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1.
Macromol Rapid Commun ; 45(8): e2300690, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38207336

RESUMEN

The compositional scope of polymer zwitterions has grown significantly in recent years and now offers designer synthetic materials that are broadly applicable across numerous areas, including supracolloidal structures, electronic materials interfaces, and macromolecular therapeutics. Among recent developments in polymer zwitterion syntheses are those that allow insertion of reactive functionality directly into the zwitterionic moiety, yielding new monomer and polymer structures that hold potential for maximizing the impact of zwitterions on the macromolecular materials chemistry field. This manuscript describes the preparation of zwitterionic choline phosphate (CP) methacrylates containing either aromatic or aliphatic thiols embedded directly into the zwitterionic moiety. The polymerization of these functional CP methacrylates by reversible addition-fragmentation chain-transfer methodology yields polymeric zwitterionic thiols containing protected thiol functionality in the zwitterionic units. After polymerization, the protected thiols are liberated to yield thiol-rich polymer zwitterions which serve as precursors to subsequent reactions that produce polymer networks as well as polymer-protein bioconjugates.


Asunto(s)
Polimerizacion , Polímeros , Compuestos de Sulfhidrilo , Compuestos de Sulfhidrilo/química , Polímeros/química , Polímeros/síntesis química , Fosforilcolina/química , Fosforilcolina/análogos & derivados , Estructura Molecular , Metacrilatos/química
2.
J Acad Consult Liaison Psychiatry ; 65(2): 126-135, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38030078

RESUMEN

BACKGROUND: Medically ill adults are at elevated risk for suicide. Chronic pain and hopelessness are associated with suicide; however, few studies have examined the interaction between chronic pain and hopelessness in predicting suicide risk among hospitalized adults. OBJECTIVE: This study aimed to describe the association between chronic pain, hopelessness, and suicide risk, defined as recent suicidal ideation or lifetime suicidal behavior. In addition, we examined the interaction between chronic pain and hopelessness. METHODS: This was a secondary analysis of a multisite study to validate the Ask Suicide-Screening Questions (ASQ) among adult medical inpatients. Participants reported if they experienced chronic pain that impacted daily life and if they felt hopeless about their medical condition and provided their current pain rating on a 1 to 10 scale, with 10 being the most severe pain. A t-test compared pain severity scores by ASQ outcome. A binary logistic regression model described the association between chronic pain, hopelessness, and suicide risk; parameter estimates are expressed as odds ratios (OR) for interpretation. The interaction between chronic pain and hopelessness was examined in both the transformed (logit) and natural (probability) scales of the generalized linear model. RESULTS: The sample included 720 participants (53.2% male, 62.4% White, mean age: 50.1 [16.3] years, range = 18-93). On the ASQ, 15.7% (113/720) of patients screened positive. Half (360/720) of the sample self-reported chronic pain. Individuals who screened positive had higher pain rating scores than those who screened negative (t = -4.2, df = 147.6, P < 0.001). Among all patients, 27.2% (196/720) felt hopeless about their medical condition. In the logistic regression model, patients with chronic pain (adjusted OR: 2.29, 95% confidence interval [CI]: 1.21-4.43, P = 0.01) or hopelessness (adjusted OR: 5.69, 95% CI: 2.52-12.64, P < 0.001) had greater odds of screening positive on the ASQ. The interaction effect between pain and hopelessness was not significant in the transformed (B = -0.15, 95% CI: -1.11 to 0.82, P = 0.76) or natural (B = 0.08, 95% CI: -0.07 to 0.23, P = 0.28) scale. CONCLUSIONS: There were significant independent associations between (1) chronic pain and suicide risk and between (2) hopelessness and suicide risk. Future research should examine the temporality and mechanisms underlying these relationships to inform prevention efforts for medically ill adults.

