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首頁> 外文期刊>The Journal of adolescent health: official publication of the Society for Adolescent Medicine >Suicide Screening in Primary Care: Use of an Electronic Screener to Assess Suicidality and Improve Provider Follow-Up for Adolescents
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Suicide Screening in Primary Care: Use of an Electronic Screener to Assess Suicidality and Improve Provider Follow-Up for Adolescents

機(jī)譯：初級(jí)保健中的自殺式篩選：使用電子篩選器來評(píng)估自由力，并改善青少年隨訪的服務(wù)

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Abstract Purpose The purpose of this study was to assess the feasibility of using an existing computer decision support system to screen adolescent patients for suicidality and provide follow-up guidance to clinicians in a primary care setting. Predictors of patient endorsement of suicidality and provider documentation of follow-up were examined. Methods A prospective cohort study was conducted to examine the implementation of a CDSS that screened adolescent patients for suicidality and provided follow-up recommendations to providers. The intervention was implemented for patients aged 12–20 years in two primary care clinics in Indianapolis, Indiana. Results The sample included 2,134 adolescent patients (51% female; 60% black; mean age?=?14.6 years [standard deviation?=?2.1]). Just over 6% of patients screened positive for suicidality. A positive endorsement of suicidality was more common among patients who were female, depressed, and seen by an adolescent?medicine board-certified provider as opposed to general pediatric provider. Providers documented follow-up action for 83% of patients who screened positive for suicidality. Documentation of follow-up action was correlated with clinic site and Hispanic race. The majority of patients who endorsed suicidality (71%) were deemed not actively suicidal after assessment by their provider. Conclusions Incorporating adolescent suicide screening and provider follow-up guidance into an existing computer decision support system in primary care is feasible and well utilized by providers. Female gender and depressive symptoms are consistently associated with suicidality among adolescents, although not all suicidal adolescents are depressed. Universal use of a multi-item suicide screener that assesses recency might more effectively identify suicidal adolescents.
機(jī)譯：摘要目的本研究的目的是評(píng)估利用現(xiàn)有計(jì)算機(jī)決策支持系統(tǒng)篩選青少年患者的可行性，為初級(jí)保健環(huán)境提供對(duì)臨床醫(yī)生的后續(xù)指導(dǎo)。研究了患者認(rèn)可的預(yù)測(cè)因素及跟進(jìn)的提供者文件。方法進(jìn)行預(yù)期隊(duì)列研究，以檢查篩查青少年患者的CDS的實(shí)施，并為提供商提供后續(xù)建議。在印第安納州印第安納州印第安納波利斯的兩次初級(jí)保健診所為12 - 20年的患者實(shí)施了干預(yù)。結(jié)果樣品包括2,134名青少年患者（51％的女性; 60％黑色;平均年齡？=？14.6歲[標(biāo)準(zhǔn)偏差嗎？=？2.1]）。只有超過6％的患者篩選了自由性陽性。在女性，沮喪和由青少年看到的患者中，自由性的積極認(rèn)可更為常見，并由青少年？醫(yī)學(xué)委員會(huì)認(rèn)證的提供商與通用兒科提供者相反。提供者記錄了83％的患者篩選適當(dāng)?shù)淖杂尚缘暮罄m(xù)行動(dòng)。后續(xù)行動(dòng)的文件與診所網(wǎng)站和西班牙裔比賽相關(guān)。在其提供者評(píng)估后，贊同自殺的大多數(shù)患者（71％）被視為未經(jīng)積極自殺。結(jié)論將青少年自殺式篩選和提供者隨訪指南納入現(xiàn)有的計(jì)算機(jī)決策支持系統(tǒng)，是可行的，提供商利用。女性性別和抑郁癥狀與青少年之間的自殺持續(xù)有關(guān)，盡管并非所有自殺青少年都被抑郁。普遍使用評(píng)估新近度的多項(xiàng)自殺篩選器可能更有效地識(shí)別自殺青少年。

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