Development of guidelines for hospital care of suicide attempts in adolescence

Abstract

This article aims to describe a qualitative and quantitative study of the construction and validation of guidelines for hospital care of adolescents with suicide attempts. The methodological approach involved an integrative literature review with thematic content analysis of 27 articles, which generated 3 categories: assessment of suicidal behavior in the context of the emergency department; intervention in suicidal behavior, and hospital multidisciplinary team. The content of these categories was the basis for the construction of an instrument with 15 statements about the performance of adolescents in suicidal crisis assisted in the hospital setting. This instrument was applied with 20 healthcare professionals selected from two hospital institutions in southern Brazil, who acted as judges/evaluators of the proposed statements. The content of the 15 statements was validated as guidelines through the Percentage of Concordance Calculation and the Score Calculation. The constructed guidelines may help multidisciplinary hospital teams when facing adolescents with suicide attempts, to base their conduct on criteria that guide actions of reception, assessment, intervention, and referral.

Drawing attention? Going through judgments regarding child and adolescent suicide attempts in emergency rooms from a professional perspective

“…A methodological investigation, with guideline construction and validation for multidisciplinary care for child and adolescent SA in the ER, indicated that welcoming must be carried out promptly and with quality, in a private room, with active listening, without the need for advice or speech, with an attitude empathetic, without minimizing emotional pain, started from the first clinical anamnesis after stabilization of the physical and mental clinical picture, identifying risk and protective factors. This approach can be carried out by different team members, without the need for a specialist professional as a mediator, as it can initiate a brief therapeutic intervention, with relapse prevention guidelines and looking at the dyad ( 3 ) .…”

“…In a study carried out with family members of children with SA, it was noted that they were unable to distinguish between children’s mental health needs and behaviors ( 3 ) . This may be a common reality and should not be labeled as negligence, because, just as professionals do not demonstrate knowledge about the topic, families also experience the same, as seen in NT10’s speech ( Chart 1 ).…”

“…SA can be defined as any non-fatal suicidal behavior, with the intention of ending one’s life, being a multifactorial phenomenon resulting from an interaction of biological, psychological, cultural and environmental factors ( 2 , 3 ) . The World Health Organization (WHO) indicates that, annually, more than 700,000 people commit suicide, and estimates that for each death there are more than 20 SA (estimated to be more than 14 million SA).…”

Chamar atenção? Atravessando julgamentos diante da tentativa de suicídio infantojuvenil em prontos-socorros na perspectiva profissional

“…Investigação metodológica, com construção e validação de diretrizes para o cuidado multiprofissional à TS infantojuvenil no PS, indicou que o acolhimento deve ser feito com prontidão e qualidade, em uma sala privada, com escuta ativa, sem a necessidade de conselhos ou falas, com postura empática, sem minimizar a dor emocional, iniciado desde a primeira anamnese clínica pós-estabilização do quadro clínico físico e mental, identificando os fatores de risco e de proteção. Essa abordagem pode ser realizada por diferentes membros da equipe, sem a necessidade de um profissional especialista como mediador, visto que pode iniciar uma intervenção terapêutica breve, com orientações de prevenção de recidivas e olhar ao binômio (3) . Na teoria, as diretrizes citadas podem parecer simples e fáceis de serem articuladas na prática clínica, porém, sem ações para sua tradução efetiva, o cuidado à TS seguirá marcado pela falta de preparo, intervenções limitadoras e julgamento.…”

“…A TS pode ser definida como qualquer comportamento suicida não fatal, com intencionalidade de acabar com a vida, sendo um fenômeno multifatorial resultante de uma interação de fatores biológicos, psicológicos, culturais e ambientais (2,3) . A Organização Mundial da Saúde (OMS) indica que, anualmente, mais de 700.000 pessoas se suicidam, e estima que a cada morte existem mais de 20 TS (estimado mais de 14 milhões de TS).…”