Knowledge Of And Attitude Towards Suicide And Related Factors Among Village Doctors In Zoucheng City

BackgroundSuicide has been one of social and public health problems with growing concern in the world.About 1 million people die of suicide in the world each year,and annual mortality of suicide is 14-15 per 100,000 people,which equates to one death every 40 seconds.Suicide mortality rate was about 26.36/100000 in Zoucheng City during 2004-2014,and suicide death rates have fallen by 44%in recent ten years.Suicide not only has damaging influence for the families but also puts heavy burden on health care and social economic.Village doctors provide basic medical and health services and preventive care for rural residents directly,and play an important role in the intervention and prevention of suicidal behavior.Their awareness of suicide has a direct impact on residents in the area.So,studying the village doctor’s knowledge of and attitude towards suicide and related factors is of great value and practical importance in suicide prevention from village doctors aspect.Objectives1.To understand the characteristics of knowledge of and attitude towards suicide of village doctors.2.To explore the influencing factors of knowledge of and attitude towards suicide of village doctors,and to provide reference for the intervention and prevention of suicideMethods1.Subjects and MethodsWe investigated village doctors of Zoucheng City from November 10th to 28th,2015,and convenient sampling method was used.There are 13 towns and 892 village doctors,and we investigated a total of 624 village doctors,616 questionnaires(98.70%)were valid including 452 males(73.38%)and 162 females(26.62%).2.InstrumentsGeneral information includes:gender,age,educational status,marital status,family finances,physical health,personal hobbies,engaged in village doctors,experience to treat mental disease,etc.Social support:Duke Social Support Index,DSSI.Depression:Center for Epidemiologic Studies Depression Scale,CES-D.Suicide attitude:five items of General Social Survey for suicide reason,GSS.Xiao’s Suicide Attitude Questionnaire for Suicidal behavior nature.Li’s Suicide Attitude Questionnaire for suicide knowledge and its social damage.Coping Style:Simplified Coping Style Questionnaire,SCSQ.3.Statistical analysis methodsEpiData3.0 software was used for data entry and SPSS 18.0 statistical software was used to describe and analyze the data.We used Cronbach’s alpha coefficient to examine internal consistency reliability of the scale.Quantitative variables were analyzed using t-test,ANOVA or nonparametric test.Categorical variables were analyzed by χ2 test.Suicide knowledge and attitudes related factors of village doctors were selected and analyzed by non-conditional logistic regression model.Results1.Demographic characteristicsThe average age of 616 village doctors was 46.21 ± 10.83,and the ratio of male to female was 2.76:1.The average age of engaging doctors was 25.33±11.62,94.82%of village doctors were married.83.94%of them were high school,secondary and vocational education.13.47%of them believed that their economic situation were poor.3.90%village doctors’ self-reported health status was poor.Among the village doctors,22.56%ever smoked,69.48%ever drunk,42.86%lacked exercise,and the average body mass index(BMI)was 24.43±2.97.2.Distribution characteristics of cognitions and attitudes of suicideThe village doctors considered that someone might suicide when the following situations happened,’suffer from incurable disease’(8.93%),’bankruptcy’(0.65%),’dishonored his/her family’(1.14%)and ’being tired of living’(1.46%).The median score of suicidal comprehension was 3.There were 57.79%of village doctors holding contradictory or neutral attitude towards suicide.The rates of the three suicidal knowledge questions were 46.62%,22.24%and 32.14%.Most of them agreed that the personal life had positive meaning for family.The median scores of accurate understanding the social importance and preventability of suicide,and positive attitude towards suicide were 10,21,and 26,respectively.3.The influence factors related to knowledge of and attitudes towards suicideIn the GSS questions,insomnia(OR=0.199,95%CI:0.060-0.662)was significantly associated with the question ’Someone can commit suicide when s/he suffered from incurable disease.’ Depression symptoms(OR=1.987,95%CI:1.326-2.978),education level(OR=0.556,95%CI:0.345-0.895),economic status(OR=0.413,95%CI:0.174-0.981)were associated with the question ’Is it understandable that one individual selects suicide?’ Gender(OR=1.759,95%CI:1.087-2.845)was significantly associated with suicide characteristic.Physical activity(OR=1.494,95%CI:1.029-2.168),economic status(OR=0.367,95%CI:0.137-0.980),having an experience with curing psychiatric patients(OR=0.423,95%CI:0.183-0.982)were significantly associated with suicide cognition.Social importance of suicide was associated with marriage status(OR=2.388,95%CI:1.066-5.350).’Whether suicide is prevented’ was significantly associated with family income(OR=1.527,95%CI:1.042-2.238)and depression symptom(OR=0.590,95%CI:0.393-0.885).The positive attitude to suicide was significantly associated with gender(OR=1.809,95%CI:1.008-3.247)and depression symptom(OR=0.491,95%CI:0.314-0.770).Conclusions1.The village doctors had a low degree of understanding about suicide,and lacked of related knowledge.They held neutral or ambivalent attitude towards suicide,could understand the social importance of suicide,and thought suicide can be prevented.2.Suicide cognitive and attitude models showed that the affecting factors of suicide knowledge were gender,economic status,marital status,and depression scores,and the affecting factor of suicidal behavior were insomnia and ever suffering from chronic physical illness.The factor of social importance,suicidal preventive view and positive attitudes were the village’s age,family income,health status,and depression.Suggestions1.To provide scientific basis for the prevention and intervention of suicide,we should increase the education of health knowledge of village doctors,carry out suicide intervention and prevention of special training,and improve the knowledge of suicide in village doctors to correct the wrong understanding of the nature of suicidal behavior.2.Use of basic public health service platform to carry out health education activities and improve the community’s health awareness,safety awareness and cherish life consciousness.3.Strengthen the monitoring of suicide damage,the understanding of the injury situation,and develop an intervention and prevention strategies on suicide.