[Self poisoning with suicidal intent- Part I]

Self poisoning is one of the most common forms of suicide- especially in adolescents- and constitutes a major reason for hospitalization and referral to emergency wards. The high frequency of repeated attempts together with the shortage of reliable epidemiologic data makes it difficult to plan effective preventive measures. The present article is the first section of a two-part paper on the epidemiology of self-poisoning in Iran. This was a cross-sectional study conducted in Tehran, Mashad, Tabriz, Isfahan, Shiraz and Kermanshah [5 major provinces of Iran]. Data were collected using a structured questionnaire and were analyzed in a descriptive fashion. In all, 723 cases were studied. There were 550 cases [%71] of self poisoning with suicidal intent. The mean age of those who had attempted suicide was [25.42 +/- 10.26] years; sixty percent [n=330] were female and the remaining 40% [n=220] were male. Eighty percent of attempted suicides involved the use of drugs; other suicide modalities included poisons, psychotropic substances and other chemicals. Thirty-one percent of the cases reported previous suicidal gestures. The mean number of past suicidal attempts was 2.08 [SD = 2.28]. The findings show that the frequency of attempted suicide is relatively high. To deal with the current situation, issues of mental heath have to be addressed more attentively and hospital emergency wards must be provided with adequate equipment and trained manpower [psychologists, psychiatrists, toxicologists, etc]

[Self poisoning with suicidal intent- Part II]

Self poisoning is one of the most common forms of suicides and a frequent cause of hospitalization in Accidents and Emergency Departments, especially in the younger age groups. This research was prompted by the current lack of reliable and adequate information on the epidemiology of suicide, and its main objective was to provide a basis for effective interventions in the future. The present article is the second section of a two-part paper on the epidemiology of self-poisoning in Iran. This was a cross-sectional study conducted in Tehran, Mashad, Tabriz, Isfahan, Shiraz and Kermanshah [5 major Provinces of Iran]. This article deals with results from data analysis and comparisons between cases of suicide and accidental self-poisoning. In all, 723 cases were studied. Among those who had committed suicide, the frequency of severe physical illness was greater in women compared to men [P<0.002]. The mean age of the subjects who expressed regret after the suicidal gesture was significantly lower than those who did not [P<0.003]. Moreover, subjects who had a real intention to kill themselves were significantly older than those who did not have such an intention [P<0.01]. Results from logistic regression analysis showed that higher age, male gender, and residing in Tehran were associated with a higher probability of deliberate self-poisoning [P<0.001 for all the three variables]. In addition, having a definite plan for suicide and previous history of a suicidal attempt were significantly related to having real intention to die [Odds ratios 2.52 and 1.87, respectively]. Most hospitalizations in poisoning wards [>74%] involve suicidal self-poisoning. Measures must be taken at all three levels of prevention with special attention to the epidemiology of the problem in different regions

[Patient satisfaction with emergency departments]

Patient satisfaction is an important indicator of quality of care and service delivery. The objective of this study was to examine patients' satisfaction with the emergency departments in hospitals affiliated to Tehran University of Medical Sciences. A study was carried out in the emergency departments of five major teaching hospitals [affiliated to Tehran University of Medical Sciences] in Tehran, Iran by trained researchers using a valid and reliable questionnaire. The study included patients who had spent at least 10 hours in the emergency department, who were able to answer the questions without the need for an interpreter, did not have significant cognitive problems, and were well enough to answer the questions. The study questionnaire comprised five sections namely: nursing care, physician care, behavioral concerns, physical comfort and hoteling, and waiting time. The questionnaire was administered in secure and confidential conditions inside the emergency department and in the absence of the hospitals' medical and non-medical staff. Data were analyzed descriptively using SPSS 13. In all 153 patients were eternal into the study. After dichotomizing the state of satisfaction in each of the five dimensions, the highest dissatisfaction rates were observed in the following domains: nurses' explanation to patients [73.2%], giving information [54.2%], investigating complaints [40.6%], patient welfare facilities [54.3%], and being kept waiting to receive laboratory services [26.2%] respectively. Only 44% of the patients rated their general satisfaction with the hospital as good or very good. The findings indicate the need for measures to improve services for patients visiting the emergency department and to ensure quality of service