Abstrakt Bakgrund:Med termen suicidförsök avses ett beteende som är livshotande och där en individ med uppsåt skadat sig men inte avlidit. Antalet suicidförsök per år i Sverige är en uppskattning då mörkertalet anses vara stort. Registrerade fall 2008 var 9643 personer (över 15 år), minst det dubbla antalet förmodas om alla oregistrerade och oupptäckta fall skulle tillkomma. Det första mötet med patienten som gjort ett suicidförsök sker inom akut somatisk sjukvård innan patienten flyttas över till psykiatrisk vård eller skrivs ut. Syftet: Att belysa hur sjuksköterskor på akut- och intensivvårdsavdelningar upplever att möta och vårda patienter efter ett suicidförsök. Metod: En narrativ metod där tolv sjuksköterskor berättar om sina upplevelser i djupintervjuer. En kvalitativ innehållsanalys valdes som analysmetod. Resultat: Sjuksköterskors upplevelser visade sig vara främst kopplade till frustration på olika plan, nämligen, frustration gällande patienten, gällande anhöriga, gällande samhället, samt gällande sjukhus-verksamheten. Dock synliggjordes även upplevelser av tillfredsställelse. Resultatet presenteras genom två teman: frustration och tillfredsställelse. Slutsats: Det finns behov för sjuksköterskor på akut- och intensivvårdsavdelningar att få utbildning i suicidologi som skulle kunna ge bättre verktyg för att vårda och möta patienter som gjort ett suicidförsök. Det finns även behov av handledning för att bearbeta och orka med sitt arbete. Vidare finns det behov av ett bättre samarbete mellan somatik och psykiatri. Sättet som verksamheten och organisationen är strukturerad innebär ibland svårigheter att i praktiken att ge en holistisk och patientcentrerad vård. Prioriteringar och det oförutsägbara med arbetet gör det svårt att tillgodose patientens alla behov. / Abstract Bakgrund: The term suicide attempt refers to life-threatening self inflicted injury by which an individual seeks to commit suicide but survives. The number of suicide attempts in Sweden per year is merely a rough estimate and the number of unregistered cases is considered as high. Registered cases in 2008 amounted to 9643 people (over the age of 15), at least double the number is presumed if all unregistered and undetected cases were to be included. The nurses’ first meetings with patients after attempted suicide often occurs within emergency and intensive care wards, before the patient is transferred to a psychiatric care unit or is discharged from hospital. Aim: This study aims to illustrate how nurses within somatic emergency and intensive care wards experience situations when meeting and caring for patients after a suicide attempt. Method: A narrative method whereby twelve nurses talked about their experiences in depth interviews. A qualitative content analysis was chosen as the method for analysis. Result: Nurses' experiences proved to be mainly linked to frustration regarding the patient, the patient’s family members, current society, and current hospital establishment. However, the results also revealed experiences of satisfaction. The results were presented by two themes: frustration and satisfaction. Conclusion: There is a need for nurses in emergency and intensive care units to receive training in suicidology which could provide better tools to care for patients after a suicide attempt. There is also a need for councelling to help nurses to cope with their work and encounters with suicidal patients. Furthermore, there is need for better cooperation between somatic and psychiatric wards when it comes to providing healthcare for suicidal patients. The manner in which work within emergency and intensive care wards is structured sometimes makes it difficult to meet all patient needs as well as offer a holistic and patient-centered care.

