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Chijiiwa T, Ishimura K. Experiences of general home visiting nurses regarding patients with suicidal ideation in Japan: Results from semi-structured interviews. J Psychiatr Ment Health Nurs 2024; 31:607-616. [PMID: 38167840 DOI: 10.1111/jpm.13017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 12/15/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: The leading reason for suicide attempts in Japan is health problems, among which depression is the most common, followed by physical illnesses. Patients with physical illness and suicide ideation are not rare among patients receiving home-based care. General home visiting nurses (GHVNs) without knowledge, skills or experience in psychiatric care are required to provide care for patients with physical illness who are at risk of suicide in Japan. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: More detailed understanding of GHVNs' experiences and perspectives on working with suicidal patients in home care. This study enriches our understanding of how suicide prevention strategies should be developed for GHVNs. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Focusing education on therapeutic communication skills and meanings with relationships with patients is required by GHVNs. Training for suicide risk assessment and guidelines appropriate to GHVNs' situation is crucial. Establishing a liaison service system with a multidisciplinary team, including psychiatric home-visiting nurses, is necessary for home healthcare to achieve continuity of care. ABSTRACT: Introduction In Japan, even a general home visiting nurse (GHVN) lacking psychiatric experience and training can provide home nursing care to patients at risk of suicide. Little attention is given to nursing care for suicide by GHVNs who care for patients with physical illness. However, these patients with suicidal ideation for home care are surprisingly common. Aim/Question We explored the experiences of GHVNs who cared for patients with suicidal ideation and focused on the nurses' perceptions and interactions. Method We conducted semi-structured interviews with 15 GHVNs. We discussed the nurses' experiences caring for patients with suicidal ideation, their perceptions during these interactions and their response. Results General home visiting nurses were perplexed upon learning of the patient's suicidal ideation. They interacted with such patients by 'avoiding the core of the matter' while focusing on maintaining a relationship with them. Discussion Not addressing the patient's suicidal thoughts will not only disable the suicide risk assessment but also lead to patient isolation. Suicide prevention care needs to consider the unique characteristics of home care. Implications for Practice General home visiting nurses require training in suicide risk assessment and communication skills. Establishing a liaison service, including psychiatric home visiting nurses, is necessary to achieve continuity of care.
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Affiliation(s)
- Tomoko Chijiiwa
- Faculty of Nursing, Fukuoka International University of Health and Welfare, Fukuoka, Japan
| | - Kayoko Ishimura
- School of Health Science, International University of Health and Welfare, Odawara, Japan
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Lyu XC, Chen C, Lee LH, Akkadechanunt T, Yang CI, Tao XB. Dealing With a Stressful Extra Duty: The Intrapersonal Conflict Experiences of Nurses Caring for Survivors of Suicide Attempts on Medical-Surgical Wards. Int J Ment Health Nurs 2024. [PMID: 38951125 DOI: 10.1111/inm.13386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 06/10/2024] [Accepted: 06/19/2024] [Indexed: 07/03/2024]
Abstract
Nurses are the frontline professionals caring for patients who have attempted suicide. When clinical nurses learn from medical records or nursing handover, or are proactively informed by patients or family members, that the patients they are caring for have suicidal tendencies, they often experience pressure and face challenges. However, little attention has been given to the experiences of the nurses caring for patients with suicidal intent on medical and surgical wards. We aimed to address this knowledge gap. The purpose of this study was to explore medical and surgical nurses' experiences, especially the internal conflicts they might experience while caring for patients who have a history of attempted suicide. A qualitative descriptive design and semi-structured interviews were used in this study. Twenty-three nurses were recruited and interviewed individually. Data were analysed by qualitative content analysis. The focus of this paper is to examine the emergent theme of intrapersonal conflict experienced by the participants. Nurses' experiences can be clustered into two themes: (1) Pity and annoyance and (2) Hard work does not necessarily pay off. Intrapersonal conflict was identified by participants as considerable fear and anxiety about the possibility of a patient's suicide, as well as a mixture of pity for and annoyance with the patients. Nurses feel sorry for such patients, but they are also annoyed by the extra work required to prevent suicide attempts in the ward. Additionally, having limited time and ability, they see that their hard work does not necessarily pay off and may sometimes lead to punishment. Our findings raise serious concerns about the adequacy of the knowledge of the nurses, their competence and their difficulties in caring for such patients. In addition, there is a need to provide them with appropriate on-the-job education and immediate emotional support relevant to caring for survivors of suicide attempts.
