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| 題 名 | Deliberate Self-Harm and Relationship to Alcohol Use at an Emergency Department in Eastern Taiwan=東臺灣蓄意自我傷害病患與飲酒 |
|---|---|
| 作 者 | 李燕鳴; | 書刊名 | The Kaohsiung Journal of Medical Sciences |
| 卷 期 | 23:5 2007.05[民96.05] |
| 頁 次 | 頁247-253 |
| 分類號 | 411.81 |
| 關鍵詞 | 飲酒相關; 蓄意自我傷害; 臺灣東部; Alcohol-related; Deliberate self-harm; Eastern Taiwan; |
| 語 文 | 英文(English) |
| 中文摘要 | 近年臺灣地區自殺死亡個案數明顯上升,在 2004 年共有 3,468 人死於自殺,自殺死亡率是 15.3 / 十萬人口。心身壓力者若有飲酒時更會增加蓄意自我傷害 (deliberate self harm) 行為的發生,本研究目的要分析自我傷害傷患之飲酒狀況。在花蓮市一所醫學中心在 2004 年依世界衛生組織所編印的指引,建立外傷監控系統,收集外傷事故最基本的資訊,由護理人員負責收集資料並評估傷患的飲酒狀況,本研究回顧蓄意自我傷害傷者的病歷,從醫師病歷記載中再次確定是蓄意自我傷害,並查閱他次自我傷害及心理疾患之記錄。全年 11,837 例外傷病例中,有 123 (1.0%) 例是蓄意自我傷害,本文分析 115 位屬第一次蓄意自我傷害個案,發現約半數是女性、20 歲至 54 歲傷者占 83.5%。超過半數傷害事故在家裡發生,80.1% 是刺傷或割傷;以護理評定為「有酒味」或「明顯酒醉」或檢驗血清酒精陽性之傷害界定為飲酒相關,發現共有 55 (47.8%) 位傷者是飲酒相關,飲酒相關的比例在年齡 45–64 歲間最高 (60.0%)。21 份陽性血清酒精檢驗來看,酒精濃度的平均值 211.2 (標準差 79.1)。七成多傷患是經處置後從急診離院,只有 20 位 (17.4%) 傷患在急診室或後期有接受精神科諮詢。蓄意自我傷害在花東地區也不少,約半數與飲酒相關,男性也高風險發生蓄意自我傷害,且較女性多用激烈方法。蓄意自傷害的原因需要進一步研究,給與精神科照會可助預防其後發生自殺的危險性;在治療蓄意自我傷害之同時,亦是發現及處理不當飲酒的好機會 |
| 英文摘要 | Suicide incidence has increased dramatically in recent years in Taiwan. In 2004, 3,468 lives were lost due to suicide and the total mortality was 15.3/100,000. It is well known that alcohol drinking raises the risk of deliberate self-harm (DSH), especially among psychologically distressed subjects. This study investigated the characteristics of DSH patients and their association with acute alcohol drinking. Since 2004, an injury surveillance system has been set up in a medical center, collecting the minimal information recommended by the World Health Organization. Attending nurses collected information and assessed each injured patient as to whether he/she smelled of alcohol. Medical records of DSH injuries were reviewed for confirmation of any prior DSH and any known mental disorder was checked. Of 11,837 injuries, 123 (1.0%) were DSH. Those who were first-time DSH patients (n = 115) were studied. About half of the patients were female and 83.5% were aged between 20 and 54 years. More than half of the DSH incidents occurred at home and 80.1% cases were stabbing or cutting injuries. Injuries were defined as alcohol-related based on the report of “alcohol odor’’ or “intoxicated’’ by the nurse or a positive blood alcohol test. In total, 55 (47.8%) DSH injuries were found to be alcohol-related. The proportion of alcohol-related injuries was highest (60.0%) in the age range 45–64 years. Of those patients who tested positive for alcohol (n = 21), the mean blood alcohol concentration was 211.2 mg/dL (standard deviation, 79.1). Most subjects were discharged from the emergency department (75.7%). Only 20 DSH patients (17.1%) went on to receive a psychiatric consultation. DSH is not uncommon in eastern Taiwan. Half of our cases were associated with alcohol use. Males had the same risk of injuring themselves and were more likely than females to adopt “severe” methods to injure themselves. Further studies into the causes of DSH or parasuicide attempts are needed. Psychiatric consultation is essential in caring for DSH patients and in preventing suicide. ADSH injury also offers an opportunity to recognize alcohol problems. |
本系統中英文摘要資訊取自各篇刊載內容。