從老人自殺危險因子看老人自殺預防之整合性照護

A View on Integrative Care for Geriatric Suicides by the Risk Factors of Suicide in the Elderly

10.6200/TCMJ.201910/SP_16.0013

曾光佩(Kuang-Pei Tseng)；游川杰(Chuan-Chieh Yu)；楊添圍(Tien-Wei Yang)；黃世傑(Shier-Chieg Huang)

老人 ； 自殺 ； 高危因子 ； 憂鬱症 ； 經濟狀況 ； 生活品質 ； elderly ； suicide ； high risk factors ； depression ； economic conditions ； quality of life

北市醫學雜誌

16卷附冊（2019 / 10 / 31）

120 - 133

繁體中文

目的：本研究目標在於探究臺北市老人之自殺意念、自殺行為之高危因子，以期早日發現自殺潛在高危長者族群。方法：本研究採對照樣本研究；透過對通報至本市自殺防治中心具自殺行為的老人60名，與隨機抽取在本市聯合醫院健檢之無自殺行為的對照組老人240名，以問卷面訪進行資料收集等，並以多元回歸分析探討各因子對自殺意念、自殺行為的影響重要性及預測力。結果：長者的自殺行為與生理健康品質、心理品質、憂鬱診斷及自評經濟足夠程度等變項有高相關，但與醫師診斷疾病數、環境品質、社會關係品質，憂鬱程度及家庭關懷度的相關性較低。結論：依本研究結果所發現的保護性因子與高危因子推測，未來在長者自殺防治策略規劃上除可提供保護性環境，如，加強生理相關衛教、鼓勵家人同住或是建立長者社區外，應更加強長者對自我現狀的正向價值，與老年憂鬱症之預防，俾利降低長者的自殺行為。

Objectives: The present study aimed to explore suicide risk factors and suicidal ideations among elderly in Taipei city so that the high risk population can be identified earlier. Methods: A case-control design was applied in the present study. A total of 60 elders with suicidal behaviors reported to the Taipei suicide prevention center were used as cases and 240 elders randomly sampled from health examinations of our hospital were used as controls. Data were collected through structured-questionnaire interviews. Multivariate regression analysis was used to examine the contribution and predictability on suicidal ideations and behaviors. Results: elderly suicide was highly correlated with physical health, psychological resilience, depressive diagnosis, and self-reported financial fulfillment, but was less correlated with number of diagnoses, quality of living environment and social relationship, severity of depression, and family solicitude. Conclusions: From the preventive factors and high risk factors identified from the current study, it is suggested that future strategy and planning on suicidal prevention should focus on providing a protective environment such as enhancing physical related health education, encouraging family living together or establishing elderly community, strengthening the positive value of self-existing state, and preventing elderly depression.