mardi 3 mai 2016

PAYS BAS ETUDE RECHERCHE Evaluation des benefices pour les patients de la formation des professionnels de la santé mentale d'aprs les lignes directrices de prevention du suicide

Evaluation of benefit to patients of training mental health professionals in suicide guidelines: cluster randomised trial
Derek P. de Beurs, Marieke H. de Groot, Jos de Keijser, Erik van Duijn, Remco F. P. de Winter, Ad J. F. M. Kerkhof
Derek P. de Beurs, PhD, Department of Clinical Psychology, VU University, Amsterdam and EMGO Institute for Health and Care Research, Amsterdam, Netherlands Institute for Health Services Research (NIVEL), Utrecht; Marieke H. de Groot, PhD, Department of Clinical Psychology, VU University, Amsterdam and EMGO Institute for Health and Care Research, Amsterdam; Jos de Keijser, PhD, GGZ Foundation for Mental Health Care Friesland and Groningen University, Groningen, The Netherlands; Erik van Duijn, PhD, MD, GGZ Foundation for Mental Health Care Delfland, Delft; Remco F. P. de Winter, PhD, MD, GGZ Foundation for Mental Health Care Parnassia, The Hague; Ad J. F. M. Kerkhof, PhD, Department of Clinical Psychology, VU University, Amsterdam and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
  1. Correspondence: Derek P. de Beurs, VU University Amsterdam, Van der Boechorststraat 1, 1081BT Amsterdam, The Netherlands. Email: derekdebeurs@gmail.com

Background
Randomised studies examining the effect on patients of training professionals in adherence to suicide guidelines are scarce.
Aims
To assess whether patients benefited from the training of professionals in adherence to suicide guidelines.
Method
In total 45 psychiatric departments were randomised (Dutch trial register: NTR3092). In the intervention condition, all staff in the departments were trained with an e-learning supported train-the-trainer programme. After the intervention, patients were assessed at admission and at 3-month follow-up. Primary outcome was change in suicide ideation, assessed with the Beck Scale for Suicide Ideation.
Results
For the total group of 566 patients with a positive score on the Beck Scale for Suicide Ideation at baseline, intention-to-treat analysis showed no effects of the intervention on patient outcomes at 3-month follow-up. Patients who were suicidal with a DSM-IV diagnosis of depression (n = 154) showed a significant decrease in suicide ideation when treated in the intervention group. Patients in the intervention group more often reported that suicidality was discussed during treatment.
Conclusions
Overall, no effect of our intervention on patients was found. However, we did find a beneficial effect of the training of professionals on patients with depression.

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