A Study to Assess the Knowledge Regarding Depression and Suicidal Behavior in Patients among the Nurses Working at the Selected Tertiary Care Hospital in the Belgaum City, Karnataka.

Mr. Gururaj Udapi

Assistant Professor, K.L.E. University’s Institute of Nursing Sciences, Belgaum, Karnataka.

*Corresponding Author Email: rajguru_2003@yahoo.co.in

INTRODUCTION:

There is increasing awareness and concern among healthcare professionals about patient suicides in general hospitals. Early recognition of suicidal intent and intervention by frontline nurses is crucial, and these nurses can play a leading role in suicide prevention if adequately prepared. Apart from those who are admitted to a hospital because of a suicide attempt, patients with chronic illnesses such as cancer, AIDS or rheumatoid arthritis frequently exhibit depression and suicidal behavior. These patients constitute a large population in general hospitals. Frontline nurses play a crucial role in patient suicide prevention and management, and providing care for patients with suicidal ideation or after suicidal acts poses particular challenges for nurses. Failure to help these patients often causes nurses to feel frustrated, inadequate and unsure about their role. Unfortunately, emergency department staff is not usually trained to competently treat people suffering from psychiatric emergencies, such as suicidality. Failure to identify just one person at risk for suicide, who subsequently kills herself/himself, exposes the hospital to significant legal risk.

If a hospital is sued for negligence for the death of a patient to suicide the amount of financial risk depends on the deceased person’s work life expectancy, medical costs associated with the death, and the facts associated with the missed occurrence. (Giordano and Stichler,2009). However, research shows that emergency department nurses need further suicide education to improve attitudes toward those who self-harm and to aid in effective suicide assessment and reduction. Mood disorders correlate highly with suicidal behaviors. In the general population about five percent of people with depression commit suicide and in the clinical setting the number rises to approximately 15%. (Dubovsky and Dubovsky, 2008) This is especially important for emergency department staff, because more than a third of the patients that receive treatment for a suicide attempt in the emergency department are diagnosed with depression. Hopelessness, which is one of the criterion for major depressive disorder is a consistent predictor of suicidal behavior. (Beck and Weishaar, 1990) In addition, more severe depression is associated with more suicide attempts, and most attempts occur early in the course of a depressive episode.¹

NEED FOR THE STUDY:

Suicide continues to be a leading and growing cause of death, especially among adolescents and the elderly. Adolescents and the elderly have a greater proportionate risk for suicide. Although women attempt suicide three times more often than men, men are three times more successful. Additionally, widowed or divorced persons, especially men, are at greater risk. Of interest, from an occupational standpoint, physicians have consistently been found to be at a higher risk for suicide than persons in most other professions.¹

The APA has also associated the following factors with an increased risk for suicide:

o Existing psychiatric disorder

o Physical illness

o Psychosocial factors

o Alcohol/substance abuse

It is important to know when to refer a patient to a psychiatrist or other mental health professional. If you identify a patient who is depressed or potentially suicidal, a referral to a psychiatrist is appropriate. Practicing outside of your specialty can be an invitation for litigation. More importantly, being proactive in referring patients to an appropriate specialist will ensure that they receive the mental health care they need and reduce mortality rates among those most at risk for suicide.

OBJECTIVES OF THE STUDY:

· To assess the Nurses knowledge regarding depression.

· To assess the Nurses knowledge regarding suicide by the patients.

· To find the correlation between depression and Suicide by the patients.

ASSUMPTION:

Nurses have some knowledge regarding depression and suicide.

HYPOTHESIS:

H₁: There will be positive correlation between depression and suicide at 0.05 level of significance.

METHODOLOGY:

A descriptive study was considered appropriate for the study. The study was conducted on 90 randomly selected nurses working in Dr. P. K. Kore Charitable hospital, Belgaum and Dr. P. K. Kore Hospital and MRC, Belgaum. Data was by using Socio-demographic data’s and Suicide Prevention Toolkit for Rural Primary Care Providers, by Western Interstate Commission for Higher Education. The collected data was tabulated and analyzed according to the objectives of the study using descriptive and inferential statics.

Research approach: Descriptive approach

Research design : Cross-sectional

Research setting : Dr. Prabhakar Kore Charitable Hospital, Belgaum and

Dr. Prabhakar Kore Hospital and MRC, Belgaum.

Research population: All the Nurses working in Dr. P. K. Kore Charitable hospital, Belgaum and Dr. P. K. Kore Hospital and MRC, Belgaum.

