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Background
The research problem is suicide ideation among adolescents, and the particular area to be studied is the role of family and professional support. To identify whether such support can help reduce suicide ideation and rates, it is primarily necessary to explore the causes of suicide ideation and attempts among adolescents, and the qualitative research design can be used for this. Such a study was conducted by Aspaslan (2014) who establishes its significance by stating that suicide rates are growing alarmingly among the young (p. 251). It is suggested that various aspects of the causes of suicide attempts can be examined by interviewing adolescent patients with a history of suicide attempts, and the understanding of reasons will allow building better strategies in suicide prevention, such as the development of family and professional support programs.
The author defines the purpose of the study broadly as an attempt to identify and explore the experience of adolescents who have attempted suicide. The goal of the study is to provide the perspective of adolescents who committed suicide attempts; the author stresses that this perspective is often missing from academic studies on suicide. The research question was formulated by the Aspaslan (2014) as follows: what are the experiences and needs of adolescents who have attempted suicide? (p. 252). The question is aligned with the purpose of the study and complies to place the focus of the research addressing suicide among adolescents on their experiences and perspectives, and this directly connected to the research problem identified above.
Methods
The choice of qualitative methodology was appropriate for the research problem and purpose identified above because qualitative methods allow exploring emotions, thoughts, perceptions, and judgments beyond any frameworks of predesigned questionnaires or scores; this strategy is justified by the recognition that such frameworks may be insufficient for analyzing certain findings related to emotions and perceptions. The study pursued exploring the issue of interest from the participants perspective as opposed to the researchers perspective only or a theoretical perspective. The reviewed literature included both qualitative and quantitative studies as well as books and methodological sources (i.e. sources on how to design a scholarly study) in two languages: English and Afrikaans. The earliest source used by the author was published in 1982, which is appropriate for qualitative studies; however, there is a quantitative source from 1998, which is 16 years before Aspaslan (2014) conducted the study and can be considered a questionable source.
The issues of validity, accuracy, and applicability of previous studies used as sources were properly discussed by the author for those sources that were used in designing the study or interpreting the results. The literature review provided enough materials for building a cohesive, well-grounded argument. The framework in this research was adapted from one of the authors sources and consisted of six phases of a qualitative study. As part of the findings, the framework of four themes associated with suicide attempts was developed: reasons, feelings, sources, and recommendations (see Results).
Results
During interviews, the participants were asked to tell about their suicide attempts, their feelings (before, during, and after the attempt), and the support they received after the attempt. They were also asked to reflect on possible improvements of such support. Among reasons, the participants frequently referred to family issues, and such specific reasons as family violence or disorganization, abuse from parents, and absence of parental role-models were identified. The participants further provided recommendations on alternative support from families, health care facilities, and social workers.
The personal perspective of adolescents who attempted suicide is a valuable source for improving nursing practice. Within recent decades, nursing theorists and practitioners paid extensive attention to the concept of patient-centeredness of care, a part of which is respect for the patients values, preferences, and expressed needs (Barry & Edgman-Levitan, 2012, p. 780). Therefore, studying how patients feel can help nursing care providers design better care delivery strategies. The study by Aspaslan (2014) explores how adolescents with the history of suicide attempts to feel and what they think should be improved about several aspects of support they receive, including family and professional support. In general, the author concludes that the participants wanted their parents to be more engaged in their lives and wanted health care providers to be more willing to communicate with them (patients) extensively and openly; nurses should consider these major recommendations when providing care to adolescents. It can be argued that the recommendations apply not only to those who attempted suicide but also all adolescents affected by depressive symptoms or other psychological problems.
Ethical Considerations
The author does not specifically mention any formal approval from a committee or a different body responsible for reviewing research design from the perspective of ethics, but procedures are described that allow concluding the ethical aspects of the study. The privacy, confidentiality, and anonymity of participants were protected. Before the interview, informed consent was obtained from the participants and their parents. The participants agreed not only to answer the questions but also to being recorded. Records, transcripts, and other materials related to the data collection process were stored in a way that prevented third parties from accessing them.
A major ethical consideration in the study was the researchers willingness to accept any participants refusal to answer a particular question or to continue the interview. It was initially taken into account during the stage of designing the study that questions that would be asked were rather delicate, and the interviewees might ask to stop the questioning. The researcher committed to being sensible in this regard. However, the researcher should have also committed to a certain degree of detachment from the participants so that the researcher could act like someone who recorded what the participants told instead of affecting or modifying their responses in any way. Although the article does not contain full transcripts of the interviews, it can be concluded, based on some excerpts, that the research was conducted with proper attention to ethical considerations.
Conclusion
The critiqued study is an example of analyzing the patient perspective, which makes it a valuable source for improving nursing practice. Based on the findings, nursing care providers can conclude that adolescent patients with a history of suicide attempts or other psychological problems need to be treated with more attention and more extensive communication. One more way to apply the study to nursing practice is to promote family engagement in care as part of the necessary support for such adolescents. It is suggested by the study that, if adolescent patients see more interest and engagement in their lives from their families and health care providers, it will improve their perception of the adequacy and effectiveness of support provided to them.
References
Aspaslan, N. (2014). Reflections on the experiences and needs of adolescents who have attempted suicide: A qualitative study. Social Work/Maatskaplike Werk, 39(3), 251-269.
Barry, M. J., & Edgman-Levitan, S. (2012). Shared decision makingThe pinnacle of patient-centered care. New England Journal of Medicine, 366(9), 780-781.
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