45例住院自杀患者病例特征分析及预防对策

目的 总结住院患者自杀的状况,分析住院患者自杀的特征,从医院、管理者、医护人员、患者家属方面提出住院患者自杀的预防对策。方法 回顾性分析某三级甲等医院主院区病案科2008年11月—2018年9月45例关于住院自杀患者的完整病历。结果 45例住院自杀患者中,女性25例（56%）,45~60岁20例（44%）;初中及以下文化程度27例（60%）;已婚40例（90%）;父母一方去世或者双方已故者36例（80%）;无业34例（76%）;住院天数≤7 d 21例（47%）;住院总次数≥3次30例（67%）;癌症及慢性病33例（73%）;住院期间有手术者14例（31%）;住院期间有病重通知书10例（22%）;住院期间精神状况差23例（51%）,住院期间饮食状况差20例（44%）,住院期间睡眠状况差27例（60%）;春夏季自杀28例（62%）;2：00-6：00时间段自杀患者占17例（38%）;跳楼自杀患者27例（60%）,其中21例（81%）患者跳楼自杀死亡;自杀结局中患者死亡占26例（58%）。结论 预防对策包括：管理者关注自杀高危人群,做好环境安全管理,培训心理护士;医护人员评估科室环境安全,进行安全告知、保护性观察和有效沟通;患者家属提供良好的社会支持、保持警惕等。

Features of Hospitalized Patients Committing Suicide and Preventive Measures: A 45-case Study

Objective To analyze the features of hospitalized patients who committed suicide and to propose preventive measures from the perspective of hospital, managers, medical staff and families of the patients. Methods Data of 45 cases of hospitalized patients who committed suicide in one tertiary grade A hospital from November 2008 to September 2018 were analyzed. Results Of the total, there were 25 females (56%), 20 cases (44%)aged from 45 to 60, 27 cases (60%)with education of junior high school or below, 40 cases (90%)of married ones, 36 cases (80%)with deceased father or mother or both, 34 unemployed ones (76%), 21 cases (47%)with hospital stay shorter than 7d, 30 cases (67%)with 3 or more hospitalization times, 33 cases (73%) of cancer patients or with chronic diseases, 14 cases (31%) with surgeries during the hospitalization, 10 cases (22%) having notice of critical condition, 23 cases (51%) with poor psychological condition, 20 cases with poor appetite (44%) and 27 with poor sleep (60%) during the hospitalization. Spring and summer witnessed 28 cases of suicide (62%) and there were 17 patients committing suicide from 2:00-6:00, accounting for 38%. Twenty-seven cases (60%) jumped to death and 21 of them died (81%). As to the suicide outcome, 26 cases (58%) died eventually. Conclusion More attention to high risk population, environment safety management, help from psychological nursing, safety education, protective observation and effective communication and good social support are all conducive to the prevention of suicide in hospitalized patients.