Impact of a Distress Brief Intervention on Suicidal Ideation, Suicide Attempts and Self-harm in the immediate, short and longer term: a mixed method evaluation study protocol
تأثیر مداخله کوتاهمدت کاهش پریشانی بر افکار خودکشی، اقدام به خودکشی و خودآسیبی در بازههای زمانی فوری، کوتاهمدت و بلندمدت: پروتکل مطالعه ارزیابی با روش ترکیبی
Background The Distress Brief Intervention (DBI) is a new approach aimed at reducing distress and is embedded in Scotland’s suicide prevention and mental health strategies. People in distress can be referred to DBI by front-line healthcare and emergency service staff. The DBI service promises to make contact within 24 hours and offers people in distress 14 days of compassionate, community-based, and person-centred support. The development of NHS 24, a new specialist National Health Service Mental Health Hub (MHH) embedded in Scotland’s urgent care service created a new national route to access DBI and enabled a natural experiment. Protocol This study is a mixed-method evaluation of the impact of the DBI service on suicidal ideation, suicide attempts and self-harm in the immediate, short and longer term among people presenting in distress. Evaluation participants include adults who access DBI, DBI staff, individuals who have used NHS 24 MHH, and GPs. A combination of analysis of quantitative survey and linked administrative data, including a comparator group analysis, qualitative interview and focus group data will support understanding of whether and how the DBI service can reduce suicidal ideation, suicidal behaviour and self-harm among those presenting to front-line services in distress. A survey of General Practitioners and a review of existing literature will be conducted to model typical care pathways for individuals in distress and at risk of self-harm. Modelled resource use and costs will be explored. All data collected will be triangulated through a summative evidence synthesis to develop evidence-based insights and conclusions to inform policy and practice development. Discussion Understanding whether, how and why the DBI service has helped prevent future suicidal thoughts and behaviour in those with a history of suicidal risk will provide important insights into how the intervention can be further developed and optimised as a suicide prevention intervention.
چکیده به فارسی
زمینه: مداخله کوتاهمدت کاهش پریشانی (DBI) رویکردی نوین با هدف کاهش پریشانی است که در راهبردهای پیشگیری از خودکشی و سلامت روان اسکاتلند جای گرفته است. افراد دچار پریشانی میتوانند توسط کارکنان خدمات درمانی و اورژانس خط مقدم به DBI ارجاع داده شوند. خدمت DBI متعهد میشود ظرف ۲۴ ساعت با فرد تماس بگیرد و به مدت ۱۴ روز حمایت دلسوزانه، مبتنی بر جامعه و فردمحور ارائه دهد. توسعه NHS 24، مرکز تخصصی جدید خدمات سلامت روان (MHH) در چارچوب خدمات اورژانس اسکاتلند، مسیر ملی جدیدی برای دسترسی به DBI ایجاد کرد و امکان انجام یک آزمایش طبیعی را فراهم ساخت. پروتکل: این مطالعه، ارزیابی با روش ترکیبی از تأثیر خدمت DBI بر افکار خودکشی، اقدام به خودکشی و خودآسیبی در بازههای زمانی فوری، کوتاهمدت و بلندمدت در میان افرادی است که با پریشانی مراجعه میکنند. شرکتکنندگان در ارزیابی شامل بزرگسالانی هستند که به DBI دسترسی دارند، کارکنان DBI، افرادی که از NHS 24 MHH استفاده کردهاند و پزشکان عمومی. ترکیبی از تحلیل دادههای کمی پرسشنامه و دادههای اداری پیوندخورده، از جمله تحلیل گروه مقایسه، دادههای مصاحبه کیفی و گروه متمرکز، به درک این موضوع کمک خواهد کرد که آیا و چگونه خدمت DBI میتواند افکار خودکشی، رفتار خودکشی و خودآسیبی را در میان مراجعهکنندگان به خدمات خط مقدم در وضعیت پریشانی کاهش دهد. یک پیمایش از پزشکان عمومی و مرور ادبیات موجود برای مدلسازی مسیرهای مراقبتی معمول برای افراد دچار پریشانی و در معرض خطر خودآسیبی انجام خواهد شد. استفاده از منابع مدلسازیشده و هزینهها بررسی خواهد شد. تمام دادههای گردآوریشده از طریق ترکیب شواهد جمعبندیشده برای توسعه بینشها و نتیجهگیریهای مبتنی بر شواهد جهت اطلاعرسانی به سیاستگذاری و توسعه عمل، تلفیق خواهد شد. بحث: درک اینکه آیا، چگونه و چرا خدمت DBI به پیشگیری از افکار و رفتارهای خودکشی آینده در افراد با سابقه خطر خودکشی کمک کرده است، بینشهای مهمی درباره نحوه توسعه و بهینهسازی بیشتر این مداخله به عنوان یک مداخله پیشگیری از خودکشی فراهم خواهد کرد.
