scholarly journals Reducing Patient Risk for Suicidal Behaviors with a Safety Bundle of Best Practices with Non-Psychiatric Patients

2021 ◽  
Author(s):  
◽  
Olayemi Akindele
Keyword(s):  
Best Practices ◽  
Risk Score ◽  
Rating Scale ◽  
Suicidal Behaviors ◽  
Suicidal Risk ◽  
Post Intervention ◽  
Severity Rating ◽  
Significant Difference ◽  
Self Harm ◽  
Surgical Unit

Practice Problem: Suicide is a public health condition that affects people globally. The increased suicidal behaviors of patients in a medical-surgical unit demanded an effective screening protocol to identify high-risk patients. PICOT: In patients 18 years and older on a medical-surgical unit, does the implementation of the Columbia Suicide Severity Rating Scale (C-SSRS) tool and application of a Safety Bundle of Best Practices (SBBP) increase early identification of suicide risk with decreased patient self-harm behaviors, compared to the current standard practice of no assessment tool or safety bundle of best practices within 12 weeks? Evidence: Ten studies served as evidence that assessment of early suicidal-risk behaviors decreased patient self-harm. The evidence supported the implementation of the C-SSRS tool and application of the Safety Bundle of Best Practices for the project intervention. Intervention: The intervention consisted of three phases (pre-intervention, intervention, and post-intervention): a) patients were screened with the Columbia-Suicide Severity Rating Scale (C-SSRS); b) suicidal patients were managed with Collaborative Assessment and Management of Suicidality (CAMS); and c) a Safety Plan Intervention (SPI) was employed to manage suicidal behaviors. Outcome: At the start of the assessment period, pre-intervention data yielded a C-SSRS risk score mean of 0.81; following the eight-week implementation period, post-intervention data yielded a C-SSRS risk score mean of 0.75. There was a marginally significant difference between the means at pre- and post-intervention, showing a lower suicidal risk at post-intervention, p = 0 .07, t-test result (31) = 1.87. Conclusion: The decrease in patient self-harm behaviors with the implementation of the C-SSRS tool and application of SBBP was not statistically significant (SBBP). However, the decrease did indicate a clinically meaningful improvement in suicidal behavior outcomes after implementation of the intervention.

scholarly journals The Role of Past Suicidal Behavior on Current Suicidality: A Retrospective Study in the Israeli Military

2021 ◽  
Vol 18 (2) ◽  
pp. 649
Author(s):  
Leah Shelef ◽  
Jessica M Rabbany ◽  
Peter M Gutierrez ◽  
Ron Kedem ◽  
Ariel Ben Yehuda ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Suicidal Behavior ◽  
Military Service ◽  
Suicide Ideation ◽  
Rating Scale ◽  
Suicide Attempts ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Severity Rating ◽  
Significant Difference

Past suicide attempts are a significant risk factor for future suicidality. Therefore, the present military-based study examined the past suicidal behavior of soldiers who recently made a severe suicide attempt. Our sample consisted of 65 active-duty soldiers (61.5% males), between the ages of 18 and 28 years old (M = 20.4, SD ± 1.3). The inclusion criterion was a recent severe suicide attempt, requiring at least a 24 h hospitalization. This sample was divided into two groups, according to previous suicidal behavior, namely whether their first suicide attempt was before or after enlistment (n = 25; 38.5% and n = 40; 61.5%, respectively). We then examined the lethality and intent of the recent event in regard to this division. Four measures were used to assess the subjects’ suicidal characteristics: the Columbia Suicide Severity Rating Scale, the Self-Harm Behavior Questionnaire, the Suicidal Behaviors Questionnaire-Revised, and the Beck Scale for Suicide Ideation. No significant difference in the severity of the suicide attempts (either actual or potential severity) were found between those who had suicide attempts before enlistment and those who had their first attempt in the service. As a matter of fact, most of the suicide attempts that occurred for the first time during military service had used a violent method (58.3%, n = 21). Finally, using multivariate analyses, we found that current thoughts and behavior, rather than past suicidality, was the strongest predictor for the lethality of suicide attempts.

