【作者】 张烜； 曹枫林；

【Author】 Xuan Zhang;Feng-lin Cao;School of Nursing,Shandong University;

【机构】 山东大学护理学院；

【摘要】 目的:探讨妊娠期女性自杀意念的危险因素以及危险因素的累积作用。方法:选取山东省某三级甲等医院产科门诊1825名孕晚期女性。采用病人健康问卷(PHQ-9)第9个条目评估自杀意念,作为结局变量。危险因素包括:低社会经济地位、妊娠相关情况(是否为初产妇、有无不良孕产史、有无妊娠合并症)、有无精神疾病史、抑郁、神经质人格、儿童期虐待史以及消极应对。运用二元logistics回归分析自杀意念的危险因素,将有统计学意义的危险因素进行二分类转化后,相加得危险因素指数(RFI),同样,采用二元logistics回归探讨危险因素的累积作用。结果:精神疾病史(OR, 9.669;95%CI,2.161-43.264)、抑郁(OR,1.262;95%CI,1.161-1.372)、神经质人格(OR,1.055;95%CI,1.004-1.109)、儿童期虐待史(OR,1.047;95%CI,1.015-1.080)以及消极应对(OR,1.094; 95%CI,1.018-1.175)是自杀的危险因素;此外,RFI与自杀意念呈正相关(OR,2.751;95%CI,2.206-3.431)。结论:妊娠期女性精神疾病史、抑郁、神经质人格、儿童期虐待史、消极应对等危险因素与自杀意念的关系呈现累积效应。临床工作者应该及早筛查妊娠期女性自杀意念的危险因素以识别自杀意念的高危人群,及早预防或者消除妊娠期女性自杀意念的出现,从而避免自杀行为的发生。更多还原

【Abstract】 Aims: This study explored the risk factors of suicidal ideation and the cumulative effects of risk factors in pregnant women. Methods: A total of 1825 women in the third trimester were recruited from the prenatal clinic of a comprehensive hospital in Shandong province. Suicidal ideation was assessed by the Patient Health Questionnaire(PHQ-9). Risk factors included: low socioeconomic status, pregnancy-related conditions(whether or not a first-time mother, history of adverse pregnancy, pregnancy complications), history of mental illness, depression, neurotic personality, history of childhood maltreatment, and negative coping strategies.The risk factors of suicidal ideation were analyzed by logistics regression, and the risk factor index(RFI) was obtained by adding significant risk factors. Similarly, the cumulative effect of risk factors was analyzed by logistics regression. Results: The history of mental illness(OR, 9.669; 95%CI, 2.161-43.264), depression(OR, 1.262; 95%CI, 1.161-1.372), neurotic personality(OR, 1.055; 95%CI, 1.004-1.109), history of childhood maltreatment(OR, 1.047; 95%CI, 1.015-1.080) and negative coping(OR, 1.094; 95%CI, 1.018-1.175) was the risk factors of suicide. In addition, RFI was positively correlated with suicidal ideation(OR, 2.751; 95% CI, 2.206-3.431). Conclusions: The relationship between risk factors including history of mental illness, depression, neurotic personality, childhood maltreatment and negative coping style and suicidal ideation is cumulative. Clinical stuff should screen the risk factors of suicidal ideation in pregnant women early to identify the high-risk groups, in order to prevent or eliminate the occurrence of suicidal ideation in pregnant women early, and avoid the occurrence of suicidal behaviors.更多还原