Suicide is of great concern nationally and has become a significant social problem within the last 10years. One group of growing concern is those who served in the United States Coast Guard (USCG) and the impact of a suicide attempt on their career retention. Previous studies had focused on potential risk factors that may lead an individual to attempt suicide, but there was limited research on the impact of a suicide attempt on an individual's career retention. It was unknown if the desire of USCG veterans to retain their career can primarily influence their decision not to attempt suicide. The experiential impact of suicide on the career retention of the participants was examined in this study. The study method was planned to be a qualitative phenomenological study but changed to a qualitative descriptive design. The theoretical framework comprised an application of Joiner's interpersonal psychological theory of suicidal behavior and Tinto's integration model for retention relevance and practical implications. Semistructured interviews were used to collect data from 12 USCG veterans to address the primary research question as to the lived experience of USCG members who have attempted suicide while on active duty that are currently veterans. NVivo analysis indicated that participants experienced difficulties with career, work, and personal relationships before their suicide attempt. Themes were similar for participants who stayed or left service after a suicide attempt. The results also indicated that all participants needed to receive support from people in their life after the attempts. Data suggested peer support was critical for retention and contributed to the promotion of a confident, healthy workforce and social growth in communities and society after an attempted suicide.

Objectives: The objective of this study was to prove concepts in the characterization of suicidal patients and the possible usefulness of those markers to potentially identify patients with a higher risk for suicidality. Methods: Patients with a recent suicide attempt were compared with patients suffering from depression, adjustment disorder, anxiety, or eating disorders without suicidality, healthy controls and remitted patients with a history of at least 1 suicide attempt (≥1 year). We analyzed impulsivity (Barratt Impulsivity Scale, BIS) and saliva cortisol concentrations. Results: Independently of suicidality and disease state patients display higher BIS scores than healthy controls. Saliva cortisol levels tend to be higher in patients in the acute disease state than in remitted patients and healthy controls. Conclusions: Saliva cortisol may be a useful marker that reveals alterations in nonsuicidal patients suffering from depression, adjustment disorder, anxiety, or eating disorders who might be at risk.

BAKGRUND Suicidal problematik är ett stort folkhälsoproblem som leder till att ca 800 000 människor tar sitt liv i världen varje år. Begreppet suicidal problematik innefattar suicid, suicidförsök och suicidtankar. Stigmatisering och attityders nära samband beskriver patientens upplevelser och sjuksköterskans sätt att bemöta, utifrån dess kunskap ge förutsättningar till en god omvårdnad.  SYFTE Syftet var att beskriva sjuksköterskors upplevelser av att vårda patienter med suicidal problematik. METOD Föreliggande litteraturstudie har en deskriptiv design och är sammanställd av 11 vetenskapliga artiklar med kvalitativ ansats. Databaser som använts är PubMed, CINAHL och PsycINFO, artiklarna kvalitetsgranskades, lästes och färgkodades vilket gav huvudrubriker och underrubriker.   HUVUDRESULTAT Sjuksköterskorna upplever både positiva och negativa känslor i mötet med patienten. Negativa upplevelser grundar sig på okunskap, bristande erfarenhet och religiös tro. Positiva upplevelser grundar sig på utbildning, erfarenhet och teamkänsla. Ett viktigt verktyg anses vara kommunikation, sjuksköterskor med erfarenhet vågar tala mer öppet om suicidal problematik än de med lite erfarenhet. Att fatta beslut över patienter med suicidrisk skapar konflikt med integritet och självständighet, detta är etiska dilemman som sjuksköterskor upplever. SLUTSATS Det finns ett tydligt kunskapsglapp där behov av utbildning och erfarenhet behövs. Avsaknad av detta ger en negativ inställning till patienter med suicidal problematik, samtidigt som man tydligt ser att utbildning och erfarenhet skapar trygghet hos sjuksköterskor. Holistiskt förhållningssätt och icke dömande inställning är något som bör prägla sjuksköterskors bemötande. / BACKGROUND Suicidal problematics are a major public health problem that causes about 800,000 people to take their lives in the World every year. The term suicidal problematics includes suicide, suicide attempts and suicidal thoughts. Stigmatization and attitudes closely relation describe the patient's experiences and the nurse's way of responding, based on this knowledge give the conditions for a good nursing. AIM The aim of this study was to describe nurses' experiences of caring for patients with suicidal problems. METHOD The present literature study has a descriptive design and is composed of 11 scientific articles with a qualitative approach. Databases that were used is PubMed, CINAHL and PsycINFO, the articles were quality checked, read and color coded which gave main headings and subheadings. MAIN RESULT The nurses experience both positive and negative feelings in the meeting with the patient. Negative experiences are based on lack of knowledge, lack of experience and religious affiliation and positive experiences are based on education, experience and team spirit. An important tool is considered communication, nurses with experience dare speak more openly about suicidal problems than those with little experience. Making decisions about patients with suicide risk conflicts with integrity and independence. These are ethical dilemmas that nurses experience. CONCLUSION There is a clear gap in knowledge where the need for education and experience is needed. The absence of this gives a negative attitude to patients with suicidal problems, at the same time you clearly seeing that education and experience create safety in nurses. A holistic approach and a non-judgmental attitude is something that should characterize nurses' attitude.

