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Assessing the recovery ability of individuals who have attempted suicide is crucial for psychiatric health nurses. The purpose of this study was to develop and test a psychometric Suicidal Recovery Ability Scale (SRAS). Confirmatory factor analysis (CFA) indicated that three subscales with 15 items best fit the data. The global SRAS score showed significant negative correlation with the Beck Hopelessness Scale (BHS) score. The Cronbach's α and test-retest reliability scores for the global SRAS and the subscales all exceeded 0.70. Nurses can use the SRAS to assess the recovery ability of individuals who have attempted suicide and provide proper care to help them.

Aims and Objectives: The aim of this study was to explore the factors predicting suicide recovery and to provide guidance for healthcare professionals when caring for individuals who have attempted suicide., Background: The high rate of suicide is a global health problem. Suicide prevention has become an important issue in contemporary mental health. Most suicide research has focused on suicidal prevention and care. There is a lack of research on the factors predicting suicidal recovery., Design: A cross-sectional design was adopted., Methods: A correlational study with a purposive sample of 160 individuals from a suicide prevention centre in southern Taiwan was conducted. The questionnaires included the Brief Symptom Rating Scale-5, Suicidal Recovery Assessment Scale and Beck Hopelessness Scale. Descriptive statistics and linear regressions were used for the analysis., Results: The mean age of the participants was 40.2 years. Many participants were striving to make changes to create a more stable and fulfilling life, had an improved recovery from suicide and had a good ability to adapt or solve problems. The linear regression showed that the Beck Hopelessness Scale scores (ß = -.551, p < .001) and Brief Symptom Rating Scale-5 (ß = -.218, p = .003) and past suicidal behaviour (ß = -.145, p = .008) were significant predictors of individuals' recovery from suicide. They accounted for 57.1% of the variance., Conclusions: Suicidal individuals who have a lower level of hopelessness, a better ability to cope with their mental condition and fewer past suicidal behaviours may better recover from suicide attempts., Relevance to Clinical Practice: The nurses could use the results of this study to predict recovery from suicide in patients with attempted suicide., (© 2017 John Wiley & Sons Ltd.)

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., (© 2013 John Wiley & Sons Ltd.)

The purpose of this study was to explore the context and the intervening conditions that impacted on individuals' healing from a suicide attempt. Patients who had survived a suicide attempt (n=14) and their caregivers (n=6) were interviewed in this study. Findings revealed that the suicidal individuals who lived in a sheltered, friendly environment, and had support systems helped their suicidal healing process. Conversely, suicidal individuals who experienced negative aspects of self, family predicaments, environmental difficulties, and the re-emergence of stressors impeded their suicidal healing process. Consequently, health professionals need to promote healthy internal and external environments for suicidal individuals., (© 2014.)

Aim: To develop a theory to guide the recovery process of a recent suicide attempt., Background: Suicide is one of the 10 leading causes of death in many countries. Many nations have set targets to reduce the high incidence of suicide by aiming to prevent people from taking their own lives and also providing care to promote the healing of those who attempt suicide., Design: A qualitative grounded theory approach was used., Methods: Data were collected in 2011-2012 in a Taiwanese hospital until data saturation occurred. Twenty participants were interviewed, comprising patients who recovered from suicide attempts (N = 14) and their caregivers (N = 6). Data were analysed using open, axial, and selective coding and using the constant comparison technique., Findings: A substantive theory was formulated to guide the recovery process of people who have recently attempted suicide. The core category that emerged from the data collected was 'Striving to accept the value of self-in-existence'. Other key categories linked to and embraced in this core category were: becoming flexible and open-minded, re-building a positive sense of self, and endeavouring to live a peaceful and contented life., Conclusion: Nurses could use this theory as a theoretical framework to guide people who are recovering from a suicide attempt by affording them the opportunity to grow and heal, and facilitating the re-building a positive sense of self, acknowledging the uncertainties of life, and inspiring hope., (© 2013 Blackwell Publishing Ltd.)

