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Larkin C, Kiefe CI, Morena AL, Rahmoun MB, Lazar P, Sefair AV, Boudreaux ED. Clinician Attitudes Toward Suicide Prevention Practices and Their Implementation: Findings From the System of Safety Study. Psychiatr Serv 2024; 75:534-542. [PMID: 38124552 DOI: 10.1176/appi.ps.20230082] [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] [Indexed: 12/23/2023]
Abstract
OBJECTIVE The authors aimed to assess clinicians' attitudes toward suicide-related practices and their implementation, across roles and settings, before implementation of the Zero Suicide model in a health care system. METHODS Clinicians (N=5,559) were invited to complete a survey assessing demographic characteristics; confidence and self-reported suicide-related practice; leadership buy-in; and attitudes toward suicide prevention, safety planning, and continuous quality improvement (CQI). RESULTS Of 1,224 respondents, most felt confident conducting suicide screening but less confident performing other suicide-related care. Provider role and care setting were significantly associated with confidence (p<0.001, Kruskal-Wallis H test) and practice (p<0.001, Kruskal-Wallis H test) of providing suicide prevention care, with behavioral health providers and providers in the emergency department (ED) reporting the highest confidence. Attitudes toward safety planning were more positive among women (p<0.001, t test) and behavioral health providers (p<0.001, F test) than among their counterparts or peers. Positive attitudes toward CQI were significantly associated with male sex (p=0.01), non-White race (p=0.03), younger age (p=0.02), fewer years working in health care (p<0.001), administrative role (p<0.001), working in the ED (p<0.001), outpatient settings (p<0.02), and medical provider role (p<0.001). CONCLUSIONS Behavioral health providers and those in the ED reported feeling prepared to deliver suicide-related care, with nurses feeling less confident and less supported. Initiatives to improve suicide-related care should account for clinical role and care setting during planning. CQI could help engage a broader range of clinicians in suicide-related care improvements.
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Affiliation(s)
- Celine Larkin
- Departments of Emergency Medicine (Larkin, Rahmoun, Sefair, Boudreaux), Psychiatry (Larkin, Boudreaux), and Population and Quantitative Health Sciences (Kiefe, Lazar), University of Massachusetts Chan Medical School, Worcester; Department of Psychology, University of Massachusetts Lowell, Lowell (Morena)
| | - Catarina I Kiefe
- Departments of Emergency Medicine (Larkin, Rahmoun, Sefair, Boudreaux), Psychiatry (Larkin, Boudreaux), and Population and Quantitative Health Sciences (Kiefe, Lazar), University of Massachusetts Chan Medical School, Worcester; Department of Psychology, University of Massachusetts Lowell, Lowell (Morena)
| | - Alexandra L Morena
- Departments of Emergency Medicine (Larkin, Rahmoun, Sefair, Boudreaux), Psychiatry (Larkin, Boudreaux), and Population and Quantitative Health Sciences (Kiefe, Lazar), University of Massachusetts Chan Medical School, Worcester; Department of Psychology, University of Massachusetts Lowell, Lowell (Morena)
| | - Mhd B Rahmoun
- Departments of Emergency Medicine (Larkin, Rahmoun, Sefair, Boudreaux), Psychiatry (Larkin, Boudreaux), and Population and Quantitative Health Sciences (Kiefe, Lazar), University of Massachusetts Chan Medical School, Worcester; Department of Psychology, University of Massachusetts Lowell, Lowell (Morena)
| | - Peter Lazar
- Departments of Emergency Medicine (Larkin, Rahmoun, Sefair, Boudreaux), Psychiatry (Larkin, Boudreaux), and Population and Quantitative Health Sciences (Kiefe, Lazar), University of Massachusetts Chan Medical School, Worcester; Department of Psychology, University of Massachusetts Lowell, Lowell (Morena)
| | - Ana Vallejo Sefair
- Departments of Emergency Medicine (Larkin, Rahmoun, Sefair, Boudreaux), Psychiatry (Larkin, Boudreaux), and Population and Quantitative Health Sciences (Kiefe, Lazar), University of Massachusetts Chan Medical School, Worcester; Department of Psychology, University of Massachusetts Lowell, Lowell (Morena)
| | - Edwin D Boudreaux
- Departments of Emergency Medicine (Larkin, Rahmoun, Sefair, Boudreaux), Psychiatry (Larkin, Boudreaux), and Population and Quantitative Health Sciences (Kiefe, Lazar), University of Massachusetts Chan Medical School, Worcester; Department of Psychology, University of Massachusetts Lowell, Lowell (Morena)