3.
Clin Teach ; : e13706, 2023 Nov 22.
Artículo en Inglés | MEDLINE | ID: mdl-37992755

RESUMEN

BACKGROUND: There is a call to action for health care systems to assess and address burnout among physician trainees. To address this need for programmatic change, we developed a novel initiative to (1) proactively assess trainee burnout and identify drivers and (2) provide resources and recommendations for preventing and reducing burnout. APPROACH: This pilot burnout tracking initiative began in 2020. A two-question burnout survey was disseminated to physician trainees at a hospital devoted exclusively to clinical research. The survey assessed burnout level and drivers of burnout. An algorithm was created to recommend action steps based on trainee responses. Participating training programmes completed a 23-question survey annually to provide information about their trainees and feedback. EVALUATION: Seven of 10 (70%) programmes completed the annual survey in the first year, and 12 of the 15 (80%) programmes completed it the second year. Reported average burnout levels and drivers of burnout varied across programmes; all drivers of burnout were cited as key drivers by at least one programme. Most programmes had conversations with their trainees and found these conversations helpful. All responding programmes who administered the trainee survey felt the initiative improved their ability to track and reduce burnout. IMPLICATIONS: An initiative to systematically track burnout levels and offer targeted interventions was feasible and useful. This project can be a model for institution-wide efforts to address trainee burnout and extend to other clinical health care settings and academic medicine faculty.

4.
Palliat Support Care ; 21(1): 38-42, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-35451355

RESUMEN

OBJECTIVE: Meaning-centered psychotherapy (MCP) principles may provide a framework for engaging healthcare professionals in meaning-centered exploration as a novel approach to prevent burnout and enhance wellbeing in healthcare professionals through heightening personal meaning. This case study aimed to teach MCP to masters-trained social workers for use with medical patients. While the primary aim was to teach MCP to masters-trained social workers, this proof-of-concept project and this paper focus on a secondary aim of enhancing meaning and connection in the virtual workplace. METHODS: A group of social workers participated in a 7-session MCP pilot from October 13th to November 24th, 2020. After each session, participants were asked to complete an anonymous continuing education evaluation with questions regarding clarity, organization, and relevance of the presentation related to use with their patient populations. Additional open-ended items queried participants for general comments about their experience using MCP to enhance professional fulfillment during COVID-19. RESULTS: Nine social workers participated in the MCP pilot. Several qualitative themes emerged, including enhanced meaning, communication, connection, and agency in the virtual workplace. SIGNIFICANCE OF THE RESULTS: This pilot demonstrated the feasibility and acceptability of using an adapted MCP instruction with hospital-based social workers during the COVID-19 pandemic to facilitate wellbeing. While MCP was originally created to intervene with patients with life-threatening illnesses, the brief, manualized experiential nature of the intervention lends itself to modification with staff for the purpose of enhancing meaning and community in their own lives.


Asunto(s)
COVID-19 , Pandemias , Humanos , Psicoterapia , Personal de Salud , Trabajadores Sociales
5.
J Affect Disord Rep ; 112023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38993189

RESUMEN

Background: Non-suicidal self-injury (NSSI) is a potent risk factor for suicide among youth. There is limited research, however, on the association between NSSI and suicide risk among adults, particularly among adult medical patients, who are a population at increased risk for suicide. To address this research gap, the current analysis aimed to describe the association between lifetime history of NSSI and suicide risk in an adult medical inpatient population. Method: Adult medical inpatients aged 18 or older from one of four United States hospitals were screened for suicide risk and a lifetime history of NSSI. Suicide risk was determined using the Ask Suicide-Screening Questions (ASQ). NSSI history, methods, frequency, and severity were assessed via a structured interview based on the Self-Injurious Thoughts and Behaviors Interview. Results: A total of 621 adult medical inpatients were included in this secondary analysis (55.2% male; 60.9% White; M[SD] age = 50.3[16.7]); 5.8% of patients (36/621) reported a lifetime history of NSSI and 16.1% (100/621) screened positive for suicide risk. Patients with a lifetime history of NSSI were significantly more likely to screen positive for suicide risk (OR = 9.4 [95% CI, 4.4-20.8]; p < .0001). Limitations: This analysis used cross sectional data and could not examine any causal relationships between NSSI and suicide risk. Conclusions: Adult medical inpatients with a lifetime history of NSSI were significantly more likely to screen positive for suicide risk. Research examining NSSI among adult medical patients is especially relevant for suicide risk detection and prevention efforts.

