Suicid är en avsiktlig, självdestruktiv handling som leder till döden. Varje år begås närmare 800 000 suicid runt om i världen och av dessa uppskattas cirka 1100 suicid begås i Sverige. I genomsnitt sörjer sex personer för varje fullbordat suicid, vilket innebär att sjuksköterskor i stor utsträckning kommer att möta dessa anhöriga inom vården. Syftet med studien var således att belysa anhörigas upplevelser av att mista en familjemedlem till följd av suicid. Föreliggande studie är en litteraturbaserad studie baserat på kvalitativa artiklar. Studien behandlade begrepp som hälsa och lidande, vilket vidare relaterades till suicid och de efterlevandes upplevelser. En sammanställning av totalt nio vetenskapliga artiklar användes som grund i utformningen av resultatet. Resultatet redovisade att de efterlevande i hög omfattning upplevde känslor av skuld och skam, relaterat till att bli dömd av andra och att döma sig själv. Att bli dömd av omgivningen framgick bero på att denna sortens handling inte var accepterat i samhället, det beskrevs vara ett tabubelagt ämne. Stöd beskrevs upplevas som antingen tillfredsställt eller bristande. Att genomgå sorg innefattade ett känslomässigt kaos och de efterlevande hade ett stort behov av att få sörja. Att därefter gå vidare i livet gjordes med hjälp av olika metoder, bland annat ritualer för att bevara minnen av den avlidne men även att uppnå acceptans för att förmå att leva vidare. Dessa efterlevande upplevde ofta både psykiskt och fysiskt lidande, genomgående i kris- och sorgeprocessen. Det beskrevs att de efterlevande upplevde stort behov av stöd, men att flertalet inte erhöll tillgodosedda stödinsatser. Sjuksköterskors förmåga till utveckling av vårdkvaliteten för att förmå att minska lidande och förebygga ohälsa hos dessa anhöriga beskrevs därför som viktig. Sjuksköterskor bör således även ha en grund i vårdvetenskap för att kunna bidra till kunskapsutveckling inom detta område. / Background: Suicide is defined as a deliberate and self-destructive act that leads to death. It’s considered as a extensive health problem and each year, nearly 800 000 people die as a result of suicide around the world. Six people in each case estimates to be affected about the suicide. Sufficient support is considered important for these people. Aim: The aim of this study was to illuminate relative’s experience of losing a family member as a result of suicide. Method: A literature-based study including qualitative studies was chosen, according to Friberg (2006), in order to illuminate the relative’s experience of losing a family member as a result of suicide. The results of a total of nine scientific articles were compiled. Results: The results are presented in four themes, and a total of eight subthemes. The presented themes where grief, to be judged by others and to judge themselves, need of support and to continue living. Conclusion: The relatives often experience great suffering, but the results in this study shows that most suicide survivors don’t receive sufficient support. The care of these survivors thus requires a big commitment from the nurses. A guidance to relevant support measures is therefore of great importance, because sufficient support relieve illness, suffering and depression. The nurse should have a reflective approach and a scientific base in the care of these suicide survivors.

