Suchergebnisse

Abstract. Despite having a suicide rate that is consistently higher than the national Canadian average, our understanding of suicide within First-Nation Canadians is limited. Furthermore, our historical research endeavors in this area have tended to focus on clarifying characteristic symptoms, symptom clusters, and risk factors; establishing causal links; and identifying clinical phenomena associated with the presence of increased risk and have tended to use quantitative methods. The "voice" of the suicidal First-Nation person is largely "silent" within this literature and, as a result, any understanding we have of this issue is unbalanced and incomplete. Accordingly, this paper makes the case for adding a complementary (or shifting the existing) research emphasis for studying suicide within First-Nation Canadian communities. It suggests a complimentary strategic research activity that is more concerned with qualitative methods: A model that augments the current understanding of the "developmental-existential" model of suicide by accessing and articulating the "voices" of the First-Nation people themselves.

Background: The introduction of antiviral agents, most particularly 'highly active antiretroviral therapy' (HAART), has changed the very nature of the care for persons with HIV and/or AIDS, from preparing patients to die to assisting patients with living with a chronic illness. Despite this dramatic turnaround in prognosis, the limited literature available indicates that these individuals often do not have a high degree of hope for the future. Accordingly, this study seeks to explain how hope might be inspired and maintained in people living long‐term with HIV/AIDS (the so‐called 'Lazarus Syndrome'). Design: The study used a modified Glaserian grounded theory method and was conducted in the United States of America. A total of 10 participants were selected by means of theoretical sampling. Methods: The study adhered to the principal features of Glaserian Grounded Theory, namely: (a) theory generation, not theory verification; (b) theoretical sampling; (c) the constant comparative method of data analysis; and (d) theoretical sensitivity (searching for/discovering the core variable, one which identifies the key psychosocial process and contains temporal dimensions or stages). Further, the authors ensured that the study was concerned with generating conceptual theory, not conceptual description. Findings/conclusion: The findings indicate that the key psychosocial problem (i.e. the maintenance of hope) is addressed through the core variable, 'Turning from death to life: finding new meaning'. This parsimonious theory describes and explains a four‐stage process of hope maintenance consisting of the subcore variables: 'Losing the Ontological Self', 'Turning from Death to Life', 'Finding Acceptance and Reconciliation', and 'Finding New Meaning'.

pt. 1. Education, training and approaches to clinical supervision -- pt. 2. Introducing, implementing and developing clinical supervision -- pt. 3. The practice and experience of clinical supervision -- pt. 4. Contemporary research activity on clinical supervision -- pt. 5. International perspectives and developments in the state of the science of clinical supervision

A modified grounded-theory (qualitative) study was undertaken in an attempt to discover the psychosocial processes involved when psychiatric/mental health nurses provide care to suicidal people, and in so doing, to induce the first comprehensive theory of psychiatric nursing care of the suicidal person. The findings highlight that the key psychosocial process (or core variable of the theory) is "reconnecting the person with humanity" and that this has three stages: reflecting an image of humanity, guiding the individual back to humanity, and learning to live.

Background: Participants' safety is the primary concern when conducting research with suicidal or potentially suicidal participants. The presence of suicide risk is often an exclusion criterion for research participants. Subsequently, few studies have examined the effects of research assessments on study participants' suicidality. Aims: The purpose of this research was to examine the patterns of postassessment changes in self-harm and suicide urges of study participants who were recently discharged from an inpatient psychiatric service. Method: Study participants (N = 120) were recruited from patients with a lifetime history of suicidal behavior admitted with current suicidal ideation or suicide attempt to an inpatient psychiatric service and/or a crisis stabilization unit. Participants were assessed for suicidal ideation with the Suicide Ideation Scale at 1, 3, and 6 months following their discharge from hospital. The risk assessment protocol was administered at the start and at the end of each of the study follow-up assessments. Results: Changes in self-harm and suicide urges following study assessments were small, infrequent, and were most likely to reflect a decrease in suicidality. Similarly, participants rarely reported worsening self-control over suicidal urges, and when they did, the effect was minimal. By the end of the 6-month follow-up period, increases in self-harm and suicidal urges postassessment were not seen. Conclusion: The inclusion of suicidal participants in research interviews rarely increased suicide risk. Research involving suicidal individuals is possible when study protocols are well planned and executed by trained assessors and clinicians who are able to identify participants at risk and provide intervention if necessary. The few participants that required intervention had high levels of suicide ideation and behavior at baseline and almost all reported symptoms of posttraumatic stress disorder. Further study is needed to better characterize this subgroup of participants.

Background: Evidence indicates that people whose mental health problems lead them to require psychiatric hospitalization are at a significantly increased risk of suicide, and that the time immediately following discharge after such hospitalizations is a particularly high-risk time. Aims: This paper reports on phenomenological findings from a federally funded, mixed-methods study that sought to better understand the observed increased risk for suicide following discharge from an inpatient psychiatric service. Methods: A purposive sample of 20 recently discharged former suicidal inpatients was obtained. Data were collected in hermeneutic interviews lasting between 1 h and 2 h and analyzed according to van Manen's (1997 ) interpretation of hermeneutic phenomenology. Results: Two key themes, "existential angst at the prospect of discharge" and "trying to survive while living under the proverbial 'sword of Damocles'" were induced. Each of these was comprised of five themes with the first key theme (which is the focus of this paper) encompassing the following: "Feeling scared, anxious, fearful and/or stressed," "Preparedness," "Leaving the place of safety," "Duality and ambivalence," and "Feel like a burden." Conclusions: Early exploration of and reconciling of patients' expectations regarding inpatient care for their suicidality would be empirically based interventions that could diminish the postdischarge risk for further suicide attempts.