Objective:To develop the Counseling Skills Rating Scale for Psychological Aids Hotline (CSRSPAH),an instrument to objectively assess the quality of process of counseling or intervention provided by hotline operators,and to test its validities and reliabilities.Methods:A draft of the scale,which consisted of 50 items under 5 dimensions,was designed in line with previous researches and the practice.In pilot study,supervisors at Beijing psychological aids hotline,assessed tape recorded sessions and gave feedbacks on the draft of the scale.The scale had been revised based on the pilot study.Twenty-eight items were deleted,and several items were rephrased.Finally,a scale which consisted of 22 items within 3 dimensions,i.e.counseling process,attitude,and communication skill,was developed.The scoring standards of the scale were also developed.To evaluate the IntraClass Coefficients (ICC) of the CSRSPAH,each of the tape records of 37 callings from 2005 to 2007 were assessed by 7 supervisors independently,using the scale.And the tape records of other 318 callings from 2013 to 2014 were also assessed by supervisors,using the CSRSPAH.The results of the 318 assessed callings were used to test the construct validities with the Confirmative Factor Analysis.The Cronbach a coefficients of the total score and three dimensions,the discriminant indices of every items,and correlations of each items and each dimensions were calculated,based on the 318 assessed callings.Results:One of the items (referral) was deleted due to excessive amount of missing data.Results of cortfirmative factor analysis of the remained 21-item scale revealed that the 3-factor construct structure of the scale was robust.The fitting indices of the confirm factor analysis were,x2/df=675.21/186,CFI =0.92,NNFI =0.91,RMSEA =0.10,SRMR =0.08.The Cronbach α coefficients of the total score,scores of counseling process,attitude,and communication skill,were 0.89,0.68,0.81 and 0.77,respectively.The ICCs of the inter-rater reliabilities of the total score and 3 dimensions of the scale were 0.67,0.59,0.59,and 0.67,respectively.The discriminant indices of all the 21 items ranged from 0.09 to 0.32.The correlation coefficients of scores of each items and scores of 3 dimensions and total scores were greater than 0.30,and reached statistical significance.Conclusion:The validities and reliabilities of the Counseling Skills Rating Scale for Psychological Aids Hotline are acceptable.The scale could be used in assessing the quality of hotline counseling or intervention,and related studies in the future.

Objectives:To explore the prevalence and correlates of attempted suicide among Beijing psycho-logical aids hotline callers,in order to provide knowledge of hotline-based suicide prevention.Methods:From De-cember 2002 to December 2008,all the effective callers who consulted themselves'psychological problem,by Bei-jing psychological aids hotline were interviewed by professional hotline operators during the consulting calling.Data of whether callers attempted suicidal behavior in 2 weeks prior to the calling,gender and other 5 demographic char-acteristics of callers were collected via hotline interview.A questionnaire including depression screening scale,com-mon psychiatric symptoms such as delusion,hallucination,etc.,a history of substance abuse or dependence,a histo-ry of suicidal behavior,having had acute or chronic life events,and severity of hopeless was used during hotline in-terview.Logistic regression model was used.Results:In 22 415 interviewed callers,362 (1.6%)callers (233 fe-males)reported that they attempted suicidal behavior in 2 weeks prior to the calling.After adjusted for demographic characteristics,prior suicidal behavior 2 weeks before calling (OR=4.43,95%CI:3.37-5.83),hopelessness (OR=2.01,95%CI:1.52-2.67),substance abuse (OR=1.97,95%CI:1.48 -2.62),acute negative life events (OR=1.94,95%CI:1.49-2.52),and severe depressive symptoms (OR=1.45,95%CI:1.08-1.95)were associatedwith attempted suicide among hotline callers.Conclusion:The rates of attempted suicide among hotline callers are probably high.Suicide prevention in hotline would shed light on improving coping skills for life events and sub-stance abuse problems for hotline callers.

Objective:To summarize the experience and outcomes of independent extracorporeal membrane oxygenation (ECMO) assistance for adult cardiac arrest patients conducted by a county-level hospital.Methods:Clinical data of 23 adult cardiac arrest patients treated with extracorporeal cardiopulmonary resuscitation (ECPR) at Tiantai County People's Hospital from January 2020 to October 2023 were retrospectively reviewed. Data, including initial cardiac rhythm, ECMO initiation time, cardiopulmonary resuscitation (CA)-Pump On time, ECMO initiation-Pump On time, ECMO cannulation-Pump On time, complications, neurological function prognosis, mortality rate, and survival rate, were collected and analyzed. Collect and analyze the mortality and survival rates of 33 adult cardiac arrest (CA) patients meeting the criteria for extracorporeal cardiopulmonary resuscitation (ECPR) but receiving only conventional cardiopulmonary resuscitation (CCPR) from January 2020 to October 2023, and compare these rates with those of patients who underwent CA-ECPR.Results:Among the 23 cardiac arrest patients, 16 patients achieved spontaneous heart rhythm recovery, 15 patients experienced death, and 8 patients showed improved conditions upon discharge, with 6 patients exhibiting good neurological function prognosis. Compared to CA-CCPR, patients who received CA-ECPR showed a significant decrease in mortality rate (65.21% vs. 90.91%, P=0.017) and a significant increase in survival rate (34.78% vs. 9.09%, P=0.017). After gradual optimization of the ECPR process, the 2022-2023 group showed a significantly increased survival rate compared to the 2020-2021 group(46% vs. 20%). ECMO initiation-Pump On time [41( IQR36.5-44.5)min vs.43( IQR32.75-58.5)min, P=0.709] and ECMO cannulation-Pump On time[30( IQR24.0-37.0)min vs. 33( IQR27.25-55.00)min, P=0.575] decreased, although the differences between the two groups were not statistically significant. In the comparison between survival and death groups, the proportion of initial shockable rhythm was significantly higher in the survival group (75% vs. 20%). CA-Pump On time [61( IQR49.25-69.25)min vs.69( IQR58.0-89.0)min, P=0.287]and ECMO initiation-Pump On time[39( IQR29.25-51.75)min vs.43( IQR34.0-52.0)min, P=0.539] were lower in the survival group, but the differences were not statistically significant. Conclusions:Independent implementation of ECPR for adult cardiac arrest at the county-level primary hospital improves the success rate of resuscitation and enhances patient prognosis. The promotion of ECPR rescue technology in county hospitals is feasible and significant, benefiting a larger population of cardiac arrest patients.