校园自杀守门人培训效果的Meta分析

Efficacy of campus-based suicide gatekeeper training programs:a Meta analysis

目的对校园内开展的自杀"守门人"培训项目进行分析总结,为构建有效的校园自杀预防策略提供证据支持。方法计算机检索the Cochrane Library、PubMed、EMbase、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方和维普等数据库关于自杀守门人培训的随机对照试验。由2名研究人员按照纳入排除标准筛选文献、提取资料、评价质量,然后采用定性描述或定量综合的方法进行分析。结果共纳入9篇文献,培训项目包括询问说服转介模式(question, persuade and refer,QPR)、以同伴支持为基础的"力量的来源"(sources of strength,SOS)、青少年心理健康意识项目(the youth aware of mental health program,YAM)、专业人员筛查项目和其他培训方案,多个培训项目在不同程度上提升了受训者的知识、态度、自我效能等,其中YAM可降低人群的自杀意念率和自杀未遂率。结论目前对自杀守门人培训效果的评价仍多局限在对受训者本人短期结局指标(知识、态度、效能)的评价,未来研究需要更加关注自杀守门人对于他人影响的结局指标。

Objective This systematic review is performed to examine and summarize the effects of suicide gatekeeper training programs conducted in a school setting, with the aim to provide evidence for the construction of effective suicide prevention strategies on campuses. Methods The Cochrane Library, PubMed, EMbase, Chinese Biomedical Literature Database(CBM), CNKI, Wanfang and Vip datebases were searched for randomized controlled trials on the training of suicide gatekeepers. Two researchers screened the literature according to the inclusion criteria, extracted the data, evaluated the quality. Then a qualitative description or quantitative synthesis strategy was adopted. Results Among the 9 eligible studies, a number of different types of gatekeeper training programs were identified, including Question, Persuade and Refer(QPR), Sources of Strength(SOS) based on peer support, the Youth Aware of Mental Health Program(YAM), and Screening by Professionals(Prof Screen) and other training approaches. These training programs, to various degrees, have improved trainees’ knowledge, attitude, self-efficacy. And YAM was effective in reducing the number of suicide attempts and severe suicidal ideation in school-based adolescents. Conclusion The current studies mainly focused on the short-term effects of suicide gatekeeper training programs(knowledge, attitude, and self-efficacy). Ideally future research should pay more attention to the long-term outcomes.