RESUMEN
BACKGROUND: The care of the emergency department (ED) for a person after a suicide attempt can act as a protector against future suicidal behavior. For this reason, it is essential that the ED ensure an assistance that involves effective interventions in preventing suicidal behaviors. Among suicidal behaviors, it is known that suicide attempt is one of the most lethal risk factors for consummated suicide. In addition, the risk for further attempts is greater in the period from the immediate post-discharge up to 12 months after the last attempt. This makes the ED a key link in the suicide prevention chain. The purpose of this review is to investigate the effects of psychosocial interventions on suicide prevention, when applied in the ED after a suicide attempt. METHODS: This systematic review protocol was built and registered with the collaboration of a multidisciplinary scientific team. The review will include randomized clinical studies, quasi-experimental trials, and comparative observational studies, all conducted with people (11 years old or more) who have received a psychosocial suicide prevention intervention initiated in the ED after a suicide attempt. The research will be conducted across databases such as Cochrane Library, PubMed, EMBASE, PsycINFO, and DARE. The repetition of a suicide attempt and death by suicide as primary outcomes will be analyzed. The eligibility of the studies and data extraction will be carried out by matched and blind researchers. The risk of bias will be addressed using appropriate instruments. The analyses and synthesis of the results will be both qualitative and quantitative. DISCUSSION: From a public health point of view, suicide is in itself a public health problem and requires appropriate interventions at different levels of care in order to be prevented. Taking into account that a high percentage of people who died by suicide sought the ED for suicide attempt in the year before their death, the ED is a clinical context with a privileged potential to implement these interventions. Presently, several clinical studies seek to validate interventions to be adopted regarding the prevention of suicidal behavior. Current evidence indicates that different interventions must be strategically combined to reduce suicide attempts and their mortality. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number CRD42019131040.
Asunto(s)
Cuidados Posteriores , Intento de Suicidio , Niño , Servicio de Urgencia en Hospital , Humanos , Alta del Paciente , Intervención Psicosocial , Ideación Suicida , Revisiones Sistemáticas como AsuntoRESUMEN
In a help relation with a suicidal person, the theoretical models of suicidality can be essential to guide the health professional's comprehension of the client/patient. The objectives of this study were to identify health professionals' explanations of suicidal behaviors and to study the effects of professional group, theoretical intervention models, and patient suicide experience in professionals' representations. Two hundred and forty-two health professionals filled out a self-report questionnaire. Exploratory principal components analysis was used. Five explanatory models were identified: psychological suffering, affective cognitive, sociocommunicational, adverse life events, and psychopathological. Results indicated that the psychological suffering and psychopathological models were the most valued by the professionals, while the sociocommunicational was seen as the least likely to explain suicidal behavior. Differences between professional groups were found. We concluded that training and reflection on theoretical models in general and in communicative issues in particular are needed in the education of health professionals.
Asunto(s)
Actitud del Personal de Salud , Modelos Psicológicos , Suicidio/psicología , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Portugal , Encuestas y Cuestionarios , Adulto JovenRESUMEN
BACKGROUND: Although intervention with suicidal patients is one of the hardest tasks in clinical practice, little is known about health professionals' perceptions about the difficulties of working with suicidal patients. AIMS: The aims of this study were to: (1) describe the difficulties of professionals facing a suicidal patient; (2) analyze the differences in difficulties according to the sociodemographic and professional characteristics of the health professionals; and (3) identify the health professionals' perceived skills and thoughts on the need for training in suicide. METHOD: A self-report questionnaire developed for this purpose was filled out by 196 health professionals. Exploratory principal components analyses were used. RESULTS: Four factors were found: technical difficulties; emotional difficulties; relational and communicational difficulties; and family-approaching and logistic difficulties. Differences were found between professionals who had or did not have training in suicide, between professional groups, and between the number of patient suicide attempts. Sixty percent of the participants reported a personal need for training and 85% thought it was fundamental to implement training plans targeted at health professionals. CONCLUSION: Specific training is fundamental. Experiential and active methodologies should be used and technical, relational, and emotional questions must be included in the training syllabus.
Asunto(s)
Actitud del Personal de Salud , Competencia Clínica , Médicos Generales , Psiquiatría , Psicología , Intento de Suicidio , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Necesidades , Encuestas y Cuestionarios , Adulto JovenRESUMEN
The experience of the most distressing patient suicide on Flemish psychiatrists is described. Of 584 psychiatrists, 107 filled a self-report questionnaire. Ninety-eight psychiatrists had been confronted with at least one patient suicide. Emotional suffering and impotence were the most common feelings reported. Changes in professional practice were described and included a more structured approach to the management of suicidal patients. Colleagues and contact with the patient's family were the most frequently used sources of help, whereas team case review and colleagues were rated as the most useful ones. Patient suicide leads to emotional suffering and has a considerable professional impact.