Attitudes of health professionals towards suicidal behavior: an intervention study

Authors

DOI:

https://doi.org/10.11606/s1518-8787.2022056003320

Keywords:

Attitude of Health Personnel, Health Human Resource Training, Suicidal Ideation, Primary Health Care, Randomized Controlled Trial

Abstract

OBJECTIVE To evaluate the effect of an educational intervention on the attitudes of primary healthcare providers regarding patients with suicidal behavior. METHODS Clinical trial randomized by clusters, with a sample of 261 healthcare professionals, from 22 health units selected by stratified sampling, were chosen and randomly allocated, by drawing, into two groups: intervention (n = 87) and control (n = 174). The participants of the intervention group were exposed to a 20-hour training on suicidal behavior. All 261 participants were evaluated before and after the intervention; the groups were compared to evaluate their attitude towards suicidal behavior using the Suicide Behavior Attitude Questionnaire (SBAQ), an evaluation made by comparison of the means via t-Student test, for independent samples, and paired t-test, for dependent samples. RESULTS The intervention group, in comparison to their evaluation before and after training, as well as in the comparison with the evaluation of the control group, showed statistically significant differences in attitudes towards suicidal behavior, according to the differences presented in the scores for the domains: “perception of professional capacity,” in all four items; “negative feeling,” in six of the seven items; and in the “right to commit suicide” domain, in three of the five items. CONCLUSION The brief training developed in primary health care was effective to improve the attitudes of the participants who were part of the intervention group regarding patients with suicidal behavior.

References

World Health Organization. Suicide data. WHO Press: Geneva (CH): WHO; 2019 [citado 16 mar 2020]. Disponível em: https://www.who.int/data/gho/data/themes/mental-health/suicide-rates

Alicandro G, Malvezzi M, Gallus S, La Vecchia C, Negri E, Bertuccio P. Worldwide trends in suicide mortality from 1990 to 2015 with a focus on the global recession time frame. Int J Public Health. 2019;64(5):785-95. https://doi.org/10.1007/s00038-019-01219-y

Ministério da Saúde (BR), Secretaria de Vigilância em Saúde. Perfil epidemiológico das tentativas e óbitos por suicidio no Brasil e a Rede de Atenção à Saúde. Bol Epidemiol. 2017 [citado 16 mar 2020];40(30):1-14. Disponível em: https://www.gov.br/saude/pt-br/centrais-de-conteudo/2017-025-perfil-epidemiologico-das-tentativas-e-obitos-por-suicidio-no-brasil-e-a-rede-de-aten-ao-a-sa-de-pdf

Cohen AA, Magnezi R, Weinstein O. Review and analysis of mental health reforms in several countries: implementation, comparison and future challenges. Ann Psychiatry Treat. 2020;4(1):13-24. https://doi.org/10.17352/apt.000015

Stene-Larsen K, Reneflot A. Contact with primary and mental health care prior to suicide: a systematic review of the literature from 2000 to 2017. Scand J Public Health. 2019;47(1):9-17. https://doi.org/10.1177/1403494817746274

Hauge LJ, Stene-Larsen K, Grimholt TK, Øien-Ødegaard C, Reneflot A. Use of primary health care services prior to suicide in the Norwegian population 2006-2015. BMC Health Serv Res. 2018;18:619. https://doi.org/10.1186/s12913-018-3419-9

Ferreira ML, Vargas MAO, Rodrigues J, Trentin D, Brehmer LCF, Lino MM. Comportamento suicida e atenção primária à saúde. Enferm Foco. 2019;9(4):1-15. https://doi.org/10.21675/2357-707X.2018.v9.n4.1803

Rosa NM, Dell Agnolo CM, Oliveira RR, Mathias TAF, Oliveira MLF. Tentativas de suicídio e suicídios na atenção pré-hospitalar. J Bras Psiquiatr. 2016;65(3):231-8. https://doi.org/10.1590/0047-2085000000129