scholarly journals Chromosome 22 Deletions and Suicidal Behavior in Schizophrenia

2021 ◽  
pp. 1-8
Author(s):  
Ali Bani-Fatemi ◽  
Christopher Adanty ◽  
Nasia Dai ◽  
Ariel Graff ◽  
Philip Gerretsen ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Suicidal Behavior ◽  
Copy Number ◽  
Rating Scale ◽  
Copy Number Variant ◽  
Chromosome 22 ◽  
Suicide Attempters ◽  
Severity Rating ◽  
Neuropsychiatric Diseases ◽  
Significant Difference

Background: Studies have shown that the overall copy number variant (CNV) load is associated with schizophrenia. Schizophrenia is a mental disorder that is frequently associated with suicidal behavior. Methods: We recruited 263 patients with schizophrenia from the Centre for Addiction and Mental Health. The Columbia Suicide Severity Rating Scale was used to assess the presence of lifetime suicide attempt. Genotyping was completed using the Illumina Omni 2.5 chip. We tested the association between deletion events on chromosome 22 with suicide attempt in our schizophrenia sample. Results: There was no significant difference between suicide attempters and non-attempters considering the presence/absence of deletion events on chromosome 22. Conclusion: Although our results did not show a significant association between deletions on chromosome 22 and suicide attempt in schizophrenia, CNV studies may reveal important, novel insights and open further investigation for the treatment of neuropsychiatric diseases.

Effectiveness of duloxetine on severity of pain and quality of life in chronic low back pain in patients who had posterior spinal fixation

2021 ◽  
pp. 221049172098333
Author(s):  
Arezoo Samadi ◽  
Razieh Salehian ◽  
Danial Kiani ◽  
Atefeh Ghanbari Jolfaei
Keyword(s):  
Quality Of Life ◽  
Back Pain ◽  
Rating Scale ◽  
Low Back ◽  
Spinal Fixation ◽  
Post Intervention ◽  
Significant Difference ◽  
Hamilton Anxiety Rating Scale ◽  
Hamilton Anxiety

Background: In this study, we want to search the effectiveness of Duloxetine on the severity of pain and quality of life in patients with chronic low back pain who had posterior spinal fixation. Methods: In this randomized, placebo-controlled trial done in 6 months 50 patients who had CLBP and were candidates for PSF surgery selected and divided into two groups (drug and placebo). They filled the VAS, SF-36, and Hamilton questionnaires before surgery and after 6 weeks from using 30 mg of duloxetine or placebo. Results: Significant differences were evidenced among groups for the Visual Analogue Scale (P = 0.005) and Verbal Analogue Scale (p = 0.003). Patients in the Duloxetine group have more visual and verbal pain scores than the placebo group. In the quality of life, there was a significant difference between the two groups before the intervention. Also, significant differences were evidenced among groups for the Hamilton Anxiety Rating Scale (p = 0.17). After the intervention, only the Hamilton Anxiety Rating Scale (p = 0.001) and ‘bodily pain’ and ‘general health’ subscales of quality of life (p = 0.008, 0.004, respectively) have a significant difference between the two groups. There was a significant difference between pre and post-intervention in the Hamilton Anxiety Rating Scale only in the duloxetine group. Also, in terms of quality of life, the subscales of ‘physical role’, ‘emotional role’, ‘physical pain’ and ‘total score of quality of life’ in the duloxetine and placebo groups were significantly different between pre and post-intervention. However, the subscales of ‘physical function’ and ‘general health’ were significantly different only in the duloxetine group between pre and post-intervention. Conclusion: The results suggest that the use of duloxetine in patients who had spinal surgery can help to better control back pain, on the other hand, it can cause a better psychological condition that affects the quality of life.

scholarly journals The Relative Merits of an Individualized Versus a Generic Approach to Rating Functional Performance in Childhood Dystonia

