Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Korea.
Int J Geriatr Psychiatry. 2014 Apr;29(4):367-76. doi: 10.1002/gps.4012. Epub 2013 Aug 13.
Despite the importance of tending to older individuals who are vulnerable to suicide, little is known about suicidal ideation in the portion of this population receiving home-care services in Asian countries. The objective of this cross-sectional study was to examine predictors of suicidal ideation in older individuals using home-care service.
Participants were randomly selected from the individuals 50 years old and over using home-care services across Jeollabuk-do Province, Korea. A total of 697 subjects participated in this study. Each participant completed the short version of the Geriatric Depression Scale, the Scale for Suicidal Ideation, the Multidimensional Scale of Perceived Social Support, and the World Health Organization Disability Assessment Schedule II.
Hierarchical regression analyses revealed that depression, perceived social support, and disability were significant predictors of suicidal ideation, whereas the roles of subjective health status and fish consumption remained ambiguous in this regard. In terms of social support, we also found that less perceived social support from family members was related to higher levels of suicidal ideation. The associations between various categories of disability and suicidal ideation disappeared after controlling for depression. Our investigation of the mediating effect of depression on the relationship between disability and suicidal ideation revealed that depression was either a complete (disability related to cognition, self-care, getting along with others, and life activities) or partial (disability related to participation) mediator.
Preventive strategies focusing on depression, social support, and disability should be emphasized during encounters with older people receiving home-care services.
尽管关注易发生自杀的老年人群体至关重要，但在亚洲国家，为接受家庭护理服务的这部分人群提供服务时，人们对自杀意念知之甚少。本横断面研究的目的是探讨使用家庭护理服务的老年个体自杀意念的预测因素。
参与者是从韩国全罗北道接受家庭护理服务的 50 岁及以上的人群中随机抽取的。共有 697 名受试者参加了这项研究。每位参与者都完成了老年抑郁量表简短版、自杀意念量表、多维感知社会支持量表和世界卫生组织残疾评估量表 II。
分层回归分析显示，抑郁、感知社会支持和残疾是自杀意念的显著预测因素，而主观健康状况和鱼类摄入的作用在这方面仍不明确。就社会支持而言，我们还发现，来自家庭成员的感知社会支持较少与更高水平的自杀意念有关。在控制抑郁后，各种残疾类别与自杀意念之间的关联消失了。我们对抑郁在残疾与自杀意念之间关系中的中介作用的调查表明，抑郁是完全（与认知、自我护理、与他人相处和生活活动有关的残疾）或部分（与参与有关的残疾）中介。
在与接受家庭护理服务的老年人接触时，应强调关注抑郁、社会支持和残疾的预防策略。