Background: Each year, over one million people around the world die as a result of suicide. About 1500 of those are in Sweden. In each case an estimated six kindred’s are to be affected. These people are in great need of support. Despite this, research shows that nurses experience difficulties to support the suicide survivors. Aim: The aim of this study was to describe kindred’s experiences after the loss of someone close as a result of suicide. Method: In order to capture the kindred’s experience of losing someone close as a result of suicide, a literature-based study were chosen, where nine scientific qualitative articles were analyzed. Results: The results are presented in four different themes, and eight subthemes, which all highlights kindred’s experience of losing someone close as a result of suicide. The themes where to feel an overwhelming grief; to feel judged by others and themselves; to feel the need of support; that life changes. Conclusion: Being related to someone who has died as a result of suicide causes great suffering and a changed life-world. The following study shows that most suicide survivors don’t get the support they need after the suicide. A better understanding of the suicide survivor’s experiences may lead to improved care and support. To prevent the suffering and to support the kindred’s health process this study shows that a caring science way of caring is required. Thus it applies to each nurse to be open and responsive to each individual’s life-world and its ambiguity

Bereavement is a challenging time for those experiencing a loss, and it poses a difficult clinical question: How do we help individuals who are grieving? The literature provides mixed evidence for variations in bereavement depending on the type of loss (e.g., suicide, expected natural, unexpected natural, accidental); however, there seems to be more overlap among grief processes than differences. Given that various religions tend to include tenets suggesting the sinfulness of death by suicide, the present study hypothesized that there would be greater levels of negative religious coping, less positive religious coping, less perceived religious support, and greater rates of lying about cause of death in response to suicide loss than natural or accidental deaths. Overall, our findings suggested little to no difference among positive religious coping or perceived religious support following suicide, accidental, or natural deaths. Various comparison methods yielded moderately consistent findings that individuals lied about cause of suicide death more often than natural or accidental deaths, consistent with extant research. Further, there was some evidence of greater levels of negative religious coping for accidental deaths than natural deaths. The current study contributes prevalence rates for exposure to and distress following suicide, natural, and accidental deaths, as well as suggesting that the role of religion in suicide bereavement need not be different from other types of death.

Målet med studien är att med kvalitativ metod undersöka efterlevandes upplevelse av en närståendes självmord. Med semi-strukturerade intervjuer har sex deltagare i Mellansverige skildrat sin upplevelse och materialet har bearbetats i enlighet med metoden Interpretative Phenomenological Analysis (IPA). Genom analysen synliggjordes tre områden nämligen 1) att uppleva en närståendes självmord, 2) att hantera en närståendes självmord och 3) att skapa mening kring en närståendes självmord. Dessa består i sin tur av ett antal teman som detaljerat beskriver varje del av den totala upplevelsen. Något som är särskilt värt att nämna är hur viktig omgivningens förståelse varit för att de efterlevande ska kunna bearbeta sitt trauma. Deltagande i stödgrupp för efterlevande har varit till hjälp samt den inre styrka som samtliga deltagare upplever sig ha anammat för att orka och utvärderat studiens begränsningar samt givit förslag på fortsatt forskning.

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Suicide has existed throughout recorded history. It is a phenomenon that has been both culturally and morally defined across time and civilizations. It is estimated that over 34,000 Americans deliberately take their own lives annually. Moreover, according to some experts, between 6 and 28 individuals are directly affected by each completed suicide. These individuals are referred to as suicide survivors. The consequences for suicide survivors are multidimensional in part because relationships to the deceased play a vital role in bereavement. Previous research studies in the areas of suicidology and bereavement have failed to explore the experience of mothers bereaved by the suicide death of a child. The purpose of this qualitative study was to explore phenomenologically the lived experience of mothers following the suicide death of a child. One-on-one, semistructured interviews were conducted with 9 mothers. The time since the suicide ranged from 1 year and 3 months to 21 years and 6 months. Data analysis was driven by Max van Manen's descriptive-investigative process. This process involved guided reflections using van Manen's 4 existentials: spatiality, corporeality, temporality, and relationality. The interviews began with a general statement; 'Tell me about your child." General questions related to the existentials were asked during the interviews to clarify the participants' stories. Data were managed using NVivo 9.0 qualitative data management software. Three essential themes were inductively derived from the data: 1) Know My Child: Not the Act, 2) Frozen Past: Altered Future, 3) Ocean of Grief. The 3 essential themes provide a deeper understanding of the role of stigmatization in the grief process of mothers following the loss of a child to suicide. In addition, these themes contribute to an appreciation of the role of past memories and future orientation as mothers are enmeshed in the grief process and its unpredictable path. Data from this study clarify the unique circumstances and needs of mothers as they attempt to navigate life after losing a child to suicide. The findings from this study suggest areas for future research and will assist healthcare professionals including nurses, school counselors, and mental health professionals as they approach mothers who are suicide survivors.

