Clinical Inquiry into Suicidal Ideation.
Identifying A Clinical Question. Module 1
1. Identify a clinical question related to your area of clinical practice and write the clinical foreground question in PICOT format utilizing the worksheet tool provided as a guide.
2. Describe why this is a clinical problem or an opportunity for improving health outcomes in your area of clinical practice. Perform a literature search and select five research articles on your topic utilizing the databases highlighted in Chapter 3 of the textbook (Melnyk and Finout-Overholt, 2015).Clinical Inquiry into Suicidal Ideation.
3. Identify the article that best supports nursing interventions for your topic. Explain why this article best supports your topic as you compare the article to the other four found in the literature search.
4. Assignment Expectations:
5. Length: 1000 – 1500 words
Structure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion.
References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of five (5) scholarly sources are required for this assignment to support the topic.Clinical Inquiry into Suicidal Ideation.
Are children (P) who lived with parents who had ended their lives by suicide (I) also have suicidal ideation (O) compared with children who have not (C) by the time they become teenagers?Clinical Inquiry into Suicidal Ideation.
In PICOT format:
Population Children, Parents
Intervention Parents ended lives by suicide
Comparison Other Children
Outcome. Suicidal Ideation
Time During growing up from childhood to teenage years
Clinical Inquiry into Suicidal Ideation.
Using the PICOT Format for Clinical Inquiry into Suicidal Ideation
Clinical inquiry is the process of finding out evidence from peer-reviewed literature that supports or disproves a common nursing practice or widely held practice view. It involves a systematic search of literature from research databases using a question about the identified problem written in the PICOT format (Melnyk & Fineout-Overholt, 2018). This paper is about such a clinical inquiry about the possibility of children whose parents died from suicide also developing suicidal ideation, compared to those whose parents have not committed suicide.Clinical Inquiry into Suicidal Ideation.
The Clinical Question in PICOT Format
According to the World Health Organization (WHO) suicide is the second leading cause of mortality among adolescents and young adults, with about 0.8 million victims annually globally (Chae et al., 2020). The notion held by mental health professionals who include psychiatric-mental health nurse practitioners or PMHNPs is that there may be a correlation between a teenager’s suicidal ideation and the fact of having a parent who committed suicide. For this reason, there is need to find scholarly evidence that either supports or disproves this notion in order to propose best practice. The PICOT question in this case is as follows: “Are children of parents (P) who died by committing suicide (I) more likely to have suicidal ideation (O) compared to those whose parents have not committed suicide (C) by the time they become teenagers (T)?”Clinical Inquiry into Suicidal Ideation.
Table 1: The PICOT elements examining the possibility of suicidal ideation in children whose parents have committed suicide
|P||Problem or population||Children of parents who committed suicide|
|I||Intervention or event||Having parents who died after committing suicide|
|C||Comparison or alternative||Having parents who haven’t committed suicide|
|O||Outcome||Likelihood of having or developing suicidal ideation|
|T||Time/ period||Childhood to adolescence|
Why this is a Clinical Problem or an Opportunity for Improvement of Health Outcomes in Psychiatric-Mental Health Nursing Practice
Suicide is a major cause of death among teenagers and those in late childhood around the globe. It is therefore an important public mental health issue that needs to be addressed by finding out the contributing risk factors causing the clinical problem (Bilsen, 2018). One of these risk factors appears to be parental history of suicide. The clinical problem presents an opportunity to improve practice in the area of psychiatric-mental health nursing as PMHNPs are the mental health clinicians practicing at the primary health care level in the community. Because they practice at the grassroots level and are the first pint of contact with suicidal teenagers and young adults, it is important that they engage in best practice or evidence-based practice (EBP).Clinical Inquiry into Suicidal Ideation.
Five Peer-Reviewed Studies (Literature) on the Clinical Problem Recovered from Research Databases
Chae et al. (2020) conducted a cross-sectional study in South Korea by using data from a national health survey between 2007 and 2015. The sample size was n=2,324 adolescents between the ages of 12 and 18 years as well as both of their parents. The aim of the study was to assess the concept of suicidal ideation in Korean families and any present relationship between parental suicidal ideation and offspring suicidal ideation. This was against a backdrop of rising cases of teenage suicide in South Korea. Nonparametric statistical tests used for analysing the data included the chi-square test and regression analysis. The results of the study showed that there was indeed some correlation between parental suicidal ideation and offspring tendency to want to commit suicide. About 18.4& of the sampled adolescents had suicidal ideation influenced by their parents (Chae et al., 2020). Clinical Inquiry into Suicidal Ideation.
Edwards et al. (2019) carried out a study with the purpose of investigating the role of social transmission of the risk of suicidal ideation among siblings in a family. The study was conducted in Sweden with a sample of n=111,848 sibling pairs. Tests for the effect of geographical proximity were conducted. The results and conclusion of the study showed that indeed the risk of suicidality is higher in siblings who are close to another sibling who has completed or attempted suicide (Edwards et al., 2019).Clinical Inquiry into Suicidal Ideation.
For Kenneally et al. (2018), they looked for evidence of familial and social suicidality transmission by studying a sample of n=356 adults. This was however a sample of adults older than 50 years. They divided the participants into five groups and face-to-face interviews were conducted to get the history of suicidal ideation in biological relatives. The results of the study showed that indeed familial transmission of suicidal behavior is present in those who attempt suicide earlier on in life as opposed to those who attempt suicide later on in life (Kenneally et al., 2018).
This peer-reviewed piece by Rajalin et al. (2017) was a study to understand the correlation between a family history of suicidality and interpersonal problems in the society. The sample of participants in this study was n=181 patients who were undergoing follow-up after an unsuccessful suicide attempt. It was found that those who attempted suicide and had a family history of suicidal ideation had “intrusive” personality styles. This means that they indeed had personality and interpersonal problems because of the family history of suicidality (Rajalin et al., 2017).Clinical Inquiry into Suicidal Ideation.
These authors on their part started on the assumption that an offspring’s suicidality is associated with a parent’s suicidal behavior. However, noted that this circumstantial evidence was coming from clinical samples or population registers. They sought to find out if indeed there was a correlation between parental suicidality and offspring likelihood of developing suicide thoughts. They used the Avon Longitudinal Study of Parents and Children (ALSPAC) which was a prospective birth cohort. The study had as a sample n=4,396 mother-child and n=2,541 father-child pairs. After controlling for confounding variables, they used the nonparametric multivariate regression analysis for data analysis. They found that maternal suicidality increased the risk of the tendency of offspring self harm (Geulayov et al., 2014).Clinical Inquiry into Suicidal Ideation.
After analyzing all these five studies, the article that best supports nursing interventions in the topic is that by Chae et al. (2020). This is because it had the best fitting dependent and independent variable and hence more specific to the clinical problem.Clinical Inquiry into Suicidal Ideation.
Suicidal ideation is a major problem affecting adolescents worldwide. The fact that this may be associated with parental suicidality is important in coming up with EBp interventions.Clinical Inquiry into Suicidal Ideation.