| Objective:To explore suicide survivors' family cohesion,adaptability and the similarity and difference of family cohesion,adaptability between the suicide survivors,accident and disease survivors through a comparative study and to explore the influencing factors.Providing new orientation for bereaved family to recover normal life and maintain physical and mental health and providing a theoretically scientific evidence for the foothold and highlight of China's rural suicide prevention and intervention strategies.Method:Randomly selecting eight villages from town of Dalian,Liaoning province as sample site.Collecting all the suicide,accident and disease individuals and choosing 1-3 relatives of the deceased as research participants.The participants were defined as parents,spouses,children and siblings.Using Family Cohesion and Adaptability(FACES?-?),the Structured Clinical Interview for DSM-?-R(SCID),Hammilton Psychiatric Rating Scales for Depression(HAMD),Paykel's Interview for Recent Life Events,(IRLE),Chinese version of Perceived Social Support Scale(PSSS),Chinese version of Five-Factor Personality Inventory(NEO-FFI),Chinese version of Beck scale for suicide ideation(BSI-CV)and Social Demography Questionnaire as research tools for all the 465 bereaved,including 254 suicide survivors,100 accident survivors and 111 disease survivors,to do face-to-face semi-structural interview and questionnaire.Only survivors who meet the definition of “family” were interviewed with family cohesion and adaptability.Result:(1)There were 123 cases in 465 rural survivors who cannot assess family cohesion and adaptability,the ratio was 26.5%.The proportion of 254 suicide survivors,111 accident survivors and 100 disease survivors who had a dysfunctional home respectively was 31.5%?22%?18.9%,and it existed significant difference among three groups(?2=7.578,p=0.023).(2)There were no significant difference in the scores of family cohesion(F=0.046,p=0.955)andadaptability(F=0.781,p=0.459)among the three groups.The maximum ratio of family cohesion type was the emmeshed,The suicide,accident and disease bereaved accounted for 43.6% ? 46.2% ? 43.4%,respectively.The maximum ratio of family adaptability type of suicide survivorswas39.7% flexible,accident and disease survivors were chaotic,accounted for 38.4%?36.7%.(3)There were no marked difference in family cohesion and adaptability among suicide,accident and disease survivors.(4)The comparison of different life stages showed,the lowest score of family cohesion in suicide survivors was the youth and the elderly,while in accident and disease survivors both were middle-aged person.The lowest score of family adaptability in suicide and accident survivors were the youth,while in disease survivors was the middle-aged person.(5)Suicide,accident and diseasesurvivors' family cohesion and adaptability in the four types of relatives(parents,spouse,offspring,siblings)existed no significant difference.(6)Suicide,accident and disease survivors' family cohesion and adaptability in the length of bereavement time existed no difference,the lowest time of suicide and disease survivors was less than 3 months,while accident was 3-6 month after the death.The change tendencyof family adaptability is the same with family cohesion.(7)In the aspect of mental disorder prevalence,survivors who had a dysfunctional home is significant more than those who did not(?2=4.275,p=0.039).the rate of mental disorder in suicide survivors,accident survivors and disease survivors was 26.0%?38.5%?17.8%,and it existed significant difference among three groups(?2=9.219,p=0.010).The most common mental disease was PTSD,accounting for 21.8%?35.9%?11.1%.(8)In the aspect of depression,survivors who had a dysfunctional home is significant more than those who did not(t=4.066,p=0.000).From highest to lowest,the scores of depression is suicide survivors,accident survivors and disease survivors,and there is no significant difference among three groups(F=0.015,p=0.985).(9)In the aspect of social support,survivors who had a dysfunctional home is significant lower than those who did not(t=4.066,p=0.000),while there is no significant difference among three groups(F=0.371,p=0.691).(10)For personality,the scores of neuroticism in survivors who had a dysfunctional home is higher than the others(t=5.524,p=0.000),while the scores of openness was contrary(t=2.949,p=0.003).there was significant difference only in openness among three groups(F=3.640,p=0.027),suicide survivors was the lowest and accident survivors was the highest.(11)There were 123 cases in 465 rural survivors who had suicide ideation,accounting for 27.5%,and there is significant difference among three groups(t=1.084,p=0.283).(12)By Logistic multiple regression analysis and path analysis,the influence factors for suicide survivors' family cohesion,from the highest to lowest,were marital status,suicide ideation and bad stimulations,for the family adaptability were bad stimulations,marital status and suicide ideation;accident survivors' family cohesion were social support,marital status,length of the loss and openness,family adaptability were social support,length of the loss,openness,marital status;family cohesion andadaptability of disease survivors were agreeableness,marital status,presence of psychiatric disorders and diseases.Conclusion:(1)In rural China,the family structure was less dysfunctional in suicide bereaved than accident and disease bereaved,survivors without family cohesion and adaptabilitywere less healthy.(2)The common influence factors for three kinds of bereaved survivors was marital status.This reminds us that further research may be about of prompting and encouragingthe bereaved people remarriage.(3)The hint for the prevention and intervention for rural family bereavement is that the foothold and highlight is based on the bereavement form.For suicide survivors,the key is suicide ideation which developed after suffering adverse events.Providing social support for accident survivors is the point.Health education and health promotion strategies are very important for disease bereavement families. |
PDF Full Text Request