Discussing Suicidality with a Patient
The interview data revealed that the guideline made nurses more aware of the issue of suicidality. Nurses mentioned that they were more alert to risk
factors for suicide and tended to respond more thor- oughly to patient symptoms indicative of suicidality. They scored slightly above neutral about whether the guideline made them more active in discussing suicidality (rating 3.06). The nature of the items in both SAs enabled discussion with patients. The use- fulness of the example questions and phrases in the assessments was rated quite positively at 3.82 and 3.59 for the basic SA and advanced SA, respectively. Memorizing the items enabled the nurses to integrate them into a natural conversation. The overall poten- tial of the guideline to support nurses in discussing suicidality with patients is reflected in a rating of 4.0. From the interviews, it became clear that some nurses experienced difficulty in adapting the wording oftheexamplequestionsandphrasestotheirpersonal communication style and the actual situation of the patient. The interviews also made clear that many nurses did not discuss suicidality with patients if there were no apparent signs of suicidality. In fact, some nurses mentioned that they found it difficult to ask a patient about suicidal thoughts if there were no clear signs of suicidality.