School of Nursing, University of North Carolina, Chapel Hill, NC 27599-7460, USA.
Cancer Nurs. 2012 Jul-Aug;35(4):E14-26. doi: 10.1097/NCC.0b013e31822fc76c.
Cancer survivors have a higher suicide rate than the general population. Oncology nurses need to have knowledge and skills in assessing risk for suicide in this population.
This study aimed to conduct a literature review on risk factors for and incidence of suicide in patients with cancer and to identify potential screening tools.
PubMed, CINAHL, and PsycINFO databases were searched to identify research articles in peer-reviewed journals from 1999 to 2009. The variables under study included suicide rate, cancer type, demographic characteristics, and signs and symptoms associated with suicide. In addition, articles focused on suicide risk assessment tools were also included.
Twenty-four articles met the inclusion criteria. As in the general population, suicide risk was higher among men with cancer as compared with women with cancer. Patients aged 65 years or older with cancer have a higher rate of suicide compared with those younger than 65 years, with rates highest among men 80 years or older. Specific diagnoses associated with higher suicide rates include prostate, lung, pancreatic, and head and neck cancers. The first year after diagnosis carries a higher risk for completed suicide. Multiple risk assessment tools have been developed and are effective in identifying patients with depression or hopelessness, factors associated with higher risk for suicide. However, no tools exist that sensitively and specifically predict suicide.
The incidence of suicide in someone with a cancer diagnosis is approximately double the incidence of suicide in the general population. Early detection of depression in special cancer populations, such as older male patients, may help identify those at greatest suicide risk.
Oncology nurses should be aware of cancer patients considered at higher risk for suicide. Systematic screening for suicidal ideation and behavior may identify cancer patients at high risk and facilitate appropriate mental health evaluation and treatment.
癌症幸存者的自杀率高于一般人群。肿瘤护士需要具备评估癌症患者自杀风险的知识和技能。
本研究旨在对癌症患者自杀的危险因素和发生率进行文献回顾，并确定潜在的筛查工具。
在 1999 年至 2009 年间，我们在同行评议期刊的 PubMed、CINAHL 和 PsycINFO 数据库中搜索了研究文章。研究的变量包括自杀率、癌症类型、人口统计学特征以及与自杀相关的迹象和症状。此外，还包括了专门针对自杀风险评估工具的文章。
符合纳入标准的文章有 24 篇。与一般人群一样，男性癌症患者的自杀风险高于女性癌症患者。与年龄小于 65 岁的患者相比，年龄在 65 岁或以上的癌症患者自杀率更高，80 岁或以上的男性患者自杀率最高。与较高自杀率相关的特定诊断包括前列腺癌、肺癌、胰腺癌和头颈部癌症。诊断后第一年完成自杀的风险更高。已经开发出多种风险评估工具，这些工具在识别患有抑郁或绝望的患者方面是有效的，这些因素与较高的自杀风险相关。但是，目前还没有能够敏感且专门预测自杀的工具。
癌症诊断后自杀的发生率大约是一般人群的两倍。在特殊的癌症人群（如老年男性患者）中，早期发现抑郁可能有助于确定那些自杀风险最高的患者。
肿瘤护士应该意识到某些癌症患者自杀风险较高。对自杀意念和行为进行系统筛查可能会发现高风险的癌症患者，并促进适当的心理健康评估和治疗。