A queimadura pode ser considerada como um dos traumatismos mais destrutivos que o ser humano pode sofrer. Sua relevância decorre não só da frequência com que acontece, mas também, pelas sequelas funcionais, estéticas e emocionais que a queimadura provoca. A autoagressão é um dos motivos preocupantes e de difícil manejo tanto para a equipe de saúde como para toda a sociedade, visto que é uma situação que relaciona tanto aspectos subjetivos e culturais, como também religiosos e de saúde pública. Os objetivos desta pesquisa são: caracterizar os pacientes que sofreram queimadura térmica por líquido inflamável na tentativa de suicídio, após a alta hospitalar de uma Unidade de Queimados de um Hospital Universitário entre os anos de 2006 e 2009; investigar a vida ocupacional do paciente em suas atividades de vida diária e prática, atividades produtivas e de trabalho e as atividades de lazer após a alta hospitalar e identificar quais são os recursos que contam para prosseguir sua vida. Trata-se de um estudo qualitativo, em que a história oral foi utilizada como método de investigação na modalidade história oral temática. Para a análise dos dados, seguiram-se os passos da técnica de Análise Indutiva de Conteúdo. A coleta de dados foi realizada no período de agosto a outubro de 2010. As entrevistas foram realizadas com oito pacientes queimados por autoagressão que forneceram subsídios para a construção de três núcleos de sentidos: \"Morrer ou viver: a busca pelo atendimento de urgência/emergência\"; \"Os desafios enfrentados pelo paciente no retorno para casa\" e \" Recursos e projetos futuros após a sobrevivência\". A partir da análise e discussão destas categorias, fica evidente a importância de conhecer estes pacientes em seu retorno para casa e saber por meio de suas experiências as principais dificuldades, avanços e desafios, bem como os recursos com que contam para enfrentar suas vidas, com um olhar atento para suas queixas relacionadas a ideias ou pensamentos de morte, a fim de atentar-se principalmente a possíveis reincidivas que certamente poderão ser letais; necessitando dos profissionais de saúde de urgência e emergência e dos familiares a capacidade, quando possível, de identificar um pedido de socorro ou ajuda com tomadas de ações mais efetivas e de acompanhamento a esses pacientes, mesmo com a falta de adesão ao tratamento. Para isso, é preciso conhecer a realidade e as necessidades dos serviços a partir das experiências das pessoas que recebem assistência nos mesmos e dos profissionais de saúde que as assistem. / The burn can be considered as one of the most destructive traumas that humans can suffer. Its relevance stems not only on how often it happens, but also by functional sequelae, both aesthetic and emotional cause. Self-harm is one reason for concern and difficult to manage both for the health care team for the whole society, since it is a situation that relates both subjective and cultural aspects, as well as religious and public health. The objectives of this research are: characterizer of patients who suffered thermal burns of flammable liquid in a suicide attempt, after discharge from a burn unit of a university hospital between the years 2006 to 2009; investigate the occupational life of the patient in their activities of daily living and practical, productive activities and work and leisure activities after discharge and identify what resources they have to continue your life. This is a qualitative study in which oral history was used as a method of research in oral history form. For data analysis, followed the steps of the technique of Inductive Content Analysis. Data collection was conducted between August to October 2010. The interviews were conducted with eight patients burned by self-harm which provided subsidies for the construction of three groups of meaning: \"To die or live: the search for urgent care / emergency,\" \"The challenges faced by the patient upon returning home\" and \"Resources and future projects after survival.\" From the analysis and discussion of these categories, it is evident the importance of knowing these patients on their return home and learn from their experiences major difficulties, progress and challenges, as well as the resources that have to face their lives with a look attentive to their complaints related to ideas or thoughts of death, to pay attention mainly to relapsed possible that certainly could be lethal for health professionals needing urgent and emergency capacity and family whenever possible to identify a distress or help with more effective actions taken and follow-up of these patients despite the lack of adherence to treatment. For this, one must know the reality and needs of services from the experiences of people who receive the same assistance and health professionals who care for them.

Suicidal behaviors are common and problematic among young populations, and attitudes held towards such behavior likely impact the frequency of its occurrence. The present study was conducted to gain insight into the attitudes held towards suicide attempt victims amongst a traditional college population. Undergraduate students (n = 360) were administered a survey to assess demographics, suicide ideation levels, and perceptions formed after reading a short suicide attempt report. Results indicated that ideation levels had the most impact on perceptions, with ideators being significantly more likely than non-ideators to view suicide attempters as more intelligent, more justified in their actions, more likable, more trusting, and more likely to be a personal friend. These findings signify that acceptance of suicidal behavior is positively correlated with one’s own level of suicidal ideation. The understanding of these attitudes is an essential aspect to address when developing prevention programs for suicidal behaviors in the future.