Osafo J, Akotia CS, Boakye KE, Dickson E. Between moral infraction and existential crisis: exploring physicians and nurses' attitudes to suicide and the suicidal patient in Ghana. Int J Nurs Stud. 2018;85:118-25. https://doi.org/10.1016/j.ijnurstu.2018.05.017

Boukouvalas E, El-Den S, Murphy AL, Salvador-Carulla L, O’Reilly CL. Exploring health care professionals’ knowledge of, attitudes towards, and confidence in caring for people at risk of suicide: a systematic review. Arch Suicide Res. 2019;24 Suppl 2:S1-31. https://doi.org/10.1080/13811118.2019.1586608

Richardson DC. Psicologia social para leigos. Rio de Janeiro: Alta Books; 2017. p. 67-112.

Rayner G, Blackburn J, Edward KL, Stephenson J, Ousey K. Emergency department nurse's attitudes towards patients who self‐harm: a meta‐analysis. Int J Ment Health Nurs. 2019;28(1):40-53. https://doi.org/10.1111/inm.12550

Wee LH, Ibrahim N, Wahab S, Visvalingam U, Yeoh SH, Siau CS. Health-care workers’ perception of patients’ suicide intention and factors leading to it: a qualitative study. Omega (Westport). 2020;82(2):323-45. https://doi.org/10.1177/0030222818814331

Kumar N, Rajendra R, Majgi SM, Krishna M, Keenan P, Jones S. Attitudes of general hospital staff toward patients who self-harm in South India: a cross-sectional study. Indian J Psychol Med. 2016;38(6):547-52. https://doi.org/10.4103 / 0253-7176.194920

Vedana KGG, Magrini DF, Zanetti ACG, Miasso AI, Borges TL, Santos MA. Attitudes towards suicidal behavior and associated factors among nursing professionals: a quantitative study. J Psychiatr Ment Health Nurs. 2017;24(9-10):651-9. https://doi.org/10.1111/jpm.12413

Nakagami Y, Kubo H, Katsuki R, Sakai T, Sugihara G, Naito C, et al. Development of a 2-h suicide prevention program for medical staff including nurses and medical residents: a two-center pilot trial. J Affect Disord. 2018;225:569-76. https://doi.org/10.1016/j.jad.2017.08.074

Kullberg MLJ, Mouthaan J, Schoorl M, Beurs D, Kenter RMF, Kerkhof AJ. E-learning to improve suicide prevention practice skills among undergraduate psychology students: randomized controlled trial. JMIR Ment Health. 2020;7(1);e14623. https://10.2196/14623

Van Landschoot R, Portzky G, Van Heeringen K. Knowledge, self-confidence and attitudes towards suicidal patients at emergency and psychiatric departments: randomised controlled trial of the effects of an educational poster campaign. Int J Environ Res Public Health. 2017;14(3):304. https://doi.org/10.3390/ijerph14030304

Siau CS, Wee LH, Ibrahim N, Visvalingam U, Yeap LLL, Wahab S. Gatekeeper suicide training's effectiveness among Malaysian hospital health professionals: a control group study with a three-month follow-up. J Contin Educ Health Prof. 2018;38(4);227-34. https://doi.org/10.1097/CEH.0000000000000213

Ramberg IL, Di Lucca MA; Hadlaczky G. The impact of knowledge of suicide prevention and work experience among clinical staff on attitudes towards working with suicidal patients and suicide prevention. Int J Environ Res Public Health. 2016;13(2):195. https://doi.org/10.3390/ijerph13020195

Ferguson M, Dollman J, Jones M, Cronin K, James L, Martinez L, Procter N. Suicide prevention training - Improving the attitudes and confidence of rural Australian health and human service professionals. Crisis. 2018;40(1):15-26. https://doi.org/10.1027/0227-5910/a000524

Holmes G, Clacy A, Hermens DF, Lagopoulos J. The long-term efficacy of suicide prevention gatekeeper training: a systematic review. Arch Suicide Res. 2021;25(2):17-207. https://doi.org/10.1080/13811118.2019.1690608

Prefeitura de Cuiabá (MT), Departamento de Atenção Básica. Unidades de Saúde - Cuiabá/MT, Competência: Dezembro de 2016 [citado 10 jun 2018]. Cuiabá, MT; 2018. Disponível em: https://www.cuiaba.mt.gov.br/imprime.php?cid=8138&sid=218

Carneiro AV. Cálculo da dimensão da amostra em estudos clínicos: princípios metodológicos básicos. Rev Port Cardiol. 2003;22(12):1513-21.

