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Caring for the suicidal person: A Delphi study of what characterizes a recovery-oriented caring approach
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.ORCID iD: 0000-0002-8306-0521
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.ORCID iD: 0000-0002-8314-387X
Uppsala Univ, Cty Hosp, Clin Res Ctr, Vasteras, Sweden..
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. UiT Archt Univ Norway, Narvik, Norway.ORCID iD: 0000-0002-9714-577X
(English)In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349Article in journal (Other academic) Epub ahead of print
Abstract [en]

More research is needed for supporting mental health nurses in their caring for suicidal individuals. This study aimed to describe what characterizes a recovery‐oriented caring approach, and how this can be expressed through caring acts involving suicidal patients and their relatives. Delphi methodology was used, and research participants were recruited as experts by experience to explore a recovery‐oriented caring approach in a dialogical process between the experts and the researchers. The results highlight that it is important to acknowledge the view of the uniqueness of each person and reflected understanding of each individual person and experience. The results also reveal that a recovery‐oriented caring approach is characterized by a ‘communicative togetherness’. This communicative togetherness is associated with enabling a nurturing and caring space for suicidal patients to really express themselves and to reach for their own resources. The recovery‐oriented caring approach has thereby potential to facilitate a mutual understanding of the complexities of the patient's situation, and supports patients in influencing their care and regaining authority over their own lives. Accordingly, mental health nurses need to listen sensitively to what suicidal patients really say by acknowledging their lifeworlds and being open to individual variations of their recovery processes. This includes recognizing available and supportive relatives as capable of contributing to the patient's life project to continue living.

National Category
Health Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-37227DOI: 10.1111/inm.12481OAI: oai:DiVA.org:mdh-37227DiVA, id: diva2:1155736
Available from: 2017-11-09 Created: 2017-11-09 Last updated: 2018-06-04Bibliographically approved
In thesis
1. A personal-recovery-oriented caring approach to suicidality
Open this publication in new window or tab >>A personal-recovery-oriented caring approach to suicidality
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Persons who are subject to care due to suicidal thoughts and/or acts, are in a vulnerable situation, struggling with issues related to life and death as well as experiences of hopelessness and powerlessness. They may also experience themselves as a burden for their relatives. The relatives’ struggle for contributing to the loved person’s survival, can involve experiences of taking responsibility for things that are outside their control. Although research considering how suicidal persons and their relatives can be supported, when the person receives care in a psychiatric inpatient setting is sparse. There is also a need for research to form the basis for mental health nurses to enable caring interventions, with the potential of acknowledging the uniqueness of each individual person and their experiences. This thesis is based on a perspective of recovery as a process, where the persons experience themselves as capable of managing both challenges and possibilities in life and incorporate meaning into it. Experiences of being capable of managing problems in living are vital for this process. Thus, it is necessary to acknowledge the lifeworld as essential for personal recovery.

The overall aim of this research  was to develop, introduce and evaluate a caring intervention, to support suicidal patients’ recovery and health, and to support patients’ and their relatives’ participation in the caring process. Considering the complexity of such a caring intervention and the importance of recognizing multiple aspects of the phenomenon (i.e., recovery in a suicidal crisis), this research was conducted from a lifeworld perspective based on phenomenological philosophy. Two studies with reflective lifeworld research approach (I, II), a Delphi study (III), and a single case study with QUAL>quan mixed methods research approach (IV) were conducted.

The developed caring intervention is characterized by “communicative togetherness”. This means that the nurse and the patient together explore how the patient’s recovery can be supported, as a way for the patient to reconnect with self and important others, and thereby being strengthened when challenged by problems in living. It was also concluded that it is more appropriate to acknowledge this as a caring approach, rather than describe it as a specific caring intervention. The final description of the findings comprise a preliminary guide to a personal-recovery-oriented caring approach to suicidality (PROCATS). This description highlights six core aspects of the caring approach. The overall aim of the PROCATS is to support suicidal patients’ recovery and health processes, even at the very edge of life. Although the findings indicate that the caring approach has potential to support suicidal patients’ recovery as well as support their relatives’ participation, there is a need for further evaluation of the PROCATS in a wider context.

Place, publisher, year, edition, pages
Västerås: Mälardalen University, 2017
Series
Mälardalen University Press Dissertations, ISSN 1651-4238 ; 245
Keywords
Dialogue, hermeneutics, lifeworld, mental health nursing, participation, patient’s perspective, person-centred care, phenomenology, recovery, reflective lifeworld research, reflective understanding, relative’s perspective, suicidality, suicide prevention
National Category
Medical and Health Sciences Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-37213 (URN)978-91-7485-358-2 (ISBN)
Public defence
2017-12-15, Beta, Mälardalens högskola, Västerås, 13:15
Opponent
Supervisors
Available from: 2017-11-06 Created: 2017-11-05 Last updated: 2018-01-26Bibliographically approved

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Sellin, LindaKumlin, TomasWiklund Gustin, Lena

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