ترجمهی خودکار برای آشنایی سریع؛ برای نقل و ارجاع، متن اصلی ملاک است.
McLean, J., Shields, J., Wildman, J. M., Hamid, A., MacGregor, A., Best, C., Duncan, E., McNicol, S., Fenocchi, L., Mason, H., MacIntyre, D. J., Melson, A. J., & O’Connor, R. C. (2026). Impact of a Distress Brief Intervention on Suicidal Ideation, Suicide Attempts and Self-harm in the immediate, short and longer term: a mixed method evaluation study protocol. NIHR Open Research, 4, 33. https://doi.org/10.3310/nihropenres.13592.2
با احترام و بدون توهین، تحقیر، برچسبزنی یا حملهی شخصی با دیگران گفتگو کنید.
از نوشتن هرگونه اطلاعات هویتی یا قابلشناسایی مراجعان، بیماران یا اشخاص ثالث، از جمله نام، شمارهی تماس، تصویر، نشانی، محل کار یا جزئیات منحصربهفرد پرونده خودداری کنید.
اگر دربارهی یک تجربهی بالینی سؤال میکنید، اطلاعات را تا حد ممکن بینام و کلی بیان کنید تا امکان شناسایی فرد وجود نداشته باشد.
این بخش برای یادگیری و گفتوگوی علمی است و جایگزین ارزیابی، تشخیص، مشاوره یا رواندرمانی شخصی نیست.
در شرایط بحران یا خطر آسیب به خود یا دیگران، به این بخش اتکا نکنید و برای دریافت کمک فوری با اورژانس اجتماعی ۱۲۳ یا صدای مشاور بهزیستی ۱۴۸۰ تماس بگیرید.
انتشار تبلیغات، معرفی خدمات شخصی، شمارهی تلفن، شناسهی شبکههای اجتماعی، پیوند تبلیغاتی یا درخواست جذب مراجع در این بخش مجاز نیست.
در بیان ادعاهای علمی، بهویژه دربارهی اثربخشی درمانها، تشخیص یا یافتههای پژوهشی، تا حد امکان نام منبع معتبر، مقاله یا راهنمای علمی را ذکر کنید.
از ارائهی تشخیص قطعی، تجویز درمان یا دارو و توصیههای بالینی شخصی به سایر کاربران خودداری کنید.
پاسخهایی که کارشناسان فکر بنیان میدهند با برچسب «پاسخ فکر بنیان» یا «کارشناس فکر بنیان» نمایش داده میشوند و سایر نوشتهها بیانگر نظر کاربران هستند.
گزارش نوشتهی نامناسب: اگر نوشتهای حاوی نقض محرمانگی، محتوای آسیبزا، توهین، تبلیغ یا تخلف از این قوانین است، گزینهی «گزارش» را انتخاب کنید تا تیم سایت بررسی کند.
Transitioning out of professional sport can present challenges for athletes and their wider environments, frequently necessitating coordinated physical, psychological, and economic support. Although these concerns have been documented in elite cycling, the extent to which structured transition programmes exist within the sport remains insufficiently understood, particularly in Europe, the historical centre of professional cycling. We conducted a cross-sectional qualitative documentary analysis, distributing a standardised inquiry to all European Cycling Federations (ECFs; N = 51) between December 2024-March 2025. Federations were asked whether they had formal strategies, policies, or resources related to athlete retirement. Responses were categorised as “ECF-level literature or initiative”, “No ECF-level provision”, or “No response” and relevant materials were descriptively synthesised. Amongst the 21 federations that responded, the majority (n = 17; ≈81%) reported no ECF-level retirement initiatives. Common reasons included limited resources, low perceived demand, or reliance on national or international bodies (i.e., Olympic Committees or sport-specific unions). Four ECFs (~19%) described transition-related structures, though these varied considerably in scope, definition, and delivery. Despite well-documented needs, structured retirement support for professional cyclists remains uncommon across European national federations, and existing programmes appear heterogeneously applied. As cycling expands globally, effective transition planning becomes increasingly important for athlete wellbeing and the long-term sustainability of the sport. Holistic, international collaborations led by cycling’s major governance bodies could strengthen career-long support systems, reinforce the public image of cycling as a health-promoting discipline, and create responsible, athlete-centered ecosystems.
