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GURUVANNA
DEVARA
MUTTU,NEAR
BINNIYSTEN GARDEN
MAGADI ROAD BANGALORE-23
NIGHTINGALE COLLEGE OF NURSING
2.
GURUVANNA
3.
4.
DATE OF ADMISSION
DEVARA
MUTTU,NEAR
BINNIYSTEN GARDEN
MAGADI ROAD BANGALORE-23
M.Sc NURSING IN
PSYCHIATRIC NURSING
13-5-2011
A STUDY TO ASSESS THE FACTORS
INFLUENCING SUICIDAL BEHAVIOR AMONG
5.
WITH
VIEW
TO
INFORMATIONAL BOOKLET.
DEVELOP
AN
6.
rate of 11 per 100000 suicides per year, an increase from 6 per 100000
during the 1980s, India occupies the second highest rate of suicides in the Region. When
corrected for underreporting, these rates are likely to be much higher. While 89000 persons
committed suicide in 1995, the number increased to 96 000 in 1997 and to 104 000 in
1998, an increase of 25% compared to the previous year. During 1988-1998, suicides
increased by a staggering 33.7%. Major variations are noticed across the country, probably
related to reporting practices. Kerala (29 per 100 000), Karnataka (21 per 100 000) and
Tripura as well as West Bengal (19 per 100 000) had the highest rates of suicide. Among
the cities, Bangalore (17%), Mumbai (14%), Chennai (11%) and Delhi (7.5%) accounted
for nearly 50% of the total suicides in the country. 19
Suicidal behaviors are often associated with depression. However, depression by
itself is seldom sufficient. Other co-existing disorders, such as attention deficit
hyperactivity disorder, substance abuse or anxiety can increase the risk of suicide. Recent
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stressful events can trigger suicidal behavior, particularly in an impulsive youth. Girls may
be more likely to make suicidal attempts, but boys are more likely to make a truly lethal
suicide attempt. 20
Adolescents often will try to support a suicidal friend by themselves. They may feel
bound to secrecy, or feel that adults are not to be trusted. This may delay needed treatment.
If the student does commit suicide, the friends will feel a tremendous burden of guilt and
failure. It is important to make students understand that one must report suicidal statements
to a responsible adult. Ideally, a teenage friend should listen to the suicidal youth in an
empathic way, but then insist on getting the youth immediate adult help.
20
21
state. Suicide rate in young people is also increasing in Kerala. Family Suicide is also
increasing in Kerala .This has increased from 38 families to 53 families during 1998 to
2000. 16
A cross-sectional study conducted on the prevalence of suicidal behavior and
its epidemiological correlates amongst adolescent students. Study conducted in three
schools and two colleges. A total of 550 adolescent students aged 14 to 19 years selected
by cluster sampling. Statistical Analysis done by Proportions, chi square test, bivariate
logistic regression. Results of study shows about 15.8% reported having thought of
attempting suicide, while 28 (5.1%) had actually attempted suicide, both being more in
females than in males. Statistically significant associations were observed with the age of
the student, living status of parents, working status of mother, and whether the student was
working part-time. The two variables found significant on multivariate analysis were
female gender and the number of role models the student had ever seen smoking or
drinking. The prevalence of suicide-risk behavior was found to be quite high and is a
matter that should evoke public health concern.
13
.
6.2.2. STUDIES
BEHAVIOR.
A study conducted on bullying and risk of suicidal behavior among adolescents.
Total 2341 adolescents aged 13-19 years who were enrolled in grades 9 through 12 in
suburban school was selected for study. Researchers used Beck Depression Inventory to
assess depression and suicide Ideation Questionnaire. Suicide attempt, history included
any attempt, regardless extend of injury. With regard bullying behavior, students were
asked how often they had been bullied or had bullied others in and out of school during the
past 4 weeks. Being bullied was defined as having the student say or do unpleasant thing
or being teased repeatedly in a way the person does not like. Result shows about 20%
student reported that they were victims of bullying in school and about 10% reported that
they were victims of bullying outside the school. With regard to bullying behavior, about
25% students reported that they bullied other students in school and 15% reported that they
were bullied others outside school .The risk of depression, suicidal ideation and suicidal
attempt was significantly higher for students who were considered either a victim or a
bully compared with students who were not. The more frequent the bullying behavior the
greater risk of depression, suicidal ideation or suicidal attempt.08.
