A b s t r a c t Objective: To describe the construction of the Suicide Behavior Attitude Questionnaire (SBAQ) which measures attitudes of nursing personnel towards suicide, and verify attitude differences among these professionals. Methods: The Suicide Behavior Attitude Questionnaire comprises 21 visual analogue scale items (beliefs, feelings and reactions on suicidal patients) selected from a pool of attitude statements generated by focal groups and experts' judgement. The questionnaire was completed by 317 nursing professionals who worked in a teaching hospital. Factor analysis and internal consistency were calculated. Results: Three interpretable factors were extracted, accounting jointly for 40% of the total variance: Feelings when caring for the patient, Professional Capacity and Right to Suicide, comprising 7, 4 and 5 items, respectively. The Cronbach's alpha coefficients were 0.7, 0.6 and 0.5, respectively. Greater Professional Capacity was reported by nursing assistants and those who had already took care of suicidal patients. The belief that a person does not have the right to commit suicide was stronger among older professionals, those who had never taken care of suicidal patients, those who had a family history of suicide, those who were Protestants and that used to go more frequently to church services. Conclusions: The Suicide Behavior Attitude Questionnaire proved to be user-friendly and quite a simple instrument to assess attitude towards suicide among nursing personnel.Keywords: Suicide; Attitudes; Health personnel; Nurse-patient relations; Questionnaires Resumo Objetivo: Descrever a construção do Questionário sobre a Atitude Frente ao Comportamento Suicida (QACS), que mede as atitudes do pessoal de enfermagem em relação aos suicidas e verifica as diferenças de atitude entre esses profissionais. Métodos: O Questionário sobre a Atitude Frente ao Comportamento Suicida compreende uma escala de 21 itens visuais análogos (crenças, sentimentos e reações em relação a pacientes suicidas) selecionados a partir de uma série de frases sobre as atitudes geradas a partir de grupos focalizados e o julgamento de especialistas. O questionário foi completado por 317 profissionais de enfermagem que trabalhavam em um hospital escola. Foram calculadas a análise fatorial e a consistência interna. Resultados: Foram extraídos três fatores interpretáveis, responsáveis em conjunto por 40% da variância total: Sentimentos ao tratar do paciente, a Capacidade Profissional e o Direito ao Suicídio, englobando 7, 4 e 5 itens, respectivamente. Os coeficientes do alfa de Cronbach foram 0,7, 0,6 e 0,5, respectivamente. Uma maior Capacidade Profissional foi relatada por assistentes de enfermagem e aqueles que já tinham cuidado de pacientes suicidas. A crença de que uma pessoa não possui o direito de cometer suicídio foi mais forte entre profissionais mais velhos, entre aqueles que não tinham nunca cuidado de pacientes suicidas, aqueles com histórico familiar, os que eram protestantes e costumavam freqüentar mais cultos religiosos. ...
Nursing personnel (N = 317) working at a general hospital attended a 6-hour training program on suicide prevention. They answered anonymously pre- and post-training the Suicide Behavior Attitude Questionnaire (SBAQ), which comprises 21 visual analogue scale items divided in three factorial subscales. The results indicated there were positive changes in the attitudes and these gains were significantly maintained at the 6-month follow-up evaluation. Improvement was in the Feelings and Professional Capacity subscales (ANOVA; p = 0.0001 and 0.01, respectively). There was no change on the Right to Suicide subscale. Because attitudes influence the effectiveness of health care personnel interventions, our findings may have important implications for the development of suicide prevention programs.
Clinical profiles of serious suicide attempters consecutively admitted to a university-based hospital: a cluster analysis study Perfis clínicos de indivíduos que fizeram tentativas graves de suicídio internados em um hospital universitário: análise de agrupamento A b s t r a c t Objective: To verify the presence of different groups of medically serious suicide attempters who had more clinical or surgical seriousness and required admission to a general hospital. Methods: 121 patients admitted consecutively were assessed. A questionnaire containing items on the patient characteristics and psychometric scales to assess the suicidal intent and lethality were used. A cluster analysis was performed using the K-means method. Results: Three groups were identified: 1) 43 subjects (mostly female) characterized by self-poisoning with medication and low suicidal intent, with highly impulsive suicide attempts; 2) 53 subjects (mostly males) who ingested pesticides and presented both moderate degrees of lethality and suicidal intent; 3) 17 subjects (predominantly males) who used more violent methods and presented high levels of lethality and suicidal intent. Conclusions: Grouped data of these inpatients could be misleading for follow-up research purposes as our findings indicate that there are relatively distinct clinical profiles among suicide attempters admitted to a general hospital.
