The Influencing Factors Of Suicidal Ideation In Gynecological Cancer Patients

Objective:(1) To investigate suicidal ideation, the coping style, social support and quality of life in patients who were hospitalized with gynecological cancer.(2) To explore the relationship among coping style, social support, quality of life and suicidal ideation in the gynecological cancer patients, thus giving evidence for prevention of suicide in gynecological cancer patients.Methods:767gynecological cancer patients from the Third Xiangya Hospital, the Second Xiangya Hospital, the Xiangya Hospital of Central South University and the Hunan Provincial Tumor Hospital, between September2012and June2013were enrolled in our survey. The questionnaires contained demographic information sheet, Medical Coping Modes Questionnaire (MCMQ), Social Support Rating Scale (SSRS), Functional Assessment of Cancer Therapy Generic scale (FACT-G) and Self-rating Idea of Suicide Scale (SIOSS). In total,697subjects completed the questionnaires. All data were analyzed by statistical analysis software package of SPSS (version13.0) and AMOS (version18.0). Statistical methods included descriptive analysis, one-way ANOVA, Chi-square test, Logistic regression analysis and path analysis and so on.Results:(1) The scores of SIOSS in gynecological cancer patients were as follows, the total suicidal ideation score was (7.21±4.58), desperation dimension score was (4.20±3.39), optimism dimension score was (0.48±0.85), sleeping dimension score was (2.52±1.37). Suicidal ideation was identified in128patients with gynecological cancer (18.4%).(2) One-way ANOVA showed there were significant differences in scores of SIOSS among patients with different diagnosis and stage of tumor, time since diagnosis, times of hospitalization, type of primary care givers, confidence of prognosis and satisfaction of treatment effect. Univariate Logistic regression analysis showed that, time since diagnosis, type of primary care givers, confidence of prognosis and satisfaction of treatment effect entered the regression equation of suicidal ideation in the gynecological cancer patients.(3) Chi-square test showed that, compared to patients who had no suicidal ideation, patients reported suicidal ideation scored higher on measures of resignation coping (P<0.05), scored lower on measures of social support and quality of life (P<0.05).(4) Path analysis showed that confrontation coping had direct positive effect on social support (β=0.150, P<0.01), and had direct negative effect on quality of life (β=-0.069, P<0.05). Avoidance coping had direct negative effect on social support (β=0.109, P<0.05) and quality of life (β=0.069,P<0.05). Resignation coping had direct negative effect on social support (β=-0.217, P<0.01) and quality of life (β=-0.520, P<0.01), and direct positive effect on suicidal ideation (β=0.413, P<0.01). Social support had direct positive effect on quality of life (β=0.213, P<0.01). Confrontation, avoidance and resignation coping had indirect effect on suicidal ideation via social support and quality of life, social support coping had indirect effect on suicidal ideation via quality of life.Conclusion:(1) Diagnosis and stage of tumor, time since diagnosis, times of hospitalization, type of primary care givers, confidence of prognosis, satisfaction of treatment effect, coping style, social support and quality of life are influencing factors for suicidal ideation in gynecological cancer patients.(2) Copying style had direct and/or indirect effect on suicidal ideation, social support had indirect negative effect on suicidal ideation and quality of life had direct negative effect on suicidal ideation. Social support and quality of life, as mediated variables, can mediate the relationship between coping style and suicidal ideation.