The thesis focuses on the attitudes of health care professionals in intensive care to patients after a suicide attempt. First chapter deals with suicide issues in detail, outlines sources of emotional problems and stress which can health care professionals encounter. The next chapter talks about burnout syndrome. The research part surveys the attitudes of healthcare professionals to suicidal patients, investigates the level and effectiveness of the awareness of health care professionals in the psychiatric and psychological issues and its impact on their attitudes, assesses awareness of burnout syndrome and eventual respondent's own experiences with this condition and evaluates the degree of mental and emotional demands of care of suicidal patients. On the qualitative research in the form of semi-structured interviews participated 20 respondents. We found that the attitudes of health care professionals to patients after a suicide attempt are rather positive. A surprising finding was that 70 % of respondents didn't receive any seminar or course focused on topics mentioned above, and that none of them are actively interested in the specific issue of psychiatric intensive care of patients with somatic disease and neither the issue of suicides. A disturbing finding was that 85 % of respondents observed...

Bakgrund Suicid är ett folkhälsoproblem som förbises av samhället. Suicid står för 25% av dödsorsakerna bland ungdomar. Män begår oftast suicid medan kvinnor främst begår suicidförsök. Ett suicidalt beteende påverkas av flera olika faktorer, såsom tidigare suicidförsök, psykiska sjukdomar, alkohol eller droger, negativa traumatiska livshändelser, ärftliga faktorer och/eller tillgång till suicidala medel. Det ultimata är att förebygga suicid, inte endast vårda och ingripa när det redan hänt. Syfte Studiens syfte var att belysa patienters upplevelser i samband med vård efter ett suicidförsök. Metod Studien är en litteraturbaserad studie med tyngdpunkt i självupplevda berättelser. För dataanalys har en modifierad kvalitativ innehållsanalys använts. Resultat Individernas skildringar resulterade i tre teman; Lidande, Bemötande och vård samt Vårdmiljö. Lidandet utgjorde en central del i de egenupplevda berättelserna, och var kopplade både till individerna själva och till vården. Bemötandet och vården var i många fall bristfällig, då den inte såg till deras behov, och vårdmiljön ansågs ofta som ogynnsam för tillfrisknandet. Slutsats Suicid är ett komplext problem, vilket gör att vården av suicidala patienter blir komplex. Lidandet är en central del hos suicidala patienter. Genom ett holistiskt perspektiv och ett sympatiskt bemötande kan vårdpersonalen minska lidande hos denna patientgrupp. Klinisk betydelse Hälso- och sjukvården har en betydande roll vid vård av suicidala patienter. Den här studien visar att sjukvården behöver ha ett mer holistiskt perspektiv vid vård av suicidala personer. Ett patientperspektiv kan öka förståelsen för dessa personers lidande och upplevelser av vården i samband med ett suicidförsök. / Background Suicide is a public health problem that is often ignored by society. Suicide stands for 25% of the cause of deaths among adolescents and young adults. Males tend to commit suicide whereas females mainly commit suicide attempts. A suicidal behavior is influenced by several factors, like previous attempts, mental illness, alcohol or drugs, negative traumatic occurrences in life, hereditary factors or access to suicidal implements. The most ultimate is to prevent suicide, and not only nurse and intervene when it has already happened. Aim The aim of this study was to illuminate patient experiences connected to health care after a suicide attempt. Method This study is a literature based study, with literature emphasized in self-experienced stories. A modified qualitative content analysis has been used to analyze data. Findings The stories resulted in three themes, Suffering, Treatment and nursing and Health care environment. Suffering was a central part in their stories and was connected to the individuals themselves and to the health care. The treatment and nursing was defective in many cases, because it did not see to their needs, the health care environment was often considered as having an unhealthy impact to recovering. Conclusion Nursing of suicidal patients is a complex problem. Suffering is a fundamental part among suicidal patients. Through a holistic perspective and a sympathetic treatment nursing staff may reduce these patients' suffering. Clinical value Health care has a significant part in nursing suicidal patients. This study shows that health care needs to have a more holistic perspective in the care of suicidal patients. A patient perspective may enhance the understanding for these patients' suffering and experiences connected to a suicide attempt.