Text in Afrikaans / Selfmoord is 'n kontroversiele aangeleentheid wat beide omstanders en agterblywendes met onsekerheid vervul. 'n Belangrike rede hiervoor is dat dit 'n onnatuurlike afsterwe is wat teen baie mense se norme en waardes indruis. ldiografiese navorsing is onderneem om die belewenisse van agterblywende gesinslede te ondersoek aangesien hulle die eintlike slagoffers van 'n selfmoord is wat met 'n komplekse realiteit gelaat word. Die doel van die navorsing was om riglyne daar te stel vir die hantering en ondersteuning van hierdie mense. Vanuit 'n in-diepte literatuurstudie, het dit geblyk dat die grootste probleme waarmee agterblywendes gekonfronteer word, wentel random problematiese emosies, veroordeling deur omstanders en belewings van persoonlike onvermoe om te midde van intense rousmart selfaktualisering optimaal te volvoer. 'n Vraelys wat aspekte (socs dit uit die literatuurstudie geblyk het) inkorporeer, is opgestel en aan agterblywendes gegee om te beantwoord. Van die belangrikste elemente wat na vore gekom het, is dat intense verhoudingskomplikasies na 'n selfmoord figureer, dat agterblywendes 'n behoefte het om rouverwerking teen hul eie tempo te doen, dat agterblywendes verkies dat omstanders nie voortdurend die gebeure sal ontleed en soek na oorsake in die teenwoordigheid van agterblywendes nie en dat elke agterblywende persoon se roubelewing persoonlik en uniek is. 'n Hoofstuk is gewy aan 'n wye verskeidenheid terapeutiese tegnieke wat geimplementeer kan word tydens hulpverlening aan agterblywendes. Die studie beskryf ook 'n gevallestudie en die verloop van sestien individuele terapeutiese sessies. In die terapeutiese insette is daar hoofsaaklik gebruik gemaak van hipnoterapie as 'n vorm van ontspanningsterapie waartydens daar gelokus word op problematiese emosies en persepsies wat voortgesette kwalitatiewe selfaktualisering belemmer. In die studie word Opvoedkundige Sielkundige riglyne vir hulpverlening aan agterblywendes, wat benut kan word deur hulpverleners (soos sielkundiges, onderwysers en ander ondersteuningsisteme). verskaf. Die studie bevestig dat die agterblywendes as die werklike slagoffers na 'n selfmoord agtergelaat word, maar dat sinvolle intervensie hierdie persone in staat kan stel om ten spyte van die gebeure weer optimaal te selfaktualiseer. / Suicide is a controversial topic. It causes both bystanders and survivors to feel insecure. An important reason for this is that it is an unnatural death which directly opposes the norms and values of the majority of people. ldiografic research has been undertaken to closely examine the experiences of suicide survivors as they are the real victims who are left to cope with a complex reality after a suicide. The objective of this study was to provide guidelines to effectively manage and render assistance to survivors. From an in depth review of available literature it appeared that troubled emotions, being denounced by bystanders and the inability to proceed with continued qualitative self-actualization are some of the most important problems survivors have to cope with. A questionnaire, incorporating significant aspects reported in literature, was compiled and given to survivors to complete. From their responses certain facets seemed to be problematic. Among the more problematic aspects were complicated interpersonal relations, the basic need to grieve at their own pace, the preference that bystanders avoid analysing the suicide and possible contributing factors (especially in the presence of survivors) and the recognition that each survivor's grief is personal and unique. A chapter has been devoted to a wide range of therapeutic techniques that can be implemented to facilitate the support given to survivors. The study also describes a case study as well as the progression of sixteen individual therapy sessions. Therapeutic intervention was mainly based on hypnotherapy as a form of relaxation therapy during which the focus is placed on problematic emotions and perceptions which prevent continued qualitative self-actualization. Educational Psychological guidelines along which assistance can be rendered by psychologists, teachers as well as other support services are given. This study not only confirms that the survivors are the actual victims of a suicide, but also that it is possible to assist these people to achieve optimal self-actualization through meaningful intervention. / Psychology of Education / D. Ed. (Sielkundige Opvoedkunde)

