Suicidal Ideation Framework: Grounded Theory Study, Catalonia

NCT07284238 | Not Yet Recruiting

• 1 other identifier: IIBSP-PCS-2025-176
• Study Type: observational
• Target: 45
• Locations: 1 country
• Sites: 1

Brief Summary

This doctoral project aims to develop a comprehensive theoretical model of the process through which the suicidal ideation framework is configured as a symbolic, narrative, and relational expression, adopting a multiperspective approach that spans the suicide attempt and the stages of care and recovery. Moving away from biomedical reductionisms, this investigation seeks to identify shared meaning-making nuclei and discursive fractures that reflect the inherent conflictuality of the suicidal act. Grounded in the integration of the theoretical frameworks previously outlined, this study adopts an interpretive-constructivist approach. Phase 1 will include studies conducted in OECD countries, providing a broad and conceptually diverse interpretive foundation. Phase 2, conducted in Catalonia, will deepen situated configurations, assuming that local sociocultural frameworks act as interpretive prisms for globally relevant phenomena. Overall, this theoretical-methodological architecture not only ensures conceptual robustness and coherence, but also articulates an ethical and epistemic commitment to understanding suicide through the complexity of its human textures. By centering suffering, listening to historically silenced voices, honoring the singularity of each life trajectory, and grounding the inquiry in an ethics of care, this study aims to transcend a merely technical-instrumental logic of knowledge.

Conditions

Suicide; Suicide Ideation; Suicide Risk; Suicide Prevention; Suicide Attempt

Keywords

Suicidal Ideation; Suicide; Meta-synthesis; Grounded Theory; Mental Health Nursing; High-Income Countries

Outcome Measures

Primary Outcomes (2)

• Conceptual Synthesis of Qualitative Findings.

  Generation of a third-order conceptual synthesis integrating first- and second-order findings from qualitative and mixed-methods studies conducted in OECD countries. This synthesis will be developed through reflexive thematic analysis and will provide a high-order interpretative framework that will: 1. consolidate cross-contextual patterns and divergences in experiences attributed to suicide. 2. inform the initial theoretical orientation of Phase 2. 3. guide purposive and theoretical sampling. 4. support the development of initial coding strategies in the constructivist grounded theory phase. Measure Type: Qualitative interpretative meta-synthesis conceptual output.

  Through Phase 1 completion, an average of 12-18 months.

• Emergent Theoretical Model.

  Qualitative identification, comparative analysis and inductive-interpretive integration of the main categories, subcategories and theoretical relationships that explain how the suicidal ideation framework is configured as a symbolic, narrative and relational phenomenon. This outcome captures the core theoretical structure produced through initial coding, focused coding and theoretical integration, derived from the constructivist grounded theory analysis of interviews and discussion groups. Measure Type: Qualitative conceptual model (Grounded Theory).

  Through study completion, an average of 24-30 months.

Secondary Outcomes (4)

• Identified Narrative Structures and Meaning-Making Patterns.

  Through study completion, an average of 24-30 months.

• Influence of Socio-cultural and Biographical Factors.

  Through study completion, an average of 24-30 months.

• Relational and Contextual Mechanisms.

  Through study completion, an average of 24-30 months.

• Perceived Barriers and Facilitators in Healthcare.

  Through study completion, an average of 24-30 months.

Study Arms (3)

Individuals with a history of suicide attempt

Participants aged ≥18 years residing in Catalonia who have made one or more suicide attempts within the past 6 to 36 months. They will take part in in-depth interviews or discussion groups to explore their attributed experiences related to the configuration of suicidal ideation. No clinical intervention will be delivered as part of the study. Data collection will focus on participants' narratives, contextual factors, and meaning-making processes connected to the suicide attempt and subsequent care and recovery pathways.

Procedure: In-Depth Qualitative Interview; Procedure: Discussion Group

Members of their support networks

Individuals who are family members, friends, or significant others providing support to a person who has attempted suicide within the past three years. They will participate in interviews or discussion groups to describe their experiences, perceptions, and relational roles in the care, crisis management, and meaning-making processes surrounding the suicide attempt. No interventions will be administered. Data collection will focus on relational dynamics, contextual influences, and perceived barriers and facilitators in support and healthcare interactions.