Suicidality rates are far higher among gender minority individuals than in the general population. This study sought to determine if intersecting identities and social support play a role in these rates. There were no differences in suicidality among gender minorities with an intersecting sexual minority identity. For intersecting racial/ethnic identities, it was found that White individuals were more likely to report past suicidal ideation than racial/ethnic minority individuals. Family support was independently associated with less suicidal ideation, whereas gender minority friend support was independently associated with an increase in suicidal ideation.

This study explores the accuracy of prevalence estimations for suicide attempts. Data came from the Early Developmental Stages of Psychopathology (EDSP) Study, a prospective community study (mean follow-up period was 42 months) of 3,021 respondents aged 14 to 24 years at the outset of the study. Suicide attempters are at least 1.6 times more likely to drop out than subjects with no suicide attempts and suicidal ideas. A total of 8% of all suicide attempters answered in the negative the depression-related gate questions of all surveys. One-third of all baseline suicide attempters did not report their suicide attempt again at the four years later assessment. In particular, 80% of all nonreporters were female, and almost 60% were aged 14–17 at baseline.

ABSTRACT Background: Suicide is one of the leading causes of death worldwide and a serious public health issue. A prior suicide attempt is therefor a significant risk factor for future suicide, which could be preventable with evidence-based interventions. Stigmatization surrounding mental health and suicide has led to many people that are thinking of suicide, or those who have attempted it, to not seek help. This increases the risk for future suicide attempts, and therefore the amount of deaths.    Aim: The aim of this study was to describe patients experiences of support and care after a suicide attempt.    Method: A qualitative literature study where 14 articles were included from the databases PubMed and PsycInfo. The articles were quality reviewed using the SBU’s quality assessment template and were analyzed using the meta-synthesis method.    Result: Experiences of inadequate care were mostly based on insufficient knowledge, deficiencies in how patients were treated, stigmatization and fear, and bad quality of care. Experiences of good care were mostly based on patient centered care, a strong patient-personal relationship, good care meeting, and patient involvement. The patients emphasized the need to be heard and support from others in the same situation.    Conclusion:  Three main categories were identified that described how patients experienced support and care after a suicide attempt: experiences of inadequate care, experiences of good care, and favorable factors for good care. The results highlighted the need for more knowledge among nurses to ensure the best possible care for people who have gone through a suicide attempt.   Keywords: Nursing Care, Patient Experience, Suicide Attempt, Suicide Prevention. / SAMMANFATTNING Bakgrund: Suicid är en av de ledande dödsorsakerna i världen, och ett allvarligt folkhälsoproblem. Ett tidigare suicidförsök är en stor riskfaktor för senare suicid, vilket anses kunna förebyggas med evidensbaserade insatser. Stigmatisering kring psykisk ohälsa och suicid har lett till att många människor som tidigare begått suicidförsök eller har tankar om det, väljer att inte söka vård vilket ökar risken för fler suicidförsök och därmed dödsfall.  