Intégration des modèles de suicidalité en suicidologie Canadienne
Une synthèse narrative
DOI :
https://doi.org/10.29173/cjen246Mots-clés :
suicide, soins infirmiers d’urgence, trajectoires suicidaires, modèle narratif de crise, modes d’attachement, stades de développementRésumé
Résumé
Contexte : Le suicide demeure un grave problème de santé publique qui exige des approches allant au-delà des modèles statiques. Les modèles traditionnels fonctionnent encore souvent de manière isolée, ce qui ne permet pas de les appliquer dans des environnements à forte intensité de soins comme les services d’urgences. Des modèles intégratifs reflétant la nature fluide et complexe de la suicidalité dans les services de soins aigus sont donc nécessaires. Objectif : La présente synthèse narrative examine comment divers modèles théoriques peuvent éclairer la pratique des soins infirmiers d’urgence en concevant la suicidalité comme un processus dynamique et évolutif. L’objectif est d’améliorer l’évaluation du risque de suicide en adoptant une approche intégrée et pertinente sur le plan clinique. Méthodes : Une synthèse narrative a été réalisée afin d’examiner les modèles empiriques et conceptuels ayant démontré leur pertinence pour la santé mentale en situation d’urgence. Les cadres théoriques comprenaient le modèle des trajectoires suicidaires, le modèle narratif de crise, la théorie de l’attachement, les perspectives de développement, les cadres relatifs au genre et le syndrome de crise suicidaire (SCS). Ces modèles ont été retenus en raison de leur valeur prédictive, de leur utilité clinique et de leur pouvoir explicatif. Résultats : La suicidalité naît de l’interaction entre les vulnérabilités à long terme et les états de crise aigus. Le cadre intégré met en évidence les rôles de l’attachement insécurisant, des perturbations de l’identité, des facteurs de risque lié au sexe et du stade développemental. Une attention particulière est prêtée aux expériences des personnes de genre divers, qui échappent souvent aux modèles de risque traditionnels. Conclusion : Un cadre pluridimensionnel et adapté au développement améliore la détection du risque de suicide et l’intervention dans les situations d’urgence. La prise en considération de l’identité, du contexte relationnel et de la dynamique de la crise permet de favoriser des stratégies de prévention plus inclusives et plus efficaces aux soins de première ligne.
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