台灣北部某縣市60歲以上老年人自殺監測系統之二手資料分析

An Analysis of Secondary Data on Suicide Surveillance System among Persons Aged Above 60 Years in Northern Taiwan

涂慧慈(Hui-Tzu Tu) ； 黃翠咪(Tsuei-Mi Huan) ； 林雪蓉(Sheue-Rong Lin) ； 史麗珠(Lai-Chu See)

《澄清醫護管理雜誌》 13卷1期 (2017/01) Pp. 15-26

摘要

目的　對台灣北部某縣市60歲以上老年人：（1）估計自殺率（意念、企圖、死亡）、（2）對自殺個案分析採取自殺行動的影響因子、（3）對自殺行動者，分析致死影響因素。方法　採用台灣北部某縣市2010年的自殺通報資料及死因統計檔進行次級資料分析。結果　得641位自殺個案（男性53.8％、女性46.2％）。整體自殺率為每十萬人口130.4（95％CI=120.7- 140.9），自殺意念率、自殺企圖率及自殺死亡率分別為19.5、80.5、30.3。男性自殺死亡率明顯高於女性調整後風險比（aRR=2.23），達統計顯著差異。隨年齡增加，自殺死亡率愈高。80歲以上者的自殺企圖率高於60-64歲者（aRR=1.70），達統計顯著差異。自殺原因以情感／人際問題（20.9％）、生理疾病（18.9％）居多。多變量分析結果，自殺原因-情感／人際問題、生理疾病是影響自殺行動的因素，其自殺行動勝算比分別為3.92、4.86，達統計顯著意義。自殺行動者中，自殺方式為自殺死亡的重要因素，吊勒／窒息、高處跳下、溺水／淹死及家用瓦斯／燒炭的自殺死亡勝算比分別為92.44、80.18、21.96及13.28，達統計顯著意義。結論　台灣北部某縣市60歲以上的老年人，男性自殺死亡率明顯高於女性。自殺原因以生理疾病、情感／人際問題居多，且為採取自殺行動的重要因素。老年人採取的自殺方式較為激烈，又自殺方式為影響自殺死亡的最重要因素。

關鍵字

老年人 ； 自殺意念 ； 自殺企圖 ； 自殺死亡 ； 自殺行動

並列摘要

Purposes (1) To estimate the rate of suicide (including ideation, attempt, and death) among the elderly (above 60 years old). (2) To determine the factors affecting those who engaged in suicidal acts. (3) To determine the factors affecting lethality. Methods We analyzed secondary data from the suicide surveillance system and death records in northern Taiwan in 2010. Results A total of 641 cases (53.8% males and 46.2% females) were identified. The total suicide rate was 130.4 per 100 000 (95% confidence interval: 120.7-140.9). The rates of suicidal ideation, attempted suicide, and suicide death were 19.5, 80.5, and 30.3, respectively. The rate of the suicide death was significantly higher in males as compared to females and the adjusted rate ratio was 2.23. The rates of suicide death increased consistently with age. The adjusted rate ratio was 1.70 for aged 80 years or older than aged between 60-64 years old. Affection/inter-personal relationships (20.9%) and physical diseases (18.9%) were the main reasons for suicide. A multivariate analysis revealed that the reason for suicide was the most important factor determining the suicidal action. Affection/interpersonal relationships and physical diseases had the higher odds ratio (OR) for suicidal action (3.92 and 4.86 respectively), when compared to cases in which job/economic reasons led to suicidal action. Among those who engaged in suicidal action, the suicide means was the most important factor in determining lethality. Hanging/suffocating, jumping, drowning, and gas/charcoal burning had higher ORs for lethality (92.44, 80.18, 21.96, and 13.28 respectively), when compared to those who used a solid/liquid to kill themselves. Conclusions Among the elderly aged above 60 years in northern Taiwan, the rates of suicide death was higher in males than in females. The reason for suicide was the most important factor determining the suicidal action. Among those who engaged in the suicidal action, the means was the most important factor in determining lethality.

並列關鍵字

Elderly ； Suicidal ideation ； Suicide attempt ； Suicide death ； Suicidal action