题名

Factors Influencing Psychiatric Nurses' Attitudes toward Suicide Attempters: Implications for Nursing Education in Suicide Prevention

DOI

10.6145/jme201707

作者

Cheng-I Yang;Wen-Chii Tzeng;Chia-Yi Wu

关键词

Attitudes ; nursing education ; ethics ; suicide attempters ; suicide prevention

期刊名称

Journal of Medical Education

卷期/出版年月

21卷2期(2017 / 06 / 01)

页次

59 - 72

内容语文

英文

中文摘要

Purpose: Evidence indicated that the nurses' negative attitudes are influential to the quality of suicidal patient care and the patients’ intention to seek help. Educating the nurses to be aware of this phenomenon is the first step to improve care quality. The study aimed to explore psychiatric nurses' perceptions and attitudes of caring for suicidal patients and their implications for suicide prevention and nursing education. Methods: Qualitative method was used with purposive sampling, one-on-one interviews audiotaped for transcriptions and content analysis for data interpretation. Results: Fifteen psychiatric nurses between the ages of 26-38 (mean: 29.3) in a general hospital in northern Taiwan agreed to participate. Three themes reflected the nurses' opinions toward factors affecting nursing care for suicidal patients in the acute psychiatric setting: (1) fluctuated attitudes; (2) dichotomized attributions of suicidal behavior; (3) the conflict between professional caring ethics and morality. Further, three strategies emerged as the way to overcome the ethical/moral conflicts, which are rationalizing suicidal behavior in the medical context, separating practice from thinking, and choosing contact timing. Conclusions: Direct care experiences affected nursing attitudes on suicide, which in turn induced personal reflections on suicide. Nurses who care for suicidal patients should receive debriefing, proper education and interactive discussions with nursing leaders to clarify negative meanings of such care for better care quality and personal growth.

