Making Sense of the Unique Pain of Survivors: A Psychoeducational Approach for Suicide Bereavement

The lived experience of family members of older people who have died by suicide in rural China

AIM

The aim of the study is to provide insight and facilitate a deeper understanding of family members who have experienced their older family member's suicide.

DESIGN

Interpretative phenomenological analysis (IPA) study.

METHODS

Semi-structured individual interviews with five family members of older people who died by suicide recruited from a rural area of Shanxi Province, China. Smith's (2009) six steps of IPA was used for data analysis.

RESULTS

Three main themes emerged from the study: (a) Initial psychological reactions; (b) Long-term life effects; (c) Social attitudes. The study shows how the family members of older people who died by suicide have experienced stigmatization and felt largely ignored. A suicide event poses a challenge to the future living quality of the family members. The study also highlights that it is necessary to pay attention to families of older people who died by suicide and providing support is required to improve the quality of life of these family members in rural China.

CONCLUSION

The study adds to the understanding of the lived experience of family members of older people who died by suicide in less economically developed rural areas.

PATIENT OR PUBLIC CONTRIBUTION

Patients and the public were not involved in the design, conduct or reporting of this study. Participants of this study helped with recruitment via snowball sampling.

The Information Seeking Behaviors and Needs of Suicide Survivors During Bereavement

The suicide of one person impacts 60 people, known as suicide survivors. These survivors are at an increased risk for negative mental health outcomes including PTSD, suicidal ideation, and suicide contagion. Despite these consequences, there have not been any information science studies that have explored the information behaviors of people who have recently survived the suicide of a loved one. This article takes a unique approach in combining autoethnography with traditional survey research. One hundred and ninteen participants sourced from a private Facebook suicide bereavement group responded to a survey asking them about their information-seeking after a loved one committed suicide. The qualitative data were fragmented and grouped into like-responses and thematic codes that gave explanation to the research questions. These results are coupled with the author’s ethnographic recounting of a similar experience. Brenda Dervin’s sense-making is employed as the methodological lens through which the study is conducted. It is found that suicide survivors are highly unlikely to have their informational needs met. In the immediate aftermath of their loss, they are most likely to look for information related to the suffering of the deceased. As time passes, they begin to look for information about coping with their loss and preventing suicide of other people; either those close to them or in a larger community scale. Being a survivor motivated many participants to advocacy work. Finally, the author argues that the findings of this article should compel further research and the creation of information policy to aid survivors and prevent suicide contagion.

Creation and validation of a high-fidelity simulation scenario for suicide postvention

OBJECTIVE

to create and validate a high-fidelity simulation scenario about the initial support to suicide bereaved people.

METHOD

a methodological research study to create and validate a simulation scenario about postvention. Its creation was based on scientific recommendations, the validation process was carried out by experts, based on an instrument developed by the authors; the data were statistically analyzed using the Content Validity Index and Gwet concordance coefficient.

RESULTS

the scenario was created to provide initial support to suicide bereaved people in the Primary Health Care context. As learning objectives, welcoming, health care and organization monitoring were proposed according to technical-scientific recommendations. The scenario was validated by 10 specialists in the themes of postvention (5 judges) and high-fidelity simulation (5 judges). The scenario items met the acceptance and reliability criteria (Content Validity Index = 0.80) and satisfactory concordance (Gwet coefficient = 0.640).

CONCLUSION

the study presented in full a scenario on postvention with innovative potential that can be used free of charge in clinical simulation development during training of different categories of health professionals, to act in support of suicide bereaved people.

Key issues, challenges, and preferred supports for those bereaved by suicide: Insights from postvention experts

For many, suicide bereavement is challenging. Postvention responses are few and evidence to inform them is lacking. Eighteen postvention experts completed an online survey regarding the key issues, challenges, and supports available to people bereaved by suicide. Participants were asked to identify the issues, then rank them in terms of importance at key times during the first 2 years after death, with navigating grief, managing relationships, and dealing with practical challenges identified. Access to information, practical assistance and non-judgmental support were most important early in the bereavement period. These findings provide a foundation for recommendations for postvention interventions.

The longitudinal contribution of attachment models and interpersonal factors to posttraumatic growth among suicide-loss survivors

OBJECTIVE

This study aimed to deepen our understanding of the interpersonal facilitators of posttraumatic growth (PTG) among suicide-loss survivors (SLSs) by focusing on the effects of attachment models on PTG in a 4-year longitudinal design.

METHOD

One-hundred and fity-two SLSs completed a series of questionnaires tapping attachment models, self-disclosure, social support and PTG in a three-wave study design.

RESULTS

Attachment models, self-disclosure, and perceived social support at T1 were found to predict PTG levels at T2. Self-disclosure alone predicted PTG at T3. Structural equation modeling analysis revealed that interpersonal factors served as mediators of the relationship between attachment models and PTG beyond the PTG trajectory.

CONCLUSIONS

Attachment models play an important role in facilitating PTG among SLSs. Thus, therapeutic interventions based on attachment models of self and other specifically designed to promote a sense of self-worth and confidence in others may be valuable in facilitating growth among SLSs.

Perceived Suicide Stigma and Associated Factors in Chinese College Students: Translation and Validation of the Stigma of Suicide Attempt Scale and the Stigma of Suicide and Suicide Survivors Scale

This study aims to translate and validate two perceived suicide stigma scales, including the Stigma of Suicide Attempt Scale (STOSA) and the Stigma of Suicide and Suicide Survivor Scale (STOSASS) into Chinese language, examining the factor structure, and assessing the correlation between suicide stigma and a series of variables. After translating and back translating the STOSA and STOSASS, an online survey was administrated to 412 college students in China. These two scales were tested for their dimensionality in a series of confirmatory factor analyses. A series of regression analyses were conducted to examine the factors that are associated with perceived and public suicide stigma, including demographics, psychological distress, suicidality, suicide exposure, and perceived entitativity of suicide ideators, decedents, and survivors. The results showed that the two translated scales, STOSA and STOSASS, were reliable (Cronbach’s α = 0.79~0.83) and valid in Chinese contexts and it can be treated as unidimensional scales. Suicidality, exposure to suicide, and perceived entitativity of suicide-related persons were significantly associated with higher endorsement of public suicide stigma (SOSS Stigma, p < 0.03), but not perceived stigma (STOSA, STOSASS). Higher levels of psychological distress were associated with both higher perceived and public suicide stigma (p < 0.05).