卫生研究

目的了解青少年自杀意念的形成与家庭功能、负性生活事件各应激量及其他影响因素之间的关系。方法采用现况研究的方法,使用自杀意念自评量表、青少年生活事件量表和家庭功能指数量表等工具对江苏省常州市一所卫生高职院校和安徽省芜湖市一所医学本科院校护理专业在校学生(包括中职、高职、大专、本科)进行问卷调查。调查两所院校共发放问卷3700份,回收问卷3675份,其中有效问卷3620份,单因素分析采用χ2检验、t检验和单因素Logistic回归分析,多因素分析采用多因素Logistic回归分析。结果自杀意念的检出率为7.0%。自杀意念检出率最高的前5类特征分别为:成绩情况差(33.6%)、家庭功能严重障碍(25.8%)、成绩情况中下(11.7%)、经济情况差(10.8%)和就读于三年级(9.9%);多因素Logistic回归分析显示负性生活事件各因子应激量中"人际关系因子"(OR=1.135,95%CI1.071¹.202)、"学习压力因子"(OR=1.169,95%CI 1.101¹.241)和"外围事件因子"(OR=1.278,95%CI 1.187¹.376)等3个因子应激量高是自杀意念产生的危险因素;此外就读年级越高(OR=1.980,95%CI 1.302³.008)、成绩情况差(OR=7.206,95%CI 1.745⁹.789)和家庭功能中度障碍(OR=2.562,95%CI 1.527².892)至严重障碍(OR=8.287,95%CI 3.154⁶.917)等也是自杀意念的危险因素。结论家庭功能障碍和负性生活事件高应激量是青少年产生自杀意念的主要影响因素,家庭和学校应给予青少年必要和充足的支持,减少负性生活事件对其的影响,从而防止自杀行为的发生。

Objective To explore the correlation between suicide ideation and family function & negative life events,as well as other influential factors in adolescents,thus present a theoretical base for clinicians and school staff to develop intervention for those problems. Methods By adopting current situation random sampling method,Self-Rating Idea of Suicide Scale,Adolescent Self-Rating Life Events Check List and Family APGAR Index were used to assess adolescents at random in a hygiene vocational school in Changzhou City,Jiangsu Province and a collage in Wuhu City,Anhui Province. 3700questionnaires were granted,3675 questionnaires were collected,among which 3620 werevalid. Chi-square test,t-test,and univariate logistic regression were employed in univariate analysis,multivariate logistic regression was used in multivariate analysis. Results The detection rate of suicide ideation is 7. 0%,and the top five suicide ideation characteristics were: poor academic performance( 33. 6%), serious family functional impairment(25.8%),lower-middle academic performance(11.7%),bad economic conditions(10.8%) and study in Grade Three(9.9%). Multiple logistic regression showed that the following three high-level stress amount in negative life events are most crucial for suicide ideation. They are "relationships"( OR = 1. 135,95% CI 1. 071- 1. 202),"academic pressure"(OR = 1. 169,95% CI 1. 101- 1. 241),and "external events"( OR = 1. 278,95% CI 1. 187- 1. 376). What's more,the stress of attending higher grades(OR = 1. 980,95% CI 1. 302- 3. 008),poor academic performance( OR = 7. 206,95% CI 1. 745-9. 789),moderate family functional impairment(OR = 2. 562,95% CI 1. 527- 2. 892) and its serious level(OR = 8. 287,95% CI 3. 154- 6. 917) are also influential factors for suicide ideation. Conclusion Severe family functional impairment and high-level stress amount of negative life events produced the main factors of suicide ideation. Therefore,necessary and sufficient support should be given to adolescents by families and schools.