Development and Evaluation of Suicide Prevention Nursing Competency Programs for Visiting Nurses

Jung Eun Kim; Suk-Sun Kim

doi:10.4040/jkan.2020.50.1.14

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Kim and Kim: Development and Evaluation of Suicide Prevention Nursing Competency Programs for Visiting Nurses

Original Article

J Korean Acad Nurs 2020;50(1):14-25.

Published online: 17 January 2020

DOI: https://doi.org/10.4040/jkan.2020.50.1.14

Development and Evaluation of Suicide Prevention Nursing Competency Programs for Visiting Nurses

Jung Eun Kim^1,², Suk-Sun Kim^1,

¹College of Nursing, Ewha Womans University, Seoul

²Daegu Regional Mental Health Welfare Center, Daegu, Korea

Address reprint requests to : Kim, Suk-Sun College of Nursing, Ewha Womans University, 52 Ewhayeodae-gil, Seodamun-gu, Seoul 03760, Korea, Tel: +82-2-3277-2885 Fax: +82-2-3277-2850 E-mail: suksunkim@ewha.ac.kr

Received 11 April 2019 Revised 29 October 2019 Accepted 19 January 2020

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

Abstract

Purpose:

The purpose of this study was to develop a suicide prevention nursing competency program for visiting nurses, and to examine the effect of this program on suicide prevention-related knowledge, attitudes, and behaviors.

Methods:

A total of 66 visiting nurses were recruited from 10 public health centers and divided equally into the experimental and control group. For the experimental group, the suicide prevention nursing competency program was provided twice a week for 120 minutes across 3 weeks. Participants were asked questions related to suicide prevention knowledge, attitudes, and behaviors at pre, post, and 1 month after the intervention. Data were analyzed using descriptive statistics, a t-test, repeated measure ANOVA, and Friedman test.

Results:

There were significant differences in knowledge and behaviors at the measured time periods, and significant differences in attitudes and behaviors between the two groups. There were also significant interactions between groups and times in attitudes and behaviors. These results suggest that the effects of the program were persistent until the 1-month follow-up.

Conclusion

The developed suicide prevention nursing competency program is effective in evidence-based education for visiting nurses to increase suicide prevention-related knowledge, attitudes, and behaviors.

Keywords: Home Health Nursing, Suicide, Prevention, Training Program

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Figure 1.

Flow of participants.

Table 1.

Suicide Prevention Nursing Competency Programs for Visiting Nurses

	Factors	Key topics	Contents (	Time (min)	Intervention methods	Material
1	Knowledge,	Open our minds to	· Complete a pre-test survey	20	Lectures, Videos,	Lecture notes,
	Attitude	think about our	· Write a pledge	30	Small Group	writing tools,
		roles	· Write a self-introduction (Make a mind map)		Actvities,	individual notes
			· Suicides in South Korea	70	Discussions
			· Importance of healthcare professional’s role in suicide
			prevention
2	Knowledge,	Recognize and	· OX quiz	10	Quizzes,	Lecture notes,
	Skills	check the	· Prejudice and misunderstanding about suicide	50	Lectures, Videos,	writing tools,
		warning signs of	· Relationship between depression and suicide		Demonstrations	individual notes
		suicide	· Recognizing verbal, behavioral, situational warning signs
			of suicide
			· Utilize a tool for suicide risk assessment and interpret the	50
			results
			· Success stories of applying a risk assessment tool	10
3	Knowledge,	Form a safety net	· Form a safety net with only the presence of suicidal	30	Lectures, Cases,	Lecture notes,
	Skills		thoughts		Demonstrations,	writing tools,
			· Form a safety net with the presence of suicidal plans	30	Role Plays	individual notes
			· Understanding ambivalence	20	(practice),
			· Confidentiality, ethical issues		Debriefing
			· Form a safety net (practice)	40
4	Knowledge,	Communicative	· 4 ways to communicate with respect	50	Lectures, Cases,	Lecture notes,
	Skills	empathyⅠ	- Acknowledge emotions for as they are		Demonstrations,	writing tools,
			- Express emotions		Role Plays	individual notes,
			- Recognize desires		(practice),	Feelings and
			- Request		Debriefing	Emotions Cards
			· Learn 4 ways of communicating skills through cases	70
			- Communicate with respect (practice)
5	Knowledge,	Communicative	· 4 skills of empathic listening	60	Lectures, Cases,	Lecture notes,
	Skills	empathy Ⅱ	- Take an interest		Demonstrations,	writing tools,
			- Identify emotions		Role Plays	individual notes,
			- Identify desires		(practice),	Feelings and
			- Be satisfied with each other		Debriefing	Emotions Cards
			· Learn 4 ways of empathic listening skills through cases	60
			- Emapthic listening (practice)
6	Knowledge,	Integrated	· OX quiz	30	Quizzes, Cases, Role	Lecture notes,
	Skills,	application	· Apply suicide knowledge and skills in real life situations		Plays (practice),	writing tools,
	Attitude,		· Suicide prevention competencies in nursing	70	Debriefing	individual notes
			· A role play through integrated cases
			· Complete a post-test survey	20

Table 2.

