Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden.
Centre of Interprofessional Collaboration within Emergency care (CICE), Linnaeus University, Växjö, Sweden.
Nurs Ethics. 2023 Sep;30(6):857-870. doi: 10.1177/09697330221149102. Epub 2023 Apr 7.
Even though the traditional focus in emergency care is on life-threatening medical crisis, ambulance clinicians frequently encounter patients with mental illness, including suicidal ideation. A suicide is preceded by a complex process where most of the suicidal ideation is invisible to others. However, as most patients seek healthcare in the year before suicide, ambulance clinicians could have an important part to play in preventing suicide, as they encounter patients in different phases of the suicidal process.
The aim of this study was to describe ambulance clinicians' conceptions of responsibility when encountering patients in a suicidal process.
A qualitative inductive design using a phenomenographic approach was used.
Twenty-seven ambulance clinicians from two regions in southern Sweden were interviewed.
The study was approved by the Swedish Ethical Review Authority.
Three categories of descriptions captured a movement from responding to a biological being to responding to a social being. Conventional responsibility was perceived as a primary responsibility for emergency care. In conditional responsibility, the patient's mental illness was given only limited importance and only if certain conditions were met. Ethical responsibility was perceived to have its primary focus on the encounter with the patient and listening to the patient's life story.
An ethical responsibility is favourable regarding suicide prevention in ambulance care, and competence development in mental illness and conversation skills could enable ambulance clinicians to have conversations with patients about suicidal ideation.
尽管传统的急救护理重点是危及生命的医疗危机，但救护车临床医生经常遇到患有精神疾病的患者，包括自杀意念。自杀之前是一个复杂的过程，大多数自杀意念对他人是不可见的。然而，由于大多数患者在自杀前一年都会寻求医疗保健，因此救护车临床医生在预防自杀方面可以发挥重要作用，因为他们会在自杀过程的不同阶段遇到患者。
本研究旨在描述救护车临床医生在遇到处于自杀过程中的患者时的责任观念。
采用现象学方法的定性归纳设计。
来自瑞典南部两个地区的 27 名救护车临床医生接受了采访。
该研究得到了瑞典伦理审查局的批准。
三个描述类别捕捉到了从对生物个体的反应到对社会个体的反应的转变。常规责任被视为紧急护理的主要责任。在有条件的责任中，患者的精神疾病只被赋予有限的重要性，并且只有在满足某些条件的情况下才会被赋予有限的重要性。道德责任被认为主要侧重于与患者的相遇和倾听患者的生活故事。
在救护车护理中，道德责任有利于预防自杀，并且在精神疾病和对话技巧方面的能力发展可以使救护车临床医生与有自杀意念的患者进行对话。
