失效模式与效应分析风险管理在住院抑郁症患者自杀预防中的应用  

The application of failure mode and effect analysis in risk management for suicide prevention in hospitalized patients with depression

作　　者：王媛媛 甘建光 陈晶 叶猛飞 WANG Yuanyuan;GAN Jianguang;CHEN Jing;YE Mengfei(Department of Psychiatry,Shaoxing Seventh People's Hospital,Shaoxing,Zhejiang 312000,China;不详)

机构地区：[1]绍兴市第七人民医院精一科,浙江绍兴312000 [2]绍兴市第七人民医院精二病区 [3]绍兴市第七人民医院精三病区 [4]绍兴市第七人民医院医务科

出　　处：《中华全科医学》2024年第4期633-637,共5页Chinese Journal of General Practice

基　　金：浙江省医药卫生科技计划项目(2020ZH058)。

摘　　要：目的分析失效模式与效应分析风险管理对住院抑郁症患者心理状态及自杀意念的影响,探讨其在患者自杀预防中的应用效果。方法选取2021年1月—2023年8月绍兴市第七人民医院收治的235例住院抑郁症患者,根据随机数字表法将其分为对照组(117例)和观察组(118例)。对照组应用常规风险管理,观察组在对照组基础上应用失效模式与效应分析风险管理干预。统计2组患者自杀(或未遂)发生率,对比2组患者干预前后风险优先指数、心理状态、负性自动思维及自杀意念评分。结果干预后,观察组风险优先指数(RPN)均低于对照组,且观察组自杀(或未遂)发生率为2.5%(3/118),低于对照组的8.5%(10/117,P<0.05)。干预后,2组患者心理状态均改善,观察组汉密尔顿焦虑量表(HAMA)及汉密尔顿抑郁量表(HAMD)得分分别为(15.73±3.11)分、(17.22±3.34)分,均低于对照组[(17.06±3.50)分、(19.29±4.01)分,P<0.05]。干预后,2组患者负性自动思维状态均改善,观察组负性自动思维问卷(ATQ)中频繁程度及相信程度评分均低于对照组(P<0.05)。干预后,2组患者自杀意念强烈程度均下降,观察组贝克自杀意念量表中文版(BSI-CV)总分为(16.30±3.82)分,低于对照组[(20.28±4.43)分,P<0.05]。结论失效模式与效应分析风险管理能明显改善住院抑郁症患者心理状态及负性自动思维,能有效降低患者自杀意念水平,具有一定的自杀预防效果。Objective This study aims to assess the effect of failure mode and effect analysis in risk management on the mental state and suicidal ideation of hospitalized patients with depression,and to explore its effectiveness in suicide prevention.Methods A total of 235 hospitalized patients with depression,admitted to Shaoxing Seventh People's Hospital from January 2021 to August 2023,were randomly divided into two groups using a random number table method:the control group(117 cases)and the observation group(118 cases).The control group received conventional risk management,while the observation group received risk management intervention using failure mode and effect analysis,based on the control group.The incidence of suicide(or attempted suicide)in both groups was analyzed.Furthermore,the risk priority index,mental state,negative automatic thinking,and suicidal ideation scores before and after intervention were compared between the two groups.Results After the intervention,the risk priority index(RPN)of the observation group was lower than that of the control group,with an incidence of suicide(or attempted suicide)of 2.5%(3/118)in the observation group,significantly lower than the 8.5%(10/117)in the control group(P<0.05).After intervention,the psychological state of patients in both groups was improved.The observation group had lower scores on the Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD)[(15.73±3.11)points and(17.22±3.34)points,respectively],compared to the control group[(17.06±3.50)points and(19.29±4.01)points,P<0.05].The intervention led to improved negative automatic thinking in both groups,with the observation group showing lower scores on the frequency and belief scores of ATQ compared to the control group(P<0.05).Additionally,the intensity of suicidal ideation decreased in both groups.The total score of BSI-CV in the observation group was(16.30±3.82)points,which was lower than that in the control group[(20.28±4.43)points,P<0.05].Conclusion The implementation of failure mode and eff

关 键 词：抑郁症 失效模式与效应分析 风险管理 自杀预防 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R473.74[医药卫生—临床医学]