Suicide Assessment for Pediatric Patients in Acute Health Care Setting
Table of Contents Data Collection Analysis Evaluation Dissemination of Results Conclusion References Data Collection Working with children is always challenging but honorable because many health problems and concerns can be identified at their early stages and preventive steps may be taken. In this project, the PICO question is “In pediatric patients in an acute health care setting (P) does the use of suicide assessment tool (I) as compared to a standard pediatric assessment (C) reduce the risk of future suicide attempts (O)? It means that all data has to be gathered from healthcare facilities where direct cooperation with pediatric patients is possible to investigate their suicidal attempts. A variety of data collection methods can be used to answer this PICO question, and researchers have to make their final choices after thorough evaluations and investigations. It is important for methods to match with research questions and goals in order to ensure the generalization of investigation results (Adams, Khan, &Raeside, 2014).
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Qualitative data will be gathered and reviewed within the frames of this research. A researcher has to be ready to perform the functions of the main instrument in this study as his/her task includes observing, taking notes, communicating with people, and making biased-free conclusions. Questionnaires will be the chosen form of data collection in this study. The peculiar feature of a qualitative research design is that information has to be received directly from the participants who experience a new phenomenon or intervention (Bradshaw, Atkinson, & Doody, 2017). In addition, it is necessary to understand that resources and time are usually limited to this type of study. Therefore, much attention should be paid to the way of how data collection will occur. The process of collecting information will begin with cooperation with local hospitals and the evaluation of patient databases. There are three central inclusion criteria that have to be used to choose potential participants: children between 12 and 16 years who speak, read, and write in English. It is expected to find at least 300 patients who meet these essential criteria. Regarding the fact that our intervention should be developed among 200 patients, it is reasonable to have several participants in reserve (in case they or their parents do not give their approval for participation). As soon as informed consent is obtained from every participant, it is necessary to develop face-to-face semi-structured interviews for a maximum of 10-20 minutes and make some notes about patients’ gender, age, and general psychological conditions. Then, the intervention that includes a suicide assessment tool will be introduced to the experimental group, and a standard pediatric assessment will be offered to the control group. The assessment of the patients from both groups will occur between 15 and 30 minutes. Post-intervention interviews will be developed with patients to recognize the risks of suicide attempts. Information taken from the interviews and the results of the assessments will be used for future analysis. There are several ways on how to improve data collection and have enough material for evaluation. Data saturation is a frequently used method to strengthen the results and deepen the quality of the information obtained from patients (Ekstam, Carlsson, Chiatti, Nilsson, & Fänge, 2014; Herath, Guruge, Fenando, Jayarathna, & Senarathna, 2018). It can be achieved if the researcher communicates with patients’ parents and gathers their opinions in the form of a focus-group interview. To enhance data quality, the triangulation method can be used to ensure the validity of the study and prove its appropriateness through adding new characteristics and verifiable knowledge from multiple sources (Benjumea, 2015). Another method is member check within the frames of which feeding back data is possible along with interpretations and evaluations of the participants after the intervention (Korstjens & Moser, 2018). Regardless of the methods and approaches are chosen to gather data, all participation has to be based on free will, confidentiality, and anonymity.