Background: Care provided by the families of those who have attempted suicide affects their healing and recovery process. Data on care provided by families to suicidal individuals in different areas of Taiwan are extremely limited., Purpose: This study explored care provided by families living in eastern and southern Taiwan to relatives admitted to hospitals and subsequently discharged after a suicide attempt., Methods: The study used a grounded theory approach. Interviews were conducted in two distinct geographical areas in 3 years and included two sample groups. Group 1 comprised suicidal participants (n = 15) and family caregivers (n = 15) in East Taiwan. Group 2 comprised suicidal participants (n = 15) and family caregivers (n = 15) in South Taiwan. Data were analyzed using open, axial, and selective coding., Results: The East Taiwan group was less prosperous than the South Taiwan group. Suicide attempt methods were more lethal in eastern than in southern Taiwan. Alcohol and family violence were more important factors in suicides in eastern than in southern Taiwan. Consequently, families in East Taiwan focused less on protecting the safety of suicidal family members than families in South Taiwan. Participants in East Taiwan received less support from their families than those in South Taiwan. CONCLUSIONS/IMPLICATION FOR PRACTICE: Suicidal participants in East Taiwan received less care from family caregivers than did participants in South Taiwan. However, all families require education to provide optimal care for suicidal relatives. Study results may help promote more appropriate education for clinical nursing professionals with a responsibility to care for suicidal patients.

Objectives: There is a dearth of evidence on the care that families provide to their relatives after they have been discharged from hospital following an attempted suicide. The aim of this study was to explore ex-patients' and family caregivers' perceptions of the care provided at home following hospital discharge., Design and Sample: A qualitative approach using Grounded Theory was adopted. Suicidal ex-patients (n=15) and family caregivers (n=15) were contacted in the south of Taiwan., Measures: Data were collected through interviews and the data were analyzed using open, axial, and selective coding., Results: A substantive theory was developed from the findings. However, for the purpose of this paper, the section of the paradigm model named the action/interaction strategies is presented and discussed. Three categories emerged in the action/interaction section relating to the family care of relatives who had been suicidal. They were: (1) "guarding the person day and night," which helped to ensure that their relatives felt safe; (2) "maintaining the activities of daily living," which promoted their physical health and recovery; and (3) "creating a nurturing environment," which facilitated their mental and emotional healing., Conclusions: Public health nurses could use the findings of this study as a theoretical map when providing health information to family caregivers during home visits.

Aims: The aim of this study was to explore family members' and ex-patients' perceptions of caring for people who had previously attempted suicide., Background: Suicide is a major public health problem in Taiwan. Official figures demonstrate that suicide was one of the top 10 causes of death in the last eight years, with 18.8 per 100,000 people taking their own lives in 2005. The Taiwanese Government has set targets to reduce this rate. All members of the population play a role in the prevention of suicide, including families and carers of those at risk. Evidence is sparse on the role that families take in caring for members who have been discharged from hospital following a suicide attempt., Methods: Grounded theory using one-to-one tape-recorded interviews were conducted with patients who had just been discharged from hospitals following a suicide attempt (n = 15) and family members (n = 15). Data were analysed using open, axial and selective coding., Results: The core category that emerged was 'Impending burnout', depicting family members' experience of caring for people who had attempted suicide. Other key categories linked to and embraced within this core category were: on guard day and night, maintaining activities of daily living and creating a nurturing environment., Conclusion: Families and carers could use the emergent theory as a guide to caring for people at risk of suicide. Psychiatric nurses could use the theory as a framework to educate family members on enhancing the quality of care provided to this group of people. The theory could go some way towards reducing suicidal attempts and decreasing re-hospitalisation rates., Relevance to Clinical Practice: The finding indicated that family members experienced difficulties when caring for those who had previously attempted suicide. Consequently, nurses have a pivotal role in educating families and carers on preventive strategies before suicidal patients are discharged from hospitals.