6.
J Am Chem Soc ; 144(48): 22059-22066, 2022 Dec 07.
Artículo en Inglés | MEDLINE | ID: mdl-36442142

RESUMEN

Stabilization of fluid droplets, classically as oil-in-water or water-in-oil emulsions, is typically conducted using molecular surfactants or small particulates that localize at oil-water interfaces. In this paper, we describe a method whereby thin polymer films are converted photolithographically to ribbon-like mesoscale objects, which, in turn, adsorb to fluid interfaces where they extend as appendages, or arms, from the droplet surface. These "mesoscale polymer surfactants", or MPSs, were prepared from thin polymer films containing reactive functional moieties, including coumarin for photo-cross-linking, triphenylsulfonium for photoacid generation, and tert-butyl ester for solubility switching. The resultant MPSs, prepared initially on Si substrates, were released into water to reveal an exquisite shape sensitivity (forming straight, bent, or helical structures) and affinity for droplet interfaces based on their preparation conditions and the properties of the surrounding liquid. Notably, the lithographic techniques employed were amenable to differentiating the wettability of MPS segments, affording access to diblock-like MPSs which adhered to dispersed droplets via their hydrophobic segments, allowing their hydrophilic segments to extend into the continuous phase.

7.
Acad Pediatr ; 22(2): 217-226, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-35248306

RESUMEN

OBJECTIVE: To describe the methodological development and feasibility of real-world implementation of suicide risk screening into a pediatric primary care setting. METHODS: A suicide risk screening quality improvement project (QIP) was implemented by medical leadership from a suburban-based pediatric (ages 12-25 years) primary care practice in collaboration with a National Institute of Mental Health (NIMH) suicide prevention research team. A pilot phase to acclimate office staff to screening procedures preceded data collection. A convenience sample of 271 pediatric medical outpatients was screened for suicide risk. Patients, their parents, and medical staff reported their experiences and opinions of the screening procedures. RESULTS: Thirty-one (11.4%) patients screened positive for suicide risk, with 1 patient endorsing imminent suicide risk (3% of positive screens; 0.4% of total sample). Over half of the patients who screened positive reported a past suicide attempt. Most patients, parents, and medical staff supported the implementation of suicide risk screening procedures into standard care. A mental health clinical pathway for suicide risk screening in outpatient settings was developed to provide outpatient medical settings with guidance for screening. CONCLUSIONS: Screening for suicide risk in pediatric primary care is feasible and acceptable to patients, their families, and medical staff. A clinical pathway used as guidance for pediatric health care providers to implement screening programs can aid with efficiently detecting and managing patients who are at risk for suicide.


Asunto(s)
Tamizaje Masivo , Prevención del Suicidio , Adolescente , Adulto , Niño , Susceptibilidad a Enfermedades , Humanos , Pacientes Ambulatorios , Atención Primaria de Salud , Mejoramiento de la Calidad , Adulto Joven
8.
Arch Suicide Res ; 26(3): 1541-1555, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34101537

RESUMEN

OBJECTIVE: A suicide attempt is the most potent predictor of future suicidal behavior, yet little is known about how to manage and respond to reports of attempt histories in hospitalized medical patients. This study aims to describe the prevalence and characteristics of pediatric and adult medical inpatients who report a past suicide attempt. METHOD: Participants were medical inpatients, aged 10-93 years, enrolled in two suicide risk screening instrument validation studies. Participants completed the Ask Suicide-Screening Questions (ASQ) and the Patient Health Questionnaire (PHQ). RESULTS: A total of 1324 medical inpatients (624 pediatric, 700 adult) completed the ASQ, with 114 participants (8.6%) reporting a past suicide attempt (51 pediatric; 63 adults). Comparing youth to adults, there was no significant difference between attempt rates (χ2=0.29, p = 0.59). Youth with a past attempt were significantly more likely to report past week suicidal ideation (OR = 28.22; 95% CI = 5.90, 135.06) and have a history of mental health care (OR = 9.11; 95% CI = 2.59-32.10), compared to those without a past attempt. Adults with a past attempt were significantly more likely to screen positive for depression, compared to those without attempt histories (OR = 5.00; 95% CI = 2.31-10.83). CONCLUSIONS: Nearly 9% of hospitalized medical patients endorsed a past suicide attempt when screened. Since adolescence is a critical time for detecting suicide risk, screening that includes past suicidal behavior may be an important means to identify youth with recent suicidal thoughts. By assessing recency of suicide attempts in adults, medical settings may optimize the effectiveness of how positive suicide risk screens are managed.HIGHLIGHTSRoughly 9% of medical patients reported a past suicide attempt when screened.Adolescence is a critical time for detecting suicide risk and intervening.Assessing past suicide attempts in adults can help with managing positive screens.


