Suicide Assessment by Psychiatric Nurses: A Phenomenographic Study

Aflague, John M.; Ferszt, Ginette G.

doi:10.3109/01612840903267612

Cited by 32 publications

(22 citation statements)

References 25 publications

(28 reference statements)

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“…Broadly speaking, there is a body of work discussing methods of risk assessment (Buchanan, 1999); risk assessment instruments (Phull, 2012); different theoretical approaches to risk assessment (Doctor, 2004;Holloway, 2004;Witteman, 2004); assessment of different kinds of risk, such as risk of violence (Langan, 2010) and risk of suicide (Cutcliffe and Barker, 2004). There is also work that has explored the practice of risk assessment from the perspective of those involved (Aflague and Ferszt, 2010;Godin, 2004;Moerman, 2012), and approaches using poststructuralist ideas to engage with risk (Crowe & Carlyle, 2003;Rose, 1998).…”

Section: Introductionmentioning

confidence: 99%

Risk assessment practice within primary mental health care: A logics perspective

2018

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From the 1980s onwards discourses of risk have continued to grow, almost in ubiquity. Ideas and practices of risk and risk aversion have extended to UK mental health care where services are expected to assess and manage risks, and high quality clinical assessment has been revised to incorporate risk assessment. This article problematises practices of risk assessment in mental health provision, focusing on the base rate problem. It presents an analysis of audio recordings of risk assessments completed within a primary care mental health service. The analysis is informed by a critical logics approach which, using ideas from discourse theory as well as Lacanian psychoanalysis, involves developing a set of logics to describe, analyse and explain social phenomena. We characterise the assessments as functioning according to social logics of well-oiled administration and preservation, whereby bureaucratic processes are prioritised, contingency ironed out or ignored and a need to manage potential risks to the service are the dominant operational frames. These logics are considered in terms of their beatific and horrific fantasmatic dimensions, whereby risk assessment is enacted as infallible (beatific) until clients become threats (horrific), creating a range of potential false negatives, false positives and so forth. These processes function to obscure or background problems with risk assessment, by generating practices that favour and offer protection to assessors, at the expense of those being assessed, thus presenting a challenge to the stated aim of risk assessment practice.

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Section: Introductionmentioning

confidence: 99%

Risk assessment practice within primary mental health care: A logics perspective

2018

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“…According to several studies (Cochrane‐Brink et al . 2000, Billings 2003, Aflague & Ferszt 2010) suicide assessment is an important component of the nurse's role. Aflague & Ferszt (2010) found in their study that nurses did not used guidelines or suicide assessment instruments when they assessed for suicidality.…”

Section: Discussionmentioning

confidence: 99%

Grasping the dynamics of suicidal behaviour: combining time‐geographic life charting and COPE ratings

Sunnqvist

Persson²,

Westrin

et al. 2012

Psychiatric Ment Health Nurs

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The aim of this study is to explore whether a time-geographic life charting, combined with a survey of a person's coping capacities over time, elucidates the pathway to suicidal behaviour, and therefore could be useful in suicide prevention. Twenty-three patients were recruited shortly after a suicide attempt. A time-geographic life charting and COPE inventory ratings were used separately and in combination. According to COPE ratings, the participants could be divided into three groups using different coping strategies: (1) adaptive, (2) maladaptive, and (3) both adaptive and maladaptive coping. Within these subgroups, three different pathways to suicidal behaviour were described and illustrated. We conclude that time-geographic life charting used in combination with the pattern of coping strategies may be helpful when assessing risk of suicidal behaviour, because this approach strengthens the comprehensive picture of the patient's life situation.

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“…Vignettes can collect information simultaneously from a large sample, manipulate variables, and avoid ethical problems that might occur in observational studies [4]. Vignettes have served to elicit diagnoses [6], pain [7], nursing knowledge [8], nursing performance [9], infection control [10], ethical decisions [11], and schizophrenia [12]. Expert panels have been used to validate vignettes.…”

Section: Suicide Vignettementioning

confidence: 99%

Nurses' Psychosocial Barriers to Suicide Risk Management

Valente

2011

Nursing Research and Practice

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Suicide remains a serious health care problem and a sentinel event tracked by The Joint Commission. Nurses are pivotal in evaluating risk and preventing suicide. Analysis of nurses' barriers to risk management may lead to interventions to improve management of suicidal patients. These data emerged from a random survey of 454 oncology nurses' attitudes, knowledge of suicide, and justifications for euthanasia. Instruments included a vignette of a suicidal patient and a suicide attitude questionnaire. Results. Psychological factors (emotions, unresolved grief, communication, and negative judgments about suicide) complicate the nurse's assessment and treatment of suicidal patients. Some nurses (n = 122) indicated that euthanasia was never justified and 11 were unsure of justifications and evaluated each case on its merits. Justifications for euthanasia included poor symptom control, poor quality of life, incurable illness or permanent disability, terminal illness, and terminal illness with inadequate symptom control or impending death, patient autonomy, and clinical organ death. The nurses indicated some confusion and misconceptions about definitions and examples of euthanasia, assisted suicide, and double effect. Strategies for interdisciplinary clinical intervention are suggested to identify and resolve these psychosocial barriers.

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Suicide Assessment by Psychiatric Nurses: A Phenomenographic Study

Cited by 32 publications

References 25 publications

Risk assessment practice within primary mental health care: A logics perspective

Risk assessment practice within primary mental health care: A logics perspective

Grasping the dynamics of suicidal behaviour: combining time‐geographic life charting and COPE ratings

Nurses' Psychosocial Barriers to Suicide Risk Management

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