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來源文獻資料
摘要
外文摘要
引文資料
題名:
Emergency Management of Adolescent Self-harm: Patients' Characteristics and Effect of Case Management
書刊名:
Taiwanese Journal of Psychiatry
作者:
黃郁心
/
吳書儀
/
林承儒
/
孫芳如
/
劉珣瑛
作者(外文):
Huang, Yu-hsin
/
Wu, Shu-i
/
Lin, Chen-ju
/
Sun, Fang-ju
/
Liu, Shen-ing
出版日期:
2010
卷期:
24:3
頁次:
頁168-180
主題關鍵詞:
青少年
;
個案管理
;
病人順從性
;
自傷行為
;
Adolescent
;
Case management
;
Patient compliance
;
Self-injurious behavior
原始連結:
連回原系統網址
相關次數:
被引用次數:期刊(0) 博士論文(0) 專書(0) 專書論文(0)
排除自我引用:0
共同引用:0
點閱:190
背景:臺灣對於因自傷行為至急診求助的青少年的相關資料較缺乏,本研究評估這類青少年的特色、自傷促發因子、處置對門診回診的影響。方法:回顧2004年6月至2007年7月間,因自傷行為至某綜合醫院急診就診的未滿二十歲青少年的病歷。2005年11月起此醫院開始進行自傷個案管理計畫,採準實驗設計,以描述及分析性統計比較計畫進行前的40位就診青少年及計畫開始後的47位的門診回診率。結果:共回顧了87位青少年的病歷,平均17.7歲,66位是女性。最常見的自傷方式為藥物過量;最常見的促發因子是人際關係問題。54人 (62%) 目前罹患精神疾患,重複自傷個案罹患精神疾患則高達86%。個案管理計畫開始前,僅5位 (12.5%) 在急診出院後三個月內有回診;開始後則增為7位 (36.2%) (p=0.016)。邏輯斯迴歸顯示回診率與急診出院時有預約精神科回診及提供個案管理計畫有關。結論:自傷青少年有高比率罹患精神疾患;尤以重複自傷者為甚。回精神科門診的比率頗低,但若在急診出院時予以預約掛號或提供個案管理計畫則能改善。
以文找文
OBJECTIVE: Data on adolescents visiting emergency departments (ED) in Asia after acts of self-harm are lacking. This study was to assess characteristics, initial management, and patient compliance with outpatient follow-up in a series of those adolescents with episode of self-harm. METHODS: We reviewed the records for the information of demographic and clinical characteristics of adolescents who had visited the ED of a general hospital for self-injurious behavior from June 2004 to June 2007. Types of self-harm and precipitating factors were assessed. We started to implement case management program for suicidal patients in November 2005. We used a quasi-experimental design, to compare the rate of show-up for outpatient clinic between those seen before (n=40) and after (n=47) the implementing of this program. RESULTS: Of 87 patients (66 females, mean age: 17.7 years), we found that the most common form of self-harm was drug overdose, and that the most common precipitating factor was having interpersonal stressor. Their current mental disorders were diagnosed in 54 (62%) patients. Those with multiple suicide attempts were found to be more likely to have psychiatric morbidity than those with only one attempt. The outpatient attendance rate was poor. Before the implementation of the case management, only 5 (13%) of those adolescent patients returned for outpatient psychiatric follow-ups in the subsequent three months compared with 17 (36%) after case management was implemented (p=0.016). Logistic regressions showed that compliance with follow-up was associated with scheduling a follow-up appointment before ED discharge and with being contacted by case managers. CONCLUSION: Adolescents who harmed themselves had a high rate of psychiatric morbidity, especially those with multiple attempts. Compliance with follow-up was improved after implementing a case management program.
以文找文
期刊論文
1.
Hawton, K.、Osborn, M.、O'Grady, J.、Cole, D.(1982)。Motivational aspects of deliberate self-poisoning in adolescents。The British Journal of Psychiatry,141,286-291。
2.
Lee CY, Lin MF, Tseng HF, Wang WL(2008)。The prevalence of suicide risk behavior among high school students in southern Taiwan, and factors related thereto。Journal of Evidence-based Nursing,4,71-81。
3.
Hawton, K.、Harriss, L.(2007)。Deliberate self-harm in young people: characteristics and subsequent mortality in a 20-year cohort of patients presenting to hospital。J Clin Psychiatry,68,1574-1583。
4.
Richardson L, McCauley E, Katon W(2009)。Collaborative care for adolescent depression: a pilot study。Gen Hosp Psychiatry,31,36-45。
5.
Waldfogel J(2009)。Prevention and the child protection system。Future Child,19,195-210。
6.
Arnold EM, Rotheram-Borus MJ(2009)。Comparisons of prevention programs for homeless youth。Prev Sc,10,76-86。
7.
Assan B, Burchell P, Chia A, et al.(2008)。The Adolescent Intensive Management Team: an intensive outreach mental health service for high-risk adolescents。Australas Psychiatry,16,423-7。
8.
Rotheram-Borus MJ, Piacentini J, Van Rossem R, et al.(1996)。Enhancing treatment adherence with specialized emergency room program for adolescent suicide attempters。J Am Acad Child Adolesc Psychiatry,35,654-63。
9.
Donaldson D, Spirito A, Esposito-Smythers C(2005)。Treatment for adolescents following a suicide attempt: results of a pilot trial。J Am Acad Child Adolesc Psychiatry,44,113-20。
10.
Shaffer D, Gould MS, Fisher P, Tuartman P(1996)。Psychiatric diagnosis in child and adolescent suicide。Arch Gen Psychiatry,53,339-48。
11.
Evans E, Hawton K, Rodham K(2004)。Factors associated with suicidal phenomena in adolescents: a systemic review of population-based studies。Clin Psychol Rev,24,957-79。
12.
Chiu CH, Kuo CJ, Chen YY, et al.(2006)。Comparison of epidemiological characteristics between first-ever and repeated suicide attempters。Taipei City Medical Journal,3,1000-7。
13.
Miranda R, Scott M, Hicks R, Wilcox HC, Munfakh JLH, Shaffer D(2008)。Suicide attempt characteristics, diagnosis, and future attempts: comparing multiple attempters to single attempters and ideators。J Am Acad Child Adolesc Psychiatry,47,32-40。
14.
Hagedorn J, Omar H(2002)。Retrospective analysis of youth evaluated for suicide attempt or suicidal ideation in an emergency room setting。Int J Adolesc Med Health,14,55-60。
15.
Olfson M, Gameroff MJ, Marcus SC, Greenberg T, Shaffer D(2005)。Emergency treatment of young people following deliberate self-harm.。Arch Gen Psychiatry,62,1122-8。
16.
Kennedy SP, Baraff LJ, Suddath RL, Asarnow JR(2004)。Emergency department management of suicidal adolescents。Ann Emerg Med,43,452-60。
17.
Stewart SE, Manion IG, Davidson S(2002)。Emergency management of the adolescent suicide attempter: a review of the literature。J Adolesc Health,30,312-25。
18.
Grandboulan V, Roudot-Thoraval F, Lemerle S, Alvin P(2001)。Predictive factors of post-discharge follow-up care among adolescent suicide attempters。Acta Psychiatr Scand,104,31-6。
圖書論文
1.
Shadish WR, Cook TD, Campbell DT(2002)。Quasi-experimental designs that either lack a control group or lack pretest observations on the outcome。Experimental and Quasi-Experimental Designs。Boston:Houghton Mifflin Company。
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