Procedure: In-Depth Qualitative Interview; Procedure: Discussion Group

Healthcare professionals involved in their care

Licensed healthcare professionals (e.g., mental health nurses, psychiatrists, psychologists, emergency clinicians) directly involved in the care of individuals who have attempted suicide. Participants will contribute through interviews or discussion groups exploring their clinical experiences, interpretive frameworks, and perceptions of care processes. No intervention is provided. Data collection will examine professional roles, institutional contexts, and factors shaping the configuration of suicidal ideation during assessment, treatment, and recovery trajectories.

Procedure: In-Depth Qualitative Interview; Procedure: Discussion Group

Interventions

In-Depth Qualitative Interview PROCEDURE

In-depth interviews aimed at exploring participants' lived experiences, meaning-making processes, and contextual factors related to the configuration of the suicidal ideation framework. Interviews will last approximately 30-45 minutes and will be conducted by the Principal Investigator in a confidential, safe, and clinically monitored setting. No clinical treatment or diagnostic procedure is administered.

Healthcare professionals involved in their care; Individuals with a history of suicide attempt; Members of their support networks

Discussion Group PROCEDURE

Non-directive discussion groups composed of 4-6 participants from the same analytic category (suicide attempt survivors, support network members, or healthcare professionals). Sessions will last 60-90 minutes and will facilitate the collective exploration of relational, contextual, and sociocultural dynamics associated with the suicidal ideation framework. The procedure is solely qualitative and involves no therapeutic intervention or clinical manipulation.

Healthcare professionals involved in their care; Individuals with a history of suicide attempt; Members of their support networks

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study population comprises three analytically complementary groups within the mental health system of Catalonia: (1) adults with a history of one or more suicide attempts within the past 6 months to 3 years; (2) members of their family, social, or community support networks who have provided meaningful accompaniment during or after the attempt; and (3) healthcare professionals directly involved in the care of individuals who have attempted suicide and with at least one year of experience in mental health services. These groups are independent from each other, ensuring contextual diversity, confidentiality and robust interpretive depth.

You may qualify if:

• Adults ≥18 years of age.
• Usual residence in Catalonia (Spain).
• Ability to understand, speak, read, and write in Catalan or Spanish.
• Belonging to one of the three defined analytical groups:
• (A) Individuals who have attempted suicide within the past 6 months to 3 years. (B) Members of their family, social, or community support networks. (C) Healthcare professionals directly involved in the care of individuals who have attempted suicide.
• Demonstrated clinical/emotional stability ensuring safe participation, as confirmed by the referring clinician.
• For individuals with lived experience (Group A): at least 6 months since the last suicide attempt or acute clinical crisis.
• For support networks (Group B): having maintained meaningful proximity or involvement during or after the suicide attempt.
• For healthcare professionals (Group C): minimum of 1 year of professional experience in mental health care.

You may not qualify if:

• Presence of acute clinical decompensation preventing safe participation.
• Active suicidal risk or acute crisis at the time of recruitment.
• Acute vulnerability identified during screening.
• Inability to provide informed consent.
• Direct hierarchical dependence or conflict of interest with the research team (for Group C).

Sponsors & Collaborators

• Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau: lead

Study Sites (1)

Hospital de la Santa Creu i Sant Pau

Barcelona, Barcelona, 08041, Spain

Location

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Related Links

• Registered protocol for the qualitative meta-synthesis (Phase 1) in PROSPERO-CRD420251036324
• Full preregistered study protocol and supplementary methodological materials hosted on the Open Science Framework (OSF).

MeSH Terms

Conditions

Suicide; Suicide, Attempted; Suicide Prevention; Suicidal Ideation

Condition Hierarchy (Ancestors)

Self-Injurious Behavior; Behavioral Symptoms; Behavior

Study Officials

• Sergio de la Hera Herrero, Bachelor of Science in Nursing

  Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Sergio de la Hera Herrero RN, MSc, DS, Bachelor of Science in Nursing

CONTACT

+34689239358; sdelahera@santpau.cat

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: CROSS SECTIONAL
• Target Duration: 1 Day
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Mental Health Nurse Specialist and PhD Candidate at the Autonomous University of Barcelona (UAB)

Study Record Dates

• First Submitted: November 18, 2025
• First Posted: December 16, 2025
• Study Start: March 1, 2026
• Primary Completion (Estimated): April 1, 2027
• Study Completion (Estimated): September 1, 2027
• Last Updated: December 16, 2025

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will not share

Locations

ES (1)