Text in Afrikaans / Selfmoord is 'n kontroversiele aangeleentheid wat beide omstanders en agterblywendes met onsekerheid vervul. 'n Belangrike rede hiervoor is dat dit 'n onnatuurlike afsterwe is wat teen baie mense se norme en waardes indruis. ldiografiese navorsing is onderneem om die belewenisse van agterblywende gesinslede te ondersoek aangesien hulle die eintlike slagoffers van 'n selfmoord is wat met 'n komplekse realiteit gelaat word. Die doel van die navorsing was om riglyne daar te stel vir die hantering en ondersteuning van hierdie mense. Vanuit 'n in-diepte literatuurstudie, het dit geblyk dat die grootste probleme waarmee agterblywendes gekonfronteer word, wentel random problematiese emosies, veroordeling deur omstanders en belewings van persoonlike onvermoe om te midde van intense rousmart selfaktualisering optimaal te volvoer. 'n Vraelys wat aspekte (socs dit uit die literatuurstudie geblyk het) inkorporeer, is opgestel en aan agterblywendes gegee om te beantwoord. Van die belangrikste elemente wat na vore gekom het, is dat intense verhoudingskomplikasies na 'n selfmoord figureer, dat agterblywendes 'n behoefte het om rouverwerking teen hul eie tempo te doen, dat agterblywendes verkies dat omstanders nie voortdurend die gebeure sal ontleed en soek na oorsake in die teenwoordigheid van agterblywendes nie en dat elke agterblywende persoon se roubelewing persoonlik en uniek is. 'n Hoofstuk is gewy aan 'n wye verskeidenheid terapeutiese tegnieke wat geimplementeer kan word tydens hulpverlening aan agterblywendes. Die studie beskryf ook 'n gevallestudie en die verloop van sestien individuele terapeutiese sessies. In die terapeutiese insette is daar hoofsaaklik gebruik gemaak van hipnoterapie as 'n vorm van ontspanningsterapie waartydens daar gelokus word op problematiese emosies en persepsies wat voortgesette kwalitatiewe selfaktualisering belemmer. In die studie word Opvoedkundige Sielkundige riglyne vir hulpverlening aan agterblywendes, wat benut kan word deur hulpverleners (soos sielkundiges, onderwysers en ander ondersteuningsisteme). verskaf. Die studie bevestig dat die agterblywendes as die werklike slagoffers na 'n selfmoord agtergelaat word, maar dat sinvolle intervensie hierdie persone in staat kan stel om ten spyte van die gebeure weer optimaal te selfaktualiseer. / Suicide is a controversial topic. It causes both bystanders and survivors to feel insecure. An important reason for this is that it is an unnatural death which directly opposes the norms and values of the majority of people. ldiografic research has been undertaken to closely examine the experiences of suicide survivors as they are the real victims who are left to cope with a complex reality after a suicide. The objective of this study was to provide guidelines to effectively manage and render assistance to survivors. From an in depth review of available literature it appeared that troubled emotions, being denounced by bystanders and the inability to proceed with continued qualitative self-actualization are some of the most important problems survivors have to cope with. A questionnaire, incorporating significant aspects reported in literature, was compiled and given to survivors to complete. From their responses certain facets seemed to be problematic. Among the more problematic aspects were complicated interpersonal relations, the basic need to grieve at their own pace, the preference that bystanders avoid analysing the suicide and possible contributing factors (especially in the presence of survivors) and the recognition that each survivor's grief is personal and unique. A chapter has been devoted to a wide range of therapeutic techniques that can be implemented to facilitate the support given to survivors. The study also describes a case study as well as the progression of sixteen individual therapy sessions. Therapeutic intervention was mainly based on hypnotherapy as a form of relaxation therapy during which the focus is placed on problematic emotions and perceptions which prevent continued qualitative self-actualization. Educational Psychological guidelines along which assistance can be rendered by psychologists, teachers as well as other support services are given. This study not only confirms that the survivors are the actual victims of a suicide, but also that it is possible to assist these people to achieve optimal self-actualization through meaningful intervention. / Psychology of Education / D. Ed. (Sielkundige Opvoedkunde)

