School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
J Psychosoc Oncol. 2020 Sep-Oct;38(5):612-626. doi: 10.1080/07347332.2020.1757799. Epub 2020 Jun 8.
The purpose of this cross-sectional survey was to investigate how family adaptability and cohesion, coping styles and depression affect suicide ideation in patients with malignant tumors. This study also aimed to examine the potential mechanisms of family adaptability and cohesion in suicidal ideation.
From January 2019 to May 2019, 357 patients with malignant tumors who were admitted to a Chinese general hospital were surveyed. Patient Health Questionnaire-9 and the Chinese version of the Family Adaptability and Cohesion Evaluation Scale II, Medical Coping Modes Questionnaire were used. Student's -test, chi-square test, Mann-Whitney U test, Spearman's rho correlation, and logistic regression analysis were used. Path analysis was used to examine the relationships among family adaptability and cohesion, coping styles, depression and suicidal ideation.
A total of 55 (15.4%) cancer patients reported suicidal ideation in the prior 2 weeks. Logistic regression analysis showed that cancer stage, depression, family cohesion, and avoidance were independently associated with suicidal ideation. Path analysis demonstrated that family adaptability and cohesion indirectly affected suicidal ideation, as mediated by coping styles and depression. Family cohesion also directly affected suicidal ideation among cancer patients.
This study suggested that family adaptability, family cohesion and confrontation coping strategies are protective factors against suicidal ideation in cancer patients. Improving the family support system and coping styles may be used to prevent suicide ideation in cancer patients in the future.
Enhancing the family adaptability and cohesion of patients will help medical staff improve family support function effectively and eliminate suicidal ideation.
本横断面调查旨在探讨家庭适应性和凝聚力、应对方式和抑郁如何影响恶性肿瘤患者的自杀意念。本研究还旨在检验家庭适应性和凝聚力对自杀意念的潜在影响机制。
本研究于 2019 年 1 月至 5 月期间,对中国某综合医院收治的 357 例恶性肿瘤患者进行了调查。采用患者健康问卷-9 量表和家庭适应性与凝聚力评估量表第二版中文版、医学应对方式问卷进行评估。采用学生 t 检验、卡方检验、Mann-Whitney U 检验、Spearman 相关分析和 logistic 回归分析。路径分析用于检验家庭适应性和凝聚力、应对方式、抑郁与自杀意念之间的关系。
共有 55 例(15.4%)癌症患者在过去 2 周内报告有自杀意念。logistic 回归分析显示,癌症分期、抑郁、家庭凝聚力和回避与自杀意念独立相关。路径分析表明,家庭适应性和凝聚力通过应对方式和抑郁间接影响自杀意念,家庭凝聚力也直接影响癌症患者的自杀意念。
本研究表明,家庭适应性、家庭凝聚力和应对策略是癌症患者自杀意念的保护因素。未来可以通过改善家庭支持系统和应对方式来预防癌症患者的自杀意念。
提高患者的家庭适应性和凝聚力将有助于医护人员有效增强家庭支持功能,消除自杀意念。