Lachal Jonathan, Orri Massimiliano, Sibeoni Jordan, Moro Marie Rose, Revah-Levy Anne
AP-HP, Hôpital Cochin, Maison de Solenn, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France; INSERM, U1178, Paris, France.
INSERM, U1178, Paris, France; Université Paris Sud-Paris 11, Paris, France.
PLoS One. 2015 May 22;10(5):e0127359. doi: 10.1371/journal.pone.0127359. eCollection 2015.
Youth suicide is a major public health issue throughout the world. Numerous theoretical models have been proposed to improve our understanding of suicidal behaviours, but medical science has struggled to integrate all the complex aspects of this question. The aim of this review is to synthesise the views of suicidal adolescents and young adults, their parents, and their healthcare professionals on the topics of suicidal behaviour and management of those who have attempted suicide, in order to propose new pathways of care, closer to the issues and expectations of each group.
This systematic review of qualitative studies--Medline, PsycInfo, Embase, CINAHL, and SSCI from 1990 to 2014--concerning suicide attempts by young people used thematic synthesis to develop categories inductively from the themes identified in the studies. The synthesis included 44 studies from 16 countries: 31 interviewed the youth, 7 their parents, and 6 the healthcare professionals. The results are organised around three superordinate themes: the individual experience, that is, the individual burden and suffering related to suicide attempts in all three groups; the relational experience, which describes the importance of relationships with others at all stages of the process of suicidal behaviour; and the social and cultural experience, or how the group and society accept or reject young people in distress and their families and how that affects the suicidal process and its management.
The violence of the message of a suicidal act and the fears associated with death lead to incomprehension and interfere with the capacity for empathy of both family members and professionals. The issue in treatment is to be able to witness this violence so that the patient feels understood and heard, and thus to limit recurrences.
青少年自杀是全球主要的公共卫生问题。人们已经提出了许多理论模型来增进我们对自杀行为的理解，但医学在整合这个问题的所有复杂方面时遇到了困难。本综述的目的是综合自杀青少年及青年、他们的父母以及他们的医护人员对自杀行为和自杀未遂者管理等话题的看法，以便提出更贴近每个群体的问题和期望的新护理途径。
这项对定性研究的系统综述——检索了1990年至2014年期间的Medline、PsycInfo、Embase、CINAHL和SSCI——涉及年轻人自杀未遂，采用主题综合法从研究中确定的主题归纳出类别。该综合分析纳入了来自16个国家的44项研究：31项访谈了青少年，7项访谈了他们的父母，6项访谈了医护人员。结果围绕三个上位主题展开：个人经历，即所有三个群体中与自杀未遂相关的个人负担和痛苦；关系经历，描述了在自杀行为过程的各个阶段与他人关系的重要性；社会文化经历，即群体和社会如何接纳或排斥处于困境的年轻人及其家庭，以及这如何影响自杀过程及其管理。
自杀行为所传达信息的强烈程度以及与死亡相关的恐惧导致了误解，并干扰了家庭成员和专业人员的共情能力。治疗中的问题是能够见证这种强烈程度，以便患者感到被理解和倾听，从而减少复发。