Suicide has immediate and long-term negative effects on surviving family members and adverse effects in the school and community. Suicide rates for children and adolescents have increased in the United States since 2009. As part of suicide prevention efforts, information about risk factors and warning signs are typically addressed in schools, private organizations, and communities. In addition to academic literature for professional audiences, various therapeutic resources are available to assist those who grieve the suicide of a loved one. In particular, practical and easy-to-implement interventions are needed by those who offer support to suicidal individuals and survivors of suicide. Practical resources are needed to address suicide prevention, intervention, and postvention needs. This study is based on a questionnaire that was given to 250 registered individuals at an annual state suicide prevention training conference. Of those attending, 60 (24%) completed the questionnaire. Participants who did not have experience working with suicidal youth did not participate, so the actual participation rate was influenced by this factor. Questions explored the recommendations of mental health professionals (N=60) who worked with (a) suicidal youth, (b) siblings of youth who completed suicide, and/or (c) youth whose parent completed suicide. More specifically this study investigated specific strategies and resources for working with these three specific groups of survivors. Findings from this study indicated that mental health professionals recommend a variety of suicide prevention resources and strategies such as implementing evidenced-based prevention programs, accessing community resources, offering individual and group counseling for survivors, involving or creating support systems, and listening to the affected youth. Also, recommended therapeutic approaches should include an action plan where students are able to receive appropriate mental health services. Based on this study, mental health professionals may be more effective as they acquaint themselves with available resources such as counselors, school psychologists, and community services to comprehensively care for struggling individuals. Mental health professionals, educators, and staff members should obtain relevant information and utilize effective intervention models in order to better address the prevention, intervention, and postvention needs of surviving individuals.Recommendations are made for future research in identifying the combination of resources that are most helpful. Recommendations are also made regarding specific content and training strategies to more effectively prepare and equip professionals to engage more fully in effective and supportive suicide prevention efforts.

Suicide in India is a complex social issue and a neglected area by the state. Research has focused on risk factors and the epidemiology of suicide; studies concerning the intersection of culture with attempted suicide are limited. The aim of this study is to explore cultural implications of attempted suicide and its prevention in Southern India by means of comparing and contrasting the accounts of survivors of attempted suicide, mental health professionals and traditional healers engaged in treating people with suicidal behaviour. Methodology: A qualitative design is used drawing on constant comparison method and thematic analysis. The analysis of the data is underpinned by the theoretical concepts of Bourdieu’s work. In-depth interviews were conducted with fifteen survivors of attempted suicide, eight mental health professionals and eight healers from Southern India. Results: Application of Bourdieu’s theory of symbolic power and violence, cultural capital and habitus to the analysis of data revealed the process of constant interaction among visible and invisible fields such as faith, power, control, family, religion and social systems which impact survivors’ disposition to situations. Disparities in gender and role structures within families, financial challenges, health concerns, abuse, and violence were commonly cited factors by all three groups of participants. A few survivors and healers attributed misfortunes and distress to magic, spells and ‘bad times’. Healers and professionals were particularly of the opinion that cultural transition has added to stress among people. Survivors considered religious and traditional methods of support as socially accepted norms. Medical assistance was sought only during apparent ill health. Psychosocial support was very rarely accessed and availed. A lack of awareness among family members and friends to identify mental health concerns and a wide gap between identification of severe stressors and treatment increased the risk of suicide and limited timely intervention. Conclusion: This study identified a set of cultural mechanisms that produced negative impact and led to attempted suicide. The role of culture in causing suicide and attempted suicide is explained by unraveling the dynamics of cultural mechanisms and support processes that survivors experienced and as reported by professionals and healers. This research evidence presents pathways into attempted suicide and a life away from suicide.