1 Summary of Nursing Care for Suicide Risk Patients1
1.1 Related Concepts and Definitions of Suicide1
1.2 Epidemiological Characteristics of Suicide2
1.3 Suicide Theory Sect5
1.4 Suicide Risk Management Principles8
1.5 Organizational Recommendations of Suicide Risk Management10
1.6 Practice Recommendations of Suicide Risk Management16
2 Patient Suicide Risk Assessment53
2.1 Indication for Suicide Risk Assessment53
2.2 Influencing Factors of Suicide in Patients55
2.3 Comprehensive Suicide Risk Assessment67
2.4 Care Decisions for Suicidal Risk Patients95
3 Suicide Prevention and Intervention in Patients111
3.1 Establish and Maintain a Therapeutic Alliance115
3.2 Brief Suicide Prevention and Intervention Measures121
3.3 Social Support Networks for Patients148
4 Follow?up of Patients at Risk of Suicide153
4.1 Discharge Planning Checklist153
4.2 Community Resource List Template161
5 Documentation of Suicide Risk Patients165
5.1 Record the Course of Treatment165
5.2 General Risk Management and Documentation Issues Specific to Suicide167
5.3 Reducing Liability Concerns171
Appendices173
Appendix1 Suicide Risk and Assessment Scale173
Appendix2 Sharing Patient Health Information183
Appendix3 Caring Contacts Sample Materials184
References187
Chinese and English Noun Comparison Index195
Postscript201
后记
自杀是一个严重的公共卫生问题。据世界卫生组织（WHO）统计，每年有近80万人自杀，至少200万人自杀未遂，自杀是15—29岁人群的第二大死因。中国的自杀人数约占全球自杀人数的10%。
Suicide is a serious public health problem. According to statistics from the World Health Organization （WHO）， nearly 800，000 people commit suicide each year， and at least 2 million people attempt suicide. Suicide is the second leading cause of death among people aged 15—29. The number of suicides in China accounts for about 10% of the global suicides.
在我国，住院患者自杀率是普通人群的4—5倍。自杀反映了社会各发展阶段经济、卫生、教育等方面问题，不仅危及患者生命，给家庭带来巨大精神痛苦，甚至威胁社会的和谐与稳定。健康中国背景下，医护人员面临着严峻的挑战。
In China， the suicide rate of hospitalized patients is 4 to 5 times that of the general population. Suicide reflects the economic， health， education and other aspects of social development stages. It endangers the lives of patients， brings huge mental pain to their families， and even threatens the harmony and stability of society. In the context of healthy Chinese， medical staff are in the face of serious challenges.
当代著名作家余华先生在《活着》一书中说过：“人只要活着，就有希望。人只要活着就是一种胜利。生不可选，死不该选。”自杀是可以通过及时的、基于证据的、低成本的干预措施来预防的。为了使国家应对措施有效，需要一项全面的多部门自杀预防战略。
The famous contemporary writer Mr. Yu Hua said in his book Living： “As long as people live， there is hope. As long as people live， there is a victory. There is no choice for life， no choice for death.” Suicide can be prevented through timely， evidence?based， low?cost interventions. For national response measures to be effective， a comprehensive multisectoral suicide prevention strategy is needed.
住院患者自杀是威胁患者安全的重大事件。护理人员在住院期间与患者接触最多，在预防患者自杀、保障患者安全方面具有不可替代的作用。培训护理人员成为自杀守门人，识别具有自杀倾向的患者，减少住院患者自杀事件的发生，具有重要的现实意义。国内一些学者围绕住院患者自杀预防开展了一些探索，但内容较分散，缺乏系统性和全面性。
Suicide of inpatients is a major event threatening the safety of patients. Nursing staff have the most contact with the patients during their hospitalization， and they play an irreplaceable role in preventing suicide and ensuring the patients’safety. It is of great practical significance to train nursing staff to become suicide gatekeepers， identify the patients with suicide tendency， and reduce the occurrence of suicides among inpatients. Some domestic scholars have carried out some explorations around suicide prevention of hospitalized patients， but the content is scattered and lacks systematicity and comprehensiveness.