Aim:To verify whether nursing personnel working at a general hospital change their attitudes after a brief training course on suicide prevention and if these newly acquired attitudes persist over a 6-month time.Method:317 nursing personnel attended a 6-hour training program. They answered anonymously pre- and post-training the Suicide Behavior Attitude Questionnaire (SBAQ) which comprises 21 visual analogue scale items divided in three factorial sub-scales. The scores on each SBAQ sub-scale (dependent variable) were compared along the time using ANOVA for repeated measures with rank transformation. The time of the measurement and characteristics of the nursing staff were considered as independent variables.Results:There have been positive changes in the attitudes and these gains were significantly maintained at the 6-month follow-up evaluation. Improvement was in the Feelings and Professional Capacity factorial subscales (p = 0.0001 and 0.01, respectively). There was no change on the Right to Suicide subscale.Conclusion:It was possible to demonstrate positive changes in the attitudes of nursing personnel as assessed six months after a brief training course on suicide prevention. As attitudes influence the effectiveness of the health care personnel interventions our findings may have important implications for the development of suicide prevention programs.
Suicidal behavior is currently thought of as a continuum. Although there is a wide variety of such behavior, most of the information for the construction of epidemiological standards is still derived from statistics of death by suicide. However, the burden associated with suicide attempts represented 1.4% of the overall burden of diseases in 2002. It is estimated that this fi gure will reach 2.4% in 2020. 1 Our study evaluated 121 patients who had been hospitalized because of medically severe suicide attempts, at Hospital das Clínicas of the Universidade Estadual de Campinas. Beck's Suicide Intent Scale (IS) was used for measuring the patient's intention of dying. The degree of lethality was evaluated on a six-point scale, based on the patient's clinical status and also on the procedures performed during hospitalization, clinical parameters, threat to life and the attending physician's impressions. The Spearman correlation test was used, for all patients and according to age groups, to evaluate the correlation between suicidal intent and lethality.There was a correlation between suicidal intent and lethality (correlation coeffi cient of 0.42; p = 0.04) within the 30 to 39-year-old group (38 individuals). Most of these patients were male (60%) and were married or living with someone (60%). 44% had a history of psychiatric treatment. Poisoning was the method most commonly used (88%) and 52% of the patients had the diagnostic hypothesis of affective disorder.Previous studies have shown a correlation between lethality and intent, based on the assumption that the individuals are aware of the lethal potential of their suicide attempt. 2 In our study, we strictly evaluated severe suicide attempts, carefully measuring suicidal intent and lethality.We noted that, for at least one third of the patients, there was a correlation, albeit moderate, between the desire to die and the lethality of the method chosen for suicide. Therefore, the resulting injuries were severe and life-threatening. Some of the patients would probably have died, had they not been cared for in a hospital. In the future, would these patients be at higher risk of dying through suicide? If we take the scientifi c literature into account, the answer is yes.Two important suicide predictors gather several risk factors. Firstly, previous suicide attempts: in Finland, a cohort study of 100 attempts was followed over 37 years, in the longest study of this type ever made, revealing a suicide rate of 31.2%. 3 Secondly, suicide attempts resulting in severe injuries, posing threat to life: in a study in New Zealand with 302 individuals in this category, 7% died through suicide after 5 years. 4 In Brazil, recent statistical data (comparison between the periods of 1980-82 and 1998-2000) show that the suicide coeffi cient has increased by 32.8% among men. In the municipality of São Paulo, for example, the young adult age group (25-44 years of age) accounts for 45% of all deaths due to suicide. 5 In summary, our fi ndings suggest that the subgroup of patients consisti...
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