基于家庭功能与心理健康问题的自杀意念解释模型:医学生横断面研究

Leslie Aguilar-Sigueñas, D. Villarreal-Zegarra
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摘要

背景:对人们生活影响最大的心理健康问题之一是自杀行为,这是一个基本上可以预防的公共卫生问题,几乎占所有暴力死亡的一半。本研究的目的是提出一个可以解释和预测基于心理健康问题(压力-焦虑-抑郁)和家庭功能(凝聚力、灵活性和凝聚力)的自杀意念的模型。方法:采用横断面研究。人口由来自秘鲁各地的医学实习生组成。采用非概率抽样。采用家庭凝聚力与适应性评估量表(FACES-III)、家庭沟通量表、家庭满意度量表、抑郁、焦虑和压力量表(DASS-21)和自杀意念量表(SSI-W)。结果:共纳入受试者480人。自杀意念的患病率为39,泊松回归分析校正后发现,有焦虑症状的人产生自杀意念的可能性是有焦虑症状的人的4倍多(PR=4.89;95%置信区间:1.90—-12.64)。此外,家庭沟通水平中高的人产生自杀意念的可能性要小得多(PR= 0.07;95% CI: 0.01-0.41),这是一个保护因素。提出的模型具有最优拟合优度指标(CFI=0.974;TLI = 0.974;SRMR = 0.055;RMSEA = 0.062)。此外,所提出的模型可以解释88.3%的自杀意念的存在(R2=0.883)。结论:我们的模型可以解释88.3%的基于家庭关系和心理健康问题的医疗实习生自杀行为。此外,与自杀行为最相关的变量分别是焦虑症状和家庭沟通作为危险因素和保护因素。
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An explanatory model of suicidal ideation based on family functionality and mental health problems: A cross-sectional study of medical students
Background: One of the mental health problems with the greatest impact on people's lives is suicidal behavior, a largely preventable public health problem that accounts for almost half of all violent deaths. The aim of the study is to propose a model that can explain and predict suicidal ideation based on mental health problems (stress-anxiety-depression) and family functionality (cohesion, flexibility, and cohesion). Methods: Our study is cross-sectional. The population consisted of medical interns from all over Peru. Non-probability sampling was used. We used Family Cohesion and Adaptability Evaluation Scale (FACES-III), Family Communication Scale, Family Satisfaction Scale, Depression Anxiety and Stress Scales (DASS-21), and the Scale for Suicide Ideation – Worst (SSI-W). Results: A total of 480 participants were included. The prevalence of suicidal ideation was 39Poisson regression analysis adjusted identified that people with anxiety symptoms were more than four times more likely to have suicidal ideation (PR=4.89; 95% CI:1.90-12.64). Also, people with moderate to high levels of family communication were much less likely to have suicidal ideation (PR= 0.07; 95% CI: 0.01-0.41), making it a protective factor. The proposed model presented optimal goodness-of-fit indices (CFI=0.974; TLI=0.974; SRMR=0.055; RMSEA=0.062). In addition, the proposed model can explain the presence of suicidal ideation in 88.3% (R2=0.883). Conclusions: Our model can explain 88.3% of suicidal behavior based on family relationships and mental health problems in medical interns. In addition, the variables that alone were most associated with suicidal behavior were anxious symptoms and family communication as risk factors and protective factors, respectively.
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