Background:

The death rate due to suicide among older people is high, especially among men. Because many older people live in nursing homes or long-term care facilities in high-income countries, reviewing the impact of prevention strategies on the suicidal behavior of residents in these settings is of interest.

Methods:

Following PRISMA guidelines, we performed a systematic review of the existing literature found in Pubmed, Scopus, Web of Science, PsycINFO, and Sociological Abstracts, focusing on interventions to prevent suicidal behavior or ideation in nursing home residents. The studies’ quality was evaluated according to TIDieR and MMAT.

Results:

Only 6 studies met the inclusion criteria. Four of them described various “gatekeeper” trainings for nursing home staff and 2 described interventions focused on residents. Only 1 study was randomized. Gatekeeper training studies were mostly before/after comparisons. No intervention demonstrated a direct effect on suicidal ideation or behaviors. One study showed that “life review” had a long-lasting effect on depression scores and another that gatekeeper training led to changes in the care of suicidal residents.

Conclusions:

Interventions to prevent suicidal ideation or behaviors in nursing homes are not rigorously evaluated, and no conclusion can be drawn on their effectiveness in preventing suicidal behaviors. We propose to better evaluate gatekeeper training for staff as well as peer support. Individual interventions targeting residents could be modified for broader implementation.

中文翻译：

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养老院和长期护理机构中老年人的预防自杀干预：系统评价

背景：

老年人中自杀导致的死亡率很高，尤其是在男性中。由于许多老年人住在高收入国家的疗养院或长期护理机构中，因此有必要对预防策略对居民自杀行为的影响进行回顾。

方法：

根据PRISMA指南，我们对在Pubmed，Scopus，Web of Science，PsycINFO和Sociological Abstracts中发现的现有文献进行了系统的综述，重点研究了预防疗养院居民自杀行为或想法的干预措施。研究质量根据TIDieR和MMAT进行评估。

结果：

只有6项研究符合纳入标准。其中有四个描述了针对疗养院工作人员的各种“关守”培训，还有两个描述了针对居民的干预措施。只有1项研究是随机的。Gatekeeper培训研究大多在比较之前/之后。没有干预措施对自杀意念或行为有直接影响。一项研究表明，“生活复习”对抑郁得分具有长期影响，而另一项研究表明，看门人的培训导致自杀居民的护理发生了变化。

结论：

没有严格评估防止在疗养院发生自杀念头或行为的干预措施，也无法得出关于预防自杀行为的效果的结论。我们建议更好地评估员工的网守培训以及同伴支持。针对居民的个人干预措施可以修改以更广泛地实施。