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肿瘤护理人员关于自杀的知识与误解。

Oncology nurses' knowledge and misconceptions about suicide.

作者信息

Valente S M, Saunders J M, Grant M

出版信息

Cancer Pract. 1994 May-Jun;2(3):209-16.

PMID:8055025
Abstract

Nurses' knowledge of suicide has been underinvestigated. This article summarizes a survey of oncology nurses' knowledge and misconceptions about suicide. Nurses' knowledge of risk factors, suicide potential, and management of a suicidal patient were examined after nurses read a vignette about a suicidal patient with cancer. Analysis included descriptive statistics and content analysis. Approximately 20% of nurses underestimated the patient's suicide risk. Nurses correctly identified an average of three of eight risk factors, but 61% misidentified worries and fears as suicide risk factors or indicators of suicide risk. More than 60% of nurses correctly identified saying goodbye, giving away a treasured object, being a widower, and wishing to be dead as risk factors. Few knew that race/ethnicity (3.23%), male gender (23.66%), and age (31.18%) were risk factors. Undiagnosed mental disorders also increase suicide risk. Physicians and nurses often fail to ask oncology patients about depression, and depressed patients often report only physical symptoms and minimize their depression or suicidal ideas. Before committing suicide, 8 of 10 suicidal people had asked for better management of their physical symptoms, but their suicide risk was not detected. After recognizing any indicator of suicide risk, a nurse should assess risk factors, detect clues, and estimate individual lethality. Few (15.12%) nurses asked about a suicide plan as a nursing assessment, and 37% of the nurses used consultation. Less than one-third of nurses recommended providing safety, protecting the patient, or taking suicide precautions. Such evidence indicates the need for education to enhance knowledge and skill building to improve the interviewing and care of suicidal patients.

摘要

护士对自杀的了解一直未得到充分研究。本文总结了一项针对肿瘤护理人员关于自杀的知识及误解的调查。在护士阅读了一篇关于一名癌症自杀患者的短文后,对他们关于自杀风险因素、自杀可能性以及自杀患者管理的知识进行了考察。分析包括描述性统计和内容分析。约20%的护士低估了患者的自杀风险。护士们平均能正确识别出八个风险因素中的三个,但61%的人将担忧和恐惧错误地识别为自杀风险因素或自杀风险指标。超过60%的护士正确识别出道别、赠送珍贵物品、丧偶以及希望死去是风险因素。很少有人知道种族/民族(3.23%)、男性(23.66%)和年龄(31.18%)是风险因素。未被诊断出的精神障碍也会增加自杀风险。医生和护士常常没有询问肿瘤患者是否患有抑郁症,而抑郁患者往往只报告身体症状,并尽量淡化他们的抑郁或自杀念头。在自杀前,十分之八的自杀者曾要求更好地控制他们的身体症状,但他们的自杀风险未被察觉。在识别出自杀风险的任何指标后,护士应评估风险因素、发现线索并估计个体致死性。很少有护士(15.12%)在护理评估时询问自杀计划,37%的护士会寻求会诊。不到三分之一的护士建议提供安全保障、保护患者或采取自杀预防措施。这些证据表明需要进行教育,以增强知识和技能培养,从而改善对自杀患者的问诊和护理。

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