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Published on: February 22, 2018
Original Research: Suicidal Ideation and Attitudes Toward Help Seeking in U.S. Nurses Relative to the General Working
Elizabeth A Kelsey1, Colin P West, Pamela F Cipriano
1Elizabeth A. Kelsey is an NP and assistant professor at Mayo Clinic Minnesota in Rochester, where Colin P. West and Liselotte N. Dyrbye are professors and codirectors of the Mayo Clinic Program on Physician Well-Being and Daniel Satele is a statistician. Pamela F. Cipriano is first vice president of the International Council of Nurses and dean of the University of Virginia School of Nursing, Charlottesville; she is also a former president of the American Nurses Association (ANA). Cheryl Peterson is vice president-nursing programs at the ANA in Silver Springs, MD. Tait Shanafelt is chief wellness officer and associate dean at the Stanford University School of Medicine, Stanford, CA. Funding for this study was provided by the Mayo Clinic Program on Physician Well-Being and the ANA and was based on work partially supported by a National Science Foundation (NSF) grant (No. 2041339). Any opinions, findings, and conclusions or recommendations expressed in this article are those of the authors and do not necessarily reflect the views of the NSF. Funding sources had no role in study design; in the collection, analysis, and interpretation of data; or in the writing and publication of this article. Contact author: Elizabeth A. Kelsey, kelsey.elizabeth@mayo.edu . The authors have disclosed no potential conflicts of interest, financial or otherwise.
Purpose:
Although previous studies have revealed professional consequences of burnout among nurses, less is known about the potential personal consequences. This study investigated the prevalence of suicidal ideation and attitudes toward help seeking among U.S. nurses relative to other workers, and the extent to which personal and professional factors, including burnout, were related to suicidal ideation.
Methods:
In November 2017, a cross-sectional survey was sent to 86,858 nurses who were members of the American Nurses Association and to a probability-based sample of 5,198 U.S. workers. The survey included questions regarding suicidal ideation, burnout, symptoms of depression, individual and professional characteristics, and willingness to seek professional help if a serious emotional problem arose. Multivariable logistic regression analyses were conducted to identify factors associated with suicidal ideation after controlling for other factors.
Results:
Among the 7,378 nurse respondents, 403 (5.5%) reported having suicidal ideation within the past year. Most nurses (84.2%) indicated willingness to seek professional help for a serious emotional problem. Yet nurses with suicidal ideation were less likely to report that they'd seek such help (72.6%) than nurses without suicidal ideation (85%). In a multivariable analysis of nurses' data, after controlling for other personal and professional characteristics, we found that burnout was strongly associated with suicidal ideation. Adjusted combined multivariable analyses showed that nurses were more likely than other workers to have suicidal ideation. Both nurses and other workers who reported suicidal ideation were less likely to seek help than were those who did not report such ideation.
Conclusions:
Compared with other U.S. workers, nurses are at higher risk for suicidal ideation, and nurses with such ideation are more reluctant to seek help than those without it. Burnout contributes to the risk of suicidal ideation. These issues warrant greater attention. Systems- and practice-level interventions must be identified and implemented, both to address the higher prevalences of burnout and suicidal ideation in nurses and to mitigate the stigma about mental health problems and other barriers to seeking help.
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