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Affiliation(s)
- Xiao-Chen Lyu
- Outpatient Operating Room, The First Affiliated Hospital of Wannan Medical College, Anhui, China
| | - Cheng Chen
- Department of Pain, The Affiliated Hospital of Chengdu University, Sichuan, China
| | - Li-Hung Lee
- Department of Nursing, Hungkuang University, Taichung, Taiwan
| | | | - Cheng-I Yang
- Department of Nursing, Hungkuang University, Taichung, Taiwan
| | - Xiu-Bin Tao
- Department of Nursing, The First Affiliated Hospital of Wannan Medical College, Anhui, China
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Quemada-González C, Flores Becerra-Martos E, Blenkarn M, Gutiérrez-Rodríguez L, García-Mayor S, León-Campos Á, Martí-García C. Nursing students' experience of approaching risk for suicide behaviour through simulated environments: A content analysis study. Arch Psychiatr Nurs 2024; 50:5-13. [PMID: 38789234 DOI: 10.1016/j.apnu.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/20/2024] [Accepted: 03/03/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Suicide is a major public health problem, especially among the young population. Nurses are in a unique position to prevent it due to their constant contact with patients. However, addressing suicidal behaviour can be complicated by the emotional responses it elicits. Simulation has been shown to be an effective tool to increase the self-confidence of nursing students in dealing with these sensitive situations in a safe environment prior to dealing with real patients. AIM To explore nursing students' perceptions, thoughts, and emotions about their performance in dealing with risk for suicidal behaviour through simulated scenarios. DESIGN Qualitative descriptive study. METHODS Students of Mental Health and Psychiatric II in the third year of the Nursing course at the University of Málaga were invited to explain their experience by answering a questionnaire of three open-ended questions following their participation in the simulated scenarios of the course. RESULTS A total of 72 students participated. Content analysis of the written responses identified three main themes: (i) Emotions experienced during the simulation; (ii) Self-criticism of the performance/intervention; (iii) Student evaluation of the learning experience. Most of the students indicated at some point during the clinical scenario, they had felt anxiety, proposing possible improvements in their own performance. The clinical scenario that elicited the most negative emotions was that of a person diagnosed with borderline personality disorder. CONCLUSION Clinical simulations contribute to a better understanding of nursing practice with mental health patients and the need for training in emotional and therapeutic communication skills among students.
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Affiliation(s)
| | | | | | - Laura Gutiérrez-Rodríguez
- Universidad de Málaga, Faculty of Health Sciences, Spain; Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Spain.
| | - Silvia García-Mayor
- Universidad de Málaga, Faculty of Health Sciences, Spain; Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Spain.
| | - Álvaro León-Campos
- Universidad de Málaga, Faculty of Health Sciences, Spain; Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Spain.
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Richardson Velmans S, Joseph C, Wood L, Billings J. A systematic review and thematic synthesis of inpatient nursing staff experiences of working with high-risk patient behaviours. J Psychiatr Ment Health Nurs 2024; 31:325-339. [PMID: 37874310 DOI: 10.1111/jpm.12987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 08/30/2023] [Accepted: 09/17/2023] [Indexed: 10/25/2023]
Abstract
INTRODUCTION Nursing staff are frequently exposed to high-risk patient behaviours within inpatient health services, yet staff commonly report a lack of training and support in managing these behaviours. AIM The aim of the study was to examine nursing staff experiences of high-risk behaviours in inpatient mental health settings. METHODS Four electronic databases (CINAHL, Medline, PsycINFO, EMBASE) were searched. The protocol for this review was prospectively registered in PROSPERO (Ref: CRD42022334739). A meta-synthesis of nursing staff's experiences of high-risk behaviours in inpatient mental health settings was conducted. RESULTS We identified 30 eligible studies. Six themes were constructed from the meta-synthesis: the social contract of care; the function of risk behaviours; the expectation of risk; risk as a relational concept; navigating contradictions in care; the aftermath. DISCUSSION Nursing staff conceptualize risk as a meaningful behaviour shaped by patient, staff and environmental factors. Managing risk is an ethical dilemma for nursing staff and they require more training and support in ethical risk decision-making. IMPLICATIONS FOR PRACTICE Inpatient mental healthcare services should formulate and manage risk as a relational concept comprising staff, patient and environmental factors. Future research and clinical practice should place further consideration on the varied experiences of different types of risk behaviours. RELEVANCE STATEMENT Nursing staff are frequently exposed to high-risk patient behaviours within inpatient health services, yet staff commonly report a lack of training and support in managing these behaviours. This systematic review offers insights into how high-risk behaviours are experienced by nursing staff and makes recommendations about how to improve the understanding and management of them. Inpatient mental healthcare services should formulate and manage risk as a relational concept comprising staff, patient and environmental factors. Future research and clinical practice should place further consideration on the varied experiences of different types of risk behaviours.