A study conducted on rates and factors associated with suicide. The main
outcome measure was death by suicide diagnosed by detailed verbal autopsy and census
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and birth and death data to identify population base. Result shows the average suicide rate
was 92.1 per 1,00.000. The ratio of male to female suicide was 1:0.66. The age specific
suicide rate for women showed two peaks: 15-24 year and over 65 years of age. Hanging
(49%) and poisoning with organo-phosphorus compound
method of suicide. Acute or chronic stress was elicited for nearly all subjects. More men
suffered from chronic stress while more women had acute precipitating events (x2= 4.58;
p<0.04). People less than 44 age had more acute precipitating events before death while
older subjects reported more chronic stress (x2=17.38;p<0.001). Conclusion of study is
there is need for sentinel centers in India and in developing countries to monitor trends and
to develop innovative strategies to reduce death by suicide.09
A case control study conducted on risk factors for completed suicide. A study
conducted with families of 269 completed suicides and 269 living control within the
broader population of city, using psychological autopsy method. Result shows that several
factors in the areas of family, marriage, education, occupation, general health, mental
health and absence of protective factors contribute significantly for suicides. The
significance factor were presence of previous suicidal attempt in self (odds ratio OR =
42.62), interpersonal conflicts and marital disharmony with spouse (O =27.98), alcoholism
in self (OR=23.38), presence of mental illness (OR=11.07), sudden economic bankruptcy
(OR=7.1), domestic violence (OR=6.82) and unemployment (OR= 6.15). Individual
completing suicide did not have a positive outlook towards life, problem solving
approaches and coping scale.15
6.2.3
COLLEGE STUDENTS.
A study conducted on suicide prevention in adolescent; a controlled study of the
effectiveness of school based psycho-educational programme. Sample collected from 172
high school students in the 16-18 age group include 108 girls and 64 boys. Method used a
structured self-report questionnaire. The results show that the programme had no effect on
coping styles and level of hopelessness. However positive effect on knowledge could be
identified an interaction effect of the programme with gender on attitude was also found. A
negative impact of programme could not be found. Result indicated effect of gender and
pretest knowledge attitude and coping. Findings from study suggest that psychoeducational programs in schools may influence knowledge about suicide and attitudes
towards suicidal persons but may not affect the use of coping styles or levels of
hopelessness 13
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high level (8.1%, 9.8% and 8.4% correspondingly in 1994, 1998 and 2002). Moreover, the
number of suicidal attempt changed from 1.0% in 1994 to 1.8% in the year 1998 and to
1.7% in the year 2002. The school childrens attitude towards suicide become more
agreeable: 36.6%, 41.9% and 62.5% of respondent correspondently in 1994, 1998 and
2002, answered that they agree with persons freedom to make a choice between life and
suicide. The study concluded, suicidal tendency are quite frequent among Lithuanian
adolescent.12.
A study conducted on the associations between peer and parental relationships
and suicidal behavior in early adolescents. Survey Method is used for data collection. This
cross sectional sample included 1049 girls and 1041 age 12 to 13 years. Answers obtained
through self- report questionnaires that included measures of peer relationships, parental
nurturance, and parental rejection, suicidal ideation and attempts. Result shows that among
early adolescent boys and girls, depression, poor peer relationships, decrease parental
nurturance and increase parental rejection wear all significantly associated with suicidal
ideation and attempt.02
6.3 STATEMENT OF PROBLEM : A STUDY TO ASSESS THE FACTORS INFLUENCING SUICIDAL BEHAVIOR
AMONG THE COLLEGE STUDENTS AT BANGALORE, WITH A VIEW TO DEVELOP
AN INFORMATIONAL BOOKLET.
6.5 HYPOTHESIS
H1.
variables.
6.6
OPERATIONAL DEFINITION :-
FACTORS
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SUICIDE
Suicide is a type of deliberate self-harm and is defined as a human act of self-intentioned
and self-inflicted cessation. It ends with fatal outcome. Attempted suicide is an
unsuccessful suicidal act with non-fatal outcome
SUICIDAL BEHAVIOR
Refers to any observable, recordable and measurable act, movement or response
in terms of suicide ideation, threat and attempt in adolescents.
COLLEGE STUDENTS
Refers to boys and girls studying in colleges in the age group 18-22 years
INFORMATIONAL BOOKLET
Refers to booklet giving information on meaning, myths, risk factors,
management, and Preventive measures of college students suicidal behavior.
6.7 ASSUMPTIONS
It is assumed that:
1. College students are more prone for suicidal behavior.
2. Demographic as well as personal, social, emotional factors are responsible
for suicidal behavior.
3. There may be relationship between demographic variable and risk factor
contributing to suicidal behavior in adolescent.
6.8 DELIMITATIONS
1. The study is delimited to students who are attending selected college only.
2. Studies are limited to only for 4 weeks
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7.1.2 SETTING
Selected colleges in banglore
7.1.3 POPULATION
100 college students belonging to the age group 18-22 years from selected colleges
in Bangalore.