本书作者胡德英主任护师从事护理工作三十余年，深入研究住院患者自杀近十年。她带领的团队在研究前期运用焦点团体访谈、根本原因分析法、5M1E 法、心理解剖法、问卷调查法等定性与定量相结合的方法，深入研究住院患者自杀风险因素，创新了“住院患者自杀原因剖析—护士分层培训—自杀风险筛查与评估—自杀预防与干预”等一系列患者自杀风险管理模式。
Hu Deying， professor of nursing， one of the authors of this book， has been engaged in nursing for more than 30 years， and has been studying inpatient suicide for nearly ten years. In the early stage of the study， her team adopted focus group interviews， root cause analysis，5M1E， psycho?anatomy， questionnaires， and other qualitative and quantitative methods to deeply study the risk factors of suicide in hospitalized patients. A series of management models for risk of suicide have been innovated such as “Analysis of the reasons of suicide in inpatients-Stratified training of nurses -Screening and assessment of suicide risk-Interventions and preventions of suicide”.
研究团队率先对经历患者自杀的护士进行针对性的心理干预，医护人员不再避讳公开谈论自杀话题，这打破了“禁区”，在全院形成了良好的预防患者自杀安全文化氛围，住院患者自杀行为发生率呈下降趋势。前期的研究为撰写本书提供了科学的理论指导，也为临床实践打下了坚实的基础。
The research team took the lead in targeted psychological intervention for nurses who have experienced suicide attempts by patients ， and medical staff are no longer afraid of talking about suicide， breaking the “forbidden zone”， forming a good culture of suicide prevention safety in the hospital， and the incidence of suicide behavior in hospitalized patients shows a downward trend. The previous research provided scientific theoretical guidance for writing this book， and laid a solid foundation for clinical practice.
本书在国家自然科学基金面上项目“安全文化视角下住院患者自杀风险评估指标体系及危机管理模型构建”（NO.71673100）资助支持下出版。研究团队参考国外患者自杀风险管理相关共识指南，结合临床实践经验，编制了这本《患者自杀风险管理手册》。本书为我国患者自杀风险评估与预防干预工作提供有力的实践指导，帮助临床管理者、医务人员、自杀患者及家属应对自杀问题。
This book is published under the support of the National Natural Science Foundation of China ，a general project of “Establishment of Suicide Risk Assessment Index System and Crisis Management Model for Inpatients under the Perspective of Safety Culture” （NO.71673100）. The research team referred to overseas consensus and guidelines related to suicide risk management for patients， combining with experience of clinical nursing practice， and compiled this Handbook of Patient Suicide Risk Management. This book provides powerful practical guidance for suicide risk assessment and prevention and intervention of patients in our country， and helps clinical managers， medical staff， suicide patients and their families cope with suicide.
全书由自杀风险患者护理概述、患者自杀风险评估、患者自杀预防干预、自杀风险患者的随访、自杀风险患者的文书记录五个部分组成。通过汉英对照，力求照顾到各级各类医院读者的阅读需求，拓展读者的知识面。此外，书中插入了一些实践框与小品文等，结合相关自杀典型案例，提高读者的阅读兴趣，帮助读者更广泛、深入地理解和把握自杀预防实践要求，能够更好地将理论与实践相结合。
The book is composed of five parts： summary of nursing care for patients at risk of suicide， assessment of patients at risk of suicide， preventions and interventions in patients with suicide， follow?up for patients at risk of suicide， and documentation of patients at risk of suicide. Through the comparison in Chinese and English， we strive to cater for the reading needs of readers of different levels and ages， and expand readers’ knowledge. In addition， some practice boxes and vignettes are inserted in the book， combined with typical suicide cases， to increase readers’ reading interest， help readers understand and grasp the requirements of suicide prevention practice more widely and deeply， and better combine theory and practice.
本书由华中科技大学同济医学院附属协和医院胡德英研究团队主编，得到了医院领导和同事的大力支持，华中科技大学出版社的领导和编辑也为本书付出了辛勤的劳动，在此一并表示衷心感谢！
This book was compiled by the research team with Hu Deying from the Union Hospital of Tongji Medical College of Huazhong University of Science and Technology， under the strong support of the leaders and colleagues of the Union Hospital. The leaders and editors of Huazhong University of Science and Technology Press have worked hard for this book， and we would like to express sincere thanks.
由于编者能力和水平有限，书中难免存在疏漏和不尽如人意之处。我们真诚希望读者和同道不吝指正，今后将根据意见与建议不断修订完善。
Due to the limited ability of the authors， there will inevitably be omissions and limitations in the book. We sincerely hope that our readers and colleagues will correct us， and we will continue to revise and improve it .
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