Syfte: Syftet var att beskriva patienters upplevelse av stöd och vård efter suicidförsök.   Metod:  En kvalitativ litteraturöversikt där 14 artiklar inkluderades från databaserna PubMed och PsycInfo. Artiklarna kvalitetsgranskades med SBU:s kvalitetsgranskningsmall, och innehållet analyserades med hjälp av metasyntesen.    Resultat: Upplevelser av bristande vård grundade sig främst i otillräcklig kunskap och kompetens, brister i bemötande, stigmatisering och rädsla, samt brister avseende vårdkvalitet. Upplevelser av god vård grundade sig mycket i personcentrerad vård, god relation mellan patient och vårdpersonal, vårdpersonalens goda bemötande, samt delaktighet. Patienterna framhävde även behovet av att bli hörd och få stöd av andra i samma situation.    Slutsats:  Tre kategorier identifierades som beskrev hur patienter upplevde stöd och vård efter suicidförsök; upplevelser av bristande vård, upplevelser av god vård, och gynnsamma faktorer för god vård. Resultatet visade på att det krävs mer kunskap och kompetens hos sjuksköterskor för att bemötandet av patienter som genomgått ett suicidförsök ska bli så bra som möjligt.    Nyckelord: Bemötande, Patienters upplevelse, Suicidförsök, Suicidprevention, Omvårdnad.

Bakgrund: Suicid är ett globalt folkhälsoproblem hela världen över. Varje år dör 700 000 människor genom fullbordat suicid. I Sverige dör dagligen ca 4 människor genom suicid.   I WHO’s handlingsplan är målet att fram till 2030 att minska suicidantalet med en tredjedel och förebygga psykisk ohälsa. Syfte: Syftet med studien var att beskriva vårdpersonalens erfarenheter av att vårda patienter med suicidalt beteende. Metod: En litteraturstudie baserad på tio kvalitativa artiklar. Databassökning genomfördes i Cinahl, PubMed, PsykInfo och Scopus. Studier analyserades med hjälp av Fribergs femstegmodell. Resultat: Analysprocessen resulterade i 3 kategorier och 7 underkategorier. De tre kategorier var: Bristande organisation, känslomässiga reaktioner och attityder. Konklusion: Psykisk ohälsa är ett stigmatiserat ämne. Att vårda suicidala patienter kan vara psykiskt påfrestande för vårdpersonalen. Vårdpersonalen behöver mer kunskap inom det här ämnet för att kunna bedriva en säker och gynnsam vård som främjar hälsa för patienterna samt bidrar till att vårdkvalitén höjs. / Background: Suicide is a global public health problem worldwide. Every year 700,000 people die by completed suicide. In sweden, about 4 people die by suicide every day. In the WHO's action plan, the goal is to reduce the number of suicides by a third by 2030 and prevent mental illness. Aim: The aim of this study was to describe the nursing stuff’s experiences of caring for patients with suicidal behavior. Methods: A literature study based on ten qualitative articles. Database search were conducted in Cinahl, PubMed, PsykInfo and Scopus. The articles were analyzed using Friberg’s five-step model. Results: The analysis process resulted in 3 categories and 7 subcategories. The four categories were: Lack of organization, emotional reactions and attitudes. Conclusion: Mental illness is a stigmatized subject. Caring for suicidal patients can be psychologically stressful for the nursing staff. The healthcare staff need more knowledge in this subject to be able to provide safe and beneficial care that promotes health for the patients and contributes to raising the quality of care.

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