Tang G X, Yan P P, Yan C L, Fu B, Zhu S J, Zhou L Q, Huang X, Wang Y, Lei J
The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.
Hunan Provincial Tumor Hospital, Changsha, Hunan, China.
Psychooncology. 2016 Jan;25(1):97-103. doi: 10.1002/pon.3880. Epub 2015 Jun 22.
Gynecological cancer survivors are at increased risk of psychological problems including suicide risk. Suicidal ideation, which was thought to be precursor to suicide attempts, has not been well studied. This study aimed to investigate the prevalence, and determinants of suicidal ideation for women with gynecological cancer, and then to assess the effect of coping style and social support on suicidal ideation.
Patients with cervical, ovarian and endometrial cancers seen at Hunan Provincial Tumor Hospital from September 2012 to June 2013 were consecutively recruited and were asked to complete the Zung Self-Rating Depression Scale, Suicidal Ideation of Self-rating Scale, Medical Coping Modes Questionnaire and Social Support Rating Scale. Path analysis was used to examine the relationship among coping style, social support, depression symptoms and suicidal ideation.
A total of 579 (579/623, 93.0%) gynecological cancer patients were enrolled in this study and completed all investigations between September 2012 and June 2013. Among them, 105 (18.1%) patients reported suicidal ideation, with the highest rate in patients with ovarian cancer (30.16%). Suicidal ideation was associated with depression symptoms, care providers, chemotherapy history and acceptance-resignation. Path analysis showed that the acceptance-resignation affected suicidal ideation directly as well as mediated by social support and depression symptoms, while confrontation and avoidance affected suicidal ideation entirely through social support and depression symptoms.
Suicidal ideation is high among patients with gynecological cancer, especially among ovarian cancer patients. Coping strategies such as confrontation and avoidance, and social support may be helpful for preventing suicidal ideation among them.
妇科癌症幸存者出现包括自杀风险在内的心理问题的风险增加。自杀意念被认为是自杀企图的先兆，但尚未得到充分研究。本研究旨在调查妇科癌症女性自杀意念的患病率及其决定因素，进而评估应对方式和社会支持对自杀意念的影响。
连续招募2012年9月至2013年6月在湖南省肿瘤医院就诊的宫颈癌、卵巢癌和子宫内膜癌患者，并要求她们完成zung自评抑郁量表、自杀意念自评量表、医学应对方式问卷和社会支持评定量表。采用路径分析来检验应对方式、社会支持、抑郁症状和自杀意念之间的关系。
本研究共纳入579例（579/623，93.0%）妇科癌症患者，她们均在2012年9月至2013年6月期间完成了所有调查。其中，105例（18.1%）患者报告有自杀意念，卵巢癌患者的自杀意念发生率最高（30.16%）。自杀意念与抑郁症状、护理提供者、化疗史和听天由命有关。路径分析表明，听天由命直接影响自杀意念，同时通过社会支持和抑郁症状起中介作用，而面对和回避则完全通过社会支持和抑郁症状影响自杀意念。
妇科癌症患者中自杀意念发生率较高，尤其是卵巢癌患者。面对和回避等应对策略以及社会支持可能有助于预防她们的自杀意念。
