QPR Institute, Spokane, WA, USA.
University of Washington School of Medicine, Department of Psychiatry and Behavioral Health, Seattle, WA, USA.
Crisis. 2019 Sep;40(5):355-359. doi: 10.1027/0227-5910/a000555. Epub 2018 Oct 30.
Researchers are increasingly interested in how clinicians should screen for suicide ideation in care settings and the merits of doing so. A common finding is that screening does no harm, and may do good, insofar as once the subject of suicide is broached clinicians can conduct a suicide risk assessment to determine the course of safe care. To date, little has been published about just how clinicians should ask "the ask" about suicidal ideation. The aim of this article is to suggest that the difficulty clinicians seem to have in initiating a verbal probe for suicidal ideation has less to do with patient characteristics than it does with clinician anticipatory anxiety about learning that a patient is positive for suicidal ideation. Face-negotiation theory and politeness theory are offered as possible explanations for why a simple direct question is so difficult to ask. Future research directions are suggested and an absence of data from public health gatekeeper training is offered as argument for clinicians to be more direct in their probes for suicidal ideation.
研究人员越来越关注临床医生在护理环境中应如何筛查自杀意念，以及这样做的优点。一个常见的发现是，筛查没有坏处，而且可能有好处，因为一旦涉及自杀主题，临床医生就可以进行自杀风险评估，以确定安全护理的过程。迄今为止，关于临床医生应该如何询问自杀意念的问题，几乎没有发表任何内容。本文的目的是表明，临床医生似乎在启动关于自杀意念的口头探查方面遇到困难，与其说是与患者特征有关，不如说是与临床医生对了解患者对自杀意念呈阳性的预期焦虑有关。面子协商理论和礼貌理论被认为是为什么简单直接的问题如此难以提出的可能解释。本文提出了未来的研究方向，并指出公共卫生把关者培训中缺乏数据，这也说明临床医生在探查自杀意念时应该更直接。