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Affiliation(s)
| | | | - Lisa Wood
- Division of Psychiatry, University College London, London, UK
| | - Jo Billings
- Division of Psychiatry, University College London, London, UK
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Lascelles KM, Davey Z, Jackson D, Aveyard H. Experiences and needs of adult informal carers of adults at risk of suicide: A systematic review with mixed methods analysis. J Adv Nurs 2024; 80:1686-1718. [PMID: 38010822 DOI: 10.1111/jan.15940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 09/29/2023] [Accepted: 10/26/2023] [Indexed: 11/29/2023]
Abstract
AIM To systematically review and synthesize primary research on experiences and needs of adult informal caregivers of adults at risk of suicide. DESIGN Systematic review with a data-based convergent synthesis. DATA SOURCES MEDLINE, PsychINFO and CINAHL were searched in April 2022 and February 2023. English language research focusing on experiences of adult carers of adults was included. METHODS Articles were screened by title (n = 9077) and abstract (n = 132) with additional articles (n = 6) obtained via citation and hand searching. Thirty-one included studies were quality assessed using the Mixed Methods Appraisal Tool and study data were systematically extracted prior to thematic synthesis. RESULTS Five interconnected themes resulted: transitions; living with fear and uncertainty; changing relationships; interface with healthcare professionals and services; what carers need and want. Caring impacts mental, physical and social wellbeing. Relationships are affected in ways which might not be evident when caring for a minor. Repeated suicidal behaviour is particularly challenging with ongoing hypervigilance contributing to burden, burnout and interpersonal strain. Poor carer support exacerbates negative effects; carers need to feel informed, educated, involved and holistically supported. CONCLUSION Timely support for carers is essential. Interventions should address emotional responses, relational changes and effective care recipient support. Longitudinal research is required to understand effects of ongoing caring where there are multiple suicide attempts. IMPLICATIONS Nurses can provide carers with early support and information and longer term psychosocial interventions. If carers are adequately equipped and supported patient safety and wellbeing will be improved. IMPACT Findings of this systematic review include relational changes due to carer hypervigilance reducing autonomy and living with the possibility of suicide. Clinician awareness of the potential for relational shifts will help them prepare and support carers. PATIENT OR PUBLIC CONTRIBUTION There was no patient or public contribution.
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Affiliation(s)
| | - Zoe Davey
- Oxford Institute of Nursing Midwifery and Allied Health Research, Oxford Brookes University, Oxford, UK
| | - Debra Jackson
- University of Sydney, Sydney, New South Wales, Australia
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Rappolt EL, Hadenfeldt CJ. Using Virtual Reality to Increase Nurses' Knowledge of Adolescent Suicide Precautions. J Contin Educ Nurs 2024; 55:165-168. [PMID: 38063800 DOI: 10.3928/00220124-20231130-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
BACKGROUND Adolescents are disproportionately impacted by suicide, making it imperative nurses know how to identify those at high risk of suicide and provide safe care in the hospital setting. The purpose of this pilot study was to determine the efficacy of a virtual escape room as a learning strategy to increase nursing knowledge of suicide precautions for adolescent patients. METHOD A 360-degree virtual escape room was developed to increase nursing knowledge of hospital policy related to suicide. Small groups of participants navigated through two virtual hospital rooms with embedded clues and questions related to suicide screening and precautions. Pretest-posttest questionnaires were used to measure changes in knowledge. RESULTS Nurses demonstrated improved knowledge of hospital policy following completion of the activity. Participants also expressed a high level of satisfaction with this form of learning. CONCLUSION The use of a virtual escape room was an effective method for educating nurses on standards related to suicide prevention. [J Contin Educ Nurs. 2024;55(4):165-168.].
