Okayama Prefectural Mental Health and Welfare Center, 1-1-10-101 Furugyo-cho, Naka-ku, Okayama, 703-8278, Japan,
Soc Psychiatry Psychiatr Epidemiol. 2014 Apr;49(4):619-27. doi: 10.1007/s00127-013-0752-5. Epub 2013 Aug 18.
Social support has consistently been reported to be effective in reducing suicidal ideation. This cross-sectional study was performed to determine whether home visits by commissioned welfare volunteers (i.e., organizations of community residents appointed by national or prefectural governments) are associated with a lower risk of suicidal ideation among the elderly.
In August 2010, questionnaires were sent to all residents aged ≥65 years in three municipalities (n = 21,232) in Okayama prefecture, Japan, and 13,929 returned the questionnaire (response rate: 65.6%). We finally analyzed 11,218 subjects. Both home visits by commissioned welfare volunteers and suicidal ideation within the last 30 days were assessed in the questionnaire. Odds ratios (ORs) and 95% confidence intervals (CIs) for suicidal ideation were calculated adjusting for age, sex, educational attainment, and marital status. We then additionally adjusted for instrumental and emotional support, separately.
The prevalence of suicidal ideation was 10.0% and higher in women than in men (11.4% vs. 8.0%). Home visits were significantly associated with a lower risk of suicidal ideation after adjusting for instrumental and emotional support, respectively (OR: 0.60, 95% CI: 0.53-0.69; OR: 0.67, 95% CI: 0.59-0.78). In sex-stratified analysis, the association was clearer for women than for men: the corresponding ORs among women were 0.55 (95% CI: 0.46-0.65) and 0.61 (95% CI: 0.52-0.73), whereas they were 0.71 (95% CI: 0.56-0.90) and 0.78 (95% CI: 0.61-0.99) among men.
Our findings suggest that home visits by commissioned welfare volunteers are significantly associated with lower suicidal ideation among the elderly, particularly in women.
社会支持一直被报道能有效降低自杀意念。本横断面研究旨在确定由委托福利志愿者（即由国家或县政府任命的社区居民组织）进行的家访是否与老年人自杀意念的风险降低有关。
2010 年 8 月，向日本冈山县三个市（n=21232）所有≥65 岁的居民发送了问卷，13929 人回复了问卷（应答率：65.6%）。我们最终分析了 11218 名受试者。问卷评估了委托福利志愿者的家访情况和过去 30 天内的自杀意念。调整年龄、性别、教育程度和婚姻状况后，计算自杀意念的比值比（OR）和 95%置信区间（CI）。然后，我们分别进一步调整了工具性和情感支持。
自杀意念的患病率为 10.0%，女性高于男性（11.4%比 8.0%）。分别调整工具性和情感支持后，家访与自杀意念风险降低显著相关（OR：0.60，95%CI：0.53-0.69；OR：0.67，95%CI：0.59-0.78）。在性别分层分析中，女性的相关性比男性更明显：女性对应的 OR 分别为 0.55（95%CI：0.46-0.65）和 0.61（95%CI：0.52-0.73），而男性的 OR 分别为 0.71（95%CI：0.56-0.90）和 0.78（95%CI：0.61-0.99）。
我们的研究结果表明，委托福利志愿者的家访与老年人自杀意念显著降低有关，尤其是在女性中。