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Huang KC, Jeang SR, Hsieh HL, Chen JW, Yi CH, Chiang YC, Wu HP. Survey of knowledge, self-efficacy, and attitudes toward suicide prevention among nursing staff. BMC MEDICAL EDUCATION 2023; 23:692. [PMID: 37740184 PMCID: PMC10517497 DOI: 10.1186/s12909-023-04685-4] [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: 01/09/2023] [Accepted: 09/14/2023] [Indexed: 09/24/2023]
Abstract
OBJECTIVE This study aimed to explore the knowledge, self-efficacy, and attitudes toward suicide prevention among nurses with different demographic characteristics. METHODS A cross-sectional descriptive design was adopted, and the study was conducted between August and September 2020. The content of the questionnaire included basic demographics, knowledge, self-efficacy, and attitudes toward suicide prevention. Correlation analysis was performed to determine nurses' knowledge, self-efficacy, and attitudes toward suicide prevention. RESULTS The sample comprised 778 nursing staff from a medical center in southern Taiwan. The results showed that age, years of nursing experience, department type, education on suicide prevention, and care experience of nursing staff were associated with their knowledge, self-efficacy, and attitudes toward suicide prevention in general hospital patients. Younger and less experienced nurses demonstrated superior knowledge, self-efficacy, and attitudes toward suicide prevention. Nurses who received suicide-related education and training exhibited better self-efficacy and attitudes than those who did not. Nurses with care experience had better knowledge of suicide prevention than those without experience. Knowledge and self-efficacy in suicide prevention were both significantly and positively correlated with attitudes. CONCLUSION Younger, less experienced, psychiatric nurses demonstrated superior knowledge, self-efficacy, and attitudes toward suicide prevention. Therefore, education on suicide prevention should be strengthened for older, experienced, and non-psychiatric nurses.
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Affiliation(s)
- Kuan Chin Huang
- Department of Nursing, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Shiow-Rong Jeang
- Department of Nursing, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | | | - Jing-Wen Chen
- Department of Nursing, College of Medicine and Life Science, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Ching-Hsien Yi
- Extension School, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yung-Chih Chiang
- Department of Psychiatry, Kaohsiung Veterans General Hospital, No.386, Dazhong 1St Rd., Kaohsiung, 813414, Taiwan.
| | - Han-Ping Wu
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.
- Department of Pediatrics, Chiayi Chang-Gung Memorial Hospital, Chiayi County, No. 6, W. Sec. , Jiapu Rd., Puzi City, Taiwan.
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Sandford DM, Kirtley OJ, Thwaites R, Dagnan D, O'Connor RC. The Adaptation of a Measure of Confidence in Assessing, Formulating, and Managing Suicide Risk. CRISIS 2023; 44:70-77. [PMID: 34859684 DOI: 10.1027/0227-5910/a000830] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: To date little has been done to evaluate the effectiveness of suicide risk formulation training. Aims: We aimed to investigate the psychometric properties of a new scale measuring clinicians' confidence in assessing, formulating, and managing suicide risk. Method: A total of 128 mental health practitioners from an UK National Health Service Trust completed the scale. Of them, 85 from an Improving Access to Psychological Therapies service did so before and after training in Risk Assessment, Formulation, and Management (RAFM); 28 practitioners from the Older Adults service also completed the measure. For test-retest analysis, a further 15 completed the scale again 1 week after baseline without attending any training. Of the training group, 52 (61%) completed the measure at the 6-month follow-up. Results: Analysis indicated a single-factor structure, good test-retest reliability, and statistically significant increases in confidence between pre- and posttraining and between pretraining and 6 month follow-up. Cohen's effect size values suggest a moderate-to-large effect. Limitations: The relatively small sample sizes indicate that this study should be considered a preliminary investigation of a new measure, which warrants further replication. Conclusion: This measure could be useful in gauging practitioners' confidence in the RAFM approach and in evaluating and developing training.
