本文選題：農(nóng)村 + 自殺遺族　； 參考：《大連醫(yī)科大學(xué)》2012年碩士論文

【摘要】：研究背景：自殺是我國第五位死因。每年我國死于自殺的人數(shù)高達(dá)28.7萬，其中80%以上的自殺是發(fā)生在農(nóng)村。Shneidman通過研究保守的估計每個自殺死亡者會使6位親友遭受沉痛的打擊，這些因自殺而失去親友的喪親者被稱為自殺遺族（suicide survivors/survivors of suicide）。自殺遺族的喪親哀傷過程較復(fù)雜，典型的反應(yīng)有認(rèn)知混亂、煩躁不安、軀體障礙、社會職能受損和工作中斷等，特殊的感受包括被拒絕感、內(nèi)疚、羞愧、恥感、憤怒、自殺的牽連和自責(zé)感、對自殺死因不斷尋求解釋等。這些問題若長時間得不到解決，會嚴(yán)重影響自殺遺族的身心健康，甚至?xí)a(chǎn)生不同程度的自殺行為，是自殺的危人群，并急待援助和干預(yù)。了解自身遺族的心理需求以及對專業(yè)心理幫助需求狀況及其相關(guān)影響因素是進(jìn)行有效干預(yù)的基礎(chǔ)和前提。 研究目的：目的是揭示農(nóng)村自殺遺族的心理需求現(xiàn)狀和專業(yè)心理幫助需求的狀況及其相關(guān)影響因素，為自殺遺族的心理干預(yù)和心理服務(wù)系統(tǒng)的構(gòu)建，提供科研依據(jù)和實際指導(dǎo)。 研究方法：本研究在遼寧省莊河市所有鄉(xiāng)鎮(zhèn)中整群隨機(jī)抽取8個鄉(xiāng)鎮(zhèn)農(nóng)村地區(qū)的自殺遺族作為被試取樣現(xiàn)場，對在2006年6月1日至2011年5月30日期間目標(biāo)鄉(xiāng)鎮(zhèn)所有自殺死亡的目標(biāo)人，對每個目標(biāo)人根據(jù)實際情況選取自愿參加本研究的四級親屬中的父母、配偶、子女和兄弟姐妹中的1-3名被訪人，采取現(xiàn)場一對一半結(jié)構(gòu)式心理訪談和心理評估、問卷調(diào)查等工作。 研究結(jié)果： （1）254例農(nóng)村自殺遺族被試是來自202例自殺死亡目標(biāo)人的四類親屬，其中配偶最多（n=86，33.86%），其次為子女（n=68，26.77%），再次是父母（n=54，21.26%），最少為兄弟姐妹（n=46，18.11%）；本次調(diào)查的自殺遺族年齡在16-89周歲之間，平均55.95±13.12歲；平均受教育年限4.11±2.24年；65.40%是文盲或小學(xué)文化，32.30%初中文化，僅2.4%為高中文化；202例自殺死亡目標(biāo)人平均受教育年限3.32±3.25年，自殺者和自殺遺族的受教育水平普遍偏低；53.50%的自殺遺族經(jīng)濟(jì)狀況較差；58.3%（n=148）的遺族罹患慢性疾�。�39%健康狀況較差；43.70%的遺族曾與自殺目標(biāo)人一起同住；46.9%的遺族報告自殺死亡者曾是被試遇到困境時的主要幫助對象和安慰的精神支柱。 （2）254例自殺遺族希望獲得正式或?qū)I(yè)機(jī)構(gòu)幫助前三位的是政府（62.2%）、鄉(xiāng)村醫(yī)生（22.4%）和醫(yī)院（19.7%）。僅有11.8%的人實際獲得了政府的幫助，其中絕大部分是“低保戶”；4.3%的遺族得到了鄉(xiāng)村醫(yī)生的幫助；6.7%的遺族得到了鄉(xiāng)鎮(zhèn)醫(yī)院的幫助；希望獲得與實際獲得的幫助之間均差異顯著（p0.05）。農(nóng)村自殺遺族被試從未獲得的專業(yè)幫助資源有電話熱線服務(wù)、心理服務(wù)中心、危機(jī)干預(yù)組織、法院和法律事務(wù)所等專業(yè)機(jī)構(gòu)。且獲得幫助人數(shù)的百分比均低于1%。 （3）自殺遺族實際獲得的非專業(yè)資源支持的前五位依次為子女（55.1%）、鄰居（55.1%）、兄弟姐妹（45.7%）、配偶或伴侶（37.0%）和朋友（35.8%）；69.3%自殺遺族希望從孩子那里能獲得幫助，而實際獲得55.1%。46.9%的遺族希望能夠在配偶或伴侶那里獲得幫助，實際獲得37.0%，差異顯著（p㩳0.05）。45.9%遺族期望能獲得兄弟姐妹的幫助和理解，與實際獲得的幫助狀況基本相符（45.7%）；鄰居的援助是實際獲得（55.1%）高于期望獲得的（45.3%）的10%（p0.05）。期望來自朋友的心理幫助（33.9%）與實際獲得的相當(dāng)（35.8%）。 （4）自殺遺族自我調(diào)適的方式有自我安慰（79.1%）、多勞動和多干農(nóng)活（55.9%）以及與親友和鄰居多溝通（49.2%）等；37.8%的遺族報告已恢復(fù)其正常生活；48.40%部分恢復(fù)；僅有11.8%的遺族其悲傷狀況沒有得到改善；2%的農(nóng)村自殺遺族則表示自己的悲傷感更嚴(yán)重了。 （5）25.2%的自殺遺族報告知道心理咨詢和心理治療能夠幫助自己；14.6%的遺族知道電視和廣播節(jié)目中有自己需要的信息；8.3%的遺族知道有關(guān)與自殺、悲傷調(diào)適方面的書籍和資料對自己有益。但對于心理電話熱線、心理服務(wù)中心和危機(jī)干預(yù)機(jī)構(gòu)、心理救援網(wǎng)站、喪親互助小組等方面的知曉率均低于5%；還有個別專業(yè)機(jī)構(gòu)聞所未聞。 （6）55.5%的自殺遺族未獲得過心理幫助障礙的主要原因是“不愿意尋求心理幫助”55.51%（n=141）；39.0%的遺族是因為“不知道如何能夠找到幫助資源”（n=99）；28.3%農(nóng)村自殺遺族報告自己“沒有錢去尋求心理幫助”。 （7）有46.9%（n=119）的遺族報告愿意接受的專業(yè)心理幫助形式的需求是“一對一的心理咨詢或治療”，前提是“國家和專業(yè)組織免費(fèi)提供”。34.6%的自殺遺族認(rèn)為聽有關(guān)心理健康和家庭幸福的專家講座會對自己有幫助；32.3%的農(nóng)村自殺遺族愿意接受一些對身心有益的音樂幫助自己療愈創(chuàng)傷；只有14.10%的自殺遺族愿意接受專業(yè)的精神藥物治療。 （8）自殺遺族對非專業(yè)心理幫助形式的需求是來自親友的理解（60.63%）、安慰（33.86%）和陪伴（31.50%）。 （9）自殺遺族中僅有0.78%（n=2）曾有過專業(yè)心理幫助行為，26.8%的遺族有專業(yè)心理幫助的意向（n=68）。其中表示需要長期心理援助者55.90%；22.8%的人認(rèn)為家人需要專業(yè)的心理幫助，其中50%的人認(rèn)為自己全家人都需要專業(yè)心理幫助；還有50%的遺族認(rèn)為自己部分家人需要，其中認(rèn)為母親需要者為最多(n=11)，，其次是妻子需要專業(yè)心理幫助(n=7)。 （10）254例自殺遺族的的SCL-90總分及各因子的平均分均高于常模，有專業(yè)心理幫助需要的遺族心理健康狀況比沒有者更差一些。 （11）二分類Logistic回歸分析結(jié)果顯示，影響農(nóng)村自殺遺族專業(yè)心理幫助需要的主要因素有性別（OR=3.299）、GEQ悲傷水平(OR=1.019)、SCL-90焦慮因子(OR=1.125)和精神病性因子(OR=1.133)。 結(jié)論: （1）農(nóng)村自殺遺族在心理幫助資源方面，國家各級政府的專業(yè)（或正式）幫助資源的需求遠(yuǎn)遠(yuǎn)未得到滿足。在非專業(yè)支持資源方面，期望獲得子女、配偶或伴侶上幫助的遺族最多，但均未得到滿足。兄弟姐妹的幫助和支持滿足了遺族們的心理需求，而鄰居的幫助則超過了期望。 （2）農(nóng)村自殺遺族的自我調(diào)適對恢復(fù)有一定的效果，但大部分遺族仍未走出喪親的悲傷。 （3）自殺遺族對于專業(yè)幫助信息的知曉率較低，多數(shù)未獲得心理幫助的障礙是不知道如何獲得專業(yè)心理幫助的信息和資源。 （4）自殺遺族在專業(yè)的心理幫助方面，多數(shù)遺族希望通過免費(fèi)的一對一的心理咨詢和治療、聽心理健康和家庭幸福方面的專家講座、聽對身心有益的音樂來幫助自己走出悲傷；最不愿意接受的是精神藥物治療。在非專業(yè)的心理幫助上，自殺遺族最希望得到的是親友的理解。 （5）農(nóng)村自殺遺族專業(yè)心理幫助需求較低，這與對專業(yè)心理幫助信息的知曉率較低有關(guān)。 （6）有專業(yè)心理幫助需求的自殺遺族比沒有需求的自殺遺族心理健康狀況差，其SCL-90總分及各因子分既高于常模又高于沒有心理幫助需求的自殺遺族。 （7）影響農(nóng)村自殺遺族專業(yè)心理幫助的因素是性別、悲傷水平、SCL-90焦慮因子和精神病性因子。說明女性較男性遺族更易產(chǎn)生專業(yè)心理幫助的需求。 （8）農(nóng)村自殺遺族干預(yù)計劃和策略的建議：首先是全面普及和實行九年義務(wù)教育，提高農(nóng)民的文化程度和受教育水平；其次，充分利用農(nóng)村家家戶戶都有的電視和廣播的優(yōu)勢，通過政府的垂直系統(tǒng)，計生委的縣、鄉(xiāng)、村和重點戶的家庭健康輔導(dǎo)站，大力宣傳和普及精神衛(wèi)生、危機(jī)干預(yù)和健康家庭促進(jìn)計劃的知識，定期舉辦有關(guān)心理健康和家庭幸福的專家講座，播放一些心靈療愈和放松的音樂，讓農(nóng)村的喪親遺族尤其是自殺遺族了解專業(yè)支持資源的信息，獲得相關(guān)的知識與心理技能，從而提高生活質(zhì)量。這是建立我國農(nóng)村自殺預(yù)防和干預(yù)以及自殺遺族的精神健康和危機(jī)干預(yù)的切實可行的策略。
[Abstract]:Research Background : Suicide is the fifth cause of death in our country . The number of suicide deaths in our country is as high as 28,700 million per year , of which more than 80 per cent of suicides occur in rural areas . Shneidman , through a study of conservative estimates , will cause six relatives and friends to suffer a painful blow , and those who lose their relatives and relatives by suicide are referred to as suicide survivors ( suicide suicide / suicide of suicide ) . These problems can seriously affect the physical and mental health of the suicide survivors and even generate different levels of suicidal behavior , which is the basis and prerequisite for the effective intervention to understand the psychological needs of their families and their influence factors on the situation of professional psychological help demand and their related factors .