Cais CFS, Silveira IU, Stefanello S, Neury JB. Suicide prevention training for professionals in the public health network in a large Brazilian city. Arch Suicide Res. 2011;15(4):384-9. https://doi.org/10.1080/13811118.2011.616152

Botega NJ, Reginato DG, Silva SS, Cais CFS, Rapeli CB, Mauro MLF, et al. Nursing personnel attitudes towards suicide: the development of a measure scale. Rev Bras Psiquiatr. 2005;27(4):315-8. https://doi.org/10.1590/S1516-44462005000400011

Patel R, Mehta R, Dave K, Chaudhary P. Effectiveness of gatekeepers’ training for suicide prevention program among medical professionals and medical undergraduate students of a medical college from Western India. Ind Psychiatry J. 2021;30(2):217. https://doi.org/10.4103/ipj.ipj_31_21

Moraes SM, Magrini DF, Zanetti ACG, Santos MA, Vedana KGG. Attitudes and associated factors related to suicide among nursing undergraduates. Acta Paul Enferm. 2016;29(6):643-9. https://doi.org/10.1590/1982-0194201600090

Park CHK, Kim B, Lee SS, Ha K, Baek CJ, Shin MS, et al. A comparative study of permissive attitudes toward suicide: an analysis of cross-national survey in South Korea, Japan, and the United States. Korean J Biol Psychiatry. 2016;23(4):157-65.

Ferreira GS, Fajardo AP, Mello ED. Possibilidades de abordagem do tema do suicídio na Estratégia Saúde da Família. Physis. 2019;29(4):e290413. https://doi.org/10.1590/S0103-73312019290413

Oliveira CT, Collares LA, Noal MHO, Dias ACG. Percepções de uma equipe de saúde mental sobre o comportamento suicida. Gerais Rev Interinst Psicol. 2016 [citado 16 mar 2020];9(1):78-89. Disponível em: http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1983-82202016000100007&lng=pt

Silva C, Smith AR, Dodd DR, Covington DW, Joiner TE. Suicide-related knowledge and confidence among behavioral health care staff in seven states. Psychiatr Serv. 2016;67(11):1240-5. https://doi.org/10.1176/appi.ps.201500271

Nakagami Y, Kubo H, Katsuki R, Sakai T, Sugihara G, Naito C, et al. Development of a 2-h suicide prevention program for medical staff including nurses and medical residents: a two-center pilot trial. J Affect Disord. 2018;225:569-76. https://doi.org/10.1016/j.jad.2017.08.074

Barreira MM. Suicídio como autodeterminação da cidadania perante o Estado. Rev Bioet. 2017;25 (2):301-10. https://doi.org/10.1590/1983-80422017252190

Freitas APA, Borges LM. Do acolhimento ao encaminhamento: o atendimento às tentativas de suicídio nos contextos hospitalares. Estud Psicol (Natal). 2017;22(1):50-60. https://doi.org/10.5935/1678-4669.20170006

Published

2022-06-13

Issue

Section

Original Articles

How to Cite

Faria, J. S., Marcon, S. R., Nespollo, A. M. ., Santos, H. G. B. dos, Espinosa, M. M., Oliveira, K. K. B. de, & Lima, J. G. da S. (2022). Attitudes of health professionals towards suicidal behavior: an intervention study. Revista De Saúde Pública, 56, 54. https://doi.org/10.11606/s1518-8787.2022056003320