Effectiveness of AIMS, a Four-Week Recovery-Oriented Suicide Prevention Pathway

IF 3.6 2区 医学 Q1 NURSING
Manaan Kar Ray, Melanie Gregory, Marianne Wyder, Md Abu Choudhury, Nikki Geffen, Abigail Lane, Kieran Kinsella, Chiara Lombardo
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Abstract

Striking a balance between risk and recovery while supporting people in suicidal distress is a challenging proposition. To address this challenge, a 4-week AIMS (Assessment, Intervention, Monitoring, Step up/down) pathway was created to support people in suicidal crisis. Each of the four functions was customised into semi-structured conversations about pain relief. The pathway operationalised tools for relational safety from the PROTECT framework for suicide prevention. To deliver this pathway, a new team was established that included both clinicians and lived experience staff. Scores for the Short Warwick Edinburgh Mental Wellbeing Scale (SWEMWBS) for 300 patients were collected before and after time on the pathway. Paired T tests were performed individually for each item as well as for the total. All 7 items and the total score had statistically significant improvement (p < 0.01). The mean pre- and post-total scores increased from 14.8 to 22.5, strongly indicating clinically meaningful improvement at an individual and group level. The improvement on baseline in each of the seven items ranged from 38% to 73.5%. The top two were in the person's ability to deal with problems and in them feeling relaxed. The study provides a blueprint for collaborative and empowering suicide prevention pathways that strike a balance between positive risk taking and safe care through a relational approach. Professional and lived experience both played a part in capturing hope through evidence-based person-centred interventions, helping a person in suicidal crisis improve their mental wellbeing.

AIMS的有效性,一个四周康复导向的自杀预防途径
在支持有自杀倾向的人的同时,在风险和康复之间取得平衡是一项具有挑战性的提议。为了应对这一挑战,创建了一个为期四周的AIMS(评估、干预、监测、上升/下降)途径,以支持处于自杀危机中的人们。四种功能中的每一种都被定制成半结构化的关于疼痛缓解的对话。途径操作工具的关系安全从保护框架预防自杀。为了实现这一途径,建立了一个新的团队,包括临床医生和有经验的工作人员。300名患者的短期华威爱丁堡心理健康量表(SWEMWBS)得分在路径时间前后收集。配对T检验分别对每个项目和总项目进行。7项及总分均有统计学显著改善(p < 0.01)。总分前和总分后的平均得分从14.8分增加到22.5分,强烈表明在个体和组水平上有临床意义的改善。七个项目中每一个项目在基线上的改善从38%到73.5%不等。最重要的两个是一个人处理问题的能力和他们的放松感。该研究为合作和授权自杀预防途径提供了蓝图,通过关系方法在积极冒险和安全护理之间取得平衡。专业和生活经验都在通过基于证据的以人为本的干预措施捕捉希望方面发挥了作用,帮助处于自杀危机中的人改善他们的心理健康。
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来源期刊
CiteScore
7.60
自引率
8.90%
发文量
128
审稿时长
6-12 weeks
期刊介绍: The International Journal of Mental Health Nursing is the official journal of the Australian College of Mental Health Nurses Inc. It is a fully refereed journal that examines current trends and developments in mental health practice and research. The International Journal of Mental Health Nursing provides a forum for the exchange of ideas on all issues of relevance to mental health nursing. The Journal informs you of developments in mental health nursing practice and research, directions in education and training, professional issues, management approaches, policy development, ethical questions, theoretical inquiry, and clinical issues. The Journal publishes feature articles, review articles, clinical notes, research notes and book reviews. Contributions on any aspect of mental health nursing are welcomed. Statements and opinions expressed in the journal reflect the views of the authors and are not necessarily endorsed by the Australian College of Mental Health Nurses Inc.
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