Suicidal risk screening: Oncology nurses' barriers and leverages

Suicide is a major issue around the world. Cancer is now well known as a higher risk of suicide. Guidelines recommend that patients need to be screened for suicidal ideation to be referred early to appropriate supportive care. Nurses are primary professional resources. Despite this role in many international studies, oncology nurses felt unable, lacked skills, and feared to deal with suicidal patients. We lack data concerning the care practices of French nurses. This study aims to describe the barriers and facilitators to screen suicidal risk in adult cancer patients by nurses working in a French cancer center.

This study was conducted through a focus group with oncology nurses. Three domains were explored: nurses' current practice in patient suicide risk screening, barriers and facilitators to identify suicidal and their training needs. A thematic analysis on the transcripts was performed through an inductive approach.

The results of the focus group (n = 11) showed that nurses don't screen systematically for suicidal risk. We identified three main barriers (organizational, cognitive, protection mechanism) and four leverages (organizational, training, therapeutic alliance, back to disciplinary fundamentals).

The lack of systematic screening for suicidal risk appears to be due to several factors, such as the fact that suicide is an act of autonomy or that there is a lack of both time and theoretical and practical knowledge. The nurses report that their views are not heard due to a pyramidal organizational structure. These barriers need to be considered in training content, particularly emotional ones.