INTRODUCTION: Attempted suicide is very common. Those who arrive to a hospital by reason of attempted suicide need a nurse with qualifications in the care of suicidal patients. OBJECTIVE: The aim of this study was to compile and elucidate research which describes how patients in care for their attempted suicide experience the care that is received. METHOD: A literature review was chosen for this study. Scientific articles sought in the database CINAHL. RESULT: The result consist of 11 scientific articles published between 1999-2009. The result gave three head themes; communication, self esteem, follow-up - safety and three subthemes; understanding, empathy and confirmation - acceptance. It emerged in the result that verbal communication with health professionals is seen as fundamental to feel better and to find a meaning of life and finding the will to live. Nurses have an excellent starting point to support and help patients to regain self-esteem. Patients feeling of safety grows by knowing that they can contact the ward after being discharged. DISCUSSION: Many patients are negative to the care they receive. Lack of qualifications and shortage of time are a few things that could have effect on the care that is applied from the health professionals to suicidal patients. / INTRODUKTION: Suicidförsök är mycket vanligt. De som inkommer till sjukhus på grund av suicidförsök är i behov av kompetens hos sjuksköterskan inom vård av suicidnära patienter. SYFTE: Syftet med studien var att sammanställa och belysa forskning som beskriver hur patienter som vårdas för suicidförsök upplever omvårdnaden. METOD: En litteraturöversikt har genomförts. Vetenskapliga artiklar söktes i databasen CINAHL. RESULTAT: Resultatet består av 11 vetenskapliga artiklar publicerade mellan 1999-2009. Resultatet gav tre huvudteman; kommunikation, självkänsla och uppföljning - säkerhet samt tre subteman; förståelse, empati och bekräftelse - acceptans. I resultatet framkommer det att verbal kommunikation med hälso- och sjukvårdspersonal ses som grundläggande för välmående och för att finna mening med livet och viljan att leva vidare. Sjuksköterskor har en utmärkt utgångspunkt för att stötta och återskapa självkänsla hos patienter. Patienters känsla av säkerhet ökar genom att veta att de kan kontakta avdelningen efter utskrivning. DISKUSSION: Många av patienterna är negativa till omvårdnaden som ges. Bristande kompetens och tidsbrist hos hälso- och sjukvårdspersonal kan ha påverkan på omvårdnaden som ges till suicidnära patienter.

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.

<p><strong>INTRODUCTION:</strong> Attempted suicide is very common. Those who arrive to a hospital by reason of attempted suicide need a nurse with qualifications in the care of suicidal patients. <strong>OBJECTIVE:</strong> The aim of this study was to compile and elucidate research which describes how patients in care for their attempted suicide experience the care that is received. <strong>METHOD:</strong> A literature review was chosen for this study. Scientific articles sought in the database CINAHL. <strong>RESULT:</strong> The result consist of 11<strong> </strong>scientific articles published between 1999-2009. The result gave three head themes; communication, self esteem, follow-up - safety and three subthemes; understanding, empathy and confirmation - acceptance. It emerged in the result that verbal communication with health professionals is seen as fundamental to feel better and to find a meaning of life and finding the will to live. Nurses have an excellent starting point to support and help patients to regain self-esteem. Patients feeling of safety grows by knowing that they can contact the ward after being discharged. <strong>DISCUSSION:</strong> Many patients are negative to the care they receive. Lack of qualifications and shortage of time are a few things that could have effect on the care that is applied from the health professionals to suicidal patients.</p> / <p> </p><p><strong>INTRODUKTION: </strong>Suicidförsök är mycket vanligt. De som inkommer till sjukhus på grund av suicidförsök är i behov av kompetens hos sjuksköterskan inom vård av suicidnära patienter. <strong>SYFTE:</strong> Syftet med studien var att sammanställa och belysa forskning som beskriver hur patienter som vårdas för suicidförsök upplever omvårdnaden. <strong>METOD:</strong> En litteraturöversikt har genomförts. Vetenskapliga artiklar söktes i databasen CINAHL. <strong>RESULTAT:</strong> Resultatet består av 11 vetenskapliga artiklar publicerade mellan 1999-2009. Resultatet gav tre huvudteman; kommunikation, självkänsla och uppföljning - säkerhet samt tre subteman; förståelse, empati och bekräftelse - acceptans. I resultatet framkommer det att verbal kommunikation med hälso- och sjukvårdspersonal ses som grundläggande för välmående och för att finna mening med livet och viljan att leva vidare. Sjuksköterskor har en utmärkt utgångspunkt för att stötta och återskapa självkänsla hos patienter. Patienters känsla av säkerhet ökar genom att veta att de kan kontakta avdelningen efter utskrivning. <strong>DISKUSSION: </strong>Många av patienterna är negativa till omvårdnaden som ges. Bristande kompetens och tidsbrist hos hälso- och sjukvårdspersonal kan ha påverkan på omvårdnaden som ges till suicidnära patienter.</p>

