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

https://doi.org/10.1016/j.ijnurstu.2018.05.017Get rights and content

Abstract

Background

Negative attitudes of health professionals towards suicide may hamper their willingness and skills to work with attempt survivors.

Objective

The purpose of this study was to explore the attitudes of physicians and nurses towards suicide and the suicidal patient.

Methods

A semi-structured qualitative interview was conducted on Twenty five (25) health professionals: (15 physicians and 10 casualty nurses) from five hospitals in Accra, the capital of Ghana.

Results

Findings showed that while majority of physicians viewed suicide as an existential crisis, most of the nurses viewed it as a moral infraction. Three key attitudes towards suicide and the suicidal patient were observed: stable, dissonant and transitioned. The findings are discussed under three main themes: Contexts, Theorizing suicide, and Shades of attitudes.

Conclusion

Nurses and Physicians are key gatekeepers in suicide prevention in Ghana. Training is however, needed to improve both attitudes (especially for nurses) and competence towards suicide prevention in the country.

Section snippets

What is already known about the topic?

  • •

    Health professionals’ attitudes can influence the help seeking relationship they have with their patients.

  • •

    In Ghana, nurses have reported negative attitudes towards suicide, condemned the suicidal patient and supported their criminalization whilst psychologists differed sharply.

  • •

    In Ghana attitude towards suicide was reported to be in transition from morality to mental health.

What this paper adds

  • •

    Attitudes towards suicide in Ghana is perceived as health crisis more than moral infraction.

  • •

    Three attitudes: stable, dissonant and transitioned attitudes exist in health workers in Ghana. These attitudes are influenced by religion and continuous education.

  • •

    Nurses have poor attitudes to suicide compared to physicians. Gatekeeper training to improve the attitudes of health workers in suicide prevention in Ghana is an urgent need.

Approach

Qualitative method was adopted for this study. Our interest was to understand and allow the participants as meaning making persons, to engage their context, share their experiences, views and interpretations about suicidal behaviour (Willig, 2008; Yin, 2015). The usefulness of qualitative approach in suicidal research in recent times has been highlighted (Hjelmeland and Knizek, 2010).

Participants and procedure

Physicians and nurses from one government hospital, a quasi-government hospital, a university hospital and two

Contexts

Analysis started by examining participants’ general perceptions about suicidality in Ghana on issues such as perceived prevalence, number of suicidal patients seen in the past one year, and awareness of how religiosity influenced their attitudes towards suicide. These background issues provided a context within which their attitudes were carefully examined.

Majority of the participants viewed suicide trends in Ghana as public health concern. A total of 14 participants (7 doctors and 7 nurses)

Discussion

The purpose of this study was to examine the attitudes of nurses and physicians towards suicide and the suicidal patient. The health professionals, most of whom had interacted with suicidal persons (either as patients, colleagues or family folks) viewed suicide as a considerable public health problem in Ghana, arising from psychosocial crisis rather than psychiatric illnesses. This is consistent with previous studies that have reported the preponderance of psychosocial/sociocultural factors in

Ethical approval

This study was approved by the Ethics Committee for the Humanities (ECH) at the University of Ghana, Legon.

Conflict of interest

None.

Acknowledgment

This project received financial support from Office of Research, Innovation and Development (ORID) at the University of Ghana (URF/7/ILG-025/2013-2014).

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