探討確診半年至一年間的愛滋感染者之自殺意念與企圖自殺

Exploring Suicide Ideation and Suicide Attempts Among HIV-Positive Patients During the First Six Months to One Year After Their Diagnosis

10.6224/JN.201808_65(4).09

盧幸馡(Hsing-Fei LU)；張念慈(Nien-Tzu CHANG)；盛望徽(Wang-Huei SHENG)；廖士程(Shih-Cheng LIAO)；巫沛瑩(Pei-Ying WU)；蕭妃秀(Fei-Hsiu HSIAO)

愛滋 ； 自殺意念 ； 企圖自殺 ； 憂鬱 ； 社會心理因素 ； HIV/AIDS ； suicide ideation ； suicide attempt ； depression ； psychosocial factors

護理雜誌

65卷4期（2018 / 08 / 01）

60 - 72

繁體中文

背景：愛滋感染者是自殺行為發生的高危險群，過去研究多以診斷半年內的感染者為研究對象，缺乏關注於確診半年後的自殺行為表現之研究，致使對於愛滋感染者的自殺行為無法有全面性的認識。目的：本研究以確診半年至一年間的愛滋感染者為對象，探討其自殺意念與企圖自殺的現況及其相關因素。方法：採橫斷性研究設計，於台北市某醫學中心感染科門診納入114位符合條件的愛滋感染者為研究對象，收集其人口學資料、愛滋疾病相關資料，並測量其自殺意念、企圖自殺、憂鬱、身體心像、生命意義感、社會支持。以獨立樣本t檢定、卡方檢定、羅吉斯迴歸檢視自殺意念與企圖自殺的相關與預測因素。結果：研究對象於最近一週內有27.2%出現自殺意念、14.0%曾企圖自殺。確診距今時間、教育程度、憂鬱症病史與自殺意念相關，有憂鬱症病史與企圖自殺相關；較高的教育程度和較佳的家庭社會支持能預測較低的自殺意念之可能性、較高的憂鬱程度則預測較高的企圖自殺之可能性。結論／實務應用：本研究發現確診半年至一年間的愛滋感染者有相當比例出現自殺意念與企圖自殺，其發生率近似於診斷半年內的感染者，顯示自殺防治應被納為確診一年內的愛滋照護重點項目。本研究結果可作為愛滋感染者的自殺防治策略之參考，建議未來的防治措施可朝向常規篩檢感染者是否有憂鬱症、輔導感染者家庭以促進其提供社會支持、積極輔導高憂鬱程度感染者等方向規劃。

Background: HIV-positive patients are at high risk of suicide behaviors. Because most previous studies have investigated suicide behaviors among HIV-positive patients during their first six months of diagnosis only, there is a current lack of understanding of suicide behaviors among this group. Purpose: This study aimed at HIV-positive patients who had been diagnosed between six months and one year ago and examined their suicide ideation and suicide attempt profiles and the associated factors of suicide. Methods: This study adopted a cross-sectional design. A total of 114 HIV-positive patients were interviewed in the HIV clinics of a medical center in Taipei City. Information collections included demographic and HIV-related data and measurements of suicide ideation, suicide attempt, depression, body image, meaning in life, and social support. Independent samples t tests, chi square tests, and logistic regressions were conducted to examine the associated factors and predictors of suicide ideation and suicide attempt. Result: Slightly over one-quarter (27.2 %) of the participants reported suicide ideation and 14.0% reported attempting suicide in recent one week prior the study interview. Duration since being diagnosed HIV-positive, level of education, and history of depression were each associated with suicide ideation, while only history of depression was associated with suicide attempt. Having a higher level of education and having a higher level of social (family) support were both predictors of lower risk of suicide ideation, while having a higher level of depression predicted a greater risk of suicide attempt. Conclusions/Implications for Practice: This study found high prevalences of suicide ideation and attempting suicide among HIV-positive patients during the six month to one year period after diagnosis. Moreover, the prevalence was similar to that among HIV-positive patients during the first six months of diagnosis. Suicide prevention should be a focus of care plans provided to HIV-positive patients during their first year after diagnosis. These results may be provided as a reference for developing suicide-prevention strategies for HIV-positive patients. Routine screening for depression, guiding families to increase their provision of social support, and giving assistance to individuals with higher levels of depression contribute to the effective prevention of suicide among HIV-positive patients.

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