Children ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 7
Author(s):  
Hortensia Gimeno ◽  
Jessica Farber ◽  
Jessica Thornton ◽  
Helene Polatajko
Keyword(s):  
Young People ◽  
Movement Disorders ◽  
Best Practice ◽  
Rating Scale ◽  
Childhood Onset ◽  
Post Intervention ◽  
Children And Young People ◽  
Change Scores ◽  
Significant Difference ◽  
And Performance

Aims. The Performance Quality Rating Scale (PQRS) is an observational measure that captures performance at the level of activity and participation. Developed for use with the Cognitive Orientation to daily Occupational Performance (CO-OP), it is a highly individualized approach to measurement. CO-OP is currently being studied in childhood-onset hyperkinetic movement disorders (HMD) and deep brain stimulation. The purpose of this study was to compare two different approaches to rating performance, generic (PQRS-G) and individualized (PQRS-I), for children with childhood-onset hyperkinetic movement disorders (HMD) including dystonia. Method. Videotaped activity performances, pre and post intervention were independently scored by two blind raters using PQRS-G PQRS-I. Results were examined to determine if the measures identified differences in e performance on goals chosen by the participants and on change scores after intervention. Dependent t-tests were used to compare performance and change scores. Results. The two approaches to rating both have moderate correlations (all data: 0.764; baseline: 0.677; post-intervention: 0.725) and yielded some different results in capturing performance. There was a significant difference in scores at pre-intervention between the two approaches to rating, even though post-intervention score mean difference was not significantly different. The PQRS-I had a wider score range, capturing wider performance differences, and greater change between baseline and post-intervention performances for children and young people with dystonic movement. Conclusions. Best practice in rehabilitation requires the use of outcome measures that optimally captures performance and performance change for children and young people with dystonic movement. When working with clients with severe motor-performance deficits, PQRS-I appears to be the better approach to capturing performance and performance changes.

Use of the Columbia-Suicide Severity Rating Scale (C-SSRS) to Classify Suicidal Behaviors

2017 ◽  
Vol 22 (2) ◽  
pp. 278-294 ◽  
Author(s):  
Alejandro Interian ◽  
Megan Chesin ◽  
Anna Kline ◽  
Rachael Miller ◽  
Lauren St. Hill ◽  
...  
Keyword(s):  
Rating Scale ◽  
Suicidal Behaviors ◽  
Severity Rating

scholarly journals Self-perception of surface hydration effect on teachers’ voice quality: an intervention study

Revista CEFAC ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 761-769
Author(s):  
Emile Rocha Santana ◽  
Tânia Maria de Araújo ◽  
Maria Lúcia Vaz Masson
Keyword(s):  
Intervention Study ◽  
Saline Solution ◽  
Rating Scale ◽  
Voice Disorder ◽  
Self Perception ◽  
Post Intervention ◽  
Severity Rating ◽  
Surface Hydration ◽  
Perceived Effects ◽  
Vocal Quality

ABSTRACT Objective: to assess the effects of surface hydration on vocal quality according to teachers’ self-perception. Methods: an examiner-blinded pre-test and post-test intervention study carried out with a single group of 27 teachers. Sociodemographic characteristics and work questionnaire, Screening Index for Voice Disorder, Vocal Severity Rating Scale, Expected Effects Pre-intervention, Perceived Effects Post-intervention and Post-intervention Perception instruments, were applied. The intervention lasted 4 weeks and consisted of 5 minutes of nebulization with saline solution (sodium chloride 0.9%), after 10 minutes of mouth dehydration, prior to teaching. Results: screening Index for Voice Disorder scores demonstrated a statistically significant reduction (p=0.001). Frequency of voice disorders in the Vocal Severity Rating Scale was reduced without a statistical significance (p= 0.172). Expected Effects, Pre-intervention, and Perceived Effects, Post-intervention, showed improvement in vocal quality (40.7%), vocal comfort (40.7%) and vocal folds hydration (37%). Post-intervention perception form showed moderate improvement of the symptoms (59.3%), cleared voice (55.6%) and ease speaking (48.1%) as well as intense belief in the intervention (74.1%) and intense compliance to the intervention (74.1%). Conclusion: surface hydration with saline solution promoted self-perceived improvement in vocal quality.

