1
|
Reid HE, Edge D, Pratt D, Wittkowski A. Working with suicidal mothers during the perinatal period: a reflexive thematic analysis study with mental health professionals. BMC Psychiatry 2024; 24:106. [PMID: 38326817 PMCID: PMC10848420 DOI: 10.1186/s12888-024-05537-1] [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: 05/09/2023] [Accepted: 01/18/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Suicide is the leading cause of death in mothers postpartum and one of the most common causes of death during pregnancy. Mental health professionals who work in perinatal services can offer insights into the factors they perceive as being linked to mothers' suicidal ideation and behaviour, support offered to mothers and improvements to current practices. We aimed to explore the experiences and perceptions of perinatal mental health professionals who have worked with suicidal mothers during the perinatal period. METHOD Semi-structured interviews were conducted face-to-face or via telephone with mental health professionals working in perinatal mental health inpatient or community services across England. Data were analysed using reflexive thematic analysis. RESULTS From the professionals' (n = 15) accounts three main themes were developed from their interview data. The first, factors linked to suicidal ideation and behaviour, overarched two sub-themes: (1.1) the mother's context and (1.2) what the baby represents and what this means for the mother. These sub-themes described factors that professionals assessed or deemed contributory in relation to suicidal ideation and behaviour when a mother was under their care. The second main theme, communicating about and identifying suicidal ideation and behaviour, which outlined how professionals enquired about, and perceived, different suicidal experiences, encapsulated two sub-themes: (2.1) how to talk about suicide and (2.2) types of suicidal ideation and attempts. The third main theme, reducing suicidal ideation through changing how a mother views her baby and herself, focused on how professionals supported mothers to reframe the ways in which they viewed their babies and in turn themselves to reduce suicidal ideation. CONCLUSION Professionals highlighted many factors that should be considered when responding to a mother's risk of suicide during the perinatal period, such as the support around her, whether the pregnancy was planned and what the baby represented for the mother. Professionals' narratives stressed the importance of adopting a tailored approach to discussing suicidal experiences with mothers to encourage disclosure. Our findings also identified psychological factors that professionals perceived as being linked to suicidal outcomes for mothers, such as self-efficacy; these factors should be investigated further.
Collapse
Affiliation(s)
- Holly E Reid
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Zochonis Building, Brunswick Street, M13 9PL, Manchester, UK
- Manchester Academic Health Sciences Centre, Manchester, UK
| | - Dawn Edge
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Zochonis Building, Brunswick Street, M13 9PL, Manchester, UK
- Manchester Academic Health Sciences Centre, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Daniel Pratt
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Zochonis Building, Brunswick Street, M13 9PL, Manchester, UK
- Manchester Academic Health Sciences Centre, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Anja Wittkowski
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Zochonis Building, Brunswick Street, M13 9PL, Manchester, UK.
- Manchester Academic Health Sciences Centre, Manchester, UK.
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.
| |
Collapse
|
2
|
Power L, O'Connor M. Radiographers' experiences and educational needs in relation to caring for suicidal patients during radiology examinations. Radiography (Lond) 2023; 29:1011-1020. [PMID: 37672965 DOI: 10.1016/j.radi.2023.08.006] [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: 06/14/2023] [Revised: 08/02/2023] [Accepted: 08/26/2023] [Indexed: 09/08/2023]
Abstract
INTRODUCTION Researchers have explored the experiences, attitudes, and educational needs of several healthcare professional groups in relation to caring for suicidal patients. However, radiographers have not been included in these studies. Radiographers are likely to encounter these patients when they present for diagnostic imaging following suicide attempts. METHODS An online questionnaire exploring radiographers' experiences and educational needs in caring for suicidal patients was circulated to radiographers working in 23 acute hospitals across Ireland and posted to a Facebook page targeting Irish-based radiographers. Closed-ended questions were used to capture respondents' demographics and five-point Likert scale questions to establish their confidence levels in imaging suicidal patients. Open-ended questions were used to explore their experiences and educational needs. Quantitative data was analysed using descriptives statistics, and qualitative data thematically analysed. RESULTS One hundred and four radiographers responded to the questionnaire, 96% of whom had imaged suicidal patients. Radiographers were confident in justifying and optimising these radiographic examinations, however, less confident in communicating with and caring for these patients. Radiographers reported insufficient patient history on imaging referrals and challenges in communicating with suicidal patients, which many attributed to lack of training. Radiographers expressed interest in further education related to caring for patients who've attempted suicide, which they felt should include an introduction to psychiatry, strategies for communicating with suicidal patients and building resilience. CONCLUSION Radiographers' experiences of imaging suicidal patients have been reported along with several challenges which could be addressed through further education. IMPLICATIONS FOR PRACTICE Further education in caring for suicidal patients should be offered to radiographers which aligns with their educational needs. Referring clinicians should be reminded of the importance of informing radiographers of patients' suicide attempt when referring them for diagnostic imaging.