Asunto(s)
Pacientes Internos , Intento de Suicidio , Adolescente , Adulto , Niño , Humanos , Tamizaje Masivo , Prevalencia , Ideación Suicida , Intento de Suicidio/psicología
9.
Artículo en Inglés | MEDLINE | ID: mdl-34170293

RESUMEN

BACKGROUND: Despite prevention efforts, suicide rates continue to rise, prompting the need for novel evidence-based approaches to suicide prevention. Patients presenting with foot and ankle disorders in a podiatric medical and surgical practice may represent a population at risk for suicide, given risk factors of chronic pain and debilitating injury. Screening has the potential to identify people at risk that may otherwise go unrecognized. This quality improvement project aimed to determine the feasibility of implementing suicide risk screening in an outpatient podiatry clinic and ambulatory surgical center. METHODS: A suicide risk screening quality improvement project was implemented in an outpatient podiatry clinic and ambulatory surgical center in collaboration with a National Institute of Mental Health suicide prevention research team. Following training for all staff, patients aged 18 years and older were screened for suicide risk with the Ask Suicide-Screening Questions as standard of care. Clinic staff were surveyed about their opinions of screening. RESULTS: Ninety-four percent of patients (442 of 470) agreed to be screened for suicide risk and nine patients (nine of 442 [2%]) were screened as nonacute positive; zero patients were screened as acute risk. The majority of clinic staff reported that they found screening acceptable, felt comfortable working with patients who have suicidal thoughts, and thought screening for suicide risk was clinically useful. CONCLUSIONS: Suicide risk screening was successfully implemented in an outpatient podiatry clinic. Screening with the Ask Suicide-Screening Questions instrument provided valuable information that would not have been ascertained otherwise, positively impacting clinical decision-making and leading to improved overall care for podiatry patients.


Asunto(s)
Podiatría , Prevención del Suicidio , Humanos , Pacientes Ambulatorios , Factores de Riesgo , Encuestas y Cuestionarios
10.
J Acad Consult Liaison Psychiatry ; 62(4): 413-420, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34219655

RESUMEN

BACKGROUND: Medically ill hospitalized patients are at elevated risk for suicide. Hospitals that already screen for depression often use depression screening as a proxy for suicide risk screening. Extant research has indicated that screening for depression may not be sufficient to identify all patients at risk for suicide. OBJECTIVE: The present study aims to determine the effectiveness of a depression screening tool, the Patient Health Questionnaire-9, in detecting suicide risk among adult medical inpatients. METHODS: Participants were recruited from inpatient medical/surgical units in 4 hospitals as part of a larger validation study. Participants completed the Patient Health Questionnaire-9 and 2 suicide risk measures: the Ask Suicide-Screening Questions and the Adult Suicidal Ideation Questionnaire. RESULTS: The sample consisted of 727 adult medical inpatients (53.4% men; 61.8% white; mean age 50.1 ± 16.3 years). A total of 116 participants (116 of 727 [16.0%]) screened positive for suicide risk and 175 (175 of 727 [24.1%]) screened positive for depression. Of the 116 patients who screened positive for suicide risk, 36 (31.0%) screened negative for depression on the Patient Health Questionnaire-9. Of 116, 73 (62.9%) individuals who were at risk for suicide did not endorse item 9 (thoughts of harming oneself or of being better off dead) on the Patient Health Questionnaire-9. CONCLUSION: Using depression screening tools as a proxy for suicide risk may be insufficient to detect adult medical inpatients at risk for suicide. Asking directly about suicide risk and using validated tools is necessary to effectively and efficiently screen for suicide risk in this population.