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Analysis The organization of data analysis in qualitative research is a tricky task with a number of options to be discussed. However, when the data remains unknown, it becomes even harder to understand the peculiarities of data analysis. In qualitative research, there is a constant interplay between data collection and analysis that promotes a considerable growth of understanding the matter (Walliman, 2016) Data analysis will be based on properly chosen qualitative data, articulation of meanings, and commenting on similarities and differences between variables. The aim of qualitative data analysis is to explain and interpret the offered patterns in terms of words and numbers. In this project, the task is to understand the worth of a suicide assessment tool in comparison to an ordinary pediatric assessment in relation to the possibility to reduce the risks of future suicide attempts. This type of analysis is a part of the evaluation of the intervention and patients’ behaviors in their intentions to commit or, at least, think about suicide. There are several steps that should be taken to organize data analysis and answer the main research question. First, it is necessary to gather all notes about participants and the intervention and make sure all of them are properly transcribed. Demographics information should also be added to this type of analysis. The next step is to review and explore the data thoroughly. It will be not enough to read interview transcripts once and memorize the main idea. The task is to read data several times in order to get a sense of what it contains. It is possible to make notes about personal thoughts and attitudes to a situation but make sure they are not too judgmental or biased. Concept maps, sticky pads, and special margins can be used to unite the data and identify the keywords for analysis. Coding turns out to be an integral part of data analysis with the help of which recurring themes and opinions can be based. Finally, the identification of the main themes for discussion is required. At this stage, the researcher should have enough information about pediatric patients and their suicide thoughts, the essence of a suicide assessment tool and a traditional pediatric assessment, and the attitudes of the participants toward such assessment. Risks of future suicidal attempts have to be discussed through evaluation of such factors as the patient’s behavior, emotion control, the level of cooperation, and trust in patient-doctor relationships. Triangulation is a useful tool in the analysis of qualitative data (Korstjens & Moser, 2018). It implies the use of several types of data analyses to verify the assessment by appropriate cross-checking results of interviews, focus groups, and observations. This method helps corroborate evidence gathered from the participants and formulated by the researcher on the basis of obtained observational notes and interpretations. Evaluation The implementation of this evidence-based practice proposal has a number of benefits and positive outcomes for nursing practice and the stakeholders identified earlier. The essence of the offered intervention is to review the behaviors of pediatric patients with the help of a new specially developed suicide assessment tool and compare its effectiveness with a standard pediatric assessment. There are five stakeholders that may be interested in the offered intervention: children (as direct participants of the study), parents (as the main caregivers), nurses, doctors, and governments.
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Children should benefit from the offered intervention in several ways. First, they can get more time to talk to medical experts and understand their issues, discuss their concerns, and discover the problems at the early stage of their development. Second, they may improve their understanding of psychological and emotional problems and try to find solutions. Finally, they will be educated and prepared for possible changes in their mood, behavior, and relationships with peers. Children with suicidal ideation are at risk for developing new mental health problems and becoming vulnerable to various outside factors (Montreuil, Butler, Stachura, & Pugnaire Gros, 2015). This intervention is a chance for pediatric patients to deal with their problems and avoid complications. Parents may experience similar benefits to those children do because of being direct caregivers for these patients. They should use this intervention as a chance to predict serious health problems in their children and understand how they can help. In family relations, not all parents may succeed in caring for their children. The development of caring relations through this intervention is an outcome that cannot be neglected (Montreuil et al., 2015). Being aware of the child’s potential problems and suicidal risks, parents can also influence a child’s future progress and develop trustful relationships (Walliman, 2016). Parents will be informed about the current emotional stage of their children and educated on how to help them, reduce the number of negative factors, and offer support. Nurses and doctors are the stakeholders who are able to identify mental health problems and develop an effective care plan for children. This intervention can be used to diagnose children and focus on the areas that play an important role in current child development. The offered assessment tool will help medical workers to save their time in cooperating with children and get an opportunity to help many patients. Nurses and doctors will receive a clear evaluation of both tools and understand which one is more effective in preventing suicidal risks. Finally, this group of stakeholders is “in a pivotal position to provide preventive care to children with mental health issues” (Montreuil et al., 2015, p. 850). Therefore, they decrease the opportunity for new symptoms to be developed and reduce the necessity to use additional healthcare resources and equipment. The government can win with the intervention under discussion by the possibility to decrease the number of suicides among young adults and avoid demoralization of society. There will be no need to develop new programs to control suicidal attempts and help children at risk of suicide. In addition, healthy children can be good sources for the government to stabilize population satisfaction, employment rates, and the wealth of a country. In nursing practice, this intervention will promote two important changes. On the one hand, nurses get a good plan on how to assess pediatric patients in a short period of time, understanding the benefits and outcomes of the offered tool. On the other hand, the reduction of suicide attempts will promote the creation of new prevention strategies and programs that have to be oriented toward children. In both cases, these changes can be a solid contribution to population mental health and suicide prevention.
