Between moral infraction and existential crisis: Exploring physicians and nurses' attitudes to suicide and the suicidal patient in Ghana

Osafo, Joseph; Akotia, Charity S.; Boakye, Kofi E.; Dickson, Erica

doi:10.1016/j.ijnurstu.2018.05.017

Cited by 24 publications

(29 citation statements)

References 45 publications

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“…Ghanaians tend to view suicidal behaviours within a moral and religious lens [47,48], what was not clear from the views of the present participants is whether they were aware of these moral and religious tenets against self-harm prior to their own self-harm.…”

Section: Adolescents Explain Their Self-harmmentioning

confidence: 61%

Adolescent self-harm in Ghana: a qualitative interview-based study of first-hand accounts

Quarshie¹,

Waterman²,

House³

2020

BMC Psychiatry

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Background: Recent prevalence studies suggest that self-harm among adolescents in sub-Saharan Africa is as common as it is in high income countries. However, very few qualitative studies exploring first-person accounts of adolescent self-harm are available from sub-Saharan Africa. We sought to explore the experiences and first-person perspectives of Ghanaian adolescents reporting self-harm-for deeper reflections on the interpretive repertoires available in their cultural context for making sense of self-harm in adolescents. Methods: Guided by a semi-structured interview protocol, we interviewed one-to-one 36 adolescents (24 in-school adolescents and 12 street-connected adolescents) on their experiences of self-harm. We applied experiential thematic analysis to the data. Results: Adolescents' description of the background to their self-harm identified powerlessness in the family context and unwanted adultification in the family as key factors leading up to self-harm among both in-school and streetconnected adolescents. Adolescents' explanatory accounts identified the contradictory role of adultification as a protective factor against self-harm among street-connected adolescents. Self-harm among in-school adolescents was identified as a means of "enactment of tabooed emotions and contestations", as a "selfish act and social injury", as "religious transgression", while it was also seen as improving social relations. Conclusions: The first-person accounts of adolescents in this study implicate familial relational problems and interpersonal difficulties as proximally leading to self-harm in adolescents. Self-harm in adolescents is interpreted as an understandable response, and as a strong communicative signal in response to powerlessness and family relationship difficulties. These findings need to be taken into consideration in the planning of services in Ghana and are likely to be generalisable to many other countries in sub-Saharan Africa.

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Section: Adolescents Explain Their Self-harmmentioning

confidence: 61%

Adolescent self-harm in Ghana: a qualitative interview-based study of first-hand accounts

Quarshie¹,

Waterman²,

House³

2020

BMC Psychiatry

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“…In addition, religion as a dominating meaning system ( Park, 2005 ) could be considered to have more power in this interdependent context than what is common in more independent settings. This was found, for example, in a study by Osafo et al (2018) , where they studied the attitudes of nurses and physicians toward suicide, and religion was the interpretive grid within which they expressed themselves.…”

Section: Meaning Making and Religionmentioning

confidence: 90%

“…The strong influence of religion on the attitudes toward suicide was found both in Uganda (Mugisha et al, 2013) and Ghana (Osafo et al, 2011(Osafo et al, , 2018. Osafo (2012) interviewed various groups as, for example, psychology students, psychologists, nurses, and lay persons and found that suicidal behavior mainly was perceived as a moral issue with moral meanings.…”

Section: Religion and Attitudes Toward Suicide And Suicidal Peoplementioning

confidence: 99%

Religion as Meaning-Making Resource in Understanding Suicidal Behavior in Ghana and Uganda

et al. 2021

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Suicidal behavior is condemned by religions and tradition, and suicide attempts are criminalized by law in several African countries, including Ghana and Uganda. Suicide and suicide attempts may have severe consequences for both the entire family and the community. Religion is known to act as a protective coping force that helps people to make meaning and find comfort when dealing with stressful life events or situations like suicide. In this article, we focus on the cultural interpretations of the dominating religion in Ghana and Uganda, Christianity, and whether these affect attitudes toward suicidal behavior, meaning making, and coping possibilities for people who have attempted suicide or are bereaved by suicide. This article is based on data material from previous studies on the mentioned topics by the authors.

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“…In addition, studies across continents uncovered elements of the sociocultural context (e.g. religious beliefs, stigma, criminalization of suicide) that can influence the individuals' lived experiences of SI, the (student) nurses' attitudes towards suicide and suicide attempts and the (student) nurses' engagement in recognizing and discussing suicide (Flood et al, 2018;Osafo, Akotia, Boakye, & Dickson, 2018;Vedana et al, 2018).…”

Section: Limitationsmentioning

confidence: 99%

Contact and communication with patients experiencing suicidal ideation: A qualitative study of nurses’ perspectives

Vandewalle

Beeckman

Hecke

et al. 2019

Journal of Advanced Nursing

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Aim To uncover and understand the core elements of how nurses in psychiatric hospitals make contact with patients experiencing suicidal ideation. Design A qualitative study based on the principles of grounded theory was performed. Methods Nineteen nurses on wards of four psychiatric hospitals were interviewed between May 2017 – February 2018. The Qualitative Analysis Guide of Leuven was used to facilitate the constant comparison of data. Findings Nurses make contact with patients experiencing suicidal ideation by “creating conditions for open and genuine communication” while maintaining a focus on “developing an accurate and meaningful picture of patients”. These interconnected core elements represent nurses’ attention to relational processes like building trust as well as their predominant focus on assessing suicide risk. Nurses put other emphases in their contacts with patients depending on whether their approach is guided more by checking and controlling suicide risk or by acknowledging and connecting (with) the person. Conclusion The study enhances the conceptual understanding of how nurses on psychiatric wards can involve in compassionate and considerate contact and communication with patients experiencing suicidal ideation. These findings can be used to underpin the nurses’ role in and contribution to suicide prevention. Impact The core elements “creating conditions for open and genuine communication” while maintaining a focus on “developing an accurate and meaningful picture of patients” can inform policies for nursing practice and education that aim to preserve and improve the capacity of nurses to involve in compassionate and considerate contact and communication with patients experiencing suicidal ideation.

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Between moral infraction and existential crisis: Exploring physicians and nurses' attitudes to suicide and the suicidal patient in Ghana

Cited by 24 publications

References 45 publications

Adolescent self-harm in Ghana: a qualitative interview-based study of first-hand accounts

Adolescent self-harm in Ghana: a qualitative interview-based study of first-hand accounts

Religion as Meaning-Making Resource in Understanding Suicidal Behavior in Ghana and Uganda

Contact and communication with patients experiencing suicidal ideation: A qualitative study of nurses’ perspectives

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