Study On Suicidal Ideation And Its Influencing Factors Among Rural Elderly In Shandong Province

BackgroundSuicide is an important global public health problem that seriously threatens people's lives,affects social and economic development,and imposes a heavy burden on individuals,families,society and even the country.China has entered an aging society,and the suicide rate among the elderly aged 60 and above is much higher than other people.And the suicide problem in the Chinese population in rural areas is significantly higher than that in urban areas.The suicide mortality of the elderly in rural areas is three to four times than that of the elderly in urban areas.Suicidal ideation is closely related to suicide attempt and suicide death.60%people with suicidal ideation reported suicide plans and suicide attempts in one year follow-up reports.At present,there are few studies on the suicidal ideation of the elderly in rural areas.Therefore,this study takes the rural elderly in Shandong Province as the research object,and discusses the distribution characteristics and influencing factors of suicidal ideation among the rural elderly in Shandong province.ObjectiveUnderstand the occurrence and related risk factors of suicidal ideation among rural elderly in Shandong Province,and provide relevant policy recommendations for suicide prevention in the elderly,improving the quality of life and quality of lives of the elderly and reducing the incidence of suicidal ideation among the elderly.MethodsThe survey adopted a multi-stage random sampling method.In the three prefecture-level cities of Shandong Province,three counties(cities)and three districts,18 townships(streets)and 108 villages(residential),a total of5514 rural elderly in Shandong Province were selected.Self-designed structured questionnaires,face-to-face interviews were used to complete the survey,Epidata software was used for data entry,and SPSS software was used for data analysis.Descriptive statistics were used to analyze the basic situation of suicidal ideation of the elderly,chi-square test and binary logistic regression analysis was used for univariate analysis,binary logistic regression was used for multivariate analysis and evaluated the influencing factors of suicidal ideation among rural elderly.The structural equation model analyzes the direct and indirect effects between chronic disease conditions,self-rated health status,activities of daily living,psychological distress and suicidal ideation.ResultsThe incidence of suicidal ideation among rural elderly in Shandong Province was 7.7%.Factors that are significant in univariate analysis are gender,education,marital status,chronic disease,self-rated economic status,self-rated health status,family relationship,life stress,negative events,drinking status,activities of daily living,loneliness and life satisfaction.The 14 factors of univariate analysis that is significant are put into two models of multivariate logistic analysis,one of which controls psychological distress.The results of Model 1 are as follows.The risk factors for suicidal ideation in the elderly are gender(P=0.023,OR=1.475).The degree of education:primary school students have a suicidal ideation of 0.713 times higher than the illiterate(P=0.011),junior high school students and above has 0.414 times of suicidal ideation than illiteracy(P=0.000),life stress:People without life stress is 0.725 times higher than people with life stress of suicidal ideation(P=0.033),There was a 0.339 times of people with no life pressure than with life pressure of suicidal ideation(P=0.000).Negative events:suicidal ideation occurred in the past two years with a negative event of 1.989 times compared with no negative event;activity of daily living(P=0.047,OR=0.979),psychological distress(P=0.000,OR=1.089),loneliness(P=0.000,OR=1.080),and life satisfaction(P=0.032,OR=0.978).On the basis of Model 1,Model 2 controls psychological distress,and finds that the influences of chronic diseases,self-assessment of health status,and activities of daily living to suicidal ideation have changed.Then chronic diseases,self-evaluation health status,psychological distress and suicidal ideation of the elderly were put into the structural equation model for analysis.The results showed that the total effect value of the elderly patients with chronic diseases was 0.030,and the total effect value of self-evaluation health status was 0.111.Activity of daily living has an indirect effecton suicidal ideation through psychological distress and the total effect value is 0.064.Psychological distress has a direct effect on suicidal ideation,with a total effect value of 0.397.Conclusions1 The incidence of suicidal ideation among rural elderly in Shandong Province is high.Gender,education level,life stress,negative events,chronic diseases,self-rated health status,activities of daily living,psychological distress,loneliness and life satisfaction are all have an impact on suicidal ideation among the rural elderly in Shandong.2 This paper finds that psychological distress has the greatest direct and mediating effect on suicidal ideation of the elderly.Chronic diseases,self-evaluation of health status and activities of daily living have an indirect effect on suicidal ideation through psychological distress.Suggstions1 Pay attention to the living conditions of the elderly and identify suicides in rural areas as soon as possible.The local government actively organizes the elderly to carry out recreational activities that are popular and enjoyable.Enhance the ability of the elderly to cope with life events.2 Carry out mental health work and psychological counseling for the elderly in rural areas comprehensively,promote the establishment of a mental health counseling network for the elderly,conduct early screening of psychological problems for the elderly in the rural areas,and treat them early,and eliminate mental illness through psychological counseling.3 Improve the social pension security system,improve the level of medical services,ease the lives pressure of the elderly,and make them old and dependent.