Asunto(s)
Pacientes Internos , Prevención del Suicidio , Adulto , Anciano , Depresión/diagnóstico , Femenino , Humanos , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Encuestas y Cuestionarios
11.
J Am Chem Soc ; 143(14): 5558-5564, 2021 04 14.
Artículo en Inglés | MEDLINE | ID: mdl-33793226

RESUMEN

We describe the role of functional polymer surfactants in the construction and triggered collapse of droplet-based fibers and the use of these macroscopic supracolloidal structures for reagent compartmentalization. Copolymer surfactants containing both zwitterionic and tertiary amine pendent groups were synthesized for stabilization of oil-in-water droplets, in which the self-adherent properties of the selected zwitterions impart interdroplet adherence, while the amine groups provide access to pH-triggered coalescence. Macroscopic fibers, obtained by droplet extrusion, were prepared with reagents embedded in spatially distinct components of the fibers. Upon acidification of the continuous aqueous phase, protonation of the polymer surfactants increases their hydrophilicity and causes rapid fiber disruption and collapse. Cross-linked versions of these supracolloidal fibers were stable upon acidification and appeared to direct interdroplet passage of encapsulants along the fiber length. Overall, these functional, responsive emulsions provide a strategy to impart on-demand chemical reactivity to soft materials structures that benefits from the interfacial chemistry of the system.


Asunto(s)
Tensoactivos/química , Aminas/química , Emulsiones , Tamaño de la Partícula , Agua/química
13.
Psychosomatics ; 61(6): 713-722, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32487323

RESUMEN

BACKGROUND: Few brief suicide risk screening instruments are validated for use in both adult and pediatric medical populations. Using the pediatric Ask Suicide-Screening Questions (ASQ) development study as a model, this study aimed to determine whether the ASQ is a valid suicide risk-screening instrument for use among adults medical patients, as well as to evaluate a set of other potential screening questions for use in adults. METHODS: Adult patients hospitalized on inpatient medical/surgical units from 4 hospitals were recruited to participate in a cross-sectional instrument-validation study. The 4-item ASQ and other candidate items were compared against the 25-item, previously validated Adult Suicidal Ideation Questionnaire as the criterion standard. RESULTS: A total of 727 adult medical inpatients completed the screening process. Compared with the Adult Suicidal Ideation Questionnaire, the ASQ performed best among the full set of candidate items, demonstrating strong psychometric properties, with a sensitivity of 100% (95% confidence interval = 90%-100%), a specificity of 89% (95% confidence interval = 86%-91%), and a negative predictive value of 100% (95% confidence interval = 99%-100%). A total of 4.8% (35/727) of the participants screened positive for suicide risk based on the standard criterion Adult Suicidal Ideation Questionnaire. CONCLUSIONS: The ASQ is a valid and brief suicide risk-screening tool for use among adults. Screening medical/surgical inpatients for suicide risk can be performed effectively for both adult and pediatric patients using this brief, primary screener.


Asunto(s)
Pacientes Internos , Prevención del Suicidio , Adulto , Niño , Estudios Transversales , Humanos , Tamizaje Masivo , Ideación Suicida
14.
Jt Comm J Qual Patient Saf ; 46(7): 417-426, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32473966