Suizidale Handlungen, also Suizide und Suizidversuche, sind mit großem Schmerz, großer Trauer und auch großem Schamgefühl verbunden. Dies betrifft nicht nur die Suizidenten selbst, sondern auch Angehörige und Freunde. Weltweit sterben etwa eine Million Menschen jährlich durch Suizid und in Deutschland steht der Suizid auf Platz sieben der häufigsten Todesursachen. Schätzungen zu Folge ist die Anzahl der Suizidversuche pro Jahr, im Vergleich zu den Suiziden, bis zu 30-fach höher. Dies zeigt, dass suizidale Handlungen zusätzlich eine hohe Relevanz für das Gesundheitssystem darstellen. Diese Arbeit entstand im Zuge des OSPI-Projektes in Leipzig. Einem europäischen Projekt zur Einführung eines Präventionsprogramms gegen suizidale Handlungen. Es wurden alle Suizidenten, die innerhalb eines Zeitraums von drei Jahren im Universitätsklinikum Leipzig behandelt wurden, erfasst. Die elektronischen Patientenakten wurden dafür, unter Verwendung der entsprechenden ICD-Kodierungen für Selbstverletzungen bzw. Selbstvergiftungen, durchsucht. Ziel war es, neben der lückenlosen Erfassung und epidemiologischen Auswertung aller Fälle, Aussagen über die Art der Behandlung von Suizidenten und den damit verbundenen direkten und indirekten Kosten zu machen. Es zeigten sich, im Vergleich zu bereits bestehenden Studien aus anderen Ländern, keine signifikante epidemiologischen Unterschiede, während deutlich mehr Patienten intensivmedizinisch versorgt und psychiatrisch untersucht wurden, als dies in anderen Ländern der Fall war. Im Hinblick auf die Gesamtkosten, in Höhe von rund 3,9 Millionen Euro, konnte diese Arbeit, abgesehen vom menschlichen Aspekt, die ebenfalls wichtige gesundheits-ökonomische Bedeutung solcher Fälle aufzeigen.

