【作者】 覃莉；

【导师】 杨莉；

【作者基本信息】 广西医科大学 ， 劳动卫生与环境卫生学， 2008， 硕士

【摘要】 目的探讨广西某少数民族农村地区自杀未遂流行病学特征。评估自杀未遂者的家庭亲密度和适应性,为对自杀未遂者进行家庭干预提供科学依据。方法采用以自杀未遂监测和报告系统为基础的非匹配设计的病例对照研究方法。由该系统上报的新发的自杀未遂者组成病例组,计31例。在全县随机抽取15岁以上,并且在研究期间未发生自杀未遂者组成对照组,计81例。以问卷形式,调查病例组自杀未遂流行病学特征,调查病例和对照组人口学特征、精神状况、家庭亲密度和适应性、经历负性生活事件和心理状况等。采用构成比、频数分布等对自杀未遂流行病学特征进行描述分析;采用t检验、秩和检验、方差分析比较病例组与对照组负性生活事件数、慢性心理压力、急性应激强度以及家庭亲密度和适应性的差异。采用t检验分析不同特征人群、不同特征家庭、以及有无各种类型负性生活事件的自杀未遂者家庭亲密度和适应性差异。结果1.失访的自杀未遂人群较实际调查的自杀未遂人群平均年龄偏小(27.1岁±8.6vs35.8岁±6.5,P=0.005),性别差异无统计学意义(P＞0.05)。病例组和对照组合作程度均为最好,提供信息可靠度均为较好。2.自杀末遂病例平均年龄35.8±6.5岁,女性占58.1%;壮族29.0%,汉族35.5%,仫佬族35.5%;已婚74.2%,受教育年限为4.3±3.3年。家庭纠纷与经济困难为自杀未遂的主要原因,口服农药(87.1%)为主要自杀方式,54.8%病例自杀前考虑自杀的时间≤2小时,在自杀行为发生前后分别只有25.8%和16.1%的病例因心理问题寻求过帮助。54.8%的病例在自杀行为发生当时有精神障碍;19.4%有自杀未遂史。3.病例组经历的负性生活事件较对照组多(P＜0.05),慢性心理压力和急性应激强度均高于对照组(P＜0.05);家庭亲密度和适应性均低于对照组(P＜0.05)。4.有“夫妻关系问题”、“和主要家庭成员关系问题”以及“家庭的其他问题”等负性生活事件的自杀未遂者的家庭亲密度和适应性分别低于无此三类负性生活事件的自杀未遂者(P＜0.05)。结论1.广西某少数民族农村地区自杀未遂流行病学特征如下:平均年龄为35.8岁,女性占58.1%,已婚占74.2%,平均受教育年限4.3年;家庭纠纷与经济困难为自杀未遂最主要原因;口服农药为主要自杀方式;54.8%自杀当时有精神障碍;19.4%有自杀未遂史。2.通过改善家庭功能,培养个体情感体验;避免家庭负性生活事件的发生,学会疏导释放压力,来提高其家庭亲密度和适应性,可能可以降低自杀未遂的发生。更多还原

【Abstract】 ObjectiveTo explore epidemical characteristic of attempted suicide in a minority rural region of Guangxi.To study the family adaptability and cohesion of attempted suicides and provide the reference on family intervention.MethodUnmatched case-control study was conducted based on the attempted suicide monitoring and reporting system. The study was carried out between the case group composed of 31 attempted suicides that were reported by the system and the control group composed of 81 non-attempted suicides in study period that were over the age of 15. Both groups received questionnaires investigation including demographic, mental illnesses, family adaptability and cohesion, life events and psychological status. Only the case group received questionnaires investigation on the epidemical characteristics of attempted suicide. Constituent ratio and frequency distribution were employed to describe the epidemical characteristics. Chi-square test , t test and ANOVA were employed to analyze the differences in family adaptability and cohesion, life events, between two groups. Also t test were employed to analyze the differences in family adaptability and cohesion of attempted suicides in different populations, different families, and different persons who had negative life events or not. Results1. The average age of missing attempted suicide was lower than that of the investigated (P<0.05) . But no significant difference in gender was found between them. The cooperation levels of the two groups were best. The reliabilities of the two groups were better.2. The attempted suicide had a mean of 35.8 years old and a mean of 4.3 years education; 58.1% were female; 29.0% were Zhang nation, 35.5% were Mulao nation, and 35.5% were Han nation. Family dispute and economic difficulties were the most important reason for attempted suicide. Pesticide ingestion was the major way of attempted suicide.25% and 16.1% asked for help because of psychological matter. 54.8% had considered suicide before acting.54.8% had one or two mental illnesses at the time of acting. 19.4% had history of attempted suicide.3.Significant differences were found in family adaptability and cohesion, negative life events, chronic mental stress, acute stress between the two groups.4. The person who had the negative life events about the relationship with the husband or wife and the major family members, or about the other family problems, gets a lower score of family adaptability and cohesion than the person who hadn’t.Conclusion1. The epidemical characteristic of attempted suicide in a minority rural region of Guangxi were as follows: a mean of 35.8 years old and a mean of 4.3 years of education; 58.1% were female; 74.2% were married; family dispute and economic difficulties were the most important reason for attempted suicide; Pesticide ingestion was the major way of attempted suicide; 54.8% had one or two mental illnesses at the time of acting; 19.4% had history of prior suicide attempt.2. Improving family function, calling the experience of feeling, avoiding negative life events about the family, releasing the pressure for improving the family adaptability and cohesion may lower the occurrence of attempted suicide.更多还原