青少年非自杀性自伤评估和管理策略的最佳证据总结

Summary of the best evidence for the evaluation and management strategy of Non-suicidal self-injury in adolescents

目的总结青少年非自杀性自伤评估和管理策略的最佳证据,为医护人员针对青少年非自杀性自伤开展规范化评估和管理提供依据。方法运用循证护理方法,按照"6S"证据金字塔模型检索BMJ最佳临床实践、UpToDate、WHO、英国国家卫生与临床优化研究所、美国国家指南网、加拿大安大略注册护士协会、苏格兰校际指南网、美国医师学会俱乐部、澳大利亚Joanna Briggs Institute(JBI)循证卫生保健中心图书馆、Cochrane Library、PubMed、Embase、PsycINFO、中国生物医学文献数据库、中国知网和万方数据库、医脉通等数据库中关于青少年非自杀性自伤的证据。包括指南、标准、案例报告、证据总结、随机对照试验(RCT)、系统评价、临床实践等,检索时限为建库至2022年6月30日。由2名经过循证课程培训的研究人员对文献进行质量评价。采用澳大利亚JBI循证卫生保健中心证据预分级系统及证据推荐级别系统(2014版)对纳入研究进行预分级。结果最终纳入文献18篇,其中指南5篇、标准2篇、案例报告1篇、证据总结1篇、系统评价3篇,Meta分析1篇、临床实践2篇、RCT 3篇。总结出筛查与评估、多专业多形式干预策略、培训与健康教育、自我管理策略、自伤后处置、随访6个方面共22条最佳证据。结论基于循证的青少年非自杀性自伤评估和管理策略的最佳证据具有科学性及实用性,可为青少年非自杀性自伤的临床实践提供参考。

Objective To summarize the best evidence for the evaluation and management strategies of adolescent non-suicidal self-injury,and provide a basis for medical staff to carry out standardized evaluation and management of adolescent non suicidal self injury.Methods According to evidence-based nursing methods and the"6S"evidence pyramid model,the evidences of non-suicidal self-injury in adolescents,including guidelines,standards,case report,evidence summary,randomized controlled trial(RCT),systematic review,clinical practice and other evidences were searched in BMJ Best Practice,UpToDate,World Health Organization,National Institute for Health and Care Excellence,National Guidelines Clearinghouse,Registered Nurses'Association of Ontario,Scottish Intercollegiate Guidelines Network,American College of Physicians Club,Australian Joanna Briggs Institute(JBI)Evidence-based Health Care Center Library,Cochrane Library,PubMed,Embase,PsycINFO,China Biology Medicine disc,China National Knowledge Infrastructure,Wanfang Database,Medlive and other databases.The retrieval period was from the establishment of the databases to June 30,2022.The quality evaluation of the articles was evaluated by two researchers trained in the evidence-based curriculum.Included studies were pre-graded using the Australian JBI Evidence-based Health Centre Evidence pre-grading system and the Evidence Recommendation Level System(2014 edition).Results Finally,a total of 18 articles were included,including 5 guidelines,2 standards,1 case report,1 evidence summary,3 systematic reviews,1 Meta-analysis,2 clinical practices and 3 RCT studies.A total of 22 pieces of best evidence were summarized from 6 dimensions,such as screening and assessment,multi-professional and multi-form intervention strategies,training and education,self-management strategies,disposal after self-injury treatment and follow-up.Conclusions The best evidence based on evidence-based assessment and management strategies of adolescent non-suicidal self-injury is scientific and practical,which can provide reference for the clinical practice of adolescent non-suicidal self-injury.