Introduction
Methods
Design and participants
Measures
Beck scale for suicide ideation (BSI)
Distress thermometer
Patient health questionnaire-9
Demoralization scale-mandarin version
Statistical analysis
Results
Demographics and disease characteristics
Demographic variables | Number of people (N = 200) (%) | Suicidal ideation (N = 200) | Psychological distress (N = 200) | Depression (N = 200) | Demoralization (N = 200) | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Mean (SD) |
t
|
F
| Mean (SD) |
T
|
F
| Mean (SD) |
t
|
F
| Mean (SD) |
t
|
F
| ||
Gender | −0.85 | 0.15 | −1.57 | −0.99 | |||||||||
Female | 105 (52.5 %) | 0.98 (2.23) | 3.49 (2.55) | 5.61 (4.02) | 27.37 (13.60) | ||||||||
Male | 95 (47.5 %) | 1.33 (3.34) | 3.43 (2.40) | 6.56 (4.56) | 29.23 (13.01) | ||||||||
Age | 0.93 | 3.92* | 2.46 | 0.50 | |||||||||
≤ 35 years | 24 (12 %) | 1.88 (3.14) | 3.67 (2.01) | 6.63 (3.93) | 31.29 (10.45) | ||||||||
36–50 years | 56 (28 %) | 1.34 (3.43) | 4.25 (2.39) | 7.18 (4.64) | 28.25 (15.88) | ||||||||
51–65 years | 111 (55.5 %) | 0.93 (2.42) | 3.14 (2.54) | 5.50 (4.11) | 27.61 (12.34) | ||||||||
> 65 years | 9 (4.5 %) | 0.67 (2.00) | 1.89 (2.03) | 4.56 (4.13) | 28.11 (15.41) | ||||||||
Education | 0.33 | 0.75 | 4.00* | 2.40 | |||||||||
Elementary school | 31 (15.5 %) | 0.81 (2.87) | 3.26 (2.76) | 4.26 (3.65) | 29.39 (13.15) | ||||||||
Junior high school | 33 (16.5 %) | 1.39 (3.80) | 3.88 (3.08) | 8.18 (5.03) | 34.18 (14.14) | ||||||||
Senior high school | 59 (29.5 %) | 1.15 (2.09) | 3.25 (2.66) | 5.88 (4.05) | 25.92 (13.65) | ||||||||
College | 64 (32 %) | 1.28 (3.02) | 3.67 (2.33) | 6.28 (4.17) | 27.31 (12.07) | ||||||||
Research institute | 13 (6.5 %) | 0.06 (1.50) | 2.77 (1.74) | 4.69 (3.38) | 25.77 (13.06) | ||||||||
Marital status | 3.08* | 1.07 | 0.74 | 0.71 | |||||||||
Never marred | 45 (22.5 %) | 2.02 (3.92) | 3.71 (2.37) | 6.53 (3.73) | 30.76 (10.16) | ||||||||
Married | 131 (65.5 %) | 0.76 (2.05) | 3.48 (2.53) | 6.04 (4.50) | 27.46 (13.89) | ||||||||
Divorced | 18 (9 %) | 2.00 (4.04) | 3.22 (2.34) | 5.78 (1.12) | 27.50 (15.60) | ||||||||
Widowed | 6 (3 %) | 0.33 (0.82) | 1.83 (2.40) | 3.83 (4.35) | 29.17 (15.28) | ||||||||
Employment status | −1.91 | −1.12 | −2.31* | −1.90 | |||||||||
Yes | 95 (47.5 %) | 0.76 (2.06) | 3.25 (2.50) | 5.33 (3.77) | 26.39 (13.15) | ||||||||
No | 105 (52.5 %) | 1.50 (3.32) | 3.65 (2.46) | 6.71 (4.65) | 29.94 (13.30) | ||||||||
Hospitalization | −0.48 | 1.58 | −2.87** | 2.56* | |||||||||
Outpatient | 132 (46.5 %) | 1.08 (2.63) | 3.27 (2.36) | 5.41 (3.91) | 26.05 (13.14) | ||||||||
Inpatient | 68 (53.5 %) | 1.28 (3.14) | 3.84 (2.67) | 7.32 (4.74) | 32.54 (12.70) | ||||||||
Type of malignancy | 0.98 | 2.56* | 2.69** | −3.35** | |||||||||
Lung | 93 (66 %) | 1.35 (3.40) | 3.94 (2.54) | 6.94 (4.66) | 30.81 (13.59) | ||||||||
Hematological | 107 (34 %) | 0.96 (2.17) | 3.05 (2.36) | 5.30 (3.81) | 26.04 (12.74) | ||||||||
Cancer stage | 1.69 | 0.76 | 0.98 | 0.33 | |||||||||
