中国循证医学杂志

中国循证医学杂志

灾难后青少年群体自杀相关因素的调查

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目的 调查灾难后青少年群体的自杀相关因素,进一步探讨其自杀观念、计划和行为的发生率及其影响因素。 方法 采用一般资料问卷和青少年健康危险行为问卷(Youth Risk Behavior Survey,YRBS)自评量表,对 2008 年汶川地震国家划定的九个极重灾区的中小学校进行整群随机抽样。以班级为抽样单位,随机抽取 110 所中小学校的在校学生。收集中小学生的一般资料、灾后相关情况及 YRBS 中自杀因子评分。根据资料的类型不同,分别采用描述性统计、t 检验、χ2 检验,其中对自杀观念、自杀计划和自杀行为分别做单因素分析及多因素 Logistic 回归分析。 结果 共计发放自评问卷 7 833 份,收回问卷总计 7 521 份,回收率为 96.02%,其中有效问卷 6 875 份(91.41%),无效问卷 636 份。调查结果发现:中小学生中曾认真考虑过自杀的比例为 6.90%,有过自杀计划比例为 4.00%,尝试采取过自杀行为的比例为 2.70%。Logistic 回归分析显示:① 以是否曾认真考虑过自杀为因变量,年龄[OR=1.178,95%CI(1.098,1.178)]、灾后家庭结构发生变化[OR=1.360,95%CI(1.360,1.085)]是灾难后青少年群体自杀观念的危险因素。② 以是否有过自杀的计划为因变量,年龄[OR=1.099,95%CI(1.050,1.150)]、被掩埋[OR=2.155,95%CI(1.104,4.205)]、灾后家庭结构发生变化[OR=1.495,95%CI(1.128,1.981)]是灾难后青少年群体自杀计划的危险因素。③ 以是否尝试采取过自杀行为为因变量,男性[OR=1.513,95%CI(1.122,2.039)]、灾后家庭结构发生变化[OR=1.555,95%CI(1.112,2.175)]是灾难后青少年群体自杀行为的危险因素。 结论 年龄和灾后家庭结构发生变化是自杀观念的危险因素,年龄、被埋和灾后家庭结构发生变化是自杀计划的危险因素,男性和灾后家庭结构发生变化是自杀行为的危险因素。灾后家庭结构改变是自杀观念、自杀计划和自杀行为共同的危险因素,故对灾后家庭结构变化的青少年应给予更多的心理评估和心理干预,以避免灾难后青少年群体自杀的风险。

Objective To investigate the suicide related factors of the teenagers after trauma and further discuss the prevalence and related factors of suicide idea plan and behavior. Methods Using the general information questionnaire and the Youth Risk Behavior Survey (YRBS) to investigate the primary and secondary students in the nine worst-hit areas in Wenchuan earthquake of 2008, with cluster random sampling and the class as a sampling unit, to extract random 110 primary and middle schools and gather their general information, disaster-related cases and scores of suicide in YRBS. According to the different types of data, we used descriptive statistics,t test,Chi square test and Logistic regression analysis and respectively use single factor analysis and multivariate logistic regression analysis for suicide idea, plan and behavior. Results A total of 7 833 questionnaires were sent out and a total of 7 521 questionnaires were collected and the recovery rate was 96. 02%. Among them, there were 6 875 valid questionnaires (91.41%) and 636 invalid questionnaires. According to the investigation, the prevalence of the primary and secondary students which had seriously considered suicide was 6. 90%, which had a plan to commit suicide was 4.00% and which tried to take over the action of suicide was 2.70%. With general information for the independent variable, logistic regression analysis showed that whether there had seriously considered suicide as the dependent variable: age (OR=1.178, 95%CI 1.098 to 1.178) and changed in family structure after the earthquake (OR=1.360, 95%CI 1.360 to 1.085) were risk factors for post disaster the teenagers with suicide idea; whether there had been plan to commit suicide as the dependent variable: age (OR=1.099, 95%CI 1.050 to 1.150), the history of being buried in ruin (OR=2.155, 95%CI to 1.104 to 4.205) and changed in family structure after the earthquake (OR=1.495, 95%CI 1.128 to 1.981) were risk factors for post disaster the teenagers with suicide plan; whether took over the action of suicide as the dependent variable: male (OR=1.513, 95%CI 1.122 to 2.039) and changed in family structure after the earthquake (OR=1.555, 95%CI 1.112 to 2.175) were risk factors for post disaster the teenagers with suicide behavior. Conclusion Age and changed in family structure after the earthquake were the risk factors for suicide idea and age was positively correlated with suicidal idea. Age, had the history of being buried in ruin and changed in family structure after the earthquake were the risk factors for suicide plan and age was positively associated with suicide plan. Male and changed in family structure after the earthquake were the risk factors for suicide behavior. Among them, changed in family structure after the earthquake was the common risk factor. So there should be targeted psychological assessment and psychological rehabilitation intervention to avoid the risk of suicide among the teenagers after the disaster.

关键词: 自杀; 青少年健康危险行为监测问卷(YRBS); 发生率; 危险因素; 灾难

Key words: Suicide; The Youth Risk Behavior Survey (YRBS); Prevalence; Risk factor; Trauma

引用本文: 李海民, 赵高锋, 张强, 庞燕, 陈颖, 张树森, 杨彦春, 邓红. 灾难后青少年群体自杀相关因素的调查. 中国循证医学杂志, 2017, 17(3): 262-268. doi: 10.7507/1672-2531.201510020 复制

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