Jansson Leila, Graneheim Ulla Hällgren
a Department of Nursing , Umeå University , Umeå , Sweden.
b Department of Health Sciences , University West , Trollhättan , Sweden.
Issues Ment Health Nurs. 2018 Jul;39(7):554-560. doi: 10.1080/01612840.2018.1431823. Epub 2018 Mar 13.
This study describes nurses' experiences of assessing suicide risk in specialised mental health outpatient care in rural areas in Sweden. We used a qualitative, descriptive design based on twelve interviews that were subjected to qualitative content analysis. The results showed that the nurses felt anguish due to a lack of control. They expressed uncertainty and loneliness, and they struggled with ethical issues and organisational challenges. Having the sole responsibility to assess suicide risk can increase a person's emotional vulnerability and moral stress. Consequently, in order to prevent ill health among these nurses, there is a need for a tolerant work climate and an organisation that provides support to its employees. Assessing suicide risk is a demanding task within mental health outpatient care. Further, nurses operating in rural areas have to initiate and conduct assessments on their own, and they are, together with the physician in charge, also held individually responsible for their assessments. Consequently, it is important to describe nurses' experiences of how they deal with questions concerning suicide risk. Their experiences can foster awareness of the responsibility and the ethical standpoints related to assessing suicide risk, can help outline the need for further education and supervision, and can improve support from co-workers and management.
本研究描述了瑞典农村地区专业精神卫生门诊护理中护士评估自杀风险的经历。我们采用了基于12次访谈的定性描述性设计，并对访谈内容进行了定性内容分析。结果表明，护士们因缺乏控制权而感到痛苦。他们表现出不确定性和孤独感，并且在伦理问题和组织挑战方面苦苦挣扎。独自承担评估自杀风险的责任会增加一个人的情绪脆弱性和道德压力。因此，为了预防这些护士的健康问题，需要一个宽容的工作氛围和一个为员工提供支持的组织。在精神卫生门诊护理中，评估自杀风险是一项艰巨的任务。此外，在农村地区工作的护士必须自行发起并进行评估，并且他们与主管医生一起，还要对自己的评估单独负责。因此，描述护士们如何处理与自杀风险相关问题的经历非常重要。他们的经历可以增强对评估自杀风险的责任和伦理立场的认识，有助于明确进一步教育和监督的必要性，并可以改善同事和管理层的支持。
