背景:意外和突击枪伤(GSW)是美国1至17岁青年受伤的第二大原因,对儿科患者的心理健康功能产生显著的负面影响。尽管GSW具有重要意义,目前还没有一个综合儿科患者心理健康结局趋势的系统评价;本评价填补了这一空白.此外,本综述确定了基于证据的心理干预措施,这些干预措施在治疗普通人群中心理障碍的亚临床症状方面被证明是有效的.
方法:使用五个数据库进行了全面搜索:美国心理学会(APA)PsycInfo,APAPsycarticles,护理和相关健康文献累积指数(CINAHL),教育资源信息中心(ERIC),和医学文献分析和检索系统在线(MEDLINE)。22篇文章符合纳入标准。
结果:研究结果表明,与其他人相比,小儿GSW患者患精神疾病的风险显着升高-(例如,机动车碰撞)和未受伤的年轻人。疾病包括创伤后压力,破坏性行为,焦虑,抑郁症,和物质使用。基于医院的暴力干预计划,在社区中培养与成年人的支持性关系,以创伤为中心的门诊服务被确定为治疗亚临床心理症状的有效干预措施。
结论:在提出的概念模型中描述,本研究描述了小儿GSW与随后的精神健康障碍发病之间的直接关联.这种关系通过针对亚临床症状的循证心理干预来缓冲。结果表明,简短的心理干预可以帮助治疗心理健康挑战,将重大长期问题的风险降至最低。建议进行文化适应,以增强所有患者干预措施的实用性和可及性。
BACKGROUND: Accidental and assault gunshot wounds (GSWs) are the second leading cause of injury in the United States for youth ages 1- to 17-years-old, resulting in significant negative effects on pediatric patients\' mental health functioning. Despite the critical implications of GSWs, there has yet to be a systematic review synthesizing trends in mental health outcomes for pediatric patients; a gap the present review fills. Additionally, this review identifies evidence-based psychological interventions shown to be effective in the treatment of subclinical symptoms of psychological disorders in the general population.
METHODS: A comprehensive search was conducted using five databases: American Psychological Association (APA) PsycInfo, APA PsycArticles, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Resource Information Center (ERIC), and Medical Literature Analysis and Retrieval Systems Online (MEDLINE). Twenty-two articles met inclusion criteria.
RESULTS: Findings suggest pediatric GSW patients are at a significantly elevated risk for mental health disorders when compared to other- (e.g., motor vehicle collision) and non-injured youth. Disorders include post-traumatic stress, disruptive behavior, anxiety, depression, and substance use. Hospital-based violence intervention programs, cultivating supportive relationships with adults in one\'s community, and trauma-focused outpatient services were identified as effective interventions for treating subclinical psychological symptoms.
CONCLUSIONS: Depicted in the proposed conceptual model, the present study delineates a direct association between pediatric GSWs and subsequent onset of mental health disorders. This relation is buffered by evidence-based psychological interventions targeting subclinical symptoms. Results suggest brief psychological interventions can help treat mental health challenges, minimizing risk for significant long-term concerns. Cultural adaptations to enhance the utility and accessibility of interventions for all patients are recommended.