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1.
Gen Hosp Psychiatry ; 63: 119-126, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-29934033

RESUMO

OBJECTIVE: A novel avatar system (Virtual Collaborative Assessment and Management of Suicidality System; V-CAMS) for suicidal patients and medical personnel in emergency departments (EDs) was developed and evaluated. V-CAMS facilitates the delivery of CAMS and other evidence-based interventions to reduce unnecessary hospitalization, readmissions, and suicide following an ED visit. METHOD: Using iterative user-centered design with 24 suicidal patients, an avatar prototype, "Dr. Dave" (based on Dr. Jobes) was created, along with other patient-facing tools; provider-facing tools, including a clinical decision support tool were also designed and tested to aid discharge disposition. RESULTS: Feasibility tests supported proof of concept. Suicidal patients affirmed the system's overall merit, positive Perception of Care, and acceptability; medical providers (n = 21) viewed the system as an efficient, effective, and safe method of improving care for suicidal ED patients and reducing unnecessary hospitalization. CONCLUSIONS: Technology tools including a patient-facing avatar and e-caring contacts, along with provider-facing tools may offer a powerful method of facilitating best-practice suicide prevention interventions and point-of-care tools for suicidal patients seeking ED services and their medical providers. Future directions include full development of V-CAMS and integration into a health electronic medical record and a rigorous randomized controlled trial to study its effectiveness.


Assuntos
Atitude do Pessoal de Saúde , Técnicas de Apoio para a Decisão , Serviço Hospitalar de Emergência , Aplicações da Informática Médica , Aceitação pelo Paciente de Cuidados de Saúde , Avaliação de Processos em Cuidados de Saúde , Prevenção do Suicídio , Interface Usuário-Computador , Adolescente , Adulto , Estudos de Viabilidade , Feminino , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Sistemas Automatizados de Assistência Junto ao Leito , Estudo de Prova de Conceito , Adulto Jovem
2.
J Psychiatr Res ; 80: 59-63, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27295122

RESUMO

BACKGROUND: Suicide is a major public health concern in military and civilian contexts. Veteran populations are at increased risk for suicide, especially veterans with mental health disorders such as Posttraumatic Stress Disorder (PTSD). Suicidal ideation (SI) is a primary risk factor for suicide. METHODS: We investigated changes in SI in a multi-site sample of treatment seeking veterans from three separate Veterans Health Administration (VA) medical centers (n = 289) who received Prolonged Exposure (PE) therapy, an evidence-based treatment (EBT) for PTSD. SI and PTSD symptoms were assessed, using self-report instruments, throughout routine clinical care. RESULTS: Both PTSD and SI symptoms reduced over the course of treatment (d-type effect sizes of 1.47 and 0.27, respectively). While SI was associated with PTSD symptoms at all time points, appropriately specified, time lagged models indicated that changes in PTSD symptoms were predictive of future declines in SI, while the converse was not true. CONCLUSIONS: Results indicate that treating PTSD symptoms with an EBT for PTSD can be an effective way to reduce SI, at least partially, and for some patients. These data are significant in light of the resources and programming devoted to addressing SI in the VA relative to available empirical evidence regarding the effectiveness of developed strategies. The findings demonstrate the importance of facilitating EBT referrals for specific disorders as a component of broad-based suicide outreach and preventions strategies.


Assuntos
Medicina Baseada em Evidências , Terapia Implosiva/métodos , Transtornos de Estresse Pós-Traumáticos/reabilitação , Transtornos de Estresse Pós-Traumáticos/terapia , Ideação Suicida , Adulto , Campanha Afegã de 2001- , Análise de Variância , Feminino , Humanos , Guerra do Iraque 2003-2011 , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Estados Unidos , United States Department of Veterans Affairs
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