The purpose of this study is to reveal the psychological needs of suicide survivors in rural areas and the status of professional psychological help demand and their influencing factors , and provide scientific basis and practical guidance for the construction of psychological intervention and psychological service system of suicide survivors .

The research method : In this study , the suicide survivors of eight villages and towns were randomly selected in all villages and towns in the province of Liaoning Province as the sampling site . The target persons who had committed suicide in the target towns during the period from June 1 , 2006 to May 30 , 2011 were selected to take 1 - 3 of the parents , spouses , children and siblings of the four - level relatives who voluntarily participated in the study according to the actual situation , and a half - structured psychological interview and psychological assessment and questionnaire survey were taken on the site .

Results of the study :

( 1 ) 254 cases of suicide survivors were attempted to be four relative relatives from 202 suicide target persons , among whom the spouse was the largest ( n = 86 , 33.86 % ) , followed by children ( n = 68 , 26.77 % ) , again the parents ( n = 54 , 21.26 % ) , and at least siblings ( n = 46 , 18.11 % ) ;
The suicide survivors of the survey ranged from 16 to 89 years old , with an average of 55.95 鹵 13.12 years .
The average duration of schooling is 4.11 鹵 2.24 years .
65.40 % is illiterate or primary culture , 32.30 % junior high school culture , only 2.4 % is high school culture ;
In 202 cases of suicide , the average age of suicide was 3.32 鹵 3.25 years . The educational level of suicide and suicide remains low .
53.50 % of the suicide survivors have poor economic conditions ;
58.3 % ( n = 148 ) of the survivors suffered from chronic diseases ;
39 % of them are in poor health ;
43 . Seventy per cent of the survivors were living with the suicide target ;
46.9 % of the survivors reported that suicide - fatalities were the main objects of help and consolation to the subjects who had been tried in distress .

( 2 ) 254 suicide survivors wish to receive formal or professional assistance from the Government ( 62.2 per cent ) , rural doctors ( 22.4 per cent ) and hospitals ( 19.7 per cent ) . Only 11.8 per cent actually received the Government ' s help , most of which were " low - holders " ;
4.3 % of the survivors were assisted by village doctors ;
6.7 % of the survivors were assisted by township hospitals ;
There was a significant difference ( p . 05 ) between what was expected to be achieved and the assistance actually obtained . The rural suicide survivors were tried never to receive professional help resources such as telephone hotline services , psychological service centres , crisis intervention organizations , courts and law firms , and the percentage of people assisted was less than 1 per cent .

( 3 ) The first five of the non - professional resources supported by the suicide survivors were children ( 55.1 % ) , neighbors ( 55.1 % ) , siblings ( 45.7 % ) , spouses or partners ( 37.0 % ) and friends ( 35.8 % ) ;
69.3 % of the suicide survivors wished to receive assistance from their children , and 55.1 % were actually obtained . 46.9 % of the survivors wished to be able to receive assistance from their spouses or partners , with a significant difference of 37.0 % ( p ? 0.05 ) . 45.9 % of the survivors were expected to receive the help and understanding of the siblings , which was substantially in line with the actual help status ( 45.7 % ) ;
The assistance of the neighbours was actually achieved ( 55.1 per cent ) higher than the 10 per cent ( 45.3 per cent ) of the expected ( 45.3 per cent ) . It was expected that psychological assistance from friends ( 33.9 per cent ) was comparable to that achieved ( 35.8 per cent ) .

( 4 ) There were self - comfort ( 79.1 % ) , multi - labor and multi - dry farming ( 55.9 % ) and multi - communication with relatives and friends ( 49.2 % ) .
39.8 per cent of the survivors reported that their normal life had been restored ;
48.40 % recovery ;
Only 11.8 per cent of the family ' s grief had not improved ;
Two percent of rural suicide survivors say their grief is more serious .

( 5 ) Twenty - two per cent of the suicide survivors reported that psychological counselling and psychotherapy could help themselves ;
14.6 % of the survivors are aware of the information they need in the television and radio programmes ;
8.3 % of the family members know that books and materials related to suicide and grief adaptation are good for themselves . But the awareness rate is less than 5 % for psychological telephone lines , psychological service centers and crisis intervention agencies , psychological rescue websites , funeral and mutual aid groups , etc .
There are also individual professional bodies to smell it .

( 6 ) 55.5 % of the suicide survivors did not receive psychological help , the main reason was " reluctance to seek psychological help " 55.51 % ( n = 141 ) ;
39.0 % of the survivors were due to " no knowledge of how to find help resources " ( n = 99 ) ;
28 . 3 % of the rural suicide survivors reported that they had " no money to seek psychological help " .

( 7 ) The needs of 46.9 % ( n = 119 ) of the family ' s psychological help form are " one - to - one psychological counseling or treatment " , provided that " national and professional organizations are provided free of charge " . 34 . 6 % of the suicide survivors believe that listening to expert lectures on mental health and family happiness will help themselves ;
32 . 3 % of the rural suicide survivors are willing to accept some of the physical and psychological benefits of music to help heal the wounds themselves ;
Only 14.10 % of the suicide survivors were willing to receive professional psychiatric medications .