Are Demoralization and Insight Involved in Suicide Risk? An Observational Study on Psychiatric Inpatients

2021 ◽  
pp. 1-9
Author(s):  
Isabella Berardelli ◽  
Marco Innamorati ◽  
Salvatore Sarubbi ◽  
Elena Rogante ◽  
Denise Erbuto ◽  
...  
Keyword(s):  
Suicide Risk ◽  
Rating Scale ◽  
Suicide Attempts ◽  
Psychiatric Inpatients ◽  
Clinical Factors ◽  
Severity Rating ◽  
Self Harm ◽  
Demoralization Scale ◽  
Insight Into Illness ◽  
Insight Into

<b><i>Introduction:</i></b> Several features contribute to determining suicide risk. This study was designed with the aim of evaluating whether insight into illness and demoralization are involved in suicide risk (active suicidal ideation or behavior). <b><i>Methods:</i></b> For this purpose, in a sample of 100 adult psychiatric inpatients, we used the Columbia Suicide Severity Rating Scale to assess suicide risk, the Demoralization Scale for demoralization symptoms, and the Insight Scale to assess illness insight. We also investigated several demographic and clinical features, including gender, age, duration of untreated illness, previous suicide attempts, and nonsuicidal self-injurious behavior. <b><i>Results:</i></b> The results demonstrated that patients with higher scores on the insight-high dimension had 1.35 greater odds of having a higher suicide risk, and those with lifetime suicide attempts had 7.45 greater odds of having a higher suicide risk. Among the various clinical factors, the study indicated that only nonsuicidal self-harm behaviors in the last 3 months was a risk factor for suicide risk. <b><i>Conclusions:</i></b> The results indicated that greater illness insight is involved in suicide risk regardless of demoralization.

scholarly journals Alexithymia, Suicidal Ideation and Behaviour in Moroccan Psychoactive Substance Users

2021 ◽  
Author(s):  
Khadija Karjouh ◽  
Fatima-Zahra Azzaoui ◽  
Riadh Ouerchefani ◽  
Wafae idrissi semlali ◽  
Khaoula Mammad ◽  
...  
Keyword(s):  
Substance Use ◽  
Suicidal Ideation ◽  
Emotional Regulation ◽  
Rating Scale ◽  
Depressive Symptomatology ◽  
Suicidal Thoughts ◽  
Severity Rating ◽  
Significant Difference ◽  
And Behaviors ◽  
Suicidal Thoughts And Behaviors

Abstract Alexithymia is an emotion regulation problem that may be related to suicidality, especially in patients with SUD.The study aimed at estimating the prevalence of alexithymia in Moroccan psychoactive substances users, and to establish the links between alexithymia and suicidal ideation and behaviors, anxiety and depression in drug-dependent patients.We also aimed to elucidate if alexithymia predicts suicidal thoughts and behaviors in these consumers. The study included 451 consecutively admitted patients with substance use. Consumers were examined with the Toronto alexithymia scale (TAS-20), State and Trait Anxiety Inventory (STAI-Y), Beck Depression Inventory (BDI) and The Columbia-Suicide Severity Rating Scale (C-SSRS)Among substance-dependent individuals, 72.7% was identified as a group with alexithymia. Current age and age at first substance use were lower in the alexithymic group (p<0.01).The mean STAI-Y state and C-SSRS scores were higher in the group with alexithymia (p<0.01). There was a statistically significant difference between the groups in terms of mean scores for anxiety traits (p<0.05) and no significant difference in terms of mean scores for depression. All of the scores correlated significantly with.Addicted patients with alexithymia could be targeted at preventing the onset of suicidal thoughts and behaviorThe present study also evokes that whenever an emotional regulation disorder is observed, the possibility of anxio-depressive symptomatology and suicidality (ideation and behavior) needs to be assessed.

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