Homogeneity of General Characteristics and Dependent Variables between Groups (N=66)

Characteristics	Categories	Exp. (n=33)	Cont. (n=33)	χ²/t/u	p
Characteristics	Categories	n (%)/M±SD	n (%)/M±SD	χ²/t/u	p
Gender	Female	33 (100)	32 (97.0)	1.01	.314
	Male	-	1 (3.0)
Age (yr)^†		45.76±7.22	42.85±8.32	1.51	.134
Level of education	Associate’s degree	16 (48.5)	22 (66.7)	2.61	.271
	Bachelor’s degree	14 (42.4)	10 (30.3)
	Advanced degree	3 (9.1)	1 (3.0)
Religion	No religion	14 (42.4)	12 (36.3)	1.23	.746
	Christians	9 (27.3)	9 (27.3)
	Catholics	3 (9.1)	6 (18.2)
	Buddhists	7 (21.2)	6 (18.2)
Total career (year)^†	Registered nurse	12.37±5.40	11.04±5.79	0.96	.337
	Visiting nurse	5.74±3.55	4.64±4.01	1.17	.243
Experience of suicide attempt	Yes	7 (21.2)	6 (18.2)	0.09	.757
	No	26 (78.8)	27 (81.8)
Experience of suicide	Yes	6 (18.2)	5 (15.2)	0.10	>.999
	No	27 (81.8)	28 (84.8)
Experience of suicide prevention education	Yes	21 (63.6)	28 (84.8)	3.88	.049
	No	12 (36.4)	5 (15.2)
Number of suicide prevention education taken^††		1.10±0.30	1.36±0.56	2.10	.041
Suicide prevention-related knowledge		74.03±11.82	73.81±11.66	541.00	.967
Attitudes toward suicide attempters^†		61.15±9.92	60.42±9.54	0.30	.763
Empathic ability^†		8.96±4.00	8.00±2.86	1.13	.262
Suicide prevention-related behaviors^††		17.15±3.83	18.82±5.35	-1.46	.151

Exp.=Experimental group; Cont.=Control group; M=Mean; SD=Standard deviation.

^† t-test,

^†† Welch’s test.

Table 3.

Effects of Suicide Prevention Nursing Competency Programs (N=66)

Outcome variables	Groups	Pre-test	Post-test	t or z (p)
Outcome variables	Groups	M ±SD		t or z (p)
Suicide	Exp.	74.03±11.82	98.27±4.73	-5.03 (<.001)
prevention-	Cont.	73.81±11.66	71.00±7.35	-1.59 (.123)
related
knowledge
Attitudes	Exp.	61.15±9.92	54.73±12.73	4.13 (.556)
toward	Cont.	60.42±9.54	61.64±12.98	-0.59 (<.001)
suicide
attempters^†
Empathic	Exp.	8.97±4.00	10.52±4.51	-2.51 (.010)
ability	Cont.	8.00±2.87	8.58±3.17	-1.29 (.203)
Suicide	Exp.	17.15±3.83	29.15±4.23	-17.69 (<.001)
prevention-	Cont.	18.82±5.35	19.48±4.51	-0.66 (.511)
related
behaviors

Exp.=Experimental group (n=33); Cont.=Control group (n=33); M= Mean; SD=Standard deviation.

^† t-test.

Table 4.

Continuous Effects of Suicide Prevention Nursing Competency Programs (N=66)

Variables	Time	Exp. (n=33)	Cont. (n=33)	Source	χ² or F (p)
Variables	Time	M±SD	M±SD	Source	χ² or F (p)
Suicide prevention-related knowledge^†	Pre-test	74.03±11.92	73.81±11.66	Experiment	50.99 (<.001)
	Post-test	98.29±4.73	71.00±7.35	Control	6.69 (.035)
	Follow up	95.67±8.36	75.97±9.75
Attitudes toward suicide attempters	Pre-test	61.15±9.92	60.42±9.54	Group	4.44 (.039)
	Post-test	54.73±12.73	61.64±12.98	Time	1.60 (.206)
	Follow up	55.88±13.96	65.09±14.39	G×T	5.36 (.006)^††
Empathic ability	Pre-test	8.97±4.00	8.00±2.87	Group	2.42 (.125)
	Post-test	10.52±4.51	8.58±3.17	Time	10.39 (<.001)
	Follow up	10.46±3.20	10.29±2.64	G×T	2.07 (.131)
Suicide prevention-related behaviors	Pre-test	17.15±3.83	18.82±5.35	Group	68.86 (<.001)
	Post-test	29.15±4.23	19.48±4.51	Time	58.57 (<.001)
	Follow up	27.61±6.18	19.82±4.22	G×T	46.91 (<.001)

Exp.=Experimental group; Cont.=Control group; G×T=Group×Time; M=Mean; SD=Standard deviation.

^† Friedman test,

^†† Greenhouse-Geisser adjusted p.

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