title: Liberating burdensomeness of suicide survivorship loss: A Critical Interpretive Synthesis.
abstract: OBJECTIVE
  What is an interpreted and synthesised understanding of responses of survivors to a suicide death of a close person?
  
  
  BACKGROUND
  It is well known that survivors of suicide loss who are in a close relationship with the deceased are at high risk for suicidality and health conditions. Nurses in various settings need evidenced-informed approaches to encounter these vulnerable persons and support their healing journey from postvention to prevention.
  
  
  METHODS
  The design is reflexive and iterative.
  
  
  METHODS
  A Critical Interpretive Synthesis comprised of six phases: formulating the review question; searching literature; sampling; determining quality; extracting data; interpretive synthesis. Qualitative content analysis was also.
  
  
  RESULTS
  Based on a sample of 15 published full-text qualitative and quantitative nursing research studies published between 1990 and 2016, an aggregated, interpreted and synthesised understanding of responses of survivors of suicide loss to the suicide death of a close person emerged. Four synthesised concepts were: dreading burden of suicide risk and stigma; facing burdensomeness in the aftermath of suicide death; enduring being burdened-unburdened, striving to invest in living; and liberating burdensomeness, journeying toward healing.
  
  
  CONCLUSIONS
  Contextually, geo-cultural gaps exist in published nursing studies. Most studies were from North American and a few from Asia. The reported suicide deaths occurred over a wide range of time. Conceptually, four synthesised concepts can be viewed as a process of moving from burdensomeness to liberating burdensomeness. Methodologically, a small body of knowledge that met quality appraisal was interpreted and synthesised into an understanding of an evidenced-informed approach to guide nurses' encounters with survivors of suicide loss.
  
  
  CONCLUSIONS
  The results contribute to an evidenced-informed approach for nurses in practice to support survivors of suicide loss journeying from burdensomeness to liberating burdensomeness. Results also serve as a foundation for further research.
authors.affiliation: Department of Health and Care Sciences, Faculty of Health Sciences, University in Tromsø, Tromsø, Norway.
authors.forename: Anne-Grethe
authors.initials: AG
authors.lastname: Talseth
authors.affiliation: College of Nursing, Montana State University-Bozeman, MT, USA.
authors.forename: Fredricka L
authors.identifier: http://orcid.org/0000-0003-0984-9345
authors.initials: FL
authors.lastname: Gilje
mesh_terms: D017281:Cost of Illness; D006117:Grief; D066296:Grounded Theory; D006801:Humans; D009729:Nursing; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology; D013405:Suicide / Q000523:psychology; D017741:Survivors / Q000523:psychology*; D000073859:Survivorship; D000092864:Suicide Prevention
keywords: evidence-based practice; health promotion; research; suicide bereavement; support