Sample size : 90

Sampling Technique: Purposive sampling

Inclusion criteria : Available at the time of study.

Willing to participate in the study.

Exclusion criteria: Any incidence of Mental illness in the family. Working at the administration section.

RESULT:

1. Frequency and Percentage distribution of the subjects on the basis of Demographic data.

Sl no	Demographic data	Variables	Frequency	%
1	Age	Below 30	90	100
		31 – 35	--	--
		36 – 40	--	--
		40 and above	--	--
2	Sex	Male	50	55.50
		Female	40	44.50
3	Qualification	GNM	80	89.00
		B. Sc (N)	05	05.50
		PB B. Sc	05	05.50
		Any other	--	--
4	Experience in the ward	Below 5 years	80	89.00
		5 – 10 years	10	11.00
		Above 10 years	--	--
5	Marital status	Unmarried	80	89.00
		Married	10	110.00
		Divorced	--	--
		Widow/widower	--	--
6	Any incidence of mental illness in the family	No	90	100.00
		Yes	--	--
7	Have you attended any programs on Depression and suicide prevention	No	75	83.30
		Yes	15	16.70

2. Frequency and Percentage of assessment of nurses knowledge on Depression: n=90

Depression status	Frequency	Percentage
Present	25	27.80
Absent	65	72.20

3. Frequency and Percentage of assessing different levels Suicidal risk in the patients. n= 90

Assessment of Suicidal risk	Frequency	Percentage
Low	70	77.80
Moderate	20	22.20
High	--	--

Correlation between knowledge of nurses regarding level of Depression and Suicide among the patients:

In this study Karl’s-Pearson’s coefficient of correlation formula used to correlate the level of Depression and suicide. The result shows “r = 0.00030688, hence there is no correlation” between the knowledge of nurses on level of Depression and suicidal behavior among the patients.

DISCUSSION:

The present study was undertaken with the aim of evaluating the nurses’ knowledge regarding assessment of depression and suicide prevention, working in tertiary care hospital at Belgaum.

A descriptive study design, with the sample size of 90 Nurses working at KLES’s Dr. Prabhakar Kore charitable Hospital, Belgaum and at KLES’s Dr. Prabhakar Kore Hospital and MRC, Belgaum by obtaining informed consent. Data was collected by using Socio-demographic data’s and Suicide Prevention Toolkit for Rural Primary Care Providers, by Western Interstate Commission for Higher Education. The collected data was tabulated and analyzed according to the objectives of the study using descriptive and inferential statics.

The findings of the study showed assessment of Depression was present (27.80%), assessment of Suicidal risk was low (77.80%) and there was no correlation between knowledge of Depression and assessment of Suicidal risk. Findings of the study are supported by the similar study conducted by Chan S, Chien WT and Tso S. in Hong Kong, The qualitative data indicated that the participants considered that the education undertaken had benefited them by improving their attitude, confidence and professional skills in responding to suicidal patients. They identified barriers in providing optimal care, which included the lack of support from senior staff, inadequate staffing, the lack of guidelines, the lack of coordination among disciplines and the physical environment of the wards.²

CONCLUSION:

The knowledge of nurses regarding assessment of Depression was present (27.80%), assessment of Suicidal risk was low (77.80%) and there was no correlation between knowledge of Depression and assessment of Suicidal risk among the patients. The findings of the study have implications on the nursing practice and nursing research.

REFERENCE:

1. Boulder, Colorado. Western Interstate Commission on Higher Education (WICHE) and Suicide Prevention Resource Center (SPRC). (2009) Suicide Prevention Toolkit for Rural Primary Care: A Primer for Primary Care Provide: Western Interstate Commission on Higher Education. 2009 by Education Development Center.

2. Chan S, Chien WT and Tso S. 2007. The provision and evaluation of a suicide prevention and management programme for frontline nurses in Hong Kong. Health Research Symposium 2007 –Building Bridges between Research, Practice and Policy (Poster P07, Program Book, p. 23).

3. Baldwin S, Griffiths P. Do specialist community public health nurses assess risk factors for depression, suicide, and self-harm among South Asian mothers living in London? Public Health Nurs. 2009 May-Jun;26(3):277-89.

4. Orla Shaughnessy, Magda Szumilas and Stan Kutcher. Evaluation of the Health Provider Training in Adolescent Depression and Suicide Program. www.teenmentalhealth.org

Received on 07.05.2014 Modified on 15.07.2014

Accepted on 28.07.2014 © A&V Publication all right reserved

Asian J. Nur. Edu. & Research 4(3): July- Sept., 2014; Page 314-316