7.2 .METHODOLOGY
7.2.1. SAMPLING TECHNIQUE
Purpose random sampling technique
7.2.2 SAMPLE SIZE
100 samples
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Inclusion criteria
1. Students belonging to the age group between 18-22 years.
2. Students who are willing to participate in the study.
3. Students who can read write and understand English.
Exclusion criteria
1. Students not willing to participate in the study.
2. Students absent during the study.
3. Student who are not sensitized with similar intervention previously.
7.2.4 TOOLS FOR DATA COLLECTION
a) Socio demographic variables such as Age, gender, religion,occupation of father
and mother ,type of family, history of mental illness etc.
b) Self administered questionnaire.
PILOT STUDY
10 samples will be selected and study will be conducted to find the feasibility.
Sample will be excluded from main study.
The data obtained will be analyzed in view of the objectives of the study
using Information booklet
data
Scores
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REFERENCES
1. Noreen CF, Lawrence EF. Psychiatric mental health nursing. 1 st ed. United state of
America: Delmar publishers; 1998. p.500.
2. Basavanthappa BT. Nursing research. 2nd edition. New Delhi: Jaypee brothers
3.
9. Prasad J, Abraham VJ, Minz S, Joseph A, George K, Jacob KS et al. Rates and
factors associated with suicide in Kaniyambadi block, Tamil Nadu, South India.
International journal of social psychiatry 2006;52(1): p.65-71.
10. Fergusson DM, Horwood LJ, Ridder EM, Beautrias AL. Suicidal behavior in
adolescent and subsequent mental health outcomes in young adulthood. Journal of
Adolescent Health. 2005 Jul; 35(7):983-93
11. L.Vijaykumar E. Etersdorfer, Schony w. Sonneck G. Comparative study on attitude
towards suicide among medical students of Madras (India) and Vienna (Austria).
Social Psychiatry and Psychiatric Epidemiology. 2004 Feb; 33(3).
12. Zemaitiene N, Zaborskis A. Suicidal tendencies and attitude towards freedom to
choose suicide among Lithuanian school children. BMC public health.2005;
(5):83:425-28
13. Gwendolyn P and Kees VH. Suicide prevention in adolescent: a controlled study of
the effectiveness of a school based psycho-educational program in Belgium. Journal
of Child Psychology and Psychiatry 2006 ;( 9): 910-18.
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14. Robert H, Asetine J, Amy J, Elizabeth A, Jaime J. Evaluating the sign of suicide
prevention program. BMC public health 2007;(7): 161
15. Naik A.S. Pattnaik K. The prevalence of suicidal behavior and its epidemiological
correlates amongst adolescent students in south Delhi. Indian journal of psychiatry
2005; 26 (1): p. 34-38
16. Sarah AF, Laurence YK, Brian JC. The associations between peer and parental
relationships and suicidal behavior in early adolescents. Canadian journal of
psychiatry 2006 Oct; 51(11): 698-703.
17. http://www.indian express.com/2007/8/11/stories/. :Kadam DB, Pandit RD, Bhatt
Ambrish. Suicide in Adolescents and youth. Indian Express Newspapers 2007 Aug
11; [cited on 2007 Nov 04]
18. http://www.pubmed.com. :World health organization. Mental Health and Substance
Abuse, Facts and Figures, Suicide Prevention: Emerging from Darkness. [Online].
1997 [cited 2007 Oct10]
19. http://www.google.com :Kuckian Uday, Iype George. National Crime Records
Bureau. [Online]. 2004 April 15 [cited 2007 Oct10].
20. http://www.pubmed.com :Watkins Carol. Suicide and the School: Recognition and
intervention for suicidal students in the school setting. [Online]. 2003 [cited 2007
Oct10]; Available from: URL:.
21. http://www.ejop.org/archives/2007/08/suicide_ideatio.html :Upadhayay BK. Suicide
ideation and psychopathology among adolescents. Europe journal of psychology.
[serial online] 2006 Aug 13. [cited 2007 Oct10].
22. http://www.afsp.org. :Watkins Carol. Suicide in youth. [serial online] 2005 Apr 12
[cited 2007 Oct 09];
23. http://en.wikipedia.org/wiki/suicide :12OConnor R, Sheeehy NP. Suicide. [Serial
online] [cited 2007 Nov 05]
24. http://www.google.com :National Crime Record Bureau (NCRB) and State Crime
Record Bureau (SCRB). High rate of suicide in Kerala. [Serial online] 2007 [cited
2007 Oct 12] Gururaj
25. http://www.ncbi.nlm.nih.gov/sites/entrez.: G, Isaac MK, Subbakrishna DK, Ranjani
R. Risk factors for completed suicides: a case control study from Bangalore, India.
[Serial online] 2004 Sep [cited on 2007 Sept 9];11(3):183-91.
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9.
10
10.1 GUIDE
10.2 SIGNATURE
10.3 CO-GUIDE
10.4 SIGNATURE
10.6 SIGNATURE
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11.2 SIGNATURE
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