RESUMEN

INTRODUCTION: Hospitals have become an important venue for identifying medical patients with occult suicidality. This article describes the implementation of a quality improvement project at the National Institutes of Health Clinical Center (NIHCC) to systematically screen medical/surgical inpatients for suicide risk. METHODS: Using the Plan-Do-Study-Act method, questions from the Ask Suicide-Screening Questions (ASQ) tool were deployed with medical inpatients aged 10 years and older between April 2018 and April 2019. Goals included the development of a training program, policy and procedure review, electronic medical record integration and data collection, and ongoing management and troubleshooting. RESULTS: A total of 4,284 patients were screened for suicide risk with a nurse screening compliance rate of 94.3%. Prevalence data on patients aged 10 years and older revealed an overall screen positive rate of 2.3% (97/4,284), with 3.1% of youth aged 10 to 24 years and 2.2% of adults screening positive. Of the 97 patients who screened positive, 96 were non-acute positive screens. Of the full sample, only 1 patient (0.02%) was deemed acute positive, requiring a 1:1 observer and full safety precautions. CONCLUSION: Universal suicide risk screening was successfully implemented in the NIHCC without incurring a need for additional resources. The intermediate step of a brief suicide safety assessment is a critical part of the workflow, providing guidance for determining appropriate follow-up in a safe and efficient manner that spares limited mental health and hospital resources. Given the increasing suicide rates in the general population, medical venues offer important opportunities for early detection, assessment, and referral.


Asunto(s)
Prevención del Suicidio , Adolescente , Adulto , Humanos , Pacientes Internos , Tamizaje Masivo , Mejoramiento de la Calidad , Derivación y Consulta
15.
J Behav Health Serv Res ; 44(3): 364-372, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-27072154

RESUMEN

As hospital clinicians and administrators consider implementing suicide risk screening on medical inpatient units, patient reactions to screening can provide essential input. This post hoc analysis examined patient opinions about screening for suicide risk in the medical setting. This analysis includes a subsample of a larger quality improvement project designed to screen medically hospitalized patients for suicide risk. Fifty-three adult medical inpatients at a clinical research hospital provided opinions about suicide risk screening. A qualitative analysis of responses to an opinion question about screening was conducted to identify major themes. Forty-three (81%) patients supported screening medical inpatients for suicide risk. Common themes emphasized asking patients directly about suicide, connection between mental/physical health, and the role of screening in suicide prevention. Adult medical inpatients supported screening for suicide risk on medical/surgical inpatient units. Behavioral health clinicians are uniquely poised to champion suicide detection and intervention in the general medical hospital setting. Patient opinions can be utilized to inform thoughtful implementation of universal suicide risk screening in the medical setting.


Asunto(s)
Actitud , Pacientes Internos , Suicidio , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Adulto Joven
17.
Clin Pediatr Emerg Med ; 14(1): 35-40, 2013 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23908600

RESUMEN

Emergency departments (EDs) are important venues for detecting youth at risk for suicide. Children and adolescents who present to the ED and report a recent life stressor, such as stressors related to interpersonal relationships, may be at elevated risk for suicide. Utilizing data from three large, urban pediatric EDs, we examined the relationship between reported recent life stressors and suicide risk, as measured by the Suicidal Ideation Questionnaire. Overall, youth who reported a recent life stressor were at elevated risk of suicide [adjOR = 5.43 (95% CI, 3.18-9.26)]. Importantly, however, this finding was tempered by the fact that 20% of youth who screened positive for suicide risk did not report a stressor. Thus, while the knowledge of stressors may provide useful supplementary information to a suicide risk assessment, the presence or absence of a reported stressor is not sufficient to determine one's risk of suicide. ED clinicians are advised to include direct questions about suicidal thoughts and behaviors.

