Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Baruch Ivcher School of Psychology, Interdisciplinary Center, Herzliya, Israel.
Psychooncology. 2018 Jan;27(1):148-154. doi: 10.1002/pon.4481. Epub 2017 Jul 13.
To identify oncologists', nurses', and social workers' strategies and barriers in identifying suicide risk in cancer patients.
Sixty-one oncology healthcare professionals (HCPs) at 2 cancer centers were interviewed. We used the grounded theory method (GT) of data collection and analysis. Analysis involved line-by-line coding, and was inductive, with codes and categories emerging from participants' narratives.
The majority of oncologists and nurses reported that they had encountered at least 1 patient who had committed suicide during their careers (56% and 55%, respectively) and/or had suicidal ideation (65% and 75%, respectively). Social workers reported having fewer suicides in their practices (22%), but similar rates of suicidal ideation among patients (66%). Strategies to identifying suicide risk included paying attention to patients' verbal indicators, explicit actions, and mental health distress. In addition HCPs reported that mental health disorders and other patient characteristics increased their likelihood to assess suicidality among patients. Reported barriers to identification included patient factors such as patients giving no warning, patients concealing suicidality, and patients failing to come in. HCP barriers to identification included lack of training and awareness, difficulty in differentiating suicidality from mental health distress, lack of time with patients, fear of asking about suicidality, and lack of coping resources to deal with suicidal patients.
HCPs reports of their lack of training and awareness on identifying suicide risk is alarming given the higher risk of suicide among cancer patients. Training programs should incorporate the successful strategies used by HCPs and overcome barriers to identifying suicide risk.
确定肿瘤学家、护士和社会工作者在识别癌症患者自杀风险方面的策略和障碍。
对 2 家癌症中心的 61 名肿瘤医疗保健专业人员（HCP）进行了访谈。我们使用了数据收集和分析的扎根理论方法（GT）。分析涉及逐行编码，并且是归纳式的，从参与者的叙述中出现了代码和类别。
大多数肿瘤学家和护士报告说，他们在职业生涯中至少遇到过 1 例自杀患者（分别为 56%和 55%）和/或有自杀意念（分别为 65%和 75%）。社会工作者报告说，他们的实践中自杀人数较少（22%），但患者的自杀意念率相似（66%）。识别自杀风险的策略包括关注患者的言语指标、明确的行为和心理健康困扰。此外，HCP 还报告说，心理健康障碍和其他患者特征增加了他们评估患者自杀倾向的可能性。报告的识别障碍包括患者因素，如患者没有警告、患者隐瞒自杀倾向以及患者未能就诊。HCP 识别障碍包括缺乏培训和意识、难以将自杀倾向与心理健康困扰区分开来、与患者相处的时间不足、害怕询问自杀倾向以及缺乏应对自杀患者的应对资源。
鉴于癌症患者自杀风险较高，HCP 报告他们在识别自杀风险方面缺乏培训和意识令人震惊。培训计划应纳入 HCP 使用的成功策略，并克服识别自杀风险的障碍。
