及使用非特定材料。

结论

儿童和青少年精神科环境中自伤行为的管理仍然不足。需要进一步研究以探索在儿童和青少年精神病医院管理自伤行为的替代方法。

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