Suicidal Clients
Suicide is associated with thwarted or unfulfilled needs, feelings of hopelessness and helplessness, ambivelent conflicts between survival and unbearable stress, a narrowing of perceived options and a need to escape
Shneidman,1996
Suicide maybe a culmination of self-destructive urges that have resulted from the clients internalising his or her anger or a desperate act by which to escape a percieved intolerable psychological state or life situation. The client may be asking for help by attempting suicide, seeking attention or attempting to manipulate someone with suicidal behavior.
Schultz & Videbeck, 2002
Etiology:
Genetic and Biologic Theories – Genetic Markers – Relationship of Neurochemical Binding Sites– Twin and Adoption Studies
Sociological Theory Psychological Theories
– Theory of Parasuicidal Behavior– Other Psychological Factors
Individuals at risk of self destructive behavior: Clients with a psychiatric disorder Clients with alexithymia Clients with medical illnesses
– Euthanasia and PAS Adolescents High-risk population groups
– Ethnic minorities, homosexuals, incarcerated, elderly
– Divorced, separated, widowed, unemployed
– High-risk occupations: anesthesiology, psychiatry, dentistry
The Nursing Process:
Assessment Nursing Diagnosis Outcome Identification Planning Interventions
Cont: Implementation
– Establishment of a safe environment
• Suicide prevention
• Suicide precautions• No suicide contract• Seclusion and restraint
– Assistance in meeting basic human needs
– Medication management
– Interactive therapies
– Client and family education Continuum of care
– Special considerations: adolescent clients
– Interventions after a successful suicide attempt
• Psychological autopsy
• Postvention for bereaved survivors
Evaluation
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