The effects of family environment cognition and its difference perceived by adolescents and their parents on the treatment effect of non-suicidal self-injury behaviors in adolescents: a 1-year prospective cohort study.

Introduction: Family environment is the primary environment for adolescent growth and development, which is believed to have an important impact on the occurrence of non-suicidal self-injury (NSSI) behavior in adolescents. This study aimed to explore the effects of family environment cognition and cognitive differences perceived by adolescents and their parents on the treatment effects of NSSI in adolescents and to provide more potential perspectives for NSSI treatment. Methods: A one-year prospective longitudinal sub-cohort investigation was carried out among 199 adolescents engaged in NSSI and one of their important guardians from the Longitudinal Psychosomatic Disease Study (LoPDS). The NSSI behaviors of adolescents were evaluated at 3 months, 6 months and 1 year after enrollment. The family environment scale (FES) and NSSI Behavior Questionnaire were used as assessment tools for family environment and adolescents NSSI behaviors. Multiple linear regression was used to investigate the role of family environment perception difference in the treatment effect of adolescent NSSI. Results: After one year of follow-up, the perceived self-injury impulse score in recent 2 weeks, self-injury impulse frequency in recent 2 weeks, total number of self-injury in recent 2 weeks decreased significantly. The higher the adolescent family cohesion (Beta: 1.130, 95% CI: 0.886,1.373; p=0.032), parental family expressiveness (Beta: 0.818, 95% CI: 0.375,1.260; p=0.037) and parental family active-recreational orientation score (Beta: 0.609, 95% CI: 0.236,0.981; p=0.048), the better the treatment effect. However, higher adolescent family conflict (Beta: -0.838, 95% CI: -1.377,-0.298; p=0.024) were associated with lower treatment outcomes. The greater the cognitive difference between parents and adolescents in family cohesion (Beta: -1.307, 95% CI: -2.074,-0.539; p=0.014) and family conflict(Beta: -0.665, 95% CI: -0.919,-0.410; p=0.037), the worse the therapeutic effect of NSSI might be. Discussion: There were certain differences in the cognition of family relationships between parents and adolescents, and subjective family relationship cognition and cognitive differences had a significant effect on the treatment effect of NSSI in adolescents. Helping them identify the cause of cognitive differences and conducting systematic family therapy from the points of difference may be another perspective to improve the treatment effect of NSSI in adolescents.

Workplace violence against Chinese health professionals 2013-2021: A study of national criminal judgment documents.

Objectives: Patient-initiated hospital violence is a global problem which threatens the safety of health professionals and is indicative of doctor-patient tensions, impeding health system quality and access. The current study aimed to improve the understanding of medical workplace violence (WPV) in China, using authoritative and nationally representative judgment records, and to approach violence prevention strategies. Methods: All litigation records relating to violence against health professionals between 2013 and 2021 were extracted from the China Judgment Online System. Basic case information, victim characteristics, perpetrator characteristics and the nature of the violence were collated. The relationship between different treatment outcomes and violence was also explored. Results: Numbers of cases of hospital violence gradually increased from 2013 to a peak in 2016 before gradually decreasing in the following years. The most common perpetrators were patients' relatives (58.2%), followed by patients themselves (38.2%). Only 9 perpetrators had a confirmed history of mental illness and only two were intoxicated with alcohol. More than half of the cases (52.5%) occurred in rural areas and this percentage is even greater for primary health care institutions (71.4%) and secondary hospitals (73.5%). On a departmental level, the highest incidence of medical WPV was found in the emergency (18.9%), pediatrics (13.2%) and obstetrics (11.5%) departments. Violent behaviors, such as stalking, mass occupation of the ward and sharp instrument injury were significantly related to cases not involving patient death (p < 0.05). Disruptive behavior, such as hanging banners, blocking hospital passages, placing flower wreaths and burning paper money were significantly correlated with cases involving patient death (p < 0.01). The interval between a patient's death and the ensuing violence was short, happening on the same day in 54.8% of cases. Conclusions: A comprehensive overview of medical WPV in China is presented and may have utility for the formulation of prevention strategies.