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Dissemination of Results Dissemination of results is a significant part of the work that should be done to complete the study. There are many methods that can be used by the researcher to disseminate the results and inform all stakeholders about the strengths and limitations of the study. One of the most evident ways to share the results is to present the project in class and receive an objective evaluation developed by a tutor and peers. In addition, as all the patients and their parents receive informed consent, they may expect the description of the results of their participation. Information may be introduced in a written or oral form depending on the demands of the participants. Nurses and doctors can be provided with special tables and graphs and use this illustrative material as a chance to introduce new strategies and policies for their hospitals or medical care centers. There are also several scientific approaches to share information with stakeholders. For example, Walliman (2016) suggests publishing academic projects in the form of a conference paper, journal article, or page on a website. However, it is necessary to understand that this process of dissemination usually involves the reduction of the length of the results and change of the style of writing to meet the required academic standards (Walliman, 2016). The researcher has to get prepared for all technical aspects of the work and make sure it sounds logical and clear. In many cases, researchers want to address a specially trained person to improve the organization of the project, consider all necessary writing techniques, and make sure that all references and tables are properly organized. The success of this evidence-based practice project also depends on how well this information is shared with the members of nursing practice at different levels. For example, at the faculty level, this project can be introduced as a formal presentation at a conference hall. Students and teachers will be invited to listen to this project, share their opinions, and discuss important lessons. The community can read about the results in local newspapers and academic journals. Regarding the state and national levels, it is effective to use online forums and specialized websites where researchers discuss their recent achievements and discoveries. Sometimes, one post and one idea can change the work of many people, and the implementation of a special suicide assessment tool during the pediatric examination may become the change that millions of people want to observe. Conclusion This evidence-based practice project aims at discussing the peculiarities of pediatric patient assessment in an acute health care setting. The task is not only to introduce a suicide assessment tool but to compare its outcomes on patients with those of a traditional pediatric assessment tool. The results should show if the reduction of future suicide attempts can be possible, and which tool is proved as more effective. The benefits of this study include the identification and prediction of new suicide attempts among pediatric patients and provoke the development of new strategies that may be used to stabilize the emotional wellbeing of children and assist their families in caregiving. The role of nurses and doctors in acute health care settings will be investigated as well to clarify the level of care and the importance of diagnosing suicidal indention at the early stage. It is expected to prove that suicide assessment tools have to become an obligatory diagnostic method in healthcare settings when nurses and doctors should cooperate with children and their families. The governmental role will also be underlined as this stakeholder can obtain certain benefits with the chosen intervention. In general, the potential contributions of this project proposal to nursing practice and acute healthcare settings include the improvements in the physical and emotional assessment of children. It is not enough for nurses to identify current health problems and threats. Medical workers have to recognize potential challenges for pediatric patients in order to avoid such complications as the development of suicidal thoughts because of being poorly understood, threatened, or offended. Despite the intentions to become the best caregivers, parents are not able to understand what actually bothers their children. Therefore, additional help and professional assessment are crucial in caregiving. In nursing practice, this study should help to identify evaluation steps, develop necessary communicative skills, and improve critical thinking and decision-making. Parental approval to interventions and their participation in caregiving contribute to their children’s healing in a variety of ways. Nurses should guide parents and give working pieces of advice without judging or challenging patients and their families. This project is a chance to help families, educate parents, support children, and guide nurses in the prevention of the risks of future suicide attempts. References Adams, J., Khan, H. T. A., & Raeside, R. (2014). Research methods for business and social science students (2nd ed.). Thousand Oaks, CA: SAGE. Benjumea, C. D. L. C. (2015). The quality of qualitative research: From evaluation to attainment. Texto & Contexto-Enfermagem, 24(3), 883-890. Web. Bradshaw, C., Atkinson, S., & Doody, O. (2017). Employing a qualitative description approach in health care research. Global Qualitative Nursing Research, 4. Web. Ekstam, L., Carlsson, G., Chiatti, C., Nilsson, M. H., & Fänge, A. M. (2014). A research-based strategy for managing housing adaptations: Study protocol for a quasi-experimental trial. BMC Health Services Research, 14, 602-612. Web. Herath, T., Guruge, D., Fenando, M., Jayarathna, S., & Senarathna, L. (2018). The effect of a community based health promotion intervention to change gender norms among women in a rural community in Sri Lanka. BMC Public Health, 18, 977-994. Web. Korstjens, I., & Moser, A. (2018). Series: Practical guidance to qualitative research. Part 4: Trustworthiness and publishing. European Journal of General Practice, 24(1), 120-124. Web. Montreuil, M., Butler, K. J. D., Stachura, M., & Pugnaire Gros, C. (2015). Exploring helpful nursing nare in pediatric mental health settings: The perceptions of children with suicide risk factors and their parents. Issues in Mental Health Nursing, 36(11), 849–859. Web. Walliman, N. (2016). Social research methods: The essentials (2nd ed.). Thousand Oaks, CA: SAGE.