Engagement between adults in suicidal crises and nurses in mental health wards: a qualitative study of patients' perspectives

Experiences of general home visiting nurses regarding patients with suicidal ideation in Japan: Results from semi-structured interviews

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.

Lifesaving turning points: First-person accounts of recovery after suicide attempt(s)

This study explores the recovery processes of persons who had attempted suicide. Semi-structured interviews were conducted with eight persons who had attempted suicide and the data were analyzed by means of systematic text condensation. The participants described lifesaving turning points, which were connected to meaningful relationships, taking control over one's own life, and establishing a new everyday life. Suicide prevention efforts must be adapted to individual needs. First-person knowledge is important if we are to understand what is seen as helpful and should be emphasized when implementing suicide prevention work.

Nursing handover involving consumers on inpatient mental healthcare units: A qualitative exploration of the consumers' perspective

Handovers between nurses are a significant cause of communication problems and possible consumer safety issues. A potential solution for both problems is the nursing handover involving consumers, in which the consumer is present at the time of handover. This practice invites consumers to be more involved in their care process and supports a recovery-oriented practice. Research into nursing handovers involving consumers on inpatient mental health units is however very limited. A qualitative, phenomenological study was conducted. Semi-structured interviews with 13 consumers staying on an inpatient mental health unit of a general hospital were used. The interviews were transcribed verbatim and thematically analysed. Data saturation was reached after 11 interviews when no new themes or codes emerged from the data. Three themes were generated from the interviews: (i) the first moments on the inpatient mental health unit; (ii) the nurse as an ally; and (iii) informing each other. The COREQ-checklist was used. According to consumers, nursing handover involving consumers initiated a change in the relationship between consumers and nurses. Consumers and nurses got to know each other better during handover and built a relationship of trust. The introduction of nursing handover involving consumers created an accessible opportunity for consumers to exchange information with nurses and ask questions concerning their admission. Consumers felt jointly responsible for the continuity of the information about their healthcare process. Due to the use of nursing handover involving consumers, consumers experienced the opportunity to take more control in their health process and ensured that information is correct and complete.