Ayaktan tedavi edilen psikiyatri hastalarında travmatik yaşam olayları ve sorun çözme becerileri: İntihar davranışıyla ilişkisi

Amaç: Psikiyatri hastalarında travmatik yaşam olayları ve sorun çözme becerisi düzeylerinin intihar davranışı ile olası ilişkilerini incelemek. Yöntem: Çalışma, ayaktan tedavi gören 121 (% 57 kadın) hasta ile gerçekleştirilmiştir. Katılmayı kabul eden hastalar demografik-klinik özellikler, intihar davranışı, travmatik yaşam olayları hakkında sorular ile sorun çözme becerilerini değerlendiren Problem Çözme Envanterini içeren bir anket formu doldurmuşlardır. Verilerin analizinde t-testi, ki-kare testi, tek yönlü varyans analizi ve lojistik regresyon analizi kullanılmıştır. Bulgular: Hastaların % 43.2?si (% 47.8 kadın) kendilerini öldürmeyi düşünmüş ve % 28.7?si (% 29.7 kadın) de bu yönde bir girişimde bulunmuşlardır. Grubun % 75.4?ü başlarına en az bir travmatik yaşam olayının geldiğini belirtmiştir. Travmatik olay sayısı ortalaması kişi başına yaklaşık 2 (ss=1.7) olaydır. Yapılan iki lojistik regresyon analizi, sorun çözme becerisindeki yetersizliğin, hem intihar düşüncesi hem de girişimlerinin bağımsız yordayıcısı olduğunu göstermiştir. Travmatik olay sayısı ise sadece intihar girişimlerinin yordayıcısı olarak bulunmuştur. Diatez-stres modeli doğrultusunda, hem intihar düşünceleri hem de girişimleri, sorun çözme becerileri yetersiz olan ve aynı zamanda başlarına fazla travmatik olay gelen hastalar arasında yoğunlaşmıştır. Sonuç: Psikiyatri hastaları arasında intihar davranışı ve travmatik yaşam olayları yaygındır. Bulgular sorun çözme becerisi düzeylerinin intihar davranışının önemli bir yordayıcısı olabileceğine işaret etmektedir. Psikiyatrik değerlendirme sırasında intihar davranışı, sorun çözme becerileri ve travmatik yaşam olaylarının sorgulanması önemlidir. Uygulamaya yönelik olarak araştırma bulguları, sorun çözme terapisinin intihar davranışı sergileyen hastaların sağaltımında kullanılabilecek önemli bir yaklaşım olabileceğine işaret etmektedir.

Traumatic life events and problem solving skills in psychiatric outpatients: Relationships with suicidal behavior

Objective: To investigate the prevalence and the relationship of traumatic life events and problem solving skills to suicidal behavior in a group of psychiatric outpatients. Method: The study was conducted with 121 (57 % women) psychiatric outpatients. Patients who accepted participation filled in a questionnaire that contained questions about socio-demographics, clinical features, suicidal behavior, traumatic life-events, and a problem-solving inventory. Data were analyzed by means of t-tests, chi-square tests, one-way analysis of variance and multiple logistic regression analyses. Results: Of the patients, 43.2 % (47.8 % women) reported having thought and 28.7 % (29.7 % women) reported having attempted suicide. 75.4 % of the sample experienced at least one traumatic life-event. On average, a person experienced approximately 2 (SD = 1.7) traumatic events. Two logistic regression analyses showed that inefficient problem solving was an independent predictor of both suicidal thoughts and attempts. Number of traumatic events appeared to be an independent predictor of suicidal attempts after the problem solving skills. In accordance with diathesis-stress model, both suicidal thoughts and attempts were found to be most frequent among persons with inefficient problem solving skills and who were also exposed to a large amount of traumatic life events. Conclusion: Suicidal behavior and traumatic life events are common among psychiatric patients. Findings indicate that inefficient problem solving may be an independent predictor of both suicidal ideation and attempts. Suicidal behavior, traumatic life-events and problem solving skills should be addressed during psychiatric assessment. Study findings imply that problem solving therapy may be an important approach that can be used for the treatment of psychiatric patients exhibiting suicidal behavior.

Kaynakça

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