Kiakos Dimitrios, Bourquin-Sachse Céline, Richard-Devantoy Stéphane, Stiefel Friedrich, Michaud Laurent
General Psychiatry Service, Lausanne University Hospital (CHUV), 18, Place Chauderon, Lausanne, 1003, Switzerland.
Liaison Psychiatry Service, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
Ann Gen Psychiatry. 2025 Oct 24;24(1):65. doi: 10.1186/s12991-025-00602-9.
The physician-patient relationship is essential in the care of suicidal patients, yet factors shaping this relationship remain insufficiently explored. This study aimed to explore physicians' emotional reactions to suicidal patients and how both physician- and patient-related issues influence these responses.
Interviews were conducted with six physicians from the Douglas Mental Health University Institute in Montreal. A thematic analysis was performed using Hayes' structural model of countertransference as the analytical framework.
Three primary emotional reactions emerged: emotional connection/avoidance, confidence/doubts, and powerlessness attributed to own limitations/to the patient. Clinicians' core needs-the need to help, need for security, and need for efficacy-were found to be pivotal in shaping these emotional responses. Similarly, patient-related factors, notably life experiences, disease, suicidality, and attitudes significantly influenced these reactions. Patterns linking physicians' emotional responses to their underlying needs and patient-related factors were analyzed, leading to the development of a conceptual framework.
This framework offers implications for research, clinical supervision, and medical training, fostering deeper insight into the physician-patient relationship in the context of suicidality.
医患关系在自杀患者的护理中至关重要，但塑造这种关系的因素仍未得到充分探索。本研究旨在探讨医生对自杀患者的情绪反应，以及医生和患者相关问题如何影响这些反应。
对蒙特利尔道格拉斯心理健康大学研究所的六位医生进行了访谈。采用海斯的反移情结构模型作为分析框架进行主题分析。
出现了三种主要的情绪反应：情感连接/回避、自信/怀疑，以及因自身局限/患者导致的无力感。临床医生的核心需求——帮助他人的需求、安全感需求和效能感需求——被发现是塑造这些情绪反应的关键因素。同样，患者相关因素，尤其是生活经历、疾病、自杀倾向和态度，对这些反应有显著影响。分析了将医生的情绪反应与其潜在需求和患者相关因素联系起来的模式，从而形成了一个概念框架。
该框架为研究、临床监督和医学培训提供了启示，有助于在自杀背景下更深入地理解医患关系。
