Identifying Suicidal Ideation in Cancer Patients

Abstract

EXTRACT

Keywords: Medical treatment, cancer diagnosis, suicide, suicidal thoughts, cancer patients, psychooncology.

Introduction: Suicidality among oncology patients in Slovenia is still a relatively unexplored topic. After a review of the literature, it was found that the risk of suicide among people diagnosed with cancer is higher compared to the general population. Therefore, we wanted to determine the presence of suicidal ideation in patients undergoing cancer treatment.

Methods: Qualitative research involved interviews (n=5) with people undergoing cancer treatment. In this paper, the transcripts of the interviews are analysed using grounded theory principles.

Results. Some of them had a plan. Anxiety, insecurity, need for antidepressants and help from a psychologist were prominent. The very diagnosis and experience of the illness is extremely painful. They reported fear of starting treatment, a feeling of helplessness, of being affected, intertwined with a feeling of denial, then hope for a cure. The most disturbing aspect of the initial treatment process was the waiting for treatment and treatment. The illness itself and the treatment also have an impact on self-image, all leading to mental consequences due to physical changes. We found that a previous history of mental illness has a significant impact, but nevertheless all participants expressed a desire to live. The category analysis showed the category of support from family and surroundings, and the high importance of an orderly family status. In the experience of the medical staff, all participants felt that the need for individualised treatment in terms of person-centredness and the need for a psychooncologist at the beginning of treatment was inevitable.Pain is also an important element. More than physical pain, they mentioned psychological, internal pain, which was linked to feelings of helplessness and suicidal thoughts.

Discussion and conclusion: Identification of suicidal oncology patients is a difficult process, as depressed mood and anxiety may be hidden during treatment. It is necessary to establish a trusting, empathic relationship with the patient. With mutual respect and trust, when suicidality occurs, healthcare staff can work together with the patient to try to solve the problem. Nurses who are present at all times with the patient should be educated in the identification of risk factors that increase the potential for suicide and in the use of prevention tools (e.g. questionnaires and interviews) and screening programmes that identify oncology patients at risk of suicidality at an early stage.