For annually between 2010 and 2020, a median of over 6,200 individuals within the UK took their very own lives (The Nationwide Confidential Inquiry into Suicide and Security in Psychological Well being, 2023). This loss could have been felt keenly by the various hundreds of members of the family, buddies and colleagues who stay. Reflecting its public and psychological well being significance, a number of Psychological Elf blogs have appeared over time specializing in up-to-date analysis within the areas of suicide and self-harm, with latest examples exploring the relationships between the therapeutic alliance, psychosis and suicide, the dangers of suicide amongst individuals with extreme bodily well being issues and suicide danger amongst younger LGBTQ+ individuals.
On this paper, Groves et al. (2023) got down to systematically carry collectively what is understood about suicide, self-harm and suicidal considering in nurses and midwives, and to concurrently synthesise the proof regarding contributory components and interventions. As they word, a part of the context for his or her examine is a longstanding concern that the dangers of suicide amongst nurses are elevated relative each to the overall inhabitants and to different occupational teams (The Nationwide Confidential Inquiry into Suicide and Security in Psychological Well being, 2020).
With the intention of bettering on earlier critiques which the authors establish as having had methodological and/or different shortcomings, on this examine the purpose was to synthesise the proof from present analysis on suicide, suicidal considering and suicidal behaviours in nurses and midwives. The evaluate additionally aimed to attract out implications for prevention, and to make suggestions for additional investigation.
Having beforehand printed their protocol on PROSPERO, the worldwide potential register of systematic critiques, Groves et al. (2023) opened with the interrogation of three databases (CINAHL, Medline and PsycINFO) within the seek for all related empirical papers, utilizing any design, printed within the English language from 1996 onwards. Detailed search methods are included in a supplementary file.
In the principle paper, info is given on the extra methods used to establish materials together with an account of how gadgets have been screened and the way knowledge from included papers have been extracted. High quality evaluation concerned use of the Blended Strategies Appraisal Device (Hong et al., 2018), with a story method used to the synthesis of findings.
A clearly labelled PRISMA movement diagram exhibits how a complete of 100 research have been lastly included within the evaluate, with the bulk utilizing quantitative strategies and the one largest quantity (40) coming from North America. Examine high quality diverse, with solely a small quantity addressing interventions to scale back the dangers of suicide.
Forty-five of the 100 research from world wide examined the prevalence of suicide. Proof from numbers of those indicated elevated dangers of suicide for nurses (and midwives, the place these have been included in research) in comparison with the overall inhabitants and to another occupational teams. Proof from some included research additionally indicated that nurses taking their very own lives have been extra possible than different occupational teams and the overall inhabitants to have skilled prior psychological well being issues. As within the common inhabitants, substance misuse and bodily ill-health have been additionally discovered to be danger components for suicide, with precise or potential job loss additionally recognized as a danger consider some research.
Twenty-one research investigated the strategies utilized in suicide completion, and 36 of the included research targeted on self-harm, suicidal behaviour and suicidal considering. Continual sickness, debt and expertise of psychological well being difficulties have been amongst the components related to nurses’ self-reporting of suicidal ideas and behaviours.
Research investigating suicidal considering have been characterised by selection by way of approaches taken to measurement and the time interval for evaluation, with some proof of burnout and melancholy being related to suicide ideation. Along with a collection of research explicitly inspecting suicidal ideas and behaviours within the context of the Covid-19 pandemic, solely three of the 100 included research targeted on interventions to forestall suicidal behaviour in nurses. These described and explored a US mannequin combining an schooling ingredient, danger screening, and counselling mixed with onwards referral.
Concluding their proof evaluate, Groves et al. (2023) word that:
Current analysis continues to indicate that nursing professionals, particularly females, are at elevated danger of suicide, warranting additional analysis consideration.
Given the restricted variety of research included on this evaluate introducing and evaluating preventative interventions to scale back the dangers of suicide in nurses and midwives makes research of this sort a urgent precedence.
Strengths and limitations
This is a crucial, well-designed and clearly written systematic evaluate, which is reported just about PRISMA requirements. There’s readability round search methods, how knowledge have been extracted, the standard of included research was appraised, and the way included materials was themed and synthesised.
One limitation, famous by the writer group, is the inclusion solely of things written within the English language. Related analysis in different languages will due to this fact not have been situated. The looking of solely CINAHL, Medline and PsycINFO is an additional limitation. Scrutiny of extra databases, past these three (e.g., Embase, and the Well being Administration Info Consortium), might have led to the identification of additional research. Searches for gray literature printed in native reviews, evaluations and theses, along with journal papers, may additionally have strengthened the comprehensiveness of the evaluate, as would additional looking efforts to search out unpublished research.
Implications for apply
The elevated fee of suicide amongst nurses and midwives which this systematic evaluate confirms calls for pressing consideration. That is significantly so, as Groves et al. (2023) write, due to the quantity and number of components related to this raised danger. These embrace prior contact with well being (together with psychological well being) providers, earlier self-harming, substance misuse and each interpersonal and office difficulties.
Alternatives for suicide danger evaluation exist within the main and secondary care settings the place nurses and midwives obtain their very own assist and therapy. Modifiable office components immediately or not directly rising the dangers of suicide and/or suicidal behaviour and considering current themselves as essential targets for intervention. Overload, worry of job loss and burnout all demand motion by service managers and scientific leaders with the purpose of bettering the on a regular basis apply environments wherein nurses and midwives perform their work.
Assertion of pursuits
Ben Hannigan declares no conflicts of curiosity.
Groves, S., Lascelles, Okay. & Hawton, Okay. 2023. Suicide, self-harm, and suicide ideation in nurses and midwives: A scientific evaluate of prevalence, contributory components, and interventions. J Have an effect on Disord, 331, 393-404.
Hong, Q. N., Fàbregues, S., Bartlett, G., Boardman, F., Cargo, M., Dagenais, P., Gagnon, M.-P., Griffiths, F., Nicolau, B., O’Cathain, A., Rousseau, M.-C., Vedel, I. & Pluye, P. 2018. The Blended Strategies Appraisal Device (MMAT) model 2018 for info professionals and researchers. Training for Info, 34, 285-291.
The Nationwide Confidential Inquiry into Suicide and Security in Psychological Well being 2020. Suicide by feminine nurses: a short report, Manchester, College of Manchester.
The Nationwide Confidential Inquiry into Suicide and Security in Psychological Well being 2023. Annual report: UK affected person and common inhabitants knowledge, 2010-2020, Manchester, College of Manchester.