Nie Yu, Hu Zhao, Zhu Tingting, Xu Huilan
Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China.
Department of Scientific Research Management, Shanghai Health Development Research Center, Shanghai, China.
Front Psychiatry. 2020 Apr 30;11:339. doi: 10.3389/fpsyt.2020.00339. eCollection 2020.
Our study aims to explore the risk factors for suicidal ideation and their interaction among the elderly in nursing homes in Hunan province, China. A cross-sectional study was conducted among the elderly in nursing homes in Hunan Province. Twenty-four nursing homes were selected by multistage cluster random sampling, and 817 elderly residents were investigated using a set of structured questionnaires. The main outcome measures included general information, suicidal ideation, depression symptoms, social support, activities of daily living (ADL), stressful life events, and sleep quality. Multivariate binary logistic regression was performed to explore the risk factors for suicidal ideation among the elderly in nursing homes, and additive interaction was used to analyze the interaction between risk factors. The prevalence of suicidal ideation among the elderly in nursing homes in Hunan province was 17.9% (95% confidence interval(CI): 15.2%, 20.6%). Living in a rural area (odds ratio(OR)=1.88, 95% CI: 1.03, 3.44), infrequent visits from relatives (OR=2.61, 95% CI: 1.42, 4.78), history of chronic disease (OR=2.34, 95% CI: 1.09, 5.01), depression symptoms (OR=8.11, 95% CI: 4.52, 14.54), lower social support (OR=3.85, 95% CI: 1.94, 7.61), and ADL disability status (OR=4.38, 95% CI: 2.10, 9.14) increased the risk of suicidal ideation. Additive interactions were detected between depression symptoms and ADL status, with a relative excess risk due to interaction (RERI) of 8.73 (95% CI: 2.04, 15.43), and between depression symptoms and social support, with an RERI of 5.98 (95% CI: 0.86, 11.10). The prevalence of suicidal ideation among the elderly in nursing homes is relatively high. Both physical conditions and psychosocial factors were associated with suicidal ideation among the elderly. These findings have significant implications for the prediction and prevention of suicidal behaviors.
我们的研究旨在探讨中国湖南省养老院老年人自杀意念的危险因素及其相互作用。对湖南省养老院的老年人进行了一项横断面研究。通过多阶段整群随机抽样选取了24所养老院，并使用一套结构化问卷对817名老年居民进行了调查。主要结局指标包括一般信息、自杀意念、抑郁症状、社会支持、日常生活活动能力（ADL）、应激性生活事件和睡眠质量。采用多变量二元逻辑回归来探讨养老院老年人自杀意念的危险因素，并使用相加交互作用来分析危险因素之间的相互作用。湖南省养老院老年人自杀意念的患病率为17.9%（95%置信区间（CI）：15.2%，20.6%）。居住在农村地区（比值比（OR）=1.88，95%CI：1.03，3.44）、亲属探访不频繁（OR=2.61，95%CI：1.42，4.78）、慢性病病史（OR=2.34，95%CI：1.09，5.01）、抑郁症状（OR=8.11，95%CI：4.52，14.54）、社会支持较低（OR=3.85，95%CI：1.94，7.61）以及ADL残疾状况（OR=4.38，95%CI：2.10，9.14）会增加自杀意念的风险。在抑郁症状与ADL状况之间检测到相加交互作用，交互作用所致相对超额危险度（RERI）为8.73（95%CI：2.04，15.43），在抑郁症状与社会支持之间也检测到相加交互作用，RERI为5.98（95%CI：0.86，11.10）。养老院老年人自杀意念的患病率相对较高。身体状况和心理社会因素均与老年人自杀意念有关。这些发现对自杀行为的预测和预防具有重要意义。
