PROFESSIONAL ATTITUDES TOWARDS SUICIDAL BEHAVIOR IN PRIMARY HEALTH CARE: A QUASI-EXPERIMENTAL STUDY

Santos, Daniele Cristina Ribeiro dos; Lima, Raquel Tanaka de Carvalho; Domingos, Thiago da Silva; Alencar, Rúbia Aguiar

doi:10.1590/1980-265X-TCE-2021-0350en

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Original Article • Texto contexto - enferm. 31 • 2022 • https://doi.org/10.1590/1980-265X-TCE-2021-0350en copy

PROFESSIONAL ATTITUDES TOWARDS SUICIDAL BEHAVIOR IN PRIMARY HEALTH CARE: A QUASI-EXPERIMENTAL STUDY

ACTITUDES PROFESIONALES EN RELACIÓN A LAS CONDUCTAS SUICIDAS EN LA ATENCIÓN PRIMARIA DE LA SALU: UN ESTUDIO CUASI-EXPERIMENTAL

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to analyze the attitudes of health professionals working in Primary Health Care before and after participating in workshops about how to approach people with suicidal behavior.

Method:

a before-and-after quantitative and quasi-experimental study, conducted in a municipality in the inland of the state of São Paulo from August to September 2019. The sample consisted of 34 workers who answered a Sociodemographic Questionnaire and the Questionnaire on Attitudes towards Suicidal Behavior, applied before and after three workshops on how to approach people with suicidal behavior in the Primary Health Care context. The data were analyzed by means of the Wilcoxon and McNemar tests, considering p<0.05.

Results:

a statistically significant difference was identified before and after the workshops regarding professional ability (p=0.011), negative feelings towards the patient (p=0.025) and without a category (p=0.006), evidencing the effectiveness of the workshops on how to approach people with suicidal behavior for management and care professionals working in Primary Health Care.

Conclusion:

the short-term results observed after the workshops point to a change in the professionals' conception and management in relation to people with suicidal behavior. Permanent and continuous training strategies as spaces for learning, reflection and action are fundamental to qualify the approach to people with suicidal behavior.

DESCRIPTORS:
Suicide. Attempted suicide. Training of human resources in health. Primary health care. Knowledge; attitudes and practice in health

Variables		n	%
Gender	Female	29	85.3
Gender	Male	5	14.7
Marital status	Married	17	50.0
	Single	16	47.1
	Divorced	1	2.9
Has children	Yes	20	58.8
Has children	No	14	41.2
Religion	Yes	29	85.3
Religion	No	5	14.7
Schooling	High School/Technical Education	6	17.6
	Incomplete Higher Education	3	8.8
	Complete Higher Education	25	73.6
Profession	Community Agent	12	35.5
	Nurse	11	32.3
	Physiotherapist	3	8.8
	Physician	2	5.9
	Nutritionist	2	5.9
	Nursing Technician	2	5.9
	Psychologist	1	2.9
	Social Worker	1	2.9
Attended graduate studies	Yes	13	38.2
Attended graduate studies	No	21	61.8
Training in mental health	Yes	15	44.1
Training in mental health	No	19	55.9
Training on how to approach suicide	Yes	15	44.1
Training on how to approach suicide	No	19	55.9
Contact with attempted suicide	Yes	16	47.1
Contact with attempted suicide	No	18	52.9
Contact with mandatory notification	Yes	3	8.8
Contact with mandatory notification	No	31	91.2

Categories	Items	Before^*		After^*		p
Categories	Items	n	%	n	%	p
Professional ability	I feel capable of helping a person who tried to commit suicide.	18	52.9	24	70.6	0.210
	I feel capable of telling when a patient is at risk of committing suicide.	11	32.4	21	61.8	0.002
	I think that I'm professionally prepared to deal with patients at risk of suicide.	8	23.5	18	52.9	0.013
	I feel insecure to care for patients at risk of suicide.	25	73.5	16	47.1	0.035
Negative feelings towards the patient	Those who threaten to do it generally don't kill themselves.	2	5.9	0	0.0	1.000
	Deep down, I'd rather not get too involved with patients who tried to commit suicide.	6	17.6	4	11.8	0.500
	I'm afraid to ask about ideas of suicide and end up inducing the patient to do it.	18	52.9	8	23.5	0.021
	Sometimes it even makes me angry, because so many people want to live... and that patient wants to die.	6	17.6	5	14.7	1.000
	You feel powerless in front of a person who wants to commit suicide.	22	64.7	16	47.1	0.238
	In the case of patients who are suffering a lot due to a physical illness, I find the idea of suicide more acceptable.	4	11.8	4	11.8	1.000
	Whoever really wants to commit suicide doesn't go around “trying.”	2	5.9	2	5.9	1.000
The right to suicide	Despite everything, I think that any person has the right to commit suicide.	2	5.9	4	11.8	0.500
	In the face of a suicide case, I think: if someone had talked to them, the person would've found another way out.	30	88.2	32	94.1	0.625
	Life is a gift from God, and only He can take it away.	24	70.6	26	76.5	0.687
	He who has God in his heart will not try to commit suicide.	5	14.7	5	14.7	1.000
	When a person speaks of putting an end to their life, I try to withdraw that from their mind.	31	91.2	32	94.1	1.000
Remaining items	Generally, those who commit suicide have some mental illness.	8	23.5	6	17.6	0.687
	I think that a person needs courage to commit suicide.	13	38.2	9	26.5	0.289
	If I suggest referral to a psychiatrist for a patient who has talked about committing suicide, I think that the psychiatrist will see it with good eyes.	29	85.3	22	64.7	0.039
	Hospitalized patients rarely commit suicide unless they have a strong reason to do it	9	26.5	7	20.6	0.754
	I've already gone through situations that made me think about suicide.	11	32.4	10	29.4	1.000

Categories	Pre-test^*			Post-test^*			p-value
Categories	Mean	Min.	Max.	Mean	Min.	Max.	p-value
Professional ability	2.0	1.0	4.0	2.5	0.0	4.0	0.011
Negative feelings towards the patient	2.0	0.0	4.0	1.0	0.0	5.0	0.025
The right to suicide	3.0	0.0	4.0	3.0	0.0	4.0	0.106
Remaining items	4.0	1.0	8.0	3.0	0.0	6.0	0.006
Score	10.0	5.0	16.0	8.5	5.0	15.0	0.084

Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem Campus Universitário Trindade, 88040-970 Florianópolis - Santa Catarina - Brasil, Tel.: (55 48) 3721-4915 / (55 48) 3721-9043 - Florianópolis - SC - Brazil
E-mail: textoecontexto@contato.ufsc.br

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[1] CORRESPONDING AUTHOR
Daniele Cristina Ribeiro dos Santos ribeiro_82@hotmail.com