Background: Patients with chronic kidney disease undergoing hemodialysis frequently experience physical and psychological complaints that may affect their sleep quality. Uremic pruritus, restless legs syndrome, anxiety, and post-hemodialysis fatigue are potential factors that may disrupt sleep quality. Objective: This study aimed to identify the factors influencing the sleep quality of patients with chronic kidney disease undergoing hemodialysis at Bahteramas Regional General Hospital, Southeast Sulawesi Province. Methods: This study employed a quantitative analytical approach with a cross-sectional design. The sample consisted of 83 respondents. Data were collected using the Pittsburgh Sleep Quality Index (PSQI), 5-D Itch Scale, International Restless Legs Syndrome Rating Scale (IRLS), Hospital Anxiety and Depression Scale-Anxiety (HADS-A), and a post-hemodialysis fatigue assessment instrument. Data were analyzed using the Chi-square test and binary logistic regression. Results: Bivariate analysis showed that uremic pruritus (p = 0.046), restless legs syndrome (p = 0.015), anxiety (p = 0.029), and post-hemodialysis fatigue (p = 0.049) were statistically significant factors associated with sleep quality. Simultaneously, the four variables had a statistically significant effect on sleep quality (p = 0.007), with a Nagelkerke R Square value of 0.217. In the multivariable analysis, only anxiety showed a statistically significant independent effect (p = 0.019). Conclusion: Uremic pruritus, restless legs syndrome, anxiety, and post-hemodialysis fatigue were statistically associated with sleep quality in the bivariate analysis. The four variables were jointly significant in the multivariable model, whereas only anxiety remained statistically significant after adjustment for the other variables.
Background: Prolonged screen exposure, after-hours connectivity, and sedentary work are linked to poor sleep and occupational burnout among Indian working professionals. Ayurvedic Dinacharya regulates waking, Vyayama, Bhojana Vidhi, and Nidra Vidhi; however, digital-era disruption of these domains among working adults remains unstudied. This study aimed to assess digital lifestyle behaviours mapped to Dinacharya principles as behavioural markers of Pragyaparadha, in relation to sleep quality and occupational burnout among working adults, and to identify behaviours independently associated with poor sleep and higher burnout. Methods: A cross-sectional analytical survey (STROBE-reported) was conducted at the All-India Institute of Ayurveda (AIIA), New Delhi, during (January 2026 to July 2026), among 400 working adults aged 25-40 years with ≥1 year of occupational experience. A structured proforma captured sociodemographic details and Dinacharya-mapped digital behaviours across five domains (morning routine, bedtime device use, after-hours connectivity, screen breaks/sedentary time, mealtime practices). Sleep quality and burnout were assessed using the PSQI and Copenhagen burnout inventory. Results: Of 400 participants, 56.8% had poor sleep quality, 61% personal burnout, and 55.8% work-related burnout. Bedtime device use and inadequate screen breaks/sedentary behaviour independently predicted poor sleep (aOR 1.76 and 1.98). After-hours connectivity, sedentary behaviour, and mealtime digital engagement predicted personal burnout; bedtime device use, sedentary behaviour, mealtime digital engagement, and digital overload predicted work-related burnout (all p<0.05). Conclusions: Digital lifestyle behaviours reflect patterns of Pragyaparadha in daily digital conduct. Interpreted through Dinacharya and Nidra, the findings support a culturally grounded, preventive Digital Dinacharya framework for digital-era occupational health.
Psychological distress during young adulthood may be influenced by early emotional experiences and current interpersonal relationships. The current study investigates the relationship between childhood emotional neglect, peer support and psychological distress in young adults. A quantitative research design was used with 200 participants aged 18-25 years selected through purposive sampling from educational institutions of Lahore. Childhood emotional neglect, peer support and psychological distress were measured with the Childhood Emotional Neglect Questionnaire (CENQ), Multidimensional Scale of Perceived social support (MSPSS), and Kessler Psychological Distress Scale (K10), respectively. Data were analyzed using Pearson- product moment correlation, hierarchical regression, PROCESS moderation analysis and one way ANOVA. Childhood emotional neglect was significantly and positively associated with psychological distress while peer support was not significantly and directly associated with psychological distress. Hierarchical regression indicates that psychological distress was significantly predicted by childhood emotional neglect, while peer support was not a significant direct predictor. The regression model explained 12.5% of variance in psychological distress. Moderation analysis showed significant interaction effects of friends’ support (P= .017) and family support (P= .032), indicating that these sources of support moderated the relationship between childhood emotional neglect and psychological distress. There were significant socio-economic differences for childhood emotional and peer support, but not for psychological distress. The findings highlight the importance of considering childhood emotional experiences and interpersonal resources when understanding psychological distress among young adults.