PDF(Pubmed)
Abstract：
The Veterans Health Administration\'s system for documenting self-directed violence (SDV) requires that clinicians make a determination of the suicidal intent of the behavior (ie, \"undetermined\" intent vs. \"suicide attempt\") which contributes to the enhanced care offered. Past studies suggest clinicians\' judgment of suicide risk is impacted by patient demographics regardless of clinical presentation. As women are less likely to die by suicide than men, women\'s SDV may be taken less seriously; they may be more likely to have their SDV classified as \"undetermined\" than men, which may impact the care received.
This study examines whether women veterans\' SDV is disproportionately classified as \"undetermined\" suicidal intent versus \"suicide attempt\" as compared with men veterans, and how one\'s classification and gender modifies the care received.
This was an observational, retrospective study of data from Veterans Health Administration administrative databases. We included all veterans with documented nonfatal \"undetermined\" SDV events and \"suicide attempts\" between 2013 and 2018 (N=55,878). Objectives were evaluated using mixed-effects logistic regression models.
Women veterans were disproportionately more likely than men veterans to have SDV classified as \"undetermined\" (odds ratio=1.17; 95% confidence interval, 1.08-1.27). Veterans who received an \"undetermined\" classification were significantly less likely to receive enhanced care. However, this relationship was not moderated by gender.
Gender may impact clinicians\' determinations of intent of SDV, but more research is needed on the extent of classification biases and to understand causes. Further, classification of intent is critical, as there is a strong relationship between classification and enhanced care.
This study examines whether women veterans\' SDV is disproportionately classified as \"undetermined\" suicidal intent versus \"suicide attempt\" as compared with men veterans, and how one\'s classification and gender modifies the care received.
This was an observational, retrospective study of data from Veterans Health Administration administrative databases. We included all veterans with documented nonfatal \"undetermined\" SDV events and \"suicide attempts\" between 2013 and 2018 (N=55,878). Objectives were evaluated using mixed-effects logistic regression models.
Women veterans were disproportionately more likely than men veterans to have SDV classified as \"undetermined\" (odds ratio=1.17; 95% confidence interval, 1.08-1.27). Veterans who received an \"undetermined\" classification were significantly less likely to receive enhanced care. However, this relationship was not moderated by gender.
Gender may impact clinicians\' determinations of intent of SDV, but more research is needed on the extent of classification biases and to understand causes. Further, classification of intent is critical, as there is a strong relationship between classification and enhanced care.
摘要：
退伍军人健康管理局记录自我导向暴力（SDV）的系统要求临床医生确定行为的自杀意图（即，“未确定”意图与“自杀未遂”)，这有助于提供更多的护理。过去的研究表明，无论临床表现如何，临床医生对自杀风险的判断都会受到患者人口统计学的影响。因为女性自杀的可能性比男性低，女性的SDV可能不那么认真;他们可能更有可能将他们的SDV归类为“未确定”比男性,这可能会影响所接受的护理。
这项研究调查了与男性退伍军人相比，女性退伍军人“SDV”是否被不成比例地归类为“未确定”自杀意图与“自杀未遂”。以及一个人的分类和性别如何改变所接受的护理。
这是一个观察,来自退伍军人健康管理局行政数据库的数据的回顾性研究。我们将所有退伍军人纳入了2013年至2018年期间记录的非致命“未确定”SDV事件和“自杀企图”（N=55,878）。使用混合效应逻辑回归模型评估目标。
女性退伍军人比男性退伍军人更有可能将SDV归类为“未确定”（优势比=1.17；95％置信区间，1.08-1.27)。接受“未确定”分类的退伍军人接受强化护理的可能性大大降低。然而,这种关系不受性别的影响.
性别可能会影响临床医生对SDV意图的判断，但是需要对分类偏差的程度进行更多的研究，并了解原因。Further,意图的分类是至关重要的，因为分类和强化护理之间有很强的关系。
这项研究调查了与男性退伍军人相比，女性退伍军人“SDV”是否被不成比例地归类为“未确定”自杀意图与“自杀未遂”。以及一个人的分类和性别如何改变所接受的护理。
这是一个观察,来自退伍军人健康管理局行政数据库的数据的回顾性研究。我们将所有退伍军人纳入了2013年至2018年期间记录的非致命“未确定”SDV事件和“自杀企图”（N=55,878）。使用混合效应逻辑回归模型评估目标。
女性退伍军人比男性退伍军人更有可能将SDV归类为“未确定”（优势比=1.17；95％置信区间，1.08-1.27)。接受“未确定”分类的退伍军人接受强化护理的可能性大大降低。然而,这种关系不受性别的影响.
性别可能会影响临床医生对SDV意图的判断，但是需要对分类偏差的程度进行更多的研究，并了解原因。Further,意图的分类是至关重要的，因为分类和强化护理之间有很强的关系。