Aims and Objectives: The aims of this study were to investigate a sample group of casualty nurses' attitudes towards patients who have attempted suicide in the middle of Taiwan and to identify factors contributing to their attitudes towards attempted suicide., Design: A quantitative study using a questionnaire containing 22 statements with a five-point Likert-type scale was developed from the Domino's Suicide Opinion Questionnaire, and from a comprehensive analysis of research literature on the area of attitudes towards suicide., Methods: The questionnaire was distributed to casualty nurses (n = 155) to investigate their attitudes toward patients who have attempted suicide. Seven large hospitals in the middle of Taiwan were targeted., Results: This sample group of casualty nurses from the middle of Taiwan held positive attitudes toward patients who have attempted suicide. In addition, three statistically significant differences were identified: (i) The higher the level of nursing education the more positive the nurses' attitudes towards patients who had attempted suicide. (ii) The casualty nurses who did not have a religion held more positive attitudes towards suicidal behaviour than those who followed a religion. (3) Casualty nurses who had suicide care experience with 1-10 patients had more positive attitudes towards suicidal patients than nurses who had nursed above 10 patients who had attempted suicide., Conclusions: The results indicated that casualty nurses in Taiwan require further education on and training in all aspects of suicide to foster more positive attitudes towards patients who attempt suicide., Relevance to Clinical Practice: The role of casualty nurses is pivotal to the front-line care of people who are suicidal and their attitudes play a major part in the provision of effective care.

Aims: The aims of this paper are to present and discuss the findings that emerged from a qualitative study exploring nurses and patients' views of the acute psychiatric ward (the context) and the type of care received (the intervening conditions)., Background: The phenomenon of suicide and the nursing care of people who are suicidal have previously been investigated. However, literature demonstrates that there is a dearth of information exploring the importance of the ward context in the care of suicidal patients and the intervening conditions that are used by professionals in the care of suicidal patients., Method: Qualitative research using the grounded theory approach., Data Collection and Analysis: Fifteen patients who had either suicidal ideas or had attempted suicide and 15 psychiatric nurses were interviewed and observed. Data were analysed using open, axial and selective coding., Findings: A substantive theory of suicide-nursing care was developed. For the purpose of this paper, the two categories that emerged in the 'context' element of the paradigm model are explored. They were: team working and the psychiatric ward environment. In addition, the four categories from the 'intervening conditions' are discussed. They were: nurses' attitudes and beliefs have an effect on caring, barriers to caring, patients' negative thoughts and feelings about the care provided and support systems., Conclusion: The findings indicated that the context of the ward environment and the intervening conditions used by nurses in the nursing care of suicidal patients helped to define some of the complex dynamics that impacted on the development of a therapeutic relationship within the practice of suicide-nursing care. Relevance to clinical practice. Environmental factors as well as the nurses' knowledge and skills and the type of support patients receive impact on the care of suicidal patients. These findings could help to enhance and advance suicide-nursing care.

Suicide is a major mental health problem in Taiwan. Estimations revealed that approximately 41% of people who committed suicide had a previous history of psychiatric inpatient care. To date, a suicide nursing care theory has not been developed. Consequently, the aim of this study was to formulate a suicide nursing care theory with the aim of enhancing and advancing the nursing care provided to people who attempt suicide or have suicidal thoughts. A qualitative approach using grounded theory was adopted. A total of 15 peoples who had either suicidal ideas or had attempted suicide and 15 psychiatric nurses were interviewed and observed. Data were analysed using open, axial and selective coding and the NUD*IST software program. A substantive theory of suicide nursing care was developed from the emergent findings. Four categories surfaced in the nursing care theory relating to the nurses' 'action/interaction strategies'. They were: the holistic assessment of people who are suicidal; providing protection; providing basic care; and providing advanced care. The findings from this study could be used to influence and advance nurse education and training, clinical practice, management and further research.