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精神科病房住院患者的自我报告尊严及其与自杀行为的关联:精神科病房住院患者的自我评估尊严丧失及其与自杀行为的关联。

Self-Reported Dignity among People Admitted to Psychiatric Wards and Its Association with Suicidal Behaviour: Perte de dignité auto-évaluée chez les personnes admises dans des services psychiatriques et son association avec les comportements suicidaires.

作者信息

Buchok Matthew, Chochinov Harvey M, Kowall Sarah, Bolton Shay-Lee, El-Gabalawy Renée, Hensel Jennifer M, Bolton James M

机构信息

Department of Psychiatry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.

CancerCare Manitoba Research Institute, Winnipeg, MB, Canada.

出版信息

Can J Psychiatry. 2025 Jul 7:7067437251355644. doi: 10.1177/07067437251355644.

Abstract

ObjectiveDignity is an important construct in vulnerable persons; however, there is limited research examining dignity in patients with mental illness. Our study aims to examine self-reported dignity-related distress among psychiatric inpatients using the patient dignity inventory (PDI) and investigate the relationship between this distress and demographic and clinical variables, including suicidality.MethodsBetween June 2021 and July 2022, 97 participants were recruited from two hospitals in Winnipeg, Canada. Participants were patients admitted to acute psychiatric wards, 18 years or older, and provided informed consent. Participants completed a series of standardized self-report measures including the PDI and validated measures of depression, alcohol use, and suicidal behaviour. Demographic and clinical information was also obtained from patient charts. General linear models were used to investigate the relationship between dignity-related distress and demographic and clinical variables.ResultsThe majority of the study sample had moderate to high depression symptomatology (57.7%), previous psychiatric hospitalizations (67.4%), and previous suicide attempts (52.6%). Dignity-related distress was not associated with gender, sexual orientation, age, marital status, or education. Higher levels of dignity-related distress were associated with mental disorder comorbidities ( < 0.01), greater depressive symptoms ( < 0.001), and higher risk alcohol use behaviours ( < 0.001). Increasing levels of dignity-related distress were associated with greater intensity of suicidal ideation ( < 0.001) having at least one previous suicide attempt ( < 0.001), and having a high desire to die during that attempt ( < 0.001).ConclusionAmong psychiatric inpatients, impairment in their sense of dignity was associated with greater clinical severity including both a history of suicide attempt and current suicidal ideation. Further investigation may lead to targeted interventions to mitigate dignity-related distress and improve patient outcomes.

摘要

目的尊严是弱势群体中的一个重要概念;然而,针对精神疾病患者尊严的研究有限。我们的研究旨在使用患者尊严量表(PDI)来调查精神科住院患者自我报告的尊严相关困扰,并探究这种困扰与人口统计学和临床变量(包括自杀倾向)之间的关系。

方法2021年6月至2022年7月期间,从加拿大温尼伯的两家医院招募了97名参与者。参与者为入住急性精神科病房、年龄在18岁及以上并提供了知情同意书的患者。参与者完成了一系列标准化的自我报告测量,包括PDI以及经过验证的抑郁、酒精使用和自杀行为测量。人口统计学和临床信息也从患者病历中获取。使用一般线性模型来研究尊严相关困扰与人口统计学和临床变量之间的关系。

结果大多数研究样本有中度至高度的抑郁症状(57.7%)、既往有精神科住院史(67.4%)和既往有自杀未遂史(52.6%)。尊严相关困扰与性别、性取向、年龄、婚姻状况或教育程度无关。较高水平的尊严相关困扰与精神障碍共病(<0.01)、更严重的抑郁症状(<0.001)以及更高风险的酒精使用行为(<0.001)相关。尊严相关困扰水平的增加与自杀意念的强度增加(<0.001)、既往至少有一次自杀未遂(<0.001)以及在那次未遂中强烈的死亡愿望(<0.001)相关。

结论在精神科住院患者中,尊严感受损与更高的临床严重程度相关,包括自杀未遂史和当前的自杀意念。进一步的调查可能会带来有针对性的干预措施,以减轻与尊严相关的困扰并改善患者的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9294/12234506/33ee44da68fc/10.1177_07067437251355644-fig1.jpg

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