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Keefner T, Minton M, Antonen K. Embracing Emotional Pain: A Case Study of Adolescent Suicidality and Spirituality. J Am Psychiatr Nurses Assoc 2024; 30:397-408. [PMID: 36016492 DOI: 10.1177/10783903221118932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Suicidality continues to be the second leading cause of adolescent death. Nurses are in a prime position to address the emotional pain associated with adolescent suicidality but report skepticism and discomfort. Moreover, spirituality is identified as a protective factor against suicidality, yet a gap exists related to exploring spirituality within the context of the emotional pain associated with adolescent suicidality. Building awareness of adolescents' spirituality and emotional pain associated with suicidality is essential to address nurse skepticism and discomfort. AIMS The purpose of this study was to explore young adults' experiences of suicide attempt(s) during adolescence in the context of spirituality using a case study application of participant narratives to Minton and Antonen's B.L.E.S.S. acronym. METHOD A multiple-case study design was used to provide an alternative perspective for understanding adolescent suicidality from a spiritual context. Reed's theory of self-transcendence and the B.L.E.S.S. acronym guided the analysis and interpretation. Convenience online sampling resulted in six adult participants who provided email narratives of their adolescent experiences. Email data collection was guided by Fritz and Vandermause. Analysis of participant narratives followed the protocol of Baxter and Jack. RESULTS Participant's narratives revealed self-transcendence that paralleled the five truths about emotional pain and spirituality inherent in the B.L.E.S.S. acronym. CONCLUSION This case study provides nurses a guide for counteracting the barriers of skepticism and stigma to promote help-seeking behavior associated with adolescent suicidality. Further research is needed for the application of the B.L.E.S.S. acronym with other population samples.
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Affiliation(s)
- Tamara Keefner
- Tamara Keefner, PhD, RN, CNE, University of South Dakota, Vermillion, SD, USA
| | - Mary Minton
- Mary Minton, PhD, RN, CHPN, South Dakota State University, Brookings, SD, USA
| | - Kathy Antonen
- Kathy Antonen, PhD, South Dakota School of Mines and Technology, Rapid City, SD, USA
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Rheinberger D, Baffsky R, McGillivray L, Z Q Gan D, Larsen M, Torok M. Digital therapeutics in the hospital for suicide crisis - content and design recommendations from young people and hospital staff. Digit Health 2024; 10:20552076241230072. [PMID: 38362237 PMCID: PMC10868481 DOI: 10.1177/20552076241230072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 02/17/2024] Open
Abstract
Objective Hospital emergency departments lack the resources to adequately support young people who present for suicidal crisis. Digital therapeutics could fill this service gap by providing psychological support without creating additional burden on hospital staff. However, existing research on what is needed for successful integration of digital therapeutics in hospital settings is scant. Thus, this study sought to identify key considerations for implementing digital therapeutics to manage acute suicidal distress in hospitals. Method Participants were 17 young people who recently presented at the hospital for suicide-related crisis, and 12 hospital staff who regularly interacted with young people experiencing mental ill-health in their day-to-day work. Interviews were conducted via videoconference. Framework analysis and reflexive thematic analysis were used to interpret the data obtained. Results Qualitative insights were centred around three major themes: hospital-specific content, therapeutic content, and usability. Digital therapeutics were seen as a useful means for facilitating hospital-based assessment and treatment planning, and for conducting post-discharge check-ins. Therapeutic content should be focused on helping young people self-manage suicide-related distress while they wait for in-person services. Features to promote usability, such as the availability of customisable features and the use of inclusive design or language, should be considered in the design of digital therapeutics. Conclusions Digital therapeutics in hospital settings need to benefit both patients and staff. Given the unique context of the hospital setting and acute nature of suicidal distress, creating specialty digital therapeutics may be more viable than integrating existing ones.
