精神科住院抑郁症患者自杀预防及护理干预措施专家共识

Expert consensus of suicide care interventions for psychiatric inpatients with depression

目的 形成《精神科住院抑郁症患者自杀预防及护理干预措施专家共识》,规范精神科住院抑郁症患者自杀护理干预措施。方法 运用循证方法及文献分析法提取住院抑郁症患者自杀护理干预措施推荐建议和研究结论,形成共识初稿,通过2轮专家函询及2次专家论证会,结合专家意见,对初稿进行调整、修改和完善,形成共识终稿。结果 2轮函询专家积极系数均为100%,专家权威系数均为0.924,各指标重要性赋值均数均>3.5分,且变异系数均<0.25,专家肯德尔和谐系数分别为0.182和0.260(均P<0.01)。最终对精神科住院抑郁症患者自杀护理干预操作性定义、自杀风险评估、干预形式、干预时间、干预理论基础、干预一般原则、自杀意念的干预措施、自杀行为的干预措施、特殊人群自杀护理干预要点、干预效果评价及出院后的健康教育计划共11个部分的内容达成一致意见。结论 该共识为精神科住院抑郁症患者自杀护理干预措施提供指导依据,使精神科住院抑郁症患者的自杀护理干预更规范。

Objective To form an expert consensus on suicide nursing interventions for inpatients with depression in psychiatric departments,standardize the contents of suicide nursing interventions for depression patients in psychiatric departments. Methods Evidence-based methods and literature analysis were used to extract recommendations and research conclusions of suicide nursing interventions for inpatients with depression,and the consensus draft was formed. After 2 rounds of expert letter consultation and 2 expert discussions,the draft was adjusted,modified and improved,and the final draft of the consensus was formed. Results The positive coefficients of the experts in 2 rounds of letter consultation were 100%;the authority degree of the experts was 0.924;the mean values of importance of each index were >3.5 points;the coefficient of variation was <0.25;the Kendall harmony coefficients of the experts were 0.182 and 0.260,respectively(P<0.01). Finally,the operational definition,suicide risk assessment,intervention form and time,theoretical basis of intervention,general principles of intervention,suicide impression intervention,suicidal behavior intervention,key points of intervention in special populations,evaluation of intervention effect and post-discharge evaluation of suicide care in hospitalized patients with depression were analyzed. A total of 11 components of the health education program were agreed upon. Conclusion The consensus provides the guidance for the suicide nursing interventions of psychiatric inpatients with depression,so that the suicide nursing intervention of psychiatric inpatients with depression is more standardized.