主题分类 醫藥衛生 > 醫藥總論
社會科學 > 教育學
参考文献
  1. Wu, CY,Whitley, R,Stewart, R(2012).Pathwaysto care and help-seeking experience prior to self-harm: a qualitative study in Taiwan.J Nurs Res,20,32-41.
    連結:
  2. Taiwan Ministry of Health and Welfare, Taiwan. Causes of death in Taiwan. Retrieved from http:// dep.mohw.gov.tw/DOS/cp-1735-3241-113.html, May 2017.
  3. Anderson, M,Standen, P,Noon, J.(2003).Nurses' and doctors' perceptions of young people who engage in suicidal behavior: a contemporary grounded theory analysis.Int J Nurs Stud,40,587-97.
  4. Botega, NJ,Reginato, DG,da Silva, SV(2005).Nursing personnel attitudes towards suicide: The development of a measurement scale.Rev Bras Psiquiatr,27,315-8.
  5. Boyes, AP.(1994).Repetition of overdose: a retrospective 5-year study.J Adv Nurs,20,462-8.
  6. Chen, YY,Wu, KC,Yousuf, S(2012).Suicide in Asia: opportunities and challenges.Epidemiol Rev,34,129-44.
  7. Cutcliffe, JR,Stevenson, C.(2008).Never the twain? Reconciling national suicide prevention strategies with the practice, educational, and policy needs of mental health nurses (Part two).Int J Ment Health Nurs,17,351-62.
  8. De Leo, D,Milne,r A.(2010).The WHO/START Study: Promoting suicide prevention for a diverse range of cultural contexts.Suicide Life Threat Behav,40,99-106.
  9. Graneheim, UH,Lundman, B.(2004).Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness.Nurs Educ Today,24,105-12.
  10. Gutheil, TG,Gabbard, GO.(1998).Misuses and misunderstandings of boundary theory in clinical and regulatory settings.Am J Psychiatry,155,409-14.
  11. Happell, B,Summers, M,Pinikahana, J.(2003).Measuring the effectiveness of the national Mental Health Triage Scale in an emergency department.Int J Ment Health Nurs,12,288-92.
  12. Kalira, V,Treisman, GJ,Clark, MR.(2013).Borderline personality disorder and chronic pain: a practical approach to evaluation and treatment.Curr Pain Headache Rep,17,350.
  13. King, G.(2014).Staff attitudes towards people with borderline personality disorder: Therapeutic optimism can be achieved with the use of specially adapted interventions and sophisticated clinical supervision, says Gemma King.Mental Health Practice,17,30-4.
  14. Koekkoek, B,van Meijel, B,Hutschemaekers, G.(2006)."Diffi cult patients" in mental health care: a review.Psychiatr Serv,57,795-802.
  15. Ma, WF,Shih, FJ,Hsiao, SM(2009).Caring Across Thorns-Different care outcomes for borderline personality disorder patients in Taiwan.J Clin Nurs,18,440-50.
  16. Markham, D,Trower, P.(2003).The effect of the psychiatric label 'borderline personality disorder' on nursing staff's perceptions and casual attributions for challenging behaviors.Br J Clin Psychol,42,243-56.
  17. McAllister, M,Creedy, D,Moyle, W(2002).Nurses' attitudes towards clients who self-harm.J Adv Nurs,40,578-86.
  18. McCann, TV,Clark, E,McConnachie, S(2007).Deliberate self-harm: emergency department nurses' attitudes, triage and care intentions.J Clin Nurs,16,1704-11.
  19. McDonald, PS,O'Dowd, TC.(1991).The heartsink patient: a preliminary study.Fam Pract,8,112-6.
  20. McLaughlin, C.(1994).Casualty nurses' attitudes to attempted suicide.J Adv Nurs,20,1111-8.
  21. Neville, K,Roan, NM.(2013).Suicide in hospitalized medical-surgical patients: exploring nurses' attitudes.J Psychosoc Nurs,51,35-43.
  22. O'Connell, B,Dowling, M.(2013).Community psychiatric nurses' experiences of caring for clients with borderline personality disorder: Bridget O'Connell and Maura Dowling report on a study that gathered nurses' views on working with this client group and suggest ways to improve care.Mental Health Practice,17,27-33.
  23. Ouzouni, C,Nakakis, K.(2013).Nurses' attitudes towards attempted suicide.Health Sci J,7,119-34.
  24. Patterson, P,Whittington, R,Bogg, J.(2007).Testing the effectiveness of an educational intervention aimed at changing attitudes to self-harming.J Psychiatr Ment Hlt,14,100-5.
  25. Sun, FK,Long, A,Boore, J(2006).Patients and nurses' perceptions of ward environmental factors and support systems in the care of suicidal patients.J Clin Nurs,15,83-92.
  26. Sun, FK,Long, A,Boore, J.(2007).The attitudes of casualty nurses in Taiwan to patients who have attempted suicide.J Clin Nurs,16,255-63.
  27. Tsai, WP,Lin, LY,Chang, HC(2010).The effects of the gatekeepers suicide-awareness program for nursing personnel: The Effects of the Gatekeeper Suicide-Awareness Program for Nursing Personnel.Perspect Psychiatr Care,47,117-25.
  28. Vivekananda, K.(2000).Integrating models for understanding self injury.Psychotherapy in Australia,7,18-25.
  29. Weight, EJ,Kendal, S.(2013).Staff attitudes towards inpatients with borderline personality disorder: Further education in the diagnosis of borderline personality disorder and better communicationwith service users is needed to change negative staff attitudes towards patients with the condition, argue Emma Jane Weight and Sarah Kendal.Mental Health Practice,17,34-8.
  30. Westwood, L,Baker, J.(2010).Attitudes and perceptions of mental health nurses towards borderline personality disorder clients in acute mental health settings: a review of literatures: Borderline personality disorder and acute mental health nurses.J Psychiatr Ment Hlt,17,657-62.
  31. Wilstrand, C,Lindgren, BM,Gilje, F(2007).Being burdened and balancing boundaries: a qualitative study of nurses' experiences caring for patients who self-harm.J Psychiatr Ment Hlt,14,72-8.
  32. Woollaston, K,Hixenbaugh, P.(2008).Destructive whirlwind: nurse' perceptions of patients diagnosed with borderline personality disorder.J Psychiatr Ment Hlt,15,703-9.
  33. Wu, CY,Lin, YY,Chang, MY(2014).Effectiveness of interactive discussion group in suicide risk assessment among general nurses in Taiwan: A randomized controlled trial.Nurse Educ Today,34,1388-94.
  34. Yang, CI.(2006).UK.,School of Nursing, University of Nottingham.