Stage I | 21 (10.5 %) | 2.48 (4.59) | 3.52 (2.33) | 6.48 (4.03) | 26.95 (12.80) | ||||||||
Stage II | 27 (13.5 %) | 1.56 (4.56) | 3.56 (2.43) | 6.00 (4.77) | 26.26 (15.07) | ||||||||
Stage III | 34 (17 %) | 0.97 (2.17) | 3.91 (2.38) | 6.88 (4.15) | 29.24 (13.81) | ||||||||
Stage IV | 38 (19 %) | 0.76 (1.76) | 3.68 (2.40) | 6.55 (4.28) | 29.53 (12.82) | ||||||||
Unknown | 80 (40 %) | 0.91 (1.91) | 3.11 (2.62) | 5.39 (4.26) | 28.25 (13.08) | ||||||||
Time since diagnosis | 0.66 | 0.11 | 0.29 | 2.86* | |||||||||
< 3 months | 37 (18.5 %) | 1.03 (3.62) | 3.57 (2.59) | 6.35 (4.51) | 28.35 (11.44) | ||||||||
3 months–1 year | 31 (15.5 %) | 0.68 (1.30) | 3.32 (2.21) | 6.26 (5.22) | 26.00 (11.19) | ||||||||
1–2 years | 50 (25 %) | 1.02 (2.33) | 3.58 (2.59) | 6.28 (4.15) | 32.76 (13.01) | ||||||||
> 2 years | 82 (41 %) | 1.45 (3.08) | 3.39 (2.50) | 5.72 (3.95) | 26.32 (14.52) | ||||||||
Treatment | −0.30 | 1.58 | 1.76 | 2.23* | |||||||||
Continued | 141 (70.5 %) | 1.11 (2.78) | 3.64 (2.52) | 6.40 (4.55) | 29.6 (13.07) | ||||||||
Discontinued | 59 (29.5 %) | 1.24 (2.91) | 3.03 (2.33) | 5.24 (3.52) | 25.03 (12.47) |
Differences in suicidal ideation, psychological distress, depression, and demoralization on the bases of demographics
Predictors and mediating factors influencing suicidal ideation
Variable |
β
| SE |
t
|
p
|
---|---|---|---|---|
Model 1 | ||||
Never married | 0.68 | 0.22 | 3.09** | 0.002 |
Divorced | 0.55 | 0.32 | 1.72 | 0.085 |
Widowed | −0.18 | 0.52 | −0.35 | 0.726 |
Married | ||||
Model 2 | ||||
Never married | 0.65 | 0.21 | 3.04** | 0.002 |
Divorced | 0.57 | 0.31 | 1.85 | 0.065 |
Widowed | −0.02 | 0.51 | −0.03 | 0.977 |
Distress | 0.10 | 0.04 | 2.85** | 0.004 |
Model 3 | ||||
Never married | 0.64 | 0.21 | 2.99** | 0.003 |
Divorced | 0.58 | 0.31 | 1.88 | 0.060 |
Widowed | 0.02 | 0.51 | 0.04 | 0.966 |
Distress | 0.06 | 0.04 | 1.63 | 0.104 |
Depression | 0.04 | 0.02 | 1.91 | 0.056 |
Model 4 | ||||
Never married | 0.58 | 0.21 | 2.78** | 0.005 |
Divorced | 0.56 | 0.30 | 1.85 | 0.064 |
Widowed | −0.13 | 0.50 | −0.26 | 0.792 |
Distress | 0.04 | 0.04 | 1.04 | 0.300 |
Depression | 0.01 | 0.03 | 0.38 | 0.701 |
Demoralization | 0.02 | 0.01 | 2.84** | 0.005 |
Model 5 | ||||
Never married | 0.57 | 0.21 | 2.69** | 0.007 |
Divorced | 0.60 | 0.30 | 2.02* | 0.043 |
Widowed | −0.16 | 0.50 | −0.31 | 0.753 |
Distress | 0.04 | 0.04 | 0.93 | 0.352 |
Depression | −0.01 | 0.05 | −0.22 | 0.824 |
Loss of meaning | 0.10 | 0.04 | 2.54* | 0.011 |
Dysphoria | 0.07 | 0.04 | 1.91 | 0.057 |
Disheartenment | 0.01 | 0.04 | 0.33 | 0.740 |
Helplessness | −0.08 | 0.05 | −1.67 | 0.095 |
Sense of failure | −0.03 | 0.04 | −0.71 | 0.481 |
Mediating variables | B-Crude | B-Adjusted | Indirect effects (%) (c − c′/c) | Direction of confounding effect |
---|---|---|---|---|
Depression | 0.214 | 0.107 | 50 % | + |
Demoralization | 0.214 | 0.076 | 77 % | + |
Depression (M1) and demoralization (M2) | 0.214 | 0.514 | 75.4 % | + |