Bittersweet transformative experiences in professionals working with suicidal patients: a meta-synthesis

Objectives: To synthesize and reinterpret findings from primary qualitative studies on the emotional experience of health care professionals working with mental health and mental health professionals providing care for people with suicidal behavior. Methods: We conducted a systematic review of the literature with the SPIDER structured search strategy in six databases (PubMed, Web of Science, Scopus, PsycINFO, CINAHL, and LILACS). A meta-synthesis was performed with data from qualitative studies published between 2005 and 2021. Two independent reviewers screened and assessed the articles. They evaluated methodological quality of included articles, extracted data, and performed the thematic synthesis. Results: Of 852 articles, 21 met the inclusion/exclusion criteria and were synthesized. The meta-synthesis revealed three descriptive themes: coping with adverse experiences; coming across fortunate experiences; professional-personal implications. Based on these descriptive themes, we elaborated the analytical theme: bittersweet experiences of personal and professional transformation. Conclusions: Mental health professionals working with people manifesting suicidal behaviors must cope with complex emotional experiences that involve controversial and ambivalent feelings. Such feelings have repercussions that may transform personal and professional life. The present results are useful for the development and implementation of interventions that promote better overall mental health outcomes for healthcare providers. Registration number: PROSPERO CRD42021257237.

Bittersweet transformative experiences in professionals working with suicidal patients: a meta-synthesis.

OBJECTIVES: To synthesize and reinterpret findings from primary qualitative studies on the emotional experience of health care professionals working with mental health and mental health professionals providing care for people with suicidal behavior. METHODS: We conducted a systematic review of the literature with the SPIDER structured search strategy in six databases (PubMed, Web of Science, Scopus, PsycINFO, CINAHL, and LILACS). A meta-synthesis was performed with data from qualitative studies published between 2005 and 2021. Two independent reviewers screened and assessed the articles. They evaluated methodological quality of included articles, extracted data, and performed the thematic synthesis. RESULTS: Of 852 articles, 21 met the inclusion/exclusion criteria and were synthesized. The meta-synthesis revealed three descriptive themes: coping with adverse experiences; coming across fortunate experiences; professional-personal implications. Based on these descriptive themes, we elaborated the analytical theme: bittersweet experiences of personal and professional transformation. CONCLUSIONS: Mental health professionals working with people manifesting suicidal behaviors must cope with complex emotional experiences that involve controversial and ambivalent feelings. Such feelings have repercussions that may transform personal and professional life. The present results are useful for the development and implementation of interventions that promote better overall mental health outcomes for healthcare providers.

Potentialities and Barriers of Online Psychotherapy During the COVID-19 Pandemic: Scoping Review / Potencialidades e Barreiras da Psicoterapia On-line na Pandemia de COVID-19: Scoping Review

Abstract The pandemic of COVID-19 demanded unprecedented efforts from psychologists to adapt to technology-mediated care. This study aimed to analyze the scientific production concerning the perception of Brazilian psychologists on online psychotherapy during the pandemic through a scoping review. We consulted four databases, while the reviewed corpus comprehended 29 studies. Psychologists identified both benefits and barriers in the transition to online psychotherapy practice, but the perception that the sparing use of this resource is valid and beneficial predominated. There is a strong perception that information and communication technologies will definitely integrate the repertoire of resources used by psychotherapists, as another relevant alternative, posing the need for further studies.

Resumo A pandemia da COVID-19 exigiu esforços sem precedentes das/os psicólogas/os para adaptação ao atendimento mediado por tecnologia. O objetivo deste estudo é analisar a produção científica acerca da percepção de psicólogas/os brasileiras/o sobre psicoterapia on-line durante a pandemia por meio de uma scoping review. Foram consultadas quatro bases de dados e o corpus revisado foi composto por 29 estudos. Psicólogas/os identificaram tanto benefícios como barreiras na transição para prática da psicoterapia on-line, porém predominou a percepção de que o uso parcimonioso deste recurso é válido e benéfico. Há forte percepção de que tecnologias da informação e comunicação integrarão, em definitivo, o repertório de recursos utilizados por psicoterapeutas, como mais uma alternativa relevante, o que coloca a necessidade de novos estudos.

Os bastidores psíquicos do suicídio: uma compreensão psicanalítica / The psychic backstage of suicide: a psychoanalytic approach / Los bastidores psíquicos del suicidio: una comprensión psicoanalítica

O suicídio é considerado um problema de saúde pública em escala planetária, com impactos não apenas na esfera interpessoal e familiar, como também econômica e social. Devido à sua proximidade com a finitude humana, um tema tabu na sociedade ocidental, o suicídio atrai estigmas e preconceitos que dificultam uma abordagem técnica isenta de juízos morais. Isso inibe o desenvolvimento de métodos de assistência que possam atender as necessidades do indivíduo com comportamento suicida, de seus familiares e da comunidade. Diante desse cenário, este estudo teve por objetivo apresentar uma compreensão psicanalítica do fenômeno do suicídio, fomentando reflexões que podem subsidiar os cuidados terapêuticos e as propostas preventivas e de promoção à saúde. Conclui-se que ainda persiste o enigma que sempre rondou o comportamento suicida em diferentes épocas e sociedades, como a motivação pessoal para o ato e a influência relativa de fatores emocionais, familiares, sociais e econômicos sobre sua concretização.

