Exploring nurse suicide by firearms: A mixed‐method longitudinal (2003–2017) analysis of death investigations

Abstract

Background: Previously it was noted that firearm use by nurses in suicide was changing. The Center for Disease Control and Prevention suicide dataset contains investigation narratives that no researcher has analyzed and may provide context to inform suicide prevention.Objective: Explore firearm deaths in nurse suicide. Second, test topic modeling techniques to analyze investigation narratives.Methods/Statistical Analysis: Mixed-method retrospective analysis of 739 nurse versus 94,838 nonnurse suicides. Odds ratios (OR) were calculated to determine relative incidence. After tokenization and stop word removal, Latent Dirichlet Analysis and Latent Semantic Indexing topic modeling techniques were applied.Topics were evaluated for clinical significance and content analysis performed.Results: Aim 1: Female nurses used firearms significantly less often than other females between 2003 and 2013 (OR: 0.71; p < .001; 95% confidence interval [CI]: 4.23%-9.83%). A rise in nurse firearm use occurred between 2014 and 2017; with rates now similar to nonnurse females (OR: 0.98; p = .7574; 95% CI: −2.68 to 3.49).Clinically relevant topics identified by topic modeling: preventable deaths, chronic pain, and job loss before suicide. Conclusions:From this research we know that work-related issues in nurse suicides by firearms center around chronic pain, substance use, and job loss. The codes tied to suicidal ideation, previous attempt and/or depression, represented preventable deaths because it is known that if a weapon is removed from the home in these situations a suicide can be aborted. The change in firearm use warrants nurse education regarding firearm safety and suicide prevention. Topic modeling holds promise in focusing analyses of suicide investigations.

Longitudinal analysis of suicides among pharmacists during 2003-2018

“…40 This means of suicide is consistent with the general population where death by firearms is much more common than death by poisoning. 6,40,41 Similar to nursing but different from physicians, benzodiazepines, antidepressants, and opioids were the most common substances found in the pharmacist suicides. 6,8 Although caution must be exercised when trying to understand the characteristics of suicide in this small sample, it is worthwhile to examine the significant findings in this study.…”

Research utility and limitations of textual data in the National Violent Death Reporting System: a scoping review and recommendations

“…While the CDC provides detailed Users’ Manuals for the NVDRS (Centers for Disease Control and Prevention 2020 , 2021 , 2022b ), there is a general lack of concrete guidance on how to reconcile incongruencies and integrate text narratives with the abstractor-coded variables. This review found that researchers who utilize the narratives as a means of case finding or case confirming often privilege the content within the qualitative data in classifying or categorizing cases and incident circumstances when coded variables were found to be insufficient (Davidson et al 2021a ; Lohman et al 2021 ; Yau and Paschall 2018 ; Wertz et al 2020 ). However, few studies reported information on missingness or incompleteness of these texts, much less how such data issues were addressed in the analysis.…”

Thematic analysis and natural language processing of job‐related problems prior to physician suicide in 2003–2018

“…Standard NLP preprocessing steps were followed: investigation narratives with five or fewer characters were removed, yielding the 204 CME and 188 LE narratives for analysis. Remaining NLP preprocessing and analysis steps have been described previously (Davidson et al, 2021) and may be found in Appendix A.…”