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From will to live to will to die: oncologists, nurses, and social workers identification of suicidality in cancer patients.

Granek L, Nakash O, Ariad S, Chen W, Birenstock-Cohen S, Shapira S, Ben-David M

Support Care Cancer. 2017 Dec;25(12):3691-3702

A qualitative study in Israel, interviewed 20 nurses, 23 oncologists and 18 social workers and used grounded theory to understand how they identify cancer patients with suicide risk. Four phases were categorized: 1) strong will to live – no suicide, patients receiving active treatment, seeking second
opinions and alternative medicine, 2) a decreasing will to live – usually when disease progressed, patients were described being apathetic, with impaired functioning, physical pain and suffering, 3) a readiness to die – this was more frequent in patients with previous mental health problems, increased
suffering, those with a terminal diagnosis, stopping oncology treatment, and wanting to maintain a sense of control and 4) a will to die – these patients take active steps to end their own lives, asking about sedation and euthanasia and have suicide ideation, intent and acts usually at diagnosis or
when receiving bad news, loss of independence, wanting control, to avoid further suffering, worried about being a burden on their families and if they had previous mental health problems. Cancer patients’ suicidality is fluctuant and dependent on circumstances and shows a strong relationship between mental and physical suffering.

Composed by Elaine Boland.

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