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Multicenter Study
. 2021 May 28;11(5):e043762.
doi: 10.1136/bmjopen-2020-043762.

Assessing risk of self-harm in acute paediatric settings: a multicentre exploratory evaluation of the CYP-MH SAPhE instrument

Joseph C Manning  1   2 , Tim Carter  3 , Gemma Walker  2 , Jane Coad  3   4 , Aimee Aubeeluck  5 ; CYP-MH SAT Study Group
Collaborators, Affiliations
Multicenter Study

Assessing risk of self-harm in acute paediatric settings: a multicentre exploratory evaluation of the CYP-MH SAPhE instrument

Joseph C Manning et al. BMJ Open. .

Abstract

Objective: To psychometrically assess the Children and Young People-Mental Health Self-harm Assessment in Paediatric healthcare Environments (CYP-MH SAPhE) instrument for the identification of immediate risk of self-harm in CYP, aged 10-19 years, in acute paediatric wards or emergency departments.

Design: The CYP-MH SAPhE Instrument was developed through a robust scoping review and Delphi consensus with 30 clinicians/topic experts. To evaluate the psychometric properties, a multicentre exploratory study was conducted.

Setting: Three acute hospitals in the UK.

Participants: 163 CYP presenting at acute hospital settings with primary mental health (cases) or physical health (non-cases) conditions.

Primary and secondary outcome measures: Psychometric properties of the CYP-MH SAPhE instrument were evaluated through Principle Axis Factoring (PAF) with Oblimin (Kaiser normalisation) alongside measures of internal consistency (Cronbach's α), convergent, discriminant and face validity.

Results: PAF of the dichotomous items (n=9) loaded onto three factors (1) behaviours and intentions; (2) suicidality and (3) self-harm. Factors 1 (Cronbach's α=0.960) and 3 (Cronbach's α=1) had high internal consistency. There was: good level of agreement between raters (kappa=0.65); a moderately positive correlation between the CYP-MH SAPhE instrument and the Columbia-Suicide Severity Rating Scale; and discrimination between cases and non-cases across the three factors (factor 1: m=88 vs 70; factor 2: m=102 vs 70; factor 3: m=104 vs 68). Assessment of face validity resulted in six items being removed, culminating in an eight question, rapid assessment instrument.

Conclusions: The results support the CYP-MH SAPhE Tool as a potentially reliable and valid instrument to identify immediate risk of self-harm in CYP presenting to acute paediatric healthcare environments, which is a burgeoning and significant global health issue.

Keywords: paediatrics; risk management; statistics & research methods; suicide & self-harm.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
A14-item CYP-MH SAPhE Instrument. CYP-MH SAPhE, Children and Young People-Mental Health Self-harm Assessment in Paediatric healthcare Environments.
Figure 2
Figure 2
Final CYP-MH SAPhE Instrument. CYP-MH SAPhE, Children and Young People-Mental Health Self-harm Assessment in Paediatric healthcare Environments.
See this image and copyright information in PMC

References

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