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Affiliation(s)
- David M Sandford
- School of Community Health and Midwifery, University of Central Lancashire, Preston, UK.,Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, UK
| | | | - Richard Thwaites
- First Step, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Penrith, UK
| | - Dave Dagnan
- First Step, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Penrith, UK
| | - Rory C O'Connor
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, UK
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Outcomes of community-based suicide prevention program in primary health care of Iran. Int J Ment Health Syst 2021; 15:67. [PMID: 34348779 PMCID: PMC8336287 DOI: 10.1186/s13033-021-00492-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/27/2021] [Indexed: 01/20/2023] Open
Abstract
Background Suicidal management and prevention in communities, especially in its first stages, is an effective intervention for the health systems. However, in numerous societies most cases go undetected. Primary Health Care (PHC) is an effective place for the management of Suicide Prevention Programs (SPP). In Malekan County, a health community assessment found suicide as the most important health problem. A regional SPP was performed for suicide prevention during 2014–2017. Methods This study was carried out in six steps: (1) Establishing a research team, (2) Improving a registry for suicidal behaviors (SBs), (3) Identifying local determinants of SBs, (4) Training healthcare providers, (5) Follow-up and monitoring of SBs, and (6) Public awareness campaigns. Our ultimate goal was to lower the rates of suicide, and suicide attempt (SA) by 15 and 20 %, respectively. Multiple logistic regression was used to estimate the adjusted odds ratios and the 95% confidence intervals. Results A total of 821 SAs and 32 suicides were identified. The gender distribution for suicides was 70% males whereas SAs were 64% among females. The majority of suicides occurred in spring 18 (56.25%) while summer was the most common season among SAs 288 (35.8%). Almost 62 and 75% of suicides and SAs have used hanging and poisoning methods, respectively. Hanging increased suicide risk significantly (OR: 8.5, 95% CI 2.9–76.99). During the study, 93 life-skill and parenting education sessions were held. The incidence rates of suicide and SA decreased from 11.22, and 203 per 100,000 in 2013 to 2.63, and 157 in 2017, respectively. Similarly, the re-attempt to SAs ratio decreased from 12% to 2013 to 6.7% in 2017. Moreover, more than 8% of SBs were collected from adjacent Counties. Conclusions At the study end, suicide, SA, and re-attempt were lowered by 75%, 22%, and 42%, respectively. The practical framework that achieved in this study could be used as a basis for developing future SPPs and suicide researches in the Iranian context. Furthermore, the various socio-economic and socio-cultural challenges highlight the need to consider a wide range of contextual factors when developing an SPP.
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López-Narváez ML, Escobar-Chan YM, Sánchez de la Cruz JP, Tovilla-Zárate CA, Juárez-Rojop IE, Fresan A, González-Castro TB, Montanee-Sandoval AC, Suarez-Méndez S. Differences in attitude toward prevention of suicide between nursing and medicine students: A study in Mexican population. Arch Psychiatr Nurs 2020; 34:159-163. [PMID: 32513466 DOI: 10.1016/j.apnu.2020.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 04/09/2020] [Indexed: 12/13/2022]
Abstract
The aim of the present study was to evaluate the attitude toward suicide prevention in medicine and nursing students attending University in south Mexico, considering their family and personal history of suicide. Demographic features and self-reported personal and family history of suicide were evaluated in 355 Mexican students at the Health Sciences School. Their views toward suicide prevention was assessed using the Attitude Toward Suicide Prevention scale. Comparisons between medicine and nursing students were performed, as well as between had or had-not previous personal or family history of suicide. Our results support that nursing students showed the most negative attitude toward suicide prevention. Therefore, training programs and strategies encouraging a better attitude in suicide prevention are necessary to be implemented. It is also necessary to consider cultural, ethnic and family backgrounds of the students/of the population when developing new strategies.
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Affiliation(s)
- María Lilia López-Narváez
- Hospital General de Yajalón "Dr. Manuel Velazco Siles", Secretaría de Salud, Yajalón, Chiapas, Mexico
| | - Yudy Merady Escobar-Chan
- Universidad Juárez Autónoma de Tabasco, División Académica Multidisciplinaria de Comalcalco, Comalcalco, Tabasco, Mexico
| | - Juan Pablo Sánchez de la Cruz
- Universidad Juárez Autónoma de Tabasco, División Académica Multidisciplinaria de Comalcalco, Comalcalco, Tabasco, Mexico
| | - Carlos Alfonso Tovilla-Zárate
- Universidad Juárez Autónoma de Tabasco, División Académica Multidisciplinaria de Comalcalco, Comalcalco, Tabasco, Mexico.
| | - Isela Esther Juárez-Rojop
- Universidad Juárez Autónoma de Tabasco, División Académica de Ciencias de la Salud, Villahermosa, Tabasco, Mexico
| | - Ana Fresan
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Ciudad de México, Mexico
| | - Thelma Beatriz González-Castro
- Universidad Juárez Autónoma de Tabasco, División Académica Multidisciplinaria de Jalpa de Méndez, Jalpa de Méndez, Tabasco, Mexico.
| | | | - Samuel Suarez-Méndez
- Universidad Juárez Autónoma de Tabasco, División Académica de Ciencias de la Salud, Villahermosa, Tabasco, Mexico
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