Through the lens of the carers : a qualitative study on barriers, resources, and opportunities for improvement in suicide prevention in (psycho-)oncology

Abstract

Objective Cancer patients are at increased risk for suicidal crises, making suicide prevention a pertinent issue for clinical practice. However, international research suggests that healthcare providers are anxious and, for example, do not actively inquire about suicidality. Such avoidance does not follow expert recommendations and puts patients at risk. First international investigations have reported diverse barriers standing in the way of the recommended clinical care. The present study aimed to expand this investigation to the German context. Methods A preregistered qualitative study following a semi-structured interview guide was conducted with healthcare professionals (HCPs) (N = 20) working in the oncological setting. The interviews were transcribed and analyzed using qualitative content analysis, following an explorative theory-generating approach. Results The main result was a category system giving insight into both barriers and resources HCPs experienced concerning suicide prevention in their practice. Barriers comprised structural (e.g., scarcity of resources) and personal ones (e.g., lack of knowledge, difficult feelings). Resources were distinguished into work-related support, self-efficacy and skills, and private life/after work as an important equalizer. Along with the mentioned personal and structural dimensions, HCPs also highlighted possibilities for improvement. Conclusions The results provide an important basis for the development of needs-based solutions to strengthen suicide prevention in oncology. The study highlights that this can be achieved by both individual-level interventions (e.g., specific training) as well as organization-level changes (e.g., better implementation of standard operating procedures and shared responsibility). Addressing the reported shortcomings will support practitioners and improve clinical practice for patients.