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Affiliation(s)
- Demee Rheinberger
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Rachel Baffsky
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | | | - Daniel Z Q Gan
- Black Dog Institute, University of New South Wales, Sydney, Australia
- Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Australia
| | - Mark Larsen
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Michelle Torok
- Black Dog Institute, University of New South Wales, Sydney, Australia
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Huang KC, Jeang SR, Hsieh HL, Chen JW, Yi CH, Chiang YC, Wu HP. Survey of knowledge, self-efficacy, and attitudes toward suicide prevention among nursing staff. BMC MEDICAL EDUCATION 2023; 23:692. [PMID: 37740184 PMCID: PMC10517497 DOI: 10.1186/s12909-023-04685-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 09/14/2023] [Indexed: 09/24/2023]
Abstract
OBJECTIVE This study aimed to explore the knowledge, self-efficacy, and attitudes toward suicide prevention among nurses with different demographic characteristics. METHODS A cross-sectional descriptive design was adopted, and the study was conducted between August and September 2020. The content of the questionnaire included basic demographics, knowledge, self-efficacy, and attitudes toward suicide prevention. Correlation analysis was performed to determine nurses' knowledge, self-efficacy, and attitudes toward suicide prevention. RESULTS The sample comprised 778 nursing staff from a medical center in southern Taiwan. The results showed that age, years of nursing experience, department type, education on suicide prevention, and care experience of nursing staff were associated with their knowledge, self-efficacy, and attitudes toward suicide prevention in general hospital patients. Younger and less experienced nurses demonstrated superior knowledge, self-efficacy, and attitudes toward suicide prevention. Nurses who received suicide-related education and training exhibited better self-efficacy and attitudes than those who did not. Nurses with care experience had better knowledge of suicide prevention than those without experience. Knowledge and self-efficacy in suicide prevention were both significantly and positively correlated with attitudes. CONCLUSION Younger, less experienced, psychiatric nurses demonstrated superior knowledge, self-efficacy, and attitudes toward suicide prevention. Therefore, education on suicide prevention should be strengthened for older, experienced, and non-psychiatric nurses.
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Affiliation(s)
- Kuan Chin Huang
- Department of Nursing, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Shiow-Rong Jeang
- Department of Nursing, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | | | - Jing-Wen Chen
- Department of Nursing, College of Medicine and Life Science, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Ching-Hsien Yi
- Extension School, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yung-Chih Chiang
- Department of Psychiatry, Kaohsiung Veterans General Hospital, No.386, Dazhong 1St Rd., Kaohsiung, 813414, Taiwan.
| | - Han-Ping Wu
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.
- Department of Pediatrics, Chiayi Chang-Gung Memorial Hospital, Chiayi County, No. 6, W. Sec. , Jiapu Rd., Puzi City, Taiwan.
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Mohammadi F, Sadeghian E, Masoumi Z, Oshvandi K, Bijani M. Psychiatric nurses' perception of dignity in patients who attempted suicide. Nurs Ethics 2023; 30:871-884. [PMID: 37057588 DOI: 10.1177/09697330221146237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
BACKGROUND Maintaining the dignity of patients who attempted suicide is one of the caregivers' main ethical duties. Yet, in many cases, these patients are not treated with dignity. The concept of dignity is abstract, and there is no research on the dignity of suicidal patients. So, the present study is done to investigate psychiatric nurses' perception of dignity in patients who attempted suicide. OBJECTIVE The present study explores the concept of dignity in patients who attempted suicide from the perspective of psychiatric nurses. RESEARCH DESIGN The present study is a qualitative, descriptive work of research. PARTICIPANTS AND RESEARCH CONTEXT A total of 20 psychiatric nurses from 2 hospitals affiliated with a university of medical sciences in the southeast of Iran were selected via purposeful sampling. ETHICAL CONSIDERATIONS The Research Ethics Committee of the Hamadan University of Medical Sciences approved the study's protocol, and ethical principles were followed in general. FINDINGS From the findings of the study, three main themes, namely " respect for personal; identity," "management of psychological tension," and "compassion-focused therapy," with 12 sub-themes were extracted. DISCUSSION AND CONCLUSION In the perspective of caregivers, patients who attempted suicide need to be cared for in supportive environments with compassionate and respectful behaviors to control their psychological tensions. These conditions would maintain such patients' dignity and result in appropriate behavioral outcomes. Policy-makers and administrators can use the present study's findings to create an appropriate clinical environment in which the dignity of patients who attempted suicide is properly maintained.