Collapse
Affiliation(s)
- L Power
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | - M O'Connor
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland.
| |
Collapse
|
3
|
Hofmann L, Wagner B. Men's Behavior and Communication in the Days Prior to a Suicide-A Psychological Autopsy Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6668. [PMID: 37681808 PMCID: PMC10488060 DOI: 10.3390/ijerph20176668] [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: 07/19/2023] [Revised: 08/04/2023] [Accepted: 08/22/2023] [Indexed: 09/09/2023]
Abstract
Men show a significantly higher suicide rate, are less often recognized as persons at risk, and are more difficult to reach for suicide prevention interventions. Warning signs and deterioration in mental health are often not recognized by their surroundings. This study aims to retrospectively analyze the behavior and communication of men before a suicide, how relatives noticed changes, and how the interaction was perceived. N = 15 individuals who lost a close male relative to suicide were interviewed using psychological autopsy interviews. The interviews were evaluated following a deductive-inductive approach while using a comprehensive category system. The majority of men showed changes in behavior before the suicide, especially social withdrawal, irritability, and generally a deterioration in mental health. In fact, men did communicate their suicidal thoughts before they died through suicide, but mainly indirectly. While only one-third of the deceased made preparations before suicide, the majority of relatives noticed a deterioration in the mental health of the individual as well as increased alcohol and substance use. Men show signs of suicide, which are little recognized by their surroundings. Suicide prevention interventions should be adapted more to the needs of men.
Collapse
Affiliation(s)
- Laura Hofmann
- Department of Clinical Psychology, Medical School Berlin, 14197 Berlin, Germany;
| | | |
Collapse
|
4
|
Whitaker-Brown C, Cornelius JB, Smoot J, Khadka A, Patil A. Statewide Assessment of North Carolina Nurse Practitioners' Knowledge of and Attitudes Toward Suicide Awareness and Prevention: Protocol for a Statewide Mixed Methods Study. JMIR Res Protoc 2023; 12:e39675. [PMID: 36881461 PMCID: PMC10031437 DOI: 10.2196/39675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 12/29/2022] [Accepted: 12/31/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Suicide is a major public health problem, which affects people of all ages and ethnicities. Despite being preventable, the rates of suicide have steadily climbed (more than a third) over the past 2 decades. OBJECTIVE Nurse practitioners (NPs) must be responsible for recognizing suicide risk and providing appropriate treatment referrals in addition to having an important role in suicide prevention. The reasons why NPs may not pursue suicide prevention training are their lack of suicide awareness and prevention, limited experiences with suicidal patients, and the stigma associated with mental illness. Before we begin to address the gaps within suicide awareness and prevention skills, we need to first examine NPs' knowledge of and attitudes (stigma) toward suicide prevention. METHODS This study will comprise a mixed methods approach. First, quantitative data will be collected using the Suicide Knowledge and Skills Questionnaireand the Suicide Stigma Scale (Brief version) questionnaire. An email will be sent to the NPs explaining the purpose of the study. If they consent, they will click on a link to access the surveys on a secure site. In our previous research with this sample, email reminders to nonresponders after 2 and 4 weeks were sent. The quantitative component will be used to inform the qualitative interviews of this study. The Suicide Knowledge and Skills Questionnaire is a 13-item questionnaire comprising 2 subscales: suicide knowledge and suicide skills. All questions are rated on a 5-point Likert scale (1=completely disagree to 5=completely agree). The survey has been shown to differentiate between those with suicide training and those without and has a Cronbach α score of .84. The Suicide Stigma Scale (Brief version) is a 16-item survey that assesses stigma regarding suicide. The items are measured on a 5-point Likert scale (1: strongly disagree to 5: strongly agree) and have a Cronbach α of .98. RESULTS This study was funded by the Faculty Research Grants program through the Office of the Vice Chancellor for Research and Economic Development at the University of North Carolina at Charlotte. Institutional review board approval was obtained in April 2022. Recruitment occurred between summer and winter 2022. Interview conduction began in December 2022 and will conclude in March 2023. Data will be analyzed during spring and summer 2023. CONCLUSIONS The study results will add to the literature on NPs' knowledge of and attitudes (stigma) toward suicide prevention. It represents a first step in addressing gaps within suicide awareness and prevention skills, among NPs in their respective practice settings. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/39675.
