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Citation
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Tsung-Hua Lu, Shih-Hsien Lin, Yi-Yi Pi, Chia-Rong Lu, Sing-How Wang, Ching-Ning Huang, Po See Chen. J. Suicidol. (Taipei) 2022; 17(1): 67-71. |
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Abstract
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BACKGROUND: Screening and evaluation of suicide risk in inpatients is often performed using the Brief Symptom Rating Scale-5 (BSRS-5), after which a suicide gatekeeper may be recruited according to the principles of Question, Persuade, Refer (QPR). In this study, we evaluated and compared the effectiveness of suicide prevention between general medical staff and consultation-liaison psychiatrists by the principles of QPR in non-psychiatric inpatient units in a medical center in Taiwan.
METHODS: From January to December 2020, inpatients received care according to the QPR principles and standard operating procedures for suicide prevention in the hospital. (1) Question: all inpatients in the non-psychiatric unit were screened using the BSRS-5. (2) Persuade: when the BSRS-5 indicated moderate-to-high risk, basic suicide prevention interventions were applied by general medical staff. (3) Refer: when appropriate, psychological specialists were consulted. All patients were then re-screened with the BSRS-5 before discharge. The t-test was applied to compare the scores of patients receiving psychiatric consultation and those receiving non-psychiatric consultation.
RESULTS: The study included 586 patients, of whom 234 were male and 352 were female. The BSRS-5 scores declined after the consultation (from 11.18 to 8.28; N = 191) and non-consultation (from 11.25 to 8.25; N = 395) groups, and no significant difference was found between groups (t = 0.10, P = 0.92). However suicidal ideation scores differed significantly between the groups (consultation, scores decreased from 1.61 to 1.09; non-consultation, from 0.98 to 0.69; t = 3.08, P ＜ 0.01).
CONCLUSION: Among inpatients with moderate-to-high suicide risk, basic suicide prevention interventions performed by general medical staff or consultation-liaison psychiatrists were similarly effective. However, referral to consultation-liaison psychiatrists was associated with decreased suicidal ideation. Education and practice of the QPR strategy therefore should be emphasized to all medical staff in the hospital.
Language: en |