背景:先前的自我伤害是未来自我伤害和自杀的最强预测因素之一。反复自我伤害和自杀的风险增加,出现在医院的高风险自我伤害和重大自我伤害重复者中。然而,到目前为止,对精神卫生专业人员进行基于证据的自我伤害管理培训是有限的。在此背景下,我们的目标是发展,实施和评估培训计划,萨马赫,爱尔兰综合医院自我伤害评估和管理计划。SAMAGH旨在(a)降低基于医院的自我伤害重复率,以及(b)提高对自我伤害患者进行心理健康评估的比率。我们还旨在评估自我伤害知识的培训,态度,以及参与培训的医疗保健专业人员的技能相关成果。
方法:本研究将分三个阶段进行。首先,已经制定了SAMAGH培训计划,其中包括两部分:1)电子学习计划和2)模拟培训。第二,SAMAGH将交付给爱尔兰综合医院的医疗保健专业人员。第三,将使用岗前设计进行结果和过程评估。结果评估将使用爱尔兰国家自我伤害登记处(NSHRI)关于爱尔兰所有27家公立医院的自我伤害重复率的汇总数据进行。基于SAMAGH实施前3年平均(2016年,2017年,2018年)自我伤害重复率的汇总数据将用作基准数据,SAMAGH实施后6个月和12个月的NSHRI数据将用作随访。对于过程评估,问卷和焦点小组将与完成培训的医疗保健专业人员一起管理和进行。
结论:本研究将为证据知情培训计划的有效性提供证据基础,该计划旨在减少重复的医院自我伤害表现并提高对自我伤害评估和管理的依从性。这项研究也有望有助于自我伤害和自杀训练,并有可能转化为其他环境。将通过过程评估来评估其可行性。
BACKGROUND: Previous self-harm is one of the strongest predictors of future self-harm and suicide. Increased risk of repeated self-harm and suicide exists amongst patients presenting to hospital with high-risk self-harm and major self-harm repeaters. However, so far evidence-based training in the management of self-harm for mental health professionals is limited. Within this context, we aim to develop, implement and evaluate a training programme, SAMAGH, Self-harm Assessment and Management Programme for General Hospitals in Ireland. SAMAGH aims to (a) reduce hospital-based self-harm repetition rates and (b) increase rates of mental health assessments being conducted with self-harm patients. We also aim to evaluate the training on self-harm knowledge, attitudes, and skills related outcomes of healthcare professionals involved in the training.
METHODS: The
study will be conducted in three phases. First, the SAMAGH Training Programme has been developed, which comprises two parts: 1) E-learning Programme and 2) Simulation Training. Second, SAMAGH will be delivered to healthcare professionals from general hospitals in Ireland. Third, an outcome and process evaluation will be conducted using a pre-post design. The outcome evaluation will be conducted using aggregated data from the National Self-Harm Registry Ireland (NSHRI) on self-harm repetition rates from all 27 public hospitals in Ireland. Aggregated data based on the 3-year average (2016, 2017, 2018) self-harm repetition rates prior to the implementation of the SAMAGH will be used as baseline data, and NSHRI data from 6 and 12 months after the implementation of SAMAGH will be used as follow-up. For the process evaluation, questionnaires and focus groups will be administered and conducted with healthcare professionals who completed the training.
CONCLUSIONS: This
study will contribute to the evidence base regarding the effectiveness of an evidence informed training programme that aims to reduce repeated hospital self-harm presentations and to improve compliance with self-harm assessment and management. This
study is also expected to contribute to self-harm and suicide training with the possibility of being translated to other settings. Its feasibility will be evaluated through a process evaluation.