Collapse
Affiliation(s)
- Charlene Whitaker-Brown
- School of Nursing, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Judith Bacchus Cornelius
- School of Nursing, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Jaleesa Smoot
- Department of Public Health, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Anjala Khadka
- Department of Public Health, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Arundhati Patil
- William States Lee College of Engineering, University of North Carolina at Charlotte, Charlotte, NC, United States
| |
Collapse
|
5
|
Karakaya D, Özparlak A, Önder M. Suicide literacy in nurses: A cross-sectional study. J Clin Nurs 2023; 32:115-125. [PMID: 34985161 DOI: 10.1111/jocn.16205] [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: 10/22/2021] [Revised: 12/13/2021] [Accepted: 12/20/2021] [Indexed: 12/14/2022]
Abstract
AIMS AND OBJECTIVES This study is a cross-sectional study aiming to determine the suicide literacy level of nurses and to examine the relationship between nurses' suicide literacy and certain variables. BACKGROUND Suicide literacy in nurses is a factor which affects knowledge levels. The level of suicide literacy in nurses may affect the care given to patients and the behaviour of obtaining help in relation to themselves. METHODS The study was conducted with 348 nurses between January and March 2020 at a hospital in the city of Antalya in Turkey. A personal information form and the Literacy of Suicide Scale (LOSS) were used to collect data. Descriptive statistical methods were used in data analysis. Stepwise multiple linear regression analysis was performed to determine the predictors of suicide literacy. The STROBE checklist was followed for this cross-sectional study. RESULTS The nurses' mean score on LOSS was 11.08 ± 3.92. Significant predictors of suicide literacy in nurses were being single, working in the emergency department, having previous experience in the psychiatry clinic, not having a mental illness, having suicide attempts in the family, having previously obtained information on intervention on individuals at risk of suicide and stating that their sources of information on this topic were nursing education and the Internet. These variables explained 19.8% of the variance in suicide literacy. CONCLUSIONS The nurses' suicide literacy was at a low level. It is recommended that education programs on the care of patients at risk of suicide be set up for all nurses working in general clinics. RELEVANCE TO CLINICAL PRACTICE It is important to raise the levels of suicide literacy in nurses in order to provide better quality care to patients who are at risk of suicide. Also, raising levels of suicide literacy may strengthen nurses' behaviours in seeking help for themselves.
Collapse
Affiliation(s)
- Dudu Karakaya
- Department of Psychiatric Nursing, Akdeniz University Faculty of Nursing, Antalya, Turkey
| | - Arif Özparlak
- Department of Psychiatric Nursing, Akdeniz University Faculty of Nursing, Antalya, Turkey
| | - Merve Önder
- Anesthesia and Reanimation Intensive Care Unit, Ministry of Health Isparta City Hospital, Isparta, Turkey
| |
Collapse
|
6
|
Berardelli I, Aguglia A, Cassioli E, Bersani FS, Longo L, Luciano M, Minichino A, Santambrogio J, Solmi M, Rossi R, Ribolsi M, Gattoni E, Monteleone AM. Suicide-Related Knowledge among Italian Early Career Psychiatrists and Trainees: Results from a Cross-Sectional Survey. Brain Sci 2022; 12:brainsci12121619. [PMID: 36552079 PMCID: PMC9776389 DOI: 10.3390/brainsci12121619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/10/2022] [Accepted: 11/19/2022] [Indexed: 11/29/2022] Open
Abstract
The training of mental health professionals is an important component of suicide-prevention programs. A cross-sectional survey was conducted in different Italian regions to evaluate knowledge of, and attitudes toward, suicide as well as the experience of a patient's suicide or a suicide attempt in early career psychiatrists (ECPs) and trainees (N = 338). The Suicide Knowledge and Skills Questionnaire and the Impact of a Patient's Suicide on Professional and Personal Lives scale were administered. Furthermore, symptoms of intrusion, avoidance, and arousal were examined through the Impact of Event Scale in ECPs and trainees who had experienced the suicide of a patient or a suicide attempt. Participants with training were more confident in the clinical management of suicide-risk patients. The group with experience of a patient's suicide reported more suicide skills except for support and supervision. Finally, the participants who reported a patient's suicide presented a more conservative patient selection, difficulties in relationships, loss of self-esteem, dreams linked to suicide, intrusive thoughts of suicide, guilt, and anger. Our results show that knowledge of, and attitudes toward, suicide are essential in the management of suicide-risk patients.
