一位曾嘗試自殺的病人治療後即將出院。出院計畫中最重要的組成部分為何？
A client is being discharged after treatment for a suicide attempt. What is the most important component of the discharge plan?
- AA specific safety plan including emergency contact numbers.✓ 正解包含緊急聯絡電話的具體安全計畫。
- BA signed 'no-suicide contract'.簽署「不自殺契約」。
- CReferral to a local gym for stress relief.轉介至當地健身房以紓解壓力。
- DA prescription for a 3-month supply of antidepressants.開立三個月劑量的抗憂鬱藥物處方。
對於曾嘗試自殺的病人，出院計畫的首要目標是預防再次自殺，確保病人回到社區後能夠安全地生活。這需要一個全面且個人化的安全計畫（safety plan），不僅僅是口頭承諾或單一的藥物處方。安全計畫的核心概念是幫助病人在危機來臨時，能夠識別警告信號，並有一系列具體的應對策略和求助管道。這包括自我管理技巧、支持性社交網絡的利用，以及緊急專業協助的聯繫方式。護理師在擬定出院計畫時，應與病人及其家屬共同參與，確保計畫的實用性和可行性，以提高病人遵從性和降低再自殺風險。
For a client who has attempted suicide, the primary goal of the discharge plan is to prevent another suicide attempt and ensure the client can live safely after returning to the community. This requires a comprehensive, individualized safety plan, not merely verbal promises or a single medication prescription. The core concept of a safety plan is to help the client identify warning signs in crisis situations and to have a specific set of coping strategies and help-seeking channels. This includes self-management techniques, use of supportive social networks, and emergency professional contact information. When developing the discharge plan, the nurse should involve the client and family to ensure the plan is practical and feasible, thus improving adherence and reducing the risk of repeat suicide attempts.
自殺防治和出院計畫在美國和台灣都是精神醫學和護理的重點。兩地都強調個案管理、心理治療和藥物治療的結合。關於「不自殺契約」（no-suicide contract），美國精神醫學界已普遍認為其臨床效益有限，並轉向推廣更全面、以病人為中心的安全計畫（safety plan）。台灣的臨床實踐也逐漸朝此方向發展，強調安全計畫的實用性。兩地都將緊急聯絡電話（如美國的 National Suicide Prevention Lifeline 988，台灣的安心專線 1925）納入重要資源，確保病人在危機時能獲得即時協助。