Most Proposed Topic :
HA Young Investigators Session (projects to be presented by and HA staff who had joined HA for less than 15 years)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Authors: (including presenting author): :
Hung YY(1), Sip YL(1), Lam YL(1), Lee TK(1)
Affiliation: :
(1) Department of Psychiatry, Tai Po Hospital
Introduction: :
The suicide rate of psychiatric patients after first three months of discharge is 100 times higher than global suicide rate. Evidence showed that ineffective problem solving and maladaptive coping are associated with higher suicidal risk. Therefore, it is imperative to emphasize on patient empowerment and encourage collaboration between nurses and patients in order to prepare ahead for emotional coping and reduce the post-discharge suicidal risk. A client-centered group intervention program with problem-solving therapy strategies (4 sessions within 2 weeks, 1.5 hours each), had been implemented to empower adult psychiatric in-patients to manage negative emotion. Participants’ possessed strength/resources would be elicited and could learn new strategies from others’ experience and psychoeducation provided by nurses. An individualized plan for problem solving and self-coping of emotion would be co-produced by participants and nurses upon completion.
Objectives: :
1. Elicit/equip problem-solving strategies
2. Improve sense of hope
3. Alleviate depression/anxiety
4. Reduce dynamic suicidal risk factors
Methodology: :
One-group pretest-posttest design and convenience sampling were adopted. Male and female adult inpatients without cognitive impairment, under suicidal observation (SO) or previously put on SO were recruited. Chinese version of Depression, Anxiety and Stress Scale–21 items (DASS-21), Herth Hope Index (HHI) and General Self-efficacy Scale (GSESC) were used to measure the emotional states, hope and self-efficacy for managing own problems respectively. The scores of dynamic suicidal risk factors in NGASR were compared. Further, participant satisfaction survey was administered. SPSS 27 was used for data analysis.
Result & Outcome: :
From 24/8/2023 to 21/12/2023, 8 intervention groups were delivered. Total of 22 out of 29 participants completed the program (Male=14, Female=8, Age=18–62). HHI and GSES’s means scores were compared by paired sample t-test with significant findings. HHI increased from 31.68 to 35.5; t(21) =-3.805, p=0.001. GSES increased from 23.82 to 27; t(21) =-3.994, p< 0.001. DASS-21 and NGASR’s median scores were compared by Mann-Whitney U test. NGASR reduced significantly from 2.0 to 0 (U=69, Z=-4.21, p< 0.00). DASS-21 reduced clinically (U=192, Z=-1.179, p=.238). Satisfaction survey showed most of participants (n=20, 90.9%) agreed the program could enhance problem-solving strategies. Majority of participants (n=21, 95.5%) were satisfied with the program and agreed that it could enhance their coping on emotional change. The program is effective to empower participants to manage negative emotions and would be benefit for mitigating post-discharge suicidal risk.