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Affiliation(s)
- Fateme Mohammadi
- Chronic Diseases(Home Care) Research Center and Autism Spectrum Disorders Research Center, Department of Nursing, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Efat Sadeghian
- Chronic Diseases (Home care) Research Center, Department of Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Zahra Masoumi
- Mother and Child Care Research Center, Department of Midwifery, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Khodayar Oshvandi
- Mother and Child Care Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mostafa Bijani
- Department of Medical Surgical Nursing, School of Nursing, Fasa University of Medical Sciences, Fasa, Iran
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Waliski A, Matthieu MM, Allison MK, Wilson MP, Skaggs EM, Adkins DA, Owen RR. Emergency Departments Treating Veterans for Suicide: Ensuring Quality Care for Veterans Outside of Department of Veterans Affairs Health Care Facilities. J Emerg Nurs 2023; 49:255-265. [PMID: 36653229 DOI: 10.1016/j.jen.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 11/30/2022] [Accepted: 12/05/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Veterans die by suicide at higher rates than nonveterans. Given that the emergency department is often the first point of entry to healthcare following a suicide attempt, it would be beneficial for community providers to have knowledge of the characteristics, medical issues, and effective treatments most often associated with those having served in the military to ensure guideline concordant and quality suicide care. This study aimed to identify assessment and referral practices of emergency departments at rural community hospitals related to care for suicidal veterans and explore the feasibility and acceptability of identifying veterans in need of postdischarge aftercare. METHODS This qualitative exploratory study involved content analysis of semistructured interviews. Ten emergency clinicians from 5 rural Arkansas counties with high suicide rates were interviewed about their experiences working with suicidal patients within the emergency department and perceptions of assessment, management, and referral practices. RESULTS Although most of the emergency departments had a process for assessing for suicide risk, emergency clinicians did not always feel confident in their knowledge of assessing and caring for suicidal patients. Military history was not included in assessment, treatment, or aftercare planning, nor were brief interventions such as safety planning or lethal means safety education provided. DISCUSSION Best practices for suicide assessment and management of veterans exist; however, challenges specific to the emergency department regarding staff training and engaging the community to effectively link at-risk veterans to needed care hinder implementation. Veteran-inclusive assessment and intervention practices could enhance the quality of care provided in community emergency departments.
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Vedana KGG, dos Santos JC, Zortea TC. The Meaning of Suicidal Behaviour for Portuguese Nursing Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14153. [PMID: 36361032 PMCID: PMC9658036 DOI: 10.3390/ijerph192114153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/23/2022] [Accepted: 10/27/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The nursing perspectives on suicidal behaviors may influence the quality of assistance and suicidal prevention. This phenomenon is scarcely investigated among nursing students. AIMS The aim of this study is to understand the meanings of suicidal behavior for Portuguese undergraduate students. METHODS This qualitative study utilized Grounded Theory and Symbolic Interactionism. We collected data in Portugal in 2017-2018 with 13 undergraduate students. RESULTS Students compared suicidal behavior to "A complex and close haze" and considered it "A neglected phenomenon". Suicidal behavior was predominantly perceived as an emotional distress that requires assistance. The students compared the person and society as "The car and the road: behavior influenced by communication and interaction" and valorized social dimensions and repercussions of suicidal behavior. LIMITATIONS Lack of triangulation in the data and the sampling restricted to nursing students of a single institution are considered limitations of this study. CONCLUSIONS This study can contribute to the development of academic education strategies and psychosocial support for nursing students.
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Affiliation(s)
| | - José Carlos dos Santos
- Health Sciences Research Unit, Nursing School of Coimbra, 7001, Bissaya Barreto Avenue, 3046-851 Coimbra, Portugal
| | - Tiago Carlos Zortea
- The Oxford Institute of Clinical Psychology Training & Research, University of Oxford, Oxford OX1 3SZ, UK
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Olarte-Godoy J. Newtonian science, complexity science and suicide-critically analysing the philosophical basis for suicide research: A discussion paper. J Adv Nurs 2022; 78:e101-e110. [PMID: 35765763 DOI: 10.1111/jan.15346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 05/04/2022] [Accepted: 06/17/2022] [Indexed: 11/27/2022]
Abstract
AIM A critical discussion comparing Newtonian science and complexity science as the philosophical basis for suicide research and its impact on suicide knowledge development and clinical practice. DESIGN Discussion paper. DATA SOURCES A review of literature on suicide research and complexity science ranging from 2000 to 2022. IMPLICATIONS FOR NURSING Suicide research based on a Newtonian worldview can have negative consequences for suicide knowledge development and can permeate nursing practice in ways that take away from addressing the complex needs of patients, their families and healthcare teams. CONCLUSION A Newtonian worldview as a philosophical basis for research is insufficient for the study of a phenomenon as complex as suicide. A complexity science approach is better suited to the study of suicide given the multiple, interrelated, emerging factors that can contribute to a person's decision to end their own life. IMPACT Suggestions are provided as to how a complexity science approach to the research of suicide can inform useful knowledge development that better meets the needs of individuals facing suicidality and their families. Researchers, healthcare administrators and nurses providing care to those struggling with suicidality can benefit from adopting a complexity science worldview in addressing this multifaceted phenomenon.
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