Décrire, comprendre et schématiser le processus de l'évaluation du risque suicidaire selon une perspective infirmière auprès des moins de 12 ans en santé mentale
Suicide prevention is an important aspect of the work of any healthcare professional, especially for nurses working in mental healthcare settings. However, suicide risk assessment is not conducted systematically, varying from one setting to another. Furthermore, there is no information to our knowledge on this type of risk assessment process with children under 12 years old. This topic is particularly difficult to explore and to understand in a society where children are expected to grow to be healthy and happy. The aim of this study is to describe, understand and schematize nurses’ suicide risk assessment process with children under12 in a mental health setting. The background of this study is the humanistic model in nursing – UdeM. Centered on the Person, this model takes into account their significant interpersonal relationships, their subjective experience of care and its meaning. Strauss et Corbin’s (1998) approach in grounded theory was used to conduct this study. Using theoretical sampling, data was obtained through 11 semi-structed interviews with nurses working in five different administrative regions in the province of Quebec, nurses’ documents, socio-demographic questionnaires, and field notes. A constant comparative analysis of the data across triple coding allowed a better understanding and a schematization of the nurses’ suicide risk assessment process with children. The process includes two main phases relating to nurses’ actions. These two phases are: (1) Understanding the meaning of the child’s distress, and (2) Ensuring the child and their family’s safety. The different elements involved in each phase are not exclusive to one phase or the other. In fact, characteristics of nurses (temperament, beliefs and perceptions, past experiences) interact with those of the child and his or her family (suicidal ideations or behaviors, level of understanding of the concept of death, mental health state, family dynamics and attitudes, parents’ perceptions and beliefs ). This interaction can produce both positive and negative impacts. The environment (health and services organization) where this interaction occurs can also impact on the whole assessment process. Our findings reveal that for both phases of the assessment process with children, nurses have to take in account the developmental aspect of the child and must be careful to maintain their empathic posture, so they are not overwhelmed by emotions. Doing so will help lessen the level of emotional intensity for the nurse during the whole process. A better understanding of this process can help nurses and other professionals improve their interventions with children presenting a suicidal risk as well as their parents and in the long term, contribute to suicide prevention.
Suicide risk Children under 12 Nurses Assessment process Grounded theory