SAMMANFATTNING Suicid och suicidförsök är ett stort folkhälsoproblem i världen och de senaste 45 åren har suicid ökat med ca 60 procent. Sjuksköterskor som arbetar inom ambulanssjukvården möter ofta patienter med psykisk ohälsa. Detta påverkar sjuksköterskan på olika sätt. Vid självmordsförsök, hot om självmord eller vid misstänkt självmord kan ambulans larmas. I den akuta situationen är ibland ambulanssjuksköterskan den första kontakten med sjukvården. En prehospital vård ställer höga krav på ambulanspersonalens förmåga och kunskap att möta olika typer av patienter i olika situationer. De flesta inom prehospital sjukvård har en mental beredskap för att möta svåra händelser, men trots detta kan omständigheter göra att personalen kan få svårt att hantera vissa händelser. Syftet var att ta beskriva sjuksköterskans upplevelser vid prehospitalt omhändertagande av suicidnära patienter. Metoden var kvalitativ med intervjuer som datainsamlingsmetod. Sju sjuksköterskor inom ambulanssjukvården intervjuades. Materialet spelades in och transkriberades för att sedan avidentifieras och analyseras med en kvalitativ manifest innehållsanalys. Resultatet redovisas i följande kategorier: Emotion och påverkad empati hos sjuksköterskan, kunskap, kompetens och erfarenhet, vården otillräcklig samt i mötet med patienten. Resultatet visade att sjuksköterskan upplevde en frustration och maktlöshet i vårdmötet. Ilska, brist på empati och osäkerhet var också upplevelser som kom fram. Det framkom att det råder en kunskapsbrist hos en del av sjuksköterskorna inom den prehospitala vården när det gäller bemötande och omhändertagande av psykiskt sjuka personer. Slutsatsen var att sjuksköterskor inom prehospital akutsjukvård behöver mer kunskap om bemötande och omhändertagande av suicidala patienter.

According to the World Health Organisation (WHO), suicide is one of the three main causes of deaths in the age group 15 to 34 years. Persons who previously attempted to commit suicide are more inclined to succeed with a second attempt. With the eventual focus on suicide prevention by means of life guidance as an assistance strategy in social work, the researcher undertook qualitative exploration amongst a specific group of adolescent girls between ages 15 and 21 years. These girls were each admitted to hospital after having attempted to commit suicide. The researcher used semi–structured in–depth interviews as a qualitative data collection method until data saturation was reached. The investigation was discussed against the backdrop of the strength perspective, crisis intervention, the system theory and existentialism. A discussion was led in Article 1 about findings regarding the psychosocial needs of adolescent girls who displayed suicidal behaviour. From the interviews, three overarching needs were foregrounded, namely the need for love and acceptance, the need for communication and the need for a secure future. The psychosocial needs were subdivided into sub–themes, which were discussed respectively. In Article 2 a discussion followed regarding the findings in terms of the support systems adolescents possess. Life guidance was eventually based on the needs of adolescent girls, as identified in Article 1, and the involvement and responsibility of the support systems, as discussed in Article 2. The guidelines for life guidance, as set out in Article 3, serve as a guiding recommendation and framework for intervention programmes for adolescent girls who display suicidal behaviour, as well as for the support systems involved. / Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2012.

According to the World Health Organisation (WHO), suicide is one of the three main causes of deaths in the age group 15 to 34 years. Persons who previously attempted to commit suicide are more inclined to succeed with a second attempt. With the eventual focus on suicide prevention by means of life guidance as an assistance strategy in social work, the researcher undertook qualitative exploration amongst a specific group of adolescent girls between ages 15 and 21 years. These girls were each admitted to hospital after having attempted to commit suicide. The researcher used semi–structured in–depth interviews as a qualitative data collection method until data saturation was reached. The investigation was discussed against the backdrop of the strength perspective, crisis intervention, the system theory and existentialism. A discussion was led in Article 1 about findings regarding the psychosocial needs of adolescent girls who displayed suicidal behaviour. From the interviews, three overarching needs were foregrounded, namely the need for love and acceptance, the need for communication and the need for a secure future. The psychosocial needs were subdivided into sub–themes, which were discussed respectively. In Article 2 a discussion followed regarding the findings in terms of the support systems adolescents possess. Life guidance was eventually based on the needs of adolescent girls, as identified in Article 1, and the involvement and responsibility of the support systems, as discussed in Article 2. The guidelines for life guidance, as set out in Article 3, serve as a guiding recommendation and framework for intervention programmes for adolescent girls who display suicidal behaviour, as well as for the support systems involved. / Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2012.