Nursing interventions promoting the safety of adolescents at risk of suicidal behavior – an integrative literature review

Abstract

Introduction
Adolescence is a stage of human development characterized by changes in multiple dimensions of life. These changes can act as significant stressors for adolescents, influencing their mental health. Suicidal behaviors are an escalating concern, posing a threat to adolescent safety and presenting challenges for nurses across various healthcare settings.

Objective
To identify the available knowledge on nursing interventions that promote safety in adolescents at risk of suicidal behavior and analyze it through the lens of Betty Neuman’s Systems Model.

Methods
We conducted an integrative literature review following Whittemore and Knafl’s framework. The search was carried out in April 2024 in the CINAHL Ultimate and MEDLINE databases. Both natural and indexed language related to the terms “adolescent,” “suicide risk,” and “nursing” were used. The review included theoretical and empirical articles, regardless of methodology, written in English and Portuguese, and published between 2014 and 2024.

Results
A total of 16 articles met the inclusion criteria. The analysis revealed two main categories of interventions based on the care context: healthcare services and community. In both contexts, nurses engage in primary, secondary, and tertiary prevention. Primary prevention is predominant in community settings, whereas secondary and tertiary prevention are more prominent in healthcare services. Three key interventions emerged as common across all contexts: suicide risk assessment, therapeutic relationships with adolescents, and psychoeducation.

Conclusion
Nurses play a crucial role in promoting the safety of adolescents at risk of suicidal behavior. Ensuring safety requires interventions that extend across all systems the adolescent is part of, including family, school, other community settings, and various healthcare services.