Suicidal intentionality is generally stronger among the elderly, suicidal acts are more violent and are combined with a greater physical fragility. The suicide of an older adult is a situation that often leads to helplessness feelings. Analysis of the literature reveals two types of major interventions in order to reduce suicide rate: reducing risk factors and increasing protective factors. Risk factors are well documented, particularly from studies using psychological autopsies. However, protective factors are much less studied for the elderly. Yet the identification of relevant and available protective mechanisms in a suicidal crisis is essential to effectively guide nurses and health professionals in therapeutic commitment and intervention.
France has a suicide rate (16.2 per 100 000 inhabitants) well above the European average rate (10.2 per 100 000 inhabitants). The Poitou-Charentes region is in a situation of excess mortality by suicide compared to France (+ 25%). While the ratio of suicide attempts per suicide is about 200/1 before 25 years, it is estimated to be 4/1 after 65 years, or even 1/1 in elderly men. In France, suicide attempts are not systematically recorded and the frequency of suicidal ideation is poorly understood. The consensus conference on suicidal crisis highlights a number of clinical points specific to the elderly population (suicidal ideas are not always clearly expressed or unidentified, there are various manifestations of the psychic crisis, greater vulnerability of this population), but the complexity of interactions between suicidal risk factors limits our predictive capabilities of suicidal intention in an elderly person. Analysis of the literature reveals two types of major interventions in order to reduce the suicide rate: those aimed at reducing risk factors and those aimed at increasing protective factors. The objective of our research is to determine the effect of protective factor methodical search on post-crisis patient care.
Study Type
OBSERVATIONAL
Enrollment
15
Protective factor exploration during post-suicidal crisis interview
Groupe Hospitalier de la Rochelle Ré Aunis
La Rochelle, France
Number of outpatients (with a low to moderate risk of suicidal recurrence)
Based on risk, emergency and hazard, patients are classified as being at low, moderate and high risk of suicidal recurrence. Patients with low to moderate risk of suicidal recurrence are either inpatient or outpatient.
Time frame: 7 days
Number of patients considering themselves to be in good health
Score \> 0 at Health Status questionnaire (SF36) item 1
Time frame: 7 days
Number of patients considering that their physical or mental state did not alter their social life
Score \> 50 at Health Status questionnaire (SF36) items 6 or 10
Time frame: 7 days
Number of patients maintaining autonomy
Score = 0 at Instrumental Activities of Daily Living scale
Time frame: 7 days
Number of patients with religious practice
Binary answer from patients (yes/no I have a religious practice)
Time frame: 7 days
Number of patients with a sense of success and self-esteem
Binary answer from patients (yes/no I have a a sense of success and self-esteem)
Time frame: 7 days
Number of patients considering their family environment to be satisfactory
Binary answer from patients (yes/no I am satisfied with my family environment)
Time frame: 7 days
Number of patients with at least one environmental protection factor
Friendly network, associative investment, volunteering, specialized care, recreation, positive image from the entourage, presence of a third party, housekeeper, postman, pet, shopping facilities, doctor, pharmacy ...
Time frame: 7 days
Number of patients with social protection factors
Easy access to Health facilities, sufficient financial income
Time frame: 7 days
Number of patients able to adapt to difficult situations
score ≤ 12 at Neo Personality Inventory vulnerability item
Time frame: 7 days
Number of patients with extraversion capabilities
score ≥ 20 at Neo Personality Inventory extraversion item
Time frame: 7 days
Number of patients with openness to others
score ≥ 20 at Neo Personality Inventory Openness to feelings item
Time frame: 7 days
Number of patients considering that their health has improved
Patients will be asked if they feel that their health has improved, has not changed or has worsened
Time frame: 3 months
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