医生的自杀预防:识别、干预和降低风险

Alys Cole-King, Stephen Platt
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引用次数: 0

摘要

综合医院的医生和全科医生站在预防自杀的最前沿,他们经常在病人出现自残或有自杀念头的情况下对病人进行评估。然而,传统的评估工具,旨在预测个人层面的风险,已被证明是不可靠的,并且在临床医生与个体患者互动时不起作用。此外,与其他高收入国家的自杀率相比,英国的自杀率相对较低,这进一步削弱了在任何给定时间点确定谁有(更大)自杀风险的有效性。所有表现出自残和自杀想法的患者都应该认真对待,给予同情和理解,并提供个性化评估,以寻求识别风险因素、需求和优势,灌输希望,使寻求帮助和接受支持的能力。自杀是可以预防的;我们需要一种新的叙事方式,从“描述、量化和管理风险”转向“同情、保障和安全规划”。我们提供了当前研究的概述,并提供临床有用的建议,以支持评估和干预,包括在初级保健和综合医院的临床遇到有用的资源。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Suicide prevention for physicians: identification, intervention and mitigation of risk
General hospital doctors and general practitioners are at the forefront of suicide prevention and frequently assess patients following an episode of self-harm or with suicidal thoughts alongside a medical condition. However, traditional assessment tools, which are designed to predict individual-level risk, have been shown to be unreliable and are not useful when the clinician interacts with an individual patient. Additionally, the suicide rate in the UK is relatively low compared to the suicide rate in other high-income countries, further undermining the validity of attempts to determine who is at (greater) risk of suicide at any given time point. All patients presenting with self-harm and suicidal thoughts should be taken seriously, met with compassion and understanding, and offered personalized assessments which seek to identify risk factors, needs and strengths, instilling hope and empowering help-seeking and acceptance of support. Suicide is preventable; we need a new narrative away from ‘characterizing, quantifying and managing risk’ towards focusing on ‘compassion, safeguarding and safety planning’. We provide an overview of current research and offer clinically useful suggestions to support assessment and intervention, including signposting helpful resources for clinical encounters within primary care and the general hospital.
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