( 8 ) The demand of suicide survivors in the form of non - professional psychological help is from relatives and friends ( 60.63 % ) , comfort ( 33.86 % ) and company ( 31.50 % ) .

( 9 ) Only 0.78 % ( n = 2 ) of the suicide survivors had a professional psychological help behavior , 26 . 8 % of the survivors had professional psychological help ( n = 68 ) , which indicated that 55.90 % of the long - term psychological assistance was needed ;
22 . 8 % believe family members need professional psychological help , 50 % of whom think their families need professional psychological help ;
There are also 50 % of the family ' s family members who believe that their mothers need to be the most ( n = 11 ) , followed by the need for professional psychological assistance ( n = 7 ) .

( 10 ) The total score of SCL - 90 and the average score of all factors in 254 suicide survivors were higher than those of norm , and the mental health status of the survivors with professional psychological help was worse than that of no one .

( 11 ) Logistic regression analysis showed that the main factors affecting the psychological help of suicide survivors in rural areas were gender ( OR = 3.299 ) , GEQ sad level ( OR = 1.019 ) , SCL - 90 anxiety factor ( OR = 1.125 ) and psychogenic factor ( OR = 1.133 ) .

Conclusion :

( 1 ) The need for professional ( or formal ) assistance resources at all levels of government in rural suicide remains is far from being met . In the area of non - professional support resources , it is expected that children , spouses or partners who are assisted in a partner are the most , but are not met . The assistance and support of siblings meet the psychological needs of the survivors , and the help of the neighbours exceeds expectations .

( 2 ) The self - adaptation of suicide survivors in rural areas has a certain effect on the restoration , but most of the survivors have not yet come out of mourning .

( 3 ) There is a low awareness rate of suicide survivors for professional help information , and most of the obstacles that do not get psychological help are information and resources that don ' t know how to get professional psychological help .

( 4 ) In the field of professional psychological help , most of the survivors want to listen to expert lectures on mental health and family happiness through a free one - on - one psychological consultation and treatment , listen to the music of physical and mental health and help themselves out of sadness ;
The most reluctant to accept is the treatment of psychotropic substances . In non - professional psychological help , the suicide survivors want to be understood by relatives and friends .

( 5 ) The psychological help demand of suicide survivors in rural areas is low , which is related to the low awareness rate of professional psychological help information .

( 6 ) The mental health status of suicide survivors with professional psychological help demand is worse than those without the demand . The scores of SCL - 90 and the scores of SCL - 90 are higher than those of suicide survivors without psychological help .

( 7 ) The factors that affect the psychological help of suicide survivors in rural areas are gender , sadness level , SCL - 90 anxiety factor and psychogenic factor .

( 8 ) Suggestions for the intervention plans and strategies of the rural suicide survivors : first , to popularize and implement nine - year compulsory education to improve the cultural level and educational level of farmers ;
Secondly , to make full use of the advantages of TV and broadcasting in rural family households , through the government ' s vertical system , the county , township , village and key family health assistant station of the government , vigorously promote and popularize the knowledge of mental health , crisis intervention and healthy family promotion plan , and regularly organize lectures on mental health and family well - being , play some spiritual healing and relaxation music , and get relevant knowledge and psychological skills so as to improve the quality of life . This is a practical strategy for the prevention and intervention of suicide prevention and intervention in rural areas as well as the mental health and crisis intervention of suicide survivors .
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：B846

【參考文獻(xiàn)】

相關(guān)期刊論文 前5條

1 陳英俊;尹蓓莉;;國外關(guān)于專業(yè)心理求助行為主要影響因素的研究述評[J];江西青年職業(yè)學(xué)院學(xué)報;2009年04期

2 童輝杰;;SCL-90量表及其常模20年變遷之研究[J];心理科學(xué);2010年04期

3 潘令儀,王祖承;自殺的國內(nèi)研究概況[J];中國行為醫(yī)學(xué)科學(xué);2005年07期

4 費(fèi)立鵬;中國的自殺現(xiàn)狀及未來的工作方向[J];中華流行病學(xué)雜志;2004年04期

5 江光榮,王銘;大學(xué)生心理求助行為研究[J];中國臨床心理學(xué)雜志;2003年03期

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