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. 2023 Aug 16:7:e43526.
doi: 10.2196/43526.

Effects of Community-Based Caring Contact in Reducing Thwarted Belongingness Among Postdischarge Young Adults With Self-Harm: Randomized Controlled Trial

Yik Wa Law #  1   2 , Rita Hui Ting Lok  1 , Byron Chiang  1 , Carmen Chui Shan Lai  2 , Sik Hon Matthew Tsui  3 , Pui Yin Joseph Chung  4 , Siu Chung Leung  5
Affiliations

Effects of Community-Based Caring Contact in Reducing Thwarted Belongingness Among Postdischarge Young Adults With Self-Harm: Randomized Controlled Trial

Yik Wa Law et al. JMIR Form Res. .

Abstract

Background: For patients with self-harm behaviors, the urge to hurt themselves persists after hospital discharge, leading to costly readmissions and even death. Hence, postdischarge intervention programs that reduce self-harm behavior among patients should be part of a cogent community mental health care policy.

Objective: We aimed to determine whether a combination of a self-help mobile app and volunteer support could complement treatment as usual (TAU) to reduce the risk of suicide among these patients.

Methods: We conducted a pragmatic randomized controlled trial on discharged patients aged between 18 and 45 years with self-harm episodes/suicide attempts, all of whom were recruited from 4 hospital emergency departments in Hong Kong. Participants were randomly assigned to one of three groups: (1) mobile app + TAU ("apps"), (2) mobile app + volunteer support + TAU ("volunteers"), or (3) TAU only as the control group ("TAU"). They were asked to submit a mobile app-based questionnaire during 4 measurement time points at monthly intervals.

Results: A total of 40 participants were recruited. Blending volunteer care with a preprogrammed mobile app was found to be effective in improving service compliance. Drawing upon the interpersonal-psychological theory of suicide, our findings suggested that a reduction in perceived burdensomeness and thwarted belongingness through community-based caring contact are linked to improvement in hopelessness, albeit a transient one, and suicide risk.

Conclusions: A combination of volunteer care with a self-help mobile app as a strategy for strengthening the continuity of care can be cautiously implemented for discharged patients at risk of self-harm during the transition from the hospital to a community setting.

Trial registration: ClinicalTrials.gov NCT03081078; https://clinicaltrials.gov/study/NCT03081078.

Keywords: care; community; effectiveness; hospital; intervention; mobile app; model; patient; risk; self-harm; suicidal ideation; suicide; support; thwarted belongingness; treatment; volunteers; youth.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
CONSORT (Consolidated Standards of Reporting Trials) flow diagram of research participant recruitment. ER: emergency room; TAU: treatment as usual.
Figure 2
Figure 2
The effects of the intervention on the 4-item short-form Adult Suicidal Ideation Questionnaire (ASIQ4) at the 4 time points, with intention-to-treat (ITT) analysis applied. ASIQ: Adult Suicidal Ideation Questionnaire; TAU: treatment as usual.
Figure 3
Figure 3
The effects of the intervention on 4-item short-form Beck Hopelessness Scale (BHS4) at the 4 time points, with intention-to-treat (ITT) analysis applied. BHS: Beck Hopelessness Scale; TAU: treatment as usual.
Figure 4
Figure 4
The effects of the intervention on Interpersonal Needs Questionnaire-Perceived Burdensomeness items (INQ-PB) at the 4 time points with intention-to-treat (ITT) analysis applied. TAU: treatment as usual.
Figure 5
Figure 5
The effects of the intervention on Interpersonal Needs Questionnaire-Thwarted Belongingness items (INQ-TB) at the 4 time points with intention-to-treat (ITT) analysis applied. TAU: treatment as usual.
See this image and copyright information in PMC

References

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