儿科医生对儿童自杀行为的预防、风险判定或检测能力:横断面调查研究

A. Basova, M. Bebchuk, N. Ustinova, L. Namazova-Baranova, Kamilla E. Efendiyeva, E. Vishneva
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引用次数: 0

摘要

背景。儿童和青少年自杀仍然是最令人痛苦的公共问题之一。2019冠状病毒病大流行加剧了这一话题,因为这一时期儿童自杀人数有所增加。研究和实践指南确定了初级保健医生在预防、识别和处理自杀行为患者方面的主导作用。同时,还没有关于儿科医生在自杀领域能力的研究。本研究的目的是研究儿科医生在自杀行为的预防、风险判断和检测方面的能力。采用原始电子问卷进行横断面研究,旨在了解儿科医生评估儿童自杀行为的能力水平。问卷共18个问题。我们收到了208份电子问卷。97.1%的专家确认他们在入院时评估过患者的情绪状态。入院时:86.1%的专家考虑了儿童的外貌特征、面部表情、语音语调,65.4%的专家询问了儿童的情绪,62.5%的专家采访了儿童的父母。98.6%的专家会注意自己造成的伤害痕迹,88.4%的专家会询问这些伤害的来源。只有36.1%的受访者询问患者自杀的想法、意图或行为。只有69.3%的专家愿意将患者转介给心理医生,51.7%的专家愿意将患者转介给精神科医生。尽管大多数接受调查的儿科医生注意到了自杀意图的迹象(情绪低落、自残),但他们在入院时避免讨论自杀的话题。提高儿科医生的能力应着眼于消除心理健康领域的污名化,提高知识水平,并发展与有自杀行为的儿童一起工作的实际技能。
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Pediatricians’ Competence in Prevention, Risk Determination or Detection of Suicidal Behavior in Children: Cross-Sectional Survey Study
Background. Child and adolescent suicides remain one of the most painful public issues. The COVID-19 pandemic has aggravated this topic as the number of suicides among children population has increased in this period. Research and practice guidelines identify the leading role of primary care physicians in the prevention, identification, and routing of patients with suicidal behavior. At the same time, there were no studies on pediatricians’ competence in the field of suicides.Objective. The aim of the study is to study pediatricians’ competence in prevention, risk determination or and detection of suicidal behavior.Methods. Cross-sectional study was conducted with the usage of original electronic questionnaire aimed on identifying the level of pediatricians’ competence in evaluating suicidal behavior in children. Questionnaire included 18 questions.Results. We have received 208 electronic questionnaires. 97.1% of specialists have confirmed that they evaluate emotional status of their patients during admission. During admission: 86.1% of specialists have considered the characteristics of children appearance, facial expression, voice intonation, 65.4% — have asked questions about mood, 62.5% — have interviewed parents. 98.6% of specialists pay attention to the presence of self-inflicted injuries marks, 88.4% — ask about the origin of these injuries. Only 36.1% of respondents ask patients about suicidal thoughts, intentions, or actions. Only 69.3% of specialists are ready to refer their patients to psychologist, and 51.7% — to psychiatrist.Conclusion. Even though most surveyed pediatricians notice signs of suicidal intent (low mood, self-inflicted injuries), they avoid discussing the topic of suicide during admission. Increasing the competence of pediatricians should be aimed on destigmatisation in the field of mental health, increasing the knowledge level, and developing practical skills in working with children with suicidal behavior.
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