Ingram School of Nursing, McGill University, Montreal, Quebec, Canada.
Quebec Network on Suicide, Mood Disorders and Related Disorders, Douglas Mental Health University Institute, Verdun, Quebec, Canada.
PLoS One. 2021 Apr 22;16(4):e0249048. doi: 10.1371/journal.pone.0249048. eCollection 2021.
Suicide occurs in people of all ages and backgrounds, which negatively affects families, communities, and the health care providers (HCPs) who care for them. The objective of this study was to better understand HCPs' perspectives of everyday ethical issues related to caring for suicidal patients, and their perceived needs for training and/or support to address these issues. We conducted a mixed methods survey among HCPs working in mental health in Québec, Canada. Survey questions addressed their perspectives and experiences of everyday ethical challenges they encounter in their practice with people who are suicidal, and their perceived needs for training and/or support therein. 477 HCPs completed the survey. Most participants mentioned encountering ethical issues when caring for people who are suicidal. The challenges HCPs encounter in their practice with people who are suicidal are numerous, including issues related to maintaining privacy, confidentiality, freedom and the therapeutic relationship. The lack of time, resources and professional support to address these issues was emphasized. Most HCPs reported that the training or education they have received does not allow them to address everyday ethical issues related to suicide care. In sum, there is a clear reported need for better training and support for HCPs who are offering care to people who are suicidal in relation to everyday ethical issues they encounter. Implications for practice include providing greater access to training, including access to specialists in ethics to address specific issues. This additional support could alleviate morally distressing situations for HCPs.
自杀发生在各个年龄段和背景的人群中，对家庭、社区和照顾他们的医疗保健提供者（HCPs）都有负面影响。本研究的目的是更好地了解 HCPs 对与照顾自杀患者相关的日常伦理问题的看法，以及他们对培训和/或支持的需求，以解决这些问题。我们在加拿大魁北克的心理健康领域的 HCPs 中进行了一项混合方法调查。调查问题涉及他们在实践中遇到的与自杀者相关的日常伦理挑战的观点和经验，以及他们在其中的培训和/或支持需求。477 名 HCPs 完成了调查。大多数参与者提到在照顾自杀者时遇到了伦理问题。HCPs 在与自杀者的实践中遇到的挑战很多，包括与维护隐私、保密、自由和治疗关系相关的问题。强调缺乏时间、资源和专业支持来解决这些问题。大多数 HCPs 报告说，他们所接受的培训或教育使他们无法解决与自杀护理相关的日常伦理问题。总之，有明确的报告表明，需要为提供自杀护理的 HCPs 提供更好的培训和支持，以解决他们在日常伦理问题方面遇到的问题。对实践的影响包括提供更多的培训机会，包括获得伦理专家的支持来解决特定问题。这种额外的支持可以减轻 HCPs 面临的道德困境。
