Healing and recovering after a suicide attempt: a grounded theory study.

AIMS AND OBJECTIVES: To explore the healing and recovery process following a suicide attempt over 12 months ago. BACKGROUND: Literature has explored the process leading up to attempted suicide. However, there is a lack of information exploring the healing and recovery process after a suicide attempt. DESIGN: Qualitative research using the grounded theory approach. METHODS: Data were collected during 2010-2011 from the psychiatric outpatient's centre in Taiwan. Interviews were conducted with people who had attempted suicide more than 12 months prior to data collection and had not reattempted since that time (n = 14). Constant comparison analysis was used to scrutinise the data. RESULTS: Findings demonstrated that healing and recovering evolved in five phases: (1) self-awareness: gained self-awareness of their responsibilities in life and their fear of death; (2) the inter-relatedness of life: awareness of the need to seek help from professionals, friends and family for support; (3) the cyclical nature of human emotions: reappearance of stressors and activators causing psyche disharmony; (4) adjustment: changes in adjustment patterns of behaviour, discovering and owning one's own unique emotions, deflecting attention from stressors and facing reality and (5) acceptance: accepting the reality of life and investing in life. CONCLUSION: The healing and recovery process symbolises an emotional navigation wheel. While each phase might follow the preceding phase, it is not a linear process, and patients might move backwards and forwards through the phases depending on the nursing interventions they receive coupled with their motivation to heal. It is important for nurses to use advanced communication skills to enable them to co-travel therapeutically with patients. RELEVANCE TO CLINICAL PRACTICE: Listening to patients' voices and analysing their healing and recovery process could serve as a reference for psychiatric nurses to use to inform therapeutic interventions.

[Traumatic response experiences: one year after Typhoon Morakot].

BACKGROUND: Disaster-related mental health problems have been a focus of recent international scholarly interest. Typhoon Morakot caused exceptional destruction in Southern Taiwan, and victims suffered physically, psychologically and financially in its aftermath. PURPOSE: This study investigates the post-traumatic response and coping behaviors of victims one year after Typhoon Morakot. METHODS: Researchers used a phenomenological method with purposive sampling and interviewed 10 Typhoon Morakot victims. Data were collected using deep, semi-structured interviews. All interview sessions were tape-recorded. Researchers used Colaizzi's seven-step phenomenological method to analyze data. RESULTS: Three common themes emerged in subjects following their disaster experiences. The first was residual traumatic response, including fear of continued flooding, fear of future flood recurrence, indifference in responses, and living on alert; The second was insecurity in daily life due to changed surroundings, including anxiety and a heavy sense of loss; The third was conformity in coping behaviors, including shifting attention away from the disaster, turning to a pluralistic support system, having an optimistic outlook on life, and living in the moment. CONCLUSION: Investigating traumatic response experiences and coping behaviors one year after the Typhoon Morakot disaster can help guide healthcare professionals to promote evidence-based health and nursing services. Findings also provide information to healthcare providers essential to improving nursing quality for victims of disasters.

[Enhancing the capability of medical team to manage aggressive events in acute psychiatric wards].

Incidences of violence in acute psychiatric ward can lead to not only facility destructions, but also mental, physical injuries and even medical disputes. As part of efforts to enhance medical team abilities to manage aggressive events, this study aimed to provide references for reducing both aggressive events and resultant damage. Over two-thirds (69%) of all unanticipated occurrences registered by our unit in 2003-2004 were classed as "aggressive events", i.e. there were 27 occurrences (0.09%) in which 0.04% resulted in staff injury. Events were mainly attributable to psychiatric symptoms, poor impulse control and interpersonal conflicts. For this study, we used several intervention methods, including categorizing patients by "risk of violence" rank, revising the hospital's standard operation processes for handling violence and revising the nursing rules to enhance nurse skills at managing violent events, countering patient violence, helping patients safely vent their anger and physical force, listening to relax music and conducting behavior modification. As a result, aggressive event prediction sensitivity increased from 56% to 100%, with successful prevention rates reaching 80%. The rate of aggressive event occurrence reduced from 0.09% to 0.06% and staff injuries decreased from 0.04% to 0.02%. Intervention methods employed were shown to be quite effective. If medical teams elsewhere enhanced their sensitivity and abilities to avoid aggressive events, injury and damages could be prevented and medical care quality enhanced.