Suicide is considered a public health problem on a planetary scale, with impacts not only in the interpersonal and family sphere, but also economic and social. Because of its proximity to human finiteness, a taboo subject in Western society, suicide attracts stigmas and prejudices that hinder a technical approach devoid of moral judgments. This inhibits the development of care methods that can meet the needs of the individual with suicidal behavior, family and community. Given this scenario, this study aimed to present a psychoanalytic understanding of the phenomenon of suicide, fostering reflections that can subsidize therapeutic care and preventive and health promotion proposals. It is concluded that the enigma that has always surrounded suicidal behavior in different times and societies, such as the personal motivation for the act and the relative influence of emotional, family, social and economic factors on its concretization still persists.

El suicidio es considerado un problema de salud pública a escala planetaria, con impactos no sólo en la esfera interpersonal y familiar, sino también económica y social. Debido a su proximidad a la finitud humana, un tema tabú en la sociedad occidental, el suicidio atrae estigmas y prejuicios que dificultan un enfoque técnico exento de juicios morales. Esto inhibe el desarrollo de métodos de asistencia que puedan satisfacer las necesidades del individuo con comportamiento suicida, de sus familiares y de la comunidad. Ante este escenario, este estudio tuvo por objetivo presentar una comprensión psicoanalítica del fenómeno del suicidio, fomentando reflexiones que pueden subsidiar los cuidados terapéuticos y las propuestas preventivas y de promoción a la salud. Se concluye que aún persiste el enigma que siempre rondó el comportamiento suicida en diferentes épocas y sociedades, como la motivación personal para el acto y la influencia relativa de factores emocionales, familiares, sociales y económicos sobre su concreción.

Quando a psicanálise entrou no centro cirúrgico: um relato de experiência / When psychoanalysis entered the surgical center: a report of experience / Cuando el psicoanálisis entró en la sala de operaciones: um relato de experiencia

O psicanalista pode atuar em diversas áreas e setores do hospital. Uma das modalidades de atendimento concerne à preparação psicológica de pacientes que serão submetidos a intervenção cirúrgica eletiva. Este estudo tem por objetivo descrever a inserção de uma psicanalista no centro cirúrgico, por meio do relato do acompanhamento psicológico de um paciente antes, durante e após uma cirurgia para correção de fratura de mandíbula em um hospital do interior do estado de São Paulo. O paciente vivenciara uma situação traumática em cirurgia anterior, por isso considerou-se que a permanência da profissional de psicologia durante todo o procedimento poderia favorecer seu enfrentamento. Atitudes da equipe multiprofissional perante a presença inusitada da psicanalista no centro cirúrgico foram descritas e analisadas. Concluiu-se que a postura inovadora e empreendedora, baseada na ética e comprometimento, pode contribuir para a ampliação do campo de conhecimento e atuação do psicólogo.

There are several areas and sectors where the psychoanalyst can work in the hospital. One of the modalities of care concerns the psychological preparation of patients who will undergo elective surgical intervention. This article aims to describe the insertion of a psychoanalyst in surgical center, through a report of the psychological monitoring of a patient before, during and after a surgery for correction of mandible fracture in a hospital in southeastern Brazil. The patient had experienced traumatic situation in a previous surgery, so it has been considered that the permanence of professional throughout the current procedure would be very useful for coping with it. Attitudes of the multiprofessional team to this unusual presence of the psychoanalyst in the surgical center were described and analyzed. It was concluded that the innovative and entrepreneurial stance, based on ethics and commitment, can contribute to the expansion of the psychologist's field of knowledge and performance.

El psicoanalista puede trabajar en diversas áreas y sectores del hospital. Una de las formas de intervención se refiere a la preparación psicológica de los pacientes sometidos a cirugía electiva. Este estudio tiene como objetivo describir la inserción de una psicoanalista en la sala de operaciones a través del relato de la asesoría psicológica prestada a un paciente antes, durante y después de una cirugía para corrección de fractura de mandíbula en un hospital en el estado de Sao Paulo. El paciente había experimentado una situación traumática en una cirugía anterior, por lo que se consideró que la presencia profesional de la psicología durante todo el procedimiento podría favorecer su afrontamiento. Las actitudes del equipo multidisciplinario frente a la inusual presencia de la psicoanalista en la sala quirúrgica fueron descritas y analizadas. Se concluyó que la actitud innovadora y emprendedora, basada en la ética y el compromiso, puede contribuir a la expansión del campo de intervención psicológica.