目的：分析家属在自杀未遂者救治早期的心理状态和求助倾向。
方法：采用一般资料调查表、简明国际神经精神访谈（Mini International Neuropsychiatric Interview,M.I.N.I.）自杀模块、抑郁-焦虑-压力量表中文简版等,对上海市3所综合医院急诊就诊的疑似自杀未遂病患及家属共148组进行调查（每组病患和家属各1人）。
结果：根据M.I.N.I.进行自杀行为评估后入组自杀未遂组（suicide attempts,SA）病患84例（56.8%）及家属84人,入组非自杀未遂组（non-suicide attempts,NA）病患64例（43.2%）,家属64人;自杀未遂组和非自杀未遂组家属都存在明显的焦虑、压力心理,自杀未遂组家属在病耻感和抑郁体验方面更加突出（p<0.05）,且更倾向于选择独处和精神科/心理门诊的方式分别来应对当前和今后的心理困扰（p<0.01）。
结论：医务工作者应对家属给予更多的理解和帮助,例如告知心理门诊预约信息等,并加强心理卫生科普工作降低家属病耻感。
Objective:To analyze the mental states and help-seeking preference of family members of suicide attempters in the early treatment.
Methods:A total of 148 groups (1 patient and 1 family member in each group) of suspected suicide attempters, who received medical consultation in the emergency departments of 3 general hospitals in Shanghai, and their families were investigated by using the self-compiled general information questionnaire, the suicide module of the Mini-International Neuropsychiatric Interview (M.I.N.I.), and the Chinese short version of the Depression Anxiety and Stress Scale.
Results:There were 84 cases (56.8%) of suicide attempters (SA) and 64 cases (43.2%) of non-suicide attempters (NA) according to the suicidal behavior evaluation of the M.I.N.I., and significant anxiety and stress existed in the family members of SA and NA. The family members of SA were more prominent in feeling the sense of shame and depression (p<0.05), and they were more inclined to choose the ways of solitude and psychiatric/psychological outpatient services to deal with the current and future psychological problems separately (p<0.01).
Conclusion:The medical staffs should give more understanding and help to the family members, such as informing the appointment information of psychological clinic to them, and strengthen the popularization of mental health science to reduce the sense of shame.
[1] 卞凤珍, 冯欣蓓, 曾雯琦. (2013). 烧炭自杀企图者之家庭照护. 护理杂志, 60(6), 84-89.
[2] 李丽, 沈乐, 赵继军. (2012). 外科ICU患者救治早期家属心理压力的现况调查及对策分析. 解放军护理杂志, 29(17), 13-16.
[3] 卢瑞梅, 彭玉维, 区秀凤, 刘惠萍. (2014). 心理护理干预在急诊创伤患者家属焦虑状态中的应用. 岭南急诊医学杂志, 19(02), 75-76.
[4] 司天梅, 舒良, 党卫民, 苏允爱, 陈景旭, 董问天, … 张卫华. (2009). 简明国际神经精神访谈中文版的临床信效度. 中国心理卫生杂志, 23(07), 493-497+503.
[5] 温弗乐, 桑未心, 林晓云. (2003). 急诊患者家属心理状况调查分析. 上海护理, (1), 1-3.
[6] 文艺, 吴大兴, 吕雪靖, 李涵贵, 刘晓婵, 杨裕萍, … 赵英. (2012). 抑郁-焦虑-压力量表中文精简版信度及效度评价. 中国公共卫生, 28(11), 1436-1438.
[7] 肖水源, 周亮, 徐慧兰. (2005). 危机干预与自杀预防(二)--自杀行为的概念与分类. 临床精神医学杂志, 15(5), 298-299.
[8] Brener N. D., Kann L., Kinchen S. A., Grunbaum J. A., Whalen L, Eaton D,.. Ross, J. G. (2004). Methodology of the youth risk behavior surveillance system. MMWR Recomm Rep, 53(RR-12), 1-13.
[9] Ferrey A. E., Hughes N. D., Simkin S., Locock L., Stewart A., Kapur N., … Hawton K. (2016). The impact of self-harm by young people on parents and families：A qualitative study. BMJ Open, 6(1), e009631. doi: 10.1136/bmjopen-2015-009631
[10] Garcia-Williams, A. G., & Mcgee, R. E. (2015). Responding to a Suicidal friend or family member: A qualitative atudy of college students. Death Stud, 40(2), 80-87. doi: 10.1080/07481187.2015.1068246
[11] Goldston D. B., Molock S. D., Whitbeck L. B., Murakami J. L., Zayas L. H., & Hall G. C. (2008). Cultural considerations in adolescent suicide prevention and psychosocial treatment. Am Psychol, 63(1), 14-31. doi:10.1037/0003-066X.63.1.14
[12] McLaughlin C., McGowan I., O’Neill S., & Kernohan G. (2014). The burden of living with and caring for a suicidal family member. J Ment Health, 23(5), 236-240. doi:10.3109/09638237.2014.928402
[13] Owens, C., Owen, G., Belam, J., Lloyd, K., Rapport, F., Donovan, J., & Lambert, H. (2011). Recognising and responding to suicidal crisis within family and social networks: qualitative study. BMJ, 343(7828), 834-834. doi: 10.1136/bmj.d5801
[14] Tzeng, W. C., & Lipson, J. G. (2004). The cultural context of suicide stigma in Taiwan. Qual Health Res, 14(3), 345-358. doi: 10.1177/10 49732303262057
[15] WHO. (2014). Preventing suicide: a global imperative. Geneva: World Health Organization.
[16] Xu Y., Phillips M. R., Wang L., Chen Q., Li C., & Wu X. (2013). Retrospective identification of episodes of deliberate self-harm from emergency room registers in general hospitals: an example from Shanghai. Arch Suicide Res, 17(4), 345-359. doi:10.1080/13811118.2013.801814