18.
Psychosomatics ; 54(3): 239-47, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23398908

RESUMEN

BACKGROUND: Suicide in hospital settings is a frequently reported sentinel event to the Joint Commission (JC). Since 1995, over 1,000 inpatient deaths by suicide have been reported to the JC; 25% occurred in non-behavioral health settings. Lack of proper "assessment" was the leading root cause for 80% of hospital suicides. This paper describes the "Ask Suicide-Screening Questions to Everyone in Medical Settings (asQ'em)" Quality Improvement Project. We aimed to pilot a suicide screening tool and determine feasibility of screening in terms of prevalence, impact on unit workflow, impact on mental health resources, and patient/nurse acceptance. METHODS: We piloted the asQ'em two-item screening instrument that assesses suicidal thoughts and behaviors, designed specifically for nurses to administer to medical patients. Educational in-services were conducted. A convenience sample of adult patients, 18 years or older, from three selected inpatient units in the National Institutes of Health Clinical Center, participated. RESULTS: A total of 331 patients were screened; 13 (4%) patients screened "positive" for suicide risk and received further evaluation. No patient had acute suicidal thoughts or required an observational monitor. Screening took approximately 2 minutes; 87% of patients reported feeling comfortable with screening; 81% of patients, 75% of nurses, and 100% of social workers agreed that all patients in hospitals should be screened for suicide risk. DISCUSSION: Nurses can feasibly screen hospitalized medical/surgical patients for suicide risk with a two-item screening instrument. Patients, nurses, and social workers rated their experience of screening as positive and supported the idea of universal suicide screening in the hospital.


Asunto(s)
Hospitales , Tamizaje Masivo/enfermería , Seguridad del Paciente/normas , Mejoramiento de la Calidad , Prevención del Suicidio , Encuestas y Cuestionarios , Adolescente , Adulto , Anciano , Actitud del Personal de Salud , Femenino , Humanos , Masculino , Persona de Mediana Edad , Evaluación en Enfermería/métodos , Admisión del Paciente , Satisfacción del Paciente , Proyectos Piloto , Factores de Riesgo , Servicio Social , Ideación Suicida , Suicidio/psicología , Suicidio/estadística & datos numéricos , Adulto Joven
19.
Pediatr Emerg Care ; 28(1): 34-8, 2012 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-22193697

RESUMEN

OBJECTIVE: Understanding how children react to suicide screening in an emergency department (ED) can inform implementation strategies. This qualitative study describes pediatric patients' opinions regarding suicide screening in that setting. METHODS: As part of a multisite instrument validation study, patients 10 to 21 years presenting with both psychiatric and nonpsychiatric complaints to an urban, tertiary care pediatric ED were recruited for suicide screening. Interviews with subjects included the question, "do you think ER nurses should ask kids about suicide/thoughts about hurting themselves...why/why not?" Responses were transcribed verbatim and uploaded into NVivo8.0 qualitative software for coding and content analysis. RESULTS: Of the 156 patients who participated in the study, 106 (68%) presented to the ED with nonpsychiatric complaints and 50 (32%) presented with psychiatric complaints. The patients' mean (SD) age was 14.6 (2.8) years (range, 10-21 years), and 56% of the sample was female. All patients answered the question of interest, and 149 (96%) of 156 patients supported the idea that nurses should ask youth about suicide in the ED. The 5 most frequently endorsed themes were as follows: (1) identification of youth at risk (31/156, 20%), (2) a desire to feel known and understood by clinicians (31/156, 20%), (3) connection of youth with help and resources (28/156, 18%), (4) prevention of suicidal behavior (25/156, 16%), and (5) lack of other individuals to speak with about these issues (19/156, 12%). CONCLUSIONS: Pediatric patients in the ED support suicide screening after being asked a number of suicide-related questions. Further work should evaluate the impact of suicide screening on referral practices and link screening efforts with evidence-based interventions.


Asunto(s)
Actitud Frente a la Salud , Servicio de Urgencia en Hospital , Tamizaje Masivo/psicología , Relaciones Enfermero-Paciente , Pacientes/psicología , Pediatría , Ideación Suicida , Prevención del Suicidio , Adolescente , Actitud Frente a la Muerte , Niño , Grupos Diagnósticos Relacionados , Enfermería de Urgencia , Servicio de Urgencia en Hospital/organización & administración , Femenino , Hospitales Urbanos , Humanos , Masculino , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Estudios Multicéntricos como Asunto/estadística & datos numéricos , Rol de la Enfermera , Psicología del Adolescente , Psicología Infantil , Riesgo , Conducta Autodestructiva/epidemiología , Conducta Autodestructiva/enfermería , Conducta Autodestructiva/psicología , Revelación de la Verdad , Adulto Joven
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