Collapse
Affiliation(s)
- Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant’Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, 1035, 00189 Rome, Italy
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, 16132 Genoa, Italy
- Correspondence: ; Tel.: +39-010-1353-7665
| | - Emanuele Cassioli
- Psychiatry Unit, Department of Health Sciences, University of Florence, 50134 Florence, Italy
| | - Francesco Saverio Bersani
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
- Psychiatry and Clinical Psychopharmacology University Unit, Department of Mental Health, Azienda Sanitaria Locale (ASL) Latina, 04100 Latina, Italy
| | - Luisa Longo
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21201, USA
| | - Mario Luciano
- Department of Psychiatry, University of Campania “L. Vanvitelli”, 80138 Naples, Italy
| | - Amedeo Minichino
- Department of Psychiatry, University of Oxford, Oxford OX1 2JD, UK
| | - Jacopo Santambrogio
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Department of Mental Health, The Ottawa Hospital, Ottawa, ON K1Z 7K4, Canada
- Ottawa Hospital Research Institute (OHRI), Clinical Epidemiology Program, University of Ottawa, Ottawa, ON K1Z 7K4, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, 10117 Berlin, Germany
| | - Rodolfo Rossi
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Michele Ribolsi
- Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine, University Campus Bio-Medico of Rome, 00128 Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy
| | - Eleonora Gattoni
- Psychiatry Ward, Maggiore della Carità University Hospital, 28100 Novara, Italy
| | | |
Collapse
|
7
|
Ferrara P, Terzoni S, Ruta F, Poggi AD, Destrebecq A, Gambini O, D'agostino A. Nursing students' attitudes towards suicide and suicidal patients: A multicentre cross-sectional survey. NURSE EDUCATION TODAY 2022; 109:105258. [PMID: 34968930 DOI: 10.1016/j.nedt.2021.105258] [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: 07/16/2021] [Revised: 12/01/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Education of nursing students can be a valuable resource in contributing to suicide prevention in mental health service users. The evaluation of students' attitudes towards a complex clinical issue is an important aspect of education that can expand traditional paths to acquisition of competence. Thus far, very few studies investigated attitudes towards suicidal risk among nursing students, and no data are available on Italian settings. OBJECTIVES The aim of this study was to explore nursing students' attitudes towards suicidal risk across the Nursing schools in three Italian universities. DESIGN Multicentre cross-sectional survey incorporating a before-after design. SETTING AND PARTICIPANTS A non-randomized sample of nursing students of the bachelor's degree in Nursing in three University hospitals was recruited. METHODS Nursing students completed "Suicide Behaviour Attitude questionnaire-Italian version" (SBAQ-ita scale); second-year nursing students of the University of Milan completed the scale before (T0) and 2 months after (T1) a specific lecture on suicide and suicidal risk. RESULTS Three hundred and fourteen students were enrolled (response rate 76.77%). The overall score of sample attitudes had a Median (Me) of 3.5[2.5;4] for the domain "Feeling towards the patient", 3[2;4] for the domains "Professional ability", 5[3;7] for the domain "Right to suicide", 5[4;6] for the domain "Knowledge". Improved median score regarding the domain "Professional ability" (0.015), and decreased median score on the "Knowledge" (0.021) domain were observed at T1. CONCLUSIONS The study highlights the impact of an educational intervention on nursing students' attitudes, supporting its implementation to improve academic education programmes.
Collapse
Affiliation(s)
- Paolo Ferrara
- San Paolo Bachelor School of Nursing, University of Milan, San Paolo Teaching Hospital, Asst Santi Paolo e Carlo. Via Ovada, 26, 20142 Milan, Italy.
| | - Stefano Terzoni
- San Paolo Bachelor School of Nursing, University of Milan, San Paolo Teaching Hospital, Asst Santi Paolo e Carlo. Via Ovada, 26, 20142 Milan, Italy.
| | - Federico Ruta
- University of Foggia, ASL BAT. Viale Ippocrate 11, 76121, Italy
| | - Alessandro Delli Poggi
- Department of Surgical Sciences, University of Rome - La Sapienza, Viale del Policlinico, 155, 00161 Rome, Italy.
| | - Anne Destrebecq
- Nursing, University of Milan, Dept. of Biomedical Sciences for Health, Via Ovada, 26, 20142 Milan, Italy.
| | - Orsola Gambini
- Associate Professor of Psychiatry, Department of Biomedical Sciences for Health, University of Milan. Via A. di Rudinì 8, 20142 Milan, Italy.
| | - Armando D'agostino
- Department of Biomedical Sciences for Health, University of Milan, Via A. di Rudinì 8, 20142 Milan, Italy.
| |
Collapse
|