Korean Journal of Psychosomatic Medicine (정신신체의학)

Korean Psychosomatic Society (한국정신신체의학회)
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Factors for Completing Case Management of Suicide Attempters: A Coihort Follow-Up Study Based on Data From Case Management of Emergency Room-Based Suicide Attempters

자살시도 환자의 지속적 관리 완수 요인: 응급실 기반 자살시도자 사후관리 사업 자료를 기반으로 한 코호트 추적 연구

  • Ryou, Jae Hyun (Department of Psychiatry, Chung Ang University Hospital) ;
  • Heo, Yoon Kyung (Life Crisis Intervention Center, Chung Ang University Hospital) ;
  • Kim, Da Seul (Life Crisis Intervention Center, Chung Ang University Hospital) ;
  • Kim, Sun Mi (Department of Psychiatry, Chung Ang University Hospital) ;
  • Han, Doug Hyun (Department of Psychiatry, Chung Ang University Hospital) ;
  • Min, Kyoung Joon (Department of Psychiatry, Chung Ang University Hospital)
  • 류재현 (중앙대학교병원 정신건강의학과) ;
  • 허윤경 (중앙대학교병원 생명사랑위기대응센터) ;
  • 김다슬 (중앙대학교병원 생명사랑위기대응센터) ;
  • 김선미 (중앙대학교병원 정신건강의학과) ;
  • 한덕현 (중앙대학교병원 정신건강의학과) ;
  • 민경준 (중앙대학교병원 정신건강의학과)
  • Received : 2021.10.20
  • Accepted : 2021.11.23
  • Published : 2021.12.31
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Abstract

Objectives : The purpose of this study was to find out how demographic factors, suicide attempt patterns, psychiatric history and management of suicide attempters affect the completion of emergency department (ED) based case management program. Methods : Among the patients who attempted suicide and visited the emergency department of Chung-Ang University Hospital from June 1, 2018 to May 31, 2021, 661 patients who agreed to case management were studied. After being discharged from the emergency department, subjects were registered for an eight-week follow-up service program. Hierarchical logistic regression analysis was conducted with demographic factors, suicide attempt patterns, psychiatric history and management as independent variables, and completion of case management program as dependent variables. Results : Suicide attempt pattern had the most significant influence on the completion of case management program, followed by demographic factors, psychiatric history and management. Those who completed the case management program were significantly more likely to have suicide plans in the future, more authentic in suicide attempts, and had higher proportion of past suicide attempts than those who did not complete the program. Conclusions : To ensure that the subjects complete the follow-up project program and get connected to community services, an individualized approach with consideration of suicide attempt patterns, demographic factors, and psychiatric history is needed.

연구목적 응급실 기반 자살시도자 사후관리사업에 등록된 자살시도자의 인구학적 요인, 자살시도 패턴 및 정신건강의학과 병력 및 관리가 사후관리 프로그램 완수에 어떠한 영향을 끼치는지 알아보고자 하였다. 방 법 2018년 6월 1일부터 2021년 5월 31일까지 중앙대학교병원 응급실을 방문한 자살시도 환자 중 사례관리에 동의한 661명을 연구대상으로 하였다. 대상자는 응급실 퇴원 후 8주간의 사후관리 서비스 프로그램에 등록하여 관리를 받았다. 인구학적 요인, 자살시도 패턴, 정신건강의학과 병력 및 관리에 해당하는 요인들을 독립변인으로, 사후관리사업 프로그램의 완수 여부를 종속변인으로 두고, 위계적 로지스틱 회귀 분석을 시행하였다. 결 과 자살시도 패턴이 사후관리 사업 완수에 가장 큰 영향을 미치고, 인구학적 요인, 정신건강의학과 병력 및 관리 순으로 사후관리 사업 완료 여부에 영향을 미치는 것으로 나타났다. 자살시도자 사후관리사업 프로그램 완수자는 미완수자에 비해, 향후 자살계획을 가진 경우가 유의하게 많았고, 자살시도의 진정성이 강했으며, 과거자살시도력 또한 유의하게 높았다. 결 론 대상자들이 사후관리사업 프로그램을 완수하고 지역사회 서비스로 연계되도록 하기 위하여, 자살시도 패턴, 인구학적 요인, 정신건강의학과 병력에 대한 고려를 바탕으로 한 개별화된 접근이 필요하다.

Keywords

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