中华护理杂志 ›› 2019, Vol. 54 ›› Issue (6): 861-867.DOI: 10.3761/j.issn.0254-1769.2019.06.011

• 护理风险管理专题 • 上一篇    下一篇

湖北省45所综合医院非精神科住院患者自杀行为的调查

丁小萍,胡德英(),万青,刘义兰,王舒杰,韩燕红,鲁睿菲,毛世清,许珂   

  1. 430022 武汉市华中科技大学同济医学院附属协和医院内分泌科(丁小萍,万青),护理部(胡德英,刘义兰,韩燕红, 鲁睿菲, 毛世清, 许珂);武汉大学人民医院新生儿科(王舒杰);
  • 收稿日期:2018-07-17 出版日期:2019-06-15 发布日期:2019-06-15
  • 通讯作者: 胡德英
  • 作者简介:丁小萍:女,硕士,护师,E-mail: <email>13886140857@163.com</email>
  • 基金资助:
    基金项目院国家自然科学基金面上项目(71673100)

A survey of non-psychiatric inpatients suicides from 45 general hospitals in Hubei Province,China

DING Xiaoping,HU Deying(),WAN Qing,LIU Yilan,WANG Shujie,HAN Yanhong,LU Ruifei,MAO Shiqing,XU Ke   

  • Received:2018-07-17 Online:2019-06-15 Published:2019-06-15
  • Contact: Deying HU

摘要:

目的 了解湖北省综合医院非精神科住院患者自杀行为特征及影响因素。方法 采用分层—目标抽样法,按照1 ∶ 1配比,抽取湖北省50所综合医院,采用住院患者自杀行为病例报告表对2015年1月1日—2017年12月31日所有医院护理不良事件报告系统中非精神科住院患者自杀未遂和自杀死亡的案例进行收集和分析。结果 45所医院接受了本次调查,共报告自杀病例169例,自杀行为发生率为3.48/10万住院人次。二级医院住院患者自杀行为发生率是三级医院的1.10倍;年龄≥60岁、学历为小学或初中、职业为无业或农民、患有恶性肿瘤或慢性疾病者更易发生自杀行为。自杀行为多出现在春季,00:00—07:59及住院1周内,主要发生在病房内,自杀方式以跳楼为主。自杀完成率高达49.11%,11所医院因患者自杀发生了医疗纠纷,自杀原因以躯体疾病、家庭关系、家庭经济状况为主。结论 综合医院住院患者自杀行为发生率高,建议管理者针对非精神科住院患者自杀行为特征及影响因素对医护人员进行培训,提高医护人员对住院患者自杀的关注与重视。

关键词: 自杀, 住院患者, 综合医院, 流行病学, 护理管理研究, 患者安全

Abstract:

Objective To understand the characteristics and influencing factors of suicidal behaviors of non-psychiatric inpatients in general hospitals in Hubei Province.Methods Using stratified-typical-target sampling method,50 general hospitals in Hubei Province were selected according to the ratio of 1∶1. All adverse event reporting system databases received between January 1st,2015,and December 31st,2017 were collected and analyzed to identify any events that involved suicide or suicide attempts occurred in the above hospitals.Results Totally 169 cases of non-psychiatric inpatients suicides were reported in 45 general hospitals. The incidence of inpatients suicidal behaviors in general hospitals was 3.48/100,000 admissions,the incidence of inpatients suicidal behaviors in secondary hospitals was 1.10 times higher than that in tertiary hospitals. Inpatients whose age≥60,with primary or junior high school education,unemployed or peasants,suffering from malignant tumors or chronic diseases,were more likely to commit suicide. Suicidal behaviors in hospitalized patients were more common in the spring,at 00:00-07:59 and within 1 week,mainly in the ward. The main suicide way was jumping from the buildings. The suicide completion rate was as high as 49.1%. Eleven hospitals had serious medical disputes due to suicide. The causes of suicide were mainly physical illness,family relationship,and family economy.Conclusion The incidence of inpatients suicidal behaviors in general hospitals is high. Administrators should provide training for healthcare providers on characteristics and influencing factors of inpatients suicidal behaviors,to improve focus and attention of healthcare providers towards suicide among inpatients.

Key words: Suicide, Inpatients, General Hospital, Epidemiology, Nursing Administration Research, Patient Safety