Changes in narratives of people with depression that have attempted suicide and a nursing approach

This study was performed to examine changes after talking to alleviate suicidal ideation in people with depression or bipolar disorder that have attempted suicide, and to clarify the role of the researcher in this process. Data were collected through unstructured interviews with participants suffering from depression or bipolar disorder that were hospitalized because of attempted suicide. The interview began when they emerged from the crisis situation, and continued after discharge from hospital. From the contents of the interview, we analyzed the parts where emotions and thoughts before and after suicide were expressed and the remarks of the researcher. The participants were five women, and the interview number ranged from three to eight times. We extracted six categories based on analysis of participantsʼ narratives. There were four categories regarding strong obsession with death and great anxiety and loneliness: “Obsession with death,” “Loneliness the same as before suicide attempt,” “Anxiety about an uncertain future,” and “Losing self-confidence by confronting reality.” In addition, there were two categories regarding alleviation of suicidal ideation and newfound affirmation of life: “Feeling inclined to live” and “Developing motivation for life.” Throughout the interview process, the researcher strove to “wait patiently for participants to express their feelings and thoughts,” never hurrying them or interrupting their remarks. In the second half of the interview, to address participantsʼ everyday problems “the researcherʼs ideas were shared so that participants could change their behavior.” When attendees made an effort and experienced behavioral changes, the researcher focused on the positive by “urging participants to be aware that they are changing and to notice what they are doing.” The results of this study clearly showed that after a suicide attempt patients with depression were moving forward but still vacillating between life and death. Even those that were hopeless and desperate enough to choose their own death had taken definite steps toward the future. Nurses need to recognize this, come close to their wavering emotions, and provide support to help them think positively and find hope for the long term.